Examining Audiences' Psychological Reactance to Christian-Sourced Excessive Alcohol Consumption Messages in the United States.

This study experimentally investigated the effect of dogmatic and suggestive language in Christian-sourced excessive alcohol consumption messages among college-aged participants who identify as Christians or non-Christians, as well as the role of perceived similarity with the message source, on their self-reported freedom-threat, psychological reactance, and behavioral intentions to consume alcohol. The results from this study support psychological reactance theory and demonstrate the various message strategies to effectively communicate the negative health effects of excessive alcohol consumption to individuals who identify either as Christians or non-Christians.

The relationship between religious affiliation and menopause symptoms and attitudes in United States women.

OBJECTIVES: This study's aim is to examine patterns of menopause symptoms and attitudes among United States women from different religious affiliations. STUDY DESIGN: We used data from a national sample of midlife and older adults. For this analysis, we included only women who were postmenopausal or had undergone hysterectomy. We constructed univariate and multivariate logistic regression models to examine the relationship between religious affiliation and menopause symptoms and attitudes while adjusting for potential confounders. MAIN OUTCOME MEASURES: Menopause symptoms (hot flashes, pain in sexual interactions, pleasure in sexual interactions, trouble falling asleep) and attitudes (relief on periods stopping, regret on periods stopping, worry about becoming less attractive) measured by self-report on Likert scales. RESULTS: Across denominations, 47 % of women experienced hot flashes, 48 % experienced pain in sexual interactions, 95 % experienced pleasure, and 88 % had trouble falling asleep. Regarding attitudes towards menopause and aging, 62 % felt relief in their periods stopping, while 56 % expressed worry about becoming less attractive with aging. Baptist women were more likely to experience hot flashes and trouble falling asleep compared to Catholic women. However, when adjusted for smoking status, this relationship did not persist. Unaffiliated and Spiritual women were less likely to experience trouble falling asleep and more likely to report pleasure in sexual interactions compared to Catholic women. Spiritual women were significantly more likely to feel regret on periods stopping compared to Catholics. CONCLUSIONS: There is a relationship between religious affiliation and the menopause experience. These findings demonstrate the importance of considering social influences on women's health.

The Influence of Religious Affiliation and Attitudes of Clinical Genetic Testing Among Medical Students in the West Texas Region.

Background: Genetic counseling is an essential and pertinent field in any society to lower the prevalence of hereditary disorders. However, the desire to undergo counseling and genetic testing varies widely depending on the cultural background and level of scientific literacy of the individual. In this survey, we examine the perspectives of medical students on clinical genetic testing based upon their religious tradition. Methods: The total number of participants in the study was 257 (122 male and 135 female) second year medical students at Texas Tech University Health Sciences Center (TTUHSC). The distribution of religious identification (Atheist, Christian, Hindu, Jewish, Muslim, Spiritual/not Affiliated, and Other) among the second-year medical students. The survey was available to students through TTUHSC's Omnibus survey program for a period of two weeks. Results: Most of the second-year medical students interviewed identified as being Christian (67%) with the next highest religious identification being Spiritual/not Affiliated (9%), Atheist (8%), and Muslim (6%). With regards to genetic tests, most of the students (95%), regardless of religious identification, have not used any commercial genetic testing services. Most second year medical students regardless of religious affiliation had similar agreement with questions regarding clinical genetic testing. However, there was a similar drop in agreement when it came on where students would want genetic screening to be performed regularly in clinics/hospitals. Conclusion: Given the numerous factors that must be considered, such as the patient's attitudes, knowledge, and beliefs towards the counseling process and genetic testing, genetic counseling is a challenging problem. Each target population's history, relevant exposure to, and domain expertise must be considered while promoting decision-making in genetic testing.

Exploring factors influencing domestic violence: a comprehensive study on intrafamily dynamics.

Introduction: This econometric analysis investigates the nexus between household factors and domestic violence. By considering diverse variables encompassing mood, depression, health consciousness, social media engagement, household chores, density, and religious affiliation, the study aims to comprehend the underlying dynamics influencing domestic violence. Methods: Employing econometric techniques, this study examined a range of household-related variables for their potential associations with levels of violence within households. Data on mood, depression, health consciousness, social media usage, household chores, density, and religious affiliation were collected and subjected to rigorous statistical analysis. Results: The findings of this study unveil notable relationships between the aforementioned variables and levels of violence within households. Positive mood emerges as a mitigating factor, displaying a negative correlation with violence. Conversely, depression positively correlates with violence, indicating an elevated propensity for conflict. Increased health consciousness is linked with diminished violence, while engagement with social media demonstrates a moderating influence. Reduction in the time allocated to household chores corresponds with lower violence levels. Household density, however, exhibits a positive association with violence. The effects of religious affiliation on violence manifest diversely, contingent upon household position and gender. Discussion: The outcomes of this research offer critical insights for policymakers and practitioners working on formulating strategies for preventing and intervening in instances of domestic violence. The findings emphasize the importance of considering various household factors when designing effective interventions. Strategies to bolster positive mood, alleviate depression, encourage health consciousness, and regulate social media use could potentially contribute to reducing domestic violence. Additionally, the nuanced role of religious affiliation underscores the need for tailored approaches based on household dynamics, positioning, and gender.

Religious affiliation and oral health-related quality of life: a cross-sectional study based on a nationally representative survey in Germany.

BACKGROUND: Studies have shown an association between a person's religiosity, and physical as well as psychological, health status. However, results differ between certain religious affiliations. While good oral health is important for our overall health and wellbeing, research on religious affiliation and oral health status, specifically oral health-related quality of life (OHRQoL), is lacking. Thus, our aim was to investigate the association between religious affiliation and OHRQoL. METHODS: A nationally representative online survey (n = 3,075 individuals) was conducted in August/September 2021. The mean age was 44.5 years (SD: 14.8 years, 18 to 70 years) and 51.1% of the individuals were female. OHRQoL was measured using the Oral Health Impact Profile (OHIP-G5). Religious affiliation served as key explanatory variable. Several covariates were included in regression analyses. RESULTS: Regressions revealed that compared to individuals with no religious affiliation, individuals belonging to Christianity had poorer OHRQoL (ß = 0.31, p < 0.01), individuals belonging to Islam had poorer OHRQoL (ß = 2.62, p < 0.01) and individuals belonging to another religious affiliation also had poorer OHRQoL (ß = 1.89, p < 0.01). CONCLUSION: Our study demonstrated an association between religious affiliation and OHRQoL. Individuals with specific religious affiliations should be addressed to avoid low OHRQoL.

Unpacking the role of adolescent religious affiliation in youth outcomes.

INTRODUCTION: The purpose of this study was to unpack the role of adolescent religious affiliation in positive and negative youth outcomes. METHODS: We used data from Wave 1 (2002-2003) of the National Study of Youth and Religion (NSYR). Participants were a nationally representative sample of 3290 adolescents from across the United States. Measures were adolescent-report or parent-report items of religiousness (individual religiousness, family religiousness, peer religiousness, and religious community supportiveness) and youth outcomes (future orientation, grades, community involvement, alcohol use, sexual activity, and depression). RESULTS: First, ANOVAs revealed that four dimensions of religiousness (individual religiousness, family religiousness, peer religiousness, and religious community supportiveness) and five youth outcomes (future orientation, grades, community involvement, alcohol use, and sexual activity, but not depression), varied significantly across religious affiliation. Second, regressions examining direct effects found that the multicategorical nominal variable of religious affiliation predicted all outcomes except alcohol use and depression after accounting for the four dimensions of religiousness. Third, each of the four dimensions of religiousness mediated relations between religious affiliation and at least one of the outcomes. CONCLUSIONS: In short, religious affiliation seems to play a unique role in youth outcomes, above and beyond other dimensions of religiousness. This role of religious affiliation perhaps functions in part via individual and contextual dimensions of religiousness.

The effect on judgment of attributing religious affiliation to a terrorist suspect.

The purpose of this study was to examine the effects and correlations of the perceived religious affiliation on a fictitious terrorism case. Participants were 402 French adults who completed a questionnaire after reading a scenario involving the arrest of a person (French vs. North African; man vs. woman) wearing an explosive belt. They indicated the level of the perpetrator's religious affiliation and judged her/him and the act. The participants' level of social dominance orientation (SDO) was measured and studied along in its two dimensions. The results showed an effect of ethnicity on perceived religious affiliation, which was correlated with judgment and mediated the effect of social dominance on judgment. The implications of this study are discussed in terms of intergroup interactions and religious prejudice.

Religious affiliation and women's receipt of person-centered contraceptive care: Findings from the National Survey of Family Growth, 2017-2019.

OBJECTIVES: To assess patient ratings of person-centered contraceptive care among women of different religious affiliations in the United States. STUDY DESIGN: Data from the 2017-2019 National Survey of Family Growth and a sample of female respondents ages 15-49 years who received contraceptive services in the past year and completed the Person-Centered Contraceptive Counseling scale (N = 2226). RESULTS: Catholic and Protestant women had higher odds of reporting overall person-centered contraceptive care (odds ratio [OR] = 1.77, OR = 1.54) compared to respondents without a religious affiliation and net sociodemographic characteristics. CONCLUSIONS: Women's experiences with person-centered contraceptive care differ based on their religious affiliation. IMPLICATIONS: Advancing research on the barriers to person-centered contraceptive care is essential for providing quality health care and reproductive autonomy. This analysis suggests that researchers and clinicians should consider how patient religious affiliation shapes patient-provider encounters and patient experiences of person-centered care to promote quality, equitable family planning care.

A civic bridge or a silo? Islam, religious affiliation, and civic engagement in rural Indonesia.

This article tests the hypothesis that membership in faith-based civic associations leads to more secular forms of civic engagement in a Muslim-majority nation. Drawing from Social Capital Theory and using survey data from rural Indonesia, this study examines whether religion, especially Islam, works as a silo that houses most civic life or as a bridge to greater and more diversified civic engagement.The study poses two questions: Does religious affiliation increase secular volunteering and charitable giving? Anddo levels of engagement and philanthropic giving vary based on a household's faith or the community's religious composition?The findings imply that Islam serves as a civic bridge to more secular forms of engagement, albeit a short civic bridge. Residents of Muslim-majority communities engaged less diversely, raising concerns that Islam may operate more as a silo that fosters local network ties rather than as a bridge to more cross-cutting connections.

COVID-19 Stress, Religious Affiliation, and Mental Health Outcomes Among Adolescents.

PURPOSE: To examine the relationship between religious affiliation, stressors due to the COVID-19 pandemic, and mental health challenges in a representative sample of adolescents. METHODS: The sample was composed of 71,001 Utah adolescents who participated in a survey by the Utah Department of Health in 2021. Data are representative of all Utah adolescents in grades 6, 8, 10, and 12. Bootstrapped mediation was used to test indirect effects of religious affiliation on mental health challenges through COVID-19 stressors. RESULTS: Religious affiliation was related to significantly lower rates of teen mental health challenges as measured by suicidal thoughts, suicide attempts, and depression. For religiously affiliated adolescents, the rate of considering and attempting suicide was nearly half of that of unaffiliated adolescents. In mediation analyses, affiliation was indirectly related to mental health challenges (suicide ideation, suicide attempt, and depression) through stressors from COVID-19, including affiliated adolescents experiencing the following: less anxiety, fewer family fights, fewer school difficulties, and fewer skipped meals. However, affiliation was positively related to becoming sick with COVID-19 (or having COVID-19 symptoms), which was related to more suicidal thoughts. DISCUSSION: Findings suggest that adolescent religious affiliation may be a promotive factor that decreases mental health challenges through a reduction in COVID-19-related stressors, except religious individuals may be more likely to become sick. To increase positive mental health outcomes among adolescents during pandemic times, consistent and clear policies that facilitate religious connections that also align with good physical health measures will be critical.

Does Lent affect rates of deliberate self-harm?

BACKGROUND: Research has shown that religious affiliation has a protective effect against deliberate self-harm. This is particularly pronounced in periods of increased religious significance, such as periods of worship, celebration, and fasting. However, no data exist as to whether this effect is present during the Christian period of Lent. Our hypothesis was that Lent would lead to decreased presentations of self-harm emergency department (ED) in a predominantly Catholic area of Ireland. METHODS: Following ethical approval, we retrospectively analysed data on presentations to the ED of University Hospital Limerick during the period of Lent and the 40 days immediately preceding it. Frequency data were compared using Pearson's chi-squared tests in SPSS. RESULTS: There was no significant difference in the overall number of people presenting to the ED with self-harm during Lent compared to the 40 days preceding it (χ2 = 0.75, df = 1, p > 0.05), and there was no difference in methods of self-harm used. However, there was a significant increase in attendances with self-harm during Lent in the over 50's age group (χ2 = 7.76, df = 1, p = 0.005). CONCLUSIONS: Based on our study, Lent is not a protective factor for deliberate self-harm and was associated with increased presentations in the over 50's age group. Further large-scale studies are warranted to investigate this finding as it has implications for prevention and management of deliberate self-harm.

Making sense of the crisis: how religion shapes the attribution of meaning during the corona pandemic.

In times of existential crisis, such as the Corona pandemic, people may turn to religious traditions that help them make new sense of the depressing situation. While recent studies have shown that during the Corona pandemic, the frequency of prayer and church attendance increased in several countries, we know little about whether and how religious interpretations of the current crisis occur. Building on Crystal Park's Meaning Making Model, the article examines whether individual religiosity, religious affiliation, and the experience of a SARS-CoV­2 infection influence religious interpretations of the Corona pandemic. Our results show that religiosity is strongly associated with the idea of a benevolent God and weakly associated with the concept of a punishing God. Members of specific religious groups differed significantly in their religious interpretation of the Corona pandemic. Finally, we found that the experience of a SARS-CoV­2 infection was associated with doubts about the power of God.

Religious Affiliation and Flu Vaccination in Germany: Results of the German Ageing Survey.

Our aim was to examine the association between religious affiliation and the likelihood of taking the flu vaccine. Cross-sectional data (year 2014 with n = 7172) were used from the nationally representative German Ageing Survey-covering community-dwelling individuals aged 40 years and over. Multiple logistic regressions showed that compared with individuals without a religious affiliation, individuals with certain religious affiliations had a lower likelihood of taking the flu vaccine. More precisely, the likelihood of taking a flu shot was significantly associated with belonging to the Roman Catholic Church (OR: 0.50, 95% CI: 0.44-0.57), the Protestant Church (OR: 0.68, 0.60-0.77), the Evangelic Free Church (OR: 0.54, 0.35-0.82) and other religious communities (OR: 0.25, 0.14-0.45). The results remained nearly the same when we restricted our analyses to individuals aged 60 years and over (according to existing recommendations for flu vaccination). The association between religious affiliation and the likelihood of taking the flu vaccine was moderated by thoughts about religion and deeds for religion. This knowledge could help to improve the immunization coverage by addressing individuals with certain religious affiliations.

The Phenomenon of Social and Pastoral Service in Eastern Slovakia and Northwestern Czech Republic during the COVID-19 Pandemic: Comparison of Two Selected Units of Former Czechoslovakia in the Context of the Perspective of Positive Solutions.

This study seeks to explain the differences in the perception of social and pastoral service after the first and second wave pandemic in 2020 among the inhabitants of two neighbouring states, both parts of the former unified Czechoslovakia. Our research study compares subjective perception, needs, and participation among inhabitants of eastern Slovakia and north-western Czech Republic in social and pastoral service during the COVID-19 pandemic. The research sample consisted of a healthy population from the Czech Republic (n = 496) and Slovakia (n = 484) over 16 years of age, of which 63% (n = 617) were women and 37% (n = 363) men. The level of education ranged from primary to postgraduate. The research sample consisted of 623 (63.6%) participants with religious affiliation and 357 (36.4%) without religion. The level of perception, needs, and participation of the participants in social and pastoral service was obtained based on a non-standardised questionnaire. The results of our study confirmed several differences in the areas studied.

Religiosity and Mental Wellbeing Among Members of Majority and Minority Religions: Findings From Understanding Society: the UK Household Longitudinal Study.

It is unclear whether links between religiosity and mental health are found in contexts outside the United States or are causal. We examined differences in mental wellbeing and associations between mental wellbeing and religiosity among the religiously unaffiliated, White and non-White Christians, Muslims of Pakistani, Bangladeshi, and other ethnicities, and other minority ethnoreligious groups. We used 4 waves of Understanding Society: the UK Household Longitudinal Study (2009-2013; n = 50,922). We adjusted for potential confounders (including socioeconomic factors and personality) and for household fixed effects to account for household-level unobserved confounding factors. Compared with those with no religious affiliation, Pakistani and Bangladeshi Muslims and members of other minority religions had worse wellbeing (as measured using the Shortened Warwick-Edinburgh Mental Wellbeing Scale and General Health Questionnaire). Higher subjective importance of religion was associated with lower wellbeing according to the General Health Questionnaire; associations were not found with the Shortened Warwick-Edinburgh Mental Wellbeing Scale. More frequent religious service attendance was associated with higher wellbeing; effect sizes were larger for those with religious affiliations. These associations were only partially attenuated by adjustment for potential confounding factors, including household fixed effects. Religious service attendance and/or its secular alternatives may have a role in improving population-wide mental wellbeing.

Impact of Ramadan Fasting on Dietary Intakes Among Healthy Adults: A Year-Round Comparative Study.

Religious rituals are considered among the principle factors that impact dietary behaviors and food selections. The main objective of this study is to characterize food intake among Lebanese adults observant of the fasting month of Ramadan and compare it to their intake of the rest of the year. During a year-round study, including the month of Ramadan, Lebanese adults (n = 62), completed multiple (9 to 13) 24-h dietary recalls. Information about sociodemographic and lifestyle characteristics was also obtained. Dietary intake was examined using food groups as well as energy, macro, and micronutrient consumption. Significant differences in dietary intakes were observed for 12 of the 19 food groups (expressed as a percent of total energy) during Ramadan as compared to the rest of the year. More specifically, the intakes of cereals, cereal-based products, pasta, eggs, nuts and seeds, milk and dairy, and fats and oils were lower, while vegetables, dried fruit, Arabic sweets, cakes and pastries, and sugar-sweetened-beverages intakes were higher during Ramadan as compared to the remainder of the year (p < 0.05). Such differences in food groups' intakes were reflected in nutrients intakes, including carbohydrates, cholesterol, calcium, beta-carotene, vitamin C, folate, and magnesium. The findings of this study highlighted major differences in dietary intakes between the fasting month as compared to the rest of the year. With the large number of adults who observe fasting during Ramadan, the particularities of dietary intake during Ramadan ought to be considered in the development of context and culture-specific dietary recommendations.

Religiosity and substance use in U.S. adults: Findings from a large-scale national survey.

BACKGROUND: In recent decades, the US religious landscape has undergone considerable change such as a decline in religious service attendance. These changes may indicate that religious social support structures have deteriorated, possibly leading to a decrease in strengths of associations with substance use. Considering this, and given limitations of past studies (e.g., limited control for potential confounders), large-scale general population studies are needed to reexamine associations between religiosity domains and substance use. METHODS: This cross-sectional study used data from the 2012-2013 National Epidemiologic Survey on Alcohol and Related Conditions-III (N = 36,309). In unadjusted and adjusted models, controlling for religiosity domains and other covariates, we examined associations between three religiosity domains (importance of religiosity/spirituality, service attendance, and religious affiliation) and DSM-5 SUD. Focusing on service attendance, we also examined associations with other substance use-related outcomes. RESULTS: Among religiosity domains, only frequency of service attendance was associated with SUD across most substances. Frequent service attendees had lower odds of alcohol use disorder (adjusted OR [aOR] = 0.4, 95 % CI 0.33,0.51), tobacco use disorder (aOR = 0.3, 95 % CI 0.22,0.33) and cannabis use disorder (aOR = 0.4, 95 % CI 0.24,0.68), compared to non-service attendees. For alcohol and tobacco, the protective effect of frequent service attendance was more robust for SUD than for respective substance use. CONCLUSIONS: Despite decreasing rates of religious belief and practice in the US, service attendance independently lowered the odds of substance use and SUD across multiple substances. Results may inform religious leaders and clinicians about the value of utilizing religious social support structures in the prevention and treatment of substance use and SUD.

Mapping the healthcare chaplaincy workforce: a baseline description.

Changing U.S. demographics and the growing emphasis on diversity in the healthcare workforce requires professional healthcare chaplains to examine the characteristics of its own workforce. Previous research suggested that chaplains were mainly Caucasian/White and Mainline Protestant. To explore further, this paper presents a baseline sketch of the workforce and identifies important differences among board-certified chaplains (BCCs), certified educators, certified educator candidates (CECs), and clinical pastoral education (CPE) students. Although missing data quickly became the central story of the analysis and thus requires caution in comparison, the preliminary results suggest BCCs and Certified Educators are older and Whiter/more Caucasian than CECs and CPE students. At least one-third of chaplains and Certified Educators identify as Mainline Protestant, but students and CECs reported greater variation in religious affiliation. Chaplains may be similar to users of healthcare and hospitalized persons in terms of gender and race/ethnicity. Recommendations include suggestions for improving the data infrastructure of professional chaplaincy organizations.

A Worldwide Internet Study Based on Implicit Association Test Revealed a Higher Prevalence of Adult Males' Androphilia than Ever Reported Before.

BACKGROUND: Social constrictions or the lack of a clear awareness about one's sexual orientation may influence the ability of individuals to explicitly declare their sexual preferences. Thus, the actual prevalence of males' sexual attraction toward adult males, which is estimated by studies relying only on explicit questionnaires, may be biased. Conversely, the implicit measurement of androphilia may be a promising method to obtain more reliable data. AIM: In the present work, explicit and implicit methods have been used to investigate the rates of explicit nonheterosexuality and implicit androphilia in a large sample of adult males from all around the world. For implicit androphilia, a rate consistent across the continents and close to that predicted by recent genetic models (about 15%) was expected. In contrast, for self-declared homosexuality, a lower and more variable rate was expected. METHODS: A sample of 1,050 participants was recruited through an online platform. All participants completed a short biographical questionnaire, an Autobiographical-Implicit Association Test, the Sexual Preference-Implicit Association Test, and an explicit measure of sexual orientation. The answers to these measures were used to explore explicit sexual orientation and implicit androphilia across six main geographical areas (Middle East and Africa, South America, North America, Asia, Europe, and Oceania). OUTCOMES: The main outcome measures were the D score at the Sexual Preference-Implicit Association Test and the scores at the explicit measure of sexual orientation. RESULTS: The rate of nonheterosexuality, which can be found using explicit measures, is rather low, variable (from 6.3% to 11.4%), and influenced by cultural factors. In contrast, the prevalence of androphilia resulting from implicit methods is higher and consistent across geographical areas (from 14.4% to 17.6%). CLINICAL IMPLICATIONS: Studying the diffusion of adult males' androphilia may be useful to better understand sexual behaviors and preferences and to develop effective health promotion programs among males who have sex with males. STRENGTHS & LIMITATIONS: The large and cross-cultural sample and the use of both implicit and explicit measures allowed for obtaining a detailed picture of adult males' sexual orientation and androphilia. The main limitations were the Web-based characteristics of the protocol and the lack of an investigation of actual sexual behaviors. CONCLUSION: Compared with the explicit measurement of nonheterosexuality, the implicit measurement of sexual preferences showed a prevalence of androphilia among adult males that is higher, more stable across continents, and more consistent with the predictions of recent genetic models. Colledani D,A. Camperio Ciani Worldwide Internet Study Based on Implicit Association Test Revealed a Higher Prevalence of Adult Males' Androphilia than Ever Reported Before. J Sex Med 2021;18:4-16.

Religious Attendance and Cancer Screening Behavior.

Background: Cancer is one of the most important health problems worldwide. Preventive examinations proved to be effective in tackling that issue, but their degree of utilization is not adequate. Thus, research is making efforts to reveal its determinants. It has been shown that religion is associated with several health outcomes, so the aim of our study is to analyze the association between religious attendance and participation in cancer prevention. Methods: Data are derived from the fifth wave of the German Aging Survey (DEAS), a nationally representative, prospective cohort study. Participants are community-dwelling Germans aged 40 years and older. Our main independent variable is the frequency of attendance in religious services, and the dependent variable is participation in cancer screening. As covariates, we include factors from all the dimensions of the Andersen behavioral health services utilization model. Multiple logistic regressions were used. In our sensitivity analysis, logistic regressions were performed stratified by religious group (Roman Catholic church, Protestant church, not belonging to any religious group). Results: Our model shows that attendance in religious services once a week, one to three times a month, several times a year, or less often is significantly associated with an increased likelihood of participating in preventive cancer screening, more than never participating in religious services. Moreover, the sensitivity analysis reveals that all these associations remain significant for the Catholic subsample, but not for the Protestant or the non-religious group. Discussion: This study finds a link between a higher frequency of attendance in religious services and an increased likelihood of participating in cancer screenings. This is important to address individuals at risk for underuse of cancer screenings.