Mammography maintenance: a longitudinal, population-based study of insured women

Early detection through mammography screening is an effective way to control breast cancer. Rates of mammography screening have increased dramatically over the last decade although recent data suggest that rates may now be declining. To reduce their risk of breast cancer morbidity and mortality, women should maintain regular on-schedule mammography use (i.e., mammography maintenance). Repeat use is a necessary step towards that goal. Many variables have been examined as predictors or correlates of repeat mammography use. However, few studies of mammography maintenance exist. The data for these secondary analyses come from PRISM (Personally Relevant Information on Screening Mammography), a five-year health communication intervention trial. Participants in this study come from PRISM control group (n=1522). Predictors of interest were informed by behavioral theory and previous research on maintenance of health behaviors. Descriptive statistics and survival analysis were used to assess study aims. Mammography use was calculated at the end of each follow-up period (12, 24 and 36 months). Unsustained maintenance was defined as not having consecutive mammograms on schedule (10 to 14 months apart). Only 38% of women sustained mammography maintenance over three years. We observed differences in the proportion of women endorsing attitudes and beliefs when trends were plotted according to on-schedule mammography use over time. When variables were examined in longitudinal models, women who reported less satisfaction with their past mammography experience, expressed lower self-efficacy, reported poor/fair health and reported barriers to getting a mammogram were more likely to be non-adherent to mammography maintenance over three years. Additionally, behavioral intentions were significant predictors of unsustained maintenance and mediated the effects of self-efficacy and barriers. This study provides evidence that we have not yet achieved high levels of compliance with mammography maintenance. Even in a previously adherent, insured population, there still may be important cognitive variables that predict regular mammography use. Continuing to search for additional factors not tested in this study that affect long-term maintenance of episodic behavior remains important. At the same time, we should look at the modifiable factors confirmed as significant variables in this study in order to promote regular mammography use

NEMO-Bohai 1.0 : a high-resolution ocean and sea ice modelling system for the Bohai Sea, China

Severe ice conditions in the Bohai Sea could cause serious harm to maritime traffic, offshore oil exploitation, aquaculture, and other economic activities in the surrounding regions. In addition to providing sea ice forecasts for disaster prevention and risk mitigation, sea ice numerical models could help explain the sea ice variability within the context of climate change in marine ecosystems, such as spotted seals, which are the only ice-dependent animal that breeds in Chinese waters. Here, we developed NEMO-Bohai, an ocean-ice coupled model based on the Nucleus for European Modelling of the Ocean (NEMO) model version 4.0 and Sea Ice Modelling Integrated Initiative (SI3) (NEMO4.0-SI3) for the Bohai Sea. This study will present the scientific design and technical choices of the parameterizations for the NEMO-Bohai model. The model was calibrated and evaluated with in situ and satellite observations of the ocean and sea ice. The model simulations agree with the observations with respect to sea surface height (SSH), temperature (SST), salinity (SSS), currents, and temperature and salinity stratification. The seasonal variation of the sea ice area is well simulated by the model compared to the satellite remote sensing data for the period of 1996-2017. Overall agreement is found for the occurrence dates of the annual maximum sea ice area. The simulated sea ice thickness and volume are in general agreement with the observations with slight overestimations. NEMO-Bohai can simulate seasonal sea ice evolution and long-term interannual variations. Hence, NEMO-Bohai is a valuable tool for long-term ocean and ice simulations and climate change studies.Peer reviewe

The microscale obstacle-resolving meteorological model MITRAS v2.0: model theory

This paper describes the developing theory and underlying processes of the microscale obstacle-resolving model MITRAS version 2. MITRAS calculates wind, temperature, humidity, and precipitation fields, as well as transport within the obstacle layer using Reynolds averaging. It explicitly resolves obstacles, including buildings and overhanging obstacles, to consider their aerodynamic and thermodynamic effects. Buildings are represented by impermeable grid cells at the building positions so that the wind speed vanishes in these grid cells. Wall functions are used to calculate appropriate turbulent fluxes. Most exchange processes at the obstacle surfaces are considered in MITRAS, including turbulent and radiative processes, in order to obtain an accurate surface temperature. MITRAS is also able to simulate the effect of wind turbines. They are parameterized using the actuator-disk concept to account for the reduction in wind speed. The turbulence generation in the wake of a wind turbine is parameterized by adding an additional part to the turbulence mechanical production term in the turbulent kinetic energy equation. Effects of trees are considered explicitly, including the wind speed reduction, turbulence production, and dissipation due to drag forces from plant foliage elements, as well as the radiation absorption and shading. The paper provides not only documentation of the model dynamics and numerical framework but also a solid foundation for future microscale model extensions.</p

Standard Definitions of Adherence for Infrequent yet Repeated Health Behaviors

To present common language for defining adherence of infrequent yet repeated health behaviors

Longitudinal Predictors of Nonadherence to Maintenance of Mammography

Regular adherence to screening mammography, also known as maintenance of mammography, reduces breast cancer morbidity and mortality. However, mammography maintenance is uncommon, and little is know about why women do not maintain regular screening schedules. We investigated longitudinal predictors of women not maintaining adherence

Roxboro, Person County : a community diagnosis including secondary data analysis and qualitative data collection

A group of six, first year Masters students from the School of Public Health at the University of North Carolina at Chapel Hill, Department of Health Behavior and Health Education (HBHE) conducted a community diagnosis of the city of Roxboro. A Community Diagnosis involves working with a community in order to discover its strengths and assess areas that may need future attention. Information about the community is compiled through a review of previously gathered data and by talking with residents and service providers about what it is like to live in their community. This is a seven-month process, which is a requirement of Masters students in the HBHE Department at the University of North Carolina at Chapel Hill. The Community Diagnosis process initially focused on collecting and summarizing pre-existing data also called secondary data. Sources of secondary data include but are not limited to census data, maps, previously existing documents and newspapers. Each of these sources provided a broader understanding of life in Roxboro. This information also allowed the community diagnosis team to define and describe the geography (location), history, economy, health status and sociodemographic characteristics of Roxboro. Although these data sources are extensive, there are some notable limitations. For example, the most recent data available are from 1990 and therefore do not reflect current changes within the county, city and state. Another limitation is that the most current data for Roxboro does not include the increased population and demographic information from newly annexed land in July 1998 (The Courier Times, 1998). After the pre-existing data were compiled and summarized, the qualitative data collection process began and consisted of interviewing community members and service providers. Qualitative data collection was essential in compiling a complete picture of what life is like in Roxboro. Separate interview guides were created for community members and service providers. In total, 36 interviews were completed: twenty-one community members and fifteen service providers. Through these interviews and our continuous presence in Roxboro, we became more familiar with the community and the residents. Community members also became more comfortable and welcoming of us. Located in Person County, Roxboro is an area of approximately 6.45 square miles in the Northern Piedmont. The city is both urban and rural with a population of 7,332 residents that is relatively evenly distributed among African Americans and Caucasians. There is a long history and lineage of the residents. Many families are descendents of those who have lived in Roxboro for hundreds of years. However, the city has also attracted many newcomers. Community members and service providers described Roxboro as a community of many strengths. For example, Roxboro is a safe, small, close-knit, quiet and friendly community; it is a good place to raise your family and flee from the chaos of a larger city. The residents of Roxboro are friendly, warm, down-to-earth individuals who care about their neighbors. One community member summed it up by saying “I wouldn’t be anywhere else, I wouldn’t live anywhere else.” Community members and service providers also expressed some concerns about Roxboro. Suggested areas of improvement included recreation, health services, transportation and Latino services. In February of 1999, with the help of the community and sponsors, the student team held a community forum in which the strengths and concerns of community members and service providers were presented to the community. The purpose of this meeting was to summarize what the team had found through both pre-existing data and interviews. It was also an opportunity for community members and services providers to further develop relationships, and to discuss common goals and future directions. Health and recreation were major areas of concern expressed by those who attended the forum.Master of Public Healt

It’s the Amount of Thought that Counts: When Ambivalence Contributes to Mammography Screening Delay

This study examines whether ambivalence towards mammography screening, as moderated by total amount of thought given to the reasons for and against getting mammograms at recommended intervals, predicts greater delay in obtaining subsequent screening mammograms