American journal of preventive medicine
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Mammography capacity in the U.S. reportedly is adequate, but has not been examined in nonmetropolitan areas. This study examined the relationships between in-county mammography facilities and rates of mammography screening and late-stage diagnosis of breast cancers. ⋯ Although mammography capacity in the U.S. may be adequate on average, the unequal distribution of facilities results in large rural areas without facilities. Screening rates in these areas are suboptimal and are associated with late-stage diagnosis of breast cancer.
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Despite the acknowledged promise of developing a public health systems research (PHSR) agenda for emergency preparedness, there has been no systematic review of the literature in this area. The purpose of this study was to conduct a systematic literature review in order to identify and characterize the PHSR literature produced in the U.S. in the past 11 years in the field of public health emergency preparedness. ⋯ Since 2001, the PHSR literature on PHEP issues has grown at about 33% per year. However, most studies lack a rigorous design, raising questions about the validity of the results.
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California has significantly decreased racial/ethnic and educational disparities in smoke-free home and indoor work policies. California's ethnic-specific surveys present an opportunity to disaggregate data and examine the impact of California's smoke-free social norm campaign for Asian-American women. ⋯ The intended consequences of California's tobacco-control efforts have resulted in similar rates of smoke-free policies at home and in indoor work environments among Asian-American women across educational levels. However, an unintended consequence of this success is a disparity in enforcement by educational status, with lower-educated Asian-American women reporting greater smoke exposure despite similar rates of knowledge about the health consequences of secondhand smoke exposure. Besides establishing policies, lower-educated Asian-American women may need to be empowered to assert and enforce their right to smoke-free environments.
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Social smoking is increasingly prevalent and poses a challenge to traditional cessation practices. Tobacco companies conducted extensive research on social smokers long before health authorities did and marketed products to promote this smoking behavior. ⋯ Previously considered a transient behavior, social smoking is also a stable consumption pattern. Focused clinical questions to detect social smoking are needed and may include, "Have you smoked any cigarettes or used any tobacco products in the past month?" as opposed to "Are you a smoker?" Clinicians should recognize that social smokers might be motivated to quit after education on the dangers of secondhand smoke rather than on personal health risks or with pharmacotherapy.
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Steps/day guidelines for children aged 12 years and under are 12,000 to 16,000. There are limited reports in the literature on how many steps/day adolescents need to meet the 60-minutes/day moderate-to-vigorous physical activity (MVPA) recommendation. This study aimed to determine the steps/day that correctly classifies adolescents as meeting the 60-minute recommendation using objective measures. ⋯ Depending on the MVPA criteria used, these data suggest that overweight adolescents are likely to meet national MVPA recommendations if they accumulate between 10,000 and 11,700 steps per day.