Gang Han’s research while affiliated with Texas A&M University and other places

The identification of genital injuries during a medical‐forensic examination may impact the investigation and prosecution of sexual assault. The purpose of this meta‐analysis was to compare prevalence of genital lacerations (or tears) in persons reporting consensual versus non‐consensual vaginal penetration. We hypothesized there would be greater prevalence of genital injuries in the non‐consensual group. We searched PubMed, CINAHL, Web of Science, and gray literature for relevant observational case–control studies. Relative risk (RR) ratios using Mantel–Haenszel method were calculated to compare prevalence of genital lacerations between patients reporting consensual versus non‐consensual penetration. Mantel–Haenszel chi‐square tested significance and Cochran's Q determined between‐study heterogeneity. In all studies, genital injuries were observed in both groups. The overall RR of 1.26 indicated a 26% greater risk of genital lacerations in the non‐consensual group compared to the consensual group ( p = 0.003). Study heterogeneity was 54% ( p = 0.05). Findings suggest a greater likelihood of observing genital lacerations in persons reporting non‐consensual vaginal penetration. High heterogeneity reflects variations between studies regarding provider education and training, visualization techniques, patient characteristics, time between assault and examination, and documentation practices. A major limitation is the lack of observer blinding creating potential bias. Findings support the need to standardize genital visualization techniques and documentation in sexual assault medical forensic examinations. Healthcare providers conducting medical forensic examinations must understand the limitations of studies comparing non‐consensual and consensual injury findings if asked to provide information or testimony on this topic.

Background: This study investigated the potential associations between neighborhood characteristics, rurality, ethnicity/race, and breast cancer screening outcomes in designated Health Professional Shortage Areas in Central Texas. Limited access to preventive medical care can impact screening rates and outcomes. Previous research on the effects of factors such as rurality, neighborhood socioeconomic status, and education level on cancer prevention behaviors has yielded inconsistent results. Materials and Methods: We analyzed data from a state-funded breast and cervical cancer screening programs for disadvantaged and medically underserved individuals. A mixed-effects logistic regression model was used to assess the impact of residency characteristics (rurality, educational attainment, unemployment, and poverty) on abnormal breast cancer screening outcomes, with individual level (age, ethnicity, race, and education) as control variables. Results: During the studied time, there were 1,139 women screened and 134 abnormal mammograms found. Residency characteristics were not significantly associated with abnormal mammography outcomes at 0.05. However, individual factors are strongly associated with abnormal screening results. Non-Hispanic or Latino white women had increased odds of abnormal clinical outcomes compared with Hispanic or Latino women (OR = 2.03, CI 1.25–3.28; p = 0.004). Additionally, women residing in counties with more than 30% of the population completing college had increased odds of abnormal mammogram outcomes compared with counties with less than 15% college attainment (OR = 2.89, CI 0.99–8.38; p = 0.051). Conclusions: This study found a significant correlation between area-level educational characteristics and abnormal mammography outcomes. Future research should explore the contextual risk factors influencing breast cancer occurrence and develop targeted interventions for this population.

Objectives: To examine associations between a history of adverse childhood experiences (ACEs) and receiving preventive cervical cancer screening and to investigate whether number and type of ACE exposures were predictive of cervical cancer screening uptake. Sample & setting: Data were from 11,042 adults who completed the 2020 Texas Behavioral Risk Factor Surveillance System survey. The U.S. Preventive Services Task Force guidelines were used to indicate whether individuals had received cervical cancer screening at recommended intervals. Methods & variables: Multiple logistic regression analysis was used to predict the likelihood of not having received the recommended preventive cancer screening by number and type of ACE exposures. Chi-square analysis was used to determine associations among demographic characteristics, cancer screening uptake, and ACE number and type. Results: Individuals with one to three ACEs and those with six or more ACEs were statistically more likely not to have received the recommended cervical cancer screenings compared to those with zero ACEs. A history of physical ACEs was associated with 3.88 times the likelihood of not having received the recommended cervical cancer screening. Implications for nursing: To promote timely cervical cancer screening and prevent retraumatization of patients with a history of ACEs, providers should implement trauma-informed care principles in their healthcare settings.