Background Fecal testing can only reduce colorectal cancer mortality if patients with an abnormal test result receive a follow-up colonoscopy. As part of the Strategies and Opportunities to STOP Colon Cancer in Priority Populations (STOP CRC) project, we examined factors associated with adherence to follow-up colonoscopy among patients with abnormal fecal test results. Methods As part of STOP CRC outreach, Virginia Garcia Memorial Health Center staff distributed 1,753 fecal immunochemical tests (FIT), of which 677 (39%) were completed, and 56 had an abnormal result (8%). Project staff used logistic regression analyses to examine factors associated with colonoscopy referral and completion. Results Of the 56 patients with abnormal FIT results; 45 (80%) had evidence of a referral for colonoscopy, 32 (57%) had evidence of a completed colonoscopy within 18 months, and 14 (25%) within 60 days of an abnormal fecal test result. In adjusted analysis, Hispanics had lower odds of completing follow-up colonoscopy within 60 days than non-Hispanic whites (adjusted OR = 0.20; 95% CI: 0.04, 0.92). Colonoscopy within 60 days trended lower for women than for men (adjusted OR = 0.25; 95% CI 0.06 – 1.04). Among the 24 patients lacking medical record evidence of a colonoscopy, 19 (79%) had a documented reason, including clinician did not pursue, patient refused, and colonoscopy not indicated. No reason was found for 21%. Conclusion Improvements are needed to increase rates of follow-up colonoscopy completion, especially among female and Hispanic patients.
This systematic review evaluates the efficacy and safety of l-arginine alone or in combination for the treatment of women with hypoactive sexual desire disorder (HSDD) or related conditions, such as female sexual interest/arousal disorder and female sexual arousal disorder. Medline, Embase, International Pharmaceutical Abstracts, Science Direct, and the Cumulative Index to Nursing and Allied Health Literature were searched using keywords “arginine”, “Lady Prelox”, “ArginMax”, “Stronvivo”, “Ristela”, “hypoactive sexual desire disorder”, “female sexual interest arousal disorder”, “female sexual arousal disorder”, “sexual dysfunction”, “sexual behavior”, “dyspareunia”, “libido”, and permutations thereof. Relevant records were retained if they were primary literature, conducted in women with HSDD or related conditions, and published as full text in English. Five randomized controlled trials and two nonrandomized studies met eligibility criteria. Six of the seven studies reported either an increase in the total mean Female Sexual Function Index score or significant increases in multiple domains therein. One study assessed vaginal pulse amplitude and found a statistically significant increase in a combination treatment group compared to placebo. No significant side effects were reported. Four of seven studies had potential risk-of-bias concerns per Cochrane assessments. This systematic review found that combination products containing l-arginine in the form of ArginMax or Lady Prelox may be considered for the treatment of HSDD and related conditions in women regardless of age.
INTRODUCTION: Breastfeeding reduces the risk of breast cancer. Disparities exist in breastfeeding with about 59% of African-American infants ever being breastfed versus 75% of white infants. One possible explanation is that African-American women may not be discussing benefits of breastfeeding. Thus, this pilot study explores the use of social media to engage pregnant African-American women in education about breastfeeding and to test its impact on breastfeeding outcomes. METHODS: This study was a randomized intervention enrolling eligible African-American women in Buffalo over 18 months into one of two private Facebook groups. The intervention arm received breastfeeding plus breast cancer risk-reduction messaging while the control arm received messaging about breastfeeding alone. A subset of the intervention and control arms failed to join the assigned Facebook group thus creating “true controls” for the study. Participants completed pre- and post-birth assessments. RESULTS: 288 women (N=135 in intervention arm, N=153 in control arm) were randomized into the study. Pre-birth, 76.7% of true controls, 74.7% of breastfeeding-only, and 85.9% of the intervention-group were planning to breastfeed, but, respectively, only 24.6%, 34.6%, and 32.9% exclusively breastfeed post-birth. Breast cancer risk perceptions did not differ between pre-birth and post-birth for the intervention group. The percentage of controls who responded that their risk was “very low” or “somewhat low” significantly increased from 61.5% at pre-birth to 80.0% at post-birth. CONCLUSION: Exclusive breastfeeding is high among groups receiving social media messaging. Therefore, continued and improved efforts should be made to use social media to promote breastfeeding and its benefits.
Purpose: This study evaluates a novel approach to address cancer disparities by incorporating a comprehensive clinical oncology outreach facility within the context of a primary care setting in Boston. We hypothesize that this unique oncology program will improve access to care for underserved populations, and may serve as a model system for other health disparity initiatives. Methods: The Whittier Street Health Clinic (WSHC) is a Federally Qualified Health Center, that provides comprehensive primary health care and support services for vulnerable communities. In 2012, the Dana-Farber Cancer Institute's Cancer Care Equity Program partnered with WSHC to develop an initiative aimed at streamlining cancer care and services to address cancer disparities in the underserved population Whittier serves. A retrospective chart review was performed to evaluate the impact of the program on patient outcomes, specifically timeliness of care/time to resolution and time to initiation of treatment. We have identified a cohort of patients (N = 50) who have been provided cancer-related services through this initiative from December 2012 to July 2013. All patients were ≥ 18 years old. Timeliness of care/time to resolution is defined as the amount of time elapsed between patient presentation until their reason for visit to the oncology facility has been resolved. Time to initiation of treatment was measured only for patients with newly diagnosed cancer; it is defined as the amount of time elapsed between patient presentation at the oncology facility to the start of treatment. T-tests and one-way ANOVA were carried out to determine if there were any statistically significant differences in the timeliness of care/time to resolution for different demographic subgroups. Results: In this cohort, 48% of patients self-identify as Black/African-American, 48% Hispanic, and 2% other. Forty-eight percent are men; 52% are women. Although the majority of patients are English-speaking (58%), a large proportion (38%) speaks Spanish. The average time to resolution for subjects was 29 days and 19 days for imaging and clinical evaluation respectively. This presents an overall reduction compared to baseline data (N = 38) from WSHC, which had an average of 67.7 days for time to resolution, which was mainly diagnostic resolution. A similar trend was also observed in time to initiation of treatment (52.5 days vs. baseline of 67.6 days). There is no statistically significant difference in the timeliness of care/time to resolution between different demographic subgroups served by the oncology program (e.g. English speakers vs. Spanish speakers, p = 0.336). Conclusion: The data supports our hypothesis that employing the use of a comprehensive oncology program within the context of an established community center improves access to specialized oncologic care for vulnerable populations. This unique model improves timeliness of care by reducing time to diagnostic resolution, which may ultimately help improve cancer outcomes. Citation Format: Ann Oluloro, Ann Oluloro, Karen M. Winkfield, Ludmila Svoboda, Laura Tesler Waldman, Christopher S. Lathan. Addressing cancer disparities through use of a novel community-based oncology program. [abstract]. In: Proceedings of the Sixth AACR Conference: The Science of Cancer Health Disparities; Dec 6–9, 2013; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2014;23(11 Suppl):Abstract nr A27. doi:10.1158/1538-7755.DISP13-A27
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.