Preventive medicine
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Preventive medicine · Jul 2019
Chronic sleep disturbance, not chronic sleep deprivation, is associated with self-rated health in adolescents.
Improving our understanding of the cumulative effects of persistent sleep problems on adolescent health has been identified as an important area of research. This prospective study aimed to ascertain prospectively gender-specific associations between quantity and quality of sleep and self-reported health. Data from a cohort of 3104 adolescents (13-18 y) with repeated measures of sleep deprivation and sleep disturbance (2011 fall, 2012 spring, 2012 fall), and self-reported health (SRH) (2011 fall, 2012 fall) were analysed with multivariable logistic regression models adjusted for confounders. ⋯ Young women reporting chronic exposure to sleep disturbance had over twice the odds of reporting sub-optimal health at follow-up (OR 2.18 [CI95: 1.13, 4.22]), compared to those with no history. Similar results were found in chronically sleep disturbed young men (OR 2.41 [1.05, 5.51]). These findings suggest that chronic exposure to impaired quality of sleep, such as difficulty falling or staying asleep, is related to adolescent self-reported health and thus may be an important determinant of young people's wellbeing.
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Preventive medicine · Jul 2019
Oral cancer examinations and lesion discovery as reported by U.S. general dentists: Findings from the National Dental Practice-Based Research Network.
General dentists (GDs) have the opportunity to examine their patients for oral premalignancy/malignancy. We estimated the annualized per dentist number of oral lesions suspicious for premalignancy/malignancy discovered by United States (U. S.) general dentists and the annualized per dentist number of histologically-confirmed cancers subsequently diagnosed. ⋯ Crude and adjusted mean numbers of histologically-confirmed oral cancers were both 0.4 cancers/dentist/year. Our findings suggest that many U. S. general dentists are actively identifying oral lesions suspicious for premalignancy/malignancy, thereby aiding in the discovery of oral malignancies and representing an important component in the frontline against cancer.
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Preventive medicine · Jul 2019
Population-based primary HPV mRNA cervical screening compared with cytology screening.
Primary HPV screening for cervical cancer by HPV mRNA testing (Aptima) was implemented in January 2017, for women ≥30 through 70 years, in the Region of Skåne, Sweden. HPV positive samples underwent cytology assessment, and women with any degree of abnormal cytology were referred for colposcopy. The aim was to audit the primary HPV screening program, by comparing the cytology results to those of corresponding women (aged ≥30 through 65 years) screened with conventional cytology during 2016. ⋯ The colposcopy referral rate increased by 54% (3.70 vs 2.41%), when primary HPV screening was introduced. In conclusion, the implemented primary HPV screening approach demonstrated similar prevalence of ASCUS+ cytology as conventional screening. In addition, primary HPV screening decreased cytology assessments by 86% in our screening population of women 30 through 70 years taken into account the co-tested women.
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Preventive medicine · Jul 2019
Women's obstetric and reproductive health care discourse in online forums: Perceived access and quality pre- and post-Affordable Care Act.
This corpus-based study examines women's framing of health issues in online forums (MedHelp.org, AphroditeWomensHealth.com, and Connect. MayoClinic.org) prior to, during, and after implementation of the Affordable Care Act (ACA). Since worldviews affect how women describe health issues, their discourse is both a way to see ideology indexed in the forums, as well as how that discourse has been shaped by policy. ⋯ While ACA implementation reduced lack of insurance as an obstacle to obtaining healthcare, online forums indicate that patients continue to find doctors' visits unhelpful, instead choosing to seek medical advice from the lay public. Patients' distrust of the medical profession persisted following ACA implementation. There is a need for public health initiatives to improve this relationship in order to augment health care outcomes.