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Objective: To develop an effective, low-cost, single-visit cervical screening strategy incorporating a modified Pap test and visual inspection with acetic acid and Lugol's iodine for low-income settings.Methods: We conducted a prospective cohort trial. Two low-income Muslim Uyghur communities in China's far western Kashi Prefecture served as pilot and validation study sites, respectively, and 4,049 women (aged 30-59 years) were screened. The conventional Pap test was modified using a cotton swab to collect cervical cells without scraping the cervix using an Ayre spatula, allowing visual inspection with acetic acid (and visual inspection with Lugol's iodine if visual inspection with acetic acid was negative) to be performed in a single visit. Results from both tests were available within 1-2 hours. Women positive for either or both underwent same-day biopsy that was shipped by a courier service to a central pathology laboratory.Results: Single-visit screening incorporating both a modified Pap test and visual inspection achieved a sensitivity of 96.0% (95% CI 91.6-100), which was superior to Pap testing (76%, 95% CI 66.3-85.7; P<.001) or visual inspection with acetic acid-visual inspection with Lugol's iodine (48%, 95% CI 36.7-59.3; P<.001) alone in detecting cervical intraepithelial neoplasia (CIN) 2 or worse lesions. Rapid interpretation of both diagnostic procedures facilitated efficient same-day biopsy that achieved a negative predictive value of 98.2% in detecting CIN 2 or worse lesions. The increased sensitivity and minimized loss of follow-up allowed this approach to identify an extremely high prevalence of CIN 1 (2,741/100,000, 95% CI 2,238-3,245/100,000), CIN 2 or 3 (1,457/100,000, 95% CI 1,088-1,826/100,000), and cervical cancer (395/100,000, 95% CI 202-589/100,000) among these underscreened, at-risk women.Conclusion: Single-visit cervical screening with both a modified Pap test and visual inspection has greater sensitivity to detect high-grade CINs, reduces loss of follow-up, and could be an efficient low-cost strategy for low-resource settings. [ABSTRACT FROM AUTHOR]

To describe social support, self-efficacy, and exercise adherence and to measure the correlations among these factors in postoperative breast cancer patients in Southwest China.Social support, self-efficacy, and exercise adherence are interacting factors that contribute to physical and mental health and quality of life. Little is known about the status of these factors in Southwest China, and little research has explored the relationships among them.Using a stratified sampling method, we selected patients who underwent modified radical mastectomy in 20 secondary and tertiary comprehensive hospitals in Southwest China. A descriptive cross-sectional study was conducted. Questionnaires were given to 632 breast cancer patients who met the inclusion and exclusion criteria (from August 2018 to February 2019). The questionnaire included the following 4 sections: general information, perceived social support scale, strategies used by people to promote health, and postoperative functional exercise adherence scale. Structural equation modeling was used to evaluate the hypothesized relationships among social support, self-efficacy, and exercise adherence.The level of social support of postoperative patients with breast cancer in Southwest China was high (63.43 ± 9.25); however, levels of self-efficacy (95.00 ± 18.81) and exercise adherence (49.07 ± 10.57) were moderate. Higher social support correlated with higher exercise adherence (r = 0.526, P < .01). Higher self-efficacy was also correlated with higher exercise adherence (r = 0.427, P < .01). In-home support, out-of-home support, and self-efficacy had direct positive effects on exercise adherence (β = 0.37, P < .01; β = 0.23, P < .01; and β = 0.32, P < .01, respectively); in-home support indirectly affected exercise adherence through self-efficacy (β = 0.58, P < .01).Social support and self-efficacy correlated highly with exercise adherence. It is recommended that attention be paid to the development of self-efficacy and social support during postoperative rehabilitation to improve the exercise adherence of postoperative breast cancer patients.