Poor Screening Research Articles

Health situation analysis of cervical cancer in Delhi

The capital city of India, Delhi is endowed with a plethora of multi- and super-specialty hospitals, both private and government, for treating various diseases. Patients from around the globe seek medical care in Delhi. The primary healthcare system is robust, with a network of newly established Mohalla and polyclinics. However, when it comes to a sensitive disease, ‘cervical cancer’, all glorious claims mentioned above seem to be inadequate. Cervical cancer is the 2nd most common cancer among Delhi's females. Delhi was 1st state to launch HPV vaccination as a public health program in 2016 despite resistance from civil societies. A situation analysis from literature reveals that cervical cancer screening services at the primary and secondary levels are on the backburner in Delhi, which is also evident from the poor screening habits of Delhi's females (0.7%) according to NFHS-5. This prompts questions regarding organization of the cervical cancer prevention program (NP-NCD) and the delivery of screening services in Delhi. In this review we have tried to illuminate the contemporary landscape of cervical cancer burden, screening, and treatment, while also identifying opportunities for enhancing cervical cancer management in Delhi. The study finds that implementation research targeted at finding barriers in program organization and service delivery would help strengthen the capacity of Delhi’s health system.

Detection of hepatocellular carcinoma methylation markers in salivary DNA.

Alterations to DNA methylation have been identified in both hepatocellular carcinoma (HCC) tumor and circulating DNA from affected individuals. These markers have potential utility in HCC screening. Adherence to HCC screening is poor and acceptable HCC screening tests are needed. A feasibility study was performed on a subset of case patients and control subjects from a prior study of risk factors for HCC. Case patients (n=12) included adults aged 47-85 years with a first diagnosis of HCC between 2011 and 2016 and without viral hepatitis. Control subjects (n=12) were matched on age, sex, and state of residence. Participants provided saliva samples for DNA genotyping. Log fold change in salivary DNA methylation at 1359 CpG sites representing 25 candidate genes previously associated with HCC was compared across case patients and control subjects. The quantity of DNA ranged from 9.65 to 257.79 μg. The purity of DNA isolates was good, with mean OD260/280 ratio of 1.78 (SD: 0.14). Of 25 candidate genes, 16 had at ≥1 CpG site with detectable differences in methylation across HCC case patients and control subjects. Sites differentially methylated in HCC case patients included genes encoding tumor suppressors (PRDM2, RUNX3, p15/16, and RASSF1/5), regulators of cell cycle progression (DAPK1 and TP73), and DNA repair (MGMT and GSTP1). No associations met the significance threshold 3.7 × 10-5 required for multiple comparisons. Salivary DNA may be a feasible alternative to blood samples in the era of novel DNA-based screening tests for HCC. The ease of saliva-based testing supports further investigation of its potential.

Parameter optimization and spatio-temporal distribution of material for variable trajectory combined equal-thickness screen

Vibrating screen is important screening equipment used extensively in coal separation and utilization at the global scale. Traditional vibrating screen usually adopts a single vibration mode, which leads to poor screening effect. In this study, the equal-thickness screening theory was applied to the combined vibrating screen, and non-uniform frequency operation of the vibrating screen was achieved. The concept of combined excitation parameter was introduced, which presented additional adjustable parameters for the screen. These made it easier for material layer on the screen to achieve equal-thickness. Subsequently, single-factor experiments were conducted for systematic exploration of the impact of various parameters on the screening efficiency. By regulating the excitation force and frequency of the four excitation motors of the variable-trajectory combined screen, the study aims to regulate the motion speed of material groups, the distribution of materials under the screen, and the thickness distribution of the material layer on the screen. The result showed that when D = 2/19, f1&f2 = 15.00 & 11.37 Hz, respectively, k = 1.2, equal-thickness screening was realized, and the screening efficiency η was 96.32%, which is 3.35% higher than those under the optimal conditions with equal amplitude and equal vibration frequency.

Factors associated with hypertension and diabetes in rural communities in the Asante Akim North Municipality of Ghana

Background Hypertension and diabetes are leading non-communicable diseases that have driven an epidemic of cardiovascular diseases globally. Understanding the factors associated with the occurrence of hypertension and diabetes, particularly in rural settings, is crucial for designing interventions to improve awareness, detection, and control. This study assessed factors associated with hypertension and diabetes in Asante Akim North Municipality, a rural community in Ghana. Methods This cross-sectional study involved 2,576 participants. Data were collected using a structured questionnaire covering sociodemographic, blood pressure measurements, anthropometric measurements, biochemical parameters, and modifiable risk factors for hypertension and diabetes. Descriptive statistics of the outcomes were performed. The factors associated with hypertension or diabetes were assessed using a multivariate logistic regression model. Results The study found that participants' mean age was 35 years (SD) with a slight female preponderance of 53.88%. Age, marital status, educational status, and occupation positively predicted the occurrence of hypertension. The prevalences of hypertension and diabetes were found to be 30.9% and 17.7%, respectively. Community members above 18 years of age had increased odds of developing hypertension [18–44 years (aOR=1.99, CI=1.06–3.71, p <0.05), 45–64 years (aOR=6.12, CI=3.15–11.9, p <0.001), and >64 years (aOR=14.55, CI=7.17–29.53, p <0.001)]. Community members who were fishing/farming (aOR=0.45, CI=0.26–0.76, p <0.01) and being student/apprentices (aOR=0.11, CI=0.02–0.56) were at reduced odds of developing diabetes. Participants who consumed snacks (aOR=0.64, CI=0.41–0.99, p <0.05) during working hours had reduced odds of developing diabetes. Conclusions The study concluded that commonly known risk factors (dietary behaviour, alcohol intake, tobacco use, and physical activities) were not associated with hypertension or diabetes. Sociodemographic characteristics and poor health screening practices were the main predictors of hypertension and diabetes in rural areas. Urgent steps to improve health education and population-level screening are pivotal for controlling hypertension and diabetes.

The development of an in vitro human hair follicle organoid with a complexity similar to that in vivo

In vitro hair follicle (HF) models are currently limited to ex vivo HF organ cultures (HFOCs) or 2D models that are of low availability and do not reproduce the architecture or behavior of the hair, leading to poor screening systems. To resolve this issue, we developed a technology for the construction of a human in vitro hair construct based on the assemblage of different types of cells present in the hair organ. First, we demonstrated that epithelial cells, when isolated in vitro, have similar genetic signatures regardless of their dissection site, and their trichogenic potential is dependent on the culture conditions. Then, using cell aggregation techniques, 3D spheres of dermal papilla (DP) were constructed, and subsequently, epithelial cells were added, enabling the production and organization of keratins in hair, similar to what is seen in vivo. These reconstructed tissues resulted in the following hair compartments: K71 (inner root-sheath), K85 (matrix region), K75 (companion layer), and vimentin (DP). Furthermore, the new hair model was able to elongate similarly to ex vivo HFOC, resulting in a shaft-like shape several hundred micrometers in length. As expected, when the model was exposed to hair growth enhancers, such as ginseng extract, or inhibitors, such as TGF-B-1, significant effects similar to those in vivo were observed. Moreover, when transplanted into skin biopsies, the new constructs showed signs of integration and hair bud generation. Owing to its simplicity and scalability, this model fully enables high throughput screening of molecules, which allows understanding of the mechanism by which new actives treat hair loss, finding optimal concentrations, and determining the synergy and antagonism among different raw materials. Therefore, this model could be a starting point for applying regenerative medicine approaches to treat hair loss.

Child health nurses' perceptions of the Family Community-based Assistance Resourcing and Education program in contemporary practice: a qualitative study.

The Family Community-based Assistance Resourcing and Education Program (FCP) is a nurse home visiting program that was introduced in Queensland two decades ago to redress health inequalities for infants from families experiencing specific social stressors. Locally adapted versions of this home visiting program are still in use, but have not been evaluated. This study examined child health nurse perceptions of the adapted FCP in one regional Queensland health service. A qualitative descriptive exploratory study using two focus groups (conducted May 2019) with Child Health Nurses who delivered the FCP was conducted. Transcripts of digital recordings were analysed using Braun and Clarke's (2006) six-step framework for guided thematic analysis. A total of 16 Child Health Nurses participated in the study, with a mean of 10years' experience with the program. Data analysis generated 12 themes organised under three domains: 'Establishing the relationship with families', 'What works in practice' and 'We could do it better'. Participants cited flexibility, expert input and in-home delivery as key program benefits. However, narrow eligibility criteria, poor screening for perinatal anxiety and resourcing constraints were identified as limitations. This study is the first to measure Child Health Nurses' perceptions of an adapted FCP. It sheds light on their 'practice wisdom', including the program's ability to meet the needs of families with social vulnerabilities. The study supports prior calls for home visiting programs to be evaluated against clearly stated program intentions. Participant insights have been shared to inform practice and program implementation both locally and as part of Queensland's First 2000Days health service delivery reform agenda.

Autoimmune gastritis

Diagnosis of autoimmune gastritis (AIG) is often challenging because of the absence of typical symptoms. Clinical guidelines are lacking, which results in inadequate treatment and poor cancer screening. This work presents an overview of current management options and aims at raising awareness for this disease. The paper also describes a clinical case of the full-scale course of AIG with all its complications. Autoimmune gastritis is mostly considered as a disease of elderly with vitamin B12 deficiency and pernicious anaemia. Today it is recognized that AIG is found with a similar prevalence in all age groups, with iron deficiency being a frequent symptom. Conventional therapy consists of adequate iron and vitamin B12 supplementation, as well as symptomatic approaches. The associated risk for gastric adenocarcinoma and gastric neuroendocrine tumours requires regular endoscopic follow-up. New treatments aiming to reduce gastric atrophy and cancer risk are currently under development. Thus, treatment of autoimmune gastritis should focus on optimizing supplementation of vitamin and macronutrient deficiencies, symptomatic therapy that improves quality of life, and include cancer prevention measures. Clinical studies should address the possibility to arrest the inflammation process and to prevent progression of AIG. The author of the article suggests that itopride hydrochloride and rebamipide will be used for symptomatic and pathogenetic therapy. The problem facing gastroenterologists today is to develop domestic guidelines for the management and screening endoscopic intervals of patients with AIG.

Missing the Mark: Evaluating the Validity of the Ventral Hernia Screen in Detecting Recurrence.

Hernia recurrence is a primary metric in evaluating the success of ventral hernia repair (VHR). Current screening methods for hernia recurrence, including the validated Ventral Hernia Screening (VHS) questionnaire, have not yet been critically evaluated. The purpose of this study was to evaluate the predictive value of the VHS for hernia recurrence. This is a retrospective cohort study of adult patients who underwent primary VHR utilizing poly-4-hydroxybutyrate mesh at a single-institution from January 2016 to December 2021 who completed at least one VHS during their postoperative follow-up. All patients who screened positive underwent follow-up diagnostic computed tomography or physical examination for confirmation of hernia recurrence. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were assessed for each item and the VHS as a whole. A total of 68 patients who completed 119 VHS questionnaires were included. The median time to VHS administration was 3.6years (range .8-6.3years). The VHS tool had a sensitivity of 40.0%, specificity of 71.1%, PPV of 5.7%, and NPV of 96.4%. Individual items of the VHS also produced poor screening effects, with sensitivities between 20 and 40%, specificities between 79 and 97%, PPVs between 4 and 25%, and NPVs from 95 to 97%. The VHS was a poor positive predictive tool for hernia recurrence, with both a low PPV and sensitivity. Many patients may be unaware of when they truly have hernia recurrence in the long term. More rigorous tools need to be developed to monitor recurrence following VHR.

Prevalence of mental disorders among middle-aged population of primary healthcare centers in Northeastern Iran

BackgroundPrimary healthcare centers (PHCs) serve as the cornerstone of accessible medical services in society, playing a crucial role in screening, detecting, and treating various health issues. This study aimed to investigate the prevalence of psychiatric disorders in middle-aged individuals who refer to PHCs and the potential of PHCs in diagnosing mental disorders.MethodsThis cross-sectional study was implemented at PHCs under the supervision of Mashhad University of Medical Sciences (MUMS) in northeast Iran in 2018. The enrolled subjects were middle-aged adults who had electronic medical records in SINA, an integrated health management system, and the electronic medical records of MUMS. The prevalence of psychiatric disorders by type and their relationship with demographic information was evaluated by a Chi-square test using SPSS 22.ResultsThis study involved 218,341 middle-aged participants. Prevalence of psychiatric disorders was 8.59%, and depression (53.72%) and anxiety (42.02%) were the most common psychiatric disorders in both males and females. The prevalence of mental disorders was significantly higher in females than in males (88.18% vs. 18.81%; P < 0.0001). Indeed, a significant higher prevalence of depression, anxiety, somatoform, childhood psychiatric disorder, and bipolar disorders was observed in females compared to males (P < 0.05). In addition, individuals between the age of 45–60 years, and those from rural areas showed more prevalence of mental disorders than others, but these differences were not significant.ConclusionsConsidering the previous studies in Iran, the prevalence of mental disorders among patients presenting to PHCs was noticeably lower than expected rates. It seems probable that this huge difference is due to poor screening and detection of mental illness in PHCs of MUMS. It is recommended that health policymakers pursue specific measures to make PHCs more helpful for people with mental health problems in the community.

Diagnostic Value of Radiographic Singh Index Compared to Dual-Energy X-Ray Absorptiometry Scan in Diagnosing Osteoporosis: A Systematic Review.

Since various medications can control the rate of fractures and subsequent complications of osteoporosis, the early detection of the disease is crucial. This systematic study aimed to compare the diagnostic accuracy of Singh index (SI) with dual-energy X-ray absorptiometry (DEXA) as a benchmark standard for diagnosing osteoporosis. The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) were utilized in the current study. A detailed search was carried out using PubMed and Scopus from inception to 30 May 2022. Examining quality of the studies was performed by the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2). A total of 22 studies were included. In general, 50% of the studies considered SI a poor screening tool for detecting osteoporosis due to a negligible inter-observer agreement between SI and DEXA or a poor correlation of SI with the bone mineral density (BMD) category or DEXA T-score. A moderate inter-observer agreement was reported for SI in 5 (55.6%) studies. Among the studies assessing the sensitivity and specificity of SI compared to DEXA (n=13), six studies estimated a low sensitivity for SI. While there is supporting evidence indicating the potential usefulness of SI for predicting femoral neck fractures in individuals with suspected osteoporosis, numerous studies challenge its reliability and diagnostic value as a screening tool for identifying femoral neck osteoporosis. Further primary studies are required to verify the effectiveness of the SI index in identifying populations at risk of osteoporosis.

Early adoption of innovation in HPV prevention strategies: closing the gap in cervical cancer.

Cervical cancer (CC) is one of the highest prevailing causes of female cancer-related mortality globally. A significant discrepancy in incidence has been noted between high and low-middle-income countries. The origins of CC have been accredited to the human papillomavirus (HPV) with serotypes 16 and 18 being the most prevalent. HPV vaccines, with 90%-97% efficacy, have proven safe and currently function as the primary prevention method. In addition, secondary prevention by timely screening can potentially increase the 5-year survival rate by >90%. High-precision HPV DNA testing has proven to be both highly sensitive and specific for early detection and is advocated by the WHO. Lack of public awareness, poor screening infrastructure and access to vaccines, socio-cultural concerns, along with economic, workforce-associated barriers and the presence of marginalised communities unable to access services have contributed to a continued high incidence. This article comprehensively analyses the efficacy, coverage, benefits and cost-effectiveness of CC vaccines and screening strategies including the transition from cytological screening to HPV self-sampling, while simultaneously exploring the real-world disparities in their feasibility. Furthermore, it calls for the implementation of population-based approaches that address the obstacles faced in approaching the WHO 2030 targets for CC elimination.

The importance of sample preparation techniques for use in mine site operational mineralogy

The use of automated mineralogy has been critical in understanding all stages of a mine cycle including; identification of potential ore phases for exploration projects; routine composites for monthly mineralogy trends including liberation of target phases plus identification of penalty phases; for mine closure; and the potential of reactions like carbon sequestration from mine waste in order to ensure efficient remediation. Whilst automated mineralogy is clearly a key technique, the quality of the data and how ‘automated’ the actual automated mineralogy process is, is driven by the accuracy and efficiency of sample preparation techniques. The need for on-site operational mineralogy is growing with the need for rapid turnaround of data to drive processing plants.This paper discusses the effects of poor sample preparation on the quality of automated mineralogy data outputs including liberation metrics, mineral abundance and grain size. Potential sources for error from preparation techniques include; inefficient cleaning of all utensils and the block itself; poor screening, deagglomeration and polishing of the sample; and the pressure to streamline these preparation techniques for optimisation of mine site laboratories in order to rapidly generate data to monitor daily processing plant activity. A further discussion touches on how automated is automated mineralogy, establishing that a large percentage of the process depends on the efficiency and accuracy of sample preparation and that research should be focused on optimising this stage of the process.

Novel uses for implanted haemodynamic monitoring in adults with subaortic right ventricles

BackgroundPulmonary hypertension (PH) is a common complication in patients with complete dextro-transposition of the great arteries (TGA) after atrial switch (D-TGA/AS) and congenitally corrected TGA (ccTGA). In this population with...

Factors influencing human papillomavirus vaccination uptake in European women and adolescents: A systematic review and meta-analysis.

Cervical Cancer (CC) lingers as a severe public health issue due to low vaccination coverage and poor screening addressability. Hence, this systematic review explored psychological factors influencing the Human Papilloma Virus (HPV) vaccination uptake in European women. As of September 2022, PubMed, EMBASE, Scopus, and Web of Science were systematically searched to include English studies assessing diverse factors influencing vaccination uptake in European women. Only studies comparing vaccinated with unvaccinated women were included. Quality assessment, publication attrition assessment, and sensitivity analyses were performed. Eighteen studies were included, totaling a population of 18,611 participants. Results indicated that knowledge about HPV infection could positively influence vaccination rates with an Odds Ratio (OR) of 1.82 and a confidence interval (CI) between 1.27 and 2.61, showing statistical significance at a Z value of 3.24 with a p-value of 0.001. Neither knowledge about HPV vaccination (OR=1.39, CI: 0.73-2.65, Z=1.01, p=0.31) nor knowledge about CC screening (OR=1.05, CI: 0.55-1.98, Z=0,14, p=0.89) seem to affect vaccination rates. Regardless, intention to undertake CC screening (CCS) showed an OR=1.68 in favor of the group intending to perform it, with a CI between 1.37 and 2.07, showing statistical significance at a Z=4.94 and p=0.00001. Other aspects affecting vaccination uptake were fear of side effects, insufficient information, and belief that chances of being infected are low. Results demonstrated that diverse aspects could affect the vaccination intent, while personalized interventions focusing on population and country characteristics need to be assembled to mitigate vaccination coverage.

Diagnostic accuracy of ePOS score in predicting DNR labeling after ICU admission: A prospective observational study (ePOS-DNR)

BackgroundResuscitation can sometimes be futile and making a do-not-resuscitate (DNR) decision is in the best interest of the patient. The electronic poor outcome screening (ePOS) score was developed to predict 6-month poor outcomes of critically ill patients. We explored the diagnostic accuracy of the ePOS score in predicting DNR decisions in the intensive care unit (ICU). MethodsThis study was conducted at the ICU of a tertiary referral hospital in Saudi Arabia between March and May 2023. Prospectively, we calculated ePOS scores for all eligible consecutive admissions after 48 h in the ICU and recorded the DNR orders. The ability of the score to predict DNR was explored using logistic regression. Youden's ideal cut-off value was calculated using the DeLong method, and different diagnostic accuracy measures were generated with corresponding 95 % confidence intervals (CIs). ResultsWe enrolled 857 patients, 125 received a DNR order and 732 did not. The average ePOS score of DNR and non-DNR patients was 28.2±10.7 and 15.2±9.7, respectively. ePOS score, as a predictor of DNR order, had an area under receiver operator characteristic (AUROC) curve of 81.8 % (95% CI: 79.0 to 84.3, P <0.001). Youden's ideal cut-off value >17 was associated with a sensitivity of 87.2 (95% CI: 80.0 to 92.5, P <0.001), specificity of 63.9 (95% CI: 60.3 to 67.4, P <0.001), positive predictive value of 29.2 (95% CI: 24.6 to 33.8, P <0.001), negative predictive value of 96.7 (95% CI: 95.1 to 98.3, P <0.001), and diagnostic odds ratio 12.1 (95% CI: 7.0 to 20.8, P <0.001). ConclusionsIn this study, the ePOS score performed well as a diagnostic test for patients who will be labeled as DNR during their ICU stay. A cut-off score >17 may help guide clinical decisions to withhold or commence resuscitative measures.

Cross-sectional study investigating the association between inflammatory biomarkers and neuropathy in adolescents with type 1 diabetes

ObjectivesThe aims of this study were to investigate circulating levels of inflammatory markers in adolescents with type 1 diabetes with and without different types of neuropathies and evaluate the association...

Women's perceptions with use of Implanon® contraceptive device at a primary healthcare facility in KwaZulu-Natal.

Early 2014, subdermal contraceptive implant was introduced in South Africa, Implanon® NXT, aiming to expand the method mix, increase effectiveness and availability to long-acting contraceptives. The initial uptake was extremely high, but concerns have been raised with treatment failure and high number of removals reported. The study focuses on describing women's perceptions with use of Implanon® at a primary health care (PHC) facility in KwaZulu-Natal. This study was conducted at a selected primary health care (PHC) facility in KwaZulu-Natal. A quantitative, descriptive study design was used. Through purposive sampling, a sample of 60 women from 15 to 50 years old were recruited. Data were gathered through a structured questionnaire and analysed using SPSS 24 software. Study findings show that slightly above half of respondents, 32 or 58.1% expressed satisfaction towards the implant, 20 or 40.9% had stopped using the implant as a result of its major implications. It was found that an edge above half of respondents continued using the implant 28 or 50.9%, while close to half had abandoned it (27 or 49.1%). Some respondents reported that they were experiencing heavy menstrual bleeding and low sex drive as serious unwanted side effects forcing them to stop using Implanon®. Side-effects and poor screening, counselling and support are major reasons for early removal. It is imperative to develop an effective screening tool and to re-train healthcare workers on Implanon® NXT. This article contributes to increase awareness of women's perceptions about Implanon® contraceptive.

Abstract P195: Association Of Unmet Social Needs With Antihypertensive Medication Prescription And Dietitian Referral: Interim Analysis Of The Study Of The Epidemiology Of Pediatric Hypertension Registry (SUPERHERO)

HTN is a significant public health concern with increasing prevalence in youth. Optimizing BP control with both lifestyle counseling and antihypertensive medications improves health outcomes. However, adequate BP control remains difficult in majority of patients, in part due to a lack of understanding of how social determinants of health affect dietitian referral and initiation of antihypertensive therapy. We performed a cross-sectional analysis of baseline EHR data from the SUPERHERO Registry in youth who received initial care from sub-specialists for HTN disorders defined by ICD-10 codes from 1/1/2015-12/31/2022. We excluded those with pregnancy, kidney transplantation, and dialysis. We examined the association of individual-level social drivers (transportation, finances, food access housing) with the likelihood of antihypertensive medication prescription and dietitian referral at initial visit in youth with HTN disorders using unadjusted generalized linear models. Of our large cohort of 11,580, only 47 youth had at least one unmet social need (0.4%). Participants with at least one unmet social need were 1.81 times more likely to be prescribed antihypertensive medication (95% CL 0.94- 3.48; p= 0.08) and 6.73 times more likely to be referred to a dietitian (95% CL 3.7-12.25). We found that children with at least one unmet social need were more likely to be referred to a dietitian at the initial visit than those without an unmet social need. The small number of participants with unmet social needs might reflect poor screening or documentation practices. It is imperative that screening for unmet social needs is incorporated into clinical practice in youth with HTN disorders.

Is there an association between intimate partner violence and the prevalence of cervical cancer screening in Jordan?

Major health inequalities exist surrounding the utilisation of cervical cancer screening services globally. Jordan, a low- and middle-income country, has poor screening rates (15.8%), with barriers to accessing services, including lack of education. Emerging studies demonstrate that intimate partner violence (IPV) impacts reproductive health decisions. As a large proportion of Jordanian women have reported experiencing IPV, this study examines the association between IPV and cervical cancer screening in Jordan, the first of its kind using national-level data. Using Jordan's Demographic Health Survey 2017-18, cervical cancer screening awareness and self-reported screening were estimated in participants who answered questions on IPV (n = 6679). After applying sample weights, Heckman's two-stage probit model determined the association of awareness and utilisation of cervical cancer screening with experience of IPV, adjusting for the socio-economic factors. Of the women with privacy to answer the IPV module, 180 (3.4%) were found to be victims of sexual violence, 691 of physical violence (12.6%) and 935 (16.2%) of emotional violence. Women subjected to sexual violence were less likely to admit to having awareness of a Pap smear test; however, this did not impact screening rates. Victims of emotional violence were more likely to be screened than non-victims. No association between physical violence and cervical cancer screening was found. A significant association between cervical screening awareness and IPV demonstrates that cancer screening policies must consider IPV among women to improve screening awareness. The paper further sheds light on the paradoxical association between emotional violence and screening. It is acknowledged this situation may be far worse than reported, as women without autonomy were unlikely to answer IPV questions that may endanger them-targeted surveys on cervical cancer screening warrant further investigation.

Development of the Clinical Interview for Bipolar Disorder (CIBD) – Rational and experts’ panel evaluation

Bipolar Disorder (BD) is underdiagnosed, and the average time gap between the onset and diagnosis due to poor screening is 7 years. This study aims to describe the development of the semi-structured Clinical Interview for Bipolar Disorder (CIBD) for diagnosing bipolar spectrum disorders and assessing the impact of psychological interventions, using a mixed method approach of clinician and interviewee ratings, with a recovery approach. Methods: CIBD was based on DSM-5 and developed by a multidisciplinary team. Firstly, a research review on BD assessment was conducted, and published guidelines from international BD experts were incorporated into the interview. Secondly, an expert panel formed by 9 psychiatrists, 8 psychologists, a nurse, and a neuropsychologist with expertise in BD was asked to assess it for clarity, pertinence, and completeness. Results: CIBD structure and sections were rated with high scores (range: 0-80) regarding usefulness (78.63), clarity (74.53), and completeness (77.63). The expert panel gave suggestions to clarify, add and change some instructions in the introduction, suicide risk scale for BD, and the empowerment scale, and an index was also added to help navigate the interview. Conclusion: CIBD is an acceptable and comprehensive tool for assessing BD and related disorders contributing to a recovery perspective and might be useful for tracing intervention improvements. Experts highlight the CIBD’s unique contributions, including the suicidality scale encompassing BD-specific risk factors, BD specifiers, and the assessment of clients’ empowerment. Overall, the CIBD seems to be a promising innovative instrument for diagnosing and assessing BD.