Breast cancer literacy and cultural factors influencing mammogram adherence among Filipino American women

The purpose of this cross-sectional study was to examine the association between mammogram adherence in Filipino American women and 3 factors: need, enabling and predisposing. These factors were represented by 10 independent variables: breast cancer literacy, number of mammogram referrals by a healthcare provider, health insurance, sociocultural deterrents, fatalism, symptomatic deterrents, catastrophic disease expectations, negative health beliefs about healthcare professionals, nativity and years of residence in the United States. These variables corresponded with the need, enabling and predisposing factors in Andersen’s Behavioral Health Model for the Utilization of Services which served as the conceptual framework of this study. The expanded version of Andersen’s model, which contained need, enabling and predisposing factors unique to vulnerable population groups, was used. The convenience sample consisted of 157 Filipino American women, who were at least 40 years old, residing in the United States and had never been diagnosed with breast cancer or breast disease. The sample was highly educated with 33.8% of whom had postgraduate credits or a post-graduate degree, 59.9% had a college degree and only 4 women (2.5%) had less than a college degree. Not surprisingly, all but 3 women had health insurance. Many of these Filipino American women lived in a household where there were at least two incomes (n=117, 74.5%), a few (n=28, 17.8%) lived in one income households and only 6 (3.8%) lived in a household where there was no income earner declared. Five Filipino American women were born in the United States, the rest of the women (n=148, 94.3%) were born in the Philippines. The average time of residence in the United States was 25.09 (±11.18) years. Logistic regression models were analyzed to determine the association between the study variables and mammogram adherence. Model 1 pertained to the need factor in Andersen’s Behavioral Health Model. The need factor consisted of 2 variables: breast cancer literacy and the number of mammogram referrals by a healthcare provider. Model 2 pertained to the enabling factor in Andersen’s Behavioral Health Model. The enabling factor consisted of 2 variables: health insurance and sociocultural deterrents. Model 3 corresponded to the predisposing factor in Andersen’s Behavioral Health Model. The predisposing factor consisted of 6 variables: fatalism, symptomatic deterrents, catastrophic disease expectations, negative health beliefs about healthcare professionals, nativity and years of residence in the United States. Two of these variables – nativity and health insurance – were eventually deleted after analysis showed that they violated the assumption of cell frequency. Of the variables in the logistic regression models, only 1 was significantly associated with mammogram adherence - the number of mammogram referrals by a healthcare provider. In Model 4, the odds of a Filipino American woman being mammogram adherent vs. being non-adherent were 113% higher with an AOR of 2.13 (95% CI, 1.094, 4.160; p-value=.026) for each additional mammogram referral from a healthcare provider, controlling for other variables in the model. Breast cancer is one of the most commonly diagnosed cancers among Filipino American women. Breast cancer disparities in Filipino American women exist in terms of mortality, age at diagnosis, tumor characteristics, delay in diagnostic follow-up and suboptimal treatment modalities. Mammogram is a proven technology to detect breast cancer early when it is most treatable and help alleviate some of these disparities. However, Filipino American women have had historically low mammogram adherence rates. What this study validated is that a referral from a healthcare professional is most determinative of mammogram adherence. This study provides a basis for health policy to be directed towards encouraging, monitoring and incentivizing healthcare professions to promote cancer screening

Global distribution and drivers of language extinction risk

Many of the world's languages face serious risk of extinction. Efforts to prevent this cultural loss are severely constrained by a poor understanding of the geographical patterns and drivers of extinction risk. We quantify the global distribution of language extinction risk—represented by small range and speaker population sizes and rapid declines in the number of speakers—and identify the underlying environmental and socioeconomic drivers. We show that both small range and speaker population sizes are associated with rapid declines in speaker numbers, causing 25% of existing languages to be threatened based on criteria used for species. Language range and population sizes are small in tropical and arctic regions, particularly in areas with high rainfall, high topographic heterogeneity and/or rapidly growing human populations. By contrast, recent speaker declines have mainly occurred at high latitudes and are strongly linked to high economic growth. Threatened languages are numerous in the tropics, the Himalayas and northwestern North America. These results indicate that small-population languages remaining in economically developed regions are seriously threatened by continued speaker declines. However, risks of future language losses are especially high in the tropics and in the Himalayas, as these regions harbour many small-population languages and are undergoing rapid economic growth

Association between convalescent plasma treatment and mortality in COVID-19: a collaborative systematic review and meta-analysis of randomized clinical trials.

Funder: laura and john arnold foundationBACKGROUND: Convalescent plasma has been widely used to treat COVID-19 and is under investigation in numerous randomized clinical trials, but results are publicly available only for a small number of trials. The objective of this study was to assess the benefits of convalescent plasma treatment compared to placebo or no treatment and all-cause mortality in patients with COVID-19, using data from all available randomized clinical trials, including unpublished and ongoing trials (Open Science Framework, https://doi.org/10.17605/OSF.IO/GEHFX ). METHODS: In this collaborative systematic review and meta-analysis, clinical trial registries (ClinicalTrials.gov, WHO International Clinical Trials Registry Platform), the Cochrane COVID-19 register, the LOVE database, and PubMed were searched until April 8, 2021. Investigators of trials registered by March 1, 2021, without published results were contacted via email. Eligible were ongoing, discontinued and completed randomized clinical trials that compared convalescent plasma with placebo or no treatment in COVID-19 patients, regardless of setting or treatment schedule. Aggregated mortality data were extracted from publications or provided by investigators of unpublished trials and combined using the Hartung-Knapp-Sidik-Jonkman random effects model. We investigated the contribution of unpublished trials to the overall evidence. RESULTS: A total of 16,477 patients were included in 33 trials (20 unpublished with 3190 patients, 13 published with 13,287 patients). 32 trials enrolled only hospitalized patients (including 3 with only intensive care unit patients). Risk of bias was low for 29/33 trials. Of 8495 patients who received convalescent plasma, 1997 died (23%), and of 7982 control patients, 1952 died (24%). The combined risk ratio for all-cause mortality was 0.97 (95% confidence interval: 0.92; 1.02) with between-study heterogeneity not beyond chance (I2 = 0%). The RECOVERY trial had 69.8% and the unpublished evidence 25.3% of the weight in the meta-analysis. CONCLUSIONS: Convalescent plasma treatment of patients with COVID-19 did not reduce all-cause mortality. These results provide strong evidence that convalescent plasma treatment for patients with COVID-19 should not be used outside of randomized trials. Evidence synthesis from collaborations among trial investigators can inform both evidence generation and evidence application in patient care

Consumer Perception on Genetically Modified Salmon: The Case of Southeastern North Carolina

The purpose of this study was to determine consumers' perception on genetically modified (GM) salmon. An anonymous survey was conducted on a college campus, regarding view on different aspects of genetic modification: ethics, health, risks (personal and environmental), and price and labeling activities. The focus of the research was GM salmon because not only is it the largest farmed species of fish, it could potentially be the first of many GM animals to be sold commercially in supermarkets. The data gathered from the survey was analyzed using SPSS, Microsoft Excel, and R documentation, to perform Crossstabs, descriptive statistics, and ANOVA tests respectively. These statistical analyses were used to determine which factors were significant and which were not in determining consumers' willingness to adopt GM products. To successfully market GM salmon, not only should the producers provide information, they would be better off specifying the target market based on the significant demographic variables a identified by the data analysis. One limitation of the study was that a post hoc test has not yet been conducted, which would reveal the sources of significance within these demographic variables

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