RESUMEN
PURPOSE: Recent cervical cancer screening technologies depend on biennial and triennial screening of cytologically normal women to be cost-effective. The guidelines for these technologies cannot be appropriately implemented if women demand continued cervical screening at their annual examinations. The purpose of this study was to identify the reasons for an annual examination that are important to women. METHODS: Age-specific focus groups elicited 22 consistently important reasons that were then incorporated into a survey given to northern New England women seeking healthcare. The reasons were classified as test-seeking reasons and as provider-patient relationship reasons. A distribution matrix of the test-seeking and provider-patient relationship reasons was constructed for paired McNemar chi-square analysis. Multivariate regression analyses compared the selected reasons to the women's demographic characteristics. RESULTS: There were 121 women from three distinct primary care offices who completed the surveys. Women were highly likely to chose patient-provider reasons as more important components of the annual examination than test-seeking reasons (chi-square for symmetry = 54.44, p < 0.001). The lesser importance of an annual Pap test did not vary by age, education level, and number of healthcare visits made in the last year. CONCLUSIONS: Our results indicate that northern New England women value the provider-patient relationship as paramount for the annual examination, thus supporting the notion that the biennial and triennial Pap intervals for cytologically normal women provided by the new cervical cancer screening technologies would be acceptable in this population.
Asunto(s)
Tamizaje Masivo , Neoplasias del Cuello Uterino/prevención & control , Frotis Vaginal , Salud de la Mujer , Adulto , Anciano , Actitud Frente a la Salud , Distribución de Chi-Cuadrado , Femenino , Grupos Focales , Humanos , Tamizaje Masivo/psicología , Tamizaje Masivo/estadística & datos numéricos , Persona de Mediana Edad , New England/epidemiología , Examen Físico/psicología , Examen Físico/estadística & datos numéricos , Factores de Riesgo , Encuestas y Cuestionarios , Neoplasias del Cuello Uterino/epidemiología , Frotis Vaginal/psicología , Frotis Vaginal/estadística & datos numéricosAsunto(s)
Antihipertensivos/efectos adversos , Conjuntivitis Alérgica/inducido químicamente , Prednisolona/análogos & derivados , Quinoxalinas/efectos adversos , Uveítis Anterior/inducido químicamente , Administración Tópica , Anciano , Anciano de 80 o más Años , Antihipertensivos/administración & dosificación , Tartrato de Brimonidina , Conjuntivitis Alérgica/tratamiento farmacológico , Femenino , Glaucoma/tratamiento farmacológico , Glucocorticoides/uso terapéutico , Humanos , Presión Intraocular/efectos de los fármacos , Masculino , Soluciones Oftálmicas , Prednisolona/uso terapéutico , Quinoxalinas/administración & dosificación , Uveítis Anterior/tratamiento farmacológicoRESUMEN
There is increasing evidence that bacterial biofilms play a role in a variety of ocular infections. Bacterial growth is characterized as a biofilm when bacteria attach to a surface and/or to each other. This is distinguished from a planktonic or free-living mode of bacterial growth where these interactions are not present. Biofilm formation is a genetically controlled process in the life cycle of bacteria resulting in numerous changes in the cellular physiology of the organism, often including increased antibiotic resistance compared to growth under planktonic conditions. The presence of bacterial biofilms has been demonstrated on many medical devices including intravenous catheters, as well as materials relevant to the eye such as contact lenses, scleral buckles, suture material, and intraocular lenses. Many ocular infections often occur when such prosthetic devices come in contact with or are implanted in the eye. For instance, 56% of corneal ulcers in the United States are associated with contact lens wear. Bacterial biofilms may participate in ocular infections by allowing bacteria to persist on abiotic surfaces that come in contact with, or are implanted in the eye, and by direct biofilm formation on the biotic surfaces of the eye. An understanding of the role of bacterial biofilm formation in ocular infections may aid in the development of future antimicrobial strategies in ophthalmology. We review the current literature and concepts relating to biofilm formation and infections of the eye.