Screening Behavior Research Articles

Do Swiss urologists and Swiss internists screen themselves and their relatives for prostate cancer? A questionnaire study.

Prostate-specific antigen (PSA) screening for men at risk of prostate cancer is controversial. The current recommendation is to raise awareness of prostate cancer and offer PSA screening in accordance with shared decision- making. Whether the possibility of a PSA screen is discussed with the patient depends on the treating physician, but data on physicians' attitudes towards PSA screening are scarce. This study aimed to examine internists' and urologists' personal PSA screening activity as an indicator of their attitude towards PSA screening. Members of the Swiss Society of Urology and the Swiss Society of General Internal Medicine were asked in 08/2020 to anonymously complete an online survey about personal PSA screening behaviour for themselves, their fathers, brothers and partners. Categorical and continuous variables were compared by chi-squared tests and t-tests, respectively. In total, 190/295 (response rate: 64%) urologists and 893/7400 (response rate: 12%) internists participated in the survey. Of the participants, 297/1083 (27.4%) were female. Male urologists >50 years of age screened themselves more often than male internists >50 years of age (89% vs 70%, p <0.05). Furthermore, urologists reported recommending screening statistically significantly more often than internists to their brother, father or partner regardless of their sex (men: 38.1% vs 18.5%; p <0.05; women: 81.8% vs 32.2%; p <0.05). CONCLUSIONS: Most participating male physicians >50 years of age have screened themselves for prostate cancer. Furthermore, PSA screening of relatives was significantly associated with the urology specialty. The reasons physicians screen themselves substantially more often than the public and why male and female urologists as well as male internists perform PSA screening more frequently in their private environment than female internists should be further examined.

Changes in Cancer Screening Knowledge Among a Prospective Cohort of Spanish-Speaking Hispanic Community Outreach Event Participants in Florida and Puerto Rico.

The current study examined cancer prevention and early detection awareness (pre-workshop) and changes in knowledge (from pre- to post-workshop) among Hispanic/Latino (H/L) community members who participated in Spanish-language educational outreach events in Puerto Rico (PR) and Florida (FL). Spanish-language educational outreach events were comprised of an educational session lasting approximately 45-60min and were delivered to groups in rural and urban community settings by a single trained community health educator (CHE). The research team assessed sociodemographic characteristics, personal and familial cancer health history, as well as awareness and knowledge (pre-test) of a range of cancer prevention and screening topics. Following the presentation, participants completed a post-test knowledge survey which also measured likelihood of engaging in cancer screening, cancer preventive behaviors, and cancer research as a result of information presented during the session. Change in the average knowledge score was evaluated using a paired samples t-test. Post-session likelihood of completing cancer screening and preventive behaviors and engaging in cancer research were examined using descriptive statistics and group/site comparisons. The percentage reporting awareness of screening procedures ranged from 33% (PSA test) to 79% (mammogram). H/L in PR reported higher percentage of stool blood test awareness when compared to H/L in FL (χ2(1)= 19.20, p<.001). The average knowledge score increased from 5.97 at pre-test to 7.09 at post-test (Cohen's d=0.69). The increase was significant across all participants (t(315)= 12.4, p<.001), as well as within the FL site (t(124)= 6.66, p<.001, d=0.59) and the PR site (t(190)=10.66, p<.001, d=0.77). Results from this study suggest that educational outreach events delivered to H/L community members by a CHE are valuable strategies to address challenges regarding cancer screening knowledge and engagement in multiple behaviors.

Rasch Analysis of the Behavioral Assessment Screening Tool for Adolescents (BAST-A) in Mild Traumatic Brain Injury

Rasch Analysis of the Behavioral Assessment Screening Tool for Adolescents (BAST-A) in Mild Traumatic Brain Injury

An Intersectional Approach to Examining Breast Cancer Screening among Subpopulations of Black Women in the United States.

This study examines breast cancer screening behavior among subpopulations of Black women in the United States. Binary logistic regression was used to analyze breast cancer screening among a nationally-representative sample (n = 9,783) of Black women-US-born, non-US-born Caribbean, and non-US-born African-from the 2011-2017 National Health Interview Survey dataset. Non-US-born African Black women were less likely to have breast cancer screening, compared to US-born Black women. Among non-US-born Black women, non-US-born Caribbean Black women were more likely to have had breast cancer screening. Differential healthcare access associated with nativity differences among Black women can be informing their breast cancer screening behaviors. Efforts to improve breast cancer outcomes among Black women can benefit from interventions that account for differential access to healthcare and breast cancer screening behaviors among subgroups of Black women.

Systematic analysis of circadian disrupting substances with a high-throughput zebrafish circadian behavior screening approach

Circadian rhythm aligns numerous biological functions in majority of animals. Aside from well-known external factors such as the light-dark cycle and temperature, circadian rhythm can also be regulated by rarely explored factors such as synthetic substances. Here, we established a circadian behavior screening approach utilizing zebrafish larvae model, which integrated high-throughput capabilities with automated batch processing. With this approach, we systematically analyzed the circadian disruptive effects of >60 synthetic substances commonly detected in aquatic environment by assessing both the circadian period length and amplitude of circadian behavior, with an exposure concentration set at 100 μg/L. Among tested substances, a series of circadian disrupting compounds (circadian disruptors) were identified. Several categories of the hit compounds can be recognized, such as phthalate (diisopentyl phthalate (DIPP), with 10.1 % and 49.6 % increases for circadian period length and amplitude, respectively), neuroactive substance (mirtazapine, with 10.6 % and 63.1 % increases, respectively), and biocides (thiamethoxam, with 100.3 % increase for amplitude). Among these compounds, DIPP increased circadian period length and amplitude with a high degree. Aside from DIPP, we further examined eleven other phthalates and demonstrated that benzyl butyl phthalate, diisobutyl phthalate and diisohexyl phthalate could also significantly increase the zebrafish circadian period length by 7.9 %, 3.7 % and 8.5 %, respectively. Collectively, the present findings substantiated the feasibility of this high throughput screening strategy for circadian disruptor's discovery and provided novel insights into understanding of the potential risks of synthetic substances.

Mammography screening beliefs and barriers through the lens of Black women during the COVID-19 pandemic.

Mammography is an effective screening tool that leads to decreased breast cancer mortality, yet minority women continue to experience barriers. The coronavirus disease 2019 (COVID-19) pandemic has been proven to have negatively affected minority communities, yet its effect on mammography screening habits in Black women is uncertain. The purpose of this study was to evaluate breast cancer mammography screening habits and barriers for Black women in two northeast communities amid the COVID-19 pandemic. The study participants were Black women aged 40years or older who were recruited from community outreach initiatives. Study coordinators conducted telephone surveys to determine mammography screening behaviors, perceptions, and psychosocial factors. Two hundred seventy-seven surveys were completed. Two hundred fifty-six patients who reported ever having a mammogram became the study population of interest. One hundred seventy-four of these patients (68%) reported having a mammogram within the past year (nondelayed), and 82 (32%) had a mammogram more than a year ago (delayed). Only thirty-one of the delayed participants (37.8%) had private insurance. There was a significant difference in the mean score for mammography screening perceived barriers for nondelayed participants (mean=9.9, standard deviation [SD]=3.6) versus delayed participants (mean=11.2, SD=4.3, p=.03). There was also a significant difference in the mean score when they were asked, "How likely is it that 'other health problems would keep you from having a mammogram'?" (p=.002). Barriers to mammography screening for Black women during the COVID-19 era include insurance, competing health issues, and perceptions of screening. Community outreach efforts should concentrate on building trust and collaborating with organizations to improve screening despite the COVID-19 pandemic.

Does genetic risk modify the effect of skin screening on melanoma detection rates?

Skin screening is associated with higher melanoma detection rates, a potential indicator of overdiagnosis, but it remains possible that this effect is due to confounding by genetic risk. To compare melanoma incidence among screened vs. unscreened participants within tertiles of genetic risk. We investigated melanoma incidence in the QSkin study, a prospective cohort study which for this analysis comprised 15 283 participants aged 40-69 years with genotype data and no prior history of melanoma. We calculated a polygenic score (PGS) for melanoma. We first calculated the age-standardized rate (ASR) of melanoma within PGS tertiles, and then measured the association between skin examination and melanoma detection by calculating the hazard ratio (HR) and 95% confidence interval (95% CI), overall and within PGS tertiles. Melanoma incidence increased with PGS (ASR per 100 000 per year): tertile 1 = 442; tertile 2 = 519; tertile 3 = 871. We found that the HRs for all melanomas (i.e. in situ and invasive) associated with skin examination differed slightly across PGS tertiles [age- and sex-adjusted tertile 1 HR 1.88 (95% CI 1.26-2.81); tertile 2 HR 1.70 (95% CI 1.20-2.41); tertile 3 HR 1.96 (95% CI 1.43-2.70); fully adjusted tertile 1 HR 1.14 (95% CI 0.74-1.75); tertile 2 HR 1.21 (95% CI 0.82-1.78); tertile 3 HR 1.41 (95% CI 1.00-1.98)], but these differences were not statistically significant. HRs for in situ melanoma associated with skin examination were similar across PGS tertiles. For invasive melanomas, the point estimates appeared to be highest in PGS tertile 3 in both the minimally adjusted (age, sex) and fully adjusted models; however, these apparent differences were also not statistically significant. Genetic risk predicts subsequent melanoma incidence, and is weakly associated with screening behaviour, but it does not explain the higher rate of melanoma detection between screened and unscreened people.

Colorectal Cancer Screening Decision Based on Predicted Risk: Protocol for a Pilot Randomized Controlled Trial.

Incidence of and mortality from colorectal cancer (CRC) can be effectively reduced by screening with the fecal immunochemical test (FIT) or colonoscopy. Individual risk to develop CRC within 15 years varies from <1% to >15% among people aged 50 to 75 years. Communicating personalized CRC risk and appropriate screening recommendations could improve the risk-benefit balance of screening test allocations and optimize the use of limited colonoscopy resources. However, significant uncertainty exists regarding the feasibility and efficacy of risk-based screening. We aim to study the effect of communicating individual CRC risk and a risk-based recommendation of the FIT or colonoscopy on participants' choice of screening test. We will also assess the feasibility of a larger clinical trial designed to evaluate the impact of personalized screening on clinical outcomes. We will perform a pilot randomized controlled trial among 880 residents aged 50 to 69 years eligible to participate in the organized screening program of the Vaud canton, Switzerland. Participants will be recruited by mail by the Vaud CRC screening program. Primary and secondary outcomes will be self-assessed through questionnaires. The risk score will be calculated using the open-source QCancer calculator that was validated in the United Kingdom. Participants will be stratified into 3 groups-low (<3%), moderate (3% to <6%), and high (≥6%) risk-according to their 15-year CRC risk and randomized within each risk stratum. The intervention group participants will receive a newly designed brochure with their personalized risk and screening recommendations. The control group will receive the usual brochure of the Vaud CRC screening program. Our primary outcome, measured using a self-administered questionnaire, is appropriate screening uptake 6 months after the intervention. Screening will be defined as appropriate if participants at high risk undertake colonoscopy and participants at low risk undertake the FIT. We will also measure the acceptability of the risk score and screening recommendations and the psychological factors influencing screening behavior. We will also assess the feasibility of a full-scale randomized controlled trial. We expect that a total sample of 880 individuals will allow us to detect a difference of 10% (α=5%) between groups. The main outcome will be analyzed using a 2-tailed chi-squared test. We expect that appropriate screening uptake will be higher in the intervention group. No difference in overall screening uptake is expected. We will test the impact of personalized risk information and screening recommendations on participants' choice of screening test in an organized screening program. This study should advance our understanding of the feasibility of large-scale risk-based CRC screening. Our results may provide insights into the optimization of CRC screening by offering screening options with a better risk-benefit balance and optimizing the use of resources. ClinicalTrials.gov NCT05357508; https://www.clinicaltrials.gov/study/NCT05357508. DERR1-10.2196/46865.

Validity and Reliability of a Thai Behavioral and Emotional Screening Tool for Children with Enuresis (TBEST-E)

Objective: Psychological comorbidity in children with enuresis is common and its screening is recommended. A brief validated screening instrument is needed for a busy medical practice. This study focused on the development of the Thai Behavioral and Emotional Screening Tool for children with Enuresis (TBEST-E) and aimed to examine its psychometric properties. Materials and Methods: Using the Short Screening Instrument for Psychological Problems in Enuresis (SSIPPE) as a template, the 15-item with a yes/no answer format of the TBEST-E was developed for the screening of emotional problems (7 items), attention and hyperactivity/impulsivity problems (3 items each), and oppositional defiant symptoms (2 items). The parents of the children with enuresis completed the TBEST-E and the behavioral rating scale “Thai Youth Checklist” (TYC). The optimal cut-off for further assessment, the sensitivity, and the specificity the TBEST-E were identified using receiver operating characteristic (ROC) curves. Results: After an adaptation following comments from three child psychiatrists, the TBEST-E showed a content validity of 0.9, an internal consistency of 0.71. A total of 33 children with enuresis (median age = 9, interquartile range = 6.5-11 years) were recruited. Further assessment was indicated when one of the following occurred; at least 3 emotional problems; 3 attention problems; or 2 hyperactivity/impulsivity together with 2 oppositional defiant symptoms. The overall sensitivity and specificity were 0.88 and 0.71 respectively with the accuracy of 0.84 (95% CI = 0.68-0.95). Conclusion: The TBEST-E is time-efficient and has acceptable psychometric properties in early detection of common psychological problems in children with enuresis.

41152 Skin Cancer Screening Behaviors in Sexual Minorities Among Adults in the United States

41152 Skin Cancer Screening Behaviors in Sexual Minorities Among Adults in the United States

The relationship between perceived self-efficacy and cervical cancer screening among health care providers

Introduction: Cervical cancer ranks second worldwide as a disease that causes death in women. Healthcare providers have low cervical cancer screening behavior with the Pap smear method. This study aimed to analyze the relationship between perceptions of self-efficacy and the behavior of cervical cancer screening using the Pap Smear method for health care providers.Methods: This descriptive observational study, namely case cross-sectional design, was applied in this study. The population in this study were all female healthcare providers at the Gotong Royong Hospital in Surabaya. The sampling method is purposive sampling. The sample in this study was 51 respondents who met the inclusion criteria. The independent variable in this study is perceived self-efficacy, using a questionnaire. The dependent variable is the screening behavior of the pap smear method using the questionnaire. Results: The results of the analysis test were 0.866 &gt; 0.05, which means there is no relationship between perceived self-efficacy on cervical pap smear cancer screening behavior. Spearman Rank test p&gt; 0.05, which means there is no relationship between perceptions of self-efficacy and healthcare providers’ screening behavior for cervical smears. Conclusion: There is no relationship between self-efficacy on the behavior of cervical cancer screening using the Pap smear method. Individual intrinsic and extrinsic factors are things that influence screening behavior. So, it is necessary to do other research on the factors influencing screening behavior, both intrinsic (demographics, health beliefs, emotional, and contextual) and extrinsic (husband support, peer support and education). Keywords: cervical cancer; medical personnel; pap smear; paramedics

Towards A Behavioural Screening Tool for Primary Psychological Triage

Rationale: Following a mass casualty event, the primary psychological triage of survivors based on clinical symptomatology is difficult for volunteer rescuers who lack the necessary knowledge of mental health issues and are under significant time pressure. To address this concern, descriptive screening tools are needed. In this context, propositions for a triage tool have taken the form of means to describe traumatic exposure or the survivors’ comorbidity factors. Objective: Alternatively, we propose a behaviour-based screening tool built on the Defence Cascade Model. This model assumes that survivors’ behaviours involve a range of motor and physiological defensive reactions. After developing this new kind of screening tool, we tested its reliability and validity. Method: Forty professionals who usually intervene in early psychological intervention units randomly rated a series of survivors’ profiles with either the behavioural tool or a tool based on classical categories of symptoms used as a control condition. The two screening tools were developed by a group of nine experts. Inter-rater reliability (unweighted kappa and Fleiss’ Kappa indexes), criterion validity (Spearman’s Rho and Kendall’s Tau indexes), face validity (subjective evaluation) and construct validity (modal classes of items) were calculated and compared between the two tools. Results: The results show that behavioural screening is significantly more reliable, while showing a significant correlation with symptom-based screening in terms of prioritisation. It also appears to be simpler than symptom screening, with most references to similar clinical concepts.

Understanding the behavioral determinants that predict barriers and enablers of screening and treatment behaviors for diabetic retinopathy among Bangladeshi women: findings from a barrier analysis

Background and aimWhile early detection and timely treatments can prevent diabetic retinopathy (DR) related blindness, barriers to receiving these DR services may cause permanent sight loss. Despite having similar prevalence to diabetes and DR, women are less likely than men to perform these behaviors due to multi-faced barriers in screening and receiving follow-up treatments for DR. This study, therefore, aimed at identifying the barriers to – and enablers of – screening and follow-up treatments behaviors for DR among women aged more than 40 years with diabetes from the behavioral perspectives in Bangladesh.MethodsThis Barrier Analysis study interviewed 360 women (180 “Doers” and 180 “Non-doers”) to explore twelve behavioral determinants of four DR behaviors including screening, injection of anti-vascular endothelial growth factor (anti-VEGF medication), laser therapy and vitro-retinal surgery. The data analysis was performed to calculate estimated relative risk to identify the degree of association between the determinants and behaviors, and to find statistically significant differences (at p < 0.05) in the responses between the Doers and Non-doers.ResultsAccess to healthcare facilities was the major barrier impeding women from performing DR behaviors. Difficulty in locating DR service centers, the need to travel long distances, the inability to travel alone and during illness, challenges of paying for transportation and managing workload significantly affected women’s ability to perform the behaviors. Other determinants included women’s perceived self-efficacy, perceived negative consequences (e.g. fear and discomfort associated with injections or laser treatment), and cues for action. Significant perceived enablers included low cost of DR treatments, supportive attitudes by healthcare providers, government policy, and perceived social norms.ConclusionThe study found a host of determinants related to the barriers to and enablers of DR screening and treatment behaviors. These determinants included perceived self-efficacy (and agency), positive and negative consequences, perceived access, perceived social norms, culture, and perceived risk. Further investments are required to enhance the availability of DR services within primary and secondary health institutions along with health behavior promotion to dispel misconceptions and fears related to DR treatments.

Enhancing Kindergarten Teachers' Capacity: IT-Based Screening for Maladaptive Behavior During COVID-19

&#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; In the context of the COVID-19 pandemic, the surge in maladaptive behavior among kindergarten students presents a pressing educational concern. Swift identification of such behaviors is crucial for effective intervention. This quantitative experimental study investigates the efficacy of the "Utilization of Information Technology-based Maladaptive Behavior Screening" training in bolstering the competence of teachers. Through quasi-experimental methods, 49 teachers from 'Aisyiyah Bustanul Athfal in Sidoarjo Regency participated in the training. The assessment tool employed was a comprehension test. Statistical analysis via paired samples t-test revealed a significant enhancement (p = 0.009; p &lt; 0.05) between pre- and post-training performance. The intervention showcased substantial effectiveness (rs = 0.053; rs &gt; 0.5) in elevating the teaching quality at 'Aisyiyah Bustanul Athfal. This study underscores the importance of IT-based tools in addressing maladaptive behavior issues and fortifying teacher aptitude amidst challenging circumstances, with implications extending to diverse educational settings.&#x0D; Highlight:&#x0D; &#x0D; Educational Imperative: The study addresses the heightened maladaptive behavior in kindergarten students during the COVID-19 pandemic, emphasizing the urgency of timely identification for effective intervention.&#x0D; IT-Based Training Impact: The research examines the positive impact of "Utilization of Information Technology-based Maladaptive Behavior Screening" training on teacher competence, demonstrated through significant performance enhancement.&#x0D; Broader Significance: The study reveals the broader applicability of IT-based tools in ameliorating maladaptive behavior issues and enhancing teaching quality, with implications extending to diverse educational settings.&#x0D; &#x0D; Keyword: Maladaptive Behavior, Kindergarten, COVID-19, Information Technology, Teacher Training&#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D;

“I Use Strawberry Flavoured Condoms during My Periods”: Safe Sex Practices and STI Screening Behaviours among Female Sex Workers in Gulu City, Uganda

Background: Female sex workers (FSWs) are at a higher risk of contracting and transmitting HIV and other sexually transmitted infections (STIs). We aimed to explore the sexual behaviour, knowledge and attitudes towards STIs, barriers, support and intervention for STI screening. Methods: In this community-based, concurrent quantitative–qualitative, exploratory mixed-methods study, we administered 87 semi-structured quantitative and six in-depth interviews to purposively select FSWs in Gulu City, Uganda. The qualitative methodology was based on descriptive phenomenology. Results: The quantitative study included 87 FSWs, with a median age of 28 years. Overall, 87.4% (n = 76) participants reported condom use during their last sexual encounter. Eighty-three (95.4%) participants were aware of their HIV status, with 6% (n = 5) reporting being HIV-positive. Seventy-six (87.4%) participants reported contracting at least one STI during sex work. In addition, 66.7% (n = 58) of the participants reported being screened for STIs in the past three months, with vulvovaginal candidiasis (55.3%, n = 42) and syphilis (32.9%, n = 25) being the most common STIs. However, only 2.3% (n = 2) of the participants reported current STIs symptoms. In the qualitative study, the main themes encompassed sexual behaviour, including condom-use negotiation strategies and challenges, as well as screening facilitators and barriers. Condom-use negotiation tactics involved leveraging health-risk information, increased charges for unprotected sex, and outright refusal. Complex challenges included limited agency in promoting safe sex due to economic reliance, vulnerability to violence, and difficulties in controlling the sexual environment. Facilitators for regular screening included social influences, emotional relief, established testing habits, and accessible clinics, while barriers encompassed cost, stigma, doubts about test accuracy, and inconvenient clinic hours. Conclusions: FSWs face significant vulnerabilities in Gulu City, Uganda, regarding STIs. While encouraging trends such as high HIV awareness and condom usage were observed, persistent challenges in STI screening, negotiation of safe sex practices, and access to prevention and treatment remain evident. To address these concerns, targeted interventions should be developed to enhance STI screening accessibility, empower sex workers with effective negotiation skills, and provide comprehensive support for STI prevention and treatment, thereby contributing to improved overall sexual health and well-being among this marginalized population.

Rural barriers and facilitators of lung cancer screening program implementation in the veterans health administration: a qualitative study.

To assess healthcare professionals' perceptions of rural barriers and facilitators of lung cancer screening program implementation in a Veterans Health Administration (VHA) setting through a series of one-on-one interviews with healthcare team members. Based on measures developed using Reach Effectiveness Adoption Implementation Maintenance (RE-AIM), we conducted a cross-sectional qualitative study consisting of one-on-one semi-structured telephone interviews with VHA healthcare team members at 10 Veterans Affairs medical centers (VAMCs) between December 2020 and September 2021. An iterative inductive and deductive approach was used for qualitative analysis of interview data, resulting in the development of a conceptual model to depict rural barriers and facilitators of lung cancer screening program implementation. A total of 30 interviews were completed among staff, providers, and lung cancer screening program directors and a conceptual model of rural barriers and facilitators of lung cancer screening program implementation was developed. Major themes were categorized within institutional and patient environments. Within the institutional environment, participants identified systems-level (patient communication, resource availability, workload), provider-level (attitudes and beliefs, knowledge, skills and capabilities), and external (regional and national networks, incentives) barriers to and facilitators of lung cancer screening program implementation. Within the patient environment, participants revealed patient-level (modifiable vulnerabilities) barriers and facilitators as well as ecological modifiers (community) that influence screening behavior. Understanding rural barriers to and facilitators of lung cancer screening program implementation as perceived by healthcare team members points to opportunities and approaches for improving lung cancer screening reach, implementation and effectiveness in VHA rural settings.

Sexual orientation and gender identity inequities in cervical cancer screening by race and ethnicity.

In the United States, inequities in preventive health behaviors such as cervical cancer screening have been documented. Sexual orientation, gender identity, and race/ethnicity all individually contribute to such disparities. However, little work has investigated their joint impact on screening behavior. Using sampling weighted data from the 2016 and 2018 Behavioral Risk Factor Surveillance System, we assessed differences in two metrics via chi-square statistics: 1) lifetime uptake, and 2) up-to-date cervical cancer screening by sexual orientation and gender identity, within and across racial/ethnic classifications. Within all races, individuals who identify as members of sexual and gender minority (SGM) communities reported higher rates of never being screened (except for Black transgender men) than straight or cisgender individuals (p < 0.0001). [*START*Across all races, the Asian/Pacific Islander transgender population (32.4%; weighted n (w.n.) = 1,313) had the lowest proportion of lifetime screening, followed by the Asian/Pacific Islander gay/lesbian (53.0%, w.n. = 21,771), Hispanic transgender (58.7%; w.n. = 24,780), Asian/Pacific Islander bisexual (61.8%, w.n. = 54,524), and Hispanic gay/lesbian (69.6%, w.n. = 125,781) populations. *END*]Straight or cisgender Non-Hispanic White (w.n. = 40,664,476) individuals had the highest proportion of lifetime screening (97.7% and 97.5%, respectively). However, among individuals who had been screened at least once in their lifetime, identifying as SGM was not associated with a decreased proportion of up-to-date screening within or between races. Due to small sample sizes, especially among Asian/Pacific Islander and Hispanic populations, confidence intervals were wide. Heterogeneity in screening participation by SGM status within and across racial/ethnic groups were observed. These screening disparities reveal the need to disaggregate data to account for intersecting identities and for studies with larger sample sizes to increase estimate reliability.

Particle Behavior and Aperture Optimization of Variable Vibration-Amplitude Screening Based on Discrete Element Method Simulation.

Recently, some novel screens were proposed based on the improved understanding of screening processes from particle-scale studies, one of which is the novel variable amplitude equal thickness vibration screen (VAETVS). This paper presents an investigation of using different aperture sizes to further optimize the VAETVS by the discrete element method (DEM). The screen was divided into three panels, and the aperture size of each panel was varied in the simulation. The particles' dynamics and spatial distribution were investigated to better understand the effects of varied amplitudes and aperture sizes on the screening efficiency. The results showed that the VAETVS can be effectively optimized by varied amplitude as well as varied aperture size for different screen panels. The amplitude variance is more effective for hard sieve particles and hindrance particles. It is also found that from the feed end to the discharge end, the difference in the distribution of particle mass between the coarse particles and the fine particles increases. Generally, such a difference can be increased with increasing aperture sizes. However, the effects of the apertures of the different panels were not the same. The simulated data were further analyzed by the Box-Behnken response surface method, which gave a mathematical model to predict the screening efficiency η with the varied apertures. From the model, the optimal aperture sizes are 7.5, 7.58, and 6.81 mm, yielding the maximum screening efficiency of 86.35%, and the optimal opening areas for the three panels are 35, 40, and 40%, respectively, yielding the maximum screening efficiency of 87.82%.

The impact of social media on guideline-concordant cervical cancer–screening: insights from a national survey

ObjectivesCervical cancer is one of the leading causes of cancer mortality in women, yet routine screenings lead to early detection and sometimes even prevention. Screening is an effective way to prevent cervical cancer, and it has been implemented in many countries and regions worldwide, especially in developed countries. However, the incidence of cervical cancer remains a public health problem due to screening disparities in the population. Social media engagement and overloading of online health information may be the cause of this disparity. Study designCross-sectional study. MethodsData from the Health Information National Trends Survey (a national survey conducted by the National Cancer Institute) was used to characterise cervical cancer screening into two dimensions; namely, high-frequency screening and guideline-concordant screening. The differences between these two screening frequency behaviours were compared by applying ordered logistic regression and binary logistic regression, and the mechanisms of guideline-concordant screening were explored. ResultsThe factors influencing high-frequency screening and guideline-concordant screening were different. Only self-efficacy (odds ratio [OR] = 1.16; 95% confidence interval [CI] = 0.98, 1.37) had a significant positive association with the high-frequency screening behaviour. Social media engagement (OR = 0.57; 95% CI = 0.33, 0.96) was shown to have a significant negative impact on guideline-concordant screening. A theory-based mechanism of screening behaviour found that traditional health perception factors no longer influence guideline-concordant screening behaviour, whereas environmental factors (e.g., social media) significantly reduce guideline-concordant screening behaviour. ConclusionsThe results from this study indicate that while the internet has become the main channel through which women acquire health resources, and social media has become a main platform for people to obtain health information, online information cannot guide people to engage in appropriate healthy behaviours. Overloading of online health information and the digital divide may lead to excessive screening. Consequently, it is important to address the screening disparity caused by health behaviours as a result of environmental factors and the digital divide.

Student Demographics as Predictors of Risk Placements via Universal Behavioral Screening

Student Demographics as Predictors of Risk Placements via Universal Behavioral Screening