Knowledge, perception and utilization of cervical cancer screening and Human Papillomavirus (HPV) vaccination among immigrants and refugees in Central Ohio

Background: Immigrants in the US are at higher risk of Human Papilloma Virus (HPV) infection and cervical cancer compared to the general US population. Low awareness surrounding cervical cancer inhibits associated preventive practices.  Purpose: This cross-sectional study examined the association between knowledge, attitude, and utilization of health services for cervical cancer screening and HPV vaccine among immigrant and refugee women in Ohio.  Method: Preliminary analyses were conducted on a total of 70 participants recruited from immigrant and refugee organizations and community centers, using a validated paper survey.  Results: There was a statistically significant association between cervical cancer screening and general knowledge on cervical cancer (p = 0.038). The study also revealed association between screening age (p < 0.001) and insurance status (p = 0.033).  Majority of the participants perceived HPV vaccine to be ineffective at preventing cervical cancer, and 40.8% participants had never heard of the vaccine and consequently had not been vaccinated. 94% participants did not receive the HPV vaccine, however, 65.3% participants indicated willingness to be vaccinated against HPV for free or at reduced cost.  Conclusion: Culturally appropriate interventions are warranted to develop effective strategies that will influence HPV screening behavior and vaccine uptake in this target population.

Perceptions of Human Milk Banks as a Response to the US Infant Formula Shortage: A Mixed Methods Study of US Mothers

Human donor milk from established milk banks is the safest alternative to mother&rsquo;s own milk. The current study examined US mothers&rsquo; perceptions of human milk banks as a response to the ongoing infant formula shortage in the United States. A cross-sectional study with closed and open-ended items was administered through nine Facebook groups, and a final sample of 863 responses was retained in the study. We used descriptive and inferential statistics for statistical analysis, and content and thematic analyses were conducted on open-ended responses. In our sample, 77.4% of respondents perceived human milk banking as a feasible response to the formula shortage crisis. Marital status, education, religion, and willingness to donate milk were associated with respondent perceptions of milk banking as a response to the formula shortage. US mothers&rsquo; concerns around the accessibility of milk banks and the cost of human milk were the primary reasons accounting for the hesitancy toward milk banking as a response to the infant formula shortage crisis. The study findings indicate support for milk banking as a potential &lsquo;temporary&rsquo; solution to the formula shortage and reveal that milk banking is a tool that is currently being underutilized. It is imperative that stakeholders address the challenges identified by the current study to improve infant feeding and health

Association between educational attainment and risky sexual behaviour among Ghanaian female youth

Background: Ghanaian female youth aged 15-24 years are especially vulnerable to sexually transmitted infections (STIs) compared to their male counterparts. Objectives: This study examined the association between educational attainment and risky sexual behavior among Ghanaian female youth. Method: A cross-sectional study was conducted using a nationally representative sample of youth from the 2014 Ghana Demographic and Health Survey (n=1702). The outcome of interest was risky sexual behavior, defined as having last intercourse with a non-marital partner without condoms. Descriptive and inferential statistical tests were utilized. Results: Overall, the prevalence of risky sexual behavior was 66.9%. In the bivariate analysis, risky sexual behavior differed by level of education. Compared to women with a college-level education, a significantly higher proportion of women with secondary education reported risky sexual behavior (72.9%), followed by those with primary education (65.7%) (p\u3c0.001). In the multivariable-adjusted model, there was a significant interaction between education and household wealth index (P =0.030) and between education and the type of place of residence (P =0.045) on risky sexual behavior. Conclusion: Culturally appropriate and targeted interventions are warranted to increase condom use among these subgroups and curb the rising rates of STIs among Ghanaian female youth

Don\u27t Shoot the Messenger: Surgical Programs Can Do More to Keep Applicants Informed.

OBJECTIVE: The interview process for applying to general surgery residency is burdened by a high volume of applicants, resulting in unprofessional behavior by both applicants and programs. Sharing more information regarding interview scheduling with applicants may limit fourth year medical student educational disruptions, minimized late cancellations to interview, and improve overall satisfaction with the process. Thus, we set out to determine what information is currently available to applicants. DESIGN: We used publicly accessible sources to determine what information was shared by US general surgery residency programs with applicants. Specifically, we looked at the deadline for applications, United States Medical Licensing Examination Step 1 and 2 score cutoffs, number of interview dates available, specific interview dates, a stated policy to not offering more interviews than slots, dates when applicants can expect to be notified of interview offers, notification of decision to decline, and International Medical Graduate and visa policies. SETTING: This study took place at Maine Medical Center in Portland, Maine, an academic medical center with a general surgery residency program. PARTICIPANTS: Not applicable. RESULTS: Three hundred seventeen programs were examined. Seventy-six percent of programs specified an application deadline, 65% of programs specified a Step 1 cut-off score, 50% of programs specified a Step 2 cut-off score, 61% of programs stated a visa policy, and 50% of programs stated an International Medical Graduate policy. Twenty-five percent of programs disclosed the number of interview dates, 23% disclosed what those interview dates were. About 3.4% of programs gave interview release dates, 2.8% of programs notify applicants of decline to interview, and 0.63% of programs explicitly describe a policy of offering only as many interviews as slots available. Thirty-two percent of programs provided conflicting information. CONCLUSIONS: The information available to applicants from public access sources regarding interview scheduling is minimal, unstandardized, and unreliable. Notably lacking were policies that only offer as many interviews as slots available, dates when applicants can expect to be notified of interview offers, and notification of declines. Providing such information to applicants in a standardized way may improve satisfaction with the interview scheduling process

Don’t Shoot the Messenger: Surgical Programs Can Do More To Keep Applicants Informed

BACKGROUND: The interview process for applying to general surgery residency is burdened by a high volume of applicants, resulting in unprofessional behavior by both applicants and programs. Sharing more information regarding interview scheduling with applicants may limit 4th year medical student educational disruptions, minimized late cancellations to interview, and improve overall satisfaction with the process

Human Milk for Vulnerable Infants: Breastfeeding and Milk Sharing Practice among Ghanaian Women

Human milk has the best impact on childhood survival. In Ghana, it is estimated that 43% of women exclusively breastfeed for 0&ndash;5 months and only 42% of breastfeeding mothers continue through 20&ndash;23 months. Although the Ghanaian government has implemented policies to facilitate exclusive breastfeeding, substantial gaps to achieve optimal newborn health and wellbeing remain. The purpose of this study was to evaluate breastfeeding prevalence and human milk sharing practices among Ghanaian women. Qualitative responses were received from Ghanaian females (n = 1050). In our sample, 81% indicated they breastfed their children and 8% reported ever sharing breastmilk with another mother. Reasons for sharing milk included (i) insufficient breastmilk production of the recipient mother, and (ii) mother&rsquo;s unavailability prompting women to offer their milk to a crying baby. About 60% of our sample reported that they were not concerned about sharing their milk. Findings present a strong indicator for milk donation towards the establishment of a human milk bank in Ghana. Health promotion efforts should aim at increasing education about the risks involved in milk sharing as well as the benefits of human milk donation through formal and safer channels such as a Human Milk Bank

&ldquo;It Was Just Really Hard to Be Pregnant in a Smaller Town &hellip;&rdquo;: Pregnant and Parenting Teenagers&rsquo; Perspectives of Social Support in Their Rural Communities

Teenage pregnancy has a history of being a &ldquo;social problem&rdquo; in the United States, with there being higher rates in rural communities. Social support, a contributor to improving mental health outcomes, can significantly impact a teenager&rsquo;s pregnancy and parenting experience. Using House&rsquo;s (1981) social support framework, this study explores the teenagers&rsquo; perceptions of how their rural community reacted and responded to them as pregnant and parenting teenagers. The results were formulated through the thematic analysis of semi-structured interviews (n = 26) with current and former pregnant and/or parenting teenagers. The participants reported experiencing both positive and negative social support. There were more reports of emotional support and instrumental support among the forms of positive support than there were in the other categories. Informational support was lacking. The appraisal support from community members was negative. There is a need for rural communities to develop effective social support strategies to provide positive support for pregnant and parenting teenagers

When a birth cohort grows up: challenges and opportunities in longitudinal developmental origins of health and disease (DOHaD) research

High-quality evidence from prospective longitudinal studies in humans is essential to testing hypotheses related to the developmental origins of health and disease. In this paper, the authors draw upon their own experiences leading birth cohorts with longitudinal follow-up into adulthood to describe specific challenges and lessons learned. Challenges are substantial and grow over time. Long-term funding is essential for study operations and critical to retaining study staff, who develop relationships with participants and hold important institutional knowledge and technical skill sets. To maintain contact, we recommend that cohorts apply multiple strategies for tracking and obtain as much high-quality contact information as possible before the child\u27s 18(th) birthday. To maximize engagement, we suggest that cohorts offer flexibility in visit timing, length, location, frequency, and type. Data collection may entail multiple modalities, even at a single collection timepoint, including measures that are self-reported, research-measured, and administrative with a mix of remote and in-person collection. Many topics highly relevant for adolescent and young adult health and well-being are considered to be private in nature, and their assessment requires sensitivity. To motivate ongoing participation, cohorts must work to understand participant barriers and motivators, share scientific findings, and provide appropriate compensation for participation. It is essential for cohorts to strive for broad representation including individuals from higher risk populations, not only among the participants but also the staff. Successful longitudinal follow-up of a study population ultimately requires flexibility, adaptability, appropriate incentives, and opportunities for feedback from participants