381 research outputs found
Predictors of Cervical Cancer Screening among Infrequently Screened Women Completing Human Papillomavirus Self-Collection: My Body My Test-1
Background: Approximately one-half of cervical cancer cases in the United States occur in underscreened or never-screened women. We examined predictors to completing Papanicolaou (Pap) testing and whether a positive human papillomavirus (HPV) self-collection result affects Pap testing adherence among underscreened women. Materials and Methods: Low-income women aged 30-65 years who reported no Pap testing in ≥4 years were recruited in North Carolina. Knowledge, attitudes, and barriers regarding cervical cancer and Pap testing were assessed by telephone questionnaires. We mailed self-collection kits for HPV testing and provided information regarding where to obtain affordable Pap testing. Participants received $45 for completing all activities. We used multivariable logistic regression to assess the predictors of longer reported time since last Pap (≥10 vs. 4-9 years) and of completion of Pap testing following study enrollment (follow-up Pap). Results: Participants (n = 230) were primarily black (55%), uninsured (64%), and with ≤high school education (59%). Cost and finding an affordable clinic were the most commonly reported barriers to screening. White women and those with ≤high school education reported longer intervals since last Pap test. Half of the participants reported completing a follow-up Pap test (55%). Women with a positive HPV self-collection were five times more likely to report completing a follow-up Pap test than those with negative self-collection (odds ratio = 5.1, 95% confidence interval 1.4-25.7). Conclusions: Improving awareness of resources for affordable screening could increase cervical cancer screening in underserved women. Home-based HPV self-collection represents an opportunity to re-engage infrequently screened women into preventive screening services
Acceptability and ease of use of mailed HPV self-collection among infrequently screened women in North Carolina
Objectives: Self-collection of cervico-vaginal samples for human papillomavirus (HPV) testing has the potential to make cervical cancer screening more accessible to underscreened women. We evaluated the acceptability and ease of use of home-based HPV self-collection within a diverse population of low-income, infrequently screened women. Methods: Participants were low-income women from North Carolina who had not received Pap testing in 4 or more years. Eligible women received a self-collection kit containing instructions and a brush for home-based sample collection. A total of 227 women returned a self-collected sample by mail and completed a questionnaire to assess their experiences with HPV self-collection. We described acceptability measures and used logistic regression to identify predictors of overall positive thoughts about the self-collection experience. Results: Nearly all women were willing to perform HPV self-collection again (98%) and were comfortable receiving the self-collection kit in the mail (99%). Overall, 81% of participants reported positive thoughts about home-based self-collection. Women with at least some college education and those who were divorced, separated or widowed were more likely to report overall positive thoughts. Aspects of self-collection that participants most commonly reported liking included convenience (53%), ease of use (32%) and privacy (23%). The most frequently reported difficulties included uncertainty that the self-collection was done correctly (16%) and difficulty inserting the self-collection brush (16%). Conclusions: Home-based self-collection for HPV was a highly acceptable screening method among low-income, underscreened women and holds the promise to increase access to cervical cancer screening in this high-risk population
Preference for Human Papillomavirus Self-Collection and Papanicolaou: Survey of Underscreened Women in North Carolina
Objectives Self-collection of samples for human papillomavirus (HPV) testing (self-collection) has the potential to increase cervical cancer screening among underscreened women. We assessed attitudes toward at-home HPV self-collection compared with clinic-based Pap testing in this higher-risk population. Materials and Methods Participants were low-income women in North Carolina overdue for cervical cancer screening. Women self-collected samples at home, returned samples by mail for HPV testing, and completed phone questionnaires about at-home HPV self-collection. Participants were referred to clinic-based Pap testing and invited to complete a second questionnaire about Pap testing. A cross-sectional questionnaire compared attitudes, experiences, and preferences for self-collection versus Pap testing and assessed predictors of preference for HPV self-collection. Results Half (51%) of 221 women reported a preference for HPV self-collection, 19% preferred Pap testing, and 27% reported no preference. More women reported difficulty finding time to do the Pap test (31%) than the self-test (13%, p =.003) and being afraid of the self-test results (50%) than the Pap test results (36%, p =.02). There were relatively fewer reports of physical discomfort and pain from self-collection than Pap testing (discomfort: 18% self; 48% Pap; pain: 8% self; 30% Pap, p =.001). No differences were found in positive versus negative thoughts about the tests, trust in the tests' safety and accuracy, or willingness to do tests again. Conclusions Overall positive attitudes toward HPV self-collection compared with Pap testing among underscreened women suggest that self-collection is a promising option to increase cervical cancer screening in this high-risk population
A stochastic model for heart rate fluctuations
Normal human heart rate shows complex fluctuations in time, which is natural,
since heart rate is controlled by a large number of different feedback control
loops. These unpredictable fluctuations have been shown to display fractal
dynamics, long-term correlations, and 1/f noise. These characterizations are
statistical and they have been widely studied and used, but much less is known
about the detailed time evolution (dynamics) of the heart rate control
mechanism. Here we show that a simple one-dimensional Langevin-type stochastic
difference equation can accurately model the heart rate fluctuations in a time
scale from minutes to hours. The model consists of a deterministic nonlinear
part and a stochastic part typical to Gaussian noise, and both parts can be
directly determined from the measured heart rate data. Studies of 27 healthy
subjects reveal that in most cases the deterministic part has a form typically
seen in bistable systems: there are two stable fixed points and one unstable
one.Comment: 8 pages in PDF, Revtex style. Added more dat
Recruitment strategies and HPV self-collection return rates for under-screened women for cervical cancer prevention
In the United States, medically underserved women carry a heavier burden of cancer incidence and mortality, yet are largely underrepresented in cancer prevention studies. My Body, My Test is a n observational cohort, multi-phase cervical cancer prevention study in North Carolina that recruited low-income women, aged 30–65 years and who had not undergone Pap testing in ≥ 4 years. Participants were offered home-based self-collection of cervico-vaginal samples for primary HPV testing. Here, we aimed to describe the recruitment strategies utilized by study staff, and the resulting recruitment and self-collection kit return rates for each specific recruitment strategy. Participants were recruited through different approaches: either direct (active, staff-effort intensive) or indirect (passive on the part of study staff). Of a total of 1,475 individuals screened for eligibility, 695 were eligible (47.1%) and 487 (70% of eligible) participants returned their self-collection kit. Small media recruitment resulted in the highest number of individuals found to be study eligible, with a relatively high self-collection kit return of 70%. In-clinic in-reach resulted in a lower number of study-eligible women, yet had the highest kit return rate (90%) among those sent kits. In contrast, 211 recruitment which resulted in the lowest kit return of 54%. Small media, word of mouth, and face-to-face outreach resulted in self-collection kit return rates ranging from 72 to 79%. The recruitment strategies undertaken by study staff support the continued study of reaching under-screened populations into cervical cancer prevention studies
Multiple drivers of decline in the global status of freshwater crayfish (Decapoda: Astacidea)
International audienceRates of biodiversity loss are higher in freshwater ecosystems than in most terrestrial or marine ecosystems, making freshwater conservation a priority. However, prioritization methods are impeded by insufficient knowledge on the distribution and conservation status of freshwater taxa, particularly invertebrates. We evaluated the extinction risk of the world's 590 freshwater crayfish species using the IUCN Categories and Criteria and found 32% of all species are threatened with extinction. The level of extinction risk differed between families, with proportionally more threatened species in the Parastacidae and Astacidae than in the Cambaridae. Four described species were Extinct and 21% were assessed as Data Deficient. There was geographical variation in the dominant threats affecting the main centres of crayfish diversity. The majority of threatened US and Mexican species face threats associated with urban development, pollution, damming and water management. Conversely, the majority of Australian threatened species are affected by climate change, harvesting, agriculture and invasive species. Only a small proportion of crayfish are found within the boundaries of protected areas, suggesting that alternative means of long-term protection will be required. Our study highlights many of the significant challenges yet to come for freshwater biodiversity unless conservation planning shifts from a reactive to proactive approach
Study of the B^0 Semileptonic Decay Spectrum at the Upsilon(4S) Resonance
We have made a first measurement of the lepton momentum spectrum in a sample
of events enriched in neutral B's through a partial reconstruction of B0 -->
D*- l+ nu. This spectrum, measured with 2.38 fb**-1 of data collected at the
Upsilon(4S) resonance by the CLEO II detector, is compared directly to the
inclusive lepton spectrum from all Upsilon(4S) events in the same data set.
These two spectra are consistent with having the same shape above 1.5 GeV/c.
From the two spectra and two other CLEO measurements, we obtain the B0 and B+
semileptonic branching fractions, b0 and b+, their ratio, and the production
ratio f+-/f00 of B+ and B0 pairs at the Upsilon(4S). We report b+/b0=0.950
(+0.117-0.080) +- 0.091, b0 = (10.78 +- 0.60 +- 0.69)%, and b+ = (10.25 +- 0.57
+- 0.65)%. b+/b0 is equivalent to the ratio of charged to neutral B lifetimes,
tau+/tau0.Comment: 14 page, postscript file also available at
http://w4.lns.cornell.edu/public/CLN
Production and Decay of D_1(2420)^0 and D_2^*(2460)^0
We have investigated and final states and
observed the two established charmed mesons, the with mass
MeV/c and width MeV/c and
the with mass MeV/c and width
MeV/c. Properties of these final states, including
their decay angular distributions and spin-parity assignments, have been
studied. We identify these two mesons as the doublet predicted
by HQET. We also obtain constraints on {\footnotesize } as a function of the cosine of the relative phase of the two
amplitudes in the decay.Comment: 15 pages in REVTEX format. hardcopies with figures can be obtained by
sending mail to: [email protected]
Measurement of the branching fraction for
We have studied the leptonic decay of the resonance into tau
pairs using the CLEO II detector. A clean sample of tau pair events is
identified via events containing two charged particles where exactly one of the
particles is an identified electron. We find . The result is consistent with
expectations from lepton universality.Comment: 9 pages, RevTeX, two Postscript figures available upon request, CLNS
94/1297, CLEO 94-20 (submitted to Physics Letters B
Measurement of the Decay Asymmetry Parameters in and
We have measured the weak decay asymmetry parameters (\aLC ) for two \LC\
decay modes. Our measurements are \aLC = -0.94^{+0.21+0.12}_{-0.06-0.06} for
the decay mode and \aLC = -0.45\pm 0.31 \pm
0.06 for the decay mode . By combining these
measurements with the previously measured decay rates, we have extracted the
parity-violating and parity-conserving amplitudes. These amplitudes are used to
test models of nonleptonic charmed baryon decay.Comment: 11 pages including the figures. Uses REVTEX and psfig macros. Figures
as uuencoded postscript. Also available as
http://w4.lns.cornell.edu/public/CLNS/1995/CLNS95-1319.p
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