American journal of preventive medicine
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Most Americans spend half their waking hours at work and consume food acquired there. The hypothesis was that the healthfulness of worksite food purchases was associated with employees' overall diet and health. ⋯ Worksite food purchases were associated with overall dietary quality and cardiometabolic risk. Interventions to increase healthfulness of food choices at work may improve employees' health.
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Since 2005, the federal government's Dietary Guidelines for Americans have recommended at least half of total grain intake be whole grains. Beginning with the 2012-2013 school year, the U.S. Department of Agriculture updated school meal regulations to align with this recommendation. ⋯ During 1994-2006, the whole grain/total grain ratio of schoolchildren's diets declined, contrary to expert advice. Following the 2012 U.S. Department of Agriculture school meal regulations, both the propensity and the intensity of whole grain consumption from school rose considerably, demonstrating the important role school meals may play in improving children's diets.
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Medicaid expansions following the Affordable Care Act have improved insurance coverage in low-income adults, but little is known about its impact on cancer screening. This study examined associations between Medicaid expansion timing and colorectal cancer (CRC) and breast cancer (BC) screening. ⋯ Prevalence of CRC and BC screening among low-income adults rose in Medicaid expansion states, though increases were significantly higher than those in non-expansion states only for recent CRC screening in VE expansion states. Large-scale improvements in cancer screening may take several years following expansion in access to care.
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Early stage diagnosis strongly predicts cancer survival. Recognition of potential symptoms of cancer may improve survival by reducing time to seeking care. ⋯ Lack of symptom recognition was associated with anticipated delay in seeking care for some cancer symptoms. Differences in recognition and delays by symptom could be driven partly by screening messaging or by ambiguity and functional impact of each symptom.
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Chlamydia and gonorrhea are the most commonly reported notifiable infections in the U.S., with direct medical costs for the treatment of these infections exceeding $700 million annually. Medicaid currently covers approximately 80 million low-income Americans, including a high percentage of racial and ethnic minorities. Studies have shown that racial and ethnic minority populations, particularly those with low SES, are at an increased risk of acquiring a sexually transmitted disease. Therefore, as Medicaid expands, there will likely be a greater demand for sexually transmitted disease services in community-based physician offices. To determine demand for these services among Medicaid enrollees, this study examined how often Medicaid was used to pay for sexually transmitted disease services received in this setting. ⋯ Focusing sexually transmitted disease prevention in Medicaid populations could reduce sexually transmitted disease incidence and resulting morbidity and costs.