Psychological impact of human papillomavirus testing in women with borderline or mildly dyskaryotic cervical smear test results: cross sectional questionnaire study.

OBJECTIVE: To describe the psychological impact on women of being tested for human papillomavirus (HPV) when smear test results are borderline or mildly dyskaryotic. DESIGN: Cross sectional questionnaire study. SETTING: Two centres participating in an English pilot study of HPV testing in women with borderline or mildly dyskaryotic smear test results. PARTICIPANTS: Women receiving borderline or mildly dyskaryotic smear test results tested for HPV and found to be HPV positive (n = 536) or HPV negative (n = 331); and women not tested for HPV with borderline or mildly dyskaryotic smear results (n = 143) or normal smear results (n = 366). MAIN OUTCOME MEASURES: State anxiety, distress, and concern about test result, assessed within four weeks of receipt of results. RESULTS: Women with borderline or mildly dyskaryotic smear results who were HPV positive were more anxious, distressed, and concerned than the other three groups. Three variables independently predicted anxiety in HPV positive women: younger age (beta = -0.11, P = 0.03), higher perceived risk of cervical cancer (beta = 0.17, P < 0.001), and reporting that they did not understand the meaning of test results (beta = 0.17, P = 0.001). Testing HPV negative was not reassuring: among women with abnormal smear test results, those who were HPV negative were no less anxious than those who were not tested for HPV. CONCLUSIONS: Informing women more effectively about the meaning of borderline or mildly dyskaryotic smear test results and HPV status, in particular about the absolute risks of cervical cancer and the prevalence of HPV infection, may avoid some anxiety for those who are HPV positive while achieving some reassurance for those who test HPV negative

The psychological impact of human papillomavirus testing in women with borderline or mildly dyskaryotic cervical smear test results: 6-month follow-up

State anxiety (S-STAI-6), distress (GHQ-12), concern and quality of life (EuroQoL-EQ-5D) 6 months after human papillomavirus (HPV) testing in women with borderline or mildly dyskaryotic smear test results were assessed based on a prospective questionnaire study, with 6-month follow-up after the smear test result. Two centres participated in an English pilot study of HPV testing. Participants included two groups of women receiving abnormal smear test results: (tested for HPV and found to be (a) HPV positive (n=369) or (b) HPV negative (n=252)) and two groups not tested for HPV (those receiving (c) abnormal smear test results (n=102) or (d) normal smear test results (n=288)). There were no differences in anxiety, distress or health-related quality of life between the four study groups at 6 months. Levels of concern about the smear test result remained elevated in all groups receiving an abnormal smear test result, and were highest in the group untested for HPV. Predictors of concern across all groups receiving an abnormal smear test were perceived risk of developing cancer, being HPV positive or untested for HPV, sexual health worries and the smear being a woman's first smear test. The raised anxiety and distress observed in women immediately after being informed of an abnormal smear test result and that they are HPV positive was no longer evident at 6 months. Concern about the smear test result was however still raised in these women and those who tested negative for HPV, and particularly among those who did not undergo HPV testing

Damage Index Seismic Assessment Methodologies of URM Buildings: A State-of-the-Art Review

This paper is written to review the previous studies of developing Damage Indices (DI) for Unreinforced Masonry (URM) Buildings. DI was designed to provide a critical indicator of damage states (DS), seismic vulnerability, and structural occupancy of buildings. DI approaches with simplified assessment methods to predict seismic vulnerability of URM structures are presented in this review, with the pros and cons of each assessment method are highlighted to propose an ideal methodology in using DI assessment.&nbsp; Thus, this paper is intended to provide a comprehensive information related to the state-of-the-art of DI methodology that can be used to seismically assess of URM buildings

Development of Intrinsic Seismic Vulnerability Index (ISVI) for assessing roadway system and its assets framework

Roadway systems and their assets are the backbone of the transport sector and are vital for social and economic prosperity. Hence, it is important to design and develop transportation networks that can withstand natural hazards such as earthquakes. In recent decades, research concerning disaster risk management for roadway systems has received a lot of attention, particularly via the use of seismic vulnerability assessment methods. The majority of those models focus on a single criterion e.g., physical degradation of road assets, traffic disturbance, and/or functionality loss of the network, rather than considering how different criteria interact, such as association between asset damage, functionality, and network traffic. The main purpose of this study is to provide an integrated methodology for evaluating the seismic vulnerability of road networks to inform decision-making for risk mitigation. The proposed framework correlates the Intrinsic Seismic Vulnerability Index (ISVI) scores with the variation of accessibility rates to critical service centers. The methodology is demonstrated through an application to a part of a road network for specific seismic scenarios. The ISVI quantifies the impact caused by a parameter’s physical performance on the road behaviour using Non-Linear Dynamic Analysis (NLDA) technique, which can reduce or limit the role of the studies that are based on expert opinion decisions. The validated results shows that the embankment height is considered the most effective parameter in the physical assessment approach, followed by the number of lanes, while the soil type and pavement strength are the least effective parameters with a better effectiveness for soil type compared to pavement strength. Additionally, the integration between the physical assessment approach and the analysed accessibility rates is clearly showing compatibility between the vulnerability and accessibility approach, demonstrating more precise assessment tool by considering the correlation between the vulnerability rates and the reduced accessibility levels. The proposed approach can assist infrastructure owners and operators to reduce risk and boost emergency accessibility. • Conducting ISVI for roadway and its assets based on physical damage approach. • Assessing road networks accessibility rates by introducing an accessibility index (AI) using different geographical aspects • Formulating an integrated model between physical damage and traffic accessibility through building transport performance maps.This research was supported by Ministry of Higher Education Malaysia for Fundamental Research Grant Scheme with Project Code: FRGS/1/2020/TK02/USM/02/

PENGARUH MENGUNYAH BUAH APEL MANALAGI (Malus Sylvestris Mill.) TERHADAP PENURUNAN INDEKS PLAK Kajian Pada Siswa Usia 9-12 Tahun di SD Muhammadiyah 11 Mangkuyudan Surakarta

Latar Belakang: Akumulasi plak gigi merupakan etiologi utama karies gigi dan penyakit periodontal, diperlukan usaha untuk mencegah akumulasi plak pada permukaan gigi dan gingiva. Kontrol plak dilakukan dengan mengunyah makanan yang padat dan berserat. Efek mekanis dari gerakan mengunyah dapat membersihkan plak pada permukaan gigi. Buah apel (Malus sylvestris Mill.) mempunyai efek kimiawi karena mengandung zat aktif anti bakteri yaitu tannin. Mengunyah buah Apel Manalagi (Malus sylvestris Mill.) dapat menstimulasi aliran saliva sebagai efek fisiologis self cleansing. Siswa sekolah dasar usia 9-12 tahun merupakan periode yang tepat untuk menanamkan sikap positif terhadap kesehatan gigi dan mulut. Penelitian ini bertujuan untuk mengetahui pengaruh mengunyah buah Apel Manalagi (Malus sylvestris Mill.) terhadap penurunan indeks plak kajian dilakukan pada siswa usia 9-12 tahun di SD Muhammadiyah 11 Mangkuyudan Surakarta. Metode: Metode penelitian yang digunakan adalah penelitian eksperimental semu. Teknik sampling yang digunakan pada penelitian ini adalah purposive sampling. Pengukuran plak gigi menggunakan indeks PHP-M untuk periode gigi bercampur. Jumlah sampel yang digunakan dalam penelitian yaitu sebanyak 30 subjek. Hasil dan kesimpulan: Data yang diperoleh dari hasil penelitian dianalisis menggunakan uji t berpasangan menunjukkan terdapat perbedaan dengan signifikansi p<0.05. Berdasarkan hasil penelitian dapat disimpulkan bahwa terdapat pengaruh mengunyah buah Apel Manalagi (Malus sylvestriss Mill.) terhadap penurunan indeks plak

An Integrated Framework for the Quantification of Road Network Seismic Vulnerability and Accessibility to Critical Services

Road networks are regarded as the backbone of transportation systems, which play an important role in the social and economic prosperity of societies. Due to this reason, it is crucial to develop road networks with higher resiliency rates to operate normally during earthquake incidents. In the last decades, the research that tackled the management of disasters for road networks gained great attention, in particular by developing various seismic vulnerability assessment models. Most of those models study a single criterion, e.g., physical damage of road assets, traffic disruption, and/or functionality loss of the network without taking into consideration the combination of different vulnerability criteria. The proposed framework is part of the global seismic vulnerability assessment models that combine fragility functions and vulnerability indices, which is demonstrated by an application in a road network in the city of Penang in Malaysia. In the first step, the fragility functions are developed where their results are used to calculate the Seismic Vulnerability Index (SVI) for roadways by weighting the main investigated parameters. This is followed by investigating the Accessibility Index (AI) model that is employed to assess the accessibility of targeted districts within the investigated area. Subsequently, an integrated approach is employed to generate the emergency evacuation maps to critical service centres by referring to the correlations between vulnerability and the accessibility rates. In conclusion, the results of this study integrate engineering judgment and numerical models to create a comparative study for assessing the performance of road networks and to validate the significance of an integrated seismic assessment on various critical societal sectors, such as improving emergency accessibility and implementing better mitigation strategies for communities living in disaster-prone areas.Ministry of Higher Education (MOHE) through Fundamental Research Grant Scheme (FRGS/1/2020/TK02/USM/02/1)

A randomised controlled trial of cognitive behaviour therapy and motivational interviewing for people with type 1 diabetes mellitus with persistent sub-optimal glycaemic control: A diabetes and psychological therapies (ADaPT) study

Published version. Copyright © 2010 NIHR Health Technology Assessment ProgrammeTo determine whether (i) motivational enhancement therapy (MET) + cognitive behaviour therapy (CBT) compared with usual care, (ii) MET compared with usual care, (iii) or MET + CBT compared with MET was more effective in improving glycaemic control when delivered by general nurses with additional training in these techniques

Making sense of information about HPV in cervical screening: a qualitative study

Introducing human papillomavirus (HPV) testing into cervical cancer screening has the potential to change the way that women understand cervical cancer, the psychological impact of abnormal screening results and the likelihood of future participation in screening. The study used in-depth interviews to examine how women make sense of information about HPV in the context of cervical cancer screening. A total of 74 women were recruited following participation in HPV testing. Women varied widely in their beliefs about the aetiology of cervical cancer and its relationship with sexual activity, as well as in their understanding of the sexually transmitted nature of HPV. While some women who understood that HPV is sexually transmitted were able to integrate this into their existing model of cervical cancer, others were shocked by the link between cervical cancer and sex, of which they had been previously unaware. Women were generally reassured to know that HPV is common, has no symptoms, can lie dormant for many years, can clear up on its own and need not raise concerns about transmission to sexual partners. Women's understanding of HPV varied considerably, even after participation in testing. The way in which information is presented to women will be crucial in minimising the negative psychological impact of testing positive and ensuring that participation in screening remains high

Short-term health-related quality of life consequences in a lung cancer CT screening trial (NELSON)

Item does not contain fulltextBACKGROUND: In lung cancer CT screening, participants often have an indeterminate screening result at baseline requiring a follow-up CT. In subjects with either an indeterminate or a negative result after screening, we investigated whether health-related quality of life (HRQoL) changed over time and differed between groups in the short term. METHODS: A total of 733 participants in the NELSON trial received four questionnaires: T0, before randomisation; T1, 1 week before the baseline screening; T2, 1 day after the screening; and T3, 2 months after the screening results but before the 3-month follow-up CT. HRQoL was measured as generic HRQoL (the 12-item Short Form, SF-12; the EuroQol questionnaire, EQ-5D), anxiety (the Spielberger State-Trait Anxiety Inventory, STAI-6), and lung-cancer-specific distress (the Impact of Event Scale, IES). For analyses, repeated-measures analysis of variance was used, adjusted for covariates. RESULTS: Response to each questionnaire was 88% or higher. Scores on SF-12, EQ-5D, and STAI-6 showed no clinically relevant changes over time. At T3, IES scores that were clinically relevant increased after an indeterminate result, whereas these scores showed a significant decrease after a negative result. At T3, differences in IES scores between the two baseline result groups were both significant and clinically relevant (P<0.01). CONCLUSION: This longitudinal study among participants of a lung cancer screening programme showed that in the short term recipients of an indeterminate result experienced increased lung-cancer-specific distress, whereas the HRQoL changes after a negative baseline screening result may be interpreted as a relief

The quality of life of patients with genital warts: a qualitative study

<p>Abstract</p> <p>Background</p> <p>Genital warts, which are caused by infection with human papillomavirus (HPV), are one of the most common sexually transmitted diseases in Europe. Although genital warts are commonly perceived as a non-serious condition, treatment is often long, of varying effectiveness and the recurrence rate is high. Very few studies have been performed on the personal consequences of genital warts. The aim of this qualitative study, set in Denmark, was to examine the ways in which genital warts may affect patients' quality of life.</p> <p>Methods</p> <p>To obtain an in-depth understanding of patients' perceptions of genital warts, we used qualitative focus-group interviews with five men and five women aged between 18 and 30 years who had genital warts. The interview guide was based on a literature review that identified important issues and questions. The data were analysed using a medical anthropological approach.</p> <p>Results</p> <p>Patients' experiences were related to cultural conceptions of venereal diseases and the respective identities and sexuality of the sexes. The disease had negative psychological and social effects both for men and for women and it affected their sex and love lives, in particular. The psychological burden of the disease was increased by the uncertain timeline and the varying effectiveness of treatment. We identified a need for more patient information about the disease and its psycho-sexual aspects.</p> <p>Conclusions</p> <p>The men and women participating in this study considered their quality of life to be significantly lowered because of genital warts. The experiences described by the participants give insights that may be valuable in treatment and counselling.</p> <p>The quadrivalent HPV vaccine that has now been added to the childhood vaccination programme for girls in Denmark for the prevention of cervical cancer can also prevent 90% of cases of genital warts. Our results suggest that HPV vaccination could considerably reduce the largely unacknowledged psychological and social burden associated with genital warts, in men as well as women.</p