American journal of preventive medicine
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Understanding the joint effects of insurance type and primary care physician density on stage at diagnosis is essential to elucidating the healthcare access and late-stage cancer relationship. ⋯ As primary care physician density increases, those with private insurance consistently benefit the most in terms of late-stage cancer diagnosis, whereas those with several other insurance types experience flatter decreases or significantly higher odds of late-stage cancer diagnosis.
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Randomized Controlled Trial
Twelve-month physical activity outcomes in Latinas in the Seamos Saludables trial.
Physical activity interventions designed for Latinas have shown short-term behavior change, but longer-term change and maintenance is rarely measured. ⋯ The intervention was more effective than the wellness control at 12 months, and physical activity increases from baseline to 6 months were maintained, suggesting the intervention may lead to sustainable behavior change.
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The U.S. population has shown increasing rates of overweight and obesity in recent years, but similar analyses do not exist for U.S. military personnel. It is important to understand these patterns in the military because of their impact on fitness and readiness. ⋯ Combined overweight and obesity in active duty personnel rose to more than 60% between 1995 and 2008, primarily because of increased obesity. The high prevalence of overweight and obesity needs attention and has implications for Department of Defense efforts to improve the health, fitness, readiness, and quality of life of the Active Forces.
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Given the increase in childhood food allergy, national and local policies have been developed to encourage schools to stock undesignated epinephrine auto-injectors in case of an anaphylactic emergency. ⋯ Chicago Public Schools is the first large, urban school district in the U.S. to develop and implement the District-Issued Emergency Epinephrine Initiative, which helped 38 students and staff avoid potential morbidity and mortality. The impact of this initiative during its first year underscores the need for stocking undesignated epinephrine in schools across the country.
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Lack of insurance is associated with suboptimal receipt of diabetes preventive care. One known reason for this is an access barrier to obtaining healthcare visits; however, little is known about whether insurance status is associated with differential rates of receipt of diabetes care during visits. ⋯ Lack of insurance is associated with a lower probability of receiving recommended services that are due during a clinic visit. Thus, the association between being uninsured and receiving fewer preventive services may not be completely mediated by access to clinic visits.