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Breaking Down Barriers: A Literature Review Understanding Cervical Cancer Screening in Hispanic Women
Get PDFBackground/Purpose:
Hispanic women have one of the highest cervical cancer rates, with a 32% higher incidence than non-Hispanic white women1. This highlights a gap in critical preventive care within the Hispanic community. This review aims to explore these barriers Hispanic women face in accessing cervical cancer screenings and what can be done to address them.
Methods:
Barriers to cervical cancer screening in Hispanic women were identified through peer-reviewed articles from PubMed. Three independent researchers assessed journal eligibility based on publication date, relevance, and study quality. The search utilized the keywords “cervical cancer,” “screening,” “Hispanic women,” and “Latinas,” and was limited to publications from 2014 to 2024, yielding 13 articles included in this study.
Results:
The literature identifies significant barriers faced by Hispanic women in attaining cervical cancer screenings. Structural obstacles include lack of transportation, lack of language con-cordant providers, and inadequate health insurance.2,3,4,5 Social factors, particularly low health literacy contribute to decreased awareness of risk factors and screening guidelines.5,6 Concerns about embarrassment and fear exacerbate these barriers particularly when the provider is male or when patients face uncertainty with their documentation status.2,6 Cultural influences rooted in Hispanic communities like machismo and fatalismo negatively impact compliance with screening while religion was shown to positively impact screening compliance.3,4,7 Despite studies efforts to address these barriers, many cited the need for further research8.
Conclusion:
This review highlights significant structural, social, and cultural barriers to cervical cancer screening among Hispanic women and stresses continued need for culturally relevant education, low or no cost screening programs, and language concordant providers. Next steps should focus on understanding barriers to follow-up after abnormal pap smears where additional needs have been identified9
Electronic Health Record Documentation of Cannabis Use in Pregnancy: A retrospective chart review
Get PDFIntroduction: Cannabis is the most commonly used federally illicit drug during pregnancy. Despite its rising prevalence, there are few well-controlled studies evaluating the impact of prenatal cannabis use (PCU) on fetal development, and clinical guidelines addressing PCU are limited. This study examines electronic health record (EHR) documentation of PCU to better understand how PCU is addressed within obstetric encounters.Methods: A retrospective chart review was performed on 8,323 patients with pregnancy outcomes in 2023 at a Midwestern healthcare system. Patients with and without documented PCU were identified using ICD-10 codes and positive urine drug screen (UDS) results. A random sample of patients was then selected for chart review: 64 with and 68 without documented PCU.Results: PCU prevalence in our sample was 11.3% (937/8,323). We identified 477 patients with a cannabis-related diagnosis, 829 with a positive UDS, and 369 with both. Qualitative assessment of individual chart reviews demonstrates that PCU is frequently recorded without an accompanying ICD-10 diagnosis, appearing instead in open notes or as a positive UDS lab result. Provider documentation of actions to address PCU varied widely, and patient-provider discussions about PCU were not consistently documented.Conclusions/Implications: These preliminary data reveal considerable variability in PCU documentation within the EHR of a large healthcare system, which may be due to stigma surrounding cannabis use, available clinic resources, or lack of prioritization and provider comfort in addressing PCU. Findings underscore the need for standardized protocols to address PCU in obstetric settings, particularly in the context of increased cannabis legalization
Minimum Clinically Important Difference Values for PROMIS PI and UE After Distal Radius Fractures in Operative vs. Non-Operative Procedures
Get PDFTitle: Minimum Clinically Important Difference Values for PROMIS PI and UE After Distal Radius Fractures in Operative vs. Non-Operative Procedures
Authors: Michaela Rasmussen, Mary Zylinski, Nebiyat M. Girma, Rahul Bodapati, Charles S. Day
Introduction: The minimum clinically important difference (MCID) is the smallest change after a procedure that is meaningful to the patient. However, there is limited data on the MCID for operative and non-operative treatment of distal radius fractures (DRF) which could provide objective data for both providers and patients, in treatment planning and postoperative counseling.
Methods: This retrospective cohort study included patients treated for distal radius fractures (DRF) in 2020-2024 by fellowship-trained orthopedic trauma surgeons at an urban, academic health system. Patients undergoing additional procedures or with incomplete questionnaires were excluded. Preoperative surveys were taken on the day of surgery or the last recorded survey, while post-operation surveys were completed between 3 weeks to 3 months after surgery. The study used the PROMIS Upper Extremity (UE) and Pain Interference (PI) questionnaires. The MCID was calculated using a distribution-based method (0.5 and 0.8 times the standard deviation of changes in scores). The minimum detectable change (MDC) was also calculated (MDC95). The final MCID for each PRO instrument was defined as the median of the three methods.
Results:
For non-operative DRF, the mean difference was 6.7 (PROMIS UE) and –7.5 (PROMIS PI), while operative DRF had a mean difference of 7.6 (PROMIS UE) and –7.8 (PROMIS PI). The distribution-based MCID for operative DRF was 5.4 (PROMIS UE) and 5.7 (PROMIS PI) whereas for non-operative DRF the MCID was 6.8 (PROMIS UE) and 4.9 (PROMIS PI). Conclusions: Both PROMIS UE and PROMIS PI showed statistically significant improvements in both operative and non-operative treatments. The MCID differences suggest greater pain reduction is needed for operative procedures to be clinically significant, while increased functional improvement is required for non-operative treatments. These findings can guide orthopedic practice, helping physicians discuss expected outcomes with patients, enabling them to make more informed decisions about treatment options for DRF
Mother Scaffolding and Adolescent Meaning-Making in Recollections of Turning Point Events: Links With Adolescent Development and Adjustment
Get PDFLife storytelling is a key method for developing the self, and family storytelling is an important setting for parents and adolescents to jointly make sense of adolescent experiences. Early adolescence is a key time for building a clearer sense of self. We studied mother scaffolding and adolescent meaning-making as adolescents recounted turning points in their lives. We recruited 30 mother-adolescent dyads (adolescent Mage = 12.8 years; 53.3% boys; 76.7% White). Adolescents were video-recorded sharing a life story about an important turning point in life with mothers. Adolescents also completed self-reports about family knowledge, attachment security, identity development, and well-being. Forms of mother scaffolding and adolescent meaning-making were correlated, and both scaffolding and meaning-making were correlated with adolescents’ reports about their development. Findings reinforce the continued importance of parental support and growing importance of deep reasoning in early adolescence, as youth are finding their place in the world
Brain Candy: Wayne State University School of Medicine Journal of Arts and Culture, 12th Edition
Get PDFBrain Candy incorporates paintings, written pieces, and poetry from all the medical classes at Wayne State University School of Medicine to shed light on the creative process in medicine, the city of Detroit, and the experiences of health care providers. This year, the journal is organized into four sections, each of which denotes a particular time period within medical school. The first edition of Brain Candy was published online and in print in 2009, produced by a generous grant by the Gold Humanism Honor Society (GHHS). The edition featured poetry, nonfiction, short fiction, and different types of artwork. With generous funding support from alumnus Dr. Tom Janisse, Class of 1975, the journal continues to be in print since 2009
The Importance of Early Intervention for Speech, Language, and Hearing Development: A Review
No full textEarly intervention can have an immense impact on the develop of children who present with speech, language, and/or hearing impairments. This literature review explores the importance of early intervention practices by comparing various research articles. First, the history of early intervention is explored in a deep dive on federal laws regarding intervention practices, as well as presents potential challenges that require future research in the field. Next, studies regarding modern day hearing intervention find that children with hearing loss who receive hearing aids between the ages 3 to 6 months of age tend to develop more intelligible speech and language skills compared to their peers who receive them later. Similarly, children with speech and/or language disorders who have autism spectrum disorder (ASD) and receive therapy at a young age show greater social communication skills compared to children who receive similar intervention later. These findings support the critical period theory. The review also analyzes effective intervention strategies that better equip and support early interventionists such as audiologists, speech-language pathologists, and early child educators. Finally, different online resources such as the CDC and Early On are highlighted to guide families and practitioners on where to access information regarding early childhood intervention. This review concludes with a call for future research to support the training of professionals such as pediatricians and early childhood educators in the early detection of children with speech, language, and hearing disorders
On Writing Backwards: Historical Fiction and the Reshaping of the American Canon by Alexander Manshel
Get PDFReview of Writing Backwards: Historical Fiction and the Reshaping of the American Canon by Alexander Manshel. New York: Columbia University Press, 2024. Pp. 352. 35.00 paperback
Chronic Illness Education 2025: Managing HIV in Youth: A Case-Based Application of the Expanded Chronic Care Model
No full textAncient Mitogenomes Reveal Population Interactions with High Maternal Genetic Diversity in the Central Plains of China during the Late Neolithic Period
Get PDFThe Central Plains region of China was one of the earliest domestication hubs for broomcorn and foxtail millet. This region nurtured rich archaeological cultures and experienced extensive interactions with neighboring populations during the Neolithic period. However, limited genomic research has hindered a clear understanding of the maternal genetic structure and population expansion history in this era. Here, we report 12 complete mitochondrial genomes from individuals of the Yanzhai site population from the Henan Province of China during the Longshan culture period, revealing a high level of maternal genetic diversity. The close genetic distance between these individuals and ancient populations from the Yellow River basin highlights the maternal genetic continuity since the late Neolithic period. Furthermore, our research uncovers multiple population expansion events driven by various factors, which may have contributed to the genetic composition of modern East Asian populations. In summary, our study provides a new perspective on the genetic origins and demographic dynamics of the Central Plains region during the late Neolithic period
