Rural physicians' perspectives on cervical and breast cancer screening: a gender-based analysis.

PubMed

Ahmad, F; Stewart, D E; Cameron, J I; Hyman, I

2001-03-01

Several studies highlight the role of physicians in determining cervical and breast cancer screening rates, and some urban studies report higher screening rates by female physicians. Rural women in North America remain underscreened for breast and cervical cancers. This survey was conducted to determine if there were significant gender differences in practices and perceptions of barriers to breast and cervical cancer screening among rural family physicians in Ontario, Canada. One hundred ninety-one family physicians (response rate 53.1%) who practiced in rural areas, small towns, or small cities completed a mail questionnaire. The physicians' mean age was 44.4 years (SD 9.9), and mean number of years in practice was 16.6 years (SD 10.3). Over 90% of physicians reported that they were very likely to conduct a Pap test and clinical breast examination (CBE) during a periodic health examination, and they had high levels of confidence and comfort in performing these procedures. Male (68%) and female (32%) physicians were similar in their likelihood to conduct screening, levels of confidence and comfort, and knowledge of breast and cervical cancer screening guidelines. However, the self-reported screening rates for Pap tests and CBE performed during last year were higher for female than male physicians (p < 0.01). Male physicians reported they were asked more frequently by patients for a referral to another physician to perform Pap tests and CBE (p < 0.001). Also, male physicians perceived patients' embarrassment as a stronger barrier to performing Pap tests (p < 0.05) and CBE (p < 0.01) than female physicians. No gender differences were observed in screening rates or related barriers to mammography referrals. These findings suggest that physicians' gender plays a role in sex-sensitive examination, such as Pap tests and CBE. There is a need to facilitate physician-patient interactions for sex-sensitive cancer screening examinations by health education initiatives targeting male physicians and women themselves. The feasibility of providing sex-sensitive cancer screening examinations by a same-sex health provider should also be explored.

Breast cancer prevention and control programs in Malaysia.

PubMed

Dahlui, Maznah; Ramli, Sofea; Bulgiba, Awang M

2011-01-01

Breast cancer is the most common cancer in Malaysian females. The National Cancer Registry in 2003 and 2006 reported that the age standardized incidence of breast cancer was 46.2 and 39.3 per 100,000 populations, respectively. With the cumulative risk at 5.0; a woman in Malaysia had a 1 in 20 chance of developing breast cancer in her lifetime. The incidence of cancer in general, and for breast cancer specifically was highest in the Chinese, followed by Indians and Malays. Most of the patients with breast cancers presented at late stages (stage I: 15.45%, stage II: 46.9%, stage III: 22.2% and stage IV: 15.5%). The Healthy Lifestyles Campaign which started in the early nineties had created awareness on breast cancer and after a decade the effort was enhanced with the Breast Health Awareness program to promote breast self examination (BSE) to all women, to perform annual clinical breast examination (CBE) on women above 40 and mammogram on women above 50. The National Health Morbidity Survey in 2006 showed that the prevalence rate of 70.35% by any of three methods of breast screening; 57.1% by BSE, 51.8% by CBE and 7.6% by mammogram. The current screening policy for breast cancer focuses on CBE whereby all women at the age of 20 years and above must undergo breast examination by trained health care providers every 3 years for age between 20-39 years, and annually for age 40 and above. Several breast cancer preventive programs had been developed by various ministries in Malaysia; among which are the RM50 subsidy for mammogram by the Ministry of Women, Family and Community Development and the SIPPS program (a call-recall system for women to do PAP smear and CBE) by the Ministry of Health. Measures to increase uptake of breast cancer screening and factors as to why women with breast cancer present late should be studied to assist in more development of policy on the prevention of breast cancer in Malaysia.

Interventions Promoting Breast Cancer Screening Among Turkish Women With Global Implications: A Systematic Review.

PubMed

Secginli, Selda; Nahcivan, Nursen O; Gunes, Gussun; Fernandez, Ritin

2017-08-01

Breast cancer is a major health concern and remains the most common malignancy in women worldwide and in Turkey. Mammography, clinical breast examination (CBE), and breast self-examination (BSE) are recommended methods to detect early breast cancer in women. Many strategies have been developed to increase the rates of mammography, CBE, and BSE among Turkish women. Despite the benefits of breast cancer screening, these modalities are still underutilized by the majority of Turkish women. To systematically review the scientific evidence on the effectiveness of various strategies aimed at improving screening behaviors for breast cancer in Turkish women. A systematic review of the literature published between 2000 and 2015 was conducted, searching 10 databases of Ovid MEDLINE, PubMed, Cochrane CENTRAL Register of Controlled Trials, CINAHL, PsycINFO, Web of Knowledge, Scopus, Google Scholar, ULAKBIM Turkish Medical Database, and Council of Higher Education Thesis Center. Twenty-three studies were included in the final review. The majority of the studies investigated the effects of multiple strategies to improve BSE. Group education comprised educational sessions, printed and audiovisual materials, which significantly improved BSE, CBE, and mammography screening rates at 3 months, 6 months, and 12 months after the intervention. One-to-one education demonstrated no significant difference in BSE rates at 6-month and 12-month follow-up. However, one-to-one education demonstrated significant differences in CBE and mammography rates at the 3-month follow-up. The use of group education comprising a multicomponent intervention demonstrated an increase in breast-screening behaviors among Turkish women. Further research investigating the duration of educational interventions is needed in order to suggest a "dose response." © 2017 Sigma Theta Tau International.

Physical examination prior to initiating hormonal contraception: a systematic review.

PubMed

Tepper, Naomi K; Curtis, Kathryn M; Steenland, Maria W; Marchbanks, Polly A

2013-05-01

Provision of contraception is often linked with physical examination, including clinical breast examination (CBE) and pelvic examination. This review was conducted to evaluate the evidence regarding outcomes among women with and without physical examination prior to initiating hormonal contraceptives. The PubMed database was searched from database inception through March 2012 for all peer-reviewed articles in any language concerning CBE and pelvic examination prior to initiating hormonal contraceptives. The quality of each study was assessed using the United States Preventive Services Task Force grading system. The search did not identify any evidence regarding outcomes among women screened versus not screened with CBE prior to initiation of hormonal contraceptives. The search identified two case-control studies of fair quality which compared women who did or did not undergo pelvic examination prior to initiating oral contraceptives (OCs) or depot medroxyprogesterone acetate (DMPA). No differences in risk factors for cervical neoplasia, incidence of sexually transmitted infections, incidence of abnormal Pap smears or incidence of abnormal wet mount findings were observed. Although women with breast cancer should not use hormonal contraceptives, there is little utility in screening prior to initiation, due to the low incidence of breast cancer and uncertain value of CBE among women of reproductive age. Two fair quality studies demonstrated no differences between women who did or did not undergo pelvic examination prior to initiating OCs or DMPA with respect to risk factors or clinical outcomes. In addition, pelvic examination is not likely to detect any conditions for which hormonal contraceptives would be unsafe. Published by Elsevier Inc.

From Community Laywomen to Breast Health Workers: A Pilot Training Model to Implement Clinical Breast Exam Screening in Malawi.

PubMed

Gutnik, Lily; Moses, Agnes; Stanley, Christopher; Tembo, Tapiwa; Lee, Clara; Gopal, Satish

2016-01-01

Breast cancer burden is high in low-income countries. Inadequate early detection contributes to late diagnosis and increased mortality. We describe the training program for Malawi's first clinical breast exam (CBE) screening effort. Laywomen were recruited as Breast Health Workers (BHWs) with the help of local staff and breast cancer advocates. The four-week training consisted of lectures, online modules, role-playing, case discussions, CBE using simulators and patients, and practice presentations. Ministry of Health trainers taught health communication, promotion, and education skills. Breast cancer survivors shared their experiences. Clinicians taught breast cancer epidemiology, prevention, detection, and clinical care. Clinicians and research staff taught research ethics, informed consent, data collection, and professionalism. Breast cancer knowledge was measured using pre- and post-training surveys. Concordance between BHW and clinician CBE was assessed. Breast cancer talks by BHW were evaluated on a 5-point scale in 22 areas by 3 judges. We interviewed 12 women, and 4 were selected as BHWs including 1 breast cancer survivor. Training was dynamic with modification based on trainee response and progress. A higher-than-anticipated level of comprehension and interest led to inclusion of additional topics like breast reconstruction. Pre-training knowledge increased from 49% to 91% correct (p<0.0001). Clinician and BHW CBE had 88% concordance (kappa 0.43). The mean rating of BHW educational talks was 4.4 (standard deviation 0.7). Malawian laywomen successfully completed training and demonstrated competency to conduct CBE and deliver breast cancer educational talks. Knowledge increased after training, and concordance was high between BHW and clinician CBE.

Utilization of Mammography Services among Elderly Rural and Urban African American Women

ERIC Educational Resources Information Center

Agho, Augustine O; Mosley, Barbara W; Rivers, Patrick A; Parker, Shandowyn

2007-01-01

Purpose: This study was a two-year educational intervention and research project aimed at increasing the awareness of breast cancer and the utilization of Clinical Breast Examination (CBE) services and Self-Breast Examination (SBE) among elderly rural and urban African American women who are Medicare beneficiaries. Design: The study was…

Screening behaviors among African American women at high risk for breast cancer: do beliefs about god matter?

PubMed

Kinney, Anita Yeomans; Emery, Gwyn; Dudley, William N; Croyle, Robert T

2002-06-01

To examine the relationship between beliefs about God as a controlling force in health and adherence to breast cancer screening among high-risk African American women. Cross-sectional cohort. In-person interviews in rural, southeastern Louisiana and telephone interviews conducted at the University of Utah. 52 females who were members of a large kindred with a BRCA1 mutation; no subjects had breast cancer. Survey through in-person or telephone interviews. Belief in God as a controlling agent over health measured by the God Locus of Health Control (GLHC) scale; screening behaviors measured by self-report. Adherence was based on consensus-approved recommendations for BRCA1 carriers or women at risk of being carriers. Bivariate analysis indicated that presence of a primary care provider and low GLHC scores were associated with seeking clinical breast examination (CBE) and mammography. With the variable "presence of a primary care provider" excluded, GLHC scores were inversely associated with seeking CBE and mammography. African American women at increased risk for breast cancer and with high GLHC scores may have a decreased inclination to adhere to CBE and mammography recommendations. Assessing religious and spiritual beliefs and incorporating belief systems into education and counseling sessions may improve understanding and acceptance of presented material.

From Community Laywomen to Breast Health Workers: A Pilot Training Model to Implement Clinical Breast Exam Screening in Malawi

PubMed Central

Gutnik, Lily; Moses, Agnes; Stanley, Christopher; Tembo, Tapiwa; Lee, Clara; Gopal, Satish

2016-01-01

Background Breast cancer burden is high in low-income countries. Inadequate early detection contributes to late diagnosis and increased mortality. We describe the training program for Malawi’s first clinical breast exam (CBE) screening effort. Methods Laywomen were recruited as Breast Health Workers (BHWs) with the help of local staff and breast cancer advocates. The four-week training consisted of lectures, online modules, role-playing, case discussions, CBE using simulators and patients, and practice presentations. Ministry of Health trainers taught health communication, promotion, and education skills. Breast cancer survivors shared their experiences. Clinicians taught breast cancer epidemiology, prevention, detection, and clinical care. Clinicians and research staff taught research ethics, informed consent, data collection, and professionalism. Breast cancer knowledge was measured using pre- and post-training surveys. Concordance between BHW and clinician CBE was assessed. Breast cancer talks by BHW were evaluated on a 5-point scale in 22 areas by 3 judges. Results We interviewed 12 women, and 4 were selected as BHWs including 1 breast cancer survivor. Training was dynamic with modification based on trainee response and progress. A higher-than-anticipated level of comprehension and interest led to inclusion of additional topics like breast reconstruction. Pre-training knowledge increased from 49% to 91% correct (p<0.0001). Clinician and BHW CBE had 88% concordance (kappa 0.43). The mean rating of BHW educational talks was 4.4 (standard deviation 0.7). Conclusions Malawian laywomen successfully completed training and demonstrated competency to conduct CBE and deliver breast cancer educational talks. Knowledge increased after training, and concordance was high between BHW and clinician CBE. PMID:26959980

Does perceived risk predict breast cancer screening use? Findings from a prospective cohort study of female relatives from the Ontario site of the breast cancer family registry.

PubMed

Walker, Meghan J; Mirea, Lucia; Glendon, Gord; Ritvo, Paul; Andrulis, Irene L; Knight, Julia A; Chiarelli, Anna M

2014-08-01

While the relationship between perceived risk and breast cancer screening use has been studied extensively, most studies are cross-sectional. We prospectively examined this relationship among 913 women, aged 25-72 with varying levels of familial breast cancer risk from the Ontario site of the Breast Cancer Family Registry. Associations between perceived lifetime breast cancer risk and subsequent use of mammography, clinical breast examination (CBE) and genetic testing were assessed using logistic regression. Overall, perceived risk did not predict subsequent use of mammography, CBE or genetic testing. Among women at moderate/high familial risk, those reporting a perceived risk greater than 50% were significantly less likely to have a CBE (odds ratio (OR) = 0.52, 95% confidence interval (CI): 0.30-0.91, p = 0.04), and non-significantly less likely to have a mammogram (OR = 0.70, 95% CI: 0.40-1.20, p = 0.70) or genetic test (OR = 0.61, 95% CI: 0.34-1.10, p = 0.09) compared to women reporting a perceived risk of 50%. In contrast, among women at low familial risk, those reporting a perceived risk greater than 50% were non-significantly more likely to have a mammogram (OR = 1.13, 95% CI: 0.59-2.16, p = 0.78), CBE (OR = 1.11, 95% CI: 0.63-1.95, p = 0.74) or genetic test (OR = 1.29, 95% CI: 0.50-3.33, p = 0.35) compared to women reporting a perceived risk of 50%. Perceived risk did not significantly predict screening use overall, however this relationship may be moderated by level of familial risk. Results may inform risk education and management strategies for women with varying levels of familial breast cancer risk. Copyright © 2014 Elsevier Ltd. All rights reserved.

Breast cancer knowledge, attitudes and screening behaviors among Indian-Australian women.

PubMed

Kwok, C; Tranberg, R; Lee, F C

2015-12-01

The aims of the study were to report breast cancer screening practices among Indian-Australian women and to examine the relationship between demographic characteristics, cultural beliefs and women's breast cancer screening (BCS) behaviors. A descriptive and cross-sectional method was used. Two hundred and forty two Indian-Australian women were recruited from several Indian organizations. English versions of the Breast Cancer Screening Beliefs Questionnaire (BCSBQ) were administered. The main research variables are BCS practices, demographic characteristics and total scores on each of the BCSBQ subscales. The majority of participants (72.7%-81.4%) had heard of breast awareness, clinical breast examination (CBE) and mammograms. Only 28.9% performed a BSE monthly and although 60% had practiced CBE, only 27.3% of women within the targeted age group had annual CBE. Only 23.6% of women within the targeted age group reported they had a mammogram biennial. Marital status and length of stay in Australia were positively associated with women's screening behaviors. In terms of BCSBQ score, women who had the three screening practices regularly as recommended obtained significantly higher scores on the "attitude towards general health check-ups" and "barriers to mammographic screening" subscales. There was a significant difference in the mean score of the "knowledge and perceptions about breast cancer" between women who did and who did not engage in breast awareness. Our study reveals that attitudes toward health check-ups and perceived barriers to mammographic screening were influential in determining compliance with breast cancer screening practices among Indian-Australian women. Copyright © 2015 Elsevier Ltd. All rights reserved.

Quality of breast cancer early detection services conducted by well woman clinics in the district of Gampaha, Sri Lanka.

PubMed

Vithana, Palatiyana Vithanage Sajeewanie Chiranthika; Ariyaratne, May; Jayawardana, Pl

2013-01-01

Breast cancer is the most common cancer diagnosed in females in Sri Lanka and early detection can lead to reduction in morbidity and mortality. To evaluate selected aspects of breast cancer early detection services implemented through well woman clinics (WWCs) in the Gampaha District. The study consisted of two components. A retrospective descriptive arm assessed clinical breast examination (CBE) coverage of target age group women (TGW) of 35-59 years in all the WWCs in Gampaha district over 2003- 2007. A cross sectional descriptive study additionally assessed quality of breast cancer early detection services. The Lot Quality Assurance Sampling (LQAS) technique was used to decide on the lot size and threshold values, which were computed as twenty and six clinics. Checklists were employed in assessing coverage, physical facilities and clinic activities. Client satisfaction on WWC services was assessed among 200 TGW attending 20 WWCs using an interviewer-administered questionnaire. CBE coverage in the Gampaha district increased only from 1.1-2.2% over 2003-2007. With regard to physical facilities, the number of clinics that were rated substandard varied between 7-18 (35- 90%). The items that were lacking included dust bins, notice boards, stationary, furniture and linen, and cleanliness of outside premises and toilets. With regard to clinic activities, punctuality of staff, late commencement of clinics, provision of health education, supervision, CBE and breast self-examination (BSE) were substandard in 7- 20 clinics (35-100%). Client satisfaction for WWC services was 45.2% (IQR: 38.7-54.8%) and only 11% had a score of ≥70%, the cut off set for satisfaction. Breast cancer early detection service coverage in the Gampaha district remained low (2.2%) in 2007, 11 years after commencing WWCs. All 20 clinics were substandard for overall CBE and BSE.

Breast Cancer Knowledge, Behaviors, and Preferences in Malawi: Implications for Early Detection Interventions From a Discrete Choice Experiment.

PubMed

Kohler, Racquel E; Gopal, Satish; Lee, Clara N; Weiner, Bryan J; Reeve, Bryce B; Wheeler, Stephanie B

2017-10-01

Breast cancer is the most common female cancer in Africa and leading cause of death resulting from cancer; however, many countries lack early detection services. In Malawi, women are frequently diagnosed with large tumors after long symptomatic periods. Little is known about local cancer knowledge. We administered a cross-sectional survey with a discrete choice experiment to a random sample in urban and rural areas of Lilongwe district. Bivariable and multivariable analyses determined factors associated with knowledge. Preference utilities for early detection interventions were estimated using a hierarchical Bayesian model in Sawtooth software. Of 213 women recruited, fewer than half were aware of breast cancer. In multivariable analysis, electricity at home and knowing someone with cancer increased the odds of awareness. Women were more knowledgeable about symptoms than treatment or risk factors; more than 60% erroneously believed local misconceptions. Seventeen percent were aware of breast self-examination, and 20% were aware of clinical breast examination (CBE); few reported either behavior. Common barriers included not knowing where to access CBE and transportation difficulties. Discrete choice experiment results indicated the detection strategy (breast health awareness, CBE, or both) was the most important attribute of an intervention, followed by the encounter setting and travel time. Addressing misconceptions in health messages and engaging survivors to promote early detection may help improve breast cancer knowledge in Malawi. Program designs accounting for women's preferences should provide breast health education and CBEs in convenient settings to address transportation barriers, particularly for women with low socioeconomic position.

Breast Cancer Knowledge, Behaviors, and Preferences in Malawi: Implications for Early Detection Interventions From a Discrete Choice Experiment

PubMed Central

Gopal, Satish; Lee, Clara N.; Weiner, Bryan J.; Reeve, Bryce B.; Wheeler, Stephanie B.

2017-01-01

Purpose Breast cancer is the most common female cancer in Africa and leading cause of death resulting from cancer; however, many countries lack early detection services. In Malawi, women are frequently diagnosed with large tumors after long symptomatic periods. Little is known about local cancer knowledge. Methods We administered a cross-sectional survey with a discrete choice experiment to a random sample in urban and rural areas of Lilongwe district. Bivariable and multivariable analyses determined factors associated with knowledge. Preference utilities for early detection interventions were estimated using a hierarchical Bayesian model in Sawtooth software. Results Of 213 women recruited, fewer than half were aware of breast cancer. In multivariable analysis, electricity at home and knowing someone with cancer increased the odds of awareness. Women were more knowledgeable about symptoms than treatment or risk factors; more than 60% erroneously believed local misconceptions. Seventeen percent were aware of breast self-examination, and 20% were aware of clinical breast examination (CBE); few reported either behavior. Common barriers included not knowing where to access CBE and transportation difficulties. Discrete choice experiment results indicated the detection strategy (breast health awareness, CBE, or both) was the most important attribute of an intervention, followed by the encounter setting and travel time. Conclusion Addressing misconceptions in health messages and engaging survivors to promote early detection may help improve breast cancer knowledge in Malawi. Program designs accounting for women’s preferences should provide breast health education and CBEs in convenient settings to address transportation barriers, particularly for women with low socioeconomic position. PMID:29094086

Breast cancer screening (breast self-examination, clinical breast exam, and mammography) in women referred to health centers in Tabriz, Iran.

PubMed

Khalili, Azizeh Farshbaf; Shahnazi, Mahnaz

2010-04-01

Breast cancer is the most common cancer and the most common cause of death in Iranian women aged 35-55 years. Breast cancer screening comprises breast self-examination (BSE), clinical breast examination (CBE) and mammography. The study aimed to examine the performance of screening methods among women referring to health centers of Tabriz, Iran. This was a descriptive-analytical research carried out on 400 women aged 20-50 years. The samples were chosen through random multistage sampling among health centers of Tabriz then active records of women. A questionnaire and observational checklist was used to elicit socio-demographic information and performance of women towards breast cancer screening methods. Descriptive and inferential statistics (chi-square and Fisher's exact test) were used to analyze the data. Only 18.8% of women did breast self-examination, 19.1% had clinical breast examination and 3.3% had mammogram. Statistical test showed a significant relationship between performing BSE and educational level, employment, income, number of children, breastfeeding history, breastfeeding quality and family history of breast cancer. There was a significant correlation between performing CBE and history of breast tumor and also, between performing the mammography and family history of breast cancer and history of breast tumor (P < 0.05). The findings showed that the performance of breast cancer screening methods was not satisfactory. Performance in high risk women was very desirable than others. The presentation of imperative education about breast cancer screening methods through health staff especially in pregnancy, post-partum and even in pre marriage counseling periods seems necessary.

Cost-effectiveness of alternative strategies for integrating MRI into breast cancer screening for women at high risk.

PubMed

Ahern, C H; Shih, Y-C T; Dong, W; Parmigiani, G; Shen, Y

2014-10-14

Magnetic resonance imaging (MRI) is recommended for women at high risk for breast cancer. We evaluated the cost-effectiveness of alternative screening strategies involving MRI. Using a microsimulation model, we generated life histories under different risk profiles, and assessed the impact of screening on quality-adjusted life-years, and lifetime costs, both discounted at 3%. We compared 12 screening strategies combining annual or biennial MRI with mammography and clinical breast examination (CBE) in intervals of 0.5, 1, or 2 years vs without, and reported incremental cost-effectiveness ratios (ICERs). Based on an ICER threshold of $100,000/QALY, the most cost-effective strategy for women at 25% lifetime risk was to stagger MRI and mammography plus CBE every year from age 30 to 74, yielding ICER $58,400 (compared to biennial MRI alone). At 50% lifetime risk and with 70% reduction in MRI cost, the recommended strategy was to stagger MRI and mammography plus CBE every 6 months (ICER=$84,400). At 75% lifetime risk, the recommended strategy is biennial MRI combined with mammography plus CBE every 6 months (ICER=$62,800). The high costs of MRI and its lower specificity are limiting factors for annual screening schedule of MRI, except for women at sufficiently high risk.

Clinical breast examination and mammography: inequalities in Southern and Northeast Brazilian regions.

PubMed

Borges, Zaida da Silva; Wehrmeister, Fernando César; Gomes, Ana Paula; Gonçalves, Helen

2016-03-01

To evaluate the prevalence and associated factors of doing clinical breast examinations (CBE) and mammogram (MMG) in the Southern and Northeast Brazilian regions, focusing on some social inequalities. This is a cross-sectional study using data from the 2008 National Household Sampling Survey (PNAD). We evaluated the prevalence of CBE during the last year and of the MMG in the last two years, which were analyzed based on demographic (age, skin color, and marital status) and socioeconomic (income and schooling) variables. Gross and adjusted prevalence ratios were obtained using Poisson regression models. All analyses were stratified by region. The sample comprised 27,718 women aged 40 to 69 years. Less than a half of the women followed the recommendation of annual CBE performance in both the regions. The MMG prevalence during the last two years was 58.6 and 45.5% for the Southern and Northeast regions, respectively. More than a quarter of the women had never had a MMG (26.5% in the Southern and 40.6% in the Northeast regions). Not having performed both examinations was almost two times higher in the Northeast region (29.7%) when compared with the Southern (15.9%). The risk for not having performed both examinations was greater among nonwhite women, aged 60 to 69 years, with lower schooling level and family income. Important inequalities were seen between the Southern and Northeast regions for CBE and MMG. Health public policies should prioritize the most vulnerable groups to reduce these inequalities.

Breast and cervical cancer-screening uptake among females in Ardabil, northwest Iran: a community-based study.

PubMed

Farzaneh, Esmaeil; Heydari, Heshmatolah; Shekarchi, Ali Akbar; Kamran, Aziz

2017-01-01

Breast and cervical cancers are the most commonly diagnosed type of cancer and cause of cancer-related deaths in Iranian females. In contrast to previous studies, this study was carried out with a large sample size for assessment of breast self-examination (BSE)-, clinical breast examination (CBE)-, mammography-, and Pap smear-uptake rates and determination of associations among these screening behaviors with sociodemographic and cognitive variables in Azeri females. This was a cross-sectional, community-based study that was carried out among 1,134 females 20-60 years old during March-June 2016. Data-collection variables included sociodemographic questions, screening behaviors for breast and cervical cancer, self-efficacy, beliefs, and barriers to breast and cervical cancer screening. Collected data were analyzed by SPSS version 13 using χ 2 , Mann-Whitney U , and logistic regression tests. Among the 1,134 participants, 53.9%, 9.8%, and 28.1% had done BSE, CBE, and Pap smear tests, respectively, and among the 625 females aged >40 years, 187 (29.9%) had done the mammography test. Moreover, 416 (36.7%), 103 (16.5%), and 64 (5.6%) females had done BSE, mammography, and CBE regularly, respectively. Beliefs, barriers, income, health insurance, number of children, and age were all important factors for BSE and regular BSE and mammography. Females who had high belief scores were more likely to undertake mammography (odds ratio [OR]: 1.2, 95% confidence interval [CI]: 1.03-1.5), regular mammography (OR: 4.2, 95% CI: 1.9-9.3), regular CBE (OR: 1.25, 95% CI: 1.2-1.3), and Pap smears (OR: 1.2, 95% CI: 1.1-1.4). Also, females who had high self-efficacy scores were more likely to perform regular BSE (OR: 1.8, 95% CI: 1.4-2.5) and mammography (OR: 2.5, 95% CI: 1.4-4.6) than females with lower self-efficacy scores. The frequency of breast and cervical cancer screening was low in our study. The findings of this study indicated that beliefs, self-efficacy, and barriers were important predictive factors of cancer-screening behavior among the females studied.

Correlates of clinical breast examination among lesbian, gay, bisexual, and queer women.

PubMed

Lacombe-Duncan, Ashley; Logie, Carmen H

2016-12-27

Lesbian, gay, bisexual, and queer (LGBQ) women have increased risk of breast cancer yet lower use of early detection screening than heterosexual women. This lower use may be due in part to sexual stigma. The study purpose was to explore correlates of past two-year clinical breast examination (CBE) among LGBQ women to better understand screening disparities, particularly among gender non-conforming LGBQ women. A cross-sectional Internet-based survey was conducted with LGBQ women in 2011-2012. We conducted multivariate logistic regression to assess the associations between individual, social/structural and health care factors and past two-year CBE among LGBQ women (n = 414), including a subsample of gender non-conforming LGBQ women (n = 148). In multivariate analyses, significant correlates of past two-year CBE among the full sample included sexually transmitted infection knowledge (OR: 1.12, 95% CI: 1.05, 1.19), sexual risk practices (OR: 0.92, 95% CI: 0.87, 0.98), past two-year Papanicolaou test (OR: 8.36, 95% CI: 4.24, 16.45), having a regular source of health care (OR: 4.84, 95% CI: 2.60, 9.01), and health care provider knowing one's sexual orientation (OR: 3.60, 95% CI: 2.29, 5.81). Among gender non-conforming LGBQ women, perceived gender non-conformity stigma (OR: 0.85, 95% CI: 0.74, 0.99) and belief that one's health care provider is uncomfortable with one's sexual orientation (OR: 0.33, 95% CI: 0.11, 1.00) were also associated with lower screening. These findings enhance understanding of individual, social/structural, and health care factors correlated with CBE among LGBQ women. More research is needed to understand the complex interplay of these factors to inform multi-level interventions to address screening disparities for diverse LGBQ women.

Guidelines for breast cancer screening in Lebanon Public Health Communication.

PubMed

Adib, Salim M; El Saghir, Nagi S; Ammar, Walid

2009-01-01

The accumulation of national epidemiological data since the late 1990s has led to the adoption of evidence-based guidelines for breast cancer screening in Lebanon (2006). Almost 50% of breast cancer patients in Lebanon are below the age of 50 years and the age-adjusted incidence rate is estimated at 69 new cases per 100,000 per year (2004). This official notification calls for breast self-examination (BSE) every month starting age 20, and a clinical breast examination (CBE) performed by a physician every three years between the ages of 20 and 40 years. Starting age 40, and for as long as a woman is in good health, an annual CBE and mammography are recommended. Women with known genetic family history of breast cancer should start screening 10 years earlier than the first young patient in the family, or earlier depending on medical advice. The Breast Cancer National Task Force (BCNTF) recommends certification of mammography centers and continued training of personnel to assure high quality mammograms, and to minimize unnecessary investigations and surgeries.It recommends that a national program should record call-backs of women for annual screening and follow-up data on abnormal mammograms. BCNTF encourages the adoption of these guidelines and monitoring of their results, as well as follow-up of breast cancer epidemiology and registry in Lebanon, and scientific progress in early breast cancer detection to determine needs for modifications in the future.

Breast and cervical cancer-screening uptake among females in Ardabil, northwest Iran: a community-based study

PubMed Central

Farzaneh, Esmaeil; Heydari, Heshmatolah; Shekarchi, Ali Akbar; Kamran, Aziz

2017-01-01

Purpose Breast and cervical cancers are the most commonly diagnosed type of cancer and cause of cancer-related deaths in Iranian females. In contrast to previous studies, this study was carried out with a large sample size for assessment of breast self-examination (BSE)-, clinical breast examination (CBE)-, mammography-, and Pap smear-uptake rates and determination of associations among these screening behaviors with sociodemographic and cognitive variables in Azeri females. Materials and methods This was a cross-sectional, community-based study that was carried out among 1,134 females 20–60 years old during March–June 2016. Data-collection variables included sociodemographic questions, screening behaviors for breast and cervical cancer, self-efficacy, beliefs, and barriers to breast and cervical cancer screening. Collected data were analyzed by SPSS version 13 using χ2, Mann–Whitney U, and logistic regression tests. Results Among the 1,134 participants, 53.9%, 9.8%, and 28.1% had done BSE, CBE, and Pap smear tests, respectively, and among the 625 females aged >40 years, 187 (29.9%) had done the mammography test. Moreover, 416 (36.7%), 103 (16.5%), and 64 (5.6%) females had done BSE, mammography, and CBE regularly, respectively. Beliefs, barriers, income, health insurance, number of children, and age were all important factors for BSE and regular BSE and mammography. Females who had high belief scores were more likely to undertake mammography (odds ratio [OR]: 1.2, 95% confidence interval [CI]: 1.03–1.5), regular mammography (OR: 4.2, 95% CI: 1.9–9.3), regular CBE (OR: 1.25, 95% CI: 1.2–1.3), and Pap smears (OR: 1.2, 95% CI: 1.1–1.4). Also, females who had high self-efficacy scores were more likely to perform regular BSE (OR: 1.8, 95% CI: 1.4–2.5) and mammography (OR: 2.5, 95% CI: 1.4–4.6) than females with lower self-efficacy scores. Conclusion The frequency of breast and cervical cancer screening was low in our study. The findings of this study indicated that beliefs, self-efficacy, and barriers were important predictive factors of cancer-screening behavior among the females studied. PMID:28255244

Evaluating the knowledge of breast cancer screening and prevention among Arab-American women in Michigan.

PubMed

Arshad, Samia; Williams, Karen Patricia; Mabiso, Athur; Dey, Subhojit; Soliman, Amr S

2011-03-01

Arab-American women are more likely to be diagnosed with advanced staged breast cancer. We analyzed data from 100 women utilizing a breast cancer literacy assessment tool aimed at understanding functional literacy levels about breast-self exams (BSE), clinical breast exams (CBE), and mammograms. The educational program improved women's knowledge of BSE (OR = 0.15; 95% CI = 0.04, 0.50) and CBE (OR = 0.15; 95% CI = 0.04, 0.54), more for women with higher education. Consideration of women's educational status is an important factor in planning educational programs to improve knowledge on breast cancer screening and prevention in this minority population.

Knowledge, attitude and practice about breast cancer and breast self-examination among women seeking out-patient care in a teaching hospital in central India.

PubMed

Siddharth, Rao; Gupta, D; Narang, R; Singh, P

2016-01-01

Breast cancer (BC) continues to be a major cause of morbidity and mortality throughout the world. Early detection of BC and early treatment increases the chance of survival. According to Breast Health Global Initiative guidelines for low and middle income countries, diagnosing BCs early by promoting breast self-awareness; clinical breast examination (CBE) and resource adapted mammographic screening will reduce BC mortality. There is a paucity of data on the knowledge and awareness of BC and self-breast examination in India. We designed this hospital based cross sectional descriptive study to evaluate the current status of knowledge, awareness and practices related to BC and breast self-examination in the female rural population attending a teaching hospital. We did a random sampling to identify and enroll 360 women and their female relatives. We excluded a participant from the study if she had already undergone a screening mammography or had had a BC. The data was collected by a self-administered questionnaire in vernacular language. Our study population included 360 women with a mean age of 45.81 (±10.9) years. Only 5 (1.38%) females had a family history of BC. A whopping 81% of women did not have any knowledge about BC. All the women thought that CBE by doctors was the only way for screening BC. We concluded that with the results of this study, it is imperative to increase awareness about BC and its detection methods in the community through health education campaigns. We should have major policy changes to increase future screening programs and health education programs which would have an overall positive impact on reducing the disease burden.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Terenziani, Monica; Casalini, Patrizia; Scaperrotta, Gianfranco

Purpose: To assess the occurrence of breast cancer (BC) after exposure to ionizing radiation for pediatric cancer, by means of a multimodal screening program. Patients and Methods: We identified 86 patients who had received chest wall radiation therapy for pediatric cancer. Clinical breast examination (CBE), ultrasound (US), and mammography (MX) were performed yearly. Magnetic resonance imaging (MRI) was added as of October 2007. We calculated the risk of developing BC by radiation therapy dose, patient age, and menarche before or after primary treatment. Results: Eleven women developed a BC from July 2002-February 2010. The sensitivity of the screening methods wasmore » 36% for CBE, 73% for MX, 55% for US, and 100% for MRI; the specificity was 91%, 99%, 95%, and 80% for CBE, MX, US, and MRI, respectively. The annual BC detection rate was 2.9%. The median age at BC diagnosis was 33 years. Although age had no influence, menarche before as opposed to after radiation therapy correlated significantly with BC (P=.027): the annual BC detection rate in the former subgroup was 5.3%. Conclusions: Mammography proved more sensitive and specific in our cohort of young women than CBE or US. Magnetic resonance imaging proved 100% sensitive (but this preliminary finding needs to be confirmed). Our cohort of patients carries a 10-fold BC risk at an age more than 20 years younger than in the general population.« less

Awareness of breast cancer and barriers to breast screening uptake in Bangladesh: A population based survey.

PubMed

Islam, Rakibul M; Bell, Robin J; Billah, Baki; Hossain, Mohammad B; Davis, Susan R

2016-02-01

To investigate the awareness of breast cancer (BCa) and BCa screening amongst women at midlife in Bangladesh. A nationally representative cross-sectional survey of women aged 30-59 years was conducted in 7 districts of the 7 divisions in Bangladesh, using a multistage cluster sampling technique. The factors associated with the awareness of BCa and breast assessment of asymptomatic women were investigated separately, using multivariable logistic regression. Of the 1590 participants, mean age 42.3 (±8.0) years, 81.9% had ever heard of BCa and 64.2% of any methods of BCa screening, respectively. Awareness of BCa was associated with being aged 40-49 years (adjusted OR 2.04, 95% CI 1.46-2.84), aged 49-59 years (1.96, 1.32-2.91), being overweight (1.46, 1.07-2.01) and obesity (1.62, 1.01-2.62), while inversely associated with rural dwelling (0.37, 0.22-0.61), primary education (0.44, 0.27-0.70), having no education (0.23, 0.14-0.36) and parity (0.62, 0.44-0.87). Of the 750 women who were aware of clinical breast examination (CBE) or mammography, reasons provided for not undergoing screening included that they had no symptoms (92%) and that they did not know screening was needed (40%). 8% of women reported CBE. Women with no education were less likely to have undergone CBE (0.38, 0.141.04; p=0.059). Lack of understanding of the assessment of asymptomatic women is the key obstacle to BCa screening uptake in Bangladesh. Health education programs, especially BCa awareness programs, have the potential to increase BCa awareness and down-staging of the disease. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

[Cost-effectiveness of multiple screening modalities on breast cancer in Chinese women from Shanghai].

PubMed

Wu, F; Mo, M; Qin, X X; Fang, H; Zhao, G M; Liu, G Y; Chen, Y Y; Cao, Z G; Yan, Y J; Lyu, L L; Xu, W H; Shao, Z M

2017-12-10

Objective: To determine the most cost-effective modality for breast cancer screening in women living in Shanghai. Methods: A Markov model for breast cancer was redeveloped based on true effect which was derived from a project for detection of women at high risk of breast cancer and an organized breast cancer screening program conducted simultaneously in Minhang district, Shanghai, during 2008 to 2012. Parameters of the model were derived from literatures. General principles related to cost-effectiveness analysis were used to compare the costs and effects of 12 different screening modalities in a simulated cohort involving 100 000 women aged 45 years. Incremental cost-effectiveness ratio (ICER) was used to determine the most cost-effective modality. Sensitivity analysis was conducted to evaluate how these factors affected the estimated cost-effectiveness. Results: The modality of biennial CBE followed by ultrasonic and mammography among those with positive CBE was observed as the most cost-effective one. The costs appeared as 182 526 Yuan RMB per life year gained and 144 386 Yuan RMB per quality adjusted life-year (QALY) saved, which were within the threshold of 2-3 times of local per capita Gross Domestic Product. Results from sensitivity analysis showed that, due to higher incidence rate of breast cancer in Shanghai, the cost per QALY would be 64 836 Yuan RMB lower in Shanghai than the average level in China. Conclusion: Our research findings showed that the biennial CBE program followed by ultrasonic and mammography for those with positive CBE results might serve as the optimal breast cancer screening modality for Chinese women living in Shanghai, and thus be widely promoted in this population elsewhere.

Tactile Imaging of an Imbedded Palpable Structure for Breast Cancer Screening

PubMed Central

2015-01-01

Apart from texture, the human finger can sense palpation. The detection of an imbedded structure is a fine balance between the relative stiffness of the matrix, the object, and the device. If the device is too soft, its high responsiveness will limit the depth to which the imbedded structure can be detected. The sensation of palpation is an effective procedure for a physician to examine irregularities. In a clinical breast examination (CBE), by pressing over 1 cm2 area, at a contact pressure in the 70–90 kPa range, the physician feels cancerous lumps that are 8- to 18-fold stiffer than surrounding tissue. Early detection of a lump in the 5–10 mm range leads to an excellent prognosis. We describe a thin-film tactile device that emulates human touch to quantify CBE by imaging the size and shape of 5–10 mm objects at 20 mm depth in a breast model using ∼80 kPa pressure. The linear response of the device allows quantification where the greyscale corresponds to the relative local stiffness. The (background) signal from <2.5-fold stiffer objects at a size below 2 mm is minimal. PMID:25148477

Factors associated with routine screening for the early detection of breast cancer in cultural-ethnic and faith-based communities.

PubMed

Freund, Anat; Cohen, Miri; Azaiza, Faisal

2017-07-04

Studies have shown a lower adherence to health behaviors among women in cultural-ethnic minorities and faith-based communities, especially lower screening attendance for the early detection of breast cancer. This study compares factors related to cancer screening adherence in two distinct cultural-ethnic minorities in Israel: Arab women as a cultural-ethnic minority and Jewish ultra-Orthodox women as a cultural-ethnic faith-based minority. During the year 2014, a total of 398 Jewish ultra-Orthodox women and 401 Arab women between the ages of 40-60, were randomly selected using population-based registries. These women answered questionnaires regarding adherence to mammography and clinical breast examination (CBE), health beliefs and cultural barriers. Arab women adhered more than ultra-Orthodox women to mammography (p < .001) and CBE exams (p < .01). Religious beliefs, exposure barriers and perceived risk were higher among the ultra-Orthodox women, while social barriers, accessibility barriers and perceived severity were higher among the Arab women (p < .01). Adjusting for background factors, higher adherence to CBE and mammography were associated with lower levels of religious beliefs (AOR = 0.90, 95% CI = 0.69-1.17 AOR = 0.62, 95% CI = 0.39-0.82, respectively), perceiving a higher risk of cancer (AOR = 1.93, 95% CI = 1.23-3.04 and AOR = 3.22, 95% CI = 1.53-6.61), and having more fears related to cancer-related losses (AOR = 1.51, 95% CI = 1.19-3.00 and AOR = 1.24, 95% CI = 0.63-1.22). In addition, perceiving greater advantages of CBE was associated with higher adherence to CBE (AOR = 1.82, 95% CI = 1.45-2.29), while not receiving a physician's recommendation was associated with lower adherence to mammography (AOR = 1.82, 95% CI = 1.45-2.29). This study addressed a lacuna in screening behaviors of women from cultural-ethnic and faith-based communities. In order to increase adherence, health care professionals and policymakers should direct their attention to the specific nature of each community.

Long-Term Cancer Outcomes From Study NRG Oncology/RTOG 9517: A Phase 2 Study of Accelerated Partial Breast Irradiation With Multicatheter Brachytherapy After Lumpectomy for Early-Stage Breast Cancer

DOE Office of Scientific and Technical Information (OSTI.GOV)

White, Julia, E-mail: Julia.White@osumc.edu; Winter, Kathryn; Kuske, Robert R.

Purpose: To examine 10-year rates of local, regional, and distant recurrences, patterns of recurrence, and survival rates for breast cancer patients enrolled on Study NRG Oncology/Radiation Therapy Oncology Group 9517, a multi-institutional prospective trial that studied one of the earliest methods of accelerated partial breast irradiation (APBI), multicatheter brachytherapy (MCT). Methods and Materials: Eligibility included stage I/II unifocal breast cancer <3 cm in size after lumpectomy with negative surgical margins and 0 to 3 positive axillary nodes without extracapsular extension. The APBI dose delivered was 34 Gy in 10 twice-daily fractions over 5 days for high-dose-rate (HDR); and 45 Gy in 3.5 to 5 days formore » low-dose-rate (LDR) brachytherapy. The primary endpoint was HDR and LDR MCT reproducibility. This analysis focuses on long-term ipsilateral breast recurrence (IBR), contralateral breast cancer events (CBE), regional recurrence (RR), and distant metastases (DM), disease-free, and overall survival. Results: The median follow-up was 12.1 years. One hundred patients were accrued from 1997 to 2000; 98 were evaluable; 65 underwent HDR and 33 LDR MCT. Median age was 62 years; 88% had T1 tumors; 81% were pN0. Seventy-seven percent were estrogen receptor and/or progesterone receptor positive; 33% received adjuvant chemotherapy and 64% antiendocrine therapy. There have been 4 isolated IBRs and 1 IBR with RR, for 5.2% 10-year IBR without DM. There was 1 isolated RR, 1 with IBR, and 1 with a CBE, for 3.1% 10-year RR without DM. The 10-year CBE rate was 4.2%, with 5 total events. Eleven patients have developed DM, 8 have died of breast cancer, and 22 have died from other causes. The 10-year DFS and OS rates are 69.8% and 78.0%, respectively. Conclusion: This multi-institutional, phase 2 trial studying MCT-APBI continues to report durable in-breast cancer control rates with long-term follow-up.« less

Long-Term Cancer Outcomes From Study NRG Oncology/RTOG 9517: A Phase 2 Study of Accelerated Partial Breast Irradiation With Multicatheter Brachytherapy After Lumpectomy for Early-Stage Breast Cancer.

PubMed

White, Julia; Winter, Kathryn; Kuske, Robert R; Bolton, John S; Arthur, Douglas W; Scroggins, Troy; Rabinovitch, Rachel A; Kelly, Tracy; Toonkel, Leonard M; Vicini, Frank A; McCormick, Beryl

2016-08-01

To examine 10-year rates of local, regional, and distant recurrences, patterns of recurrence, and survival rates for breast cancer patients enrolled on Study NRG Oncology/Radiation Therapy Oncology Group 9517, a multi-institutional prospective trial that studied one of the earliest methods of accelerated partial breast irradiation (APBI), multicatheter brachytherapy (MCT). Eligibility included stage I/II unifocal breast cancer <3 cm in size after lumpectomy with negative surgical margins and 0 to 3 positive axillary nodes without extracapsular extension. The APBI dose delivered was 34 Gy in 10 twice-daily fractions over 5 days for high-dose-rate (HDR); and 45 Gy in 3.5 to 5 days for low-dose-rate (LDR) brachytherapy. The primary endpoint was HDR and LDR MCT reproducibility. This analysis focuses on long-term ipsilateral breast recurrence (IBR), contralateral breast cancer events (CBE), regional recurrence (RR), and distant metastases (DM), disease-free, and overall survival. The median follow-up was 12.1 years. One hundred patients were accrued from 1997 to 2000; 98 were evaluable; 65 underwent HDR and 33 LDR MCT. Median age was 62 years; 88% had T1 tumors; 81% were pN0. Seventy-seven percent were estrogen receptor and/or progesterone receptor positive; 33% received adjuvant chemotherapy and 64% antiendocrine therapy. There have been 4 isolated IBRs and 1 IBR with RR, for 5.2% 10-year IBR without DM. There was 1 isolated RR, 1 with IBR, and 1 with a CBE, for 3.1% 10-year RR without DM. The 10-year CBE rate was 4.2%, with 5 total events. Eleven patients have developed DM, 8 have died of breast cancer, and 22 have died from other causes. The 10-year DFS and OS rates are 69.8% and 78.0%, respectively. This multi-institutional, phase 2 trial studying MCT-APBI continues to report durable in-breast cancer control rates with long-term follow-up. Copyright © 2016 Elsevier Inc. All rights reserved.

Use of Simulators to Explore Specialty Recommendation for a Palpable Breast Mass

PubMed Central

Laufer, Shlomi; Ray, Rebecca D.; D'Angelo, Anne-Lise D.; Jones, Grace F.; Pugh, Carla M.

2015-01-01

Background The study aim was to evaluate recommendation patterns of different specialties for the work-up of a palpable breast mass using simulated scenarios and clinical breast examination (CBE) models. Methods Study participants were a convenience sample of physicians (n=318) attending annual surgical, family practice and obstetrics and gynecology (OB/GYN) conferences. Two different silicone-based breast models (superficial mass vs chest wall mass) were used to test CBE skills and recommendation patterns (imaging, tissue sampling, and follow-up). Results Participants were more likely to recommend mammography (p<.001) and core biopsy (p<.0001) and less likely to recommend needle aspiration (p<.043) and 1-month follow up (p<.001) for the chest wall mass compared to the superficial mass. Family practitioners were less likely to recommend ultrasound (p<.001) and OB/GYNs were less likely to recommend mammogram (p<.006) across models. Surgeons were more likely to recommend core biopsy and less likely to recommend needle aspiration across models (p<.001) Conclusions Recommendation patterns differed across the two models in line with existing practice guidelines. Additionally, differences in practice patterns between primary care and specialty providers may represent varying clinician capabilities, health care resources, and individual preferences. Our work shows that simulation may be used to track adherence to practice guidelines for breast masses. PMID:26198334

Breast Cancer Screening (PDQ®)—Patient Version

Cancer.gov

Breast cancer screening is performed using mammogram, clinical breast exam (CBE), and MRI (magnetic resonance imaging) tests. Learn about these and other tests that have been studied to detect or screen for breast cancer in this expert-reviewed and evidence-based summary.

Does medical students' preference of test format (computer-based vs. paper-based) have an influence on performance?

PubMed

Hochlehnert, Achim; Brass, Konstantin; Moeltner, Andreas; Juenger, Jana

2011-10-25

Computer-based examinations (CBE) ensure higher efficiency with respect to producibility and assessment compared to paper-based examinations (PBE). However, students often have objections against CBE and are afraid of getting poorer results in a CBE.The aims of this study were (1) to assess the readiness and the objections of students to a CBE vs. PBE (2) to examine the acceptance and satisfaction with the CBE on a voluntary basis, and (3) to compare the results of the examinations, which were conducted in different formats. Fifth year medical students were introduced to an examination-player and were free to choose their format for the test. The reason behind the choice of the format as well as the satisfaction with the choice was evaluated after the test with a questionnaire. Additionally, the expected and achieved examination results were measured. Out of 98 students, 36 voluntarily chose a CBE (37%), 62 students chose a PBE (63%). Both groups did not differ concerning sex, computer-experience, their achieved examination results of the test, and their satisfaction with the chosen format. Reasons for the students' objections against CBE include the possibility for outlines or written notices, a better overview, additional noise from the keyboard or missing habits normally present in a paper based exam. The students with the CBE tended to judge their examination to be more clear and understandable. Moreover, they saw their results to be independent of the format. Voluntary computer-based examinations lead to equal test scores compared to a paper-based format.

Does Medical Students' Preference of Test Format (Computer-based vs. Paper-based) have an Influence on Performance?

PubMed Central

2011-01-01

Background Computer-based examinations (CBE) ensure higher efficiency with respect to producibility and assessment compared to paper-based examinations (PBE). However, students often have objections against CBE and are afraid of getting poorer results in a CBE. The aims of this study were (1) to assess the readiness and the objections of students to a CBE vs. PBE (2) to examine the acceptance and satisfaction with the CBE on a voluntary basis, and (3) to compare the results of the examinations, which were conducted in different formats. Methods Fifth year medical students were introduced to an examination-player and were free to choose their format for the test. The reason behind the choice of the format as well as the satisfaction with the choice was evaluated after the test with a questionnaire. Additionally, the expected and achieved examination results were measured. Results Out of 98 students, 36 voluntarily chose a CBE (37%), 62 students chose a PBE (63%). Both groups did not differ concerning sex, computer-experience, their achieved examination results of the test, and their satisfaction with the chosen format. Reasons for the students' objections against CBE include the possibility for outlines or written notices, a better overview, additional noise from the keyboard or missing habits normally present in a paper based exam. The students with the CBE tended to judge their examination to be more clear and understandable. Moreover, they saw their results to be independent of the format. Conclusions Voluntary computer-based examinations lead to equal test scores compared to a paper-based format. PMID:22026970

Costs, effects and cost-effectiveness of breast cancer control in Ghana.

PubMed

Zelle, Sten G; Nyarko, Kofi M; Bosu, William K; Aikins, Moses; Niëns, Laurens M; Lauer, Jeremy A; Sepulveda, Cecilia R; Hontelez, Jan A C; Baltussen, Rob

2012-08-01

Breast cancer control in Ghana is characterised by low awareness, late-stage treatment and poor survival. In settings with severely constrained health resources, there is a need to spend money wisely. To achieve this and to guide policy makers in their selection of interventions, this study systematically compares costs and effects of breast cancer control interventions in Ghana. We used a mathematical model to estimate costs and health effects of breast cancer interventions in Ghana from the healthcare perspective. Analyses were based on the WHO-CHOICE method, with health effects expressed in disability-adjusted life years (DALYs), costs in 2009 US dollars (US$) and cost-effectiveness ratios (CERs) in US$ per DALY averted. Analyses were based on local demographic, epidemiological and economic data, to the extent these data were available. Biennial screening by clinical breast examination (CBE) of women aged 40-69 years, in combination with treatment of all stages, seems the most cost-effective intervention (costing $1299 per DALY averted). The intervention is also economically attractive according to international standards on cost-effectiveness. Mass media awareness raising (MAR) is the second best option (costing $1364 per DALY averted). Mammography screening of women of aged 40-69 years (costing $12,908 per DALY averted) cannot be considered cost-effective. Both CBE screening and MAR seem economically attractive interventions. Given the uncertainty about the effectiveness of these interventions, only their phased introduction, carefully monitored and evaluated, is warranted. Moreover, their implementation is only meaningful if the capacity of basic cancer diagnostic, referral and treatment and possibly palliative services is simultaneously improved. © 2012 Blackwell Publishing Ltd.

3-D in vitro estimation of temperature using the change in backscattered ultrasonic energy.

PubMed

Arthur, R Martin; Basu, Debomita; Guo, Yuzheng; Trobaugh, Jason W; Moros, Eduardo G

2010-08-01

Temperature imaging with a non-invasive modality to monitor the heating of tumors during hyperthermia treatment is an attractive alternative to sparse invasive measurement. Previously, we predicted monotonic changes in backscattered energy (CBE) of ultrasound with temperature for certain sub-wavelength scatterers. We also measured CBE values similar to our predictions in bovine liver, turkey breast muscle, and pork rib muscle in 2-D in vitro studies and in nude mice during 2-D in vivo studies. To extend these studies to three dimensions, we compensated for motion and measured CBE in turkey breast muscle. 3-D data sets were assembled from images formed by a phased-array imager with a 7.5-MHz linear probe moved in 0.6-mm steps in elevation during uniform heating from 37 to 45 degrees C in 0.5 degrees C increments. We used cross-correlation as a similarity measure in RF signals to automatically track feature displacement as a function of temperature. Feature displacement was non-rigid. Envelopes of image regions, compensated for non-rigid motion, were found with the Hilbert transform then smoothed with a 3 x 3 running average filter before forming the backscattered energy at each pixel. CBE in 3-D motion-compensated images was nearly linear with an average sensitivity of 0.30 dB/ degrees C. 3-D estimation of temperature in separate tissue regions had errors with a maximum standard deviation of about 0.5 degrees C over 1-cm(3) volumes. Success of CBE temperature estimation based on 3-D non-rigid tracking and compensation for real and apparent motion of image features could serve as the foundation for the eventual generation of 3-D temperature maps in soft tissue in a non-invasive, convenient, and low-cost way in clinical hyperthermia.

Computer-Based Education (CBE): Tomorrow's Traditional System.

ERIC Educational Resources Information Center

Rizza, Peter J., Jr.

1981-01-01

Examines the role of computer technology in education; discusses reasons for the slow evolution of Computer-Based Education (CBE); explores educational areas in which CBE can be used; presents barriers to widespread use of CBE; and describes the responsibilities of education, government, and business in supporting technology-oriented education.…

Surveillance for cancer recurrence in long-term young breast cancer survivors randomly selected from a statewide cancer registry.

PubMed

Jones, Tarsha; Duquette, Debra; Underhill, Meghan; Ming, Chang; Mendelsohn-Victor, Kari E; Anderson, Beth; Milliron, Kara J; Copeland, Glenn; Janz, Nancy K; Northouse, Laurel L; Duffy, Sonia M; Merajver, Sofia D; Katapodi, Maria C

2018-05-01

This study examined clinical breast exam (CBE) and mammography surveillance in long-term young breast cancer survivors (YBCS) and identified barriers and facilitators to cancer surveillance practices. Data collected with a self-administered survey from a statewide, randomly selected sample of YBCS diagnosed with invasive breast cancer or ductal carcinoma in situ younger than 45 years old, stratified by race (Black vs. White/Other). Multivariate logistic regression models identified predictors of annual CBEs and mammograms. Among 859 YBCS (n = 340 Black; n = 519 White/Other; mean age = 51.0 ± 5.9; diagnosed 11.0 ± 4.0 years ago), the majority (> 85%) reported an annual CBE and a mammogram. Black YBCS in the study were more likely to report lower rates of annual mammography and more barriers accessing care compared to White/Other YBCS. Having a routine source of care, confidence to use healthcare services, perceived expectations from family members and healthcare providers to engage in cancer surveillance, and motivation to comply with these expectations were significant predictors of having annual CBEs and annual mammograms. Cost-related lack of access to care was a significant barrier to annual mammograms. Routine source of post-treatment care facilitated breast cancer surveillance above national average rates. Persistent disparities regarding access to mammography surveillance were identified for Black YBCS, primarily due to lack of access to routine source of care and high out-of-pocket costs. Public health action targeting cancer surveillance in YBCS should ensure routine source of post-treatment care and address cost-related barriers. Clinical Trials Registration Number: NCT01612338.

Cost-Effectiveness Analysis of Breast Cancer Control Interventions in Peru

PubMed Central

Zelle, Sten G.; Vidaurre, Tatiana; Abugattas, Julio E.; Manrique, Javier E.; Sarria, Gustavo; Jeronimo, José; Seinfeld, Janice N.; Lauer, Jeremy A.; Sepulveda, Cecilia R.; Venegas, Diego; Baltussen, Rob

2013-01-01

Objectives In Peru, a country with constrained health resources, breast cancer control is characterized by late stage treatment and poor survival. To support breast cancer control in Peru, this study aims to determine the cost-effectiveness of different breast cancer control interventions relevant for the Peruvian context. Methods We performed a cost-effectiveness analysis (CEA) according to WHO-CHOICE guidelines, from a healthcare perspective. Different screening, early detection, palliative, and treatment interventions were evaluated using mathematical modeling. Effectiveness estimates were based on observational studies, modeling, and on information from Instituto Nacional de Enfermedades Neoplásicas (INEN). Resource utilizations and unit costs were based on estimates from INEN and observational studies. Cost-effectiveness estimates are in 2012 United States dollars (US$) per disability adjusted life year (DALY) averted. Results The current breast cancer program in Peru ($8,426 per DALY averted) could be improved through implementing triennial or biennial screening strategies. These strategies seem the most cost-effective in Peru, particularly when mobile mammography is applied (from $4,125 per DALY averted), or when both CBE screening and mammography screening are combined (from $4,239 per DALY averted). Triennially, these interventions costs between $63 million and $72 million per year. Late stage treatment, trastuzumab therapy and annual screening strategies are the least cost-effective. Conclusions Our analysis suggests that breast cancer control in Peru should be oriented towards early detection through combining fixed and mobile mammography screening (age 45-69) triennially. However, a phased introduction of triennial CBE screening (age 40-69) with upfront FNA in non-urban settings, and both CBE (age 40-49) and fixed mammography screening (age 50-69) in urban settings, seems a more feasible option and is also cost-effective. The implementation of this intervention is only meaningful if awareness raising, diagnostic, referral, treatment and basic palliative services are simultaneously improved, and if financial and organizational barriers to these services are reduced. PMID:24349314

Cost-effectiveness analysis of breast cancer control interventions in Peru.

PubMed

Zelle, Sten G; Vidaurre, Tatiana; Abugattas, Julio E; Manrique, Javier E; Sarria, Gustavo; Jeronimo, José; Seinfeld, Janice N; Lauer, Jeremy A; Sepulveda, Cecilia R; Venegas, Diego; Baltussen, Rob

2013-01-01

In Peru, a country with constrained health resources, breast cancer control is characterized by late stage treatment and poor survival. To support breast cancer control in Peru, this study aims to determine the cost-effectiveness of different breast cancer control interventions relevant for the Peruvian context. We performed a cost-effectiveness analysis (CEA) according to WHO-CHOICE guidelines, from a healthcare perspective. Different screening, early detection, palliative, and treatment interventions were evaluated using mathematical modeling. Effectiveness estimates were based on observational studies, modeling, and on information from Instituto Nacional de Enfermedades Neoplásicas (INEN). Resource utilizations and unit costs were based on estimates from INEN and observational studies. Cost-effectiveness estimates are in 2012 United States dollars (US$) per disability adjusted life year (DALY) averted. The current breast cancer program in Peru ($8,426 per DALY averted) could be improved through implementing triennial or biennial screening strategies. These strategies seem the most cost-effective in Peru, particularly when mobile mammography is applied (from $4,125 per DALY averted), or when both CBE screening and mammography screening are combined (from $4,239 per DALY averted). Triennially, these interventions costs between $63 million and $72 million per year. Late stage treatment, trastuzumab therapy and annual screening strategies are the least cost-effective. Our analysis suggests that breast cancer control in Peru should be oriented towards early detection through combining fixed and mobile mammography screening (age 45-69) triennially. However, a phased introduction of triennial CBE screening (age 40-69) with upfront FNA in non-urban settings, and both CBE (age 40-49) and fixed mammography screening (age 50-69) in urban settings, seems a more feasible option and is also cost-effective. The implementation of this intervention is only meaningful if awareness raising, diagnostic, referral, treatment and basic palliative services are simultaneously improved, and if financial and organizational barriers to these services are reduced.

Cost-effectiveness of breast cancer control strategies in Central America: the cases of Costa Rica and Mexico.

PubMed

Niëns, Laurens M; Zelle, Sten G; Gutiérrez-Delgado, Cristina; Rivera Peña, Gustavo; Hidalgo Balarezo, Blanca Rosa; Rodriguez Steller, Erick; Rutten, Frans F H

2014-01-01

This paper reports the most cost-effective policy options to support and improve breast cancer control in Costa Rica and Mexico. Total costs and effects of breast cancer interventions were estimated using the health care perspective and WHO-CHOICE methodology. Effects were measured in disability-adjusted life years (DALYs) averted. Costs were assessed in 2009 United States Dollars (US$). To the extent available, analyses were based on locally obtained data. In Costa Rica, the current strategy of treating breast cancer in stages I to IV at a 80% coverage level seems to be the most cost-effective with an incremental cost-effectiveness ratio (ICER) of US$4,739 per DALY averted. At a coverage level of 95%, biennial clinical breast examination (CBE) screening could improve Costa Rica's population health twofold, and can still be considered very cost-effective (ICER US$5,964/DALY). For Mexico, our results indicate that at 95% coverage a mass-media awareness raising program (MAR) could be the most cost-effective (ICER US$5,021/DALY). If more resources are available in Mexico, biennial mammography screening for women 50-70 yrs (ICER US$12,718/DALY), adding trastuzumab (ICER US$13,994/DALY) or screening women 40-70 yrs biennially plus trastuzumab (ICER US$17,115/DALY) are less cost-effective options. We recommend both Costa Rica and Mexico to engage in MAR, CBE or mammography screening programs, depending on their budget. The results of this study should be interpreted with caution however, as the evidence on the intervention effectiveness is uncertain. Also, these programs require several organizational, budgetary and human resources, and the accessibility of breast cancer diagnostic, referral, treatment and palliative care facilities should be improved simultaneously. A gradual implementation of early detection programs should give the respective Ministries of Health the time to negotiate the required budget, train the required human resources and understand possible socioeconomic barriers.

Cost-Effectiveness of Breast Cancer Control Strategies in Central America: The Cases of Costa Rica and Mexico

PubMed Central

Niëns, Laurens M.; Zelle, Sten G.; Gutiérrez-Delgado, Cristina; Rivera Peña, Gustavo; Hidalgo Balarezo, Blanca Rosa; Rodriguez Steller, Erick; Rutten, Frans F. H.

2014-01-01

This paper reports the most cost-effective policy options to support and improve breast cancer control in Costa Rica and Mexico. Total costs and effects of breast cancer interventions were estimated using the health care perspective and WHO-CHOICE methodology. Effects were measured in disability-adjusted life years (DALYs) averted. Costs were assessed in 2009 United States Dollars (US$). To the extent available, analyses were based on locally obtained data. In Costa Rica, the current strategy of treating breast cancer in stages I to IV at a 80% coverage level seems to be the most cost-effective with an incremental cost-effectiveness ratio (ICER) of US$4,739 per DALY averted. At a coverage level of 95%, biennial clinical breast examination (CBE) screening could improve Costa Rica's population health twofold, and can still be considered very cost-effective (ICER US$5,964/DALY). For Mexico, our results indicate that at 95% coverage a mass-media awareness raising program (MAR) could be the most cost-effective (ICER US$5,021/DALY). If more resources are available in Mexico, biennial mammography screening for women 50–70 yrs (ICER US$12,718/DALY), adding trastuzumab (ICER US$13,994/DALY) or screening women 40–70 yrs biennially plus trastuzumab (ICER US$17,115/DALY) are less cost-effective options. We recommend both Costa Rica and Mexico to engage in MAR, CBE or mammography screening programs, depending on their budget. The results of this study should be interpreted with caution however, as the evidence on the intervention effectiveness is uncertain. Also, these programs require several organizational, budgetary and human resources, and the accessibility of breast cancer diagnostic, referral, treatment and palliative care facilities should be improved simultaneously. A gradual implementation of early detection programs should give the respective Ministries of Health the time to negotiate the required budget, train the required human resources and understand possible socioeconomic barriers. PMID:24769920

The effectiveness of using standardized patients to improve community physician skills in mammography counseling and clinical breast exam.

PubMed

Costanza, M E; Luckmann, R; Quirk, M E; Clemow, L; White, M J; Stoddard, A M

1999-10-01

Traditional didactic continuing education is relatively ineffective in improving physicians' clinical skills. We hypothesized that a centralized course including small group workshops utilizing standardized patients could improve clinical skills for a reasonable cost. We designed a 5-h course aimed at improving physicians' counseling skills (re: screening mammography) and clinical breast exam (CBE) skills. The course included lectures, demonstrations, and small group skills sessions utilizing standardized patients and was offered to 156 typical community-based primary care physicians. Pre- and postcourse evaluation included in-office assessments of physician CBE and counseling performance by standardized patients and a written test of knowledge and attitudes. A total of 54.5% of eligible physicians participated. They improved modestly in only one of three areas of counseling skills measured (providing counseling appropriate to the patient's readiness to accept mammography, P = 0.01). The overall CBE score increased substantially from 24.8 to 34.7 (P < 0.0001). Knowledge in all areas measured and confidence in counseling patients also increased. The basic course cost $202 per physician trained. Most community-based primary care physicians may find small group training and in-office evaluation involving standardized patients acceptable. Such training may be more effective in improving physical exam skills than complex communication skills.

Impact of Cancer Awareness Drive on Generating Understanding and Improving Screening Practices for Breast Cancer: a Study on College Teachers in India

PubMed

Shankar, Abhishek; Roy, Shubham; Rath, Goura Kishor; Chakraborty, Abhijit; Kamal, Vineet Kumar; Biswas, Aalekhya Sarma

2017-07-27

Background: Breast cancer is the most common cancer among women in India and most present at advanced stage. Although early detection is the only way to reduce morbidity and mortality, people have a very low awareness about breast cancer signs and symptoms and screening practices. The purpose of this study was to assess the level of awareness and impact of awareness programs in adoption of safe practices in prevention and early detection. Methods: This assessment was part of a pink chain campaign on cancer awareness. During events from 2011 to 2015 at various women colleges in different parts in India, a pre-test of knowledge related to breast cancer was followed by an awareness program. Post-tests using the same questionnaire were conducted at the end of the interactive sessions, at 6 months and after1 year. Results: A total of 872 out of 985 teachers participated in the study (overall response rate of 88.5 %). Mean age of the study population was 41.6 years (range 28-59 yrs). There was a significant increase in level of knowledge regarding breast cancer at 6 months and this was sustained at 1 year. Adoption of breast self-examination (BSE) was significantly more frequent in comparison to CBE and mammography. Magazines and newspapers were sources for knowledge regarding screening tests for breast cancer for more than 60% of teachers. Regarding post-awareness at 6 months and 1 year, there was a significant change in alcohol and smoking habits. Major reasons came out to be ignorance (83%) at the start of the campaign which was changed to lack of time (37.7%), lethargic attitude (32.2 %) and lack of time (31.5 %) at 6 months and same at 1 year also. Conclusions: With our awareness program there was a significant increase in level of knowledge regarding breast cancer at 6 months and this was sustained at 1 year. Adoption of BSE was significantly greater in comparison to CBE, mammography. To inculcate safe lifestyle practices in people, awareness programmes such as pink chain campaigns should be conducted more widely and frequently. Creative Commons Attribution License

Impact of Cancer Awareness Drive on Generating Understanding and Improving Screening Practices for Breast Cancer: a Study on College Teachers in India

PubMed Central

Shankar, Abhishek; Roy, Shubham; Rath, Goura Kishor; Chakraborty, Abhijit; Kamal, Vineet Kumar; Biswas, Aalekhya Sarma

2017-01-01

Background: Breast cancer is the most common cancer among women in India and most present at advanced stage. Although early detection is the only way to reduce morbidity and mortality, people have a very low awareness about breast cancer signs and symptoms and screening practices. The purpose of this study was to assess the level of awareness and impact of awareness programs in adoption of safe practices in prevention and early detection. Methods: This assessment was part of a pink chain campaign on cancer awareness. During events from 2011 to 2015 at various women colleges in different parts in India, a pre-test of knowledge related to breast cancer was followed by an awareness program. Post-tests using the same questionnaire were conducted at the end of the interactive sessions, at 6 months and after1 year. Results: A total of 872 out of 985 teachers participated in the study (overall response rate of 88.5 %). Mean age of the study population was 41.6 years (range 28-59 yrs). There was a significant increase in level of knowledge regarding breast cancer at 6 months and this was sustained at 1 year. Adoption of breast self-examination (BSE) was significantly more frequent in comparison to CBE and mammography. Magazines and newspapers were sources for knowledge regarding screening tests for breast cancer for more than 60% of teachers. Regarding post-awareness at 6 months and 1 year, there was a significant change in alcohol and smoking habits. Major reasons came out to be ignorance (83%) at the start of the campaign which was changed to lack of time (37.7%), lethargic attitude (32.2 %) and lack of time (31.5 %) at 6 months and same at 1 year also. Conclusions: With our awareness program there was a significant increase in level of knowledge regarding breast cancer at 6 months and this was sustained at 1 year. Adoption of BSE was significantly greater in comparison to CBE, mammography. To inculcate safe lifestyle practices in people, awareness programmes such as pink chain campaigns should be conducted more widely and frequently. PMID:28749636

An Application of a Computer Instructional Management Package.

ERIC Educational Resources Information Center

Sullivan, David W.

Following the presentation of a conceptual framework for computer-based education (CBE), this paper examines the use of one aspect of CBE, computer-managed instruction (CMI), in a Major Appliance Serving Program. The paper begins with definitions and a graphic illustration of CBE and its components and uses, i.e., CMI, tutorial or…

Level of awareness of cervical and breast cancer risk factors and safe practices among college teachers of different states in india: do awareness programmes have an impact on adoption of safe practices?

PubMed

Shankar, Abhishek; Rath, Gk; Roy, Shubham; Malik, Abhidha; Bhandari, Ruchir; Kishor, Kunal; Barnwal, Keshav; Upadyaya, Sneha; Srivastava, Vivek; Singh, Rajan

2015-01-01

Breast and cervical cancers are the most common causes of cancer mortality among women in India, but actually they are largely preventable diseases. Although early detection is the only way to reduce morbidity and mortality, there are limited data on breast and cervical cancer knowledge, safe practices and attitudes of teachers in India. The purpose of this study is to assess the level of awareness and impact of awareness programs in adoption of safe practices in prevention and early detection. This assessment was part of a pink chain campaign on cancer awareness. During cancer awareness events in 2011 at various women colleges in different parts in India, a pre-test related to cervical cancer and breast cancer was followed by an awareness program. Post-tests using the same questionnaire were conducted at the end of the interactive session, at 6 months and 1 year. A total of 156 out of 182 teachers participated in the study (overall response rate was 85.7 %). Mean age of the study population was 42.4 years (range- 28-59 yrs). There was a significant increase in level of knowledge regarding cervical and breast cancer at 6 months and this was sustained at 1 year. Adoption of breast self examination (BSE) was significantly more frequent in comparison to CBE, mammography and the Pap test. Magazines and newspapers were sources for knowledge regarding screening tests for breast cancer in more than 60% of teachers where as more than 75% were educated by doctors regarding the Pap test. Post awareness at 6 months and 1 year, there was a significant change in alcohol and smoking habits. Major reasons for not doing screening test were found to be ignorance (50%), lethargic attitude (44.8%) and lack of time (34.6%). Level of knowledge of breast cancer risk factors, symptoms and screening methods was high as compared to cervical cancer. There was a significant increase in level of knowledge regarding cervical and breast cancer at 6 months and this was sustained at 1 year. Adoption of BSE was significantly greater in comparison to CBE, mammography and the Pap test. To inculcate safe practices in lifestyle of people, awareness programmes such as pink chain campaign should be conducted more widely and frequently.

Perceived Discrimination Is Associated with Reduced Breast and Cervical Cancer Screening: The Study of Women's Health Across the Nation (SWAN)

PubMed Central

Rathouz, Paul J.; Karavolos, Kelly; Everson-Rose, Susan A.; Janssen, Imke; Kravitz, Howard M.; Lewis, Tené T.; Powell, Lynda H.

2014-01-01

Abstract Background: Racial disparities in breast and cervical cancer screening have been documented in African American, Hispanic, and Asian populations. Perceived discrimination may contribute to this disparity. The aim of this study was to understand the relationship between perceived everyday racial/ethnic and other discrimination and receipt of breast and cervical cancer screening in a multiethnic population of women. Methods: We analyzed data from 3,258 women participating in the Study of Women's Health Across the Nation (SWAN), a multiethnic/racial, longitudinal cohort study of the natural history of the menopausal transition conducted at seven U.S. sites. Participants completed a validated measure of perceived discrimination and reasons for believing that they were treated differently, along with Pap smears, clinical breast exams (CBE), and mammography at each follow-up period. We used multiple logistic regression for the binary outcomes of having a Pap smear, CBE, or mammogram in each of the two follow-up years, using self-reported “race discrimination” and “other discrimination” at baseline as the main predictors. Results: African American women reported the highest percentage of racial discrimination (35%), followed by Chinese (20%), Hispanic (12%), Japanese (11%), and non-Hispanic white women (3%). Non-Hispanic white women reported the highest percentage of “other” discrimination (40%), followed by Chinese (33%), African American (24%), Japanese (23%), and Hispanic women (16%). Perceived racial discrimination was not associated with reduced receipt of preventive screening, except in one fully adjusted model. Reported discrimination owing to “other” reasons, such as age or gender, was associated with reduced receipt of Pap smear (odds ratio [OR] 0.85; 95% confidence interval [CI] 0.74–0.99), CBE (OR 0.78; 95% CI 0.67–0.91), and mammography (OR 0.80; 95% CI 0.69–0.92) regardless of patient race. Conclusions: Perceived discrimination is an important issue across racial/ethnic groups and is negatively associated with receipt of breast and cervical cancer screening. This is an important issue that needs to be further explored and addressed in efforts to improve the delivery of healthcare to all groups. PMID:24261647

Perceived discrimination is associated with reduced breast and cervical cancer screening: the Study of Women's Health Across the Nation (SWAN).

PubMed

Jacobs, Elizabeth A; Rathouz, Paul J; Karavolos, Kelly; Everson-Rose, Susan A; Janssen, Imke; Kravitz, Howard M; Lewis, Tené T; Powell, Lynda H

2014-02-01

Racial disparities in breast and cervical cancer screening have been documented in African American, Hispanic, and Asian populations. Perceived discrimination may contribute to this disparity. The aim of this study was to understand the relationship between perceived everyday racial/ethnic and other discrimination and receipt of breast and cervical cancer screening in a multiethnic population of women. We analyzed data from 3,258 women participating in the Study of Women's Health Across the Nation (SWAN), a multiethnic/racial, longitudinal cohort study of the natural history of the menopausal transition conducted at seven U.S. sites. Participants completed a validated measure of perceived discrimination and reasons for believing that they were treated differently, along with Pap smears, clinical breast exams (CBE), and mammography at each follow-up period. We used multiple logistic regression for the binary outcomes of having a Pap smear, CBE, or mammogram in each of the two follow-up years, using self-reported "race discrimination" and "other discrimination" at baseline as the main predictors. African American women reported the highest percentage of racial discrimination (35%), followed by Chinese (20%), Hispanic (12%), Japanese (11%), and non-Hispanic white women (3%). Non-Hispanic white women reported the highest percentage of "other" discrimination (40%), followed by Chinese (33%), African American (24%), Japanese (23%), and Hispanic women (16%). Perceived racial discrimination was not associated with reduced receipt of preventive screening, except in one fully adjusted model. Reported discrimination owing to "other" reasons, such as age or gender, was associated with reduced receipt of Pap smear (odds ratio [OR] 0.85; 95% confidence interval [CI] 0.74-0.99), CBE (OR 0.78; 95% CI 0.67-0.91), and mammography (OR 0.80; 95% CI 0.69-0.92) regardless of patient race. Perceived discrimination is an important issue across racial/ethnic groups and is negatively associated with receipt of breast and cervical cancer screening. This is an important issue that needs to be further explored and addressed in efforts to improve the delivery of healthcare to all groups.

Relationships of Fear of Breast Cancer and Fatalism with Screening Behavior in Women Referred to Health Centers of Tabriz in Iran.

PubMed

Ghahramanian, Akram; Rahmani, Azad; Aghazadeh, Ahmad Mirza; Mehr, Lida Emami

2016-01-01

Fear and fatalism have been proposed as factors affecting breast cancer screening, but the evidence is not strong. This study aimed to determine relationships of fear and fatalism with breast cancer screening behavior among Tabriz women in Iran. In a cross- sectional study, 370 women referred to 12 health centers in Tabriz were selected with two-stage cluster sampling and data regarding breast cancer screening, fatalism and fear of breast cancer were collected respectively with a checklist for screening performance, Champions Fear and Pow Fatalism Questionnaires. Data were analyzed by logistic regression with SPSS software version 16. Only 43% and 23% of participants had undergone breast self- examination and clinical breast examination. Among women older than 40 years, 38.2% had mammography history and only 2.7% of them had done it annually. Although fatalism and fear had a stimulating effects on breast cancer screening performance th relationships were not signi cant (P>0.05). There was a negative significant correlation between fear and fatalism (r= -0.24, p=0.000). On logistic regression analysis, age (OR=1.037, p<0.01) and income status (OR= 0.411, p<0.05) significantly explained BSE and age (OR=1.051, p<0.01) and body mass index (OR= 0.879, p<0.01) explained CBE. Also BMI (OR= 0.074, p<0.05) and income status (OR=0.155, p<0.01) was significantly effective for mammography following. Breast cancer screening behavior is inappropriate and affected by family livelihood status and lifestyle leads to weight gain, so that for promoting of screening behavior, economic support to families, lifestyle modification and public education are suggested.

Profile of Breast Diseases in Post Pubertal Women Assessed By Clinical Breast Examination - A Community Based Study in Rural Pondicherry.

PubMed

Janaki, Kavasseri L; Kannan, Narayanasamy Subbaraju; Palaniappan, M; Nandi, Partha

2016-02-01

Breast diseases in women, whether benign or malignant, are very commonly encountered. Benign diseases are under reported and cancer is one of the leading causes of mortality in women. This study was undertaken with an aim to study the profile of various breast disease in the community. In this observational study all the post pubertal women residing in the selected village (n=1000) were included. The study was done from September 2013 to August 2015. A thorough history taking was done with the help of a predesigned proforma followed by a clinical breast examination and further investigation at our hospital if necessary. It was found in this study that mastalgia, both cyclical and non-cyclical as well as lumps were a common finding in the general population. Significant proportions of women were found to be in the peri-menopausal age group. Median age of menarche was 13 years; menopause was 45 years. The average age at first childbirth was 21 years with 1 year being the median duration of breast-feeding. A total of 128 women (1 in 8) had positive symptomatology with 94 (1 in 11) of them having a breast disease on examination. One was diagnosed with breast cancer. The prevalence of cyclical mastalgia was 1 in 11, non-cyclical mastalgia 1 in 34, fibroadenosis 1 in 23 and fibroadenoma 1 in 100. The awareness regarding risk factors and the availability of screening program was very poor. The average age of presentation of mastalgia was 34 years; fibroadenosis was 35 years and fibroadenoma 29 years. None of the women interacted with or had consulted a practitioner regarding mastalgia as it was not perceived to be a sign of malignancy and did not cause any significant discomfort. It was thus concluded from this study that benign breast diseases are a common occurrence in the general population. Breast cancer continues to be diagnosed only at later stages owing to lack of awareness and inadequately structured screening program. The concept of self-breast examination seems to be poorly understood. CBE is more fruitful with subsequent radiological and histopathological investigation, if warranted.

An analysis of the structure of the compound biological effectiveness factor.

PubMed

Ono, Koji

2016-08-01

This report is an analysis of the structure of the compound biological effectiveness (CBE) factor. The value of the CBE factor previously reported was revalued for the central nervous system, skin and lung. To describe the structure, the following terms are introduced: the vascular CBE (v-CBE), intraluminal CBE (il-CBE), extraluminal CBE (el-CBE) and non-vascular CBE (nv-CBE) factors and the geometric biological factor (GBF), i.e. the contributions that are derived from the total dose to the vasculature, each dose to vasculature from the intraluminal side and the extraluminal side, the dose to the non-vascular tissue and the factor to calculate el-CBE from il-CBE, respectively. The el-CBE factor element was also introduced to relate il-CBE to el-CBE factors. A CBE factor of 0.36 for disodium mercaptoundecahydrododecaborate (BSH) for the CNS was independent of the (10)B level in the blood; however, that for p-Boron-L-phenylalanine (BPA) increased with the (10)B level ratio of the normal tissue to the blood (N/B). The CBE factor was expressed as follows: factor = 0.32 + N/B × 1.65. The factor of 0.32 at 0 of N/B was close to the CBE factor for BSH. GBFs had similar values, between BSH and BPA, 1.39 and 1.52, respectively. The structure of the CBE factor for BPA to the lung was also elucidated based on this idea. The factor is described as follows: CBE factor = 0.32 + N/B × 1.80. By this elucidation of the structure of the CBE factor, it is expected that basic and clinical research into boron neutron capture therapy will progress. © The Author 2016. Published by Oxford University Press on behalf of The Japan Radiation Research Society and Japanese Society for Radiation Oncology.

Funding Mechanisms, Cost Drivers, and the Distribution of Education Funds in Alberta: A Case Study.

ERIC Educational Resources Information Center

Neu, Dean; Taylor, Alison

2000-01-01

Critical analysis of historical financial data of the Calgary Board of Education (CBE) examined the impact of Alberta's 1994 funding changes on the CBE and the distribution of Alberta's education funding. Findings illustrate how funding mechanisms are used to govern from a distance and how seemingly neutral accounting/funding techniques function…

Developing a Disruptive Innovation in U.S. Higher Education: A Case Study of Competency-Based Education at College for America

ERIC Educational Resources Information Center

Hansen, Sarah Elizabeth Wilson

2016-01-01

Direct assessment competency-based education (CBE) is an online, self-directed learning innovation that is disrupting higher education. This study examined the development and early diffusion of direct assessment CBE at a private, nonprofit university. The purpose of this case study was to investigate the presence of organizational factors and the…

Restriction/modification polypeptides, polynucleotides, and methods

DOEpatents

Westpheling, Janet; Chung, DaeHwan; Huddleston, Jennifer; Farkas, Joel A

2015-02-24

The present invention relates to the discovery of a novel restriction/modification system in Caldicellulosiruptor bescii. The discovered restriction enzyme is a HaeIII-like restriction enzyme that possesses a thermophilic activity profile. The restriction/modification system also includes a methyltransferase, M.CbeI, that methylates at least one cytosine residue in the CbeI recognition sequence to m.sup.4C. Thus, the invention provides, in various aspects, isolated CbeI or M.CbeI polypeptides, or biologically active fragments thereof; isolated polynucleotides that encode the CbeI or M.CbeI polypeptides or biologically active fragments thereof, including expression vectors that include such polynucleotide sequences; methods of digesting DNA using a CbeI polypeptide; methods of treating a DNA molecule using a M.CbeI polypeptide; and methods of transforming a Caldicellulosiruptor cell.

Student nurses' learning on community-based education in Ethiopia.

PubMed

Salmon, Karen; Keneni, Gutema

2004-07-01

At Jimma University educational goals are to apply the concept of community-oriented education through community-based education (CBE) of health students. This study examined the experiences of student nurses on CBE. The aims of the study were to identify factors that students considered had helped or hindered their learning on CBE and to ascertain if the stated learning objectives were met. A quantitative, descriptive, survey design was adopted, using a single, anonymous questionnaire. Some qualitative data were gained using open questions. A convenience sample of 95 students participated in the research. Participants represented 90% of all students who had completed their CBE placements. Participation, mentors' willingness to answer questions and the relevance of the placement were factors that facilitated learning. Factors reported by students that hindered learning were difficulties of self-expression in a group, mentors emphasising mistakes and weakness and the short time-frame due to ongoing lectures during placement. Students said learning objectives most met were socio-demographic assessment, identifying health problems and action planning. Objectives reported to be least met were identifying environmental health problems, planning preventive health interventions and implementing health interventions. These include the need to develop students' group skills, prepare mentors to facilitate learning, organise CBE in spiral phases, avoid concurrent lectures and improve study facilities.

Aronia melanocarpa (chokeberry) polyphenol-rich extract improves antioxidant function and reduces total plasma cholesterol in apolipoprotein E knockout mice.

PubMed

Kim, Bohkyung; Ku, Chai Siah; Pham, Tho X; Park, Youngki; Martin, Derek A; Xie, Liyang; Taheri, Rod; Lee, Jiyoung; Bolling, Bradley W

2013-05-01

We hypothesized that a polyphenol-rich chokeberry extract (CBE) would modulate hepatic lipid metabolism and improve antioxidant function in apolipoprotein E knockout (apoE(-/-)) mice. ApoE(-/-) mice were fed diets containing 15% fat with 0.2% cholesterol alone or supplemented with 0.005% or 0.05% CBE for 4 weeks. CBE polyphenol content was determined by the total phenols, 4-dimethylaminocinnamaldehyde, and ultra high-performance liquid chromatography-mass spectrometry methods. The 0.05% CBE diet provided mice with mean daily doses of 1.2 mg gallic acid equivalents of total phenols, 0.19 mg anthocyanins, 0.17 mg phenolic acids, 0.06 mg proanthocyanidins (as catechin-equivalents), and 0.02 mg flavonols. The 0.05% CBE group had 12% less plasma total cholesterol concentrations than the control. Despite the hypocholesterolemic effect of CBE, hepatic mRNA levels of low-density lipoprotein receptor, hydroxyl-3-methylglutaryl coenzyme A reductase and cholesterol 7α-hydroxylase in CBE-fed mice were not significantly different from controls. Dietary CBE did not alter hepatic lipid content or the hepatic expression of genes involved in lipogenesis and fatty acid β-oxidation such as fatty acid synthase, carnitine palmitoyltransferase 1 and acyl-CoA oxidase. Plasma paraoxonase and catalase activities were significantly increased in mice fed 0.05% CBE. Both CBE diets increased hepatic glutathione peroxidase (GPx) activity but the 0.05% CBE group had 24% less proximal intestine GPx activity relative to controls. Thus, dietary CBE lowered total cholesterol and improved plasma and hepatic antioxidant function at nutritionally-relevant doses in apoE(-/-) mice. Furthermore, the CBE cholesterol-lowering mechanism in apoE(-/-) mice was independent of hepatic expression of genes involved in cholesterol metabolism. Copyright © 2013 Elsevier Inc. All rights reserved.

Family correlates of childhood binge eating: A systematic review.

PubMed

Saltzman, Jaclyn A; Liechty, Janet M

2016-08-01

Binge Eating Disorder is the most prevalent eating disorder in the US, and binge eating has been identified in children as young as five. As part of a larger registered systematic review, we identified family correlates of binge eating in children (C-BE) aged 12 and under. Using established guidelines, we searched PubMed and PsycInfo for peer-reviewed studies published in English between 1980 and April 2015 that examined family correlates and predictors of C-BE. This yielded 736 records for review; after exclusions fifteen studies were reviewed. Risk of bias was assessed. A risk factor typology was used to classify correlates. Nine of the included studies were cross-sectional and six longitudinal. Family weight teasing and parent emotional unresponsiveness were correlates of C-BE. Parent weight, education/socio-economic situation, and parent race/ethnicity were not associated with C-BE in any study reviewed. There was insufficient or unclear evidence regarding associations between C-BE and parent disordered eating, weight or thinness concern, harsh discipline, maternal dieting, attachment security, and mealtimes and feeding practices. Limitations included too few studies on many of the correlates to summarize, inconsistency of findings, homogenous samples, and predominately cross-sectional designs. Weight-related teasing in families and parental emotional unresponsiveness are correlates of C-BE and important areas to address in parent education and eating disorder prevention programs with families. Further longitudinal studies on putative risk factors for binge eating in childhood are needed to address current limitations, enable synthesis across studies, and inform public health efforts to prevent binge eating problems in children. Copyright © 2016 Elsevier Ltd. All rights reserved.

Using ultrasound CBE imaging without echo shift compensation for temperature estimation.

PubMed

Tsui, Po-Hsiang; Chien, Yu-Ting; Liu, Hao-Li; Shu, Yu-Chen; Chen, Wen-Shiang

2012-09-01

Clinical trials have demonstrated that hyperthermia improves cancer treatments. Previous studies developed ultrasound temperature imaging methods, based on the changes in backscattered energy (CBE), to monitor temperature variations during hyperthermia. Echo shift, induced by increasing temperature, contaminates the CBE image, and its tracking and compensation should normally ensure that estimations of CBE at each pixel are correct. To obtain a simplified algorithm that would allow real-time computation of CBE images, this study evaluated the usefulness of CBE imaging without echo shift compensation in detecting distributions in temperature. Experiments on phantoms, using different scatterer concentrations, and porcine livers were conducted to acquire raw backscattered data at temperatures ranging from 37°C to 45°C. Tissue samples of pork tenderloin were ablated in vitro by microwave irradiation to evaluate the feasibility of using the CBE image without compensation to monitor tissue ablation. CBE image construction was based on a ratio map obtained from the envelope image divided by the reference envelope image at 37°C. The experimental results demonstrated that the CBE image obtained without echo shift compensation has the ability to estimate temperature variations induced during uniform heating or tissue ablation. The magnitude of the CBE as a function of temperature obtained without compensation is stronger than that with compensation, implying that the CBE image without compensation has a better sensitivity to detect temperature. These findings suggest that echo shift tracking and compensation may be unnecessary in practice, thus simplifying the algorithm required to implement real-time CBE imaging. Copyright © 2012 Elsevier B.V. All rights reserved.

[Concept analysis "Competency-based education"].

PubMed

Loosli, Clarence

2016-03-01

Competency-based education (CBE) stands out at global level as the best educational practice. Indeed, CBE is supposed to improve the quality of care provided by newly graduated nurses. Yet, there is a dearth of knowledge in nursing literature regarding CBE concept's definition. CBE is implemented differently in each entity even inside the same discipline in a single country. What accounts for CBE in nursing education ? to clarify CBE concept meaning according to literature review in order to propose a definition. Wilson concept analysis method framed our literature review through two databases: CINHAL and ERIC. following the 11 Wilson techniques analysis, we identified CBE concept as a multidimensional concept clustering three dimensions : learning, teaching and assessment. nurses educators are accountable for providing performants newly graduated professional to the society. Schools should struggle for the visibility and the transparency of means they are using to accomplish their educational activities. This first attempt to understand CBE concept opens a matter of debate concerning further development and clarification of the concept. This first description of CBE concept is a step toward its identification and assessment.

Partner Resources at CBE

Science.gov Websites

Resources CBE's Next Industry Advisor Board Meeting CBE's Industry Advisory Board (IAB) provides guidance meeting logistics page >> Partner Website We maintain a website that allows partner access to all searchable by keyword and author on the eRepository, a service of the California Digital Library. Go to CBE

Instructors' Perceptions of Mostly Seated Exercise Classes: Exploring the Concept of Chair Based Exercise.

PubMed

Robinson, Katie R; Masud, Tahir; Hawley-Hague, Helen

2016-01-01

Chair based exercise (CBE) can be used to engage older adults unable to take part in standing exercise programmes. Defining and understanding the context of CBE have been acknowledged as a challenge. We explore instructor experiences of delivering mostly seated exercise classes for older people and how this helps us to further understand the concept of CBE. We extracted qualitative data from a cross-sectional survey with 731 exercise instructors. 378 delivered mostly seated classes and 223 of those instructors provided qualitative data. There were 155 instructors who did not provide any qualitative comments. Framework analysis was used and informed by a Delphi consensus study on CBE. Instructors perceived mostly seated classes as predominantly CBE; they defined it as an introductory class that should be offered as part of a continuum of exercise. It was considered suitable for those with limitations and older adults in long-term care and with dementia. Instructors reported CBE used inappropriately for more active older people. Instructors reported observing improvements in mood and cognition and broader social benefits. Instructors' perspectives largely support expert consensus that CBE has an important role in a continuum of exercise. Providers of CBE need to ensure that more challenging exercises are introduced where appropriate. Further research is needed to explore older adults' perceptions of CBE.

Effects of chlorpyrifos on soil carboxylesterase activity at an aggregate-size scale.

PubMed

Sanchez-Hernandez, Juan C; Sandoval, Marco

2017-08-01

The impact of pesticides on extracellular enzyme activity has been mostly studied on the bulk soil scale, and our understanding of the impact on an aggregate-size scale remains limited. Because microbial processes, and their extracellular enzyme production, are dependent on the size of soil aggregates, we hypothesized that the effect of pesticides on enzyme activities is aggregate-size specific. We performed three experiments using an Andisol to test the interaction between carboxylesterase (CbE) activity and the organophosphorus (OP) chlorpyrifos. First, we compared esterase activity among aggregates of different size spiked with chlorpyrifos (10mgkg -1 wet soil). Next, we examined the inhibition of CbE activity by chlorpyrifos and its metabolite chlorpyrifos-oxon in vitro to explore the aggregate size-dependent affinity of the pesticides for the active site of the enzyme. Lastly, we assessed the capability of CbEs to alleviate chlorpyrifos toxicity upon soil microorganisms. Our principal findings were: 1) CbE activity was significantly inhibited (30-67% of controls) in the microaggregates (<0.25mm size) and smallest macroaggregates (<1.0 - 0.25mm), but did not change in the largest macroaggregates (>1.0mm) compared with the corresponding controls (i.e., pesticide-free aggregates), 2) chlorpyrifos-oxon was a more potent CbE inhibitor than chlorpyrifos; however, no significant differences in the CbE inhibition were found between micro- and macroaggregates, and 3) dose-response relationships between CbE activity and chlorpyrifos concentrations revealed the capability of the enzyme to bind chlorpyrifos-oxon, which was dependent on the time of exposure. This chemical interaction resulted in a safeguarding mechanism against chlorpyrifos-oxon toxicity on soil microbial activity, as evidenced by the unchanged activity of dehydrogenase and related extracellular enzymes in the pesticide-treated aggregates. Taken together, these results suggest that environmental risk assessments of OP-polluted soils should consider the fractionation of soil in aggregates of different size to measure the CbE activity, and other potential soil enzyme activities. Copyright © 2017 Elsevier Inc. All rights reserved.

Goal, Objectives, and Responsibilities. Competency-Based Education (CBE): Pathways to College, Career, and Life Ready Graduates

ERIC Educational Resources Information Center

Iowa Department of Education, 2018

2018-01-01

In 2012 Senate File 2284 approved competency-based education (CBE). In 2013 House File 215 provided $100,000 to be used as grants to districts/schools participating in a collaborative effort toward CBE pathways for their students and a framework toward statewide implementation. The Iowa CBE Collaborative will engage in collaborative inquiry to…

Knowledge, attitudes and practices of prevention for cervical cancer and breast cancer among medical students.

PubMed

Rodríguez-Feria, Pablo; Hernández-Flórez, Luis J; Rodríguez-Feria, Daniela

2016-06-01

Objective To assess the knowledge, attitudes and practices of medical students for health promotion, primary prevention and early detection of breast neoplasm and uterine cervical neoplasm, as well as to make recommendations for improving the Public Health curriculum at the Universidad de los Andes. Methodology This study utilized a survey of medical knowledge, attitudes and practices applied to fifth year Colombian medical students attending the Universidad de los Andes in the first semester of 2013. Results 64/76 students answered the surveys (response rate 84.2 % ): 62.5 % (40/64) and 37.5 % (24/64) response rates from students in their ninth and tenth semesters, respectively; and 64.1 % (41/64) and 35.9 % (23/64) response rates from female and male students, respectively. Knowledge: clinical breast exam (CBE), breast self-examination (BSE) and mammography were recommended by 95.3 % (61/64) of students, 96.9 % (62/64) of medical students and 90.7 % (58/64) of students, respectively. Attitude: the most effective tests to reduce mortality in women aged ≥ 50 years were the Papanicolaou test according to 90.6 % (58/64) of students and mammography according to 82.8 % (53/64) of students. Practice: 55.0 % (35/64) of students had received training in the guidelines and protocols for breast neoplasm and uterine cervical neoplasm screening. Discussion To promote early detection of cervical and breast cancer, knowledge, attitudes and practices must be improved to enhance clinical practices (e.g. Papanicolaou test) and medical student training guidelines or protocols for these two cancers. Overall, with induced demand and support from research communities and institutions seeking to make these improvements, we collaborate to decrease missed opportunities in medical research and Public Health.

PLA and CBE on the Competency Continuum: The Relationship between Prior Learning Assessment and Competency-Based Education

ERIC Educational Resources Information Center

Tate, Pamela; Klein-Collins, Rebecca

2015-01-01

Competency-based education (CBE) is the hot new thing in higher education. While forms of CBE have been around since the 1970s, there has been a surge of interest in CBE, with more than 600 postsecondary institutions now reporting that they are either offering competency-based degree programs or are planning to do so. Similarly, institutional…

An Alternative Pathway to College: A Qualitative Case Study of an Adult Learner in an Online Competency-Based Education (CBE) Bachelor's Degree Program

ERIC Educational Resources Information Center

Chen, Fang

2017-01-01

My dissertation research investigated an adult learner's experience in an online competency-based education (CBE) bachelor's degree program. The purpose of my study was to understand how CBE was transforming the practices of traditional post-secondary education and how CBE was serving the needs of students, particularly nontraditional adult…

Factors that influence awareness of breast cancer screening among Arab women in Qatar: results from a cross sectional survey.

PubMed

Donnelly, Tam Truong; Khater, Al-Hareth Al; Al-Bader, Salha Bujassoum; Al Kuwari, Mohammed Ghaith; Malik, Mariam; Al-Meer, Nabila; Singh, Rajvir; Fung, Tak

2014-01-01

Breast cancer is the most common cancer among women in the State of Qatar. Due to low participation in breast cancer screening (BCS) activities, women in Qatar are often diagnosed with breast cancer at advanced stages of the disease. Findings indicate that low participation rates in BCS activities are significantly related to women's low level of awareness of breast cancer screening. The objectives of this study were to: (1) determine the factors that influence Qatari women's awareness of breast cancer and its screening activities: and (2) to find ways to effectively promote breast cancer screening activities among Arabic speaking women in Qatar. A multicenter, cross-sectional quantitative survey of 1,063 (87.5% response rate) female Qatari citizens and non-Qatari Arabic-speaking residents, 35 years of age or older, was conducted in Qatar from March 2011 to July 2011. Outcome measures included participant awareness levels of the most recent national recommended guidelines of BCS, participation rates in BCS activities, and factors related to awareness of BCS activities. While most participants (90.7%) were aware of breast cancer, less than half had awareness of BCS practices (28.9% were aware of breast self-examination and 41.8% of clinical breast exams, while 26.4% knew that mammography was recommended by national screening guidelines. Only 7.6% had knowledge of all three BCS activities). Regarding BCS practice, less than one-third practiced BCS appropriately (13.9% of participants performed breast self-examination (BSE) monthly, 31.3% had a clinical breast exam (CBE) once a year or once every two years, and 26.9% of women 40 years of age or older had a mammogram once every year or two years). Awareness of BCS was significantly related to BCS practice, education level, and receipt of information about breast cancer and/or BCS from a variety of sources, particularly doctors and the media. The low levels of participation rates in BCS among Arab women in this study indicate a strong need to increase awareness of the importance of breast cancer screening in Qatari women. Without this awareness, compliance with the most recent breast cancer screening recommendations in Qatar will remain low. An increased effort to implement mass media and public health campaigns regarding the impact of breast cancer on women's health and the benefits of early detection of breast cancer must be coupled with an enhanced participation of health care providers in delivering this message to Qatar population.

Polyphenol-rich black chokeberry (Aronia melanocarpa) extract regulates the expression of genes critical for intestinal cholesterol flux in Caco-2 cells.

PubMed

Kim, Bohkyung; Park, Youngki; Wegner, Casey J; Bolling, Bradley W; Lee, Jiyoung

2013-09-01

Black chokeberry (Aronia melanocarpa) is a rich source of polyphenols. The hypolipidemic effects of polyphenol-rich black chokeberry extract (CBE) have been reported, but underlying mechanisms have not been well characterized. We investigated the effect of CBE on the expression of genes involved in intestinal lipid metabolism. Caco-2 cells were incubated with 50 or 100 μg/ml of CBE for 24 h for quantitative realtime polymerase chain reaction analysis. Expression of genes for cholesterol synthesis (3-hydroxy-3-methylglutaryl coenzyme A reductase and sterol regulatory element binding protein 2), apical cholesterol uptake (Niemann-Pick C1 Like 1 and scavenger receptor class B Type 1) and basolateral cholesterol efflux [ATP-binding cassette transporter A1 (ABCA1)] was significantly decreased by CBE compared with control. Western blot analysis confirmed that CBE inhibited expression of these proteins. In contrast, CBE markedly induced mRNA and/or protein levels of ABCG5 and ABCG8 that mediate apical cholesterol efflux to the intestinal lumen. Furthermore, CBE significantly increased mRNA and protein levels of low-density lipoprotein (LDL) receptor, and cellular LDL uptake. Expression of genes involved in lipid metabolism and lipoprotein assembly, including sterol regulatory element-binding protein 1c, fatty acid synthase and acyl-CoA oxidase 1, was significantly decreased by CBE in a dose-dependent manner. Concomitantly, CBE significantly increased sirtuin 1, 3 and 5 mRNA levels, while it decreased SIRT-2. Our data suggest that hypolipidemic effects of CBE may be attributed, at least in part, to increased apical efflux of LDL-derived cholesterol and to decreased chylomicron formation in the intestine; and specific isoforms of SIRT may play an important role in this process. Copyright © 2013 Elsevier Inc. All rights reserved.

An Approach for the Visualization of Temperature Distribution in Tissues According to Changes in Ultrasonic Backscattered Energy

PubMed Central

Li, Qiang; Liu, Hao-Li; Chen, Wen-Shiang

2013-01-01

Previous studies developed ultrasound temperature-imaging methods based on changes in backscattered energy (CBE) to monitor variations in temperature during hyperthermia. In conventional CBE imaging, tracking and compensation of the echo shift due to temperature increase need to be done. Moreover, the CBE image does not enable visualization of the temperature distribution in tissues during nonuniform heating, which limits its clinical application in guidance of tissue ablation treatment. In this study, we investigated a CBE imaging method based on the sliding window technique and the polynomial approximation of the integrated CBE (ICBEpa image) to overcome the difficulties of conventional CBE imaging. We conducted experiments with tissue samples of pork tenderloin ablated by microwave irradiation to validate the feasibility of the proposed method. During ablation, the raw backscattered signals were acquired using an ultrasound scanner for B-mode and ICBEpa imaging. The experimental results showed that the proposed ICBEpa image can visualize the temperature distribution in a tissue with a very good contrast. Moreover, tracking and compensation of the echo shift were not necessary when using the ICBEpa image to visualize the temperature profile. The experimental findings suggested that the ICBEpa image, a new CBE imaging method, has a great potential in CBE-based imaging of hyperthermia and other thermal therapies. PMID:24260041

Utilization of breast cancer screening methods in a developing nation: results from a nationally representative sample of Malaysian households.

PubMed

Dunn, Richard A; Tan, Andrew K G

2011-01-01

As is the case in many developing nations, previous studies of breast cancer screening behavior in Malaysia have used relatively small samples that are not nationally representative, thereby limiting the generalizability of results. Therefore, this study uses nationally representative data from the Malaysia Non-Communicable Disease Surveillance-1 to investigate the role of socio-economic status on breast cancer screening behavior in Malaysia, particularly differences in screening behaviour between ethnic groups. The decisions of 816 women above age 40 in Malaysia to screen for breast cancer using mammography, clinical breast exams (CBE), and breast self-exams (BSE) are modeled using logistic regression. Results indicate that after adjusting for differences in age, education, household income, marital status, and residential location, Malay women are less likely than Chinese and Indian women to utilize mammography, but more likely to perform BSE. Education level and urban residence are positively associated with utilization of each method, but these relationships vary across ethnicity. Higher education levels are strongly related to using each screening method among Chinese women, but have no statistically significant relationship to screening among Malays. © 2011 Wiley Periodicals, Inc.

Competency-based education: programme design and challenges to implementation.

PubMed

Gruppen, Larry D; Burkhardt, John C; Fitzgerald, James T; Funnell, Martha; Haftel, Hilary M; Lypson, Monica L; Mullan, Patricia B; Santen, Sally A; Sheets, Kent J; Stalburg, Caren M; Vasquez, John A

2016-05-01

Competency-based education (CBE) has been widely cited as an educational framework for medical students and residents, and provides a framework for designing educational programmes that reflect four critical features: a focus on outcomes, an emphasis on abilities, a reduction of emphasis on time-based training, and promotion of learner centredness. Each of these features has implications and potential challenges for implementing CBE. As an experiment in CBE programme design and implementation, the University of Michigan Master of Health Professions Education (UM-MHPE) degree programme was examined for lessons to be learned when putting CBE into practice. The UM-MHPE identifies 12 educational competencies and 20 educational entrustable professional activities (EPAs) that serve as the vehicle for both learning and assessment. The programme also defines distinct roles of faculty members as assessors, mentors and subject-matter experts focused on highly individualised learning plans adapted to each learner. Early experience with implementing the UM-MHPE indicates that EPAs and competencies can provide a viable alternative to traditional courses and a vehicle for rigorous assessment. A high level of individualisation is feasible but carries with it significant costs and makes intentional community building essential. Most significantly, abandoning a time-based framework is a difficult innovation to implement in a university structure that is predicated on time-based education. © 2016 John Wiley & Sons Ltd.

CBe5Hn((n-4)) (n = 2-5): Hydrogen-Stabilized CBe5 Pentagons Containing Planar or Quasi-Planar Pentacoordinate Carbons.

PubMed

Guo, Jin-Chang; Ren, Guang-Ming; Miao, Chang-Qing; Tian, Wen-Juan; Wu, Yan-Bo; Wang, Xiaotai

2015-12-31

The diagonal relationship between beryllium and aluminum and the isoelectronic relationship between BeH unit and Al atom were utilized to design a new series ppC- or quasi-ppC-containing species C5v CBe5H5(+), Cs CBe5H4, C2v CBe5H3(-), and C2v CBe5H2(2-) by replacing the Al atoms in previously reported global minima planar pentacoordinate carbon (ppC) species D5h CAl5(+), C2v CAl4Be, C2v CAl3Be2(-), and C2v CAl2Be3(2-) with BeH units. The three-center two-electron (3c-2e) bonds formed between Be and bridging H atoms were crucial for the stabilization of these ppC species. The natural bond orbital (NBO) and adaptive natural density partitioning (AdNDP) analyses revealed that the central ppCs or quasi-ppCs possess the stable eight electron-shell structures. The AdNDP analyses also disclosed that these species are all 6σ+2π double-aromatic in nature. The aromaticity was proved by the calculated negative nucleus-independent chemical shifts (NICS) values. DFT and high-level CCSD(T) calculations revealed that these ppC- or quasi-ppC species are the global minimum or competitive low-lying local minimum (Cs CBe5H4) on their potential energy surfaces. The Born-Oppenheimer molecular dynamic (BOMD) simulations revealed that the H atoms in C2v CBe5H3(-) and C2v CBe5H2(2-) can easily rotate around the CBe5 cores and the structure of quasi-planar C5v CBe5H5(+) will become the planar structure at room temperature; however, these interesting dynamic behaviors did not indicate the kinetic instability as the basic ppC structures were maintained during the simulations. Therefore, it would be potentially possible to realize these interesting ppC- or quasi-ppc-species in future experiments.

Plasma esterases in the tegu lizard Tupinambis merianae (Reptilia, Teiidae): impact of developmental stage, sex, and organophosphorus in vitro exposure.

PubMed

Basso, Agustín; Attademo, Andrés M; Lajmanovich, Rafael C; Peltzer, Paola M; Junges, Celina; Cabagna, Mariana C; Fiorenza, Gabriela S; Sanchez-Hernandez, Juan Carlos

2012-01-01

In this study, we determined normal serum butyrylcholinesterase (BChE) and carboxylesterase (CbE) activities in Tupinambis merianae in order to obtain reference values for organophosphorus pesticide monitoring. Forty-two T. merianae individuals were grouped by sex and size to identify potential differences in their enzyme levels to allow for proper representation of normal values for females, males, juveniles, and hatchlings. Mean CbE was determined using two model substrates: alpha-naphtylacetate (α-NA) and p-nitrophenyl valerate (4-NPV). BChE and CbE sensitivity to malaoxon (Mx) was also evaluated as well as the possibility of BChE reactivation with pyridine-2-aldoxime methochloride (2-PAM). Mean adult females' BChE was significantly higher than adult males, juveniles, and hatchlings. No significant differences were found between groups regarding CbE. CbE (4-NPV) activity showed slightly negative correlation with lizard snout-vent length, while BChE and CbE (α-NA) showed no correlation with body size. Apparent IC(50) values for BChE and CbE (α-NA) suggested different sensitivities among groups. CbE (4-NPV) could not be inhibited. All Mx-inhibited groups treated with 2-PAM in a final concentration of 2.8 mM showed clear signs of reactivation. In conclusion, the results demonstrate that (1) plasma esterase activity did not vary with age and sex, except for BChE activity, and (2) because biological and environmental variables could be confounding factors in the response of plasma cholinesterases, complementary biomarkers like CbE inhibition and oxime-induced reactivation of esterases are strongly recommended.

Competency-Based Education: Understanding the CBE Student's Experience

ERIC Educational Resources Information Center

Loveless, Jill L.

2017-01-01

Research on competency-based education (CBE) has primarily focused on elements of development, design, and implementation. The researcher interviewed students about their experiences in a CBE course as an avenue to deepen existing knowledge, build upon previous research, and improve development, design, and implementation. The researcher…

Implementing Competency-Based Education: Challenges, Strategies, and a Decision-Making Framework

ERIC Educational Resources Information Center

Dragoo, Amie; Barrows, Richard

2016-01-01

The number of competency-based education (CBE) degree programs has increased rapidly over the past five years, yet there is little research on CBE program development. This study utilized conceptual models of higher education change and a qualitative methodology to analyze the strategies and challenges in implementing CBE business degree programs…

The Comprehensive Business Exam: Usefulness for Assessing Instructional and Student Performance Outcomes

ERIC Educational Resources Information Center

Hahn, William; Leslie, Beth

2017-01-01

The authors explore the results of the Comprehensive Business Exam (CBE) administered to business majors during their senior-year business capstone course. The study results identified students' SAT and grade point average as a predictor of CBE performance, and variables that explain the correlation between CBE performance, SAT score, and grade…

Competency-Based Education and the World of Work.

ERIC Educational Resources Information Center

Huff, Sheila M.

Some issues in connection with competency-based education (CBE) and the world of work discussed by the author include the relevance of CBE programs to work, the changing attitudes of students and young workers toward work, "credentialism" or the continual upgrading of educational requirements for employment, underemployment and CBE, and others.…

Membership in CBE's Industry Consortium

Science.gov Websites

Membership Benefits of Membership Membership FAQs Become a Member Board Meeting Logistics CBE's Overview CBE's research program is supported and guided by its Industry Advisory Board (IAB). Twice a year projects, and identify new research topics. Our Industry Advisory Board mirrors the diversity of the

Childbirth Education Class and Birth Plans Are Associated with a Vaginal Delivery.

PubMed

Afshar, Yalda; Wang, Erica T; Mei, Jenny; Esakoff, Tania F; Pisarska, Margareta D; Gregory, Kimberly D

2017-03-01

To determine whether the mode of delivery was different between women who attended childbirth education (CBE) class, had a birth plan, or both compared with those who did not attend CBE class or have a birth plan. This is a retrospective cross-sectional study of women who delivered singleton gestations > 24 weeks at our institution between August 2011 and June 2014. Based on a self-report at the time of admission for labor, women were stratified into four categories: those who attended a CBE class, those with a birth plan, both, and those with neither CBE or birth plan. The primary outcome was the mode of delivery. Multivariate logistic regression analyses adjusting for clinical covariates were performed. In this study, 14,630 deliveries met the inclusion criteria: 31.9 percent of the women attended CBE class, 12.0 percent had a birth plan, and 8.8 percent had both. Women who attended CBE or had a birth plan were older (p < 0.001), more likely to be nulliparous (p < 0.001), had a lower body mass index (p < 0.001), and were less likely to be African-American (p < 0.001). After adjusting for significant covariates, women who participated in either option or both had higher odds of a vaginal delivery (CBE: OR 1.26 [95% CI 1.15-1.39]; birth plan: OR 1.98 [95% CI 1.56-2.51]; and both: OR 1.69 [95% CI 1.46-1.95]) compared with controls. Attending CBE class and/or having a birth plan were associated with a vaginal delivery. These findings suggest that patient education and birth preparation may influence the mode of delivery. CBE and birth plans could be used as quality improvement tools to potentially decrease cesarean rates. © 2016 Wiley Periodicals, Inc.

Toward a definition of competency-based education in medicine: a systematic review of published definitions.

PubMed

Frank, Jason R; Mungroo, Rani; Ahmad, Yasmine; Wang, Mimi; De Rossi, Stefanie; Horsley, Tanya

2010-01-01

Competency-based education (CBE) has emerged in the health professions to address criticisms of contemporary approaches to training. However, the literature has no clear, widely accepted definition of CBE that furthers innovation, debate, and scholarship in this area. To systematically review CBE-related literature in order to identify key terms and constructs to inform the development of a useful working definition of CBE for medical education. We searched electronic databases and supplemented searches by using authors' files, checking reference lists, contacting relevant organizations and conducting Internet searches. Screening was carried out by duplicate assessment, and disagreements were resolved by consensus. We included any English- or French-language sources that defined competency-based education. Data were analyzed qualitatively and summarized descriptively. We identified 15,956 records for initial relevancy screening by title and abstract. The full text of 1,826 records was then retrieved and assessed further for relevance. A total of 173 records were analyzed. We identified 4 major themes (organizing framework, rationale, contrast with time, and implementing CBE) and 6 sub-themes (outcomes defined, curriculum of competencies, demonstrable, assessment, learner-centred and societal needs). From these themes, a new definition of CBE was synthesized. This is the first comprehensive systematic review of the medical education literature related to CBE definitions. The themes and definition identified should be considered by educators to advance the field.

The Renewal of Competency-Based Education: A Review of the Literature

ERIC Educational Resources Information Center

Burnette, Diane M.

2016-01-01

Although competency-based education (CBE) has existed since the early 1970s adult-focused degree programs, interest in CBE has spiked in recent years due to the increased attention on higher education affordability and accountability. This article reviews the extant literature on CBE to address the following questions: (a) What are the definitions…

Influence of supercritical CO(2) pressurization on the phase behavior of mixed cholesteryl esters.

PubMed

Huang, Zhen; Feng, Mei; Su, Junfeng; Guo, Yuhua; Liu, Tie-Yan; Chiew, Yee C

2010-09-15

Evidences indicating the presence of phase transformations in the mixed cholesteryl benzoate (CBE) and cholesteryl butyrate (CBU) under the supercritical CO(2) pressurization, by means of differential scanning calorimetry (DSC) and X-ray diffraction (XRD), are presented in this work. These include (1) the DSC heating curve of pure CBU; (2) the DSC heating curves of CBU/CBE mixtures; (3) the XRD spectra of pure CBU; (4) the XRD spectra of CBU/CBE mixtures; (5) CBU and CBE are miscible in either solid phase or liquid phase over the whole composition range. As a result of the presence of these phase transformations induced by pressurization, it could be deduced that a solid solution of the CBU/CBE mixture might have formed at the interfaces under supercritical conditions, subsequently influencing their dissolving behaviors in supercritical CO(2). Copyright 2010 Elsevier B.V. All rights reserved.

Structural and optical properties of GaxIn1-xP layers grown by chemical beam epitaxy

NASA Astrophysics Data System (ADS)

Seong, Tae-Yeon; Yang, Jung-Ja; Ryu, Mee Yi; Song, Jong-In; Yu, Phil W.

1998-05-01

Chemical beam epitaxial (CBE) GaxIn1-xP layers (x≈0.5) grown on (001) GaAs substrates at temperatures ranging from 490 to 580°C have been investigated using transmission electron diffraction (TED), transmission electron microscopy, and photoluminescence (PL). TED examination revealed the presence of diffuse scattering 1/2{111}B positions, indicating the occurrence of typical CuPt-type ordering in the GaInP CBE layers. As the growth temperature decreased from 580 to 490°C, maxima in the intensity of the diffuse scattering moved from ½{111}B to ½{-1+δ,1-δ,0} positions, where δ is a positive value. As the growth temperature increased from 490 to 550°C, the maxima in the diffuse scattering intensity progressively approached positions of 1/2\\{bar 110\\} , i.e., the value of δ decreased from 0.25 to 0.17. Bandgap reduction (˜45 meV) was observed in the CBE GaInP layers and was attributed to the presence of ordered structures.

Evaluation of Simulated Clinical Breast Exam Motion Patterns Using Marker-Less Video Tracking

PubMed Central

Azari, David P.; Pugh, Carla M.; Laufer, Shlomi; Kwan, Calvin; Chen, Chia-Hsiung; Yen, Thomas Y.; Hu, Yu Hen; Radwin, Robert G.

2016-01-01

Objective This study investigates using marker-less video tracking to evaluate hands-on clinical skills during simulated clinical breast examinations (CBEs). Background There are currently no standardized and widely accepted CBE screening techniques. Methods Experienced physicians attending a national conference conducted simulated CBEs presenting different pathologies with distinct tumorous lesions. Single hand exam motion was recorded and analyzed using marker-less video tracking. Four kinematic measures were developed to describe temporal (time pressing and time searching) and spatial (area covered and distance explored) patterns. Results Mean differences between time pressing, area covered, and distance explored varied across the simulated lesions. Exams were objectively categorized as either sporadic, localized, thorough, or efficient for both temporal and spatial categories based on spatiotemporal characteristics. The majority of trials were temporally or spatially thorough (78% and 91%), exhibiting proportionally greater time pressing and time searching (temporally thorough) and greater area probed with greater distance explored (spatially thorough). More efficient exams exhibited proportionally more time pressing with less time searching (temporally efficient) and greater area probed with less distance explored (spatially efficient). Just two (5.9 %) of the trials exhibited both high temporal and spatial efficiency. Conclusions Marker-less video tracking was used to discriminate different examination techniques and measure when an exam changes from general searching to specific probing. The majority of participants exhibited more thorough than efficient patterns. Application Marker-less video kinematic tracking may be useful for quantifying clinical skills for training and assessment. PMID:26546381

Tomographic image reconstruction using the cell broadband engine (CBE) general purpose hardware

NASA Astrophysics Data System (ADS)

Knaup, Michael; Steckmann, Sven; Bockenbach, Olivier; Kachelrieß, Marc

2007-02-01

Tomographic image reconstruction, such as the reconstruction of CT projection values, of tomosynthesis data, PET or SPECT events, is computational very demanding. In filtered backprojection as well as in iterative reconstruction schemes, the most time-consuming steps are forward- and backprojection which are often limited by the memory bandwidth. Recently, a novel general purpose architecture optimized for distributed computing became available: the Cell Broadband Engine (CBE). Its eight synergistic processing elements (SPEs) currently allow for a theoretical performance of 192 GFlops (3 GHz, 8 units, 4 floats per vector, 2 instructions, multiply and add, per clock). To maximize image reconstruction speed we modified our parallel-beam and perspective backprojection algorithms which are highly optimized for standard PCs, and optimized the code for the CBE processor. 1-3 In addition, we implemented an optimized perspective forwardprojection on the CBE which allows us to perform statistical image reconstructions like the ordered subset convex (OSC) algorithm. 4 Performance was measured using simulated data with 512 projections per rotation and 5122 detector elements. The data were backprojected into an image of 512 3 voxels using our PC-based approaches and the new CBE- based algorithms. Both the PC and the CBE timings were scaled to a 3 GHz clock frequency. On the CBE, we obtain total reconstruction times of 4.04 s for the parallel backprojection, 13.6 s for the perspective backprojection and 192 s for a complete OSC reconstruction, consisting of one initial Feldkamp reconstruction, followed by 4 OSC iterations.

Hydroacoustics for the discovery and quantification of Nassau grouper ( Epinephelus striatus) spawning aggregations

NASA Astrophysics Data System (ADS)

Egerton, J. P.; Johnson, A. F.; Le Vay, L.; McCoy, C. M.; Semmens, B. X.; Heppell, S. A.; Turner, J. R.

2017-06-01

Fish spawning aggregations (FSAs) are vital life-history events that need to be monitored to determine the health of aggregating populations; this is especially true of the endangered Nassau grouper ( Epinephelus striatus). Hydroacoustics were used to locate Nassau grouper FSAs at sites on the west end of Little Cayman (LCW), and east ends of Grand Cayman (GCE) and Cayman Brac (CBE). Fish abundance and biomass at each FSA were estimated via echo integration and FSA extent. Acoustic mean fish abundance estimates (±SE) on the FSA at LCW (893 ± 459) did not differ significantly from concurrent SCUBA estimates (1150 ± 75). Mean fish densities (number 1000 m-3) were significantly higher at LCW (33.13 ± 5.62) than at the other sites (GCE: 7.01 ± 2.1, CBE: 4.61 ± 1.16). We investigate different acoustic post-processing options to obtain target strength (TS), and we examine the different TS to total length (TL) formulas available. The SCUBA surveys also provided measures of TL through the use of laser callipers allowing development of an in situ TS to TL formula for Nassau grouper at the LCW FSA. Application of this formula revealed mean fish TL was significantly higher at LCW (65.4 ± 0.7 cm) than GCE (60.7 ± 0.4 cm), but not CBE (61.1 ± 2.5 cm). Use of the empirical TS to TL formula resulted in underestimation of fish length in comparison with diver measurements, highlighting the benefits of secondary length data and deriving specific TS to TL formulas for each population. FSA location examined with reference to seasonal marine protected areas (Designated Grouper Spawning Areas) showed FSAs were partially outside these areas at GCE and very close to the boundary at CBE. As FSAs often occur at the limits of safe diving operations, hydroacoustic technology provides an alternative method to monitor and inform future management of aggregating fish species.

Effect of diet on carboxylesterase activity of tadpoles (Rhinella arenarum) exposed to chlorpyrifos.

PubMed

Attademo, A M; Sanchez-Hernandez, J C; Lajmanovich, R C; Peltzer, P M; Junges, C

2017-01-01

An outdoor microcosm was performed with tadpoles (Rhinella arenarum) exposed to 125μgL -1 chlorpyrifos and fed two types of food, i.e., lettuce (Lactuca sativa) and a formulated commercial pellet. Acetylcholinesterase (AChE) and carboxylesterase (CbE) activities were measured in liver and intestine after 10 days of pesticide exposure. Non-exposed tadpoles fed lettuce had an intestinal AChE activity almost two-fold higher than that of pellet-fed tadpoles. No significant differences were observed, however, in liver AChE activity between diets. Likewise, intestinal CbE activity - measured using two substrates, i.e. 1-naphthyl acetate (1-NA) and 4-nitrophenyl valerate (4-NPV) - was higher in tadpoles fed lettuce than in those fed pellets. However, the diet-dependent response of liver CbE activity was opposite to that in the intestine. Chlorpyrifos caused a significant inhibition of both esterase activities, which was tissue- and diet-specific. The highest inhibition degree was found in the intestinal AChE and CbE activities of lettuce-fed tadpoles (42-78% of controls) compared with pellet-fed tadpoles (<60%). Although chlorpyrifos significantly inhibited liver CbE activity of the group fed lettuce, this effect was not observed in the group fed pellets. In general, intestinal CbE activity was more sensitive to chlorpyrifos inhibition than AChE activity. This finding, together with the high levels of basal CbE activity found in the intestine, may be understood as a detoxification system able to reduce intestinal OP uptake. Moreover, the results of this study suggest that diet is a determinant factor in toxicity testing with tadpoles to assess OP toxicity, because it modulates levels of this potential detoxifying enzyme activity. Copyright © 2016 Elsevier Inc. All rights reserved.

Impact of the addition of cocoa butter equivalent on the volatile compounds profile of dark chocolate.

PubMed

de Silva Souza, Cristiano; Block, Jane Mara

2018-02-01

The effect of the partial replacement of cocoa butter (CB) by cocoa butter equivalent (CBE) in the release of volatile compounds in dark chocolate was studied. The fatty acid profile, triacylglyceride composition, solid fat content (SFC) and melting point were determined in CB and CBE. Chocolate with CB (F1) and with different content of CBE (5 and 10%-F2 and F3, respectively) were prepared. Plastic viscosity and Casson flow limit, particle size distribution and release of volatile compounds using a solid phase microextraction with gas chromatography (SMPE-GC) were determined in the chocolate samples. The melting point was similar for the studied samples but SFC indicated different melting behavior. CBE showed a higher saturated fatty acid content when compared to CB. The samples showed similar SOS triglyceride content (21 and 23.7% for CB and CBE, respectively). Higher levels of POS and lower POP were observed for CB when compared to CBE (44.8 and 19.7 and 19 and 41.1%, respectively). The flow limit and plastic viscosity were similar for the studied chocolates samples, as well as the particle size distribution. Among the 27 volatile compounds identified in the samples studied, 12 were detected in significantly higher concentrations in sample F1 (phenylacetaldehyde, methylpyrazine, 2,6-dimethylpyrazine, 2-ethyl-5-methylpyrazine, 2-ethyl-3,5-dimethylpyrazine, tetramethylpyrazine, trimethylpyrazine, 3-ethyl-2,5-dimethylpyrazine, phenethyl alcohol, 2-acetylpyrrole, acetophenone and isovaleric acid). The highest changes were observed in the pyrazines group, which presented a decrease of more than half in the formulations where part of the CB was replaced by the CBE.

A Comparative Study of Natural Antimicrobial Delivery Systems for Microbial Safety and Quality of Fresh-Cut Lettuce.

PubMed

Hill, Laura E; Oliveira, Daniela A; Hills, Katherine; Giacobassi, Cassie; Johnson, Jecori; Summerlin, Harvey; Taylor, T Matthew; Gomes, Carmen L

2017-05-01

Nanoencapsulation can provide a means to effectively deliver antimicrobial compounds and enhance the safety of fresh produce. However, to date there are no studies which directly compares how different nanoencapsulation systems affect fresh produce safety and quality. This study compared the effects on quality and safety of fresh-cut lettuce treated with free and nanoencapsulated natural antimicrobial, cinnamon bark extract (CBE). A challenge study compared antimicrobial efficacy of 3 different nanoencapsulated CBE systems. The most effective antimicrobial treatment against Listeria monocytogenes was chitosan-co-poly-N-isopropylacrylamide (chitosan-PNIPAAM) encapsulated CBE, with a reduction on bacterial load up to 2 log 10 CFU/g (P < 0.05) compared to the other encapsulation systems when fresh-cut lettuce was stored at 5 °C and 10 °C for 15 d. Subsequently, chitosan-PNIPAAM-CBE nanoparticles (20, 40, and 80 mg/mL) were compared to a control and free CBE (400, 800, and 1600 μg/mL) for its effects on fresh-cut lettuce quality over 15 d at 5 °C. By the 10th day, the most effective antimicrobial concentration was 80 mg/mL for chitosan-PNIPAAM-CBE, up to 2 log 10 CFU/g reduction (P < 0.05), compared with the other treatments. There was no significant difference between control and treated samples up to day 10 for the quality attributes evaluated. Chitosan-PNIPAAM-CBE nanoparticles effectively inhibited spoilage microorganisms' growth and extended fresh-cut lettuce shelf-life. Overall, nanoencapsulation provided a method to effectively deliver essential oil and enhanced produce safety, while creating little to no detrimental quality changes on the fresh-cut lettuce. © 2017 Institute of Food Technologists®.

Cranberry extract attenuates hepatic inflammation in high fat-fed obese mice

PubMed Central

Glisan, Shannon L.; Ryan, Caroline; Neilson, Andrew P.; Lambert, Joshua D.

2016-01-01

Cranberry (Vaccinium macrocarpon) consumption has been associated with health beneficial effects. Non-alcoholic fatty liver disease (NAFLD) is a co-morbidity of obesity. In the present study, we investigated the effect of a polyphenol-rich cranberry extract (CBE) on hepatic inflammation in high fat-fed obese C57BL/6J mice. Following dietary treatment with 0.8% CBE for 10 weeks, we observed no change in body weight or visceral fat mass in CBE supplemented mice compared to high fat-fed control mice. We did observe a significant decrease in plasma alanine aminotransferase (31%) and histological severity of NAFLD (33% decrease in area of involvement, 29% decrease in lipid droplet size) compared to high fat-fed controls. Hepatic protein levels of tumor necrosis factor alpha and C-C chemokine ligand 2 were reduced by 28% and 19%, respectively, following CBE supplementation. CBE significantly decreased hepatic mRNA levels of toll-like receptor 4 (TLR4, 63%) and nuclear factorκ B (NFκB, 24%), as well as a number of genes related to the nucleotide-binding domain, leucine-rich-containing family, pyrin domain-containing-3 inflammasome. In conclusion, CBE reduced NAFLD and hepatic inflammation in high fat-fed obese C57BL/6J mice. These effects appear to be related to mitigation of TLR4-NFκB related signaling, however further studies into the underlying mechanisms of these hepatoprotective effects are needed. PMID:27619543

Bioelectrochemically-assisted anaerobic composting process enhancing compost maturity of dewatered sludge with synchronous electricity generation.

PubMed

Yu, Hang; Jiang, Junqiu; Zhao, Qingliang; Wang, Kun; Zhang, Yunshu; Zheng, Zhen; Hao, Xiaodi

2015-10-01

Bioelectrochemically-assisted anaerobic composting process (AnCBE) with dewatered sludge as the anode fuel was constructed to accelerate composting of dewatered sludge, which could increase the quality of the compost and harvest electric energy in comparison with the traditional anaerobic composting (AnC). Results revealed that the AnCBE yielded a voltage of 0.60 ± 0.02 V, and total COD (TCOD) removal reached 19.8 ± 0.2% at the end of 35 d. The maximum power density was 5.6 W/m(3). At the end of composting, organic matter content (OM) reduction rate increased to 19.5 ± 0.2% in AnCBE and to 12.9 ± 0.1% in AnC. The fuzzy comprehensive assessment (FCA) result indicated that the membership degree of class I of AnCBE compost (0.64) was higher than that of AnC compost (0.44). It was demonstrated that electrogenesis in the AnCBE could improve the sludge stabilization degree, accelerate anaerobic composting process and enhance composting maturity with bioelectricity generation. Copyright © 2015 Elsevier Ltd. All rights reserved.

CBE awarded to DoH officer (england).

PubMed

2000-02-01

Julie Hartley-Jones, Department of Health (England) nursing officer with responsibilities for acute and specialist services including A & E, has been awarded a CBE in the New Year's honours list. Ms Hartley-Jones, who was awarded her CBE for services to renal nursing, is also a former president of the European Dialysis and Transplant Nurses Association/European Renal Care Association. She recently spoke at the RCN A & E Nursing Association Conference on 'Making a Difference' and has a keen interest in emergency nursing issues.

Cranberry extract attenuates hepatic inflammation in high-fat-fed obese mice.

PubMed

Glisan, Shannon L; Ryan, Caroline; Neilson, Andrew P; Lambert, Joshua D

2016-11-01

Cranberry (Vaccinium macrocarpon) consumption has been associated with health beneficial effects. Nonalcoholic fatty liver disease (NAFLD) is a comorbidity of obesity. In the present study, we investigated the effect of a polyphenol-rich cranberry extract (CBE) on hepatic inflammation in high fat (HF)-fed obese C57BL/6J mice. Following dietary treatment with 0.8% CBE for 10 weeks, we observed no change in body weight or visceral fat mass in CBE-supplemented mice compared to HF-fed control mice. We did observe a significant decrease in plasma alanine aminotransferase (31%) and histological severity of NAFLD (33% decrease in area of involvement, 29% decrease in lipid droplet size) compared to HF-fed controls. Hepatic protein levels of tumor necrosis factor α and C-C chemokine ligand 2 were reduced by 28% and 19%, respectively, following CBE supplementation. CBE significantly decreased hepatic mRNA levels of toll-like receptor 4 (TLR4, 63%) and nuclear factor κB (NFκB, 24%), as well as a number of genes related to the nucleotide-binding domain, leucine-rich-containing family, pyrin domain-containing 3 inflammasome. In conclusion, CBE reduced NAFLD and hepatic inflammation in HF-fed obese C57BL/6J mice. These effects appear to be related to mitigation of TLR4-NFκB related signaling; however, further studies into the underlying mechanisms of these hepatoprotective effects are needed. Copyright © 2016 Elsevier Inc. All rights reserved.

Development of the movement domain in the global body examination.

PubMed

Kvåle, Alice; Bunkan, Berit Heir; Opjordsmoen, Stein; Friis, Svein

2012-01-01

The purpose of this study was to develop a new Movement domain, based on 16 items from the Global Physiotherapy Examination-52 (GPE-52) and 18 items from the Comprehensive Body Examination (CBE). Furthermore, we examined how well the new domain and its scales would discriminate between healthy individuals and different groups of patients, compared to the original methods. Two physiotherapists, each using one method, independently examined 132 individuals (34 healthy, 32 with localized pain, 32 with generalized pain, and 34 with psychoses). The number of items was reduced by means of correlational and exploratory factor analysis. Internal consistency was examined with Cronbach's alpha. For examination of discriminative validity, Mann-Whitney U-test and Area under the Curve (AUC) were used. The initial 34 items were reduced to two subscales with 13 items: one for range of movement and balance and one for flexibility. Cronbach's alpha was 0.84 and 0.87 for the two subscales. The new subscales showed very good to excellent discriminating ability between healthy persons and the different patient groups (p < 0.001; AUC 0.82-0.95). Furthermore, patients with localized pain had significantly less movement aberrations than the other patient groups. The new Movement domain had fewer items than the GPE-52 and CBE, without losing discriminative validity.

Community-based exercise programs as a strategy to optimize function in chronic disease: a systematic review.

PubMed

Desveaux, Laura; Beauchamp, Marla; Goldstein, Roger; Brooks, Dina

2014-03-01

Chronic diseases are the leading cause of death and disability worldwide. Preliminary evidence suggests that community-based exercise (CBE) improves functional capacity (FC) and health-related quality of life (HRQL). To describe the structure and delivery of CBE programs for chronic disease populations and compare their impact on FC and HRQL to standard care. Randomized trials examining CBE programs for individuals with stroke, chronic obstructive pulmonary disease, osteoarthritis, diabetes, and cardiovascular disease were identified. Quality was assessed using the Cochrane risk of bias tool. Meta-analyses were conducted using Review Manager 5.1. The protocol was registered on PROSPERO (CRD42012002786). Sixteen studies (2198 individuals, mean age 66.8±4.9 y) were included to describe program structures, which were comparable in their design and components, irrespective of the chronic disease. Aerobic exercise and resistance training were the primary interventions in 85% of studies. Nine studies were included in the meta-analysis. The weighted mean difference for FC, evaluated using the 6-minute walk test, was 41.7 m (95% confidence interval [CI], 20.5-62.8). The standardized mean difference for all FC measures was 0.18 (95% CI, 0.05-0.3). The standardized mean difference for the physical component of HRQL measures was 0.21 (95% CI, 0.05-0.4) and 0.38 (95% CI, 0.04-0.7) for the total score. CBE programs across chronic disease populations have similar structures. These programs appear superior to standard care with respect to optimizing FC and HRQL in individuals with osteoarthritis; however, the effect beyond this population is unknown. Long-term sustainability of these programs remains to be established.

Opportunistic Breast Cancer Education and Screening in Rural Honduras

PubMed Central

Kennedy, Linda S.; Bejarano, Suyapa A.; Onega, Tracy L.; Stenquist, Derek S.

2016-01-01

Purpose In Honduras, the breast cancer burden is high, and access to women’s health services is low. This project tested the connection of community-based breast cancer detection with clinical diagnosis and treatment in a tightly linked and quickly facilitated format. Methods The Norris Cotton Cancer Center at Dartmouth College partnered with the Honduran cancer hospital La Liga Contra el Cancer to expand a cervical cancer screening program, which included self-breast exam (SBE) education and clinical breast exams (CBEs), to assess patient attitudes about and uptake of breast cancer education and screening services. The cervical cancer screening event was held in Honduras in 2013; 476 women from 31 villages attended. Results Half of the women attending elected to receive a CBE; most had concerns about lactation. Clinicians referred 12 women with abnormal CBEs to La Liga Contra el Cancer for additional evaluation at no cost. All referred patients were compliant with the recommendation and received follow-up care. One abnormal follow-up mammogram/ultrasound result was negative on biopsy. One woman with an aggressive phyllodes tumor had a mastectomy within 60 days. Multimodal education about breast cancer screening maximized delivery of women’s health services in a low-tech rural setting. Conclusion The addition of opportunistic breast cancer education and screening to a cervical cancer screening event resulted in high uptake of services at low additional cost to program sponsors. Such novel strategies to maximize delivery of women’s health services in low-resource settings, where there is no access to mammography, may result in earlier detection of breast cancer. Close follow-up of positive results with referral to appropriate treatment is essential. PMID:28717699

Fast multi-core based multimodal registration of 2D cross-sections and 3D datasets.

PubMed

Scharfe, Michael; Pielot, Rainer; Schreiber, Falk

2010-01-11

Solving bioinformatics tasks often requires extensive computational power. Recent trends in processor architecture combine multiple cores into a single chip to improve overall performance. The Cell Broadband Engine (CBE), a heterogeneous multi-core processor, provides power-efficient and cost-effective high-performance computing. One application area is image analysis and visualisation, in particular registration of 2D cross-sections into 3D image datasets. Such techniques can be used to put different image modalities into spatial correspondence, for example, 2D images of histological cuts into morphological 3D frameworks. We evaluate the CBE-driven PlayStation 3 as a high performance, cost-effective computing platform by adapting a multimodal alignment procedure to several characteristic hardware properties. The optimisations are based on partitioning, vectorisation, branch reducing and loop unrolling techniques with special attention to 32-bit multiplies and limited local storage on the computing units. We show how a typical image analysis and visualisation problem, the multimodal registration of 2D cross-sections and 3D datasets, benefits from the multi-core based implementation of the alignment algorithm. We discuss several CBE-based optimisation methods and compare our results to standard solutions. More information and the source code are available from http://cbe.ipk-gatersleben.de. The results demonstrate that the CBE processor in a PlayStation 3 accelerates computational intensive multimodal registration, which is of great importance in biological/medical image processing. The PlayStation 3 as a low cost CBE-based platform offers an efficient option to conventional hardware to solve computational problems in image processing and bioinformatics.

The current provision of community-based teaching in UK medical schools: an online survey and systematic review.

PubMed

Lee, Sandra W W; Clement, Naomi; Tang, Natalie; Atiomo, William

2014-12-01

To evaluate the current provision and outcome of community-based education (CBE) in UK medical schools. An online survey of UK medical school websites and course prospectuses and a systematic review of articles from PubMed and Web of Science were conducted. Articles in the systematic review were assessed using Rossi, Lipsey and Freeman's approach to programme evaluation. Publications from November 1998 to 2013 containing information related to community teaching in undergraduate medical courses were included. Out of the 32 undergraduate UK medical schools, one was excluded due to the lack of course specifications available online. Analysis of the remaining 31 medical schools showed that a variety of CBE models are utilised in medical schools across the UK. Twenty-eight medical schools (90.3%) provide CBE in some form by the end of the first year of undergraduate training, and 29 medical schools (93.5%) by the end of the second year. From the 1378 references identified, 29 papers met the inclusion criteria for assessment. It was found that CBE mostly provided advantages to students as well as other participants, including GP tutors and patients. However, there were a few concerns regarding the lack of GP tutors' knowledge in specialty areas, the negative impact that CBE may have on the delivery of health service in education settings and the cost of CBE. Despite the wide variations in implementation, community teaching was found to be mostly beneficial. To ensure the relevance of CBE for 'Tomorrow's Doctors', a national framework should be established, and solutions sought to reduce the impact of the challenges within CBE. This is the first study to review how community-based education is currently provided throughout Medical Schools in the UK. The use of Rossi, Lipsey and Freeman's method of programme evaluation means that the literature was analysed in a consistent and comprehensive way. However, a weakness is that data from the online survey was obtained from online medical school prospectuses. This means the data may be incomplete or out of date. Data in the literature review may also be skewed by publication bias. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

The current provision of community-based teaching in UK medical schools: an online survey and systematic review

PubMed Central

Lee, Sandra W W; Clement, Naomi; Tang, Natalie; Atiomo, William

2014-01-01

Objective To evaluate the current provision and outcome of community-based education (CBE) in UK medical schools. Design and data sources An online survey of UK medical school websites and course prospectuses and a systematic review of articles from PubMed and Web of Science were conducted. Articles in the systematic review were assessed using Rossi, Lipsey and Freeman's approach to programme evaluation. Study selection Publications from November 1998 to 2013 containing information related to community teaching in undergraduate medical courses were included. Results Out of the 32 undergraduate UK medical schools, one was excluded due to the lack of course specifications available online. Analysis of the remaining 31 medical schools showed that a variety of CBE models are utilised in medical schools across the UK. Twenty-eight medical schools (90.3%) provide CBE in some form by the end of the first year of undergraduate training, and 29 medical schools (93.5%) by the end of the second year. From the 1378 references identified, 29 papers met the inclusion criteria for assessment. It was found that CBE mostly provided advantages to students as well as other participants, including GP tutors and patients. However, there were a few concerns regarding the lack of GP tutors’ knowledge in specialty areas, the negative impact that CBE may have on the delivery of health service in education settings and the cost of CBE. Conclusions Despite the wide variations in implementation, community teaching was found to be mostly beneficial. To ensure the relevance of CBE for ‘Tomorrow's Doctors’, a national framework should be established, and solutions sought to reduce the impact of the challenges within CBE. Strengths and limitations of this study This is the first study to review how community-based education is currently provided throughout Medical Schools in the UK. The use of Rossi, Lipsey and Freeman's method of programme evaluation means that the literature was analysed in a consistent and comprehensive way. However, a weakness is that data from the online survey was obtained from online medical school prospectuses. This means the data may be incomplete or out of date. Data in the literature review may also be skewed by publication bias. PMID:25448625

Brief Report: Group Social-Multimodal Intervention for HFASD

ERIC Educational Resources Information Center

Bauminger, Nirit

2007-01-01

Current study is the second part of a 2-year cognitive-behavioral-ecological (CB-E) intervention for high-functioning (HF) children with autism spectrum disorder (ASD). We examined the utility of a group-centered intervention on children's ability to interact cooperatively with peers during structured and non-structured social situations. Direct…

Underpinnings of Competency-Based Education

ERIC Educational Resources Information Center

Schilling, Jim F.; Koetting, J. Randall

2010-01-01

Context: To understand and appropriately implement competency-based education (CBE) to its fullest potential in professional programs, an investigation of its evolution is required. Objective: To reveal the development of the CBE approach now dominating many professional programs in higher education, including Athletic Training Education Programs…

Fast multi-core based multimodal registration of 2D cross-sections and 3D datasets

PubMed Central

2010-01-01

Background Solving bioinformatics tasks often requires extensive computational power. Recent trends in processor architecture combine multiple cores into a single chip to improve overall performance. The Cell Broadband Engine (CBE), a heterogeneous multi-core processor, provides power-efficient and cost-effective high-performance computing. One application area is image analysis and visualisation, in particular registration of 2D cross-sections into 3D image datasets. Such techniques can be used to put different image modalities into spatial correspondence, for example, 2D images of histological cuts into morphological 3D frameworks. Results We evaluate the CBE-driven PlayStation 3 as a high performance, cost-effective computing platform by adapting a multimodal alignment procedure to several characteristic hardware properties. The optimisations are based on partitioning, vectorisation, branch reducing and loop unrolling techniques with special attention to 32-bit multiplies and limited local storage on the computing units. We show how a typical image analysis and visualisation problem, the multimodal registration of 2D cross-sections and 3D datasets, benefits from the multi-core based implementation of the alignment algorithm. We discuss several CBE-based optimisation methods and compare our results to standard solutions. More information and the source code are available from http://cbe.ipk-gatersleben.de. Conclusions The results demonstrate that the CBE processor in a PlayStation 3 accelerates computational intensive multimodal registration, which is of great importance in biological/medical image processing. The PlayStation 3 as a low cost CBE-based platform offers an efficient option to conventional hardware to solve computational problems in image processing and bioinformatics. PMID:20064262

Knowledge of risk factors and early detection methods and practices towards breast cancer among nurses in Indira Gandhi Medical College, Shimla, Himachal Pradesh, India.

PubMed

Fotedar, Vikas; Seam, Rajeev K; Gupta, Manoj K; Gupta, Manish; Vats, Siddharth; Verma, Sunita

2013-01-01

Breast cancer is an increasing health problem in India. Screening for early detection should lead to a reduction in mortality from the disease. It is known that motivation by nurses influences uptake of screening methods by women. This study aimed to investigate knowledge of breast cancer risk factors and early detection methods and the practice of screening among nurses in Indira Gandhi Medical College, Shimla, Himachal Pradesh. A cross-sectional study was conducted using a self-administered questionnaire to assess the knowledge of breast cancer risk factors, early detection methods and practice of screening methods among 457 nurses working in an Indira Gandhi Medical College, Shimla-H.P. Chi square test, Data was analysed using SPSS version 16. Test of significance used was chi square test. The response rate of the study was 94.9%. The average knowledge of risk factors about breast cancer of the entire population is 49%. 10.5% of nurses had poor knowledge, 25.2% of the nurses had good knowledge, 45% had very good knowledge and 16.3% of the nurses had excellent knowledge about risk factors of breast cancer and early detection methods. The knowledge level was significantly higher among BSC nurses than nurses with Diploma. 54% of participants in this study reportedly practice BSE at least once every year. Less than one-third reported that they had CBE within the past one year. 7% ever had mammogram before this study. Results from this study suggest the frequent continuing medical education programmes on breast cancer at institutional level is desirable.

Star-like superalkali cations featuring planar pentacoordinate carbon

DOE Office of Scientific and Technical Information (OSTI.GOV)

Guo, Jin-Chang; Tian, Wen-Juan; Zhao, Xue-Feng

Superalkali cations, known to possess low vertical electron affinities (VEAs), high vertical detachment energies, and large highest occupied molecular orbital (HOMO)-lowest unoccupied molecular orbital (LUMO) energy gaps, are intriguing chemical species. Thermodynamically, such species need to be the global minima in order to serve as the promising targets for experimental realization. In this work, we propose the strategies of polyhalogenation and polyalkalination for designing the superalkali cations. By applying these strategies, the local-minimum planar pentacoordinate carbon (ppC) cluster CBe{sub 5} can be modified to form a series of star-like superalkali ppC or quasi-ppC CBe{sub 5}X{sub 5}{sup +} (X = F,more » Cl, Br, Li, Na, K) cations containing a CBe{sub 5} moiety. Polyhalogenation and polyalkalination on the CBe{sub 5} unit may help eliminate the high reactivity of bare CBe{sub 5} molecule by covering the reactive Be atoms with noble halogen anions and alkali cations. Computational exploration of the potential energy surfaces reveals that the star-like ppC or quasi-ppC CBe{sub 5}X{sub 5}{sup +} (X = F, Cl, Br, Li, Na, K) clusters are the true global minima of the systems. The predicted VEAs for CBe{sub 5}X{sub 5}{sup +} range from 3.01 to 3.71 eV for X = F, Cl, Br and 2.12–2.51 eV for X = Li, Na, K, being below the lower bound of the atomic ionization potential of 3.89 eV in the periodic table. Large HOMO-LUMO energy gaps are also revealed for the species: 10.76–11.07 eV for X = F, Cl, Br and 4.99–6.91 eV for X = Li, Na, K. These designer clusters represent the first series of superalkali cations with a ppC center. Bonding analyses show five Be–X–Be three-center two-electron (3c-2e) σ bonds for the peripheral bonding, whereas the central C atom is associated with one 6c-2e π bond and three 6c-2e σ bonds, rendering (π and σ) double aromaticity. Born-Oppenheimer molecular dynamics simulations indicate that the CBe{sub 5} motif is robust in the clusters. As planar hypercoordination carbon species are often thermodynamically unstable and highly reactive, the superalkali cation characters of these ppC species should be highlighted, which may be suitable for experimental realization.« less

Competency-Based Education: A Quantitative Study of the U.S. Air Force Noncommissioned Officer Academy

ERIC Educational Resources Information Center

Houser, Bonnie L.

2017-01-01

There are relatively few empirical studies that examine whether using a competency-based education (CBE) approach results in increased student learning or achievement when compared to traditional education approaches. This study uses a quantitative research methodology, a nonexperimental comparative descriptive research design, and a two-group…

Competency-Based Education. Innovations in Teaching and Learning. Research Brief 1

ERIC Educational Resources Information Center

Katz, Philip M.

2015-01-01

Competency-based education (CBE) is an approach to pedagogy that emphasizes the mastery of skills and concepts rather than credit hours or seat time. The assessment of mastery can take several forms, including formal assessments of prior learning (such as portfolio reviews or examinations) and automated evaluations of online coursework. Advocates…

The anti-inflammatory effect of cherry blossom extract (Prunus yedoensis) used in soothing skincare product.

PubMed

Zhang, Y Q; Guan, L; Zhong, Z Y; Chang, M; Zhang, D K; Li, H; Lai, W

2014-12-01

Previous investigations suggested that cherry blossoms could provide valuable bioactive materials. However, few observations regarding the anti-inflammatory effect of cherry blossoms were reported. This study was to explore the anti-inflammatory effect of cherry blossom extract (CBE), which was used as a soothing ingredient in skincare product. In vitro study, the anti-inflammatory effect of CBE on the nitric oxide (NO) inhibition assay in lipopolysaccharide (LPS)-treated RAW 264.7 cells was investigated. In vivo study, 40 volunteers were included in a randomized, single-blinded, placebo-controlled trial. 24-hour-occlusive test chambers were applied on the flexor side of the forearm with 3% sodium lauryl sulphate (SLS). Subsequently, the test areas were treated on 9 subsequent days with a cream containing 3% CBE or a placebo. Evaluation included a visual score and determination of erythema value (E value). In vitro study, 2% CBE reduced NO production by 31.83% compared to the placebo. In the SLS irritant patch test, the visual score and erythema value of CBE were lower than that of the placebo on D5 and D9. Cherry blossom extract shows good anti-inflammatory effect in vitro and in vivo and represents a promising functional ingredient in soothing skincare product by reducing skin inflammation. © 2014 Society of Cosmetic Scientists and the Société Française de Cosmétologie.

Dissipationless transport of spin-polarized electrons and Cooper pairs in an electron waveguide

NASA Astrophysics Data System (ADS)

Levy, J.; Annadi, A.; Lu, S.; Cheng, G.; Tylan-Tyler, A.; Briggeman, M.; Tomczyk, M.; Huang, M.; Pekker, D.; Irvin, P.; Lee, H.; Lee, J.-W.; Eom, C.-B.

Electron systems undergo profound changes in their behavior when constrained to move along a single axis. To date, clean one-dimensional (1D) electron transport has only been observed in carbon-based nanotubes and nanoribbons, and compound semiconductor nanowires. Complex-oxide heterostructures can possess conductive two-dimensional (2D) interfaces with much richer chemistries and properties, e.g., superconductivity, but with mobilities that appear to preclude ballistic transport in 1D. Here we show that nearly ideal 1D electron waveguides exhibiting ballistic transport of electrons and non-superconducting Cooper pairs can be formed at the interface between the two band insulators LaAlO3 and SrTiO3. The electron waveguides possess gate and magnetic-field selectable spin and charge degrees of freedom, and can be tuned to the one-dimensional limit of a single spin-polarized quantum channel. The strong attractive electron-electron interactions enable a new mode of dissipationless transport of electron pairs that is not superconducting. The selectable spin and subband quantum numbers of these electron waveguides may be useful for quantum simulation, quantum informatio We gratefully acknowledge financial support from ONR N00014-15-1-2847 (JL), AFOSR (FA9550-15-1-0334 (CBE) and FA9550-12-1-0057 (JL, CBE)), AOARD FA2386-15-1-4046 (CBE) and NSF (DMR-1104191 (JL), DMR-1124131 (CBE, JL) and DMR-1234096 (CBE)).

Competency-Based Education Programs: A Library Perspective

ERIC Educational Resources Information Center

Sanders, Colleen

2015-01-01

Competency-based education (CBE) is an emerging model for higher education designed to reduce certain barriers to educational attainment. This essay describes CBE and the challenges and opportunities for academic librarians desiring to serve students and faculty in Library and Information Management Master of Library Science (MLS) programs. Every…

Designing CBE for Continuing Professional Education.

ERIC Educational Resources Information Center

Rees, Keith

Deakin Australia (DA) CBE (Continuing Business Education) programs are designed for use in conjunction with print and audio materials which are distributed as distance learning packages to business studies graduates working or planning to work as accountants, who are enrolled in the professional licensing program run by the Australian Society of…

CBE: The Right Angle for Learning.

ERIC Educational Resources Information Center

Seitz, Fred

Designed for instructors at Beaufort Technical College (BTC) in South Carolina, this handbook provides a brief guide to competency-based education (CBE) and to the available resources at the college for assistance. Section 1 offers introductory comments on the concept of quality control and the five basic components of educational quality control.…

Do We Really Need Performance Objectives?

ERIC Educational Resources Information Center

Duenk, Lester G.

Trade and industrial education (T&I) has been using performance-based instructional systems long before competency-based education (CBE) emerged as a creative innovation in other subject areas. Allen devised the forerunner of the present CBE system in 1917 by carefully plotting competencies and delineating job analyses from these, and Fryklund's…

Proposed Directions for Research in Computer-Based Education.

ERIC Educational Resources Information Center

Waugh, Michael L.

Several directions for potential research efforts in the field of computer-based education (CBE) are discussed. (For the purposes of this paper, CBE is defined as any use of computers to promote learning with no intended inference as to the specific nature or organization of the educational application under discussion.) Efforts should be directed…

Antiphotoaging Effect of Prunus yeonesis Blossom Extract via Inhibition of MAPK/AP-1 and Regulation of the TGF-βI/Smad and Nrf2/ARE Signaling Pathways.

PubMed

Li, Lu; Hwang, Eunson; Ngo, Hien T T; Lin, Pei; Gao, Wei; Liu, Ying; Yi, Tae-Hoo

2018-02-08

Cherry blossoms have attracted attention as an ingredient with potential for use in skincare products. However, no skin photoaging-related research has been performed with this plant. In this study, cherry blossom extract (CBE) at 1, 10 and 100 μg mL -1 was investigated for its skin antiphotoaging effects in UVB-irradiated normal human dermal fibroblasts (NHDF) cells in vitro. Our results showed that CBE markedly increased type-I procollagen during UVB exposure via two pathways. Firstly, transcription activator protein-1 expression and MAP kinases were downregulated, consequently reducing the production of matrix metalloproteinase (MMP)-1 and MMP-3. Secondly, transforming growth factor TGF-βI secretion was upregulated by Smads. Application of CBE facilitated the nuclear translocation of Nrf2 against reactive oxygen species (ROS)-induced damage, which is essential for the coordinated induction of cytoprotective enzymes. Together, our findings suggest that CBE may be a promising ingredient for skin aging therapy and provide a novel approach for alleviating cutaneous aging. © 2018 The American Society of Photobiology.

Chemical, Biological, and Explosive Sensors for Field Measurements

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kevin Kyle, Manuel Manard, Stephan Weeks

Special Technologies Laboratory (STL) is developing handheld chemical, biological, and explosive (CBE) detection systems and sensor motes for wireless networked field operations. The CBE sensors are capable of detecting and identifying multiple targeted toxic industrial chemicals (TICs) and high-explosive vapor components. The CBE devices are based on differential mobility spectrometry (DMS) coupled with fast gas chromatography (GC) or mass spectrometry. The systems all include the concepts of: 1. Direct air/particulate “smart” sampling 2. Selective, continuous real-time (~1 sec) alert monitoring using DMS 3. Highly selective, rapid dual technology separation/verification analysis The biosensor technology is based on Raman aerosol particle flowmore » cytometry for target detection and identification. Monitoring and identifying trace level chemical vapors directly from ambient air will allow First Responders to quickly adapt situational response strategies and personal protective equipment needs to the specific response scenario being encountered. First Responders require great confidence in the measurements and ability of a given system to detect CBE below threshold levels without interferences. The concept of determining the background matrix in near real-time to allow subsequent automated field-programmable method selection and cueing of high-value assets in a wide range of environs will be presented. This provides CBE information for decisions prior to First Responders entering the response site or sending a portable mobile unit for a remote site survey of the hazards. The focus is on real-time information needed by those responsible for emergency response and national security.« less

Investigating Pre-Service Early Childhood Teachers' Attitudes towards the Computer Based Education in Science Activities

ERIC Educational Resources Information Center

Yilmaz, Nursel; Alici, Sule

2011-01-01

The purpose of this study was to investigate pre-service early childhood teachers' attitudes towards using Computer Based Education (CBE) while implementing science activities. More specifically, the present study examined the effect of different variables such as gender, year in program, experience in preschool, owing a computer, and the…

Kindergarten Children and Language Learning: Missing Pillars for Language Acquisition

ERIC Educational Resources Information Center

Al-Darwish, Salwa

2013-01-01

This study examines the perceptions of the Kuwaiti kindergarten school teachers and parents as well as the English curriculum in an attempt to identify areas that need to be improved in the kindergarten teachers' program at the CBE (College of Basic Education). In addition, the paper looks closely into the delivery of information and sequence of…

A new miniature hand-held solar-blind reagentless standoff chemical, biological, and explosives (CBE) sensor

NASA Astrophysics Data System (ADS)

Hug, W. F.; Reid, R. D.; Bhartia, R.; Lane, A. L.

2008-04-01

Improvised explosive devices (IEDs), vehicle-borne improvised explosive devices (VBIEDs), and suicide bombers are a major threat to many countries and their citizenry. The ability to detect trace levels of these threats with a miniature, hand-held, reagentless, standoff sensor represents a major improvement in the state of the art of CBE surface sensors. Photon Systems, Inc., in collaboration with Jet Propulsion Laboratory, recently demonstrated a new technology hand-held sensor for reagentless, close-range, standoff detection and identification of trace levels CBE materials on surfaces. This targeted ultraviolet CBE (TUCBE) sensor is the result of an Army Phase I STTR program. The resulting 5lb, 5W, flashlight-sized sensor can discriminate CBE from background materials using a combination of deep UV excited resonance Raman (RR) and laser induced native fluorescence (LINF) emissions resulting from excitation by a new technology deep UV laser. Detection and identification is accomplished in less than 1ms. Standoff excitation of suspicious packages, vehicles, persons, and other objects that may contain hazardous materials is accomplished using wavelengths below 250nm where Raman and native fluorescence emissions occupy distinctly different wavelength regions. This enables simultaneous detection of RR and LINF emissions with no interferences. The sensor employs fused RR/LINF chemometric methods to extract the identity of targeted materials from background clutter. Photon Systems has demonstrated detection and identification of 100ng/cm2 of explosives materials at a distance of 1 meter using a sensor with 3.8 cm optical aperture. Expansion of the optical aperture to 38 cm in a lantern-sized sensor will enable similar detection and identification of CBE materials at standoff distances of 10 meters. As a result of excitation and detection in the deep UV and the use of a gated detection system, the sensor is solar blind and can operate in full daylight conditions.

Evaluating a community-based exercise intervention with adults living with HIV: protocol for an interrupted time series study

PubMed Central

O'Brien, Kelly K; Bayoumi, Ahmed M; Solomon, Patricia; Tang, Ada; Murzin, Kate; Chan Carusone, Soo; Zobeiry, Mehdi; Nayar, Ayesha; Davis, Aileen M

2016-01-01

Introduction Our aim was to evaluate a community-based exercise (CBE) intervention with the goal of reducing disability and enhancing health for community-dwelling people living with HIV (PLWH). Methods and analysis We will use a mixed-methods implementation science study design, including a prospective longitudinal interrupted time series study, to evaluate a CBE intervention with PLWH in Toronto, Canada. We will recruit PLWH who consider themselves medically stable and safe to participate in exercise. In the baseline phase (0–8 months), participants will be monitored bimonthly. In the intervention phase (8–14 months), participants will take part in a 24-week CBE intervention that includes aerobic, resistance, balance and flexibility exercise at the YMCA 3 times per week, with weekly supervision by a fitness instructor, and monthly educational sessions. In the follow-up phase (14–22 months), participants will be encouraged to continue to engage in unsupervised exercise 3 times per week. Quantitative assessment: We will assess cardiopulmonary fitness, strength, weight, body composition and flexibility outcomes followed by the administration of self-reported questionnaires to assess disability and contextual factor outcomes (coping, mastery, stigma, social support) bimonthly. We will use time series regression analysis to determine the level and trend of outcomes across each phase in relation to the intervention. Qualitative assessment: We will conduct a series of face-to-face interviews with a subsample of participants and recreation providers at initiation, midpoint and completion of the 24-week CBE intervention. We will explore experiences and anticipated benefits with exercise, perceived impact of CBE for PLWH and the strengths and challenges of implementing a CBE intervention. Interviews will be audio recorded and analysed thematically. Ethics and dissemination Protocol approved by the University of Toronto HIV/AIDS Research Ethics Board. Knowledge translation will occur with stakeholders in the form of presentations and publications in open access peer-reviewed journals. Trial registration number NCT02794415; Pre-results. PMID:27798038

The Council of Regional Accrediting Commissions Framework for Competency-Based Education: A Grounded Theory Study

ERIC Educational Resources Information Center

Butland, Mark James

2017-01-01

Colleges facing pressures to increase student outcomes while reducing costs have shown an increasing interest in competency-based education (CBE) models. Regional accreditors created a joint policy on CBE evaluation. Two years later, through this grounded theory study, I sought to understand from experts the nature of this policy, its impact, and…

Innovate and Evaluate: Expanding the Research Base for Competency-Based Education. AEI Series on Competency-Based Higher Education

ERIC Educational Resources Information Center

Kelly, Andrew P.; Columbus, Rooney

2016-01-01

Competency-based education (CBE) has garnered significant attention lately from reformers and policymakers. Put simply, CBE awards credit based on what students have learned rather than how much time they spend in class. Competency-based programs identify specific competencies, develop assessments to measure mastery of those competencies, and then…

Next-Generation CBE: Designing Competency-Based Education for Underprepared College Learners

ERIC Educational Resources Information Center

Girardi, Amy; Crew, Rachel

2016-01-01

Competency-based education (CBE) is widely viewed as an innovative alternative to traditional higher education, yet most programs serve only a narrow slice of the postsecondary population. Few are intended for adults who need to boost basic skills in order to succeed in college coursework. However, if designed with the needs of a broader range of…

Rethinking the Regulatory Environment of Competency-Based Education. AEI Series on Competency-Based Higher Education

ERIC Educational Resources Information Center

Lacey, Aaron; Murray, Christopher

2015-01-01

In recent years, competency-based education (CBE) has made considerable inroads in higher education. Various institutions have developed or begun developing a range of programs modeled on competency-based principles. CBE is viewed by many, and with good reason, as a potential means to deliver a more effective educational experience at a lower…

One-session computer-based exposure treatment for spider-fearful individuals--efficacy of a minimal self-help intervention in a randomised controlled trial.

PubMed

Müller, Birgit H; Kull, Sandra; Wilhelm, Frank H; Michael, Tanja

2011-06-01

Computer-based self-help treatments have been proposed to provide greater access to treatment while requiring minimum input from a therapist. The authors employed a randomised controlled trial to investigate the efficacy of one-session computer-based exposure (CBE) as a self-help treatment for spider-fearful individuals. Spider-fearful participants in a CBE group underwent one 27-min session of standardised exposure to nine fear-eliciting spider pictures. Treatment outcome was compared to spider-fearful control participants exposed to nine neutral pictures. Fear reduction was quantified on a subjective level by the Fear of Spiders Questionnaire (FSQ) and complemented with a behavioural approach test (BAT). Results demonstrate that compared to control participants, CBE participants showed greater fear reduction from pre- to posttreatment on both the subjective level (FSQ) and the behavioural level (BAT). Moreover, in contrast to the control group, the obtained subjective fear reduction effect remained stable in the CBE group at 1-month follow-up. These findings highlight the role of computer-based self-help as a minimal but effective intervention to reduce fear of spiders. Copyright © 2010 Elsevier Ltd. All rights reserved.

Therapeutic implications of continuing bonds expressions following the death of a pet.

PubMed

Packman, Wendy; Carmack, Betty J; Ronen, Rama

Through the exploration of 12 continuing bonds expressions (CBE), this current study investigated the grief reaction and continuing impact of the death of a pet. Thirty-three individuals were interviewed to determine the degree of connection maintained with the deceased pet and how that affects their coping. Findings emphasize that the majority of respondents frequently maintain ongoing meaningful ties with their deceased pet through the use of CBE such as fond memories, rituals, dreams. The findings suggest that it is not the number of CBE but the degree of adaptability that is significant. The importance of recognizing the unique, total experience of those grieving the death of a pet is addressed. Implications for those working with and supporting those in grief are included. Future directions for research are described.

Is there a propeller neutron star in γ Cas?

NASA Astrophysics Data System (ADS)

Smith, M. A.; Lopes de Oliveira, R.; Motch, C.

2017-08-01

γ Cas is the prototype of a small population of B0-B1.5 III-V classical Be (cBe) stars that emit anomalous and hard X-rays with a unique array of properties. γ Cas is known to host, like other cBe stars, a decretion disc and also a low-mass companion. Recently, Postnov et al. have posited that this companion is a magnetized rapidly spinning neutron star that deflects direct gravitational accretion from a stellar/disc wind via the 'propeller mechanism'. These authors state that the key X-ray observations are 'remarkably well produced' in this scenario. We re-examine this mechanism in detail and conclude that there are a number of fatal objections in its application to the γ Cas case. Among other considerations these issues include the prediction under the propeller scenario of a much smaller population of γ Cas stars than is observed and the lack of allowance for observed correlations of X-ray and UV and/or optical properties over a variety of time-scales.

Exploring Competence Based Education (CBE) in Rural Secondary Schools in Tanzania: English Language Teachers' Conceptions and Experiences

ERIC Educational Resources Information Center

Lukindo, Jesse John

2016-01-01

This study aimed at getting an insight on the implementation of Competence Based Education in Tanzania (CBE) in Tanzania. A study was conducted in Changchun, Jilin in China due to limited time the researcher had. The study was guided by the following research objective; specifically this study did the following; to assess the knowledge that rural…

State Policies to Support Competency-Based Education for Overage, Under-Credited Students. Ask the CCRS Center

ERIC Educational Resources Information Center

Tomasello, Jenna; Brand, Betsy

2016-01-01

How can states ensure that students who are overage or under-credit (OA/UC) not only graduate high school but are prepared for college or the workforce? Competency-based education (CBE) is one emerging strategy for addressing the needs of at-risk youth. CBE can address the needs of at-risk students because it is personalized to individual…

A Computer Based Education (CBE) Program for Middle School Mathematics Intervention

ERIC Educational Resources Information Center

Gulley, Bill

2009-01-01

A Computer Based Education (CBE) program for intervention mathematics was developed, used, and modified over a period of three years in a computer lab at an Arizona Title I middle school. The program is described along with a rationale for the need, design, and use of such a program. Data was collected in the third year and results of the program…

The Student Experience: How Competency-Based Education Providers Serve Students. AEI Series on Competency-Based Higher Education

ERIC Educational Resources Information Center

Baker, Rachel B.

2015-01-01

The rise of competency-based education (CBE) has redefined what college looks like for a growing number of students. The basic idea underlying CBE is simple: programs award credit based on demonstrated student competencies rather than on the amount of time a student has spent in a given course. Recent advances in technology, including online…

Evaluating a community-based exercise intervention with adults living with HIV: protocol for an interrupted time series study.

PubMed

O'Brien, Kelly K; Bayoumi, Ahmed M; Solomon, Patricia; Tang, Ada; Murzin, Kate; Chan Carusone, Soo; Zobeiry, Mehdi; Nayar, Ayesha; Davis, Aileen M

2016-10-20

Our aim was to evaluate a community-based exercise (CBE) intervention with the goal of reducing disability and enhancing health for community-dwelling people living with HIV (PLWH). We will use a mixed-methods implementation science study design, including a prospective longitudinal interrupted time series study, to evaluate a CBE intervention with PLWH in Toronto, Canada. We will recruit PLWH who consider themselves medically stable and safe to participate in exercise. In the baseline phase (0-8 months), participants will be monitored bimonthly. In the intervention phase (8-14 months), participants will take part in a 24-week CBE intervention that includes aerobic, resistance, balance and flexibility exercise at the YMCA 3 times per week, with weekly supervision by a fitness instructor, and monthly educational sessions. In the follow-up phase (14-22 months), participants will be encouraged to continue to engage in unsupervised exercise 3 times per week. Quantitative assessment: We will assess cardiopulmonary fitness, strength, weight, body composition and flexibility outcomes followed by the administration of self-reported questionnaires to assess disability and contextual factor outcomes (coping, mastery, stigma, social support) bimonthly. We will use time series regression analysis to determine the level and trend of outcomes across each phase in relation to the intervention. Qualitative assessment: We will conduct a series of face-to-face interviews with a subsample of participants and recreation providers at initiation, midpoint and completion of the 24-week CBE intervention. We will explore experiences and anticipated benefits with exercise, perceived impact of CBE for PLWH and the strengths and challenges of implementing a CBE intervention. Interviews will be audio recorded and analysed thematically. Protocol approved by the University of Toronto HIV/AIDS Research Ethics Board. Knowledge translation will occur with stakeholders in the form of presentations and publications in open access peer-reviewed journals. NCT02794415; Pre-results. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Coherent Backscattering Effect in Saturnian vs. Uranian Satellites: Observations and Enhanced MSTM Modeling

NASA Astrophysics Data System (ADS)

Pitman, Karly M.; Kolokolova, Ludmilla; Verbiscer, Anne J.; Joseph, Emily C.; Mackowski, Daniel W.; Buratti, Bonnie J.; Momary, Thomas W.

2014-11-01

We continue our campaign to extract spectra and measure absorption band parameters from Cassini Visual & Infrared Mapping Spectrometer (VIMS) and ground-based near-infrared observations of saturnian and uranian icy satellites. We compare these spectra to numerical models to study the coherent backscattering effect (CBE; constructive interference of radiation) that should significantly alter the interpretation of spacecraft spectra obtained at solar phase angles α < 2 degrees. To quantify CBE, we extract VIMS spectra for different α from the same location on the icy satellite surface, ideally within +/- 1-2 degrees in subspacecraft latitude and longitude. Using 2013-2014 calibration updates for VIMS, we present groups of VIMS spectra (pairs or trios) for 3 saturnian moons that most closely fit these ideal criteria. We also show models of the light-scattering characteristics of icy surfaces using a new version of the Multiple Sphere T-Matrix (MSTM) code (Mackowski, D., 2014, in Proceedings of the Workshop “Scattering by aggregates (on surfaces)”, Bremen, Germany, 24 - 25. March 2014, p. 6-9). This code, called MSTM4, allows users to build large, thick slabs of dozens of thousands of spheres to model planetary regolith more accurately. The results clearly indicate the influence of CBE on the spectra and show significant dependence on the size of particles and their packing. To extend the low phase angle coverage of Cassini VIMS data and examine CBE on darker surfaces, we also compare to spectra of several uranian satellites (Titania, Oberon Ariel) acquired using Triplespec ( 3500) at Apache Point Observatory, New Mexico. Synthesizing such results will ultimately place limits on the size and packing fraction of icy satellite regolith particles and aid in interpretations of the structure, composition, and evolution of icy satellites.This work is supported by NASA’s Outer Planets Research program (NNX12AM76G; PI Pitman), Planetary Astronomy program (NNX09AD06G; PI Verbiscer), and NASA’s Advanced Supercomputing Division. Calibrated Cassini VIMS data cubes appear courtesy of the Cassini VIMS team and the PDS.

HIV Treatment and Prevention: A Simple Model to Determine Optimal Investment.

PubMed

Juusola, Jessie L; Brandeau, Margaret L

2016-04-01

To create a simple model to help public health decision makers determine how to best invest limited resources in HIV treatment scale-up and prevention. A linear model was developed for determining the optimal mix of investment in HIV treatment and prevention, given a fixed budget. The model incorporates estimates of secondary health benefits accruing from HIV treatment and prevention and allows for diseconomies of scale in program costs and subadditive benefits from concurrent program implementation. Data sources were published literature. The target population was individuals infected with HIV or at risk of acquiring it. Illustrative examples of interventions include preexposure prophylaxis (PrEP), community-based education (CBE), and antiretroviral therapy (ART) for men who have sex with men (MSM) in the US. Outcome measures were incremental cost, quality-adjusted life-years gained, and HIV infections averted. Base case analysis indicated that it is optimal to invest in ART before PrEP and to invest in CBE before scaling up ART. Diseconomies of scale reduced the optimal investment level. Subadditivity of benefits did not affect the optimal allocation for relatively low implementation levels. The sensitivity analysis indicated that investment in ART before PrEP was optimal in all scenarios tested. Investment in ART before CBE became optimal when CBE reduced risky behavior by 4% or less. Limitations of the study are that dynamic effects are approximated with a static model. Our model provides a simple yet accurate means of determining optimal investment in HIV prevention and treatment. For MSM in the US, HIV control funds should be prioritized on inexpensive, effective programs like CBE, then on ART scale-up, with only minimal investment in PrEP. © The Author(s) 2015.

Optimization of synthesis process of thermally-responsive poly-n-isopropylacrylamide nanoparticles for controlled release of antimicrobial hydrophobic compounds

NASA Astrophysics Data System (ADS)

Hill, Laura E.; Gomes, Carmen L.

2014-12-01

The goal of this study was to develop an effective method to synthesize poly-n-isopropylacrylamide (PNIPAAM) nanoparticles with entrapped cinnamon bark extract (CBE) to improve its delivery to foodborne pathogens and control its release with temperature stimuli. CBE was used as a model for hydrophobic natural antimicrobials. A top-down procedure using crosslinked PNIPAAM was compared to a bottom-up procedure using NIPAAM monomer. Both processes relied on self-assembly of the molecules into micelles around the CBE at 40 °C. Processing conditions were compared including homogenization time of the polymer, hydration time prior to homogenization, lyophilization, and the effect of particle ultrafiltration. The top-down versus bottom-up synthesis methods yielded particles with significantly different characteristics, especially their release profiles and antimicrobial activities. The synthesis methods affected particle size, with the bottom-up procedure resulting in smaller (P < 0.05) diameters than the top-down procedure. The controlled release profile of CBE from nanoparticles was dependent on the release media temperature. A faster, burst release was observed at 40 °C and a slower, more sustained release was observed at lower temperatures. PNIPAAM particles containing CBE were analyzed for their antimicrobial activity against Salmonella enterica serovar Typhimurium LT2 and Listeria monocytogenes Scott A. The PNIPAAM particles synthesized via the top-down procedure had a much faster release, which led to a greater (P < 0.05) antimicrobial activity. Both of the top-down nanoparticles performed similarly, therefore the 7 min homogenization time nanoparticles would be the best for this application, as the process time is shorter and little improvement was seen by using a slightly longer homogenization.

Cranberry extract-enriched diets increase NAD(P)H:quinone oxidoreductase and catalase activities in obese but not in nonobese mice.

PubMed

Boušová, Iva; Bártíková, Hana; Matoušková, Petra; Lněničková, Kateřina; Zappe, Lukáš; Valentová, Kateřina; Szotáková, Barbora; Martin, Jan; Skálová, Lenka

2015-10-01

Consumption of antioxidant-enriched diets is 1 method of addressing obesity, which is associated with chronic oxidative stress and changes in the activity/expression of various enzymes. In this study, we hypothesized that the modulation of antioxidant enzymes and redox status through a cranberry extract (CBE)-enriched diet would differ between obese and nonobese mice. The CBE used in this study was obtained from the American cranberry (Vaccinium macrocarpon, Ericaceae), a popular constituent of dietary supplements that is a particularly rich source of (poly)phenols and has strong antioxidant properties. The present study was designed to test and compare the in vivo effects of 28-day consumption of a CBE-enriched diet (2%) on the antioxidant status of nonobese mice and mice with monosodium glutamate-induced obesity. Plasma, erythrocytes, liver, and small intestine were studied concurrently to obtain more complex information. The specific activities, protein, and messenger RNA expression levels of antioxidant enzymes as well as the levels of malondialdehyde and thiol (SH) groups were analyzed. Cranberry extract treatment increased the SH group content in plasma and the glutathione S-transferase activity in the erythrocytes of the obese and nonobese mice. In addition, in the obese animals, the CBE treatment reduced the malondialdehyde content in erythrocytes and increased quinone oxidoreductase (liver) and catalase (erythrocytes and small intestine) activities. The elevation of hepatic quinone oxidoreductase activity was accompanied by an increase in the corresponding messenger RNA levels. The effects of CBE on the activity of antioxidant enzymes and redox status were more pronounced in the obese mice compared with the nonobese mice. Copyright © 2015 Elsevier Inc. All rights reserved.

Do Something, Even if It's Wrong! An Approach to Better Management and Planning in Public Schools through a Systematic Approach to Improvement of Basic Skills.

ERIC Educational Resources Information Center

Noggle, Vernon R.

Maintaining that lack of action is one of the biggest errors school managers make, this author describes development of competency based education (CBE) programs as one example of how action can be taken by identifying a problem area and systematically approaching it. He defines CBE programs as those involving identification of basic skills, a…

Avoidance behaviour response and esterase inhibition in the earthworm, Lumbricus terrestris, after exposure to chlorpyrifos.

PubMed

Martínez Morcillo, S; Yela, J L; Capowiez, Y; Mazzia, C; Rault, M; Sanchez-Hernandez, Juan C

2013-05-01

The avoidance response of earthworms to polluted soils has been standardised using a simple and low-cost test, which facilitates soil toxicity screening. In this study, the avoidance response of Lumbricus terrestris was quantified in chlorpyrifos-spiked soils, depending on the pesticide concentration and exposure duration. The inhibition of acetylcholinesterase (AChE) and carboxylesterase (CbE) activities was also determined as indirect measures of pesticide bioavailability. The effects of different chlorpyrifos concentrations were examined in a standardised test (two-chamber system) with 0.6, 3 and 15 mg/kg chlorpyrifos. A modification of the test involved a pre-exposure step (24, 48 or 72 h) in soils spiked with 15 mg/kg. In both protocols, earthworms were unable to avoid the contaminated soils. However, the esterase activities showed that all earthworms were exposed to chlorpyrifos. Acetylcholinesterase activity did not change in earthworms in the standardised behavioural test (0.58 ± 0.20 U/mg protein, mean ± SD; n = 72), whereas the CbE activity was significantly inhibited (62-87 % inhibition) in earthworms exposed to 3 and 15 mg/kg. In the modified test, earthworms had greatly inhibited AChE activity (0.088 ± 0.034 U/mg protein, n = 72), which was supported by reactivation of the inhibited enzyme activity in the presence of pralidoxime (2-PAM). Similarly, the CbE activity was significantly inhibited in earthworms with all treatments. This study suggests that the avoidance behaviour test for organophosphorus-contaminated soils could be supported by specific biomarkers to facilitate a better understanding of pesticide exposure and toxicity during this test.

The Perspectives of Students and Teachers in the English Department in the College of Basic Education on the Student Evaluation of Teachers

ERIC Educational Resources Information Center

Taqi, Hanan A.; Al-Nouh, Nowreyah A.; Dashti, Abdulmuhsin A.; Shuqair, Khaled M.

2014-01-01

In the context of students' evaluation of teachers in higher education, this paper examines the perspectives of students and faculty members in the English Department in the college of Basic education (CBE) in the State of Kuwait. The study is based on a survey that covered 320 students and 19 members of staff in the English department. The study…

Does Competency-Based Education Have a Role in Academic Pharmacy in the United States?

PubMed Central

Medina, Melissa S.

2017-01-01

Competency-based Education (CBE) is an educational model that allows students to learn and demonstrate their abilities at their own pace. CBE is growing in popularity in undergraduate educational programs and its role in pharmacy education in the United States (US) is under review. In comparison, medical education is utilizing competency-based approaches (such as competencies and Entrustable Professional Activities) to ensure that students possess the required knowledge, skills, and attitudes prior to graduation or program completion. The concept of competency-based approaches is growing in use in pharmacy education in the US, but the future related to aspects of this concept (e.g., mandatory Entrustable Professional Activities) is not certain. A review of pharmacy education’s evolution in the US and a comparison of competency-related terms offers insight into the future use of competency-based approaches and CBE in pharmacy education in the US through the lens of benefits and challenges. PMID:28970425

Characterization of temperature and pH-responsive poly-N-isopropylacrylamide-co-polymer nanoparticles for the release of antimicrobials

NASA Astrophysics Data System (ADS)

Hill, Laura E.; Gomes, Carmen L.

2014-09-01

Chitosan and alginate are both pH-responsive biopolymers extracted from crustacean exoskeletons and brown algae, respectively. Poly-N-isopropylacrylamide (PNIPAAM) is a hydrogel that becomes hydrophobic at a lower-critical solution temperature. This study sought to combine pH- and temperature-responsive polymers via crosslinking, in order to create a dual-stimuli responsive polymer for hydrophobic antimicrobial compounds delivery, improving their antimicrobial effects. Cinnamon bark extract (CBE) was used as a model for hydrophobic antimicrobial. Two co-polymers were synthesized to create two nanoparticles types: chitosan-co-PNIPAAM and alginate-co-PNIPAAM. Nanoparticles were formed from the resulting co-polymers using a self-assembly top-down process followed by glutaraldehyde or calcium chloride crosslinking. These nanoparticles were then used as controlled delivery vehicles for CBE, whose rapid release could be triggered by specific external stimuli. For the same pH and temperature conditions, the chitosan-co-PNIPAAM nanoparticles were significantly more potent bacterial inhibitors against both pathogens and also exhibited a faster CBE release over time as well as slightly higher entrapment efficiency. The alginate-co-PNIPAAM nanoparticles were significantly smaller and exhibited a slow, gradual release over a long time period. Although both nanoparticles were able to effectively inhibit pathogen growth at lower (P < 0.05) concentration than free CBE, the chitosan-co-PNIPAAM nanoparticles were more effective in delivering a natural antimicrobial with controlled release against foodborne pathogens.

Sequences in the intergenic spacer influence RNA Pol I transcription from the human rRNA promoter

DOE Office of Scientific and Technical Information (OSTI.GOV)

Li, W.M.; Sylvester, J.E.

1994-09-01

In most eucaryotic species, ribosomal genes are tandemly repeated about 100-5000 times per haploid genome. The 43 Kb human rDNA repeat consists of a 13 Kb coding region for the 18S, 5.8S, 28S ribosomal RNAs (rRNAs) and transcribed spacers separated by a 30 Kb intergenic spacer. For species such as frog, mouse and rat, sequences in the intergenic spacer other than the gene promoter have been shown to modulate transcription of the ribosomal gene. These sequences are spacer promoters, enhancers and the terminator for spacer transcription. We are addressing whether the human ribosomal gene promoter is similarly influenced. In-vitro transcriptionmore » run-off assays have revealed that the 4.5 kb region (CBE), directly upstream of the gene promoter, has cis-stimulation and trans-competition properties. This suggests that the CBE fragment contains an enhancer(s) for ribosomal gene transcription. Further experiments have shown that a fragment ({approximately}1.6 kb) within the CBE fragment also has trans-competition function. Deletion subclones of this region are being tested to delineate the exact sequences responsible for these modulating activities. Previous sequence analysis and functional studies have revealed that CBE contains regions of DNA capable of adopting alternative structures such as bent DNA, Z-DNA, and triple-stranded DNA. Whether these structures are required for modulating transcription remains to be determined as does the specific DNA-protein interaction involved.« less

The effectiveness of competency-based education in equipping primary health care workers to manage chronic disease in Australian general practice settings.

PubMed

Glasgow, Nicholas J; Wells, Robert; Butler, James; Gear, Anna

2008-04-21

To review the literature on the effectiveness of competency-based education (CBE) as a means of equipping the Australian general practice workforce to deliver optimal chronic disease outcomes to articulate policy options for the Australian context. Systematic review of the literature (1991-2005) using a narrative approach followed by analysis of the findings using the actors/context/ processes/content framework of Buse et al. Few high-quality studies were identified. National policy options include incorporating clear statements about education and training, research and evaluation in any policy document targeting chronic disease; and provision of funding to enhance general practice teaching facilities and/or facilitate the development of supportive coordinating and administrative structures for training practices. Designers of CBE should consider five key questions: Are the educational objectives of the CBE clearly aligned with the chronic disease or workforce-related outcomes of interest? Is the design of the CBE sound? Have similar educational programs targeting the same outcomes been identified and every attempt made to maximise synergies between programs? Are the educational designers fully aware of and working within the existing complexity of the training environment? Are all involved in the program actively managing the process of change? Policy options range from those relatively simple and achievable to more complex and difficult. The full report is available at http://www.anu.edu.au/aphcri/Domain/Workforce/final_25_glasgow.pdf.

A Comparative Analysis of Meeting the Whole Child Initiatives through Standardized and Competency-Based Education Systems in Terms of Achievement and Meeting the Whole Child Initiatives: Comparing Professional Perceptions and Identified Measurable Results

ERIC Educational Resources Information Center

Ward, Jacqueline M.

2011-01-01

Traditional education (TE) largely uses a standardized (SbE) approach while alternatives (nTE) tend to more of a competency (CbE), or student-centered approach. This comparative analysis examines essential aspects of such pedagogies in determining the effectiveness of schooling systems in meeting the Whole Child Initiative (Souza, 1999; Carter et…

Validation of the COURAGE Built Environment Self-Reported Questionnaire.

PubMed

Raggi, Alberto; Quintas, Rui; Bucciarelli, Paola; Franco, Maria Grazia; Andreotti, Alessandra; Miret, Marta; Zawisza, Katarzyna; Olaya, Beatriz; Chatterji, Somnath; Sainio, Päivi; Frisoni, Giovanni Battista; Martinuzzi, Andrea; Minicuci, Nadia; Power, Mick; Leonardi, Matilde

2014-01-01

The built environment (BE) impacts on people's disability and health, in terms of overweight, depression, alcohol abuse, poor self-rated health and presence of psychological symptoms; it is reasonable to assume that BE also impacts on participation levels. This paper presents the validation of the COURAGE Built Environment Self-Reported Questionnaire (CBE-SR), an instrument designed to evaluate BE in the context of health and disability. Subjects participating to COURAGE, a cross-sectional study conducted on 10,800 citizens of Poland, Finland and Spain, completed a protocol inclusive of the CBE-SR. Psychometric properties and factor structure were analysed, and factor scores created. Gender differences, differences between persons from different age groups and persons reporting the environment as facilitating, hindering or neutral were calculated. Eight items were deleted so that the final version of CBE-SR comprises 19 items. Cronbach's alpha ranged from 0.743 to 0.906, and test-retest stability was demonstrated for the majority of items. Four subscales were identified: Usability of the neighbourhood environment; Hindrance of walkable environment; Easiness of use of public buildings, places and facilities; and Risk of accidents and usability of the living place. Younger respondents reported their neighbourhood as more usable but perceived walkways as more hindering and public buildings as less easy to use; gender differences were almost inexistent. The CBE-SR is a four-scale instrument with good psychometric properties that measures the person-environment interaction. It is sensitive across age groups and is consistent with the subject's overall judgement of the degree to which the environment is facilitating or hindering. Poor built environments have a negative impact on the level of a person's participation. However, instruments measuring the person-environment interaction are lacking. The CBE-SR is a valid and reliable instrument that researchers can use to assess the relationships between the intrinsic health state and the objective features of the environment. Understanding this relationship would provide further insight into the need of addressing the individual's functioning either by means of interventions directed to the individual or by making changes to the individual's environment. Copyright © 2013 John Wiley & Sons, Ltd.

Performance status of a small robot-mounted or hand-held, solar-blind, standoff chemical, biological, and explosives (CBE) sensor

NASA Astrophysics Data System (ADS)

Hug, W. F.; Reid, R. D.; Bhartia, R.; Lane, A. L.

2009-05-01

Photon Systems and JPL are continuing development of a new technology robot-mounted or hand-held sensor for reagentless, short-range, standoff detection and identification of trace levels CBE materials on surfaces. This deep ultraviolet CBE sensor is the result of ongoing Army STTR and DTRA programs. The evolving 6 lb, 15W, lantern-size sensor can discriminate CBE from background clutter materials using a combination of deep UV excited resonance Raman (RR) and laser induced native fluorescence (LINF) emissions resulting from excitation by a new technology deep UV laser. Standoff excitation of suspicious packages, vehicles, persons, and other objects that may contain hazardous materials is accomplished using wavelengths below 250nm where RR and LINF emissions occupy distinctly different wavelength regions. This enables simultaneous detection of RR and LINF emissions with no spectral overlap or interference of LINF over RR or RR over LINF. The new eye-safe targeted ultraviolet chemical, biological, and explosives (TUCBE) sensor can detect and identify less than 1 μg/cm2 of explosives or 104 bacterial spores at 10 meters standoff, or 10 ng/cm2 of explosives or 102 bacterial spores/cm2 at 1 meter standoff. Detection and identification requires less than 1 ms and has a sample rate up to 20 Hz. Lower concentrations of contamination can be detected and identified as closer ranges and higher concentrations at longer ranges. The sensor is solar blind and can be operated in full daylight conditions as a result of excitation and detection in the deep UV and the use of a gated detection system.

Structure of an Insecticide Sequestering Carboxylesterase from the Disease Vector Culex quinquefasciatus: What Makes an Enzyme a Good Insecticide Sponge?

PubMed

Hopkins, Davis H; Fraser, Nicholas J; Mabbitt, Peter D; Carr, Paul D; Oakeshott, John G; Jackson, Colin J

2017-10-17

Carboxylesterase (CBE)-mediated metabolic resistance to organophosphate and carbamate insecticides is a major problem for the control of insect disease vectors, such as the mosquito. The most common mechanism involves overexpression of CBEs that bind to the insecticide with high affinity, thereby sequestering them before they can interact with their target. However, the absence of any structure for an insecticide-sequestering CBE limits our understanding of the molecular basis for this process. We present the first structure of a CBE involved in sequestration, Cqestβ2 1 , from the mosquito disease vector Culex quinquefasciatus. Lysine methylation was used to obtain the crystal structure of Cqestβ2 1 , which adopts a canonical α/β-hydrolase fold that has high similarity to the target of organophosphate and carbamate insecticides, acetylcholinesterase. Sequence similarity networks of the insect carboxyl/cholinesterase family demonstrate that CBEs associated with metabolic insecticide resistance across many species share a level of similarity that distinguishes them from a variety of other classes. This is further emphasized by the structural similarities and differences in the binding pocket and active site residues of Cqestβ2 1 and other insect carboxyl/cholinesterases. Stopped-flow and steady-state inhibition studies support a major role for Cqestβ2 1 in organophosphate resistance and a minor role in carbamate resistance. Comparison with another isoform associated with insecticide resistance, Cqestβ1, showed both enzymes have similar affinity to insecticides, despite 16 amino acid differences between the two proteins. This provides a molecular understanding of pesticide sequestration by insect CBEs and could facilitate the design of CBE-specific inhibitors to circumvent this resistance mechanism in the future.

Smart phones: platform enabling modular, chemical, biological, and explosives sensing

NASA Astrophysics Data System (ADS)

Finch, Amethist S.; Coppock, Matthew; Bickford, Justin R.; Conn, Marvin A.; Proctor, Thomas J.; Stratis-Cullum, Dimitra N.

2013-05-01

Reliable, robust, and portable technologies are needed for the rapid identification and detection of chemical, biological, and explosive (CBE) materials. A key to addressing the persistent threat to U.S. troops in the current war on terror is the rapid detection and identification of the precursor materials used in development of improvised explosive devices, homemade explosives, and bio-warfare agents. However, a universal methodology for detection and prevention of CBE materials in the use of these devices has proven difficult. Herein, we discuss our efforts towards the development of a modular, robust, inexpensive, pervasive, archival, and compact platform (android based smart phone) enabling the rapid detection of these materials.

The Cosmic Background Explorer

NASA Technical Reports Server (NTRS)

Gulkis, Samuel; Lubin, Philip M.; Meyer, Stephan S.; Silverberg, Robert F.

1990-01-01

The Cosmic Background Explorer (CBE), NASA's cosmological satellite which will observe a radiative relic of the big bang, is discussed. The major questions connected to the big bang theory which may be clarified using the CBE are reviewed. The satellite instruments and experiments are described, including the Differential Microwave Radiometer, which measures the difference between microwave radiation emitted from two points on the sky, the Far-Infrared Absolute Spectrophotometer, which compares the spectrum of radiation from the sky at wavelengths from 100 microns to one cm with that from an internal blackbody, and the Diffuse Infrared Background Experiment, which searches for the radiation from the earliest generation of stars.

InP tunnel junction for InGaAs/InP tandem solar cells

NASA Technical Reports Server (NTRS)

Vilela, M. F.; Freundlich, A.; Bensaoula, A.; Medelci, N.; Renaud, P.

1995-01-01

Chemical beam epitaxy (CBE) has been shown to allow the growth of high quality materials with reproducible complex compositional and doping profiles. The main advantage of CBE compared to metalorganic chemical vapor deposition (MOCVD), the most popular technique for InP-based photovoltaic device fabrication, is the ability to grow high purity epilayers at much lower temperatures (450-530 C). We have previously shown that CBE is perfectly suited toward the fabrication of complex photovoltaic devices such as InP/InGaAs monolithically integrated tandem solar cells, because its low process temperature preserves the electrical characteristics of the InGaAs tunnel junction commonly used as an ohmic interconnect. In this work using CBE for the fabrication of optically transparent (with respect to the bottom cell) InP tunnel diodes is demonstrated. Epitaxial growth were performed in a Riber CBE 32 system using PH3 and TMIn as III and V precursors. Solid Be (p-type) and Si (n-type) have been used as doping sources, allowing doping levels up to 2 x 10(exp -19)/cu cm and 1 x 10(exp -19)/cu cm for n and p type respectively. The InP tunnel junction characteristics and the influence of the growth's conditions (temperature, growth rate) over its performance have been carefully investigated. InP p(++)/n(++) tunnel junction with peak current densities up to 1600 A/sq cm and maximum specific resistivities (V(sub p)/I(sub p) - peak voltage to peak current ratio) in the range of 10(exp -4) Omega-sq cm were obtained. The obtained peak current densities exceed the highest results previously reported for their lattice matched counterparts, In(0.53)Ga( 0.47)As and should allow the realization of improved minimal absorption losses in the interconnect InP/InGaAs tandem devices for Space applications. Owing to the low process temperature required for the top cell, these devices exhibit almost no degradation of its characteristics after the growth of subsequent thick InP layer suggesting minimal doping cross diffusion in the narrow space-charge region (approximately 1-5 nm) of the device. The fabrication of tandem devices using InP tunnel diodes as interconnect is in progress and will be reported at the conference.

High-Speed Computation of the Kleene Star in Max-Plus Algebraic System Using a Cell Broadband Engine

NASA Astrophysics Data System (ADS)

Goto, Hiroyuki

This research addresses a high-speed computation method for the Kleene star of the weighted adjacency matrix in a max-plus algebraic system. We focus on systems whose precedence constraints are represented by a directed acyclic graph and implement it on a Cell Broadband Engine™ (CBE) processor. Since the resulting matrix gives the longest travel times between two adjacent nodes, it is often utilized in scheduling problem solvers for a class of discrete event systems. This research, in particular, attempts to achieve a speedup by using two approaches: parallelization and SIMDization (Single Instruction, Multiple Data), both of which can be accomplished by a CBE processor. The former refers to a parallel computation using multiple cores, while the latter is a method whereby multiple elements are computed by a single instruction. Using the implementation on a Sony PlayStation 3™ equipped with a CBE processor, we found that the SIMDization is effective regardless of the system's size and the number of processor cores used. We also found that the scalability of using multiple cores is remarkable especially for systems with a large number of nodes. In a numerical experiment where the number of nodes is 2000, we achieved a speedup of 20 times compared with the method without the above techniques.

A longitudinal study of women’s memories of their childbirth experiences at five years postpartum

PubMed Central

2014-01-01

Background Few studies have investigated whether women can accurately recall their birthing experiences after a long period. We investigated the consistency of women’s memories of their childbirth experiences between those at a few days postpartum and 5 years later. Methods This prospective cohort study comprised 1,168 women who delivered at a maternity hospital and four maternity homes in Japan between May 2002 and August 2003. Data were collected using structured interviews and transcriptions from medical records. The childbirth experience was assessed using the Childbirth Experience Scale (CBE-Scale) at a few days postpartum and 5 years later. Results We obtained 584 (50.0%) valid responses from women who completed the survey at a few days postpartum and 5 years later. Significant differences were observed in 16 out of 18 items on the CBE-Scale when responses were compared at both time points. Women who answered "yes" to any item on the CBE-Scale at the baseline survey tended to demonstrate a more precise recollection for that item 5 years after childbirth than those who answered "no" for the corresponding item. Conclusions We conclude that women remember their childbirth experience clearly at 5 years after the childbirth. PMID:24996683

Nurse educators' experiences of case-based education in a South African nursing programme.

PubMed

Daniels, Felicity M; Fakude, Lorraine P; Linda, Ntombizodwa S; Marie Modeste, Rugira R

2015-12-09

A school of nursing at a university in the Western Cape experienced an increase in student enrolments from an intake of 150 students to 300 students in the space of one year. This required a review of the teaching and learning approach to ensure that it was appropriate for effective facilitation of large classes. The case-based education (CBE) approach was adopted for the delivery of the Bachelor of Nursing programme in 2005. The aim of the study was to explore nurse educators' experiences, current practices and possible improvements to inform best practice of CBE at the nursing school in the Western Cape. A participatory action research method was applied in a two day workshop conducted with nurse educators in the undergraduate nursing programme. The nominal group technique was used to collect the data. Three themes emerged from the final synthesis of the findings, namely: teaching and learning related issues, student issues and teacher issues. Amongst other aspects, theory and practice integration, as well as the need for peer support in facilitation of CBE, were identified as requiring strengthening. It was concluded that case-based education should continue to be used in the school, however, more workshops should be arranged to keep educators updated and new staff orientated in respect of this teaching and learning approach.

Response of rat skin to boron neutron capture therapy with p-boronophenylalanine or borocaptate sodium.

PubMed

Morris, G M; Coderre, J A; Hopewell, J W; Micca, P L; Rezvani, M

1994-08-01

The effects of boron neutron capture irradiation employing either BPA or BSH as neutron capture agents has been assessed using the dorsal skin of Fischer 344 rats. Pharmacokinetic studies, using prompt gamma spectrometry, revealed comparable levels of boron-10 (10B) in blood and skin after the intravenous infusion of BSH (100 mg/kg body wt.). The 10B content of blood (12.0 +/- 0.5 micrograms/g) was slightly higher than that of skin (10.0 +/- 0.5 micrograms/g) after oral dosing with BPA. Biphasic skin reactions were observed after irradiation with the thermal neutron beam alone or in combination with BPA or BSH. The time of onset of the first phase of the skin reaction, moist desquamation, was approximately 2 weeks. The time at which the second-wave skin reaction, dermal necrosis, became evident was dose-related and occurred after a latent interval of > or = 24 weeks, well after the acute epithelial reaction had healed. The incidence of both phases of skin damage was also dose-related. The radiation doses required to produce skin damage in 50% of skin sites (ED50 values) were calculated from dose-effect curves and these values were used to determine relative biological effectiveness (RBE) and compound biological effectiveness (CBE) factors for both moist desquamation and dermal necrosis. It was concluded on the basis of these calculations that the microdistribution of the two neutron capture agents had a critical bearing on the overall biological effect after thermal neutron activation. BSH, which was possibly excluded from the cytoplasm of epidermal cells, had a low CBE factor value (0.56 +/- 0.06) while BPA, which may be selectively accumulated in epidermal cells had a very high CBE factor (3.74 +/- 0.7). For the dermal reaction, where vascular endothelial cells represent the likely target cell population, the CBE factor values were comparable, at 0.73 +/- 0.42 and 0.86 +/- 0.08 for BPA ad BSH, respectively.

[Undergraduate psychiatric training in Turkey].

PubMed

Cıngı Başterzi, Ayşe Devrim; Tükel, Raşit; Uluşahin, Aylin; Coşkun, Bülent; Alkın, Tunç; Murat Demet, Mehmet; Konuk, Numan; Taşdelen, Bahar

2010-01-01

The current trend in medical education is to abandon the experience-based traditional model and embrace the competency-based education model (CBE). The basic principle behind CBE is standardization. The first step in standardization is to determine what students must know, what they must accomplish, and what attitude they should display, and the establishment of educational goals. One of the goals of the Psychiatric Association of Turkey, Psychiatric Training Section is to standardize psychiatric training in Turkish medical schools. This study aimed to determine the current state of undergraduate psychiatric training in Turkish medical schools. Questionnaires were sent to the psychiatry department chairs of 41 medical schools. Data were analyzed using descriptive statistical methods. Of the 41 department chairs that were sent the questionnaire, 29 (70%) completed and returned them, of which 16 (66.7%) reported that they had already defined goals and educational objectives for their undergraduate psychiatric training programs. The Core Education Program, prepared by the Turkish Medicine and Health Education Council, was predominately used at 9 (37.5%) medical schools. Pre-clinical and clinical training schedules varied between medical schools. In all, 3 of the medical schools did not offer internships in psychiatry. The majority of chairs emphasized the importance of mood disorders (49.9%) and anxiety disorders (40%), suggesting that these disorders should be treated by general practitioners. Computer technology was commonly used for lecturing; however, utilization of interactive and skill-based teaching methods was limited. The most commonly used evaluation methods were written examination (87.5%) during preclinical training and oral examination (91.6%) during clinical training. The most important finding of this study was the lack of a standardized curriculum for psychiatric training in Turkey. Standardization of psychiatric training in Turkish medical schools must be developed.

The effectiveness of a nurse-delivered breast health promotion program on breast cancer screening behaviours in non-adherent Turkish women: A randomized controlled trial.

PubMed

Secginli, Selda; Nahcivan, Nursen O

2011-01-01

Few studies have investigated breast health programs to promote rates of having a mammography, clinical breast examination and breast self-examination among non-adherent Turkish women. To determine the effectiveness of a breast health promotion program on mammography and clinical breast examination use, breast self-examination frequency and proficiency (breast self-examination skills and lump detection), breast health knowledge and health beliefs about breast cancer screening in a sample of Turkish women. Experimental (pretest-posttest control group). A community-based setting in Istanbul, Turkey. 190 Non-adherent women (intervention group=97, control group=93) aged 41 and older, residing in Istanbul, Turkey. The intervention group (n=97) received a 120-min breast health promotion program based on health belief model including a breast health education, film, breast self-examination instruction, and a booklet, a calendar, a card designed specifically for the study. The control group (n=93) received general information except breast health. Data were collected before the program, immediately after the program, and at 3- and 6-month post-program. The outcome measures are the mammography, clinical breast examination, and breast self-examination frequency, breast self-examination proficiency, breast health knowledge, and health beliefs (perceived susceptibility to breast cancer, benefits to mammography and breast self-examination, barriers of mammography and breast self-examination, confidence in performing breast self-examination). The breast health promotion program significantly increased breast self-examination frequency and proficiency and breast health knowledge. No significant differences existed in mammography and clinical breast examination rates between the two groups at 6 months. The program was effective in increasing perceived susceptibility to breast cancer, perceived benefits of mammography and breast self-examination, and confidence of breast self-examination. No significant difference was found between the two groups for perceived barriers to mammography. The breast health promotion program was effective in increasing breast self-examination frequency and proficiency in a sample of Turkish women. In addition, it appears to be useful in raising the knowledge of breast health, enhancing confidence in performing breast self-examination, and increasing most health belief levels. Copyright © 2010 Elsevier Ltd. All rights reserved.

Determination of esterase activity and characterization of cholinesterases in the reef fish Haemulon plumieri.

PubMed

Leticia, Alpuche-Gual; Gerardo, Gold-Bouchot

2008-11-01

White grunt (Haemulon plumieri) has been proposed by the Mesoamerican Barrier Reef System (MBRS) Synoptic Monitoring Program as a bioindicator species. It is in this sense that the present study has a main goal to evaluate this organism's suitability as an indicator species. Individuals were captured during three seasons at the port of Sisal, Yucatan, Mexico which is located in an area that is considered to be weakly impacted by human activities such as agriculture or industry. Both cholinesterase (ChE) and carboxylesterase (CbE) activities were measured in brain, muscle, liver and eye of sampled individuals. Results indicated that ChE and CbE activities were greatest in the brain (256.3 ± 43) and in the liver (191 ± 21), respectively. Furthermore, ChEs detected in brain, liver and muscle were characterized, and results suggested that the acetylcholinesterase (AChE) type was more abundant relative to pseudocholinesterase (BChE) which was rare. In addition, K(m) and V(max) and IC(50) values were calculated from the Michaelis-Menten equation. Finally, an additional experiment in vitro showed a significant decrease in both ChE and CbE activities when different tissues were exposed to model xenobiotics, such as benzo[a]pyrene and Chlorpyrifos. In conclusion, findings from this study confirm the potential suitability of H. plumieri as an organic pollution bioindicator species, and thus of practical use for environmental biomonitoring purposes.

High reflectance and low stress Mo2C/Be multilayers

DOEpatents

Bajt, Sasa; Barbee, Jr., Troy W.

2001-01-01

A material for extreme ultraviolet (EUV) multilayers that will reflect at about 11.3 nm, have a high reflectance, low stress, and high thermal and radiation stability. The material consists of alternating layers of Mo.sub.2 C and Be deposited by DC magnetron sputtering on a substrate, such as silicon. In one example a Mo.sub.2 C/Be multilayer gave 65.2% reflectance at 11.25 nm measured at 5 degrees off normal incidence angle, and consisted of 70 bilayers with a deposition period of 5.78 nm, and was deposited at 0.83 mTorr argon (Ar) sputtering pressure, with the first and last layers being Be. The stress of the multilayer is tensile and only +88 MPa, compared to +330 MPa of a Mo/Be multilayers of the same thickness. The Mo.sub.2 C/Be multilayer was capped with carbon which produced an increase in reflectivity of about 7% over a similar multilayer with no carbon capping material, thus raising the reflectivity from 58.3% to over 65%. The multilayers were formed using either Mo.sub.2 C or Be as the first and last layers, and initial testing has shown the formation of beryllium carbide at the interfaces between the layers which both stabilizes and has a smoothing effect, and appear to be smoother than the interfaces in Mo/Be multilayers.

Industry Partners at CBE

Science.gov Websites

* Charles M. Salter Associates DIALOG HGA Architects and Engineers HOK Integral Group Interface Engineering + Will SERA Architects Taylor Engineering Team: Atelier Ten Taylor Engineering TRC Energy Services

Hepatitis C and Incarceration

MedlinePlus

... the following: fever, stomach pain, feeling very tired, grey–colored stool, not wanting to eat, bone or ... Cbe treated? Yes, but not everyone needs medical treatment or can benefit from it. If possible, it ...

Assessment of biological effectiveness of boron neutron capture therapy in primary and metastatic melanoma cell lines.

PubMed

Rossini, Andrés E; Dagrosa, Maria A; Portu, Agustina; Saint Martin, Giselle; Thorp, Silvia; Casal, Mariana; Navarro, Aimé; Juvenal, Guillermo J; Pisarev, Mario A

2015-01-01

In order to optimize the effectiveness of Boron Neutron Capture Therapy (BNCT), Relative Biological Effectiveness (RBE) and Compound Biological Effectiveness (CBE) were determined in two human melanoma cell lines, M8 and Mel-J cells, using the amino acid p-boronophenylalanine (BPA) as boron carrier. The effects of BNCT on the primary amelanotic cell line M8 and on the metastatic pigmented melanoma cell line Mel-J were studied using colony formation assay. The RBE values were determined using both a gamma ray source, and the neutron beam from the Nuclear Reactor of the National Atomic Energy Commission (RA-3). For the determination of the RBE, cells were irradiated with increasing doses of both sources, between 1 and 8 Gy; and for the determination of CBE factors, the cells were pre-incubated with BPA before irradiation. Afterwards, the cell surviving fraction (SF) was determined for each treatment. Marked differences were observed between both cell lines. Mel-J cells were more radioresistant than the M8 cell line. The clonogenic assays showed that for a SF of 1%, the RBE values were 1.3 for M8 cells and 1.5 for Mel-J cells. Similarly, the CBE values for a 1% SF were 2.1 for M8 and 3 for Mel-J cell lines. For the endpoint of 0.1% of SF the RBE values obtained were 1.2 for M8 and 1.4 for Mel-J cells. Finally, CBE values calculated for a 0.1% were 2 and 2.6 for M8 and Mel-J cell lines respectively. In order to estimate the uptake of the non-radioactive isotope Boron 10 ((10)B), a neutron induced autoradiographic technique was performed showing discrepancies in (10)B uptake between both cell lines. These obtained in vitro results are the first effectiveness factors determined for human melanoma at the RA-3 nuclear reactor and show that BNCT dosimetry planning for patients could be successfully performed using these new factors.

Careers at the Center for the Built Environment

Science.gov Websites

Careers Job Opportunities at CBE Staff Positions We do not currently have any open positions. Student Positions We are not currently accepting applications for student positions except those from current UC

Croissance epitaxiale de GaAs sur substrats de Ge par epitaxie par faisceaux chimiques

NASA Astrophysics Data System (ADS)

Belanger, Simon

La situation energetique et les enjeux environnementaux auxquels la societe est confrontee entrainent un interet grandissant pour la production d'electricite a partir de l'energie solaire. Parmi les technologies actuellement disponibles, la filiere du photovoltaique a concentrateur solaire (CPV pour concentrator photovoltaics) possede un rendement superieur et mi potentiel interessant a condition que ses couts de production soient competitifs. La methode d'epitaxie par faisceaux chimiques (CBE pour chemical beam epitaxy) possede plusieurs caracteristiques qui la rendent interessante pour la production a grande echelle de cellules photovoltaiques a jonctions multiples a base de semi-conducteurs III-V. Ce type de cellule possede la meilleure efficacite atteinte a ce jour et est utilise sur les satellites et les systemes photovoltaiques a concentrateur solaire (CPV) les plus efficaces. Une des principales forces de la technique CBE se trouve dans son potentiel d'efficacite d'utilisation des materiaux source qui est superieur a celui de la technique d'epitaxie qui est couramment utilisee pour la production a grande echelle de ces cellules. Ce memoire de maitrise presente les travaux effectues dans le but d'evaluer le potentiel de la technique CBE pour realiser la croissance de couches de GaAs sur des substrats de Ge. Cette croissance constitue la premiere etape de fabrication de nombreux modeles de cellules solaires a haute performance decrites plus haut. La realisation de ce projet a necessite le developpement d'un procede de preparation de surface pour les substrats de germanium, la realisation de nombreuses sceances de croissance epitaxiale et la caracterisation des materiaux obtenus par microscopie optique, microscopie a force atomique (AFM), diffraction des rayons-X a haute resolution (HRXRD), microscopie electronique a transmission (TEM), photoluminescence a basse temperature (LTPL) et spectrometrie de masse des ions secondaires (SIMS). Les experiences ont permis de confirmer l'efficacite du procede de preparation de surface et d'identifier les conditions de croissance optimales. Les resultats de caracterisation indiquent que les materiaux obtenus presentent une tres faible rugosite de surface, une bonne qualite cristalline et un dopage residuel relativement important. De plus, l'interface GaAs/Ge possede une faible densite de defauts. Finalement, la diffusion d'arsenic dans le substrat de germanium est comparable aux valeurs trouvees dans la litterature pour la croissance a basse temperature avec les autres procedes d'epitaxie courants. Ces resultats confirment que la technique d'epitaxie par faisceaux chimiques (CBE) permet de produire des couches de GaAs sur Ge de qualite adequate pour la fabrication de cellules solaires a haute performance. L'apport a la communaute scientifique a ete maximise par le biais de la redaction d'un article soumis a la revue Journal of Crystal Growth et la presentation des travaux a la conference Photovoltaics Canada 2010 . Mots-cles : Epitaxie par jets chimiques, Chemical beam epitaxy, CBE, MOMBE, Germanium, GaAs, Ge

Coherent backscattering enhancement in cavities. Highlights of the role of symmetry.

PubMed

Gallot, Thomas; Catheline, Stefan; Roux, Philippe

2011-04-01

Through experiments and simulations, the consequences of symmetry on coherent backscattering enhancement (CBE) are studied in cavities. Three main results are highlighted. First, the CBE outside the source is observed: (a) on a single symmetric point in a one-dimensional (1-D) cavity, in a disk and in a symmetric chaotic plate; (b) on three symmetric points in a two-dimensional (2-D) rectangle; and (c) on seven symmetric points in a three-dimensional (3-D) parallelepiped cavity. Second, the existence of enhanced intensity lines and planes in 2-D and 3-D simple-shape cavities is demonstrated. Third, it is shown how the anti-symmetry caused by the special boundary conditions is responsible for the existence of a coherent backscattering decrement with a dimensional dependence of R = (½)(d), with d = 1,2,3 as the dimensionality of the cavity.

Benefits of community-based education to the community in South African health science facilities

PubMed Central

Flack, Penny

2013-01-01

Abstract Background Community-based education (CBE) is utilised by health science faculties worldwide to provide a relevant primary care experience for students and a service to underserved communities and, hopefully, to affect student career choices. The benefits to training institutions and students are well documented, but it may well be that communities, too, will be able to benefit from a more balanced partnership, where they are consulted in the planning of such training programmes. Method An exploratory qualitative study was undertaken by three South African universities in the provinces of Limpopo, KwaZulu-Natal and the Western Cape. Focus group interviews were conducted in their local languages with groups of community leaders, patients and supervisors at community sites involved in CBE training. A thematic analysis of their views was undertaken with the aid of NVivo (version 9). Ethics approval was obtained from the respective universities and health care training sites. Results Benefits to the community could be categorised into short-term and long-term benefits. Short-term benefits included improved service delivery, reduction in hospital referrals, home visits and community orientated primary health care, improved communication with patients and enhanced professionalism of the health care practitioner. Long-term benefits included improved teaching through a relationship with an academic institution and student familiarity with the health care system. Students also became involved in community upliftment projects, thereby acting as agents of change in these communities. Conclusion Communities can certainly benefit from well-planned CBE programmes involving a training site - community site partnership.

Adjustment of Conduction Band Edge of Compact TiO2 Layer in Perovskite Solar Cells Through TiCl4 Treatment.

PubMed

Murakami, Takurou N; Miyadera, Tetsuhiko; Funaki, Takashi; Cojocaru, Ludmila; Kazaoui, Said; Chikamatsu, Masayuki; Segawa, Hiroshi

2017-10-25

Perovskite solar cells (PSCs) without a mesoporous TiO 2 layer, that is, planar-type PSCs exhibit poorer cell performance as compared to PSCs with a porous TiO 2 layer, owing to inefficient electron transfer from the perovskite layer to the compact TiO 2 layer in the former case. The matching of the conduction band levels of perovskite and the compact TiO 2 layer is thus essential for enhancing PSC performance. In this study, we demonstrate the shifting of the conduction band edge (CBE) of the compact TiO 2 layer through a TiCl 4 treatment, with the aim of improving PSC performance. The CBE of the compact TiO 2 layer was shifted to a higher level through the TiCl 4 treatment and then shifted in the opposite direction, that is, to a lower level, through a subsequent heat treatment. These shifts in the CBE were reflected in the PSC performance. The TiCl 4 -treated PSC showed an increase in the open-circuit voltage of more than 150 mV, as well as a decrease of 100 mV after being heated at 450 °C. On the other hand, the short-circuit current decreased after the treatment but increased after heating at temperatures higher than 300 °C. The treated PSC subjected to subsequent heating at 300 °C exhibited the best performance, with the power conversion efficiency of the PSC being 17% under optimized conditions.

The contested space: The impact of competency-based education and accreditation on dietetic practice in Australia.

PubMed

Ash, Susan; Palermo, Claire; Gallegos, Danielle

2018-05-06

Competency-based Education (CBE) has underpinned the education of dietitians in Australia since the first Competency Standards (CS) were published; however, little is known about how CBE has influenced dietetic practice. The aim of this paper is to explore how a CBE framework and the CS have influenced dietetic practice in Australia since 1990. A qualitative investigation explored concepts of dietetic practice. Data analysed were original interviews previously undertaken with recent graduate dietitians during 1991 (n = 26), 1998 (n = 23) and 2007 (n = 19) and seven guided discussions with dietitians and employers (n = 28) conducted in 2014 to identify themes. The DAA Competency Standards and Accreditation Manuals/Standards since 1990 were also analysed to triangulate the interview data and to investigate how the CS were interpreted. Themes identified from interviews included: (i) communicating for better care, (ii) scientific enquiry for effective practice, (iii) critical thinking and evidence-based practice and (iv) professionalism, which remained core to dietetic practice over time, but leadership, advocacy, business management and entrepreneurial skills have emerged more strongly as the scope of practice has diversified. The landscape in which dietitians' practice showed increasing complexity and clear boundaries separating professional roles were disappearing. The 2015 CS and the 2017 Accreditation Standards highlighted that competency remains a shifting construct and that professional behaviours change depending on economic and political reasons in the play of power. Accreditation policy and current standards have successfully maintained a standard of dietetic practice across a diverse country but have the potential to constrain innovation. © 2018 Dietitians Association of Australia.

Microduplications at 22q11.21 are associated with non-syndromic classic bladder exstrophy.

PubMed

Draaken, Markus; Reutter, Heiko; Schramm, Charlotte; Bartels, Enrika; Boemers, Thomas M; Ebert, Anne-Karoline; Rösch, Wolfgang; Schröder, Annette; Stein, Raimund; Moebus, Susanne; Stienen, Dietlinde; Hoffmann, Per; Nöthen, Markus M; Ludwig, Michael

2010-01-01

The exstrophy-epispadias complex (EEC) comprises a spectrum of urogenital anomalies in which part or all of the distal urinary tract fails to close. The present study aimed to identify microaberrations characterized by loss or gain of genomic material that contribute to the EEC at a genome-wide level. Molecular karyotyping, utilizing 549,839 single nucleotide polymorphisms (SNPs) with an average spacing of 5.7 kilobases, was performed to screen an initial cohort of 16 patients with non-syndromic EEC. A de novo microduplication involving chromosomal region 22q11.21 was identified in one patient with classic exstrophy of the bladder (CBE). Subsequent multiplex ligation-dependent probe amplification (MLPA) analysis was performed with an MLPA 22q11 kit in a further 50 non-syndromic EEC cases. We identified one CBE patient with an overlapping 22q11.21 duplication in whom the duplication had been transmitted from the unaffected mother. Chromosomal region 22q11 is well known for its susceptibility to genomic rearrangements, and these are associated with various syndromes including the velo-cardio-facial/DiGeorge syndrome (VCFS/DGS), the der(22) syndrome, and the cat-eye syndrome. Duplications in this region result in a wide and variable spectrum of clinical presentations that include features of the VCFS/DGS, while some carriers present with a completely normal phenotype. Our findings extend the phenotypic spectrum of the 22q11.2 duplication syndrome, and indicate that this aberration predisposes to CBE with incomplete penetrance. Copyright 2009 Elsevier Masson SAS. All rights reserved.

Characteristics of successful and unsuccessful completers of 3 postacute brain injury rehabilitation pathways.

PubMed

Malec, James F; Degiorgio, Lisa

2002-12-01

To determine whether successful participants along different postacute brain injury rehabilitation pathways differ on demographic, injury-related, disability, and outcome variables. Secondary analysis of pre- and posttreatment, and 1-year follow-up data obtained in a previous study of specialized vocational services (SVS) for persons with brain injury. Outpatient brain injury rehabilitation clinic. One hundred fourteen persons with acquired brain injury. Participants in 3 distinct rehabilitation pathways were studied: SVS only; SVS and a 3-h/wk community reintegration outpatient group; and SVS and 6-h/d comprehensive day treatment (CDT). Mayo-Portland Adaptability Inventory (MPAI); Vocational Independence Scale; and "success," as defined by community-based employment (CBE) at 1-year follow-up. The percentage (77%-85%) of participants in CBE at 1-year follow-up did not differ among the 3 pathways. CDT participants had more limited educational backgrounds, were less recently injured, and showed greater disability and more impaired self-awareness than those receiving limited intervention (ie, SVS or community reintegration outpatient group). MPAI scores for limited-intervention participants who were unsuccessful were similar in level to successful participants in CDT. Logistic regression models were developed to predict the probability of success with limited intervention and CDT. Different rehabilitation pathways result in CBE for a large percentage of persons with brain injury if the intensity of service is appropriately matched to the severity of the disability, the time since injury, and other participant characteristics. Copyright 2002 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation

First Evaluation of the Biologic Effectiveness Factors of Boron Neutron Capture Therapy (BNCT) in a Human Colon Carcinoma Cell Line

DOE Office of Scientific and Technical Information (OSTI.GOV)

Dagrosa, Maria Alejandra, E-mail: dagrosa@cnea.gov.a; National Research Council; Crivello, Martin

2011-01-01

Purpose: DNA lesions produced by boron neutron capture therapy (BNCT) and those produced by gamma radiation in a colon carcinoma cell line were analyzed. We have also derived the relative biologic effectiveness factor (RBE) of the neutron beam of the RA-3- Argentine nuclear reactor, and the compound biologic effectiveness (CBE) values for p-boronophenylalanine ({sup 10}BPA) and for 2,4-bis ({alpha},{beta}-dihydroxyethyl)-deutero-porphyrin IX ({sup 10}BOPP). Methods and Materials: Exponentially growing human colon carcinoma cells (ARO81-1) were distributed into the following groups: (1) BPA (10 ppm {sup 10}B) + neutrons, (2) BOPP (10 ppm {sup 10}B) + neutrons, (3) neutrons alone, and (4) gammamore » rays ({sup 60}Co source at 1 Gy/min dose-rate). Different irradiation times were used to obtain total absorbed doses between 0.3 and 5 Gy ({+-}10%) (thermal neutrons flux = 7.5 10{sup 9} n/cm{sup 2} sec). Results: The frequency of micronucleated binucleated cells and the number of micronuclei per micronucleated binucleated cells showed a dose-dependent increase until approximately 2 Gy. The response to gamma rays was significantly lower than the response to the other treatments (p < 0.05). The irradiations with neutrons alone and neutrons + BOPP showed curves that did not differ significantly from, and showed less DNA damage than, irradiation with neutrons + BPA. A decrease in the surviving fraction measured by 3-(4,5-dimetiltiazol-2-il)-2,5-difeniltetrazolium bromide (MTT) assay as a function of the absorbed dose was observed for all the treatments. The RBE and CBE factors calculated from cytokinesis block micronucleus (CBMN) and MTT assays were, respectively, the following: beam RBE: 4.4 {+-} 1.1 and 2.4 {+-} 0.6; CBE for BOPP: 8.0 {+-} 2.2 and 2.0 {+-} 1; CBE for BPA: 19.6 {+-} 3.7 and 3.5 {+-} 1.3. Conclusions: BNCT and gamma irradiations showed different genotoxic patterns. To our knowledge, these values represent the first experimental ones obtained for the RA-3 in a biologic model and could be useful for future experimental studies for the application of BNCT to colon carcinoma.« less

Breast self-examination: do religious beliefs matter? A descriptive study.

PubMed

Montazeri, Ali; Haji-Mahmoodi, Mehregan; Jarvandi, Soghra

2003-06-01

A descriptive study was conducted in Tehran, Iran, to investigate the beliefs of Muslim women and their practices regarding screening modalities of breast cancer. A questionnaire was specially designed and validated to collect data and was completed by 410 Muslim women. A vast majority of women (90 per cent) said that breast self-examination is not against their religious beliefs. With regard to clinical breast examination, although 58 per cent preferred to be examined by a female physician, 47 per cent said that clinical breast examination by a male physician is not against their Islamic beliefs. However, only 6 per cent of respondents performed breast self-examination on a regular basis (monthly). The study findings suggest that most Muslim women do not perceive breast self-examination as being against their Islamic beliefs and that they believe clinical breast examination by a male physician does not interfere with their religious beliefs.

Improved sensing using simultaneous deep-UV Raman and fluorescence detection-II

NASA Astrophysics Data System (ADS)

Hug, W. F.; Bhartia, R.; Sijapati, K.; Beegle, L. W.; Reid, R. D.

2014-05-01

Photon Systems in collaboration with JPL is continuing development of a new technology robot-mounted or hand-held sensor for reagentless, short-range, standoff detection and identification of trace levels chemical, biological, and explosive (CBE) materials on surfaces. This deep ultraviolet CBE sensor is the result of Army STTR and DTRA programs. The evolving 10 to 15 lb, 20 W, sensor can discriminate CBE from background clutter materials using a fusion of deep UV excited resonance Raman (RR) and laser induced native fluorescence (LINF) emissions collected is less than 1 ms. RR is a method that provides information about molecular bonds, while LINF spectroscopy is a much more sensitive method that provides information regarding the electronic configuration of target molecules. Standoff excitation of suspicious packages, vehicles, persons, and other objects that may contain hazardous materials is accomplished using excitation in the deep UV where there are four main advantages compared to near-UV, visible or near-IR counterparts. 1) Excited between 220 and 250 nm, Raman emission occur within a fluorescence-free region of the spectrum, eliminating obscuration of weak Raman signals by fluorescence from target or surrounding materials. 2) Because Raman and fluorescence occupy separate spectral regions, detection can be done simultaneously, providing an orthogonal set of information to improve both sensitivity and lower false alarm rates. 3) Rayleigh law and resonance effects increase Raman signal strength and sensitivity of detection. 4) Penetration depth into target in the deep UV is short, providing spatial/spectral separation of a target material from its background or substrate. 5) Detection in the deep UV eliminates ambient light background and enable daylight detection.

Effects of high source flow and high pumping speed on gas source molecular beam epitaxy / chemical beam epitaxy

NASA Astrophysics Data System (ADS)

McCollum, M. J.; Jackson, S. L.; Szafranek, I.; Stillman, G. E.

1990-10-01

We report the growth of GaAs by molecular beam epitaxy (MBE), gas source molecular beam epitaxy (GSMBE), and chemical beam epitaxy (CBE) in an epitaxial III-V reactor which features high pumping speed. The system is comprised of a modified Perkin-Elmer 430P molecular beam epitaxy system and a custom gas source panel from Emcore. The growth chamber is pumped with a 7000 1/s (He) diffusion pump (Varian VHS-10 with Monsanto Santovac 5 oil). The gas source panel includes pressure based flow controllers (MKS 1150) allowing triethylaluminum (TEA), triethylgallium (TEG), and trimethylindium (TMI) to be supplied without the use of hydrogen. All source lines, including arsine and phosphine, are maintained below atmospheric pressure. The high pumping speed allows total system flow rates as high as 100 SCCM and V/III ratios as high as 100. The purity of GaAs grown by MBE in this system increases with pumping speed. GaAs layers grown by GSMBE with arsine flows of 10 and 20 SCCM have electron concentrations of 1 × 10 15 cm -3 (μ 77=48,000 cm 2/V·) and 2 × 10 14 cm -3 (μ 77=78,000 cm 2/V·s) respectively. El ectron concentration varies with hydride injector temperature such that the minimum in electron concentration occurs for less than complete cracking. The effect of V/III ratio and the use of a metal eutectic bubbler on residual carrier concentration in GaAs grown by CBE is presented. Intentional Si and Be doping of CBE grown GaAs is demonstrated at a high growth rate of 5.4 μm/h.

Urogynaecological and obstetric issues in women with the exstrophy-epispadias complex.

PubMed

Mathews, R I; Gan, M; Gearhart, J P

2003-06-01

To review of the sexual and urogynaecological issues faced by a large cohort of women with the exstrophy-epispadias complex (EEC). The study comprised 83 women and girls with EEC; a confidential survey was mailed to identify their social and sexual concerns. Fifty-six women had classical bladder exstrophy (CBE), 13 had female epispadias (FE) and 14 had cloacal exstrophy (CE). Data on the initial method of reconstruction and urogynaecological problems were obtained from a review of the hospital records. Information on continence, infection and sexual function was obtained from 34 completed surveys. The bladder was closed in 51 patients with CBE and 13 with CE. Urinary calculi developed in 10 patients with CBE, two with FE and three with CE. Vaginal and uterine prolapse occurred an earlier age in patients with EEC. Eight women had 13 pregnancies, eight of which resulted in normal healthy children. Overall continence was achieved in 85% of the women surveyed. Urinary tract infections remained a frequent problem for women with EEC; only 27% of respondents indicated that they were infection-free. Women aged > 18 years (24) who responded indicated that they had appropriate sexual desire; 16 were sexually active and the mean age for commencing sexual activity was 19.9 years. Six patients had dyspareunia and 10 indicated that they had orgasms. However, five additional patients indicated that they had restricted intercourse, as they were dissatisfied with the cosmesis of their external genitalia. Sexual and gynaecological issues become increasingly important in patients with EEC as they become adults. Understanding these issues faced by patients with EEC as they mature will permit better counselling of future patients.

Chemical beam epitaxy for high efficiency photovoltaic devices

NASA Technical Reports Server (NTRS)

Bensaoula, A.; Freundlich, A.; Vilela, M. F.; Medelci, N.; Renaud, P.

1994-01-01

InP-based multijunction tandem solar cells show great promise for the conversion efficiency (eta) and high radiation resistance. InP and its related ternary and quanternary compound semiconductors such as InGaAs and InGaAsP offer desirable combinations for energy bandgap values which are very suitable for multijunction tandem solar cell applications. The monolithically integrated InP/In(0.53)Ga(0.47)As tandem solar cells are expected to reach efficiencies above 30 percent. Wanlass, et.al., have reported AMO efficiencies as high as 20.1% for two terminal cells fabricated using atmospheric-pressure metalorganic vapor phase epitaxy (APMOVPE). The main limitations in their technique are first related to the degradation of the intercell ohmic contact (IOC), in this case the In(0.53)Ga(0.47)As tunnel junction during the growth of the top InP subcell structure, and second to the current matching, often limited by the In(0.53)Ga(0.47)As bottom subcell. Chemical beam epitaxy (CBE) has been shown to allow the growth of high quality materials with reproducible complex compositional and doping profiles. The main advantage of CBE compared to metalorganic chemical vapor deposition (MOCVD), the most popular technique for InP-based photovoltaic device fabrication, is the ability to grow high purity epilayers at much lower temperatures (450 C - 530 C). In a recent report it was shown that cost-wise CBE is a breakthrough technology for photovoltaic (PV) solar energy progress in the energy conversion efficiency of InP-based solar cells fabricated using chemical beam epitaxy. This communication summarizes our recent results on PV devices and demonstrates the strength of this new technology.

Predicting performance using background characteristics of international medical graduates in an inner-city university-affiliated Internal Medicine residency training program.

PubMed

Kanna, Balavenkatesh; Gu, Ying; Akhuetie, Jane; Dimitrov, Vihren

2009-07-13

IMGs constitute about a third of the United States (US) internal medicine graduates. US residency training programs face challenges in selection of IMGs with varied background features. However data on this topic is limited. We analyzed whether any pre-selection characteristics of IMG residents in our internal medicine program are associated with selected outcomes, namely competency based evaluation, examination performance and success in acquiring fellowship positions after graduation. We conducted a retrospective study of 51 IMGs at our ACGME accredited teaching institution between 2004 and 2007. Background resident features namely age, gender, self-reported ethnicity, time between medical school graduation to residency (pre-hire time), USMLE step I & II clinical skills scores, pre-GME clinical experience, US externship and interest in pursuing fellowship after graduation expressed in their personal statements were noted. Data on competency-based evaluations, in-service exam scores, research presentation and publications, fellowship pursuance were collected. There were no fellowships offered in our hospital in this study period. Background features were compared between resident groups according to following outcomes: (a) annual aggregate graduate PGY-level specific competency-based evaluation (CBE) score above versus below the median score within our program (scoring scale of 1 - 10), (b) US graduate PGY-level specific resident in-training exam (ITE) score higher versus lower than the median score, and (c) those who succeeded to secure a fellowship within the study period. Using appropriate statistical tests & adjusted regression analysis, odds ratio with 95% confidence intervals were calculated. 94% of the study sample were IMGs; median age was 35 years (Inter-Quartile range 25th - 75th percentile (IQR): 33-37 years); 43% women and 59% were Asian physicians. The median pre-hire time was 5 years (IQR: 4-7 years) and USMLE step I & step II clinical skills scores were 85 (IQR: 80-88) & 82 (IQR: 79-87) respectively. The median aggregate CBE scores during training were: PG1 5.8 (IQR: 5.6-6.3); PG2 6.3 (IQR 6-6.8) & PG3 6.7 (IQR: 6.7 - 7.1). 25% of our residents scored consistently above US national median ITE scores in all 3 years of training and 16% pursued a fellowship.Younger residents had higher aggregate annual CBE score than the program median (p < 0.05). Higher USMLE scores were associated with higher than US median ITE scores, reflecting exam-taking skills. Success in acquiring a fellowship was associated with consistent fellowship interest (p < 0.05) and research publications or presentations (p <0.05). None of the other characteristics including visa status were associated with the outcomes. Background IMG features namely, age and USMLE scores predict performance evaluation and in-training examination scores during residency training. In addition enhanced research activities during residency training could facilitate fellowship goals among interested IMGs.

Predicting performance using background characteristics of international medical graduates in an inner-city university-affiliated Internal Medicine residency training program

PubMed Central

Kanna, Balavenkatesh; Gu, Ying; Akhuetie, Jane; Dimitrov, Vihren

2009-01-01

Background IMGs constitute about a third of the United States (US) internal medicine graduates. US residency training programs face challenges in selection of IMGs with varied background features. However data on this topic is limited. We analyzed whether any pre-selection characteristics of IMG residents in our internal medicine program are associated with selected outcomes, namely competency based evaluation, examination performance and success in acquiring fellowship positions after graduation. Methods We conducted a retrospective study of 51 IMGs at our ACGME accredited teaching institution between 2004 and 2007. Background resident features namely age, gender, self-reported ethnicity, time between medical school graduation to residency (pre-hire time), USMLE step I & II clinical skills scores, pre-GME clinical experience, US externship and interest in pursuing fellowship after graduation expressed in their personal statements were noted. Data on competency-based evaluations, in-service exam scores, research presentation and publications, fellowship pursuance were collected. There were no fellowships offered in our hospital in this study period. Background features were compared between resident groups according to following outcomes: (a) annual aggregate graduate PGY-level specific competency-based evaluation (CBE) score above versus below the median score within our program (scoring scale of 1 – 10), (b) US graduate PGY-level specific resident in-training exam (ITE) score higher versus lower than the median score, and (c) those who succeeded to secure a fellowship within the study period. Using appropriate statistical tests & adjusted regression analysis, odds ratio with 95% confidence intervals were calculated. Results 94% of the study sample were IMGs; median age was 35 years (Inter-Quartile range 25th – 75th percentile (IQR): 33–37 years); 43% women and 59% were Asian physicians. The median pre-hire time was 5 years (IQR: 4–7 years) and USMLE step I & step II clinical skills scores were 85 (IQR: 80–88) & 82 (IQR: 79–87) respectively. The median aggregate CBE scores during training were: PG1 5.8 (IQR: 5.6–6.3); PG2 6.3 (IQR 6–6.8) & PG3 6.7 (IQR: 6.7 – 7.1). 25% of our residents scored consistently above US national median ITE scores in all 3 years of training and 16% pursued a fellowship. Younger residents had higher aggregate annual CBE score than the program median (p < 0.05). Higher USMLE scores were associated with higher than US median ITE scores, reflecting exam-taking skills. Success in acquiring a fellowship was associated with consistent fellowship interest (p < 0.05) and research publications or presentations (p <0.05). None of the other characteristics including visa status were associated with the outcomes. Conclusion Background IMG features namely, age and USMLE scores predict performance evaluation and in-training examination scores during residency training. In addition enhanced research activities during residency training could facilitate fellowship goals among interested IMGs. PMID:19594918

Clinical Breast Examination As the Recommended Breast Cancer Screening Modality in a Rural Community in Malaysia; What Are the Factors That Could Enhance Its Uptake?

PubMed Central

Nik Farid, Nik Daliana; Abdul Aziz, Norlaili; Al-Sadat, Nabilla; Jamaludin, Mariam; Dahlui, Maznah

2014-01-01

Breast cancer is the most common cause of deaths and the most frequently diagnosed cancer among women worldwide. This study aimed to determine the prevalence of breast cancer screening, specifically on clinical breast examination, and the predictors of its uptake among women in Malaysia. A cross-sectional study was carried out in five selected districts whereby women aged between 20 to 64 years old, from a total of 1000 households were interviewed. A total of 1192 women responded to the survey of which 53.3% reported had ever done clinical breast examination. Significant associations with clinical breast examination were noted for income and distance from the hospital. These factors should be considered in developing interventions aimed at promoting clinical breast examination. In particular, healthcare providers should be proactive in raising awareness about clinical breast examination among women in Malaysia. PMID:25188003

Knowledge and Intentions of Ninth-Grade Girls after a Breast Self-Examination Program

ERIC Educational Resources Information Center

Ogletree, Roberta J.; Hammig, Bart; Drolet, Judy C.; Birch, David A.

2004-01-01

Breast cancer ranks as the second-leading cause of death for women. Until recently the American Cancer Society advocated teaching breast self-examination (BSE) procedures. The Susan G. Komen Breast Cancer Foundation, active in the fight against breast cancer, continues to support educational efforts to teach breast self-examination skills to…

The Japanese Guidelines for Breast Cancer Screening.

PubMed

Hamashima, Chisato; Hamashima C, Chisato; Hattori, Masakazu; Honjo, Satoshi; Kasahara, Yoshio; Katayama, Takafumi; Nakai, Masahiro; Nakayama, Tomio; Morita, Takako; Ohta, Koji; Ohnuki, Koji; Sagawa, Motoyasu; Saito, Hiroshi; Sasaki, Seiju; Shimada, Tomoyuki; Sobue, Tomotaka; Suto, Akihiko

2016-05-01

The incidence of breast cancer has progressively increased, making it the leading cause of cancer deaths in Japan. Breast cancer accounts for 20.4% of all new cancers with a reported age-standardized rate of 63.6 per 100 000 women. The Japanese guidelines for breast cancer screening were developed based on a previously established method. The efficacies of mammography with and without clinical breast examination, clinical breast examination and ultrasonography with and without mammography were evaluated. Based on the balance of the benefits and harms, recommendations for population-based and opportunistic screenings were formulated. Five randomized controlled trials of mammographic screening without clinical breast examination were identified for mortality reduction from breast cancer. The overall relative risk for women aged 40-74 years was 0.75 (95% CI: 0.67-0.83). Three randomized controlled trials of mammographic screening with clinical breast examination served as eligible evidence for mortality reduction from breast cancer. The overall relative risk for women aged 40-64 years was 0.87 (95% confidence interval: 0.77-0.98). The major harms of mammographic screening were radiation exposure, false-positive cases and overdiagnosis. Although two case-control studies evaluating mortality reduction from breast cancer were found for clinical breast examination, there was no study assessing the effectiveness of ultrasonography for breast cancer screening. Mammographic screening without clinical breast examination for women aged 40-74 years and with clinical breast examination for women aged 40-64 years is recommended for population-based and opportunistic screenings. Clinical breast examination and ultrasonography are not recommended for population-based screening because of insufficient evidence regarding their effectiveness. © The Author 2016. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Principles for Developing Competency-Based Education Programs

ERIC Educational Resources Information Center

Johnstone, Sally M.; Soares, Louis

2014-01-01

The 2013 US college/university policy agenda, "Making College Affordable: A Better Agenda for the Middle Class," highlighted the role of developing technologies, institutional curriculum-design processes, and new delivery methods as keys to providing quality, affordable postsecondary education. Competency-based education (CBE) is given…

CBE Faculty and Staff

Science.gov Websites

About Us Research Staff Edward Arens Fred Bauman Gail Brager Darryl Dickerhoff Ali Ghahramani Uhl Zhe Wang Tom Webster Hui Zhang Research Affiliates Student Researchers Visiting Scholars Industry interdisciplinary group based in several academic departments, who collaborate regularly on research to improve the

People Interview: Black-tie science gets modern

NASA Astrophysics Data System (ADS)

2009-03-01

INTERVIEW Black-tie science gets modern Baroness Susan Greenfield CBE is director of the Royal Institution and professor of pharmacology at Oxford where she heads a multidisciplinary group studying neurodegenerative disorders. David Smith speaks to her about specialities, keeping busy and how science is changing.

Misconceptions Yesterday, Today, and Tomorrow

ERIC Educational Resources Information Center

Leonard, Mary J.; Kalinowski, Steven T.; Andrews, Tessa C.

2014-01-01

A recent essay in "CBE-Life Sciences Education" criticized biology education researchers' use of the term "misconceptions" and recommended that, in order to be up-to-date with education research, biology education researchers should use alternative terms for students' incorrect ideas in science. We counter that…

Aharanov-Bohm quantum interference in a reconfigurable electron system

NASA Astrophysics Data System (ADS)

Irvin, P.; Lu, S.; Annadi, A.; Cheng, G.; Tomczyk, M.; Huang, M.; Levy, J.; Lee, J.-W.; Lee, H.; Eom, C.-B.

Aharanov-Bohm (AB) interference can arise in transport experiments when magnetic flux threads through two or more transport channels. The existence of this behavior requires long-range ballistic transport and is typically observed only in exceptionally clean materials. We observe AB interference in wide (w 100 nm) channels created at the LaAlO3/SrTiO3 interface using conductive AFM lithography. Interference occurs above a critical field B 4 T and increases in magnitude with increasing magnetic field. The period of oscillation implies a ballistic length that greatly exceeds the micron-scale length of the channel, consistent with Fabry-Perot interference in 1D channels. The conditions under which AB oscillations are observed will be discussed in the context of the electron pairing mechanism in LaAlO3/SrTiO3. We gratefully acknowledge financial support from AFOSR FA9550-12-1-0342 (CBE), NSF DMR-1234096 (CBE), and ONR N00014-15-1-2847 (JL).

Grappling with the literature of education research and practice.

PubMed

Dolan, Erin L

2007-01-01

The absence of a central database and use of specialized language hinder nonexperts in becoming familiar with the science teaching and learning literature and using it to inform their work. The challenge of locating articles related to a specific question or problem, coupled with the difficulty of comprehending findings based on a variety of different perspectives and practices, can be prohibitively difficult. As I have transitioned from bench to classroom-based research, I have become familiar with how to locate, decipher, and evaluate the education research literature. In this essay, I point out analogies to the literature of science research and practice, and I reference some of the literature that I have found useful in becoming an education researcher. I also introduce a new regular feature, "Current Insights: Recent Research in Science Teaching and Learning," which is designed to point CBE--Life Sciences Education (CBE-LSE) readers to current articles of interest in life sciences education, as well as more general and noteworthy publications in education research.

Education at the National Academies

ERIC Educational Resources Information Center

Labov, Jay B.

2003-01-01

The past three issues of "Cell Biology Education" (CBE) have provided overviews of education projects within the National Research Council's (NRC's) Center for Education, Board on Life Sciences, National Academy of Engineering, and National Academy of Science's Office of Public Understanding of Science. In this article, the author provides…

CBE Worplace Performance Webinar Series

Science.gov Websites

Speech Privacy Task Ambient Conditioning Team Space Design Study Thermal Comfort Automotive Research , Design and Evaluation Theory, tools and strategies to help professionals create and support successful Design With Science View slide presentation (PDF) Janice Barnes, PhD, LEED AP, Principal and Global

Teacher's Guide for Competency-Based Education Curriculum for Floriculture.

ERIC Educational Resources Information Center

Associated Educational Consultants, Inc., Pittsburgh, PA.

This teacher's guide is designed to facilitate use of the West Virginia floriculture competency-based education (CBE) curriculum by instructors in floriculture programs. The curriculum is organized into 13 learning units, correlated with specific competencies. Each competency includes a learning checklist, learning activities, and evaluative…

A meta-analysis of mammographic screening with and without clinical breast examination

PubMed Central

Hamashima, Chisato; Ohta, Koji; Kasahara, Yoshio; Katayama, Takafumi; Nakayama, Tomio; Honjo, Satoshi; Ohnuki, Koji

2015-01-01

Mammographic screening with clinical breast examination has been recommended in Japan since 2000. Although mammographic screening without clinical breast examination has not been recommended, its introduction is anticipated. The efficacies of mammographic screening with and without clinical breast examination were evaluated based on the results of randomized controlled trials. PubMed and other databases for studies published between 1985 and 2014 were searched. The study design was limited to randomized controlled trials to evaluate mortality reduction from breast cancer. Five studies were eligible for meta-analysis of mammographic screening without clinical breast examination. The relative risk for women aged 40–74 years was 0.75 (95% confidence interval, 0.67–0.83). Three studies evaluated the efficacy of mammographic screening with clinical breast examination. The relative risk for women aged 40–64 years was 0.87 (95% confidence interval, 0.77–0.98). The number needed to invite was always lower in mammographic screening without clinical breast examination than in mammographic screening with clinical breast examination. In both screening methods, the number needed to invite was higher in women aged 40–49 years than in women aged 50–70 years. These results suggest that mammographic screening without clinical breast examination can afford higher benefits to women aged 50 years and over. Although evidence of the efficacy of mammographic screening without clinical breast examination was confirmed based on the results of the randomized controlled trials, a Japanese study is needed to resolve local problems. PMID:25959787

Effectiveness of online education in teaching breast self- examination.

PubMed

Tuna, Arzu; Avdal, Elif Unsal; Yucel, Sebnem Cinar; Dal, Nursel Alp; Dicle, Aklime; Ozkan, Arife; Sezgin, Handan; Gumus, Aysun Babacan; Turgay, Ayse San; Degirmenci, Mustafa

2014-01-01

This research evaluated the effectiveness of an online education model in teaching breast self- examination to university staff and students. 1,679 women participated in a breast self-examination online training program. Breast self-examination knowledge evaluation forms developed by Maurer (1997) were used in the research and were evaluated on a 100 point scale. Paired t-test and McNemar's Test statistics were employed. The participants scored an average of 46.5 (14.0%) on knowledge on breast self-examination before training, but 77.4 (11.0%) one month after education and 76.7 (9.52%) after six months. There was a clear significant difference between these knowledge levels (p<0.05). Similarly, while the rate for systematic practice of breast self-examination among women was 30.8% before training it increased to 47.8% afterwards. Again the difference was significant (p<0.05). Online education is an effective method for teaching breast self-examination to women.

Implementing Competency-Based Education

ERIC Educational Resources Information Center

Curry, Lynn; Docherty, Marcia

2017-01-01

The rapid and widespread adoption of competency-based education (CBE) has brought into sharp focus long-standing tensions built into education systems, particularly for graduate and professional schools. We all share the desire to produce graduates equipped to respond capably in a rapidly changing world. However, many of us struggle with the…

Recent Research in Science Teaching and Learning

ERIC Educational Resources Information Center

Allen, Deborah

2013-01-01

This feature is designed to point "CBE-Life Sciences Education" readers to current articles of interest in life sciences education, as well as more general and noteworthy publications in education research. URLs are provided for the abstracts or full text of articles. This themed issue focuses on recent studies of concepts and…

Recent Research in Science Teaching and Learning

ERIC Educational Resources Information Center

Allen, Deborah

2014-01-01

This feature is designed to point "CBE - Life Sciences Education" readers to current articles of interest in life sciences education as well as more general and noteworthy publications in education research. URLs are provided for the abstracts or full text of articles. For articles listed as "Abstract available," full text may…

Plant Behavior

ERIC Educational Resources Information Center

Liu, Dennis W. C.

2014-01-01

Plants are a huge and diverse group of organisms, ranging from microscopic marine phytoplankton to enormous terrestrial trees epitomized by the giant sequoia: 300 feet tall, living 3000 years, and weighing as much as 3000 tons. For this plant issue of "CBE-Life Sciences Education," the author focuses on a botanical topic that most…

Recent Research in Science Teaching and Learning

ERIC Educational Resources Information Center

Allen, Deborah

2013-01-01

This article is designed to point "CBE-Life Sciences Education" readers to current articles of interest in life sciences education as well as more general and noteworthy publications in education research. URLs are provided for the abstracts or full text of articles. For articles listed as "Abstract available," full text may be…

Competency-Based Education: Leadership Challenges

ERIC Educational Resources Information Center

Nodine, Thad; Johnstone, Sally M.

2015-01-01

Competency-based education (CBE) refers to online and hybrid courses and programs that offer credit or degrees based on evidence of student learning, or competencies, rather than on the amount of time spent in a course. Students work at their own pace, receive personalized academic support, and demonstrate mastery as they progress through their…

Reform of the Method for Evaluating the Teaching of Medical Linguistics to Medical Students

ERIC Educational Resources Information Center

Zhang, Hongkui; Wang, Bo; Zhang, Longlu

2014-01-01

Explorating reform of the teaching evaluation method for vocational competency-based education (CBE) curricula for medical students is a very important process in following international medical education standards, intensify ing education and teaching reforms, enhancing teaching management, and improving the quality of medical education. This…

Bipolar Cascade Vertical-Cavity Surface-Emitting Lasers for RF Photonic Link Applications

DTIC Science & Technology

2007-09-01

6 IV Current versus Voltage . . . . . . . . . . . . . . . . . . . . . 7 MBE Molecular Beam Epitaxy ...of carrying maximum photocur- rent. Numerous material parameters have been studied. Growth parameters for molecular beam epitaxy (MBE), metal-organic...12 MOCVD Metal-Organic Chemical Vapor Deposition . . . . . . . . . . 12 CBE Chemical Beam Epitaxy . . . . . . . . . . . . . . . . . . . . 12 LPE

Knowledge, attitude about breast cancer and practice of breast cancer screening among female health care professionals: a study from Turkey.

PubMed

Akpinar, Yeliz Yelen; Baykan, Zeynep; Naçar, Melis; Gün, Iskender; Çetinkaya, Fevziye

2011-01-01

The awareness of health professionals about breast cancer prevention is of vital importance, since their beliefs and behaviors may have a major impact on other women. The aim of this study was to investigate the knowledge, and attitudes regarding risk factors for breast cancer as well as screening such as breast self-examination, clinical breast examination and mammography among different groups of female health professionals. In this cross- sectional study, 444 female health professionals in various health centers located in Corum Province, Turkey, were interviewed using a self-administered questionnaire. The mean age was 33.1 ± 6.1 and most were married (81.3%). The rate of feeling under risk regarding breast cancer among female health personnel was 31.3%. The majority (98.4 %) perceived breast self-examination as a beneficial method for the early detection of breast cancer. Although 81.3 % of the participants stated that they did breast self examination, only 27.3 % reported doing so on a regular basis (performed monthly or once per menstrual cycle). The most common reason for not doing breast self-examination was the belief that it was not necessary (45.8 %). Of the entire group, the rate of having a mammography was 10.1% and the rate of clinical breast examination was 24.8%. Health professionals are a direct source of medical information to the public. The use of breast self-examination and mammography was found lower than expected when considering the fact that participants were health care professionals.

Giant fibroadenoma presenting like fungating breast cancer in a Nigerian teenager.

PubMed

Arowolo, O A; Akinkuolie, A A; Adisa, A O; Obonna, G C; Olasode, B J

2013-03-01

Giant fibroadenoma of the breast is a rare benign breast tumour which seldom grows to a giant size, it is even rarer for this benign tumour to grow rapidly, ulcerate spontaneously and present like a fungating breast tumour in a way mimicking breast cancer. This is a presentation of a 14 year old premenarchal girl with a massive ulcerating and fungating left breast mass that was initially thought to be a fungating locally advanced breast carcinoma on clinical examination. Further examination of the morphology of the resected surgical specimen and histological examination confirmed it to be giant fibroadenoma of the breast. It was successfully managed by partial mastectomy and breast reconstruction with an excellent result and a high degree of patient satisfaction was achieved. Though a rare clinical entity benign breast tumour can present like a fungating breast cancer and this must be bore in mind especially in young adolescent patients presenting with ulcerating breast tumour.

Do Clinical Breast Examination Skills Improve During Medical School?

ERIC Educational Resources Information Center

Lee, Karen C.; Dunlop, Dorothy; Dolan, Nancy C.

1998-01-01

A study assessed the effect of training stage, gender, and specialty interest on 493 Northwestern University (Illinois) medical students' breast cancer knowledge, attitudes, and clinical breast examination skills. Results suggest knowledge and attitudes are not related to clinical breast examination proficiency, which is a practiced tactile skill.…

Evaluating Breast Self-Examinations in a Military Beneficiary Population

DTIC Science & Technology

1999-05-01

behaviors (p. 8), by I . Ajzen and M . Fishbein , 1980, Englewood Cliffs, NJ: Prentice-Hall. Belief of consequence Beliefs of others Motivation to comply...D. (1987). Performance of breast self-examination by women at high risk for breast cancer. Women & Health, 12(2), 29- 46. Ajzen , I . & Fishbein , M ...BSE performance. Key Words: Ajzen - Fishbein Theory of Reasoned Action; breast neoplasms; breast self- examination; cancer screening; military medicine

Visiting Scholars Program in Building Science at UC Berkeley

Science.gov Websites

part of the evaluation process, as it is essential that there is a relationship between your interests and the research being conducted at CBE. Visiting scholars must have some prior research experience with information on education, research experience, papers published and technical skills (e.g

All Hands on Deck: Ten Lessons from Early Adopters of Competency-Based Education

ERIC Educational Resources Information Center

Book, Patricia A.

2014-01-01

The perceived value of postsecondary education to economic competitiveness and individual success is driving innovation in higher education. Competency-based education (CBE) is the latest disruption that seeks to respond to the growing sense of national urgency to boost education attainment. The target audience generally includes those adult…

Community-Based Education in Egypt: Is It Achieving Its Stated Goals?

ERIC Educational Resources Information Center

Langsten, Ray

2016-01-01

Egypt promises "education for all". Primary attendance and completion have increased substantially. Still, many children remain out of school. There remain questions about the quality of education. Since the early 1990s, community-based education (CBE) has been part of Egypt's educational programme. Community-based education is meant to…

Early Results in Capella's Prior Learning Assessment Experimental Site Initiative

ERIC Educational Resources Information Center

Klein, Jillian

2017-01-01

In July 2014, the U.S. Department of Education announced a new round of experimental sites focusing on competency-based education. Capella University was selected to participate in three of the Department of Education's competency-based education (CBE) experiments and began by implementing the prior learning assessment experiment, which allows…

Electronic Reverse Auctions in the Federal Government

DTIC Science & Technology

2007-12-01

William R. Gates _____________________________________ Peter J. Coughlan _____________________________________ Robert N. Beck ...AND ACRONYMS BAA Buy American Act BPA Blanket Purchase Agreement CBE Competitive Bidding Event CCR Central Contractor Registration CECOM...BUY AMERICAN ACT Even if a buyer employs e-RAs to determine the price of an item, the regulations such as the Buy American Act ( BAA ) still apply

Teaching Representations of Competency-Based Education. A Case Study

ERIC Educational Resources Information Center

Covarrubias-Papahiu, Patricia

2016-01-01

The aim of this research was to know how the Competency-Based Education (CBE) approach is represented by professors who are part of the professional education of psychologists, and the challenges and implications of, in their opinion, incorporating it in the classroom practice. Therefore, a research was conducted to know the type of…

Competency Based Instructional Resource Guide. Sample Format. Welding.

ERIC Educational Resources Information Center

Hoerner, James L.; Horne, Ralph A.

The purpose of this sample guide is to assist teachers and curriculum specialists in developing instructional materials that are competency based and that meet Virginia standards for competency-based education (CBE) programs. The sample deals with the occupation of welding, but it is the format that is of interest here, not the subject matter.…

Evaluation Checklist for Student Writing in Grades K-3, Ottawa County.

ERIC Educational Resources Information Center

Ottawa County Office of Education, OH.

Developed to assist teachers in Ottawa County, Ohio, in monitoring students' pupil performance objectives (PPOs) in grades K-3, this writing evaluation form is the primary record keeping tool in the Competency Based Education (CBE) Program. The form consists of: (1) the evaluation checklist; (2) the intervention code; and (3) record keeping…

Computer-Based Education. The Best of ERIC, June 1976-August 1980.

ERIC Educational Resources Information Center

Hall, Keith A.

This bibliography contains annotations of reports, reviews, conference proceedings, other documents, and journal articles on computer based education (CBE), most of which were derived from a search of the Educational Resources Information Center (ERIC) system. Covering June 1976 through August 1980, this compilation serves as an update to two…

Transient surface states during the CBE growth of GaAs

NASA Astrophysics Data System (ADS)

Farrell, T.; Hill, D.; Joyce, T. B.; Bullough, T. J.; Weightman, P.

1997-05-01

We report the occurrence of a transient surface state during the initial stages of CBE GaAs(0 0 1) growth. The state was detected in real-time reflectance ( R) and reflectance anisotropy spectroscopy (RAS) growth monitoring. At low growth rates, less than 1 μm/h, beam equivalent pressure (BEP) of triethylgallium (TEG) < 2.5 × 10 -5 mbar there was no change in R and the RAS signal changed from its pre-growth value under arsenic stabilisation at the growth temperature to its "during growth" value upon admission of the TEG, with the familiar monolayer oscillations. At higher TEG BEPs there was a rapid increase in R at all monitoring wavelengths, followed by a monotonic decay to its pre-growth value. This transient increase in R was accompanied by a change in the RAS signal, the magnitude and sign of which varied with wavelength. The initial increase in R is shown to be associated with the development of a metallic-like surface whereas the changes in the RAS signal are consistent with the formation of Ga dimers.

Combination feeding of breast milk and formula: evidence for shorter breast-feeding duration from the National Health and Nutrition Examination Survey.

PubMed

Holmes, Alison Volpe; Auinger, Peggy; Howard, Cindy R

2011-08-01

To examine combination breast milk and formula-feeding (CBFF), defined as daily breast-feeding and formula-feeding begun in the first week of life and to examine associations between CBFF and overall breast-feeding duration. We used the National Health and Nutrition Examination Survey, 1999-2006, to determine the prevalence of CBFF in both univariable and multivariable analyses. We examined breast-feeding duration using Kaplan-Meier and Cox proportional hazards analyses. Among 6788 children ages 0-71 months, 8% were CBFF and 55% were exclusively breast-fed during the first week of life. Factors independently associated with CBFF were Hispanic ethnicity (adjusted OR, 3.81) and black race (adjusted OR, 2.59). CBFF was associated with decreased overall breast-feeding duration in the full cohort (P < .001) but not in the Hispanic or black subgroups. CBFF and formula-feeding, when compared with 4 months of exclusive breast-feeding, were associated with an increased risk for overweight/obesity between ages 2 and 6 years. In a nationally representative sample, CBFF is associated with shorter overall breast-feeding duration in white but not Hispanic or black mother-baby dyads. A significant number of US infants, though breast-fed, do not receive the health benefits of exclusive breast-feeding. Copyright © 2011 Mosby, Inc. All rights reserved.

Nitrogen-Induced Perturbation of the Valence Band States in GaP1-xNx Alloys

DOE Office of Scientific and Technical Information (OSTI.GOV)

Dudiy, S. V.; Zunger, A.; Felici, M.

2006-01-01

The effects of diluted nitrogen impurities on the valence- and conduction-band states of GaP{sub 1-x}N{sub x} have been predicted and measured experimentally. The calculation uses state-of-the-art atomistic modeling: we use large supercells with screened pseudopotentials and consider several random realizations of the nitrogen configurations. These calculations agree with photoluminescence excitation (PLE) measurements performed for nitrogen concentrations x up to 0.035 and photon energies up to 1 eV above the GaP optical-absorption edge, as well as with published ellipsometry data. In particular, a predicted nitrogen-induced buildup of the L character near the valence- and conduction-band edges accounts for the surprising broad-absorptionmore » plateau observed in PLE between the X{sub 1c} and the {Lambda}{sub 1c} critical points of GaP. Moreover, theory accounts quantitatively for the downward bowing of the indirect conduction-band edge and for the upward bowing of the direct transition with increasing nitrogen concentration. We review some of the controversies in the literature regarding the shifts in the conduction band with composition, and conclude that measured results at ultralow N concentration cannot be used to judge behavior at a higher concentration. In particular, we find that at the high concentrations of nitrogen studied here ({approx}1%) the conduction-band edge (CBE) is a hybridized state made from the original GaP X{sub 1c} band-edge state plus all cluster states. In this limit, the CBE plunges down in energy as the N concentration increases, in quantitative agreement with the measurements reported here. However, at ultralow nitrogen concentrations (<0.1%), the CBE is the nearly unperturbed host X{sub 1c}, which does not sense the nitrogen cluster levels. Thus, this state does not move energetically as nitrogen is added and stays pinned in energy, in agreement with experimental results.« less

Identifying women with dense breasts at high risk for interval cancer: a cohort study.

PubMed

Kerlikowske, Karla; Zhu, Weiwei; Tosteson, Anna N A; Sprague, Brian L; Tice, Jeffrey A; Lehman, Constance D; Miglioretti, Diana L

2015-05-19

Twenty-one states have laws requiring that women be notified if they have dense breasts and that they be advised to discuss supplemental imaging with their provider. To better direct discussions of supplemental imaging by determining which combinations of breast cancer risk and Breast Imaging Reporting and Data System (BI-RADS) breast density categories are associated with high interval cancer rates. Prospective cohort. Breast Cancer Surveillance Consortium (BCSC) breast imaging facilities. 365,426 women aged 40 to 74 years who had 831,455 digital screening mammography examinations. BI-RADS breast density, BCSC 5-year breast cancer risk, and interval cancer rate (invasive cancer ≤12 months after a normal mammography result) per 1000 mammography examinations. High interval cancer rate was defined as more than 1 case per 1000 examinations. High interval cancer rates were observed for women with 5-year risk of 1.67% or greater and extremely dense breasts or 5-year risk of 2.50% or greater and heterogeneously dense breasts (24% of all women with dense breasts). The interval rate of advanced-stage disease was highest (>0.4 case per 1000 examinations) among women with 5-year risk of 2.50% or greater and heterogeneously or extremely dense breasts (21% of all women with dense breasts). Five-year risk was low to average (0% to 1.66%) for 51.0% of women with heterogeneously dense breasts and 52.5% with extremely dense breasts, with interval cancer rates of 0.58 to 0.63 and 0.72 to 0.89 case per 1000 examinations, respectively. The benefit of supplemental imaging was not assessed. Breast density should not be the sole criterion for deciding whether supplemental imaging is justified because not all women with dense breasts have high interval cancer rates. BCSC 5-year risk combined with BI-RADS breast density can identify women at high risk for interval cancer to inform patient-provider discussions about alternative screening strategies. National Cancer Institute.

US Female College Students' Breast Health Knowledge, Attitudes, and Determinants of Screening Practices: New Implications for Health Education

ERIC Educational Resources Information Center

Early, Jody; Armstrong, Shelley Nicole; Burke, Sloane; Thompson, Doris Lee

2011-01-01

Objective: This study examined female college students' knowledge, attitudes, and breast cancer screening and determined significant predictors of breast self-examination, clinical breast examination, and mammography among this population. Participants: A convenience sample of 1,074 college women from 3 universities participated in the research.…

Breast self-examination: importance of technique in early diagnosis.

PubMed Central

Hislop, T G; Coldman, A J; Skippen, D H

1984-01-01

Shortly after diagnosis of breast cancer 416 patients were interviewed about their use of screening procedures and the method of tumour detection. Although 72% reported that they performed breast self-examination (BSE), only 12% actually inspected and palpated their breasts monthly. BSE was not significantly associated with tumour size or involvement of the lymph nodes; however, thorough inspection was associated with smaller tumours, and careful palpation with the absence of palpable nodes. Of those who no longer or never had examined their breasts 40% reported having annual breast examinations by their physician and had significantly smaller tumours than did the others. Most of the women (86%) reported having detected their own tumours, and BSE did not significantly increase the likelihood of self-detection. The frequency of use of screening procedures was similar in a sample of women without breast cancer. PMID:6498686

[Knowledge, attitude and practice of breast self-examination in health centers].

PubMed

Marinho, Luiz Alberto Barcelos; Costa-Gurgel, Maria Salete; Cecatti, José Guilherme; Osis, Maria José Duarte

2003-10-01

Breast cancer is one of the most important problems of public health and education regarding breast self-examination is one of the important steps for identifying breast tumors at an early stage. The present study was carried out to assess knowledge, attitude, and practice of breast self-examination among patients attending health centers. In a KAP (Knowledge, Attitude and Practice) survey 663 women of 13 randomly selected municipal health centers were interviewed. The number of interviews in each health center was proportional to the mean number of women seen per month. In the data analysis, women's answers for knowledge, attitude and practice regarding breast self-examination were classified according to their adequacy as previously defined. Adequacy was compared among categories of control variables with Chi2 test. The results showed that knowledge and practice of breast self-examination were adequate in 7.4% and 16.7%, respectively. However, attitude was adequate in 95.9% of the women interviewed. The study also showed that 58.1% of the women interviewed referred that forgetfulness was the main barrier for not performing self-examination. Women attending the health centers sampled in this study had inadequate knowledge and practice about breast self-examination but they had an adequate and favorable attitude about it.

Examining breast cancer screening barriers among Central American and Mexican immigrant women: fatalistic beliefs or structural factors?

PubMed

De Jesus, Maria; Miller, Eva B

2015-01-01

Researchers have examined "cancer fatalism" (the belief that cancer is predetermined, beyond individual control, and necessarily fatal) as a major barrier to breast cancer screening among Latinas. The authors examine perceptions of breast cancer, its causes, and experiences with screening among Salvadoran, Guatemalan, Mexican, and Bolivian immigrant women in Washington, DC. Two salient themes emerged: (a) perceptions of breast cancer causes and breast cancer screening; and (b) structural factors are the real barriers to breast cancer screening. Findings demonstrate participants' awareness and motivation to get screened and elucidate structural barriers that are obscured by the discourse of fatalism and hinder breast cancer screening.

A survey of overall life satisfaction and its association with breast diseases in Chinese women.

PubMed

Bai, Aili; Li, Haixin; Huang, Yubei; Liu, Xueou; Gao, Ying; Wang, Peishan; Dai, Hongji; Song, Fengju; Hao, Xishan; Chen, Kexin

2016-01-01

To investigate the association between overall life satisfaction and healthy lifestyle, knowledge of breast cancer, physical examination, and detection rate of breast cancer and benign breast disease in Chinese women. In a multicentered breast disease screening program in China, we enrolled 33,057 women aged 45-65 years without prior diagnosis of breast cancer. After completing an epidemiological questionnaire, all participants were examined by clinical breast examination, breast ultrasound, and mammography independently. All breast cancer cases and a selected sample of benign breast diseases were confirmed pathologically. Univariate and multivariate odds ratios (ORs) and 95% confidence intervals (CIs) were calculated to estimate the association between life satisfaction and lifestyle, knowledge of breast cancer, physical examination, and detection rate of breast diseases. Overall life satisfaction was positively associated with women's healthy lifestyle. Compared with less satisfied women, satisfied women were less likely to be smokers (OR = 0.54; 95% CI: 0.47-0.62), have more exercise (OR = 1.49; 95% CI: 1.26-1.75), eat less fried (OR = 0.60; 95% CI: 0.50-0.71), smoked (OR = 0.54, 95% CI: 0.47-0.63), pickled (OR = 0.66, 95% CI: 0.55-0.79), and grilled (OR = 0.63, 95% CI: 0.54-0.74) foods. Satisfied women were more likely to have knowledge of breast cancer (OR = 1.48, 95% CI: 1.29-1.70), and have regular physical examinations (OR = 1.11, 95% CI: 1.01-1.12). Compared to less satisfied women, we found significantly lower detection rate of benign breast diseases (OR = 0.90, 95% CI: 0.82-0.99), and lower but nonsignificant detection rate of breast cancer (OR = 0.66, 95% CI: 0.35-1.25) in satisfied women. Women with a higher overall life satisfaction are more likely to have healthy lifestyle, knowledge of breast cancer, and regular physical examination, thus resulting in a lower detection rate of breast diseases in screening. © 2015 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.

78 FR 67985 - Supplemental Applications Proposing Labeling Changes for Approved Drugs and Biological Products

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-13

... reference listed drug (RLD) upon submission to FDA of a ``changes being effected'' (CBE-0) supplement. The.... Effective Date VIII. Federalism IX. Request for Comments X. References Executive Summary Purpose of the.... Costs and Benefits The economic benefits to the public health from adoption of the proposed rule are not...

Human Resource Management Strategies and Teacher's Efficiency within Schools: A Co-Relational Study

ERIC Educational Resources Information Center

Hashmi, Kiran

2014-01-01

The aim of the paper is to study Human Resource Management and Development (HRMD) strategies and their effect on teachers' efficiency within the Catholic Board of Education (CBE) schools of Pakistan whose teachers are graduates in educational leadership courses from a private teacher education institutes in Karachi. The study endeavored to build a…

Call for Papers. Correctional Education Association 1986 Annual Conference (Cincinnati, Ohio, July 6-9, 1986).

ERIC Educational Resources Information Center

Littlefield, John F., Ed.

The 13 papers in this volume are: "Behind Bars with CBE--Look What's Happening to Inmate Training" (Beverly A. Stitt, Rita Noel); "Communication Skills: Relevance, Respect, Responsibility and the Process of Change" (Meredith Whaley); "The Educational Needs of Inmates in the Kingston Prison for Women" (Richard Volpe, Colleen Kearney); "The Effects…

Breast MRI: EUSOBI recommendations for women's information.

PubMed

Mann, Ritse M; Balleyguier, Corinne; Baltzer, Pascal A; Bick, Ulrich; Colin, Catherine; Cornford, Eleanor; Evans, Andrew; Fallenberg, Eva; Forrai, Gabor; Fuchsjäger, Michael H; Gilbert, Fiona J; Helbich, Thomas H; Heywang-Köbrunner, Sylvia H; Camps-Herrero, Julia; Kuhl, Christiane K; Martincich, Laura; Pediconi, Federica; Panizza, Pietro; Pina, Luis J; Pijnappel, Ruud M; Pinker-Domenig, Katja; Skaane, Per; Sardanelli, Francesco

2015-12-01

This paper summarizes information about breast MRI to be provided to women and referring physicians. After listing contraindications, procedure details are described, stressing the need for correct scheduling and not moving during the examination. The structured report including BI-RADS® categories and further actions after a breast MRI examination are discussed. Breast MRI is a very sensitive modality, significantly improving screening in high-risk women. It also has a role in clinical diagnosis, problem solving, and staging, impacting on patient management. However, it is not a perfect test, and occasionally breast cancers can be missed. Therefore, clinical and other imaging findings (from mammography/ultrasound) should also be considered. Conversely, MRI may detect lesions not visible on other imaging modalities turning out to be benign (false positives). These risks should be discussed with women before a breast MRI is requested/performed. Because breast MRI drawbacks depend upon the indication for the examination, basic information for the most important breast MRI indications is presented. Seventeen notes and five frequently asked questions formulated for use as direct communication to women are provided. The text was reviewed by Europa Donna-The European Breast Cancer Coalition to ensure that it can be easily understood by women undergoing MRI. • Information on breast MRI concerns advantages/disadvantages and preparation to the examination • Claustrophobia, implantable devices, allergic predisposition, and renal function should be checked • Before menopause, scheduling on day 7-14 of the cycle is preferred • During the examination, it is highly important that the patient keeps still • Availability of prior examinations improves accuracy of breast MRI interpretation.

Patterns of Breast Magnetic Resonance Imaging Use in Community Practice

PubMed Central

Wernli, Karen J.; DeMartini, Wendy B.; Ichikawa, Laura; Lehman, Constance D.; Onega, Tracy; Kerlikowske, Karla; Henderson, Louise M.; Geller, Berta M.; Hofmann, Mike; Yankaskas, Bonnie C.

2014-01-01

Importance Breast magnetic resonance imaging (MRI) is increasingly used for breast cancer screening, diagnostic evaluation, and surveillance However, we lack data on national patterns of breast MRI use in community practice. Objective To describe 2005–2009 patterns of breast magnetic resonance imaging (MRI) use in U.S. community practice. Design Observational cohort study Setting Data collected from 2005–2009 on breast MRI and mammography from five national Breast Cancer Surveillance Consortium registries. Participants Data included 8931 breast MRI examinations and 1,288,924 screening mammograms from women aged 18–79 years. Main measures We calculated the rate of breast MRI examinations per 1000 women with breast imaging within the same year and described the clinical indications for the breast MRI examinations by year and age. We compared women screened with breast MRI to women screened with mammography alone for patient characteristics and lifetime breast cancer risk. Results The overall rate of breast MRI from 2005 through 2009 nearly tripled from 4.2 to 11.5 examinations per 1000 women with the most rapid rise from 2005–2007 (p=0.02). The most common clinical indication was diagnostic evaluation (40.3%), followed by screening (31.7%). Compared to women who received screening mammography alone, women who underwent screening breast MRI were more likely to be <50 years, white non-Hispanic, nulliparous, and have extremely dense breast tissue, a family history of breast cancer, and a personal history of breast cancer. The proportion of women screened by breast MRI at high lifetime risk for breast cancer (>20%) increased during the study period from 9% in 2005 to 29% in 2009. Conclusions and relevance Use of breast MRI for screening in high-risk women is increasing. However, our findings suggest there is a need to improve appropriate utilization, including among women who may benefit from screening breast MRI. PMID:24247555

Synchronous Bilateral Male Breast Cancer: A Case Report

PubMed Central

Sun, Woo-Young; Lee, Ki-Hyeong; Lee, Ho-Chang; Ryu, Dong-Hee; Park, Jin-Woo; Yun, Hyo-Young

2012-01-01

Synchronous bilateral breast cancer is extremely rare in men and has not, up to date, been reported in Korea. A 54-year-old man presented with a palpable mass in the right breast. The right nipple was retracted and bilateral axillary accessory breasts and nipples were present. On physical examination, a 2 cm-sized mass was palpated directly under the right nipple, and, with squeezing, bloody discharge developed in a single duct of the left nipple. There was no palpable mass in the left breast, and axillary lymph nodes were not palpable. Physical examination of external genitalia revealed a unilateral undescended testis on the left side. Synchronous bilateral breast cancer was diagnosed using mammography, ultrasonography, and core-needle biopsy. Histopathological examination revealed invasive ductal carcinoma in the right breast and ductal carcinoma in situ in the left breast. Bilateral total mastectomy, sentinel lymph node biopsy, and excision of accessory breasts in the axilla were performed. PMID:22807945

Synchronous bilateral male breast cancer: a case report.

PubMed

Sun, Woo-Young; Lee, Ki-Hyeong; Lee, Ho-Chang; Ryu, Dong-Hee; Park, Jin-Woo; Yun, Hyo-Young; Song, Young-Jin

2012-06-01

Synchronous bilateral breast cancer is extremely rare in men and has not, up to date, been reported in Korea. A 54-year-old man presented with a palpable mass in the right breast. The right nipple was retracted and bilateral axillary accessory breasts and nipples were present. On physical examination, a 2 cm-sized mass was palpated directly under the right nipple, and, with squeezing, bloody discharge developed in a single duct of the left nipple. There was no palpable mass in the left breast, and axillary lymph nodes were not palpable. Physical examination of external genitalia revealed a unilateral undescended testis on the left side. Synchronous bilateral breast cancer was diagnosed using mammography, ultrasonography, and core-needle biopsy. Histopathological examination revealed invasive ductal carcinoma in the right breast and ductal carcinoma in situ in the left breast. Bilateral total mastectomy, sentinel lymph node biopsy, and excision of accessory breasts in the axilla were performed.

US female college students' breast health knowledge, attitudes, and determinants of screening practices: new implications for health education.

PubMed

Early, Jody; Armstrong, Shelley Nicole; Burke, Sloane; Thompson, Doris Lee

2011-01-01

This study examined female college students' knowledge, attitudes, and breast cancer screening and determined significant predictors of breast self-examination, clinical breast examination, and mammography among this population. A convenience sample of 1,074 college women from 3 universities participated in the research. Respondents completed an online version of the Toronto Breast Self-examination Instrument as well as questions developed by the authors. Descriptive statistics showed gaps in college women's knowledge of breast health and negative attitudes toward screening that were relative to age. Multiple linear and logistic regression analyses revealed that knowledge, attitudes, and copay were significant predictors of screening, whereas family history and ethnicity were not. This study supported previous smaller-sample studies that showed college women to be a priority population for breast health education and revealed new significant factors that should be addressed in health education for this group.

Breast Self-Examination in the Personal Health Course.

ERIC Educational Resources Information Center

Young, Michael

1983-01-01

Female college students were surveyed regarding their acceptance of a film format for teaching breast self-examination. Factors that distinguished college women who regularly examined their breasts included: (1) conservatism; (2) confidence; (3) previous instruction; and (4) perception of the threat of cancer. (Author/PP)

Teacher's knowledge and practice of breast self examination.

PubMed

Drakshyani Devi, K; Venkata Ramaiah, P

1994-12-01

Data collected by interview of 100 teachers of schools and colleges regarding knowledge and practice of self examination of breast is analysed. Results showed that although the fear of breast cancer is common, the knowledge and practice of self examination was deficient and not regularly followed. A plea is made to publicise this in health education programmes and in media as a measure for early detection of breast cancer.

Breast self-exam

MedlinePlus

Self-examination of the breast; BSE; Breast cancer - BSE; Breast cancer screening - self exam ... chap 15. US Preventive Services Task Force website. Breast cancer: screening. www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/breast- ...

Factors affecting the palpability of breast lesion by self-examination.

PubMed

Lam, W W M; Chan, C P; Chan, C F; Mak, C C C; Chan, C F; Chong, K W H; Leung, M H J; Tang, M H

2008-03-01

This study aims to assess the accuracy of detection of breast lesion by breast self-examination and to assess different factors affecting the accuracy. All consecutive Chinese female patients, who attended our breast imaging unit in 2001, completed our questionnaire, had retrievable hard copy films, and had more than three years clinical follow-up, were recruited for this study. Different factors, such as age, menopausal status, previous experience of breastfeeding, family history of breast cancer, previous history of mastectomy or lumpectomy, hormonal therapy, oral contraceptive pills and previous history of mammography, were correlated with accuracy in self-detection of breast lesions retrospectively. The nature, size and location of the lesion, and breast size based on imaging, were also correlated with the accuracy in self-detection of breast lesions. A total of 163 questionnaires were analysed. 111 patients detected a breast lesion themselves and 24 of these lesions were false-positives. A total of 173 lesions (27 cancerous, 146 benign lesions) were documented by either ultrasonography and/or mammography, and confirmed by either histology or three-year clinical follow-up. The overall sensitivity in detecting both benign and malignant breast lesions was 71% when number of breast lesions was used as the denominator, and up to 78% sensitivity was achieved when number of patients was used as the denominator. History of mastectomy, and size and nature of the lesions were found to affect the accuracy of self-detection of breast lesions. Overall, breast self-examinations were effective in the detection of breast lesions and factors such as size of lesion, nature of the lesion and history of mastectomy affect the accuracy of the detections. Breast self-examination should be promoted for early detection of breast cancer.

Evidence that breast tissue stiffness is associated with risk of breast cancer.

PubMed

Boyd, Norman F; Li, Qing; Melnichouk, Olga; Huszti, Ella; Martin, Lisa J; Gunasekara, Anoma; Mawdsley, Gord; Yaffe, Martin J; Minkin, Salomon

2014-01-01

Evidence from animal models shows that tissue stiffness increases the invasion and progression of cancers, including mammary cancer. We here use measurements of the volume and the projected area of the compressed breast during mammography to derive estimates of breast tissue stiffness and examine the relationship of stiffness to risk of breast cancer. Mammograms were used to measure the volume and projected areas of total and radiologically dense breast tissue in the unaffected breasts of 362 women with newly diagnosed breast cancer (cases) and 656 women of the same age who did not have breast cancer (controls). Measures of breast tissue volume and the projected area of the compressed breast during mammography were used to calculate the deformation of the breast during compression and, with the recorded compression force, to estimate the stiffness of breast tissue. Stiffness was compared in cases and controls, and associations with breast cancer risk examined after adjustment for other risk factors. After adjustment for percent mammographic density by area measurements, and other risk factors, our estimate of breast tissue stiffness was significantly associated with breast cancer (odds ratio = 1.21, 95% confidence interval = 1.03, 1.43, p = 0.02) and improved breast cancer risk prediction in models with percent mammographic density, by both area and volume measurements. An estimate of breast tissue stiffness was associated with breast cancer risk and improved risk prediction based on mammographic measures and other risk factors. Stiffness may provide an additional mechanism by which breast tissue composition is associated with risk of breast cancer and merits examination using more direct methods of measurement.

The Effect of Breast Cancer Fatalism on Breast Cancer Awareness Among Turkish Women.

PubMed

Altintas, Hulya Kulakci; Ayyildiz, Tulay Kuzlu; Veren, Funda; Topan, Aysel Kose

2017-10-01

The aim of this study was to evaluate the effect of breast cancer fatalism and other factors on breast cancer awareness among Turkish women. This cross-sectional and comparative descriptive study was conducted with 894 women. Data were collected by Personal Information Form, Powe Fatalism Inventory and Champion's Health Belief Model Scale. Seriousness, health motivation, BSE benefits and BSE self-efficacy perceptions of the women were moderate, and susceptibility and BSE barriers perceptions were low. It was determined that awareness of breast cancer of the women was affected by breast cancer fatalism, age, education level, employment status, marital status, family type, economic status, social assurance, menopause status, family history of cancer, family history of breast cancer, knowledge on BSE, source of information on BSE, performing of BSE, frequency of BSE performing, having a problem with breast, having a breast examination in hospital, feeling during breast examination by healthcare professional, sex of healthcare professional for breast examination and their health beliefs (p < .05). The results suggested that awareness of breast cancer of the women was affected by breast cancer fatalism. In providing breast cancer early diagnosis behaviors, it is recommended to evaluate fatalism perceptions and health beliefs of the women and to arrange educational programs for this purpose.

Effectiveness of planned teaching intervention on knowledge and practice of breast self-examination among first year midwifery students.

PubMed

Abera, Hiwot; Mengistu, Daniel; Bedaso, Asres

2017-01-01

The prevalence of cancer is growing rapidly in all parts of the word and Ethiopia is no exception. Secondary prevention, as simple as monthly breast self-examination, is the best option to tackle the rising of this epidemic. Health awareness programs on screening and early detection are the corner stones to reduce the morbidity and mortality resulting from breast cancer. The aim of the study is to assess the effectiveness of planned teaching program on knowledge and practice of breast self-examination among first year female midwifery students in Hawassa health Sciences College. A pre-experimental one group pre-posttest design was used among 61 students who were selected by systematic random sampling technique. Data was collected using structured questionnaire and adapted and approved checklist. Data was entered using Epi-Info and analyzed using SPSS version 20. Pre-and post-intervention results were calculated using paired t-test. The mean age of the study participants was 20.13(±2.27) and 77% of the study participants were single. Before the intervention 14(23%) of respondents had information and practiced breast self-examination, only 8(13.1%) performed breast self -examination on a regular monthly basis. The number and percentage of the knowledgeable respondents pre-post intervention is 23(37.7%) and 35(57.4%), respectively. The mean knowledge difference for the pre-post intervention is 0.18±0.695 (P < 0.05). The respondents' pre- post interventions score of satisfactory practical competency were 10(16.4%) and 43(70.5%), respectively as well. The mean net gain for the pre-post breast self-examination intervention is 0.51± 0.62 (P < 0.001). Both the knowledge and practical competency scores showed highly significant increment after the intervention, showing that the research hypothesis was accepted. Planned teaching intervention on knowledge and Breast self-examination of students has resulted in an increment of both knowledge and the practice of breast self-examination. Teaching breast self-examination with demonstration to all at risk groups as a secondary prevention for breast cancer and large scale studies on heterogeneous groups is important.

Learning French as a Second Official Language in Canada: Comparing Monolingual and Bilingual Students at Grade 6

ERIC Educational Resources Information Center

Mady, Callie

2014-01-01

This paper presents the results of a study that compared the French as a second official achievement of three groups of students: (1) Canadian-born English speaking (CBE), (2) Canadian-born multilingual (CBM), and (3) immigrant multilinguals (IMM) as determined by multiskills test results. ANOVAs and subsequent post hoc tests revealed that the…

Sir John and Lady Rita Cornforth: a distinguished chemical partnership.

PubMed

Purchase, Rupert; Hanson, James R

2015-01-01

This review describes the life of Sir John Cornforth AC CBE FRS, who was awarded the Nobel Prize for Chemistry in 1975. It covers his early life in Australia, his work in Oxford, the National Institute for Medical Research, the Milstead Laboratory of Chemical Enzymology and the University of Sussex, together with the contributions made by his wife, Lady Rita Cornforth.

Improved high-frequency equivalent circuit model based on distributed effects for SiGe HBTs with CBE layout

NASA Astrophysics Data System (ADS)

Sun, Ya-Bin; Li, Xiao-Jin; Zhang, Jin-Zhong; Shi, Yan-Ling

2017-08-01

Not Available Project supported by the National Natural Science Funds of China (Grant Nos. 61574056 and 61504156), the Natural Science Foundation of Shanghai, China (Grant No. 14ZR1412000), Shanghai Sailing Program, China (Grant No. 17YF1404700), and the Science and Technology Commission of Shanghai Municipality, China (Grant No. 14DZ2260800).

Vision and Change in the Biology Community: Snapshots of Change

ERIC Educational Resources Information Center

Vasaly, Helen L.; Feser, Jason; Lettrich, Matthew D.; Correa, Kevin; Denniston, Katherine J.

2014-01-01

When the authors were first invited to write these columns, the editors felt it would be an interesting way to give the readers of "CBE - Life Sciences Education" an agency's-eye view of its concerns, workings, and accomplishments. This column is written with that charge in mind. It is intended to inform the community about outreach…

The Nature of Study Programmes in Vocational Education: Evaluation of the Model for Comprehensive Competence-Based Vocational Education in the Netherlands

ERIC Educational Resources Information Center

Sturing, Lidwien; Biemans, Harm J. A.; Mulder, Martin; de Bruijn, Elly

2011-01-01

In a previous series of studies, a model of comprehensive competence-based vocational education (CCBE model) was developed, consisting of eight principles of competence-based vocational education (CBE) that were elaborated for four implementation levels (Wesselink et al. "European journal of vocational training" 40:38-51 2007a). The…

Integrating interprofessional education in community-based learning activities: case study.

PubMed

Hosny, Somaya; Kamel, Mohamed H; El-Wazir, Yasser; Gilbert, John

2013-01-01

Faculty of Medicine/Suez Canal University (FOM/SCU) students are exposed to clinical practice in primary care settings within the community, in which they encounter patients and begin to work within interprofessional health teams. However, there is no planned curricular interaction with learners from other professions at the learning sites. As in other schools, FOM/SCU faces major challenges with the coordination of community-based education (CBE) program, which include the complexity of the design required for Interprofessional Education (IPE) as well as the attitudinal barriers between professions. The aim of the present review is to: (i) describe how far CBE activities match the requirements of IPE, (ii) explore opinions of graduates about the effectiveness of IPE activities, and (iii) present recommendations for improvement. Graduates find the overall outcome of their IPE satisfactory and believe that it produces physicians who are familiar with the roles of other professions and can work in synergy for the sake of better patient care. However, either a specific IPE complete module needs to be developed or more IPE specific objectives need to be added to current modules. Moreover, coordination with stakeholders from other health profession education institutes needs to be maximized to achieve more effective IPE.

Monitoring/Verification using DMS: TATP Example

DOE Office of Scientific and Technical Information (OSTI.GOV)

Stephan Weeks, Kevin Kyle, Manuel Manard

Field-rugged and field-programmable differential mobility spectrometry (DMS) networks provide highly selective, universal monitoring of vapors and aerosols at detectable levels from persons or areas involved with illicit chemical/biological/explosives (CBE) production. CBE sensor motes used in conjunction with automated fast gas chromatography with DMS detection (GC/DMS) verification instrumentation integrated into situational operations-management systems can be readily deployed and optimized for changing application scenarios. The feasibility of developing selective DMS motes for a “smart dust” sampling approach with guided, highly selective, fast GC/DMS verification analysis is a compelling approach to minimize or prevent the illegal use of explosives or chemical and biologicalmore » materials. DMS is currently one of the foremost emerging technologies for field separation and detection of gas-phase chemical species. This is due to trace-level detection limits, high selectivity, and small size. Fast GC is the leading field analytical method for gas phase separation of chemical species in complex mixtures. Low-thermal-mass GC columns have led to compact, low-power field systems capable of complete analyses in 15–300 seconds. A collaborative effort optimized a handheld, fast GC/DMS, equipped with a non-rad ionization source, for peroxide-based explosive measurements.« less

1D quantum simulation using a solid state platform

NASA Astrophysics Data System (ADS)

Kirkendall, Megan; Irvin, Patrick; Huang, Mengchen; Levy, Jeremy; Lee, Hyungwoo; Eom, Chang-Beom

Understanding the properties of large quantum systems can be challenging both theoretically and numerically. One experimental approach-quantum simulation-involves mapping a quantum system of interest onto a physical system that is programmable and experimentally accessible. A tremendous amount of work has been performed with quantum simulators formed from optical lattices; by contrast, solid-state platforms have had only limited success. Our experimental approach to quantum simulation takes advantage of nanoscale control of a metal-insulator transition at the interface between two insulating complex oxide materials. This system naturally exhibits a wide variety of ground states (e.g., ferromagnetic, superconducting) and can be configured into a variety of complex geometries. We will describe initial experiments that explore the magnetotransport properties of one-dimensional superlattices with spatial periods as small as 4 nm, comparable to the Fermi wavelength. The results demonstrate the potential of this solid-state quantum simulation approach, and also provide empirical constraints for physical models that describe the underlying oxide material properties. We gratefully acknowledge financial support from AFOSR (FA9550-12-1- 0057 (JL), FA9550-10-1-0524 (JL) and FA9550-12-1-0342 (CBE)), ONR N00014-15-1-2847 (JL), and NSF DMR-1234096 (CBE).

Pascal Liquid Phase in Electronic Waveguides

NASA Astrophysics Data System (ADS)

Tomczyk, M.; Briggeman, M.; Tylan-Tyler, A.; Huang, M.; Tian, B.; Pekker, D.; Lee, J.-W.; Lee, H.; Eom, C.-B.; Levy, J.

Clean one-dimensional electron transport has been observed in very few material systems. The development of exceptionally clean electron waveguides formed at the interface between complex oxides LaAlO3 and SrTiO3 enables low-dimensional transport to be explored with newfound flexibility. This material system not only supports ballistic 1D transport, but possesses a rich phase diagram and strong attractive electron-electron interactions which are not present in other solid-state systems. Here we report an unusual phenomenon in which quantized conductance increases by steps that themselves increase sequentially in multiples of e2 / h . The overall conductance exhibits a Pascal-like sequence: 1, 3, 6, 10... e2 / h , which we ascribe to ballistic transport of 1, 2, 3, 4 ... bunches of electrons. We will discuss how subband degeneracies can occur in non-interacting models that have carefully tuned parameters. Strong attractive interactions are required, however, for these subbands to lock together. This Pascal liquid phase provides a striking example of the consequences of strong attractive interactions in low-dimensional environments. We gratefully acknowledge financial support from AFOSR (FA9550-12-1- 0057 (JL) and FA9550-12-1-0342 (CBE)), ONR N00014-15-1-2847 (JL), and NSF DMR-1234096 (CBE).

Monitoring/Verification Using DMS: TATP Example

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kevin Kyle; Stephan Weeks

Field-rugged and field-programmable differential mobility spectrometry (DMS) networks provide highly selective, universal monitoring of vapors and aerosols at detectable levels from persons or areas involved with illicit chemical/biological/explosives (CBE) production. CBE sensor motes used in conjunction with automated fast gas chromatography with DMS detection (GC/DMS) verification instrumentation integrated into situational operationsmanagement systems can be readily deployed and optimized for changing application scenarios. The feasibility of developing selective DMS motes for a “smart dust” sampling approach with guided, highly selective, fast GC/DMS verification analysis is a compelling approach to minimize or prevent the illegal use of explosives or chemical and biologicalmore » materials. DMS is currently one of the foremost emerging technologies for field separation and detection of gas-phase chemical species. This is due to trace-level detection limits, high selectivity, and small size. GC is the leading analytical method for the separation of chemical species in complex mixtures. Low-thermal-mass GC columns have led to compact, low-power field systems capable of complete analyses in 15–300 seconds. A collaborative effort optimized a handheld, fast GC/DMS, equipped with a non-rad ionization source, for peroxide-based explosive measurements.« less

Breast magnetic resonance imaging for surveillance of women with a personal history of breast cancer: outcomes stratified by interval between definitive surgery and surveillance MR imaging.

PubMed

Park, Vivian Youngjean; Kim, Eun-Kyung; Kim, Min Jung; Moon, Hee Jung; Yoon, Jung Hyun

2018-01-22

Women with a personal history of breast cancer are at increased risk of future breast cancer events, and may benefit from supplemental screening methods that could enhance early detection of subclinical disease. However, current literature on breast magnetic resonance (MR) imaging surveillance is limited. We investigated outcomes of surveillance breast magnetic resonance (MR) imaging in women with a personal history of breast cancer. We reviewed 1053 consecutive breast MR examinations that were performed for surveillance in 1044 women (median age, 53 years; range, 20-85 years) previously treated for breast cancer between August 2014 and February 2016. All patients had previously received supplemental surveillance with ultrasound. Cancer detection rate (CDR), abnormal interpretation rate and characteristics of MR-detected cancers were assessed, including extramammary cancers. We also calculated the PPV 1 , PPV 3 , sensitivity and specificity for MR-detected intramammary lesions. Performance statistics were stratified by interval following initial surgery. The CDR for MR-detected cancers was 6.7 per 1000 examinations (7 of 1053) and was 3.8 per 1000 examinations (4 of 1053) for intramammary cancers. The overall abnormal interpretation rate was 8.0%, and the abnormal interpretation rate for intramammary lesions was 7.2%. The PPV 1 , PPV 3 , sensitivity and specificity for intramammary lesions was 5.3% (4 of 76), 15.8% (3 of 19), 75.0% (3 of 4) and 98.3% (1031 of 1049), respectively. For MR examinations performed ≤36 months after surgery, the overall CDR was 1.4 per 1000 examinations. For MR examinations performed > 36 months after surgery, the overall CDR was 17.4 per 1000 examinations. Surveillance breast MR imaging may be considered in women with a history of breast cancer, considering the low abnormal interpretation rate and its high specificity. However, the cancer detection rate was low and implementation may be more effective after more than 3 years after surgery.

Insufficient Knowledge of Breast Cancer Risk Factors Among Malaysian Female University Students

PubMed Central

Samah, Asnarulkhadi Abu; Ahmadian, Maryam; Latiff, Latiffah A.

2016-01-01

Background: Despite continuous argument about the efficacy of breast self-examination; it still could be a life-saving technique through inspiring and empowering women to take better control over their body/breast and health. This study investigated Malaysian female university students’ knowledge about breast cancer risk factors, signs, and symptoms and assessed breast self-examination frequency among students. Method: A cross-sectional survey was conducted in 2013 in nine public and private universities in the Klang Valley and Selangor. 842 female students were respondents for the self-administered survey technique. Simple descriptive and inferential statistics were employed for data analysis. Results: The uptake of breast self-examination (BSE) was less than 50% among the students. Most of students had insufficient knowledge on several breast cancer risk factors. Conclusion: Actions and efforts should be done to increase knowledge of breast cancer through the development of ethnically and traditionally sensitive educational training on BSE and breast cancer literacy. PMID:26234996

Evidence That Breast Tissue Stiffness Is Associated with Risk of Breast Cancer

PubMed Central

Boyd, Norman F.; Li, Qing; Melnichouk, Olga; Huszti, Ella; Martin, Lisa J.; Gunasekara, Anoma; Mawdsley, Gord; Yaffe, Martin J.; Minkin, Salomon

2014-01-01

Background Evidence from animal models shows that tissue stiffness increases the invasion and progression of cancers, including mammary cancer. We here use measurements of the volume and the projected area of the compressed breast during mammography to derive estimates of breast tissue stiffness and examine the relationship of stiffness to risk of breast cancer. Methods Mammograms were used to measure the volume and projected areas of total and radiologically dense breast tissue in the unaffected breasts of 362 women with newly diagnosed breast cancer (cases) and 656 women of the same age who did not have breast cancer (controls). Measures of breast tissue volume and the projected area of the compressed breast during mammography were used to calculate the deformation of the breast during compression and, with the recorded compression force, to estimate the stiffness of breast tissue. Stiffness was compared in cases and controls, and associations with breast cancer risk examined after adjustment for other risk factors. Results After adjustment for percent mammographic density by area measurements, and other risk factors, our estimate of breast tissue stiffness was significantly associated with breast cancer (odds ratio = 1.21, 95% confidence interval = 1.03, 1.43, p = 0.02) and improved breast cancer risk prediction in models with percent mammographic density, by both area and volume measurements. Conclusion An estimate of breast tissue stiffness was associated with breast cancer risk and improved risk prediction based on mammographic measures and other risk factors. Stiffness may provide an additional mechanism by which breast tissue composition is associated with risk of breast cancer and merits examination using more direct methods of measurement. PMID:25010427

Health responsibility and workplace health promotion among women: early detection of cancer.

PubMed

Kushnir, T; Rabinowitz, S; Melamed, S; Weisberg, E; Ribak, J

1995-01-01

The importance of health responsibility as one aspect of a health-promoting lifestyle has been emphasized repeatedly. Yet there are only a few empirical studies of its role in preventive behavior. We examined the relationship between health responsibility and early-detection practices for breast and cervical cancer. A group of 253 women employees of a large industrial company participated in a cancer screening program subsidized by the employer. They completed questionnaires assessing health responsibility and reported early-detection practices: frequency of breast self-examination and physician breast examinations, frequency of Pap tests, and time lapsed since last Pap test and breast examinations. Health responsibility was a significant independent predictor of breast examination indicators but not of Pap tests. Education level was an important predictor for Pap tests, and age predicted most early-detection practices. The findings lend some support to the role of health responsibility in initiating breast examinations. Better prediction of early-detection practices could be achieved by adding cognitive and emotional components to the existing responsibility scale and by distinguishing between retrospective and prospective responsibility.

Relationship between body image and breast self-examination intentions and behavior among female university students in Malaysia.

PubMed

Samah, Asnarulkhadi Abu; Ahmadian, Maryam

2014-01-01

This study aimed to examine the relationship between body image satisfaction and breast self-screening behavior and intentions. The sample for this cross-sectional study consisted of 842 female university students who were recruited from a number of public and private universities. Data were obtained between the months of November and December, 2013, using multistage random cluster sampling. Main research variables were breast cancer screening behavior and intentions, demographic factors, and the total scores on each of the Multidimensional Body-Self Relations Questionnaire (MBSRQ-Appearance Scales) subscales. Results of multivariate analysis showed that having higher satisfaction and more positive evaluation of appearance were related to having performed breast self-examination more frequently in the last year and intending to perform breast self-examination more frequently in the next year. Longitudinal research can potentially provide detailed information about overall body image satisfaction and breast cancer screening behavior among various communities.

Effects of education based on the health belief model on screening behavior in high risk women for breast cancer, Tehran, Iran.

PubMed

Hajian, Sepideh; Vakilian, Katayon; Najabadi, Khadijeh Mirzaii; Hosseini, Jalil; Mirzaei, Hamid Reza

2011-01-01

Breast cancer is the most common malignancy in women. Early diagnosis allows efficient treatment and increases survival, but the efficacy of breast self examination (BSE) is not sufficiently well established. The American Cancer Society aims to give women the opportunity to recognize the utility, limitations and adverse effects of breast cancer screening through education models based on psychological theories. With the Health Belief Model, people's health perceptions and attitudes influence their practices, for example with screening. The purpose of this randomized controlled clinical trial was to determine the effect of education based on this model on breast cancer screening in high risk Iranian women. Participants were women with a family history of breast cancer (mother, sister, and daughter). After explanation of the study objectives to participants, they were recruited on obtaining oral consent and each filled out the study questionnaire based on the Health Belief Model. Allocation was into two groups by computerized randomization, control and intervention, receiving education on breast cancer screening. Perceived susceptibility to and seriousness of breast cancer, perceived usefulness of and barriers to BSE, clinical breast examination, and mammography, and self-efficacy in the ability to perform these, were assessed, with comparison of scores for BSE practice before and after education and doing mammography and clinical examination by a physician in intervention and control group. The mean age was 37.8 ± 11.7 (range 19-60). The mean rank in the intervention group significantly differed before and after the education, but except for " perceived threat" and "perceived usefulness of breast self examination", we did not find any significant differences from the control group. After educational sessions, breast self examination and clinical examination practice rates were elevated. Health education based on well known psychological theories for breast cancer screening should be extended to the entire populations in developing countries. In addition, we should pay attention to barriers to women undergoing mammography, such as costs, shame and accessibility, and increase the target population awareness and positive attitudes towards benefits of early breast cancer screening.

A therapeutic and diagnostic dilemma: granular cell tumor of the breast.

PubMed

Pergel, Ahmet; Yucel, Ahmet Fikret; Karaca, A Serdar; Aydin, Ibrahim; Sahin, Dursun Ali; Demirbag, Nilgun

2011-01-01

Six to eight percent of granular cell tumors are seen in the breast. Although mostly benign, they rarely have malignant features clinically and radiologically reminding of breast cancer. This may lead to a potential misdiagnosis of breast carcinoma and overtreatment of patients. The final diagnosis is made by immunohistochemical examination. We performed excisional biopsy on a patient who was diagnosed to have a breast mass. The histopathological examination of the mass revealed granular cell tumor.

Breast Self-Examination Beliefs and Practices, Ethnicity, and Health Literacy: Implications for Health Education to Reduce Disparities

ERIC Educational Resources Information Center

Armin, Julie; Torres, Cristina Huebner; Vivian, James; Vergara, Cunegundo; Shaw, Susan J.

2014-01-01

Objective: This study aimed to quantitatively and qualitatively examine breast cancer screening practices, including breast self-examination (BSE), and health literacy among patients with chronic disease. Design: A prospective, multi-method study conducted with a targeted purposive sample of 297 patients with diabetes and/or hypertension from four…

Impact of a health education intervention program regarding breast self examination by women in a semi-urban area of Madhya Pradesh, India.

PubMed

Gupta, Sanjeev K

2009-01-01

Breast cancer is the most common carcinoma in the world and the second most prevalent in Indian females. Over 0.7 million new cases of carcinoma breast are detected every year globally, with nearly 0.3 million deaths, affecting 28 per 100,000 females in the age group of 35 to 60 years. Breast self examination (BSE) can detect 40% of breast lesions. The present study aimed to assess the impact of a health education intervention program about breast self examination (BSE) among women in a semi-urban area in Madhya Pradesh, India. The study was carried out in three phases; pre-intervention phase, intervention phase, and post-intervention phase. A total of 1000 women were included. Interventional health education in the form of a lecture, pamphlets, flip charts and demonstration of the five step method of breast self examination using audio-visual aids was administrated. There was a significant improvement in knowledge regarding all aspects of breast self examination of the intervention group from pre- to post-test. After the intervention program, 590 (59%) women had good knowledge and among them 90.7% practiced (BSE) compared to 0% pre-test. An overall increase in the awareness of 43% and 53% of BSE practice was observed in the study group after intervention. Seven cases of breast disease were detected in which two were breast carcinoma and five were fibroadenomas. The knowledge and practices of women toward breast self examination for early detection were observed to be inadequate in respondents but there was a significant improvement after the intervention. Health education programs through various channels to increase the awareness and knowledge about BSE are the need of the hour. Mass media cancer education should promote widespread access to information about early detection behavior.

Nodular Fasciitis of the Breast Previously Misdiagnosed as Breast Carcinoma

PubMed Central

Ozben, Volkan; Aydogan, Fatih; Karaca, Fatih Can; Ilvan, Sennur; Uras, Cihan

2009-01-01

Summary Background Nodular fasciitis of the breast is a rare benign pathology that can mimic breast cancer clinically, radiologically, and histopathologically. Case Report An 18-year-old female patient had first visited a physician in a different center with the complaint of a lump in her left breast. Breast examination had revealed a palpable mass located in the left upper outer quadrant. Ultrasonography had demonstrated a hypoechoic lesion. Excisional biopsy of the lump had been performed and histopathologic examination misdiagnosed this lump as a mesenchymal tumor. The patient was then referred to our clinic for further investigations. Pathologic revision was performed and the diagnosis of nodular fasciitis of the breast was established. Conclusion Awareness of this rare clinical entity, nodular fasciitis, in the breast eliminates the misdiagnosis of breast cancer. PMID:20877676

Reactions of Methamidophos with Mammalian Cholinesterase,

DTIC Science & Technology

1978-07-01

dynamics of its reactions with insmvnstlian cholinesterase (CbE), Methamidophos is highly toxic to the cosmon housefly , Muaca domestics L., exhibiting a...between two properties which tend to oppose each other. It does not react rapidly with housefly —head ChE. However , the enzyme—inhibitor complex...toxicity of methamidophos to female houseflies was reported (Quistad et al., 1970) to be approximately the same as that of other potent

What Makes Teacher Teams in a Vocational Education Context Effective?: A Qualitative Study of Managers' View on Team Working

ERIC Educational Resources Information Center

Truijen, K. J. P.; Sleegers, P. J. C.; Meelissen, M. R. M.; Nieuwenhuis, A. F. M.

2013-01-01

Purpose: At a time when secondary vocational education is implementing competence-based education (CBE) on a large scale, to adapt to the needs of students and of the labour market in a modern society, many vocational schools have recognised that interdisciplinary teacher teams are an important condition for this implementation. In order to…

The Landscape of Competency-Based Education: Enrollments, Demographics, and Affordability. AEI Series on Competency-Based Higher Education

ERIC Educational Resources Information Center

Kelchen, Robert

2015-01-01

Competency-based education (CBE), broadly defined as a form of higher education in which credit is provided on the basis of student learning rather than credit or clock hours, has begun to catch the attention of federal and state policymakers, foundations, and colleges. Among the model's promising features are its potential to lower college costs…

A sensitive and reproducible fluorescent-based HPLC assay to measure the activity of acid as well as neutral beta-glucocerebrosidases.

PubMed

Hayashi, Yasuhiro; Zama, Kouta; Abe, Eriko; Okino, Nozomu; Inoue, Takehiko; Ohno, Kousaku; Ito, Makoto

2008-12-01

The activity of lysosomal acid beta-glucocerebrosidase (AGC, EC 3.2.1.45), which hydrolyzes the O-glycosidic linkage between D-glucose and ceramide of glucosylceramide (GlcCer), is a marker for the diagnosis of Gaucher disease because the disease is caused by dysfunction of AGC due to mutations in the gene. The activity of AGC is potently inhibited by conduritol B epoxide (CBE), whereas CBE-insensitive nonlysosomal neutral beta-glucocerebrosidase (NGC) activities have been found in various vertebrates, including humans. We report here a new reliable method to determine AGC as well as NGC activities using normal-phase high-performance liquid chromatography (HPLC) and NBD (4-nitrobenzo-2-oxa-1,3-diazole)- or BODIPY (4,4-difluoro-4-boro-3a,4a-diaza-s-indacene)-labeled GlcCer as a substrate. The reaction products of the enzymes, C6-NBD-ceramide and C12-BODIPY-ceramide, were clearly separated from the corresponding substrates on a normal-phase column within 5 min using a different solvent system. Reaction products could be detected quantitatively at concentrations ranging from 50 fmol to 50 pmol for C6-NBD-ceramide and from 10 fmol to 5 pmol for C12-BODIPY-ceramide. V(max)/K(m) values of human fibroblast AGC for fluorescent GlcCer were much higher than those for 4-methylumbelliferyl-beta-d-glucoside (4MU-Glc), which is used prevalently for Gaucher disease diagnosis. As a result, AGC activity was detected quantitatively using fluorescent GlcCer, but not 4MU-Glc, using 5 microl of human serum or 1 x 10(4) cultured human fibroblasts. The current method clearly showed the decrease of AGC activities in fibroblasts and serum from the patient with Gaucher disease compared with normal individuals, suggesting that the method is applicable for the diagnosis of Gaucher disease. Furthermore, this method was found to be useful for measuring the activities of nonlysosomal NGC of various cells and tissues in the presence of CBE.

Esterases activity in the axolotl Ambystoma mexicanum exposed to chlorpyrifos and its implication to motor activity.

PubMed

Robles-Mendoza, Cecilia; Zúñiga-Lagunes, Sebastian R; Ponce de León-Hill, Claudia A; Hernández-Soto, Jesús; Vanegas-Pérez, Cecilia

2011-10-01

The axolotl Ambystoma mexicanum is a neotenic salamander considered a good biological model due to its ability to regenerate limbs, tail, brain and heart cells. Nevertheless, severe reduction of A. mexicanum wild populations in the lacustrine area of Xochimilco, the natural habitat of the axolotl, could be related to several environmental pressures as the presence of organophosphate pesticides (OPPs), intensively applied in agricultural activities in Xochimilco. Thus the aim of this study was to evaluate the effect of environmentally realistic chlorpyrifos (CPF) concentrations, a OPP commonly used in this zone, on esterases activity (acetylcholinesterase and carboxylesterase) and bioconcentration of CPF and to relate them with the motor activity of A. mexicanum juveniles. Axolotls were exposed 48 h to 0.05 and 0.1mg CPF/L, and the responses were evaluated at the end of the CPF exposure. Results suggest that CPF is bioconcentrated into axolotls and that the CPF internal concentrations are related with the observed inhibition activity of AChE (>50%) and CbE (≈ 50%). CPF concentration responsible of the inhibition of the 50% of AChE activity (IC50) was estimated in 0.04 mg CPF/L; however IC50 for CbE activity was not possible to calculate since inhibition levels were lower than 50%, results that suggest a higher resistance of CbE enzymatic activity to CPF. However, motor activity was a more sensitive endpoint to CPF poisoning since time that axolotls spent active and walking, frequency and speed of swimming, frequency of prey attack were reduced >90% of control groups. The motor activity alterations in the axolotl could be related with the registered esterases inhibition. Thus important alterations on axolotls were identified even at short time and low concentrations of CPF exposure. Also, it was possible to link biochemical responses as esterases activity with higher levels of biological organization as behavior. This study provides tools for the regulation of the use of organophosphorus pesticides in the natural habitat of the axolotl. Copyright © 2011 Elsevier B.V. All rights reserved.

A Comparison of Breast Milk and Sucrose in Reducing Neonatal Pain During Eye Exam for Retinopathy of Prematurity.

PubMed

Şener Taplak, Ayşe; Erdem, Emine

2017-06-01

This double-blind randomized controlled experimental study aimed to determine the effects of breast milk and sucrose in reducing pain in preterm infants during retinopathy of prematurity (ROP) examination. This study was conducted with 60 preterm infants (breast milk group = 20, sucrose group = 20, and control/distilled water group = 20) meeting the inclusion criteria. The data were collected with the use of an Infant Evaluation Form, Procedure Monitoring Form, and Premature Infant Pain Profile (PIPP). The preterm infants were provided with 1 mL of breast milk, sucrose, and distilled water before the ROP examination. The pain level in preterm infants was measured by the PIPP 5 minutes before, during, and 5 minutes after the ROP examination. The ROP examinations were video recorded, and videos were evaluated by three observers blinded to the study. No significant difference was determined between the three groups in terms of their postconceptional and postnatal ages, their body weights at birth and during the ROP examination. The PIPP scores of the preterm infants in the three groups were higher during the ROP examination and were not significantly different. The PIPP scores of the control group were significantly higher than those in the breast milk and sucrose groups after the ROP examination (p < 0.001). The preterm infants in the breast milk group recovered and returned to their initial values more quickly after the ROP examination than the infants in the sucrose group. To reduce pain in preterm infants during ROP examination, breast milk is recommended.

Knowledge of Female Undergraduate Students on Breast Cancer and Breast Self-examination in Klang Valley, Malaysia.

PubMed

Akhtari-Zavare, Mehrnoosh; Latiff, Latiffah A; Juni, Muhamad Hanafiah; Said, Salmiah Md; Ismail, Irmi Zarina

2015-01-01

In Malaysia, breast cancer is the first cancer among females regardness of race. The purpose of this study was to identify the knowledge and BSE practice among undergraduate female students at four public universities in Klang Valley, Malaysia. This cross-sectional study was conducted among 820 undergraduate female students using a self-administered questionnaire covering socio-demographic data, knowledge of breast cancer and BSE practice. The mean age of the respondents was 21.7±1.2 years. The majority of them were single (96.8%), Malay (91.9%) and 16.5% of respondents had a family history of breast cancer. This study showed low level of knowledge on breast cancer and breast self-examination among participants. Only 19.6% participants were performing BSE regularly. Knowledge of breast self-examination was significantly associated with BSE practice (p=0.00). Also, there were significant associations between performing BSE with age, marital status and being trained by a doctor for doing BSE (p<0.05). Our findings showed that the rate of BSE practice and knowledge of breast cancer is inadequate among young Malaysian females. A public health education program is essential to improve breast cancer prevention among this group.

A Therapeutic and Diagnostic Dilemma: Granular Cell Tumor of the Breast

PubMed Central

Pergel, Ahmet; Yucel, Ahmet Fikret; Karaca, A. Serdar; Aydin, Ibrahim; Sahin, Dursun Ali; Demirbag, Nilgun

2011-01-01

Six to eight percent of granular cell tumors are seen in the breast. Although mostly benign, they rarely have malignant features clinically and radiologically reminding of breast cancer. This may lead to a potential misdiagnosis of breast carcinoma and overtreatment of patients. The final diagnosis is made by immunohistochemical examination. We performed excisional biopsy on a patient who was diagnosed to have a breast mass. The histopathological examination of the mass revealed granular cell tumor. PMID:21547223

Are breast density and bone mineral density independent risk factors for breast cancer?

PubMed

Kerlikowske, Karla; Shepherd, John; Creasman, Jennifer; Tice, Jeffrey A; Ziv, Elad; Cummings, Steve R

2005-03-02

Mammographic breast density and bone mineral density (BMD) are markers of cumulative exposure to estrogen. Previous studies have suggested that women with high mammographic breast density or high BMD are at increased risk of breast cancer. We determined whether mammographic breast density and BMD of the hip and spine are correlated and independently associated with breast cancer risk. We conducted a cross-sectional study (N = 15,254) and a nested case-control study (of 208 women with breast cancer and 436 control subjects) among women aged 28 years or older who had a screening mammography examination and hip BMD measurement within 2 years. Breast density for 3105 of the women was classified using the American College of Radiology Breast Imaging Reporting and Data System (BI-RADS) categories, and percentage mammographic breast density among the case patients and control subjects was quantified with a computer-based threshold method. Spearman rank partial correlation coefficient and Pearson's correlation coefficient were used to examine correlations between BI-RADS breast density and BMD and between percentage mammographic breast density and BMD, respectively, in women without breast cancer. Logistic regression was used to examine the association of breast cancer with percentage mammographic breast density and BMD. All statistical tests were two-sided. Neither BI-RADS breast density nor percentage breast density was correlated with hip or spine BMD (correlation coefficient = -.02 and -.01 for BI-RADS, respectively, and -.06 and .01 for percentage breast density, respectively). Neither hip BMD nor spine BMD had a statistically significant relationship with breast cancer risk. Women with breast density in the highest sextile had an approximately threefold increased risk of breast cancer compared with women in the lowest sextile (odds ratio = 2.7, 95% confidence interval = 1.4 to 5.4); adjusting for hip or spine BMD did not change the association between breast density and breast cancer risk. Breast density is strongly associated with increased risk of breast cancer, even after taking into account reproductive and hormonal risk factors, whereas BMD, although a possible marker of lifetime exposure to estrogen, is not. Thus, a component of breast density that is independent of estrogen-mediated effects may contribute to breast cancer risk.

Risk of Breast Cancer among Young Women and Importance of Early Screening.

PubMed

Memon, Zahid Ali; Kanwal, Noureen; Sami, Munam; Larik, Parsa Azam; Farooq, Mohammad Zain

2015-01-01

Breast cancer is the most common type of cancer in women throughout the world. However, in comparison with Western women, it presents relatively early in women of Asian ethnicity. Early menarche, late menopause, use of OCP's, family history of benign or malignant breast disease, exposure to radiation and BMI in the under-weight range are well known risk factors for the development of breast cancer in premenopausal women. Early detection with the use of breast self-examination (BSE) and breast cancer screening programs can lead to a reduction in the mortality rates due to breast cancer. The aim of our study was to assess the risk factors for breast cancer among young women and to emphasize the importance of early screening among them. We conducted a cross-sectional study among women aged 18 to 25 using a self- administered questionnaire. Data was collected over a period of 6 months from June to December, 2014. A total of 300 young women selected randomly from Dow Medical College and various departments of Karachi University successfully completed the survey. Respondents were 18-25 years of age (mean age=21.5). Out of the 300 young females, 90 (30%) had at least one risk factor, 90 (30%) had two, 40 (13%) had three, 8 (2.7%) had four, 2 (0.7%) had five while one female was found to have six positive risk factors for breast cancer. Some 66 women (22%) experienced symptoms of breast cancer such as non-cyclical pain and lumps. While 222 women (74%) had never performed breast self-examination, 22 (7.3%) had had a breast examination done by a health professional while 32 (10.7%) had participated in breast screening programs. A total of 223 (74.3%) women considered breast cancer screening important for young women. The percentage of young women with risk factors for breast cancer was found to be alarmingly high. Therefore, screening for breast cancer should start at an early age especially in high risk groups. Awareness about breast self-examination should be emphasized. Moreover, screening programs should be started to ensure early detection and reduction of mortality rates caused by breast cancer also in young Pakistani females.

Effects of an Educational Intervention on Breast Self-Examination, Breast Cancer Prevention-Related Knowledge, and Healthy Lifestyles in Scholars from a Low-Income Area in Bogota, Colombia.

PubMed

Masso-Calderón, A M; Meneses-Echávez, J F; Correa-Bautista, J E; Tovar-Cifuentes, A; Alba-Ramírez, P A; Charry-Ángel, C E

2018-06-01

The aim of this study was to evaluate the effects of an educational intervention on breast self-examination, cancer prevention-related knowledge, practices, and behavior change in scholars from a low-income area in Bogota, Colombia. Uncontrolled trial was conducted in 155 scholars. Two educational sessions, 90 min each, were carried out in March 2015 according to the Colombian guidelines for educational communication in the framework of cancer control. All participants completed a self-reported questionnaire at pre- and post-intervention, as well as 1, 3, and 6 months after the intervention. Breast self-examination was practiced by 78.1% of the scholars, and the overall knowledge of breast cancer risk factors was poor. The educational intervention resulted in significant improvements on breast self-examination practice, the knowledge of the technique, and the knowledge of the main risk factors for breast cancer as well as the practice of physical activity and vegetable intake at 6 months follow-up. An educational intervention according to the Colombian guidelines for educational communication in the framework of cancer control improved the practice of breast self-examination, cancer prevention-related knowledge, as well as the practice of physical activity and vegetable consumption in scholars from a low-income area in Bogota, Colombia. Further randomized controlled studies are warranted.

Imaging-Assisted Large-Format Breast Pathology: Program Rationale and Development in a Nonprofit Health System in the United States

PubMed Central

Tucker, F. Lee

2012-01-01

Modern breast imaging, including magnetic resonance imaging, provides an increasingly clear depiction of breast cancer extent, often with suboptimal pathologic confirmation. Pathologic findings guide management decisions, and small increments in reported tumor characteristics may rationalize significant changes in therapy and staging. Pathologic techniques to grossly examine resected breast tissue have changed little during this era of improved breast imaging and still rely primarily on the techniques of gross inspection and specimen palpation. Only limited imaging information is typically conveyed to pathologists, typically in the form of wire-localization images from breast-conserving procedures. Conventional techniques of specimen dissection and section submission destroy the three-dimensional integrity of the breast anatomy and tumor distribution. These traditional methods of breast specimen examination impose unnecessary limitations on correlation with imaging studies, measurement of cancer extent, multifocality, and margin distance. Improvements in pathologic diagnosis, reporting, and correlation of breast cancer characteristics can be achieved by integrating breast imagers into the specimen examination process and the use of large-format sections which preserve local anatomy. This paper describes the successful creation of a large-format pathology program to routinely serve all patients in a busy interdisciplinary breast center associated with a community-based nonprofit health system in the United States. PMID:23316372

Breast Cancer Translational Research Center of Excellence

DTIC Science & Technology

2017-11-01

treating breast diseases and breast cancer. This multidisciplinary model integrates prevention, screening, diagnosis, treatment and continuing care...breast diseases and breast cancer. This approach integrates prevention, screening, diagnosis, treatment and continuing care, incorporation of...mammography and clinical breast examination have a very poor accuracy in the young active duty force in determining which breast abnormalities

Simulation training for breast and pelvic physical examination: a systematic review and meta-analysis.

PubMed

Dilaveri, C A; Szostek, J H; Wang, A T; Cook, D A

2013-09-01

Breast and pelvic examinations are challenging intimate examinations. Technology-based simulation may help to overcome these challenges. To synthesise the evidence regarding the effectiveness of technology-based simulation training for breast and pelvic examination. Our systematic search included MEDLINE, EMBASE, CINAHL, PsychINFO, Scopus, and key journals and review articles; the date of the last search was January 2012. Original research studies evaluating technology-enhanced simulation of breast and pelvic examination to teach learners, compared with no intervention or with other educational activities. The reviewers evaluated study eligibility and abstracted data on methodological quality, learners, instructional design, and outcomes, and used random-effects models to pool weighted effect sizes. In total, 11 272 articles were identified for screening, and 22 studies were eligible, enrolling 2036 trainees. In eight studies comparing simulation for breast examination training with no intervention, simulation was associated with a significant improvement in skill, with a pooled effect size of 0.86 (95% CI 0.52-1.19; P < 0.001). Four studies comparing simulation training for pelvic examination with no intervention had a large and significant benefit, with a pooled effect size of 1.18 (95% CI 0.40-1.96; P = 0.003). Among breast examination simulation studies, dynamic models providing feedback were associated with improved outcomes. In pelvic examination simulation studies, the addition of a standardised patient to the simulation model and the use of an electronic model with enhanced feedback improved outcomes. In comparison with no intervention, breast and pelvic examination simulation training is associated with moderate to large effects for skills outcomes. Enhanced feedback appears to improve learning. © 2013 RCOG.

An equity analysis of health examination service utilization by women from underdeveloped areas in western China

PubMed Central

Gao, Jianmin; Zhou, Zhongliang; Yan, Ju’e; Xu, Yongjian; Yang, Xiaowei; Li, Yanli

2017-01-01

Objective This study sought to examine the sources of inequity in health examination service utilization by women from underdeveloped areas in western China. Methods Based on data from the 5th National Health Service Survey in Shaanxi province, women’s utilization of health examination services was examined according to gynecological, cervical smear, and breast examination rates. The equity of health examination service utilization by 15- to 64-year-old women and the factors contributing to inequity were determined using the health concentration index, decomposition of the concentration index, and the horizontal inequity index. Results The examination rates for gynecological, cervical smear, and breast exams for 15- to 64-year-old women in Shaanxi province were 40.61%, 27.08%, and 24.59%, respectively. The horizontal inequity indices of gynecological, cervical smear, and breast examination rates were 0.0480, 0.0423, and 0.0764, respectively, and each examination rate was higher for wealthy individuals. The contribution rates of economic status to the inequalities in gynecological, cervical smear, and breast examination rates were 65.80%, 74.31%, and 56.49%, respectively. The contribution rates of educational status to the inequalities in gynecological, cervical smear, and breast examination rates were 21.01%, 14.83% and 30.00%, respectively. The contribution rates of age to the inequalities in gynecological, cervical smear, and breast examination rates were 25.77%, 26.55%, and 18.40%, respectively. Conclusions Women’s health examination rates differed between populations with different socio-demographic characteristics. There is pro-wealth inequality in each examination rate. This study found that financial status, age, and education level were the main reasons for the unequal utilization of health examination services. PMID:29065129

A case of synchronous metastasis of breast cancer to stomach and colon.

PubMed

Takeuchi, Hideya; Hiroshige, Shozi; Yoshikawa, Yasuji; Kusumoto, Tetusya; Muto, Yoichi

2012-09-01

A case of synchronous metastasis of breast cancer to the stomach and colon is reported. A 38-year-old woman with a history of bilateral breast cancer was admitted for endoscopic examination because of occult blood. Endoscopic examination showed elevated lesions on the mucosal surface of the stomach and cecum. Histopathological examination of the biopsy specimens obtained from both sites showed adenocarcinoma, comprised of tumor cells with structural and nuclear atypia, which were similar to those of the primary breast cancer cells. In immunohistochemical analysis, these tumor cells stained positive for ER. Therefore, we diagnosed a synchronous metastasis of breast cancer to the stomach and colon. Synchronous metastasis of breast cancer to the stomach and colon without liver metastasis or peritoneal dissemination is extremely rare, with only 4 reported cases existing in literature.

Breast cancers not detected at MRI: review of false-negative lesions.

PubMed

Shimauchi, Akiko; Jansen, Sanaz A; Abe, Hiroyuki; Jaskowiak, Nora; Schmidt, Robert A; Newstead, Gillian M

2010-06-01

The objective of our study was to determine the sensitivity of cancer detection at breast MRI using current imaging techniques and to evaluate the characteristics of lesions with false-negative examinations. Two hundred seventeen patients with 222 newly diagnosed breast cancers or highly suspicious breast lesions that were subsequently shown to be malignant underwent breast MRI examinations for staging. Two breast imaging radiologists performed a consensus review of the breast MRI examinations. The absence of perceptible contrast enhancement at the expected site was considered to be a false-negative MRI. Histology of all lesions was reviewed by an experienced breast pathologist. Enhancement was observed in 213 (95.9%) of the 222 cancer lesions. Of the nine lesions without visible enhancement, two lesions were excluded because the entire tumor had been excised at percutaneous biopsy performed before the MRI examination and no residual tumor was noted on the final histology. The overall sensitivity of MRI for the known cancers was 96.8% (213/220); for invasive cancer, 98.3% (176/179); and for ductal carcinoma in situ, 90.2% (37/41). In a population of 220 sequentially diagnosed breast cancer lesions, we found seven (3.2%) MRI-occult cancers, fewer than seen in other published studies. Small tumor size and diffuse parenchymal enhancement were the principal reasons for these false-negative results. Although the overall sensitivity of cancer detection was high (96.8%), it should be emphasized that a negative MRI should not influence the management of a lesion that appears to be of concern on physical examination or on other imaging techniques.

Improve Knowledge, Beliefs and Behavior of Undergraduate Female Nursing Students in Al-Alzhar University toward Breast Self-Examination Practice

ERIC Educational Resources Information Center

El-Mohsen, Afaf S. Abd; El-Maksoud, Mona M. Abd

2015-01-01

Breast cancer is a public health problem that is most common form of cancer among females in both developed and developing world, The Health Belief Model (HBM) has been used as a theoretical framework to study Breast Self-Examination and other breast cancer detection behaviors. The aim of this study: Was to improve knowledge, beliefs and behavior…

Body Esteem and Self–examination in British Men and Women

PubMed Central

Brewer, Gayle; Dewhurst, Anne M.

2013-01-01

Background: Breast and testicular cancers affect a substantial and increasing proportion of the global population. Self-examination encourages early detection and treatment of these cancers, which positively impacts on patient quality of life and survival. Methods: The present study investigated the role of body esteem in breast and testicular self-examination. Men (N = 60) and women (N = 90) recruited from a British University completed the body esteem scale and either the testicular self-examination or breast self-examination questionnaire. Results: Logistic regression models revealed that body esteem predicted women's intention to engage in breast self-examination. Women with higher levels of sexual attractiveness and those with lower levels of weight concern were more likely to report that they would regularly self-examine in the future. Body esteem did not however, distinguish between those women that did or did not currently self-examine or predict men's current or intended testicular self-examination. Conclusion: The findings have implications for the promotion of self-examination and highlight an emerging area of preventive health research. PMID:23930186

Knowledge, attitude and practices amongst the Pakistani females towards breast cancer screening programme.

PubMed

Sarwar, Muhammad Zeeshan; Hassan Shah, Syed Farazul; Yousaf, Muhammad Rehan; Ahmad, Qamar Ashfaq; Khan, Sadaqat Ali

2015-10-01

To assess the knowledge, attitude and practices amongst Pakistani females towards breast screening programmes. The descriptive cross-sectional study was conducted from June 2013 to July2014 at Mayo Hospital, Lahore, and comprised attendants and patients who visited out-patients department and/or were treated as in-patients. The questionnaire contained 25 open and close-ended questions regarding knowledge and attitude, along with 7 questions regarding practices. Data was analysed using SPSS 17. There were 1184 women with a mean age of 32.7±8.6 years. The mean score was 12.7±4.9. Positive family history of breast cancer was reported by 156(13.2%) women; 420(35.5%) believed advancing age was a risk factor; 1041(87.9%) never had breast self-examination; 1106(93.4%) never had a clinical breast examination; and 1171(98.9%) never had screening mammogram. The knowledge and practices regarding breast cancer screening, breast self-examination and mammogram among women were not good. The knowledge about breast cancer risk factors was very poor and showed an alarming attitude towards practices.

Sociocultural factors and breast cancer in sub-Saharan Africa: implications for diagnosis and management.

PubMed

Tetteh, Dinah A; Faulkner, Sandra L

2016-01-01

The incidence of breast cancer is on the rise in sub-Saharan Africa (SSA) and efforts at early diagnosis have not been very successful because the public has scant knowledge about the disease, a large percentage of breast cancer cases are diagnosed late and mainly rural SSA women's practice of breast self-examination is poor. In this paper, we argue that an examination of the social and cultural contexts of SSA that influence breast cancer diagnosis and management in the region is needed. We discuss the implications of sociocultural factors, such as gender roles and spirituality, on breast cancer diagnosis and management in SSA.

A Framework for Strategic Planning and Change in Higher Education: The Case of a Business School. AIR 1993 Annual Forum Paper.

ERIC Educational Resources Information Center

Baker, Douglas D.; Markin, Rom J.

At Washington State University's College of Business and Economics (CBE) a strategic planning program was introduced using a focus on the student as the product and the potential employers as the customers of the product. Using this approach the focus of planning is redirected with future employers the most heavily weighted source of feedback on…

What Should Count as Worthwhile Knowledge in Determining a Curriculum for Supporting Out-of-school Children and Youth?

ERIC Educational Resources Information Center

Nampota, Dorothy Cynthia

2009-01-01

Due to the increasing number of children and youth dropping out of school, the Malawi government came up with a strategy to address their learning needs through non-formal means in its Education for All (EFA) plan. This resulted in the introduction of a three-year cycle pilot programme known as Complementary Basic Education (CBE). Funded by GTZ, a…

Texas Affordable Baccalaureate Program: A Collaboration between the Texas Higher Education Coordinating Board, South Texas College, and Texas A&M University-Commerce. CBE Case Study

ERIC Educational Resources Information Center

Klein-Collins, Rebecca; Glancey, Kathleen

2015-01-01

This case study is part of a series on newer competency-based degree programs that have been emerging in recent years. In January 2014, the Texas Higher Education Coordinating Board (THECB), South Texas College (STC), and Texas A&M University-Commerce (A&M Commerce) launched the Texas Affordable Baccalaureate Program, the state's first…

Epidemiology and diagnostic testing for meningitis in adults as the meningococcal epidemic declined at Middlemore Hospital.

PubMed

McBride, Stephen; Fulke, Jennifer; Giles, Hannah; Hobbs, Mark; Suh, Jun; Sathyendran, Vani; Thompson, Emily; Taylor, Susan; Holland, David

2015-03-13

To describe changes in epidemiology and diagnostic techniques for adult meningitis at Middlemore Hospital following the decline of the meningococcal epidemic. Retrospective audit of cases of meningitis from 2000 to 2009. Microbiologically-confirmed diagnosis (MCD) was established in 296 of 743 episodes (40%), most commonly enterovirus (123/296, 42%), Neisseria meningitidis (43/296, 15%) and Streptococcus pneumoniae (34/296, 11%). N. meningitidis meningitis declined and herpes viruses increased over time, without significant change in overall meningitis case numbers. By 2009, S. pneumoniae constituted a greater proportion of cases than N. meningitidis. Cerebrospinal fluid (CSF) polymerase chain reaction (PCR) and pneumococcal immunochromatographic testing (PICT) increased over time as did the proportion of cases with MCD. CSF Gram stain was positive in 45% (53/118) and CSF culture made MCD in 37% (44/118) of confirmed bacterial episodes (CBE). PCR provided MCD in 59% (26/54) of CBE and 99% (168/170) of viral episodes. CSF PICT was tested in 76% (26/34) of S. pneumoniae meningitis (positive in 92% (24/26). As the epidemic waned, local incidence of meningococcal meningitis decreased without significant decreasing meningitis overall. Empiric treatment for meningitis in New Zealand adults should routinely include pneumococcal cover. Increased PCR testing increases MCD in meningitis.

Impact of insecticide exposure on the predation activity of the European earwig Forficula auricularia.

PubMed

Malagnoux, Laure; Capowiez, Yvan; Rault, Magali

2015-09-01

The European earwig Forficula auricularia is an effective predator in apple orchards. It is therefore crucial to study whether insecticides affect this natural pest control agent. Predation activity, i.e., the number of aphids eaten in 24 h, was determined under laboratory conditions after exposure of fourth-instar nymphs and adult earwigs to widely used insecticides (acetamiprid, chlorpyrifos-ethyl, deltamethrin, and spinosad), which were applied at the normal application rates. Inhibition of acetylcholinesterase and carboxylesterase activities were also measured as indicators of pesticide exposure. Predation activity decreased significantly in nymphs exposed to spinosad (62%) and chlorpyrifos-ethyl (98%) compared with controls. A similar response was found for both esterase activities. Spinosad had a stronger effect on AChE (-33%) whereas chlorpyrifos-ethyl affected CbE activity preferentially (-59%). Spinosad (20% of controls), acetamiprid (28%), and chlorpyrifos-ethyl (66%) also significantly decreased the predation behavior of adult male but not female (5 to 40%) earwigs. Adult AChE and CbE activities were also significantly reduced (28 to 67% of controls) in pesticide-exposed earwigs. Our results suggest that earwigs should be included in the environmental risk assessment framework for authorization of newly marketed plant protection products. Their predation behavior appears to be a sensitive and complementary biomarker.

Tunable Magneto-electric Subbands in Oxide Electron Waveguides

NASA Astrophysics Data System (ADS)

Cheng, Guanglei; Annadi, Anil; Lu, Shicheng; Lee, Hyungwoo; Lee, Jungwoo; Eom, Chang-Beom; Huang, Mengchen; Irvin, Patrick; Levy, Jeremy

Strontium titanate-based complex-oxide interfaces hold great promise for exploring new correlated electron physics and applications in quantum technologies. Previous reports show electron mobility can be greatly enhanced in 1D, while the 2D interface can contain 1D channels due to the presence of ferroelastic domains. In addition, carrier density measurements at the 2D interface by Shubnikov-de Haas (SdH) oscillations and Hall effect reveal a large discrepancy. Here we fabricate quasi-1D electron waveguides at the LaAlO3/SrTiO3 (LAO/STO) interface to locally probe the interface. The conductance of the waveguides is fully quantized, and the corresponding magneto-electric subbands can be depopulated by increasing the magnetic field. The 2D carrier densities (1012 cm-2) extracted from magnetic depopulation are consistent with measurements by SdH oscillations at the 2D interface. Our results show that magneto-electric subbands of quasi-1D electron waveguides can reproduce known SdH signatures without discrepancies in electron density, and suggest that 2D SdH measurements may also arise from quasi-1D channels. We gratefully acknowledge financial support from AFOSR (FA9550-12-1- 0057 (JL) and FA9550-12-1-0342 (CBE)), ONR N00014-15-1-2847 (JL), and NSF DMR-1234096 (CBE).

Probing 1D superlattices at the LaAlO3 / SrTiO3 interface

NASA Astrophysics Data System (ADS)

Briggeman, M.; Huang, M.; Tylan-Tyler, A.; Irvin, P.; Levy, J.; Lee, J.-W.; Lee, H.; Eom, C.-B.

Complex oxides and other quantum systems exhibit behavior that is currently too complex to be understood using analytic or computational methods. One approach is to use a configurable quantum system whose Hamiltonian can be mapped onto the system of interest. This approach, known as quantum simulation, requires a rich physical system whose quanta and interactions can be controlled precisely, at the level of single electrons and other degrees of freedom. Here we describe steps toward developing a quantum simulation platform, using the complex oxide heterostructure LaAlO3 / SrTiO3 , by creating quantum systems with features comparable to the mean spacing between electrons. This interface has strong, sign changing, gate-tunable electron-electron interactions that can strongly influence the quantum ground state. We explore the magnetotransport properties of 1D superlattices, where periodic modulation produces reproducible dispersive features not seen in control structures. The results of these experiments can be compared with effective 1D model Hamiltonians to bridge experiment and theory and enable quantum simulation of more complex systems. We gratefully acknowledge financial support from AFOSR (FA9550-12-1- 0057 (JL) and FA9550-12-1-0342 (CBE)), ONR N00014-15-1-2847 (JL), and NSF DMR-1234096 (CBE).

Density Functional Theory Calculation of the Band Alignment of (101̅0) In(x)Ga(1-x)N/Water Interfaces.

PubMed

Meng, Andrew C; Cheng, Jun; Sprik, Michiel

2016-03-03

Conduction band edge (CBE) and valence band edge (VBE) positions of InxGa1-xN photoelectrodes were computed using density functional theory methods. The band edges of fully solvated GaN and InN model systems were aligned with respect to the standard hydrogen electrode using a molecular dynamics hydrogen electrode scheme applied earlier to TiO2/water interfaces. Similar to the findings for TiO2, we found that the Purdew-Burke-Ernzerhof (PBE) functional gives a VBE potential which is too negative by 1 V. This cathodic bias is largely corrected by application of the Heyd-Scuseria-Ernzerhof (HSE06) hybrid functional containing a fraction of Hartree-Fock exchange. The effect of a change of composition was investigated using simplified model systems consisting of vacuum slabs covered on both sides by one monolayer of H2O. The CBE was found to vary linearly with In content. The VBE, in comparison, is much less sensitive to composition. The data show that the band edges straddle the hydrogen and oxygen evolution potentials for In fractions less than 47%. The band gap was found to exceed 2 eV for an In fraction less than 54%.

Direct-Conversion Molecular Breast Imaging of Invasive Breast Cancer: Imaging Features, Extent of Invasive Disease, and Comparison Between Invasive Ductal and Lobular Histology.

PubMed

Conners, Amy Lynn; Jones, Katie N; Hruska, Carrie B; Geske, Jennifer R; Boughey, Judy C; Rhodes, Deborah J

2015-09-01

The purposes of this study were to compare the tumor appearance of invasive breast cancer on direct-conversion molecular breast imaging using a standardized lexicon and to determine how often direct-conversion molecular breast imaging identifies all known invasive tumor foci in the breast, and whether this differs for invasive ductal versus lobular histologic profiles. Patients with prior invasive breast cancer and concurrent direct-conversion molecular breast imaging examinations were retrospectively reviewed. Blinded review of direct-conversion molecular breast imaging examinations was performed by one of two radiologists, according to a validated lexicon. Direct-conversion molecular breast imaging findings were matched with lesions described on the pathology report to exclude benign reasons for direct-conversion molecular breast imaging findings and to document direct-conversion molecular breast imaging-occult tumor foci. Associations between direct-conversion molecular breast imaging findings and tumor histologic profiles were examined using chi-square tests. In 286 patients, 390 invasive tumor foci were present in 294 breasts. A corresponding direct-conversion molecular breast imaging finding was present for 341 of 390 (87%) tumor foci described on the pathology report. Invasive ductal carcinoma (IDC) tumor foci were more likely to be a mass (40% IDC vs 15% invasive lobular carcinoma [ILC]; p < 0.001) and to have marked intensity than were ILC foci (63% IDC vs 32% ILC; p < 0.001). Direct-conversion molecular breast imaging correctly revealed all pathology-proven foci of invasive disease in 79.8% of cases and was more likely to do so for IDC than for ILC (86.1% vs 56.7%; p < 0.0001). Overall, direct-conversion molecular breast imaging showed all known invasive foci in 249 of 286 (87%) patients. Direct-conversion molecular breast imaging features of invasive cancer, including lesion type and intensity, differ by histologic subtype. Direct-conversion molecular breast imaging is less likely to show all foci of ILC compared with IDC.

Mutually Dependent Health Beliefs Associated with Breast Self-Examination in British Female University Students

ERIC Educational Resources Information Center

Umeh, Kanayo; Jones, Leonnie

2010-01-01

Objective: Whereas research suggests young women's beliefs about breast cancer (susceptibility/severity) and its early detection (barriers/benefits) reliably distinguish breast self-examiners from nonexaminers, this study assessed whether these impressions are interreliant, especially in the context of familial risk. Participants: The sample…

Predictors of Breast Cancer Screening in Asian and Latina University Students

ERIC Educational Resources Information Center

Regan, Pamela C.; Durvasula, Ramani S.

2008-01-01

Preventative screening in the form of clinical breast examinations remains among the best protections against breast cancer. Despite the benefits that regular examinations confer, many women fail to obtain screening tests. Because ethnic minority women are particularly unlikely to undergo regular screening, and experience increased mortality and…

Differences in knowledge of breast cancer screening among African American, Arab American, and Latina women.

PubMed

Williams, Karen Patricia; Mabiso, Athur; Todem, David; Hammad, Adnan; Hill-Ashford, Yolanda; Hamade, Hiam; Palamisono, Gloria; Robinson-Lockett, Murlisa; Zambrana, Ruth E

2011-01-01

We examined differences in knowledge and socioeconomic factors associated with 3 types of breast cancer screening (breast self-examination, clinical breast examination, and mammogram) among African American, Arab, and Latina women. Community health workers used a community-based intervention to recruit 341 women (112 Arab, 113 Latina, and 116 African American) in southeastern Michigan to participate in a breast cancer prevention intervention from August through October 2006. Before and after the intervention, women responded to a previously validated 5-item multiple-choice test on breast cancer screening (possible score range: 0 to 5) in their language of preference (English, Spanish, or Arabic). We used generalized estimating equations to analyze data and to account for family-level and individual correlations. Although African American women knew more about breast cancer screening at the baseline (pretest median scores were 4 for African American, 3 for Arab and 3 for Latina women), all groups significantly increased their knowledge after participating in the breast cancer prevention intervention (posttest median scores were 5 for African American and 4 for Arab and Latina women). Generalized estimating equations models show that Arab and Latina women made the most significant gains in posttest scores (P < .001). Racial/ethnic differences in knowledge of breast cancer screening highlight the need for tailored information on breast cancer screening for African American, Arab, and Latina women to promote adherence to breast cancer screening guidelines.

Axillary metastasis as first symptom of occult breast cancer: a case report.

PubMed

Frattaroli, Fabrizio Maria; Carrara, Alessandro; Conte, Anna Maria; Pappalardo, Giuseppe

2002-01-01

Axillary lymph node metastasis from an occult breast carcinoma is a rare occurrence. We report this condition in a 59-year-old woman who presented with a swelling in the right axilla. No breast mass was clinically evident. Mammography, ultrasonography and multiple random fine-needle breast biopsies yielded no pathological findings. No extramammary primary lesions were present. Axillary sampling was performed and histological examination revealed the presence of metastatic adenocarcinoma in three of the 12 dissected lymph nodes. Estrogen receptors were positive and immunohistochemistry pointed to a breast origin. All these data were suggestive of occult breast cancer. The patient refused any further treatment but accepted clinical and radiological follow-up. Eight years later mammography revealed in the same breast a 10-mm nodule containing microcalcifications, which was not evident at physical examination. The patient underwent a lumpectomy. Intraoperative histology was positive for breast carcinoma and complete axillary clearance was performed. Histological examination revealed a lobular invasive breast carcinoma and the presence of micrometastasis in one of the 23 removed lymph nodes. The patient was given radiotherapy to the breast and axilla and tamoxifen. At present, one year after the appearance of the primary tumor, she is free of disease. Based on this case report we suggest an eclectic approach in the management of patients with axillary metastasis from occult breast cancer, depending on the clinical, pathological and biological findings.

Occult Breast Cancer: Scintimammography with High-Resolution Breast-specific Gamma Camera in Women at High Risk for Breast Cancer

DOE Office of Scientific and Technical Information (OSTI.GOV)

Rachel F. Brem; Jocelyn A. Rapelyea; , Gilat Zisman

2005-08-01

To prospectively evaluate a high-resolution breast-specific gamma camera for depicting occult breast cancer in women at high risk for breast cancer but with normal mammographic and physical examination findings. MATERIALS AND METHODS: Institutional Review Board approval and informed consent were obtained. The study was HIPAA compliant. Ninety-four high-risk women (age range, 36-78 years; mean, 55 years) with normal mammographic (Breast Imaging Reporting and Data System [BI-RADS] 1 or 2) and physical examination findings were evaluated with scintimammography. After injection with 25-30 mCi (925-1110 MBq) of technetium 99m sestamibi, patients were imaged with a high-resolution small-field-of-view breast-specific gamma camera in craniocaudalmore » and mediolateral oblique projections. Scintimammograms were prospectively classified according to focal radiotracer uptake as normal (score of 1), with no focal or diffuse uptake; benign (score of 2), with minimal patchy uptake; probably benign (score of 3), with scattered patchy uptake; probably abnormal (score of 4), with mild focal radiotracer uptake; and abnormal (score of 5), with marked focal radiotracer uptake. Mammographic breast density was categorized according to BI-RADS criteria. Patients with normal scintimammograms (scores of 1, 2, or 3) were followed up for 1 year with an annual mammogram, physical examination, and repeat scintimammography. Patients with abnormal scintimammograms (scores of 4 or 5) underwent ultrasonography (US), and those with focal hypoechoic lesions underwent biopsy. If no lesion was found during US, patients were followed up with scintimammography. Specific pathologic findings were compared with scintimammographic findings. RESULTS: Of 94 women, 78 (83%) had normal scintimammograms (score of 1, 2, or 3) at initial examination and 16 (17%) had abnormal scintimammograms (score of 4 or 5). Fourteen (88%) of the 16 patients had either benign findings at biopsy or no focal abnormality at US; in two (12%) patients, invasive carcinoma was diagnosed at US-guided biopsy (9 mm each at pathologic examination). CONCLUSION: High-resolution breast-specific scintimammography can depict small (<1-cm), mammographically occult, nonpalpable lesions in women at increased risk for breast cancer not otherwise identified at mammography or physical examination.« less

Breast Cancer Knowledge among College Students: Influencing Factors and Resultant Behaviors

ERIC Educational Resources Information Center

Justice, Mary F.; King, Keith A.; Vidourek, Rebecca A.; Merianos, Ashley L.

2018-01-01

Background: Many misconceptions about breast cancer exist. College students have the opportunity to perform breast cancer risk-reducing behaviors. Purpose: The purpose of this study was to assess breast cancer knowledge among university students and examine the influence of breast cancer knowledge on health behaviors for breast cancer prevention.…

Tubular Adenoma of the Breast: A Rare Presentation and Review of the Literature

PubMed Central

Salemis, Nikolaos S.; Gemenetzis, Georgios; Karagkiouzis, Gregorios; Seretis, Charalambos; Sapounas, Konstantinos; Tsantilas, Vlasios; Sambaziotis, Dimitrios; Lagoudianakis, Emmanuel

2012-01-01

Tubular adenomas, also known as pure adenomas, are rare epithelial tumors of the breast. Only a few cases have been reported in the literature, especially in young women of reproductive age. Postmenopausal women are very rarely affected. We describe here a very rare case of tubular breast adenoma in a postmenopausal woman who presented with a gradually enlarging breast lump. Clinical examination and imaging studies revealed a non-tender well circumscribed left breast tumor suggestive of a fibroadenoma. Due to the history of progressive enlargement of the breast lump, a surgical excision was performed. Histological findings were suggestive of a tubular breast adenoma. We conclude that although tubular breast adenoma is rare, it should always be considered in the differential diagnosis in postmenopausal patients presenting with a gradually enlarging breast mass. Preoperative diagnosis is difficult because tubular adenoma is indistinguishable from a fibroadenoma on physical examination and breast imaging. Surgical excision is necessary to establish a definitive diagnosis. Clinical presentation and management of our patient are discussed along with a review of the literature. Keywords Tubular adenoma; Breast; Breast mass. PMID:22383931

Tubular adenoma of the breast: a rare presentation and review of the literature.

PubMed

Salemis, Nikolaos S; Gemenetzis, Georgios; Karagkiouzis, Gregorios; Seretis, Charalambos; Sapounas, Konstantinos; Tsantilas, Vlasios; Sambaziotis, Dimitrios; Lagoudianakis, Emmanuel

2012-02-01

Tubular adenomas, also known as pure adenomas, are rare epithelial tumors of the breast. Only a few cases have been reported in the literature, especially in young women of reproductive age. Postmenopausal women are very rarely affected. We describe here a very rare case of tubular breast adenoma in a postmenopausal woman who presented with a gradually enlarging breast lump. Clinical examination and imaging studies revealed a non-tender well circumscribed left breast tumor suggestive of a fibroadenoma. Due to the history of progressive enlargement of the breast lump, a surgical excision was performed. Histological findings were suggestive of a tubular breast adenoma. We conclude that although tubular breast adenoma is rare, it should always be considered in the differential diagnosis in postmenopausal patients presenting with a gradually enlarging breast mass. Preoperative diagnosis is difficult because tubular adenoma is indistinguishable from a fibroadenoma on physical examination and breast imaging. Surgical excision is necessary to establish a definitive diagnosis. Clinical presentation and management of our patient are discussed along with a review of the literature. Tubular adenoma; Breast; Breast mass.

An Examination of Ultrasound Measured Tissue Perfusion on Breast Cancer

DTIC Science & Technology

1998-12-01

is similar to those of the study by Ivey et al. [9] in which high intensity fields were used to produce cavitation bubbles for ultrasound contrast...ft * * AD AWARD NUMBER DAMD17-94-J-4144 TITLE: ^ Examination of Ultrasound Measured Tissue Perfusion on Breast Cancer...Examination of Ultrasound Measured Tissue Perfusion on Breast Cancer 3. REPORT TYPE AND DATES COVERED Final (1 Jun 94 - 30 Nov 98) 5. FUNDING

Screening for breast cancer in a high-risk series

DOE Office of Scientific and Technical Information (OSTI.GOV)

Woodard, E.D.; Hempelmann, L.H.; Janus, J.

1982-01-01

A unique cohort of women at increased risk of breast cancer because of prior X-ray treatment of acute mastitis and their selected high-risk siblings were offered periodic breast cancer screening including physical examination of the breasts, mammography, and thermography. Twelve breast cancers were detected when fewer than four would have been expected based on age-specific breast cancer detection rates from the National Cancer institute/American Cancer Society Breast Cancer Demonstration Detection Projects. Mammograpy was positive in all cases but physical examination was positive in only three cases. Thermography was an unreliable indicator of disease. Given the concern over radiation-induced risk, usemore » of low-dose technique and of criteria for participation that select women at high risk of breast cancer will maximize the benefit/risk ratio for mammography screening.« less

Screening for breast cancer in a high-risk series

DOE Office of Scientific and Technical Information (OSTI.GOV)

Woodard, E.D.; Hempelmann, L.H.; Janus, J.

1982-01-01

A unique cohort of women at increased risk of breast cancer because of prior X-ray treatment of acute mastitis and their selected high-risk siblings were offered periodic breast cancer screening including physical examination of the breasts, mammography, and thermography. Twelve breast cancers were detected when fewer than four would have been expected based on age-specific breast cancer detection rates from the National Cancer Institute/American Cancer Society Breast Cancer Demonstration Detection Projects. Mammography was positive in all cases but physical examination was positive in only three cases. Thermography was an unreliable indicator of disease. Given the concern over radiation-induced risk, usemore » of low-dose technique and of criteria for participation that select women at high risk of breast cancer will maximize the benefit/risk ratio for mammography screening.« less

Body image dissatisfaction in patients undergoing breast reconstruction: Examining the roles of breast symmetry and appearance investment.

PubMed

Teo, Irene; Reece, Gregory P; Huang, Sheng-Cheng; Mahajan, Kanika; Andon, Johnny; Khanal, Pujjal; Sun, Clement; Nicklaus, Krista; Merchant, Fatima; Markey, Mia K; Fingeret, Michelle Cororve

2018-03-01

Reconstruction as part of treatment for breast cancer is aimed at mitigating body image concerns after mastectomy. Although algorithms have been developed to objectively assess breast reconstruction outcomes, associations between objectively quantified breast aesthetic appearance and patient-reported body image outcomes have not been examined. Further, the role of appearance investment in explaining a patient's body image is not well understood. We investigated the extent to which objectively quantified breast symmetry and patient-reported appearance investment were associated with body image dissatisfaction in patients undergoing cancer-related breast reconstruction. Breast cancer patients in different stages of reconstruction (n = 190) completed self-report measures of appearance investment and body image dissatisfaction. Vertical extent and horizontal extent symmetry values, which are indicators of breast symmetry, were calculated from clinical photographs. Associations among breast symmetry, appearance investment, body image dissatisfaction, and patient clinical factors were examined. Multi-variable regression was used to evaluate the extent to which symmetry and appearance investment were associated with body image dissatisfaction. Vertical extent symmetry, but not horizontal extent symmetry, was associated with body image dissatisfaction. Decreased vertical extent symmetry (β = -.19, P < .05) and increased appearance investment (β = .45, P < .001) were significantly associated with greater body image dissatisfaction while controlling for clinical factors. Breast symmetry and patient appearance investment both significantly contribute to an understanding of patient-reported body image satisfaction during breast reconstruction treatment. Copyright © 2017 John Wiley & Sons, Ltd.

From the set-up of a screening program of breast cancer patients to the identification of the first BRCA mutation in the DR Congo.

PubMed

Luyeye Mvila, Gertrude; Postema, Sandra; Marchal, Guy; Van Limbergen, Erik; Verdonck, Fons; Matthijs, Gert; Devriendt, Koen; Michils, Genevieve; Van Ongeval, Chantal

2014-07-28

Breast cancer incidence in African population is low compared to western countries but the mortality rate is higher and the disease presents at a younger age and at a more advanced stage. The World Health Organisation and the Breast Health Global Initiative concluded that in low and middle income countries early breast cancer detection can be achieved by informing women on symptoms of breast cancer, on the practice of breast self-examination and clinical breast examination by trained health care workers. Based on these recommendations, we set up a breast cancer awareness campaign in Kinshasa, Democratic Republic of Congo (DRC). This paper describes the strategy that was established and the results that were achieved. A breast cancer awareness campaign was started in 2010 and data were collected until the end of 2012. Clinicians (expert group) trained nurses and health care workers (awareness groups) on clinical, technical and social aspects of breast cancer. Different channels were used to inform women about the campaign and clinical data (on medical and family history) were collected. The participating women were investigated with clinical breast examination by the awareness group. Women in whom a palpable mass was detected were referred to the hospital: they received a mammography and ultrasound and--in case of suspicious findings--additionally a core needle biopsy. In case of a positive family history, a blood sample was taken for genetic investigation. In total, 4,315 women participated, resulting in 1,113 radiological breast examinations, performed in the General Hospital of Kinshasa of which 101 turned out to be malignant lesions. Fifty six percent of the women with breast cancer were less than 50 years old and 75% (65/87) were stage III tumors. A BRCA gene mutation was identified in a family with a severe history of breast cancer. Even without financial support, it was possible to start an awareness campaign for breast cancer in Kinshasa. This campaign increased the awareness on cancer of the women in Kinshasa. The results demonstrate that this campaign had an immediate impact on patients and their families.

Psychometric Properties of the Breast Cancer Screening Beliefs Questionnaire Among Women of Indian Ethnicity Living in Australia.

PubMed

Kwok, Cannas; Pillay, Rona; Lee, Chun Fan

2016-01-01

Indian women have been consistently reported as having low participation in breast cancer screening practices. A valid and reliable instrument to explore their breast cancer beliefs is essential for development of interventions to promote breast cancer screening practices. The aim of this study was to report the psychometric properties of the Breast Cancer Screening Beliefs Questionnaire (BCSBQ) in an Indian community in Australia. A convenience sample of 242 Indian Australian women was recruited from Indian community organizations and personal networking. Explanatory factor analysis was conducted to study the factor structure. Clinical validity was examined by Cuzick's nonparametric test, and Cronbach's α was used to assess internal consistency reliability. Exploratory factor analysis showed a similar fit to the hypothesized 3-factor structure. The frequency of breast cancer screening practices was significantly associated with attitudes toward general health check-up. Knowledge and perceptions about the breast cancer scale were not significantly associated with clinical breast examinations and mammography. Perceived barriers to mammography were much less evident among women who engaged in breast awareness and clinical breast examination. Results indicated that the BCSBQ had satisfactory validity and internal consistency. Cronbach's α of the 3 subscales ranged from .81 to .91. The BCSBQ is a culturally appropriate, valid, and reliable instrument for assessing the beliefs, knowledge, and attitudes about breast cancer and breast cancer screening practices among women of Indian ethnic extraction living in Australia. The BCSBQ can be used to provide nurses with information relevant for the development of culturally sensitive breast health education programs.

Health Beliefs of Midwifery Students at Istanbul University about Breast Cancer and Breast Self-Examination Acknowledgements.

PubMed

Gençtürk, Nuran; Demirezen, Esma; Ay, Fatma

2017-12-01

Knowing the attitudes and beliefs of midwifery students toward breast cancer and breast self-examination (BSE) practice may reduce breast cancer-related deaths by increasing breast cancer awareness. This study was conducted to examine the attitudes and beliefs of midwifery students toward breast cancer and the BSE practice. The study was conducted with 160 midwifery students at Istanbul University as a descriptive, cross-sectional study. Data were collected by a part of Champion's Health Belief Model Scale and a self-administered questionnaire. The descriptive characteristics were given as frequencies and percentages. The evaluation was done with Kruskal-Wallis test, a non-parametric test. It has been observed 70.0 % among midwifery students have knowledge of breast cancer. 90.0 % of midwifery students know about BSE, however only 14.4 % among them practice BSE regularly every month. The benefit, barrier and confidence sub-dimension scores were positively associated with BSE practice regularity (p ≤ 0.05). It has been determined that more than half of midwifery students have knowledge about breast cancer and BSE, and that only a fraction of those with knowledge about BSE practice BSE regularly every month. The perceived seriousness of breast cancer and knowledge about breast cancer affect the ability of individuals to perform BSE, initiating BSE and continuing to practice BSE for early diagnosis of breast cancer. The results from the study provide the midwifery students awareness of breast cancer and BSE both for themselves and for the women for whom they take responsibility.

American Society of Clinical Oncology 2006 update of the breast cancer follow-up and management guidelines in the adjuvant setting.

PubMed

Khatcheressian, James L; Wolff, Antonio C; Smith, Thomas J; Grunfeld, Eva; Muss, Hyman B; Vogel, Victor G; Halberg, Francine; Somerfield, Mark R; Davidson, Nancy E

2006-11-01

To update the 1999 American Society of Clinical Oncology (ASCO) guideline on breast cancer follow-up and management in the adjuvant setting. An ASCO Expert Panel reviewed pertinent information from the literature through March 2006. More weight was given to studies that tested a hypothesis directly relating testing to one of the primary outcomes in a randomized design. The evidence supports regular history, physical examination, and mammography as the cornerstone of appropriate breast cancer follow-up. All patients should have a careful history and physical examination performed by a physician experienced in the surveillance of cancer patients and in breast examination. Examinations should be performed every 3 to 6 months for the first 3 years, every 6 to 12 months for years 4 and 5, and annually thereafter. For those who have undergone breast-conserving surgery, a post-treatment mammogram should be obtained 1 year after the initial mammogram and at least 6 months after completion of radiation therapy. Thereafter, unless otherwise indicated, a yearly mammographic evaluation should be performed. Patients at high risk for familial breast cancer syndromes should be referred for genetic counseling. The use of CBCs, chemistry panels, bone scans, chest radiographs, liver ultrasounds, computed tomography scans, [18F]fluorodeoxyglucose-positron emission tomography scanning, magnetic resonance imaging, or tumor markers (carcinoembryonic antigen, CA 15-3, and CA 27.29) is not recommended for routine breast cancer follow-up in an otherwise asymptomatic patient with no specific findings on clinical examination. Careful history taking, physical examination, and regular mammography are recommended for appropriate detection of breast cancer recurrence.

Breast cancer associated with type 1 neurofibromatosis.

PubMed

Salemis, Nikolaos S; Nakos, Georgios; Sambaziotis, Dimitrios; Gourgiotis, Stavros

2010-10-01

The association between breast cancer and type 1 neurofibromatosis (NF1) is a rare clinical entity. We herein present the case of a 59-year-old woman, with typical clinical manifestations of NF1, who presented with a painless lump in her right breast, which she had first noticed 8 months earlier. Clinical examination and diagnostic workup were suggestive of a breast carcinoma, and a modified radical mastectomy was performed. Histopathological examination revealed a poorly differentiated invasive ductal breast carcinoma and multiple neurofibromas. The pathological staging was pT2N1a according to TNM/UICC. Delayed presentation of the patient was the result of her mistakenly identifying the breast tumor as a manifestation of NF1 neurofibromatosis.

Soy isoflavone supplementation and breast density in postmenopausal women

USDA-ARS?s Scientific Manuscript database

Soy isoflavones may protect against breast cancer. Breast density, a marker for breast cancer risk, increases as a result of hormone replacement therapy. We examined the relation between isoflavone supplementation and breast density using the mammograms from 358 women who participated in the multi-s...

Breast feeding, bottle feeding, and maternal autonomic responses to stress.

PubMed

Mezzacappa, Elizabeth Sibolboro; Kelsey, Robert M; Katkin, Edward S

2005-04-01

The aim of this study was to examine the effects of breast feeding on autonomic nervous system (ANS) response to stressors. Sympathetic and parasympathetic activities were examined before, during, and after standard laboratory stressors in women who were either exclusively breast feeding (n=14) or nonexclusively breast feeding (n=14), and in non-postpartum controls (n=15). Mothers who breast fed exclusively showed greater levels of parasympathetic cardiac modulation and slower heart rate (HR) throughout the session and less HR increase and preejection period (PEP) shortening to mental arithmetic (MA) than did nonexclusive breast feeders and controls. Nonexclusive breast-feeders showed greater electrodermal reactivity to, and greater differences in skin conductance response (SCR) frequency between baseline and recovery from cold pressor (CP) than did either exclusive breast-feeders or controls. Sympathetic activity was negatively related to the number of breast feedings and positively related to bottle feedings. Breast feeding shifts maternal ANS balance toward relatively greater parasympathetic and lesser sympathetic activity; the opposite occurs with bottle feeding. The frequency of feeding also is a critical factor in determining breast feeding effects on maternal ANS function.

Breast cancer amongst Filipino migrants: a review of the literature and ten-year institutional analysis.

PubMed

Simpson, Jory S; Briggs, Kaleigh; George, Ralph

2015-06-01

As one migrates from an area of low to high incidence of breast cancer their personal risk of developing breast cancer increases. This is however not equally distributed across all races and ethnicities. This paper specifically examines Filipino migrants. A literature review was conducted to summarize breast cancer incidence, screening practices and trends in treatment amongst Filipino migrants. In addition, a retrospective cohort study was conducted specifically examining the age in which Filipino women were diagnosed with breast cancer compared to Asian and Caucasian counterparts. Filipino women are diagnosed with breast cancer at a statistically significant younger age (53.2) compared to their Asian (55.1) and Caucasian (58.4) counterparts. In addition, they are at an increased risk of developing more aggressive breast cancer with noteworthy disparities in the care they are receiving. The evidence suggest this group is worthy of special focus when diagnosing and treating breast cancer.

What do women know about breast cancer prophylaxis and a healthy style of life?

PubMed

Sielska, Jolanta; Matecka, Monika; Dąbrowska, Eliza; Jakubek, Ewa; Urbaniak, Monika

2015-01-01

The aim of the study was to determine the factors influencing women's knowledge concerning breast cancer prophylaxis and find out the sources of the knowledge. In the Greater Poland region, breast cancer has been the most frequently detected tumour for years. The percentage of breast cancer cases has increased by 31% in the last decade. The study encompassed 337 women aged 40-59 who participated in the mammographic examinations. An original research tool was used which assessed the level of knowledge concerning breast cancer prophylaxis, the knowledge of health-oriented behaviour in this regard and the influence of the medical personnel on women's education. Age is a factor diversifying the knowledge of the breast self-examination method. Doctors and nurses were rarely indicated as a source of knowledge concerning breast cancer prophylaxis. The subjects presented a high level of knowledge of the factors increasing the risk of developing cancer. A correlation between the level of education and the knowledge of one's own breast to a degree which enables a woman to detect even a slight change was observed. Vital findings also concern the sources of knowledge concerning breast cancer prophylaxis. The results of the studies indicated little informative support on the part of the medical personnel; therefore, one should call for supplementing training courses for doctors and nurses focusing on the issues of prophylaxis, including the method of breast self-examination.

Cultural Beliefs and Attitudes About Breast Cancer and Screening Practices Among Arabic Women in Australia.

PubMed

Kwok, Cannas; Endrawes, Gihane; Lee, Chun Fan

2016-01-01

Arabic women have been consistently reported as having remarkably low participation rates in breast cancer screening measures in their home countries and after migration to Western countries. Little is known about the screening behaviors of Arabic women in Australia. This study aimed to report breast cancer screening practices among Arabic women in Australia and to examine the relationship between (1) demographic factors and (2) the Arabic version of the Breast Cancer Screening Beliefs Questionnaire (BCSBQ) score and women's breast screening behaviors. A descriptive cross-sectional method was used. Both English and Arabic versions of the BCSBQ were administered to the 251 Arabic Australian women 18 years or older who participated in the study. The majority of participants (62.9%-92%) had heard of breast awareness, clinical breast examination, and mammography. However, only 7.6% practiced breast awareness monthly, 21.4% had undergone clinical breast examination annually, and 40.3% had biannual mammography. Length of stay in Australia, being retired, and being unemployed were positively associated with the recommended performance of breast awareness and mammography. In terms of BCSBQ scores, women who engaged in the 3 screening practices had significantly higher scores on the attitudes to health check-ups and barriers to mammography subscales. Attitudes toward health check-ups and perceived barriers to mammography were important determinants of breast cancer screening practices among Arabic Australian women. To fully understand barriers discouraging Arabic Australian women from participating in breast cancer screening practices, efforts should be focused on specific subgroup (ie, working group) of Arabic Australian women.

Temporal and lateral dynamics of HIV shedding and elevated sodium in breast milk among HIV-positive mothers during the first 4 months of breast-feeding.

PubMed

Semrau, Katherine; Ghosh, Mrinal; Kankasa, Chipepo; Sinkala, Moses; Kasonde, Prisca; Mwiya, Mwiya; Thea, Donald M; Kuhn, Louise; Aldrovandi, Grace M

2008-03-01

To better understand the dynamics of breast milk HIV shedding and its relation to postnatal HIV transmission, we investigated the temporal and lateral relations of breast milk viral shedding and sodium concentrations in HIV-positive women. This was a longitudinal cohort study in Lusaka, Zambia. We examined patterns of HIV shedding in breast milk over the first 4 months of breast-feeding and their correlations with postnatal HIV transmission among 138 breast-feeding mothers. Sodium concentration in breast milk was also examined in the same samples and in breast milk from 23 HIV-negative controls. Higher breast milk viral load at 1 week, 1 month, and 4 months and consistent viral shedding in breast milk were significantly associated with increased risk of HIV transmission. Elevated breast milk sodium concentration (> or =13 mmol/L) at 4 months was associated with HIV transmission, low maternal CD4 cell count, and high maternal plasma viral load. Elevated sodium concentration at 1 week postpartum was common and was not associated with any of these parameters. Consistent viral shedding and high breast milk viral load are strong predictors of mother-to-child HIV transmission. Although sodium concentrations later in breast-feeding correlate with breast milk viral load, increased breast milk sodium is normal in early lactation and does not predict HIV transmission.

Knowledge of breast cancer and breast self-examination practice among Iranian women in Hamedan, Iran.

PubMed

Akhtari-Zavare, Mehrnoosh; Ghanbari-Baghestan, Abbas; Latiff, Latiffah A; Matinnia, Nasrin; Hoseini, Mozhgan

2014-01-01

In Iran, breast cancer is the most prevalent cancer in women and a major public health problem. A cross sectional study was carried out to determine knowledge on breast cancer and breast self- examination (BSE) practices of 384 females living in the city of Hamadan, Iran. A purposive sampling method was adopted and data were collected via face-to-face interviews based on a validated questionnaire developed for this study. Among respondents 268 (69.8%) were married and 144 (37.5%) of the respondents reported having a family history of breast cancer. One hundred respondents (26.0%) claimed they practiced BSE. Level of breast cancer knowledge was significantly associated with BSE practice (p=0.000). There was no association with demographic details (p<0.05). The findings showed that Iranian women's knowledge regarding breast cancer and the practice of BSE is inadequate. Targeted education should be implemented to improve early detection of breast cancer.

Breast Self Examination Practice among Female Students of Tertiary Institutions

ERIC Educational Resources Information Center

Agbonifoh, Julia Adesua

2016-01-01

Against the background of the dangers posed by breast cancer world-wide, and the importance of its early detection and therefore breast self examination (BSE), this study investigated the practice of BSE among female students in tertiary institutions in Edo state. A sample of 723 participants selected through a combination of multi-stage,…

Interactions of Family History of Breast Cancer with Radiotherapy in Relation to the Risk of Breast Cancer Recurrence.

PubMed

Li, Danmeng; Mai, Volker; Gerke, Travis; Pinney, Susan Mengel; Yaghjyan, Lusine

2017-12-01

We examined associations between a family history of breast cancer and the risk of breast cancer recurrence in women who received or did not receive radiotherapy. Our study included 2,440 women enrolled in the Breast Cancer Registry of Greater Cincinnati. Information on breast cancer risk factors, including detailed family history of breast cancer, characteristics of the primary tumor, treatment received, and recurrence status was collected at baseline and via updates. Associations between a family history of breast cancer and the risk of breast cancer recurrence were examined separately in women treated with and without radiotherapy using survival analysis. Over an average follow-up time of 8.78 years, we found no associations between a family history of breast cancer and the risk of breast cancer recurrence among women with a history of radiotherapy (hazard ratio [HR], 0.96; 95% confidence interval [CI], 0.75-1.23). Among women who did not receive radiotherapy, the total number of relatives with breast cancer was positively associated with the risk of breast cancer recurrence (HR, 1.21; 95% CI, 1.00-1.47). We found no interactions of radiotherapy with family history (p-interaction >0.05). Radiotherapy for a primary breast cancer in women with a family history of breast cancer does not increase risk of breast cancer recurrence. If these findings are replicated in future studies, the results may translate into an important health message for breast cancer survivors with a family history of breast cancer.

Development of a breast self-examination program for the Internet: health information for Korean women.

PubMed

Kim, H S; Kim, E; Kim, J W

2001-04-01

Internet-based health information will enable us to interact with many people despite distance and time constraints. Informational media by computer is expected to become an important factor that affects health behavior. This study was done to develop an accessible multimedia program about breast self-examination on the Internet. This study was designed by using the two steps of need assessment and program development. For the need assessment step, a survey was carried out. The sample consisted of the 82 women of Yonsei University selected by convenient random sampling. At the program development step, screen design took into account perspectives of computer engineering. A storyboard for every screen was made via screen design and then ported to computer using the Netscape Navigator program. A breast self-examination program was developed using Netscape 4.0 on the Windows 98 platform. The multimedia program, including text, graphics, animation, and sound, was constructed with HTML language using Memo Sheet in Netscape Navigator. The contents of health information posted on the Internet included general information about breast cancer, the importance of breast self-examination, self-risk appraisal of breast cancer, the diverse methods about breast self-examination, the monthly check list graph, and social network for consultation. It is possible to interact with clients through the Question and Answer function on screen. This Internet-based health information program provides enough information, which can be accessed using search systems on the Internet.

Supplemental Screening for Breast Cancer in Women With Dense Breasts: A Systematic Review for the U.S. Preventive Services Task Force.

PubMed

Melnikow, Joy; Fenton, Joshua J; Whitlock, Evelyn P; Miglioretti, Diana L; Weyrich, Meghan S; Thompson, Jamie H; Shah, Kunal

2016-02-16

Screening mammography has lower sensitivity and specificity in women with dense breasts, who experience higher breast cancer risk. To perform a systematic review of reproducibility of Breast Imaging Reporting and Data System (BI-RADS) density categorization and test performance and clinical outcomes of supplemental screening with breast ultrasonography, magnetic resonance imaging (MRI), and digital breast tomosynthesis (DBT) in women with dense breasts and negative mammography results. MEDLINE, PubMed, EMBASE, and Cochrane database from January 2000 to July 2015. Studies reporting BI-RADS density reproducibility or supplemental screening results for women with dense breasts. Quality assessment and abstraction of 24 studies from 7 countries; 6 studies were good-quality. Three good-quality studies reported reproducibility of BI-RADS density; 13% to 19% of women were recategorized between "dense" and "nondense" at subsequent screening. Two good-quality studies reported that sensitivity of ultrasonography for women with negative mammography results ranged from 80% to 83%; specificity, from 86% to 94%; and positive predictive value (PPV), from 3% to 8%. The sensitivity of MRI ranged from 75% to 100%; specificity, from 78% to 94%; and PPV, from 3% to 33% (3 studies). Rates of additional cancer detection with ultrasonography were 4.4 per 1000 examinations (89% to 93% invasive); recall rates were 14%. Use of MRI detected 3.5 to 28.6 additional cancer cases per 1000 examinations (34% to 86% invasive); recall rates were 12% to 24%. Rates of cancer detection with DBT increased by 1.4 to 2.5 per 1000 examinations compared with mammography alone (3 studies). Recall rates ranged from 7% to 11%, compared with 7% to 17% with mammography alone. No studies examined breast cancer outcomes. Good-quality evidence was sparse. Studies were small and CIs were wide. Definitions of recall were absent or inconsistent. Density ratings may be recategorized on serial screening mammography. Supplemental screening of women with dense breasts finds additional breast cancer but increases false-positive results. Use of DBT may reduce recall rates. Effects of supplemental screening on breast cancer outcomes remain unclear. Agency for Healthcare Research and Quality.

[System for organizing the active screening of breast diseases at industrial enterprises].

PubMed

Pavlov, K A; Mishura, V I; Nazarenko, V P; Karachunskiĭ, M S; Shal'man, Ia S

1982-01-01

The scheme of detection of breast tumors includes such measures of complex screening as self-examination, questionnaires, examination by shop floor doctor, fluoromammography and thermography followed by consultation of an oncologist, needle biopsy and use of surgical manuals. Out of 12,862 females examined by the scheme, 52 (0.4%) had breast tumors (early forms in 23 cases -- 44.2%), 254 (2%) -- benign tumors and cysts; 981 (7.6%) -- dyshormonal mastopathy and 522 (4.0%) -- local fibroadenomatosis.

Breast Cancer Screening for Women at Average Risk: 2015 Guideline Update From the American Cancer Society.

PubMed

Oeffinger, Kevin C; Fontham, Elizabeth T H; Etzioni, Ruth; Herzig, Abbe; Michaelson, James S; Shih, Ya-Chen Tina; Walter, Louise C; Church, Timothy R; Flowers, Christopher R; LaMonte, Samuel J; Wolf, Andrew M D; DeSantis, Carol; Lortet-Tieulent, Joannie; Andrews, Kimberly; Manassaram-Baptiste, Deana; Saslow, Debbie; Smith, Robert A; Brawley, Otis W; Wender, Richard

2015-10-20

Breast cancer is a leading cause of premature mortality among US women. Early detection has been shown to be associated with reduced breast cancer morbidity and mortality. To update the American Cancer Society (ACS) 2003 breast cancer screening guideline for women at average risk for breast cancer. The ACS commissioned a systematic evidence review of the breast cancer screening literature to inform the update and a supplemental analysis of mammography registry data to address questions related to the screening interval. Formulation of recommendations was based on the quality of the evidence and judgment (incorporating values and preferences) about the balance of benefits and harms. Screening mammography in women aged 40 to 69 years is associated with a reduction in breast cancer deaths across a range of study designs, and inferential evidence supports breast cancer screening for women 70 years and older who are in good health. Estimates of the cumulative lifetime risk of false-positive examination results are greater if screening begins at younger ages because of the greater number of mammograms, as well as the higher recall rate in younger women. The quality of the evidence for overdiagnosis is not sufficient to estimate a lifetime risk with confidence. Analysis examining the screening interval demonstrates more favorable tumor characteristics when premenopausal women are screened annually vs biennially. Evidence does not support routine clinical breast examination as a screening method for women at average risk. The ACS recommends that women with an average risk of breast cancer should undergo regular screening mammography starting at age 45 years (strong recommendation). Women aged 45 to 54 years should be screened annually (qualified recommendation). Women 55 years and older should transition to biennial screening or have the opportunity to continue screening annually (qualified recommendation). Women should have the opportunity to begin annual screening between the ages of 40 and 44 years (qualified recommendation). Women should continue screening mammography as long as their overall health is good and they have a life expectancy of 10 years or longer (qualified recommendation). The ACS does not recommend clinical breast examination for breast cancer screening among average-risk women at any age (qualified recommendation). These updated ACS guidelines provide evidence-based recommendations for breast cancer screening for women at average risk of breast cancer. These recommendations should be considered by physicians and women in discussions about breast cancer screening.

Intramammary Findings on CT of the Chest – a Review of Normal Anatomy and Possible Findings

PubMed Central

Gossner, Johannes

2016-01-01

Summary Computed tomography (CT) is a frequently performed examination in women of all ages. In all thoracic CT examinations of the chest at least parts of the breasts are included. Therefore incidental breast pathology may be observed. It has been suggested that one out of 250 women undergoing chest CT will show a malignant incidental breast lesion. Given the high number of performed chest CT examinations, this contributes to a significant number of malignancies. In this review, after a brief discussion of the value of computed tomography in breast imaging, normal and pathologic findings are discussed to create awareness of this potential “black box” on chest CT. PMID:28058068

What do women know about breast cancer prophylaxis and a healthy style of life?

PubMed Central

Sielska, Jolanta; Matecka, Monika; Dąbrowska, Eliza; Jakubek, Ewa; Urbaniak, Monika

2015-01-01

Aim The aim of the study was to determine the factors influencing women's knowledge concerning breast cancer prophylaxis and find out the sources of the knowledge. Background In the Greater Poland region, breast cancer has been the most frequently detected tumour for years. The percentage of breast cancer cases has increased by 31% in the last decade. Materials and methods The study encompassed 337 women aged 40–59 who participated in the mammographic examinations. An original research tool was used which assessed the level of knowledge concerning breast cancer prophylaxis, the knowledge of health-oriented behaviour in this regard and the influence of the medical personnel on women's education. Results Age is a factor diversifying the knowledge of the breast self-examination method. Doctors and nurses were rarely indicated as a source of knowledge concerning breast cancer prophylaxis. The subjects presented a high level of knowledge of the factors increasing the risk of developing cancer. Conclusions A correlation between the level of education and the knowledge of one's own breast to a degree which enables a woman to detect even a slight change was observed. Vital findings also concern the sources of knowledge concerning breast cancer prophylaxis. The results of the studies indicated little informative support on the part of the medical personnel; therefore, one should call for supplementing training courses for doctors and nurses focusing on the issues of prophylaxis, including the method of breast self-examination. PMID:26549989

Temporal and Lateral Dynamics of HIV Shedding and Elevated Sodium in Breast Milk Among HIV-Positive Mothers During the First 4 Months of Breast-Feeding

PubMed Central

Semrau, Katherine; Ghosh, Mrinal; Kankasa, Chipepo; Sinkala, Moses; Kasonde, Prisca; Mwiya, Mwiya; Thea, Donald M.; Kuhn, Louise; Aldrovandi, Grace M.

2009-01-01

Objective To better understand the dynamics of breast milk HIV shedding and its relation to postnatal HIV transmission, we investigated the temporal and lateral relations of breast milk viral shedding and sodium concentrations in HIV-positive women. Design This was a longitudinal cohort study in Lusaka, Zambia. Method We examined patterns of HIV shedding in breast milk over the first 4 months of breast-feeding and their correlations with postnatal HIV transmission among 138 breast-feeding mothers. Sodium concentration in breast milk was also examined in the same samples and in breast milk from 23 HIV-negative controls. Results Higher breast milk viral load at 1 week, 1 month, and 4 months and consistent viral shedding in breast milk were significantly associated with increased risk of HIV transmission. Elevated breast milk sodium concentration ($13 mmol/L) at 4 months was associated with HIV transmission, low maternal CD4 cell count, and high maternal plasma viral load. Elevated sodium concentration at 1 week postpartum was common and was not associated with any of these parameters. Conclusions Consistent viral shedding and high breast milk viral load are strong predictors of mother-to-child HIV transmission. Although sodium concentrations later in breast-feeding correlate with breast milk viral load, increased breast milk sodium is normal in early lactation and does not predict HIV transmission. PMID:18398972

[Mastitis revealing Churg-Strauss syndrome].

PubMed

Dannepond, C; Le Fourn, E; de Muret, A; Ouldamer, L; Carmier, D; Machet, L

2014-01-01

Churg-Strauss syndrome often involves the skin, and this may sometimes reveal the disease. A 25-year-old woman was referred to a gynaecologist for inflammation of the right breast with breast discharge. Cytological analysis of the liquid showed numerous inflammatory cells, particularly polymorphonuclear eosinophils and neutrophils. Ultrasound examination of the breast was consistent with galactophoritis. CRP was normal, and hypereosinophilia was seen. The patient was subsequently referred to a dermatology unit. Skin examination revealed inflammation of the entire breast, which was painful, warm and erythematous; the border was oedematous with blisters. Necrotic lesions were also present on the thumbs and knees. Skin biopsy of the breast showed a dermal infiltrate with abundant infiltrate of polymorphonuclear eosinophils, including patchy necrosis and intraepidermal vesicles. Histological examination of a biopsy sample from a thumb revealed eosinophilic granuloma and leukocytoclastic vasculitis. The patient was also presenting asthma, pulmonary infiltrates and mononeuropathy at L3, consistent with Churg-Strauss syndrome. Breast involvement in Churg-Strauss syndrome is very rare (only one other case has been reported). This is the first case in which the breast condition revealed the disease. Cutaneous involvement of the breast is, however, also compatible with Wells' cellulitis. The lesions quickly disappeared with 1mg/kg/d oral prednisolone. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

Increased incidence of breast carcinoma in patients with irradiation for post-partum mastitis: a screening situation. [X-radiation

DOE Office of Scientific and Technical Information (OSTI.GOV)

Logan, W.W.; Mansur, P.S.; Cullinan, A.

1979-01-01

In Rochester, New York, 606 women were treated with ionizing radiation for post-partum mastitis, mostly between 1940 and 1955. Two-thirds of all breasts were treated, the average dose per breast being 377 rads (at 2.5 cm breast depth). Mammographic examinations were performed on 265 of these women still residing in this vicinity. Two nonpalpable carcinomas (with no axillary node metastases) were found in the twelve breast lesions that have been biopsied. Some of the biopsies revealed premalignant changes. It is recommended that women in this high-risk category have close medical supervision, as well as periodic mammographic evaluation, and that themore » importance of periodic breast self-examinations should be emphasized.« less

Radiological assessment of the breast following enhancement with Macrolane: Managing the challenges.

PubMed

Scaperrotta, Gianfranco; Satchithananda, Keshtra; Tengvar, Magnus; Post, Karin; Lim, Adrian K; Panizza, Pietro; Wesolowska, Ewa; Inglefield, Christopher J

2017-01-01

Macrolane VRF ® , a biodegradable, stabilized hyaluronic acid gel, was used for breast enhancement 2008-2012. Similar to permanent implants, the presence of Macrolane gel may interfere with interpretation of mammography. This short communication aims to provide a guide to the appearance of Macrolane on radiology examination (including mammography, ultrasound and magnetic resonance imaging) and aid selection of the most appropriate imaging modality to facilitate breast examination in women who have undergone Macrolane breast enhancement. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Osteocyte Alterations Induce Osteoclastogenesis in an In Vitro Model of Gaucher Disease.

PubMed

Bondar, Constanza; Ormazabal, Maximiliano; Crivaro, Andrea; Ferreyra-Compagnucci, Malena; Delpino, María Victoria; Rozenfeld, Paula Adriana; Mucci, Juan Marcos

2017-01-13

Gaucher disease (GD) is caused by mutations in the glucosylceramidase β ( GBA 1 ) gene that confer a deficient level of activity of glucocerebrosidase (GCase). This deficiency leads to the accumulation of the glycolipid glucocerebroside in the lysosomes of cells, mainly in the monocyte/macrophage lineage. Its mildest form is Type I GD, characterized by non-neuronopathic involvement. Bone compromise is the most disabling aspect of the Gaucher disease. However, the pathophysiological aspects of skeletal alterations are not yet fully understood. The bone tissue homeostasis is maintained by a balance between resorption of old bone by osteoclasts and new bone formation by osteoblasts. A central player in this balance is the osteocyte as it controls both processes. We studied the involvement of osteocytes in an in vitro chemical model of Gaucher disease. The osteocyte cell line MLO-Y4 was exposed to conduritol-β-epoxide (CBE), an inhibitor of GCase, for a period of 7, 14 and 21 days. Conditioned media from CBE-treated osteocytes was found to induce osteoclast differentiation. GCase inhibition caused alterations in Cx43 expression and distribution pattern and an increase in osteocyte apoptosis. Osteoclast differentiation involved osteocyte apoptotic bodies, receptor activator of nuclear factor κ-B ligand (RANKL) and soluble factors. Thus, our results indicate that osteocytes may have a role to play in the bone pathophysiology of GD.

Coherent backscattering effect in spectra of icy satellites and its modeling using multi-sphere T-matrix (MSTM) code for layers of particles

NASA Astrophysics Data System (ADS)

Pitman, Karly M.; Kolokolova, Ludmilla; Verbiscer, Anne J.; Mackowski, Daniel W.; Joseph, Emily C. S.

2017-12-01

The coherent backscattering effect (CBE), the constructive interference of light scattering in particulate surfaces (e.g., regolith), manifests as a non-linear increase in reflectance, or opposition surge, and a narrow negative polarization feature at small solar phase angles. Due to a strong dependence of the amplitude and angular width of this opposition surge on the absorptive characteristics of the surface material, CBE also produces phase-angle-dependent variations in the near-infrared spectra. In this paper we present a survey of such variations in the spectra of icy satellites of Saturn obtained by the Cassini spacecraft's Visual and Infrared Mapping Spectrometer (VIMS) and in the ground-based spectra of Oberon, a satellite of Uranus, obtained with TripleSpec, a cross-dispersed near-infrared spectrometer on the Astrophysical Research Consortium 3.5-m telescope located at the Apache Point Observatory near Sunspot, New Mexico. The paper also presents computer modeling of the saturnian satellite spectra and their phase-angle variations using the most recent version of the Multi-Sphere T-Matrix (MSTM) code developed to simulate light scattering by layers of randomly distributed spherical particles. The modeling allowed us not only to reproduce the observed effects but also to estimate characteristics of the icy particles that cover the surfaces of Rhea, Dione, and Tethys.

Interaction of Type IV Toxin/Antitoxin Systems in Cryptic Prophages of Escherichia coli K-12.

PubMed

Wen, Zhongling; Wang, Pengxia; Sun, Chenglong; Guo, Yunxue; Wang, Xiaoxue

2017-03-01

Toxin/antitoxin (TA) systems are widespread in prokaryotic chromosomes and in mobile genetic elements including plasmids and prophages. The first characterized Type IV TA system CbtA/CbeA was found in cryptic prophage CP4-44 in Escherichia coli K-12. Two homologous TA loci of CbtA/CbeA also reside in cryptic prophages of E. coli K-12, YkfI/YafW in CP4-6 and YpjF/YfjZ in CP4-57. In this study, we demonstrated that YkfI and YpjF inhibited cell growth and led to the formation of "lemon-shaped" cells. Prolonged overproduction of YkfI led to the formation of "gourd-shaped" cells and immediate cell lysis. YafW and YfjZ can neutralize the toxicity of YkfI or YpjF. Furthermore, we found that YkfI and YpjF interacted with cell division protein FtsZ in E. coli , but ectopic expression in Pseudomonas and Shewanella did not cause the formation of "lemon-shaped" cells. Moreover, deletion of all of the three toxin genes together decreased resistance to oxidative stress and deletion of the antitoxin genes increased early biofilm formation. Collectively, these results demonstrated that the homologous Type IV TA systems in E. coli may target cell division protein FtsZ in E. coli and may have different physiological functions in E. coli .

Interaction of Type IV Toxin/Antitoxin Systems in Cryptic Prophages of Escherichia coli K-12

PubMed Central

Wen, Zhongling; Wang, Pengxia; Sun, Chenglong; Guo, Yunxue; Wang, Xiaoxue

2017-01-01

Toxin/antitoxin (TA) systems are widespread in prokaryotic chromosomes and in mobile genetic elements including plasmids and prophages. The first characterized Type IV TA system CbtA/CbeA was found in cryptic prophage CP4-44 in Escherichia coli K-12. Two homologous TA loci of CbtA/CbeA also reside in cryptic prophages of E. coli K-12, YkfI/YafW in CP4-6 and YpjF/YfjZ in CP4-57. In this study, we demonstrated that YkfI and YpjF inhibited cell growth and led to the formation of “lemon-shaped” cells. Prolonged overproduction of YkfI led to the formation of “gourd-shaped” cells and immediate cell lysis. YafW and YfjZ can neutralize the toxicity of YkfI or YpjF. Furthermore, we found that YkfI and YpjF interacted with cell division protein FtsZ in E. coli, but ectopic expression in Pseudomonas and Shewanella did not cause the formation of “lemon-shaped” cells. Moreover, deletion of all of the three toxin genes together decreased resistance to oxidative stress and deletion of the antitoxin genes increased early biofilm formation. Collectively, these results demonstrated that the homologous Type IV TA systems in E. coli may target cell division protein FtsZ in E. coli and may have different physiological functions in E. coli. PMID:28257056

B-esterase activities and blood cell morphology in the frog Leptodactylus chaquensis (Amphibia: Leptodactylidae) on rice agroecosystems from Santa Fe Province (Argentina).

PubMed

Attademo, Andrés M; Cabagna-Zenklusen, Mariana; Lajmanovich, Rafael C; Peltzer, Paola M; Junges, Celina; Bassó, Agustín

2011-01-01

Activity of B-esterases (BChE: butyrylcholinesterase and CbE: carboxylesterase using two model substrates: α-naphthyl acetate and 4-nitrophenyl valerate) in a native frog, Leptodactylus chaquensis from rice fields (RF1: methamidophos and RF2: cypermethrin and endosulfan sprayed by aircraft) and non-contaminated area (pristine forest) was measured. The ability of pyridine-2-aldoxime methochloride (2-PAM) to reactivate BChE levels was also explored. In addition, changes in blood cell morphology and parasite infection were determined. Mean values of plasma BChE activities were lower in samples from the two rice fields than in those from the reference site. CbE (4-nitrophenyl valerate) levels varied in the three sites studied, being highest in RF1. Frog plasma from RF1 showed positive reactivation of BChE activity after incubation with 2-PAM. Blood parameters of frogs from RF2 revealed morphological alterations (anisochromasia and immature erythrocytes frequency). Moreover, a major infection of protozoan Trypanosoma sp. in individuals from the two rice fields was detected. We suggest that integrated use of several biomarkers (BChE and CBEs, chemical reactivation of plasma with 2-PAM, and blood cell parameters) may be a promising procedure for use in biomonitoring programmes to diagnose pesticide exposure of wild populations of this frog and other native anuran species in Argentina.

Automated detection of breast cancer in false-negative screening MRI studies from women at increased risk.

PubMed

Gubern-Mérida, Albert; Vreemann, Suzan; Martí, Robert; Melendez, Jaime; Lardenoije, Susanne; Mann, Ritse M; Karssemeijer, Nico; Platel, Bram

2016-02-01

To evaluate the performance of an automated computer-aided detection (CAD) system to detect breast cancers that were overlooked or misinterpreted in a breast MRI screening program for women at increased risk. We identified 40 patients that were diagnosed with breast cancer in MRI and had a prior MRI examination reported as negative available. In these prior examinations, 24 lesions could retrospectively be identified by two breast radiologists in consensus: 11 were scored as visible and 13 as minimally visible. Additionally, 120 normal scans were collected from 120 women without history of breast cancer or breast surgery participating in the same MRI screening program. A fully automated CAD system was applied to this dataset to detect malignant lesions. At 4 false-positives per normal case, the sensitivity for the detection of cancer lesions that were visible or minimally visible in retrospect in prior-negative examinations was 0.71 (95% CI=0.38-1.00) and 0.31 (0.07-0.59), respectively. A substantial proportion of cancers that were misinterpreted or overlooked in an MRI screening program was detected by a CAD system in prior-negative examinations. It has to be clarified with further studies if such a CAD system has an influence on the number of misinterpreted and overlooked cancers in clinical practice when results are given to a radiologist. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Breast imaging. A practical look at its capabilities and its limitations.

PubMed

Clark, R; Nemec, L; Love, N

1992-10-01

The film-screen technique is evolving as the standard for mammography. Sonography is the only other method that currently has a defined role in breast imaging. Mammography should be performed at facilities that have received American College of Radiology accreditation or its equivalent, because technical quality assurance is an important part of mammographic practice. Interpretive quality may be assured by outcome audits performed by mammography facilities. Primary care physicians are best suited to encouraging eligible women to undergo screening studies and should consider these recommendations: Refer patients for screening mammography to accredited facilities according to established guidelines. Educate patients about the need for regular screening. Provide annual breast physical examination. Refresh your knowledge on breast health and the techniques of physical examination if necessary. Teach patients breast self-examination techniques. Demand low-cost, high-quality screening mammography; be aware of local variability of charges and quality.

Breast cancer survivorship: the role of perceived discrimination and sexual orientation.

PubMed

Jabson, Jennifer M; Donatelle, Rebecca J; Bowen, Deborah

2011-03-01

Breast cancer disproportionately affects sexual minority women (SMW) compared to heterosexual women and a small but growing literature indicates that SMW may have diminished survivorship outcomes; outcomes that are measurably and importantly different from heterosexual breast cancer survivors. However, it remains unknown how sexual orientation influences breast cancer survivorship outcomes such as quality of life. One possible route of influence is SMW's perceived discrimination in the health care setting. This cross-sectional study examines SMW perceptions of discrimination as one of the multiple facets of the breast cancer survivorship process. This study assessed SMW breast cancer survivor's perceptions of discrimination during their breast cancer treatment experience and secondarily, examined the role of this perceived discrimination on SMW's quality of life. Sixty-eight purposefully sampled sexual minority breast cancer survivors completed assessments of quality of life, perceived discrimination, perceived social support and perceived stress via an online survey. Statistical analyses point to perceived discrimination and perceived social support as important indicators for predicting SMW's quality of life. Future research on SMW's breast cancer survivorship should include measures of perceived discrimination.

Breast Self-Examination in Terms of Knowledge, Attitude, and Practice among Nursing Students of Arab American University/Jenin

ERIC Educational Resources Information Center

Ayed, Ahmad; Eqtait, Faeda; Harazneh, Lubna; Fashafsheh, Imad; Nazzal, Sewar; Talahmeh, Bian; Hajar, Deena; Awawdeh, Rrawan

2015-01-01

Background: Breast self-examination is a simple, very low cost, noninvasive with no special material/tool requirements; and it is an effective diagnostic method for breast cancer which only takes five minutes to apply. Aim of the Study: The study aimed to assess the level of BSE knowledge, attitude, and practice among female nursing students in…

We only talk about breast feeding: a discourse analysis of infant feeding messages in antenatal group-based education.

PubMed

Jennifer, Fenwick; Elaine, Burns; Athena, Sheehan; Virginia, Schmied

2013-05-01

the aim of the study was to examine the dominant discourses that midwives draw on to present information on breast feeding in group-based antenatal education sessions. breast-feeding initiation rates are high among Australian women however, duration rates are low. Antenatal breast-feeding education is considered a key strategy in promoting breast feeding to childbearing women. The efficacy and effectiveness of such a strategy is equivocal and there is little qualitative work examining group-based antenatal breast-feeding education. discourse analysis was used to explore the language and practises of midwives facilitating group antenatal breast-feeding education sessions at two Australian maternity facilities. Nine sessions were observed and tape recorded over a 12 month period. Each session lasted between 60 and 140 mins. the analysis revealed four dominate discourses midwives used to promote breast feeding during group-based antenatal education session. The predominant discourses 'There is only one feeding option': breast feeding' and 'Selling the 'breast is best' reflected how midwives used their personal and professional commitment to breast feeding, within supportive and protective policy frameworks, to convince as many pregnant women as possible to commit to breast feeding. Sessions were organised to ensure women and their partners were 'armed' with as much information as possible about the value of breastmilk, successful positioning and attachment and practical strategies to deal with early breast-feeding problems. Antenatal commitment to breast feeding was deemed necessary if women were to overcome potential hurdles and maintain a commitment to the supply of breast milk. The latter two discourses, drawn upon to promote the breast-feeding message, presented infants as 'hard wired' to breast feed and male partners as 'protectors' of breast feeding. midwives clearly demonstrated a passion and enthusiasm for breast-feeding education. Examining the dominant discourses used by midwives during the antenatal sessions revealed, however, that their language and practices were often limited to convincing women to breast feed rather than engaging with them in conversations that facilitated exploration and discovery of how breast feeding might be experienced within the mother-infant relationship and broader social and cultural context. In addition, there was evidence that global breast-feeding policies, in resource rich countries such as Australia, may influence how midwives talk about breast feeding without them being fully cognisant of the potentially coercive nature of the messages women receive. Copyright © 2012 Elsevier Ltd. All rights reserved.

Digital Mammography and Digital Breast Tomosynthesis.

PubMed

Moseley, Tanya W

2016-06-01

Breast imaging technology has advanced significantly from the 1930s until the present. American women have a 1 in 8 chance of developing breast cancer. Mammography has been proven in multiple clinical trials to reduce breast cancer mortality. Although a mainstay of breast imaging and improved from film-screen mammography, digital mammography is not a perfect examination. Overlapping obscuring breast tissue limits mammographic interpretation. Breast digital tomosynthesis reduces and/or eliminates overlapping obscuring breast tissue. Although there are some disadvantages with digital breast tomosynthesis, this relatively lost-cost technology may be used effectively in the screening and diagnostic settings.

Metastatic breast disease from cutaneous malignant melanoma.

PubMed

Moschetta, Marco; Telegrafo, Michele; Lucarelli, Nicola Maria; Martino, Gianluigi; Rella, Leonarda; Stabile Ianora, Amato Antonio; Angelelli, Giuseppe

2014-01-01

Malignant melanoma is one of the most rapidly increasing cancer in the world. Breast metastases from melanoma are uncommon but could reflect a widespread disease. We report a case of malignant widespread melanoma presenting with bilateral breast nodules in a 39 year-old pre-menopausal Caucasian woman with an history of cutaneous melanoma of the trunk. Breast clinical examination revealed the presence of a hard and mobile lump located on the left breast. Ultrasound detected two bilateral nodules corresponding to oval opacities with well-defined edges and without calcifications or architectural distortion on mammography. Fine needle aspiration cytology performed on both breast nodules confirmed that the breast lesions were metastases from primary cutaneous malignant melanoma. A total-body CT examination detected brain, lung and abdominal lymph nodes metastases. The breast represents an uncommon site of metastatic disease from extra-mammary tumors. Imaging features of breast metastases from melanoma usually do not allow a differential diagnosis with breast primary tumors. Breast metastases may be asymptomatic or palpable as dense and well-circumscribed nodules. Breast metastases indicate a widespread disease and should lead to avoid aggressive surgical procedures because of the poor prognosis of patients affected by metastatic melanoma. The detection of bilateral breast metastases from melanoma is highly suggestive of metastatic multi-organ disease and could be useful to address the therapeutic approach. Copyright © 2013 The Authors. Published by Elsevier Ltd.. All rights reserved.

Development of a Breast Cancer Awareness Scale for Thai Women: Moving towards a Validated Measure.

PubMed

Rakkapao, Nitchamon; Promthet, Supannee; Moore, Malcolm A; Hurst, Cameron P

2016-01-01

Breast cancer is a major health problem among women around the world. Recent developments in screening and treatment have greatly improved the prognosis of patients with breast cancer in developed countries. However, in developing countries breast cancer mortality remains high.Breast cancer awareness is a first and important step in reducing breast cancer mortality. The development of a validated instrument to measure breast cancer awareness is crucial for the understanding and implementation of suitable health education programs to facilitate early deletion and minimize mortality. The objective of this study was to develop an instrument for the assessment of breast cancer awareness in Thai women. This methodological study was conducted in two stages: (1) literature searches and semi-structured interviews were conducted to generate items of the breast cancer awareness scale (B-CAS) which were subsequently examined for content and face validity, and (2) an exploration of the factor structure of the resulting instrument and an examination of its reliability. Data were collected using a self-administered questionnaire in Thai women aged 20-64 in August, 2015. A total of 219 women (response rate 97.4 %) participated in this validation study. The B-CAS contains five domains with 53 items on breast cancer awareness: 1) knowledge of risk factors, 2) knowledge of signs and symptoms, 3) attitude to breast cancer prevention, 4) barriers of breast screening, and 5) health behavior related to breast cancer awareness. Items with a content validity index <0.80 were excluded, and factor structure for the remaining items reflected the hypothesized five factor model. The scales based on all retained items was shown to have strongly internal consistency reliability (Cronbach's α=0.86). The B-CAS provides good psychometric properties to assess breast cancer awareness in women. It can be used to examine breast cancer awareness in Thai women and it could lead to the development and evaluation of suitable educational interventions for raising breast cancer awareness. Future research should focus on further validating the B-CAS including an assessment of construct and criterion-based validity.

[Factors associated with secondary breast cancer prevention in Maringá, Paraná State, Brazil].

PubMed

Matos, Jéssica Carvalho de; Pelloso, Sandra Marisa; Carvalho, Maria Dalva de Barros

2011-05-01

This study analyzed the prevalence of secondary breast cancer prevention and associated factors in women 40 to 69 years of age in Maringá, Paraná State, Brazil. Prevalence was 64.5% for breast self-examination, 71.5% for clinical examination, and 79% for mammography. The data suggest that age, schooling, ethnicity, socioeconomic status, religion, and prior hormone replacement therapy influenced the rates of the three types of examination. Preventive practices were significantly more common among women of higher socioeconomic status. Proper orientation and performance of preventive measures and tests should be at the reach of all women in the highest-risk age bracket, thereby decreasing late diagnosis and avoidable deaths and increasing the odds of curing breast cancer.

Evaluation of effect of self-examination and physical examination on breast cancer.

PubMed

Hassan, Lotfi Mohammad; Mahmoud, Noori; Miller, Anthony B; Iraj, Harrirchi; Mohsen, Mirzaei; Majid, Jafarizadea; Reza, Sadeghian Mohammad; Mojgan, Minosepehr

2015-08-01

Breast cancer is the number one cancer of women in the world. More than 90% of breast cancers can be cured with early diagnosis followed by effective multimodality treatment. The efficacy of screening by breast self-examination (BSE) and breast physical examination (BPx) is best evaluated using randomized screening trials. A total of 12,660 women aged 35-64 years, 6330 in the intervention group and 6330 in the control group, were randomly selected from four areas of Yazd city, I.R. of Iran. The number of detected cancers along with kind of cancer, staging of cancer, the route of detected cancer and the number of deaths during the first 5 years of the study were collected and analyzed. No significance difference between the two groups was seen in respect to socio-demographic and socio-economic variables (P > 0.05). Subjects in the intervention group had a response rate of 83.5% for attending the health center and 80.2% for visiting the assigned surgeon. A total of 31 and 13 new cases of breast cancer were identified in the intervention and control groups, respectively, of which 48.5% of cases in the intervention group were <50 yr of age. A significant difference between the cumulative incidence of breast cancer in the two groups with a ratio of 2.4 was observed. BSE & BPx have a significant effect in detecting breast cancers at early stages (<3) suggesting they are effective screening tests with high availability and low costs that can be applied at the community level. Copyright © 2015 Elsevier Ltd. All rights reserved.

How breast cancer presents.

PubMed Central

Devitt, J. E.

1983-01-01

A study of 501 new breast cancers in patients seen in a consulting surgical practice revealed that 87% were in patients 45 years of age or older. The patients had found 83% of the cancers. The distributions of size and stage were the same for the tumours found by the patients and those found by the referring physicians. Two thirds of the cancers had an associated visible clinical sign, demonstrating the importance of inspection in the examination of the breast. Dimpling, sometimes apparent only on manipulation of the tumour, was present with 264 of the cancers and was often associated with "minimal" lesions. Mammography was done for 63 of the breast cancers but it missed 27. Of the physician-found cancers 15 were in patients who had already had breast cancer, 4 were in patients presenting with symptomatic metastases and 14 were in women presenting with other disorders. Of the 52 cancers found by periodic examination 3 were locally advanced and 21 had axillary metastases, while among the 28 "early" cancers 12 were in women who were senile, mentally defective or psychotic. Only four of the cancers found by the physicians were in women under age 45; two were rapidly fatal, one had an axillary metastasis, and the fourth was in a woman who had had cancer of the opposite breast. The remaining 284 lesions found by periodic or routine examination in women under age 45 were benign. Thus, periodic or routine examination for unsuspected breast cancer in women under age 45 seems unjustified except in those who have already had breast cancer. Images FIG. 1 FIG. 2 PMID:6861046

Cancer Knowledge and Examination Frequency in College Students.

ERIC Educational Resources Information Center

Craun, Ann M.; Deffenbacher, Jerry L.

1981-01-01

A study investigated whether the personality construct of repression-sensitization could identify which college students would or would not practice regular examinations for breast, cervical, or testicular cancer. Although knowledge of cancer increased after the lecture, no change was found in the frequency of breast self-examination while…

Adaptable Near-Infrared Spectroscopy Fiber Array for Improved Coupling to Different Breast Sizes During Clinical MRI

PubMed Central

Mastanduno, Michael A.; El-Ghussein, Fadi; Jiang, Shudong; DiFlorio-Alexander, Roberta; Junqing, Xu; Hong, Yin; Pogue, Brian W.; Paulsen, Keith D.

2016-01-01

Rationale and Objectives Near-infrared spectroscopy (NIRS) of breast can provide functional information on the vascular and structural compartments of tissues in regions identified during simultaneous magnetic resonance imaging (MRI). NIRS can be acquired during dynamic contrast-enhanced MRI (DCE-MRI) to accomplish image-guided spectroscopy of the enhancing regions, potentially increasing the diagnostic specificity of the examination and reducing the number of biopsies performed as a result of inconclusive MRI breast imaging studies. Materials and Methods We combine synergistic attributes of concurrent DCE-MRI and NIRS with a new design of the clinical NIRS breast interface that couples to a standard MR breast coil and allows imaging of variable breast sizes. Spectral information from healthy volunteers and cancer patients is recovered, providing molecular information in regions defined by the segmented MR image volume. Results The new coupling system significantly improves examination utility by allowing improved coupling of the NIR fibers to breasts of all cup sizes and lesion locations. This improvement is demonstrated over a range of breast sizes (cup size A through D) and normal tissue heterogeneity using a group of eight healthy volunteers and two cancer patients. Lesions located in the axillary region and medial-posterior breast are now accessible to NIRS optodes. Reconstructed images were found to have biologically plausible hemoglobin content, oxygen saturation, and water and lipid fractions. Conclusions In summary, a new NIRS/MRI breast interface was developed to accommodate the variation in breast sizes and lesion locations that can be expected in clinical practice. DCE-MRI–guided NIRS quantifies total hemoglobin, oxygenation, and scattering in MR-enhancing regions, increasing the diagnostic information acquired from MR examinations. PMID:24439327

Growing Use of Contralateral Prophylactic Mastectomy Despite no Improvement in Long-term Survival for Invasive Breast Cancer.

PubMed

Wong, Stephanie M; Freedman, Rachel A; Sagara, Yasuaki; Aydogan, Fatih; Barry, William T; Golshan, Mehra

2017-03-01

To update and examine national temporal trends in contralateral prophylactic mastectomy (CPM) and determine whether survival differed for invasive breast cancer patients based on hormone receptor (HR) status and age. We identified women diagnosed with unilateral stage I to III breast cancer between 1998 and 2012 within the Surveillance, Epidemiology, and End Results registry. We compared characteristics and temporal trends between patients undergoing breast-conserving surgery, unilateral mastectomy, and CPM. We then performed Cox proportional-hazards regression to examine breast cancer-specific survival (BCSS) and overall survival (OS) in women diagnosed between 1998 and 2007, who underwent breast-conserving surgery with radiation (breast-conserving therapy), unilateral mastectomy, or CPM, with subsequent subgroup analysis stratifying by age and HR status. Of 496,488 women diagnosed with unilateral invasive breast cancer, 59.6% underwent breast-conserving surgery, 33.4% underwent unilateral mastectomy, and 7.0% underwent CPM. Overall, the proportion of women undergoing CPM increased from 3.9% in 2002 to 12.7% in 2012 (P < 0.001). Reconstructive surgery was performed in 48.3% of CPM patients compared with only 16.0% of unilateral mastectomy patients, with rates of reconstruction with CPM rising from 35.3% in 2002 to 55.4% in 2012 (P < 0.001). When compared with breast-conserving therapy, we found no significant improvement in BCSS or OS for women undergoing CPM (BCSS: HR 1.08, 95% confidence interval 1.01-1.16; OS: HR 1.08, 95% confidence interval 1.03-1.14), regardless of HR status or age. The use of CPM more than tripled during the study period despite evidence suggesting no survival benefit over breast conservation. Further examination on how to optimally counsel women about surgical options is warranted.

Positive predictive values by mammographic density and screening mode in the Norwegian Breast Cancer Screening Program.

PubMed

Moshina, Nataliia; Ursin, Giske; Roman, Marta; Sebuødegård, Sofie; Hofvind, Solveig

2016-01-01

To investigate the probability of breast cancer among women recalled due to abnormal findings on the screening mammograms (PPV-1) and among women who underwent an invasive procedure (PPV-2) by mammographic density (MD), screening mode and age. We used information about 28,826 recall examinations from 26,951 subsequently screened women in the Norwegian Breast Cancer Screening Program, 1996-2010. The radiologists who performed the recall examinations subjectively classified MD on the mammograms into three categories: fatty (<30% fibroglandular tissue); medium dense (30-70%) and dense (>70%). Screening mode was defined as screen-film mammography (SFM) and full-field digital mammography (FFDM). We examined trends of PPVs by MD, screening mode and age. We used logistic regression to estimate odds ratio (OR) of screen-detected breast cancer associated with MD among women recalled, adjusting for screening mode and age. PPV-1 and PPV-2 decreased by increasing MD, regardless of screening mode (p for trend <0.05 for both PPVs). PPV-1 and PPV-2 were statistically significantly higher for FFDM compared with SFM for women with fatty breasts. Among women recalled, the adjusted OR of breast cancer decreased with increasing MD. Compared with women with fatty breasts, the OR was 0.90 (95% CI: 0.84-0.96) for those with medium dense breasts and 0.85 (95% CI: 0.76-0.95) for those with dense breasts. PPVs decreased by increasing MD. Fewer women needed to be recalled or undergo an invasive procedure to detect one breast cancer among those with fatty versus dense breasts in the screening program in Norway, 1996-2010. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Association of breast-feeding and feeding on demand with child weight status up to 4 years.

PubMed

Gubbels, Jessica S; Thijs, Carel; Stafleu, Annette; van Buuren, Stef; Kremers, Stef P J

2011-06-01

The mechanisms underlying the protective effect of breast-feeding on the development of childhood overweight are unclear. This study examines the association of breast-feeding with weight gain in the first year, and body mass index (BMI) and overweight up to 4 years. In addition, we examine possible mechanisms of this effect (i.e., feeding pattern, eating style, unhealthy snacking behavior). Data originated from the KOALA Birth Cohort Study (N = 2 834). Questionnaires assessed breast-feeding duration up to 12 months, feeding pattern (i.e., feeding on demand or feeding to schedule) at 3 months, BMI at 1, 2 and 4 years, eating style (e.g., slow eating) at age 1, and unhealthy snacking at age 2. Linear and logistic regression analyses were used to examine the association of breast-feeding and feeding pattern with eating style, unhealthy snacking, BMI z-scores and overweight. Each additional month of breast-feeding was associated with less weight gain in the first year (regression coefficient B = -37.6 g, p < 0.001), a lower BMI z-score at age 1 (B = -0.02, p < 0.01), and a lower odds of being overweight at age 1 (odds ratio = 0.96, p < 0.05). Breast-feeding was associated with fewer unhealthy snacking occasions per week at age 2 (B = -0.19 for each month of breast-feeding, p < 0.001), but was unrelated to eating style. Feeding pattern was unrelated to all outcome variables after adjustment for breast-feeding duration. The study showed a short-term protective effect of breast-feeding against overweight development. Possible mechanisms through which breast-feeding may protect against overweight include less unhealthy snacking behavior, but not feeding pattern or child's eating style.

Misclassification of Breast Imaging Reporting and Data System (BI-RADS) mammographic density and implications for breast density reporting legislation

PubMed Central

Gard, Charlotte C.; Aiello Bowles, Erin J.; Miglioretti, Diana L.; Taplin, Stephen H.; Rutter, Carolyn M.

2015-01-01

U.S. states have begun legislating mammographic breast density reporting to women, requiring that women undergoing screening mammography who have dense breast tissue (BI-RADS density c or d) receive written notification of their breast density; however, the impact that misclassification of breast density will have on this reporting remains unclear. The aim of this study was to assess reproducibility of the four-category Breast Imaging Reporting and Data System (BI-RADS) density measure and examine its relationship with a continuous measure of percent density. We enrolled 19 radiologists, experienced in breast imaging, from a single integrated healthcare system. Radiologists interpreted 341 screening mammograms at two points in time six months apart. We assessed intra- and inter-observer agreement in radiologists’ interpretations of BI-RADS density and explored whether agreement depended upon radiologist characteristics. We examined the relationship between BI-RADS density and percent density in a subset of 282 examinations. Intra-radiologist agreement was moderate to substantial, with kappa varying across radiologists from 0.50–0.81 (mean=0.69, 95% CI (0.63, 0.73)). Intra-radiologist agreement was higher for radiologists with ≥10 years experience interpreting mammograms (difference in mean kappa=0.10, 95% CI (0.01, 0.24)). Inter-radiologist agreement varied widely across radiologist pairs from slight to substantial, with kappa ranging from 0.02–0.72 (mean=0.46, 95% CI (0.36, 0.55)). Of 145 examinations interpreted as “non-dense” (BI-RADS density a or b) by the majority of radiologists, 82.8% were interpreted as “dense” (BI-RADS density c or d) by at least one radiologist. Of 187 examinations interpreted as “dense” by the majority of radiologists, 47.1% were interpreted as “non-dense” by at least one radiologist. While the examinations of almost half of the women in our study were interpreted clinically as having BI-RADS density c or d, only about 10% of examinations had percent density >50%. Our results suggest that breast density reporting based on a single BI-RADS density interpretation may be misleading due to high inter-radiologist variability and a lack of correspondence between BI-RADS density and percent density. PMID:26133090

Result of randomized control trial to increase breast health awareness among young females in Malaysia.

PubMed

Akhtari-Zavare, Mehrnoosh; Juni, Muhamad Hanafiah; Said, Salmiah Md; Ismail, Irmi Zarina; Latiff, Latiffah A; Ataollahi Eshkoor, Sima

2016-08-08

Breast cancer is the most common cancer and the second principal cause of cancer deaths in women worldwide as well as in Malaysia. Breast self-examination (BSE) has a role in raising breast cancer awareness among women and educational programs play an important role in breast cancer preventive behavior. The aim of this study is to develop, implement and evaluate the effectiveness of Breast Health Awareness program based on health belief model on knowledge of breast cancer and breast-selfexamination and BSE practice among female students in Malaysia. A single-blind randomized controlled trial was carried out among 370 female undergraduate students from January 2011 to April 2012 in two selected public universities in Malaysia. Participants were randomized to either the intervention group or the control group. The educational program was delivered to the intervention group. The outcome measures were assessed at baseline, 6, and 12 months after implementing the health educational program. Chi-square, independent samples t-test and two-way repeated measures ANOVA (GLM) were conducted in the course of the data analyses. Mean scores of knowledge on breast cancer (p<0.003), knowledge on breast self examination (p<0.001), benefits of BSE (p<0.00), barrier of BSE (0.01) and confidence of BSE practice (p<0.00) in the intervention group had significant differences in comparison with those of the control group 6 and 12 months after the intervention. Also, among those who never practiced BSE at baseline, frequency of BSE practice increased 6 and 12 months after the intervention (p<0.05). The Breast Health Awareness program based on health the belief model had a positive effect on knowledge of breast cancer and breast self-examination and practice of BSE among females in Malaysia. The ANZCTR clinical trial registry ( ACTRN12616000831482 ), retrospectively registered on Jun 23, 2016 in ANZCTR.org.au.

Cognitive deficits in Korean women treated with chemotherapy for breast cancer.

PubMed

Jung, Mi Sook; Cimprich, Bernadine

2014-01-01

Cognitive deficits have been reported as detrimental side effects in chemotherapy-treated breast cancer patients and survivors. Korean women treated for breast cancer may experience unrecognized cognitive deficits related to their treatment. However, no research has examined cognitive test performance in chemotherapy-treated Korean breast cancer survivors. The objectives of this study were 2-fold: (1) to examine differences in occurrence and severity of cognitive deficits in Korean women treated with adjuvant chemotherapy for breast cancer as compared with a control group of women without breast cancer and (2) to examine the relationship of selected demographic and cultural factors with cognitive test performance. Sixty-four Korean women, 32 women treated for localized breast cancer and 32 healthy controls, were enrolled. Breast cancer participants were assessed with established cognitive measures within 4 months after chemotherapy, and healthy controls, within 6 months after negative screening mammography. The breast cancer group showed a significantly higher occurrence and greater severity of cognitive deficits than controls did. Importantly, older age, less education, greater collectivist tendency, and greater childrearing burden were reliably associated with poorer attention and working memory test performance. Cognitive deficits were found in chemotherapy-treated Korean women with moderate to large effect sizes compared with controls. Cultural characteristics contributed to worse cognitive performance. Healthcare providers should recognize that Korean women may be highly vulnerable to cognitive deficits. Cultural factors also need to be considered when assessing cognitive function and designing therapeutic interventions to counteract negative cognitive outcomes.

Liposuction breast reduction: a prospective trial in African American women.

PubMed

Moskovitz, Martin J; Baxt, Sherwood A; Jain, Aridaman K; Hausman, Robert E

2007-02-01

Recently published case reports and outcome studies support the use of liposuction alone as an effective technique for ameliorating symptoms of breast hypertrophy. This study is the first prospective trial to examine the effectiveness of liposuction breast reduction as a primary modality of breast reduction. In addition, this study examines the role that liposuction breast reduction can play in the treatment of African American women, given the known scarring difficulties that darker skinned patients can encounter with traditional breast reduction surgery. Twenty African American women were recruited through newspaper and Internet advertisements. Patients aged 20 to 60 years were serially accepted to the study. Patients with a chief complaint of breast ptosis were excluded. No other exclusion criteria were used. Previously validated questionnaire instruments were used preoperatively and postoperatively to measure breast-related symptoms, general patient health perception, bodily pain, and self-esteem. Comorbid conditions, demographics, financial status, prior treatments, and smoking history were also documented. Seventeen patients completed the preoperative and postoperative questionnaires. An average of 1075 cc of tissue was removed per breast during liposuction breast reduction surgery. Postoperative assessment showed a significant decrease in breast-related symptoms, a significant decrease in patient pain, and a significant improvement in overall patient health perception. Liposuction breast reduction is a useful breast reduction modality in the properly selected patient. African American women, who may traditionally forego breast reduction surgery because of scarring, are excellent candidates for this type of reduction procedure.

Benign Breast Disease: Toward Molecular Prediction of Breast Cancer Risk

DTIC Science & Technology

2008-06-01

of benign histology in predicting risk of future breast cancer, examining in detail the role of proliferative disease, atypia , papillomas, radial...who had proliferative disease with atypia , especially those of younger age. • We identified a marked increased risk of breast cancer in women with...imparts an increased risk of developing a subsequent carcinoma similar to other forms of proliferative breast disease without atypia . Atypical

Culture, attitude and knowledge about breast cancer and preventive measures: a qualitative study of South Asian breast cancer patients in the UK.

PubMed

Karbani, Gulshan; Lim, Jennifer N W; Hewison, Jenny; Atkin, Karl; Horgan, Kieran; Lansdown, Mark; Chu, Carol E

2011-01-01

Little is known about the influence of culture and beliefs about breast cancer, and its implications on preventive health behaviour among South Asian people in the UK. Using a qualitative approach, 24 South Asian breast cancer patients and their significant others were interviewed. Most patients were unfamiliar with the subject of cancer; they expressed lack of knowledge of cancer as a disease and its symptoms. They identified a painless lump in the breast as sign of abnormality, but not cancer. They also did not know any non-lump breast symptoms. Over half participated in breast screening after encouragement from daughters or relatives. Most did not practise breast self-examination. Perceptions of cancer and health behaviour were influenced by cultural beliefs. Common themes were cancer is a taboo subject and cancer is a stigma. Patients also expressed misunderstandings about the cause of cancer. Cancer in the family had ramifications on children' s marriage prospects and may cause marital breakdown. Terminology used also caused communication problems with healthcare professionals and within the family: the use of ' chest' to substitute ' breast' changed the meaning of the message conveyed. Cultural beliefs and practices accentuate difficulties in understanding breast cancer, breast screening and breast self-examination, and can prevent South Asian women from adopting preventive health practices.

Localized primary amyloidosis of the breast: a case report and review of the literature.

PubMed

Tsuji, Wakako; Takeuchi, Eiji; Oka, Satoshi; Yamashita, Taro; Yotsumoto, Fumiaki

2016-09-13

Primary amyloidosis of the breast is an unusual benign disease that mostly occurs in postmenopausal elderly women. Amyloidosis is the deposition of amorphous protein within tissues. Breast biopsy is necessary to make a definite diagnosis in order to avoid unnecessary surgical methods. Localized primary amyloidosis of the breast has a good prognosis. However, secondary amyloidosis is a systemic disease and has a poor prognosis. We report the case of a 77-year-old female with primary amyloidosis of the breast. She noticed a lump in her left breast. Mammographic and ultrasonographic examinations indicated breast cancer. However, core needle biopsy showed amyloidosis, not cancer of the breast. For further examinations, the patient visited the outpatient clinics of the hematology, dermatology, and gastroenterology departments. She underwent bone marrow aspiration, computed tomography, cardiac ultrasonography, random skin biopsy, gastrofiberscopy, and colonofiberscopy. Plasma cell myeloma and systemic amyloidosis were ruled out, and localized breast amyloidosis was highly suspected. Lumpectomy was performed to make a definite diagnosis, and histological evaluations revealed that this patient had localized amyloidosis of the breast, and the deposited amyloid protein was of the amyloid light chain kappa type. Breast biopsy is necessary in order to avoid unnecessary surgical technique. A diagnosis should be achieved only through a histological evaluation. The main treatment of localized primary amyloidosis of the breast is surgical removal.

Breast Cancer and the Environment Research Program

Cancer.gov

The Breast Cancer and the Environment Research Program supports a multidisciplinary network of scientists, clinicians, and community partners to examine the effects of environmental exposures that may predispose a woman to breast cancer throughout her life.

Basic Biological Concepts: What Should the World's Children Know? Proceedings from the International Union of Biological Sciences and the Commission for Biological Education (IUBS/CBE) Symposium (Colorado Springs, Colorado, August 30-September 5, 1992).

ERIC Educational Resources Information Center

McWethy, Patricia J., Ed.

Science is not a phenomenon restricted to one group of people. Instead it is something that is experienced by all, though often its form is unrecognized. Because science is experienced by many, one would expect that different groups of people would share common experiences in science. In an effort to determine whether there are similarities in…

Mission of the Future. Proceedings of the Annual Convention of the Association for the Development of Computer-Based Instructional Systems. Volume I: General Session Papers and Project Reports (San Diego, California, February 27 to March 1, 1979).

ERIC Educational Resources Information Center

Association for the Development of Computer-based Instructional Systems.

The first of three volumes of papers presented at the 1979 ADCIS convention, this collection includes most of the 30 papers presented at the general session and 34 project reports. The general session opened with seven papers on various aspects of videodisc technology and five papers describing phases in the life of CBE sites. The remaining…

A Computer-Based Educational Approach to the Air Command and Staff College Associate Program

DTIC Science & Technology

1985-04-01

control interactive vid e o, grade student responses and perform some analysis on the dat a . Its main advantages lie in the ability of the author to...basic goal of provid- ing the instructor with assitance in the development of good CBE. One way of viewing the different tools on the market is to...ractice , tutorials and simple games all have as their premise the computer replacing the teacher in a one-on-one en- counter. The other modes, simulation

"Voices of fear and safety" women's ambivalence towards breast cancer and breast health: a qualitative study from Jordan.

PubMed

Taha, Hana; Al-Qutob, Raeda; Nyström, Lennarth; Wahlström, Rolf; Berggren, Vanja

2012-07-26

Breast cancer is the leading cause of cancer mortality among Jordanian women. Breast malignancies are detected at late stages as a result of deferred breast health-seeking behaviour. The aim of this study was to explore Jordanian women's views and perceptions about breast cancer and breast health. We performed an explorative qualitative study with purposive sampling. Ten focus groups were conducted consisting of 64 women (aged 20 to 65 years) with no previous history and no symptoms of breast cancer from four governorates in Jordan. The transcribed data was analysed using latent content analysis. Three themes were constructed from the group discussions: a) Ambivalence in prioritizing own health; b) Feeling fear of breast cancer; and c) Feeling safe from breast cancer. The first theme was seen in women's prioritizing children and family needs and in their experiencing family and social support towards seeking breast health care. The second theme was building on women's perception of breast cancer as an incurable disease associated with suffering and death, their fear of the risk of diminished femininity, husband's rejection and social stigmatization, adding to their apprehensions about breast health examinations. The third theme emerged from the women's perceiving themselves as not being in the risk zone for breast cancer and in their accepting breast cancer as a test from God. In contrast, women also experienced comfort in acquiring breast health knowledge that soothed their fears and motivated them to seek early detection examinations. Women's ambivalence in prioritizing their own health and feelings of fear and safety could be better addressed by designing breast health interventions that emphasize the good prognosis for breast cancer when detected early, involve breast cancer survivors in breast health awareness campaigns and catalyse family support to encourage women to seek breast health care.

“Voices of Fear and Safety” Women’s ambivalence towards breast cancer and breast health: a qualitative study from Jordan

PubMed Central

2012-01-01

Background Breast cancer is the leading cause of cancer mortality among Jordanian women. Breast malignancies are detected at late stages as a result of deferred breast health-seeking behaviour. The aim of this study was to explore Jordanian women’s views and perceptions about breast cancer and breast health. Methods We performed an explorative qualitative study with purposive sampling. Ten focus groups were conducted consisting of 64 women (aged 20 to 65 years) with no previous history and no symptoms of breast cancer from four governorates in Jordan. The transcribed data was analysed using latent content analysis. Results Three themes were constructed from the group discussions: a) Ambivalence in prioritizing own health; b) Feeling fear of breast cancer; and c) Feeling safe from breast cancer. The first theme was seen in women’s prioritizing children and family needs and in their experiencing family and social support towards seeking breast health care. The second theme was building on women’s perception of breast cancer as an incurable disease associated with suffering and death, their fear of the risk of diminished femininity, husband’s rejection and social stigmatization, adding to their apprehensions about breast health examinations. The third theme emerged from the women’s perceiving themselves as not being in the risk zone for breast cancer and in their accepting breast cancer as a test from God. In contrast, women also experienced comfort in acquiring breast health knowledge that soothed their fears and motivated them to seek early detection examinations. Conclusions Women’s ambivalence in prioritizing their own health and feelings of fear and safety could be better addressed by designing breast health interventions that emphasize the good prognosis for breast cancer when detected early, involve breast cancer survivors in breast health awareness campaigns and catalyse family support to encourage women to seek breast health care. PMID:22834874

Breast Cancer Screening by Physical Examination: Randomized Trial in the Phillipines

DTIC Science & Technology

2005-10-01

J -4327 TITLE: Breast Cancer Screening by Physical Examination: Randomized Trial in the Phillipines...Examination: Randomized Trial in the 5a. CONTRACT NUMBER Phillipines 5b. GRANT NUMBER DAMD17-94- J -4327 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S...Grant DAMD17-94- J -4327 3 Table of

Self-efficacy mediates the relationship between behavioral processes of change and physical activity in older breast cancer survivors.

PubMed

Loprinzi, Paul D; Cardinal, Bradley J

2013-01-01

The degree to which breast cancer survivors use behavioral processes of change has not been investigated. Additionally, the relationship between behavioral processes and other theory-based mediators of adult physical activity behavior has not been extensively studied among breast cancer survivors. The objectives of this study were to: (1) determine the extent to which breast cancer survivors use behavioral processes associated with physical activity behavior change, and (2) examine the inter-relationships between behavioral processes, self-efficacy, and physical activity behavior among breast cancer survivors. Sixty-nine breast cancer survivors completed surveys examining behavioral processes and exercise-specific self-efficacy. Six months later they completed a self-report physical activity questionnaire. Findings showed the majority of breast cancer survivors did not use approximately half of the behavioral processes on a regular basis, and self-efficacy completely mediated the relationship between behavioral processes and physical activity. Health care professionals may help enhance self-efficacy and ultimately increase physical activity behavior in breast cancer survivors by teaching behavior skills such as enlisting social support.

Assessment of two mammographic density related features in predicting near-term breast cancer risk

NASA Astrophysics Data System (ADS)

Zheng, Bin; Sumkin, Jules H.; Zuley, Margarita L.; Wang, Xingwei; Klym, Amy H.; Gur, David

2012-02-01

In order to establish a personalized breast cancer screening program, it is important to develop risk models that have high discriminatory power in predicting the likelihood of a woman developing an imaging detectable breast cancer in near-term (e.g., <3 years after a negative examination in question). In epidemiology-based breast cancer risk models, mammographic density is considered the second highest breast cancer risk factor (second to woman's age). In this study we explored a new feature, namely bilateral mammographic density asymmetry, and investigated the feasibility of predicting near-term screening outcome. The database consisted of 343 negative examinations, of which 187 depicted cancers that were detected during the subsequent screening examination and 155 that remained negative. We computed the average pixel value of the segmented breast areas depicted on each cranio-caudal view of the initial negative examinations. We then computed the mean and difference mammographic density for paired bilateral images. Using woman's age, subjectively rated density (BIRADS), and computed mammographic density related features we compared classification performance in estimating the likelihood of detecting cancer during the subsequent examination using areas under the ROC curves (AUC). The AUCs were 0.63+/-0.03, 0.54+/-0.04, 0.57+/-0.03, 0.68+/-0.03 when using woman's age, BIRADS rating, computed mean density and difference in computed bilateral mammographic density, respectively. Performance increased to 0.62+/-0.03 and 0.72+/-0.03 when we fused mean and difference in density with woman's age. The results suggest that, in this study, bilateral mammographic tissue density is a significantly stronger (p<0.01) risk indicator than both woman's age and mean breast density.

Overexpression of Activin Receptor-like Kinase 7 in Breast Cancer Cells Is Associated with Decreased Cell Growth and Adhesion.

PubMed

Hu, Tingting; Su, Fengxi; Jiang, Wenguo; Dart, D Alwyn

2017-07-01

To examine the expression and function of activin receptor-like kinase 7 (ALK7) in breast cancer, its association with disease prognosis, and its impact on breast cancer cell function. A cohort of patients with breast cancer were examined for ALK7 expression in association with pathological and clinical aspects. In vitro cell assays of ALK7 were investigated using an expression plasmid. Overall higher levels of ALK7 transcripts were seen in the breast cancer samples vs. normal tissue. However, within the cancer cohort, lower levels of ALK7 transcript were associated with poor prognosis. Patients with lower expression of ALK7 also had shorter survival. Overexpression of ALK7 reduced proliferation and adhesion of breast cancer cells in vitro. We found that overexpressed ALK7 had complex effects on the MCF-7 cell sensitivity to chemotherapy drugs. Decreased expression of ALK7 in breast cancer is correlated with poor prognosis. ALK7 is a negative regulator of adhesion and proliferation of breast cancer cells. This suggests that ALK7 is a potential tumor suppressor in breast cancer. Copyright© 2017, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

[Exploring a non-inflammatory clinical breast mass: Clinical practice guidelines].

PubMed

Legendre, G; Guilhen, N; Nadeau, C; Brossard, A; Fauvet, R

2015-12-01

The aim of the study was to assess the diagnostic value of physical examination, radiologic explorations and percutaneous procedures of the breast in the exploration of a non-inflammatory palpable mass, in order to propose guidelines. A systematic literature review was conducted in the Medline and Cochrane library databases. International guidelines in French and English language were also consulted until April 30th 2015. Physical examination of a non-inflammatory palpable breast mass is not sufficient to eliminate a breast cancer (LE2). Mammography alone has a sensitivity between 70 and 95% for the diagnosis of breast cancer (LE3). Echography alone has a sensitivity of 98 to 100% for the diagnosis of breast cancer (LE2). The core needle biopsy has a better sensitivity and specificity than the fine-needle aspiration for breast cancer diagnosis (LE2). The association of mammography and 2D echography presents excellent sensitivity and negative predictive value (close to 100 %) to exclude a breast cancer (LE3). A double evaluation using mammography and echography is recommended in the exploration of a non-inflammatory palpable breast mass (grade B). Copyright © 2015 Elsevier Masson SAS. All rights reserved.

Screening for breast cancer: U.S. Preventive Services Task Force recommendation statement.

PubMed

2009-11-17

Update of the 2002 U.S. Preventive Services Task Force (USPSTF) recommendation statement on screening for breast cancer in the general population. The USPSTF examined the evidence on the efficacy of 5 screening modalities in reducing mortality from breast cancer: film mammography, clinical breast examination, breast self-examination, digital mammography, and magnetic resonance imaging in order to update the 2002 recommendation. To accomplish this update, the USPSTF commissioned 2 studies: 1) a targeted systematic evidence review of 6 selected questions relating to benefits and harms of screening, and 2) a decision analysis that used population modeling techniques to compare the expected health outcomes and resource requirements of starting and ending mammography screening at different ages and using annual versus biennial screening intervals. The USPSTF recommends against routine screening mammography in women aged 40 to 49 years. The decision to start regular, biennial screening mammography before the age of 50 years should be an individual one and take into account patient context, including the patient's values regarding specific benefits and harms. (Grade C recommendation) The USPSTF recommends biennial screening mammography for women between the ages of 50 and 74 years. (Grade B recommendation) The USPSTF concludes that the current evidence is insufficient to assess the additional benefits and harms of screening mammography in women 75 years or older. (I statement) The USPSTF concludes that the current evidence is insufficient to assess the additional benefits and harms of clinical breast examination beyond screening mammography in women 40 years or older. (I statement) The USPSTF recommends against clinicians teaching women how to perform breast self-examination. (Grade D recommendation) The USPSTF concludes that the current evidence is insufficient to assess additional benefits and harms of either digital mammography or magnetic resonance imaging instead of film mammography as screening modalities for breast cancer. (I statement).

Relative value of physical examination, mammography, and breast sonography in evaluating the size of the primary tumor and regional lymph node metastases in women receiving neoadjuvant chemotherapy for locally advanced breast carcinoma.

PubMed

Herrada, J; Iyer, R B; Atkinson, E N; Sneige, N; Buzdar, A U; Hortobagyi, G N

1997-09-01

The purpose of this study was to correlate physical examination and sonographic and mammographic measurements of breast tumors and regional lymph nodes with pathological findings and to evaluate the effect of neoadjuvant chemotherapy on clinical Tumor-Node-Metastasis stage by noninvasive methods. This was a retrospective analysis of 100 patients with locally advanced breast cancer registered and treated in prospective trials of neoadjuvant chemotherapy. All patients received four cycles of a doxorubicin-containing regimen and had noninvasive evaluation of the primary tumor and regional lymph nodes before and after neoadjuvant chemotherapy by physical examination, sonography, and mammography and underwent breast surgery and axillary dissection within 5 weeks after completion of neoadjuvant chemotherapy. The correlations between clinical and pathological measurements were determined by Spearman rank correlation analysis. A proportional odds model was used to examine predictive values. Eighty-three patients had both a clinically detectable primary tumor and lymph node metastases. Sixty-four patients had a decrease in Tumor-Node-Metastasis stage after chemotherapy. For 54% of patients, there was concordance in clinical response between the primary tumor and lymph node compartment; for the rest, results were discordant. Physical examination correlated best with pathological findings in the measurement of the primary tumor (P = 0.0003), whereas sonography was the most accurate predictor of size for axillary lymph nodes (P = 0.0005). The combination of physical examination and mammography worked best for assessment of the primary tumor (P = 0.003), whereas combining physical examination with sonography gave optimal evaluation of regional lymph nodes (P = 0.0001). In conclusion, physical examination is the best noninvasive predictor of the real size of locally advanced primary breast cancer, whereas sonography correlates better with the real dimensions of axillary lymph nodes. The combination of physical examination with either mammography or sonography significantly improves the accuracy of noninvasive assessment of tumor dimensions.

A fatal gastric perforation secondary to ulcerated metastasis in undiagnosed breast cancer: pathological aspects and review of literature.

PubMed

Barranco, R; Orcioni, G F; Ventura, F

2017-08-01

The authors describe a fatal case of gastric perforation secondary to an ulcerated metastasis in a woman with undiagnosed breast cancer. The 48-year-old woman, with no significant medical history, presented with weight loss, persistent dyspepsia and pain in the epigastric and mesogastric region. She was treated by her primary care physician with proton-pump inhibitors and antispasmodics. The following day she was found dead at her home. External examination showed a tumefaction in the lateral region of her left breast, near the axilla. Autopsy revealed 1000 ml of turbid, light-brown peritoneal fluid in the abdominal cavity and a perforated gastric wall. Histological examination of the breast mass showed an infiltrating, poorly-differentiated breast carcinoma. Microscopical analysis of the stomach wall revealed a perforated metastatic gastric ulcer. Immunohistochemistry was required to confirm the neoplastic involvement of the stomach due to metastatic breast cancer.

Automated Breast Density Computation in Digital Mammography and Digital Breast Tomosynthesis: Influence on Mean Glandular Dose and BIRADS Density Categorization.

PubMed

Castillo-García, Maria; Chevalier, Margarita; Garayoa, Julia; Rodriguez-Ruiz, Alejandro; García-Pinto, Diego; Valverde, Julio

2017-07-01

The study aimed to compare the breast density estimates from two algorithms on full-field digital mammography (FFDM) and digital breast tomosynthesis (DBT) and to analyze the clinical implications. We selected 561 FFDM and DBT examinations from patients without breast pathologies. Two versions of a commercial software (Quantra 2D and Quantra 3D) calculated the volumetric breast density automatically in FFDM and DBT, respectively. Other parameters such as area breast density and total breast volume were evaluated. We compared the results from both algorithms using the Mann-Whitney U non-parametric test and the Spearman's rank coefficient for data correlation analysis. Mean glandular dose (MGD) was calculated following the methodology proposed by Dance et al. Measurements with both algorithms are well correlated (r ≥ 0.77). However, there are statistically significant differences between the medians (P < 0.05) of most parameters. The volumetric and area breast density median values from FFDM are, respectively, 8% and 77% higher than DBT estimations. Both algorithms classify 35% and 55% of breasts into BIRADS (Breast Imaging-Reporting and Data System) b and c categories, respectively. There are no significant differences between the MGD calculated using the breast density from each algorithm. DBT delivers higher MGD than FFDM, with a lower difference (5%) for breasts in the BIRADS d category. MGD is, on average, 6% higher than values obtained with the breast glandularity proposed by Dance et al. Breast density measurements from both algorithms lead to equivalent BIRADS classification and MGD values, hence showing no difference in clinical outcomes. The median MGD values of FFDM and DBT examinations are similar for dense breasts (BIRADS d category). Published by Elsevier Inc.

The effect of knowledge on uptake of breast cancer prevention modalities among women in Kyadondo County, Uganda.

PubMed

Atuhairwe, Christine; Amongin, Dinah; Agaba, Elly; Mugarura, Steven; Taremwa, Ivan M

2018-02-23

Breast cancer, the third most frequent cancer of women is preventable through knowledge on breast self-examination. Of the 44% of women diagnosed with breast cancer at the Uganda Cancer Institute, only 22% go for check-up in less than three months. This study explored the effect of breast cancer knowledge on the uptake of breast cancer prevention modalities among women in Kyadondo County, Uganda. A household survey of women in Kyadondo County was conducted during June, 2014 to August, 2015. This involved studying in-depth using a questionnaire the level of breast cancer knowledge of the respondents. Data was analyzed using logistic regression model. Chi-square test was used to establish relationships between knowledge base factors and the uptake of breast cancer prevention modalities. This study has established an empirical relationship between uptake of breast cancer prevention modalities and source of information especially radio (OR 1.94 95% CI: 1.16-3.24), television (OR 1.82 95%CI: 1.14-2.93), awareness of breast cancer (OR 4.03 95%CI: 1.01-15.98), knowledge on how to reduce risk of breast cancer (OR 1.98 95% CI: 1.20-3.27), what reduces breast cancer acquisition (OR 2.75 95% CI: 1.42-5.35), how to check for signs of breast cancer especially through breast self-examination (OR 3.09 95% CI: 1.62-5.88), and other methods of breast cancer diagnosis in a health care set up. The women's level of breast cancer awareness as a primary prevention strategy was found wanting, and requires a boost through community health education.

Adipose-Derived Stromal Vascular Fraction Differentially Expands Breast Progenitors in Tissue Adjacent to Tumors Compared to Healthy Breast Tissue

PubMed Central

Chatterjee, Sumanta; Laliberte, Mike; Blelloch, Sarah; Ratanshi, Imran; Safneck, Janice; Buchel, Ed

2015-01-01

Background: Autologous fat grafts supplemented with adipose-derived stromal vascular fraction are used in reconstructive and cosmetic breast procedures. Stromal vascular fraction contains adipose-derived stem cells that are thought to encourage wound healing, tissue regeneration, and graft retention. Although use of stromal vascular fraction has provided exciting perspectives for aesthetic procedures, no studies have yet been conducted to determine whether its cells contribute to breast tissue regeneration. The authors examined the effect of these cells on the expansion of human breast epithelial progenitors. Methods: From patients undergoing reconstructive breast surgery following mastectomies, abdominal fat, matching tissue adjacent to breast tumors, and the contralateral non–tumor-containing breast tissue were obtained. Ex vivo co-cultures using breast epithelial cells and the stromal vascular fraction cells were used to study the expansion potential of breast progenitors. Breast reduction samples were collected as a source of healthy breast cells. Results: The authors observed that progenitors present in healthy breast tissue or contralateral non–tumor-containing breast tissue showed significant and robust expansion in the presence of stromal vascular fraction (5.2- and 4.8-fold, respectively). Whereas the healthy progenitors expanded up to 3-fold without the stromal vascular fraction cells, the expansion of tissue adjacent to breast tumor progenitors required the presence of stromal vascular fraction cells, leading to a 7-fold expansion, which was significantly higher than the expansion of healthy progenitors with stromal vascular fraction. Conclusions: The use of stromal vascular fraction might be more beneficial to reconstructive operations following mastectomies compared with cosmetic corrections of the healthy breast. Future studies are required to examine the potential risk factors associated with its use. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, V. PMID:26090768

Fibroadenoma in axilla: another manifestation of ectopic breast

PubMed Central

Tiwary, Satyendra K; Kumar, Puneet; Khanna, Ajay Kumar

2015-01-01

Fibroadenoma of an accessory breast is a rare disease. The clinical significance lies in the fact that a number of cystic, inflammatory, neoplastic diseases similar to those of a normal breast have been reported in accessory breasts as well. Vigilant self-assessment and complete clinical examination are always encouraged to detect earliest malignancy in the axilla. We report two cases of ectopic breast fibroadenoma with the relevant literature. PMID:25917072

Health beliefs related to breast self-examination in a sample of Turkish women.

PubMed

Nahcivan, Nursen O; Secginli, Selda

2007-03-01

To examine health beliefs and sociodemographic and breast cancer-related variables influencing breast self-examination (BSE) practice. Descriptive, cross-sectional. Two vocational training centers in Istanbul, Turkey. 438 women were selected using a convenience sampling method. Participants had not had breast cancer and were not currently pregnant or breast-feeding. The mean age of participants was 33.51 years (range = 18-67). Willing participants were asked to complete a self-administered questionnaire and the Turkish version of Champion's Health Belief Model Scale. The sample was categorized into two groups: performers (i.e., women who performed BSE at least occasionally) and non-performers (i.e., women who had never performed BSE). Perceived susceptibility to and seriousness of breast cancer, perceived benefits of and barriers to BSE, confidence in the ability to perform BSE, health motivation, and frequency of BSE practice. Significant differences between performers and non-performers correlated to age, marital status, health insurance, regular gynecologic visits, and education about breast cancer and BSE. The mean scores of perceived benefits and confidence were noticeably higher in performers. Stepwise logistic regression analysis yielded three significant predictor variables. Women who had more confidence in their ability to perform BSE, had health insurance, and were informed about breast cancer were more likely to practice BSE. Women in Turkey are at great risk for advanced breast cancer and metastatic spread because of their lack of knowledge. Nurses must provide information on breast cancer etiology, risks, prevention, and detection. To promote BSE practice among Turkish women, tailored health education and health promotion programs should be developed based on a specific understanding of women's health beliefs.

Improvement in diagnostic performance of breast cancer: comparison between conventional digital mammography alone and conventional mammography plus digital breast tomosynthesis.

PubMed

Ohashi, Ryoko; Nagao, Michinobu; Nakamura, Izumi; Okamoto, Takahiro; Sakai, Shuji

2018-04-12

The aim of this study was to determine if the diagnostic performance of breast lesion examinations could be improved using both digital breast tomosynthesis (DBT) and conventional digital mammography (CDM). Our institutional review board approved the protocol, and patients were provided the opportunity to opt out of the study. A total of 628 patients aged 22-91 years with abnormal screening results or clinical symptoms were consecutively enrolled between June 2015 and March 2016. All patients underwent DBT and CDM, and 1164 breasts were retrospectively analyzed by three radiologists who interpreted the results based on the Breast Imaging Reporting and Data System. Categories 4 and 5 were considered positive, and pathological results were the gold standard. The diagnostic performance of CDM and CDM plus DBT was compared using the mean areas under the receiver operating characteristic (ROC) curves. A total of 100 breast cancer cases were identified. The areas under the ROC curves were 0.9160 (95% confidence interval 0.8779-0.9541) for CDM alone and 0.9376 (95% confidence interval 0.9019-0.9733) for CDM plus DBT. The cut-off values for both CDM alone and CDM plus DBT measurements were 4, with sensitivities of 61.0% (61/100) and 83.0% (83/100), respectively, and specificities of 99.1% (1054/1064) and 98.9% (1052/1064), respectively. CDM yielded 39 false-negative diagnoses, while CDM plus DBT identified breast cancer in 22 of those cases (56.4%). The combination of DBT and CDM for the diagnosis of breast cancer in women with abnormal examination findings or clinical symptoms proved effective and should be used to improve the diagnostic performance of breast cancer examinations.

Young investigator challenge: The utility of GATA3 immunohistochemistry in the evaluation of metastatic breast carcinomas in malignant effusions.

PubMed

Lew, Madelyn; Pang, Judy C; Jing, Xin; Fields, Kristina L; Roh, Michael H

2015-10-01

It is not uncommon to encounter challenges in the immunohistochemical confirmation of metastatic breast cancer given the limited sensitivities of mammaglobin and gross cystic disease fluid protein 15 (GCDFP-15/BRST-2) and the significant proportion of triple-negative breast carcinomas (ie, tumors that are negative for estrogen receptor [ER], and progesterone receptor [PgR], and human epidermal growth factor 2 [HER2]). GATA binding protein 3 (GATA3) has emerged as a potentially useful immunohistochemical adjunct during the evaluation of metastatic breast carcinomas in cytology specimens. The objective of the current study was to examine GATA3 expression in the context of malignant effusions secondary to both mammary and extramammary malignancies. In total, 306 malignant effusions (from 62 metastatic breast carcinomas and 244 extramammary malignancies) were examined using GATA3 immunohistochemistry. Effusions with metastatic breast carcinoma were also examined using immunohistochemistry for additional breast markers (ER, PgR, HER2, mammaglobin, and GCDFP-15/BRST-2). GATA3 immunohistochemistry highlighted the tumor cells in 58 of the 62 samples (93.5%) from patients with metastatic breast carcinoma, which was higher than the observed sensitivity of immunohistochemistry for ER (63.8%), PgR (41.4%), HER2 (15.5%), mammaglobin (22.4%), and GCDFP-15/BRST-2 (5.2%). GATA3 expression also was observed in a subset of malignant effusions secondary to extramammary primaries, specifically, in 28 of 244 specimens (11.5%). GATA3 is a highly sensitive marker for the detection of metastatic breast carcinomas in effusion specimens. However, this marker is not entirely specific for malignancies of breast origin. Thus, GATA3 should be used in conjunction with additional immunohistochemical markers during the cytologic evaluation of malignant effusions. © 2015 American Cancer Society.

Breast tumor size assessment: comparison of conventional ultrasound and contrast-enhanced ultrasound.

PubMed

Jiang, Yu-Xin; Liu, He; Liu, Ji-Bin; Zhu, Qing-Li; Sun, Qiang; Chang, Xiao-Yan

2007-12-01

Accurate assessment of tumor size is necessary when selecting patients for breast-conserving surgery. In the study of breast contrast-enhanced ultrasound (CEUS), we found that tumor size discrepancy between CEUS and conventional ultrasound (US) existed in some breast lesions, for which the reasons are not clear. Breast CEUS examinations were performed in 104 patients with breast lesions. The measurement of the 104 breast tumors on conventional US was obtained and compared with the measurement on CEUS. A difference in measuring tumor size of >3 mm for tumors up to 1.7 cm and 4 mm for tumors >or=1.7 cm, was defined as a significant discrepancy between conventional US and CEUS. The histopathological examination of size discrepancy was performed and the margin characteristics of breast cancers with larger measurements were compared with those with unchanged measurements. Among the 104 lesions (43 malignant, 60 benign, 1 borderline), the size of 27 breast cancers and one granulomatous mastitis appeared larger at CEUS. Pathologic examinations of the region corresponding to the measurement discrepancy were mainly ductal carcinomas in situ (DCIS), invasive carcinoma with a DCIS component, adenosis with lobular hyperplasia in breast cancers and inflammatory cell infiltration in one granulomatous mastitis. Well-defined margin characteristics were significantly different between breast cancers with larger measurements at CEUS and those with unchanged measurements of size (p = 0.002), whereas no significant difference was found between the two groups in ill-defined, spiculated, hyperechoic halo, microlobulated and angulated margins (p = 0.463, 0.117, 0.194, 0.666 and 0.780, respectively). This initial study suggests that significant discrepancy of breast lesion measurement between conventional US and CEUS is more likely presented in breast cancer than benign lesions. The pathologic findings corresponding to the region of size increased at CEUS are malignant in most malignant lesions and benign in benign lesions. It is difficult to predict whether the size measurement of the breast cancer increases at CEUS based on the margin characteristics showed on conventional US.

Increasing cancer detection yield of breast MRI using a new CAD scheme of mammograms

NASA Astrophysics Data System (ADS)

Tan, Maxine; Aghaei, Faranak; Hollingsworth, Alan B.; Stough, Rebecca G.; Liu, Hong; Zheng, Bin

2016-03-01

Although breast MRI is the most sensitive imaging modality to detect early breast cancer, its cancer detection yield in breast cancer screening is quite low (< 3 to 4% even for the small group of high-risk women) to date. The purpose of this preliminary study is to test the potential of developing and applying a new computer-aided detection (CAD) scheme of digital mammograms to identify women at high risk of harboring mammography-occult breast cancers, which can be detected by breast MRI. For this purpose, we retrospectively assembled a dataset involving 30 women who had both mammography and breast MRI screening examinations. All mammograms were interpreted as negative, while 5 cancers were detected using breast MRI. We developed a CAD scheme of mammograms, which include a new quantitative mammographic image feature analysis based risk model, to stratify women into two groups with high and low risk of harboring mammography-occult cancer. Among 30 women, 9 were classified into the high risk group by CAD scheme, which included all 5 women who had cancer detected by breast MRI. All 21 low risk women remained negative on the breast MRI examinations. The cancer detection yield of breast MRI applying to this dataset substantially increased from 16.7% (5/30) to 55.6% (5/9), while eliminating 84% (21/25) unnecessary breast MRI screenings. The study demonstrated the potential of applying a new CAD scheme to significantly increase cancer detection yield of breast MRI, while simultaneously reducing the number of negative MRIs in breast cancer screening.

Is breast compression associated with breast cancer detection and other early performance measures in a population-based breast cancer screening program?

PubMed

Moshina, Nataliia; Sebuødegård, Sofie; Hofvind, Solveig

2017-06-01

We aimed to investigate early performance measures in a population-based breast cancer screening program stratified by compression force and pressure at the time of mammographic screening examination. Early performance measures included recall rate, rates of screen-detected and interval breast cancers, positive predictive value of recall (PPV), sensitivity, specificity, and histopathologic characteristics of screen-detected and interval breast cancers. Information on 261,641 mammographic examinations from 93,444 subsequently screened women was used for analyses. The study period was 2007-2015. Compression force and pressure were categorized using tertiles as low, medium, or high. χ 2 test, t tests, and test for trend were used to examine differences between early performance measures across categories of compression force and pressure. We applied generalized estimating equations to identify the odds ratios (OR) of screen-detected or interval breast cancer associated with compression force and pressure, adjusting for fibroglandular and/or breast volume and age. The recall rate decreased, while PPV and specificity increased with increasing compression force (p for trend <0.05 for all). The recall rate increased, while rate of screen-detected cancer, PPV, sensitivity, and specificity decreased with increasing compression pressure (p for trend <0.05 for all). High compression pressure was associated with higher odds of interval breast cancer compared with low compression pressure (1.89; 95% CI 1.43-2.48). High compression force and low compression pressure were associated with more favorable early performance measures in the screening program.

Use of quantitative optical imaging to examine the role of cholesterol-rich lipid raft microdomains in the migration of breast cancer cells

NASA Astrophysics Data System (ADS)

You, Minghai; Chen, Jianling; Wang, Shaobing; Dong, Shiqing; Wang, Yuhua; Xie, Shusen; Wang, Zhengchao; Yang, Hongqin

2018-04-01

Lipid rafts have been extensively studied and shown to be involved in many cancers, including breast cancer. However, the exact role of lipid rafts in the migration of breast cancer cells remains unclear. This study was designed to examine lipid rafts (cholesterol) in the plasma membrane of breast cancer cells (MDA-MB-231 and MCF-7) and normal breast epithelial cells (MCF-10A) through generalized polarization values, and further investigate the role of cholesterol-rich lipid rafts in the migration of breast cancer cells. The results showed that the plasma membrane in breast cancer cells was more orderly than that in normal epithelial cells; this was correlated with expression changes of matrix metallopeptidase 9 (MMP-9) and urokinase-type plasminogen activator receptor (uPAR), the markers of cancer cell migration. Moreover, the breast cancer cells were more sensitive to the reagent that induced cholesterol depletion than the normal breast epithelial cells, while the capacity of cancer cells to migrate decreased significantly according to changes in MMP-9 and uPAR expression. To our best knowledge, this is the first demonstration of the relationship between cholesterol-rich lipid rafts and the migration of breast cancer cells; it could be useful for the prevention of breast cancer and early treatment through reduction of the level of cholesterol in the plasma membrane of the cells.

Association of Knowledge and Cultural Perceptions of Malaysian Women with Delay in Diagnosis and Treatment of Breast Cancer: a Systematic Review.

PubMed

Khan, Tahir Mehmood; Leong, Jamie Pik Yan; Ming, Long Chiau; Khan, Amer Hayat

2015-01-01

Breast cancer is the most common cancer and the leading cause of cancer mortality among women of all ethnic and age groups in Malaysia. Delay in seeking help for breast cancer symptoms is preventable and by identifying possible factors for delayed diagnosis, patient prognosis and survival rates could be improved. This narrative review aimed to understand and evaluate the level of in-depth breast cancer knowledge in terms of clinical breast examination and breast self-examination, and other important aspects such as side-effects and risk factors in Malaysian females. Since Malaysia is multicultural, this review assessed social perceptions, cultural beliefs and help-seeking behaviour in respect to breast cancer among different ethnic groups, since these may impinge on efforts to 'avoid' the disease. A comprehensive literature search of seven databases was performed from December 2015 to January 2015. Screening of relevant published journals was also undertaken to identify available information related to the knowledge, perception and help-seeking behaviour of Malaysian women in relation to breast cancer. A total of 42 articles were appraised and included in this review. Generally, women in Malaysia had good awareness of breast cancer and its screening tools, particularly breast self-examination, but only superficial in-depth knowledge about the disease. Women in rural areas had lower levels of knowledge than those in urban areas. It was also shown that books, magazines, brochures and television were among the most common sources of breast cancer information. Delay in presentation was attributed mainly to a negative social perception of the disease, poverty, cultural and religion practices, and a strong influence of complementary and alternative medicine, rather than a lack of knowledge. This review highlighted the need for an intensive and in-depth breast cancer education campaigns using media and community health programmes, even with the existing good awareness of breast cancer. This is essential in order to avoid misconceptions and to frame the correct mind-set about breast cancer among women in Malaysia. Socio-cultural differences and religious practices should be taken into account by health care professionals when advising on breast cancer. Women need to be aware of the risk factors and symptoms of breast cancer so that early diagnosis can take place and the chances of survival improved.

One Sister's Story

MedlinePlus

... vital through breast self-examination and regular mammograms. Need more information on Breast Cancer? From MedlinePlus.gov : For a slideshow with sound and pictures: Click on Interactive Tutorials at upper right; ... on What You Need to Know about Breast Cancer. This research is ...

Screening Breast MRI Outcomes in Routine Clinical Practice: Comparison to BI-RADS Benchmarks.

PubMed

Strigel, Roberta M; Rollenhagen, Jennifer; Burnside, Elizabeth S; Elezaby, Mai; Fowler, Amy M; Kelcz, Frederick; Salkowski, Lonie; DeMartini, Wendy B

2017-04-01

The BI-RADS Atlas 5th Edition includes screening breast magnetic resonance imaging (MRI) outcome benchmarks. However, the metrics are from expert practices and clinical trials of women with hereditary breast cancer predispositions, and it is unknown if they are appropriate for routine practice. We evaluated screening breast MRI audit outcomes in routine practice across a spectrum of elevated risk patients. This Institutional Review Board-approved, Health Insurance Portability and Accountability Act-compliant retrospective study included all consecutive screening breast MRI examinations from July 1, 2010 to June 30, 2013. Examination indications were categorized as gene mutation carrier (GMC), personal history (PH) breast cancer, family history (FH) breast cancer, chest radiation, and atypia/lobular carcinoma in situ (LCIS). Outcomes were determined by pathology and/or ≥12 months clinical and/or imaging follow-up. We calculated abnormal interpretation rate (AIR), cancer detection rate (CDR), positive predictive value of recommendation for tissue diagnosis (PPV2) and biopsy performed (PPV3), and median size and percentage of node-negative invasive cancers. Eight hundred and sixty examinations were performed in 566 patients with a mean age of 47 years. Indications were 367 of 860 (42.7%) FH, 365 of 860 (42.4%) PH, 106 of 860 (12.3%) GMC, 14 of 860 (1.6%) chest radiation, and 8 of 22 (0.9%) atypia/LCIS. The AIR was 134 of 860 (15.6%). Nineteen cancers were identified (13 invasive, 4 DCIS, two lymph nodes), resulting in CDR of 19 of 860 (22.1 per 1000), PPV2 of 19 of 88 (21.6%), and PPV3 of 19 of 80 (23.8%). Of 13 invasive breast cancers, median size was 10 mm, and 8 of 13 were node negative (61.5%). Performance outcomes of screening breast MRI in routine clinical practice across a spectrum of elevated risk patients met the American College of Radiology Breast Imaging Reporting and Data System benchmarks, supporting broad application of these metrics. The indication of a personal history of treated breast cancer accounted for a large proportion (42%) of our screening examinations, with breast MRI performance in this population at least comparable to that of other screening indications. Copyright © 2017 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

Screening Breast MRI Outcomes in Routine Clinical Practice: Comparison to BI-RADS Benchmarks

PubMed Central

Strigel, Roberta M.; Rollenhagen, Jennifer; Burnside, Elizabeth S.; Elezaby, Mai; Fowler, Amy M.; Kelcz, Frederick; Salkowski, Lonie; DeMartini, Wendy B.

2017-01-01

Rationale and Objectives The BI-RADS Atlas 5th Edition includes screening breast magnetic resonance imaging (MRI) outcome benchmarks. However, the metrics are from expert practices and clinical trials of women with hereditary breast cancer predispositions, and it is unknown if they are appropriate for routine practice. We evaluated screening breast MRI audit outcomes in routine practice across a spectrum of elevated risk patients. Materials and Methods This Institutional Review Board-approved, Health Insurance Portability and Accountability Act-compliant retrospective study included all consecutive screening breast MRI examinations from July 1, 2010 to June 30, 2013. Examination indications were categorized as gene mutation carrier (GMC), personal history (PH) breast cancer, family history (FH) breast cancer, chest radiation, and atypia/lobular carcinoma in situ (LCIS). Outcomes were determined by pathology and/or ≥12 months clinical and/or imaging follow-up. We calculated abnormal interpretation rate (AIR), cancer detection rate (CDR), positive predictive value of recommendation for tissue diagnosis (PPV2) and biopsy performed (PPV3), and median size and percentage of node-negative invasive cancers. Results Eight hundred and sixty examinations were performed in 566 patients with a mean age of 47 years. Indications were 367 of 860 (42.7%) FH, 365 of 860 (42.4%) PH, 106 of 860 (12.3%) GMC, 14 of 860 (1.6%) chest radiation, and 8 of 22 (0.9%) atypia/LCIS. The AIR was 134 of 860 (15.6%). Nineteen cancers were identified (13 invasive, 4 DCIS, two lymph nodes), resulting in CDR of 19 of 860 (22.1 per 1000), PPV2 of 19 of 88 (21.6%), and PPV3 of 19 of 80 (23.8%). Of 13 invasive breast cancers, median size was 10 mm, and 8 of 13 were node negative (61.5%). Conclusions Performance outcomes of screening breast MRI in routine clinical practice across a spectrum of elevated risk patients met the American College of Radiology Breast Imaging Reporting and Data System benchmarks, supporting broad application of these metrics. The indication of a personal history of treated breast cancer accounted for a large proportion (42%) of our screening examinations, with breast MRI performance in this population at least comparable to that of other screening indications. PMID:27986508

The long-term financial consequences of breast cancer: a Danish registry-based cohort study.

PubMed

Jensen, Laura Schärfe; Overgaard, Charlotte; Bøggild, Henrik; Garne, Jens Peter; Lund, Thomas; Overvad, Kim; Fonager, Kirsten

2017-10-30

A breast cancer diagnosis affects an individual's affiliation to labour market, but the long-term consequences of breast cancer on income in a Danish setting have not been examined. The present study investigated whether breast cancer affected future income among Danish women that participated in the work force. We also examined the roles of sociodemographic factors and prior psychiatric medical treatment. This registry-based cohort study was based on information retrieved from linked Danish nationwide registries. We compared the incomes of 13,101 women (aged 30-59 years) diagnosed with breast cancer (exposed) to those of 60,819 women without breast cancer (unexposed). Changes in income were examined during a 10-year follow-up; for each follow-up year, we calculated the mean annual income and the relative change compared to the income earned one year prior to diagnosis. Expected changes in Danish female income, according to calendar year and age, were estimated based on information from Statistics Denmark. For exposed and unexposed groups, the observed income changes were dichotomized to those above and those below the expected change in income in the Danish female population. We examined the impact of breast cancer on income each year of follow-up with logistic regression models. Analyses were stratified according to educational level, marital status, and prior psychiatric medical treatment. Breast cancer had a temporary negative effect on income. The effect was largest during the first three years after diagnosis; thereafter, the gap narrowed between exposed and unexposed cohorts. The odds ratio for an increase in income in the cancer cohort compared to the cancer-free cohort was 0.81 (95% CI 0.77-0.84) after three years. After seven years, no significant difference was observed between cohorts. Stratified analyses demonstrated that the negative effect of breast cancer on income lasted longest among women with high educational levels. Being single or having received psychiatric medical treatment increased the chance to experience an increase in income among women with breast cancer. A breast cancer diagnosis led to negative effects on income, which ameliorated over the following seven years. Sociodemographic factors and prior psychiatric medical treatment might influence long-term consequences of breast cancer on income.

Pseudogynecomastia secondary to injection of heroin into breast tissue.

PubMed

Carlson, R H; Velez, R; Rivlin, R S

1978-03-01

A 50-year-old man who has a heroin addict developed bilateral, symmetrical swelling of the breasts as a result of injecting himself directly into the breasts for several years. Results of histologic examination of the breast tissue showed granulomatous inflammation and a foreign body reaction without gynecomastia or tumor. Liver and endocrine functions were generally normal.

Biomonitoring Breast Milk Polybrominated Diphenyl Ethers as a Function of Environment, Dietary Intake, and Demographics in New Hampshire

USDA-ARS?s Scientific Manuscript database

Breast milk is a valuable biological specimen for biomonitoring lipid-soluble polybrominated diphenyl ethers (PBDEs). The purpose of this study was to determine the levels of PBDEs in breast milk from New Hampshire and to examine potential relationships between PBDE levels in breast milk and stage o...

Impact of Breast Self-Examination Planned Educational Messages on Social Network Communications: An Exploratory Study.

ERIC Educational Resources Information Center

Gravell, Joanne; And Others

1985-01-01

This study examined the effect of college women's participation in a breast self-examination (BSE) educational program on discussion of BSE with specific members of their social network. Also, the characteristics of college women who did report discussion with others were investigated as was the relationship between this discussion and the…

HER2-positive double primary tumor of gastric and breast cancer occur synchronously in a patient: A case report

PubMed Central

OUYANG, QUCHANG; TIAN, CAN; GAO, JIANXIANG; HUANG, JIN; FU, HUA; HE, JINSONG; YANG, JIANBO

2016-01-01

The simultaneous occurrence of primary gastric cancer and breast cancer is rare, and the positive expression of human epidermal growth factor receptor (HER)2 in double primary carcinoma of gastric and breast cancer remains to be reported. The present study presented a 46-year-old woman complaining of irregular acid reflux and stomach discomfort. The stomach cancer was diagnosed by esophagogastroduodenoscopy examination of the pathological biopsies in 2010. The patient underwent a radical gastrectomy for gastric cancer, and postoperative pathological examination revealed moderately-poorly differentiated adenocarcinoma with HER2 positive expression. The tumor invaded into the entire thickness of the gastric wall and lymph nodes. The patient received five treatments of postoperative chemotherapy. In August 2011, the patient felt a lump in the right breast. Simple excision of the right breast mass was performed on September 2011, and postoperative pathological examination revealed the invasive ductal carcinoma of the right breast with HER2 amplification by fluorescent in situ hybridization assay. The patient was treated with postoperative chemotherapy and radiotherapy, and also Trastuzumab target therapy. The patient succumbed to aggressive disease progression in March 2012. PMID:27123269

The evolution of FDA policy on silicone breast implants: a case study of politics, bureaucracy, and business in the process of decision-making.

PubMed

Palley, H A

1995-01-01

The central issue facing federal regulation of breast implants is that while such devices are not functionally necessary or needed for survival, the side effects may be harmful and have not been proven unharmful. The Medical Device Amendments of 1976 appear to require such evidence prior to the FDA permitting the unrestricted marketing of these devices. However, only recently have such requirements been imposed by the FDA. The author examines the FDA's decision-making process, particularly as applied to silicone breast implants, and the factors that appears to have affected such decisions. In pursuing this study, the activities of a number of interest-group actors, as well as congressional responses and the role of federal bureaucratic actors, were examined. In 1992, the FDA established a regulatory protocol that effectively withdrew most silicone breast implants from the market for the purpose of breast augmentation and allows for the monitoring of the impact of new implants on women's health. This increase concern for determining the safety of breast implants is due to a number of factors, which are examined in this article.

Consistency of breast and arm symptoms during the first two years after breast cancer surgery.

PubMed

Wennman-Larsen, Agneta; Petersson, Lena-Marie; Saboonchi, Fredrik; Alexanderson, Kristina; Vaez, Marjan

2015-03-01

To examine the severity and development of breast and arm symptoms separately during the two years following breast cancer surgery, and to examine whether previously defined predictors of arm symptoms are associated with breast symptoms. Prospective cohort study with two-year follow-up. Three institutions in the Stockholm, Sweden, region. 645 women, aged 20-63 years, enrolled within 12 weeks of surgery for primary breast cancer. Baseline register and questionnaire data with five follow-ups were submitted to descriptive, inferential, and logistic regression analysis. Severity of breast and arm symptoms measured by the European Organisation for Research and Treatment of Cancer breast cancer-specific quality-of-life questionnaire. Most participants had undergone breast-conserving 
surgery and sentinel lymph node dissection, and were scheduled for postoperative radiation therapy. Overall mean levels of breast and arm symptoms were low, but with large individual variations. At all six time points, the mean levels of breast symptoms were significantly higher than those of arm symptoms. Overall, the mean level of both types of symptoms decreased during follow-up. A body mass index (BMI) of 25 or greater and breast symptoms at eight months were associated with having breast symptoms at two years. Arm symptoms at baseline and at eight months, and radiation therapy and a BMI of 25 or greater were associated with having arm symptoms at two years. Breast symptoms show different patterns of change and are not associated with the same factors as arm symptoms. For nurses monitoring women treated for breast cancer, the results of this study provide knowledge regarding the importance of early symptom identification and long-term symptoms after treatment.

Does Breast-feeding Relate to Development of Atopic Dermatitis in Young Korean Children?: Based on the Fourth and Fifth Korea National Health and Nutrition Examination Survey 2007–2012

PubMed Central

Lee, Kyung Suk; Rha, Yeong-Ho; Oh, In-Hwan; Choi, Yong Sung; Kim, Young-Eun

2017-01-01

Purpose There have been conflicting reports concerning the relationship between breast-feeding and the development of atopic dermatitis (AD) in early childhood. The objective of this study was to investigate the associations between breast-feeding and the risk of AD in early childhood in Korea. Methods We combined the fourth and fifth Korea National Health and Nutrition Examination Survey data collected from 2007 to 2012 and analyzed 2,015 children at 1 to 3 years old. Regression analysis was used to determine the association of the following variables: AD, feeding types, duration of breast-feeding, and others. Results The annual prevalence of exclusive breast-feeding and AD decreased. Parents with allergic diseases preferred breast-feeding and extended duration of feeding compared with those without. In multiple logistic regression analyses, exclusive breast-feeding in feeding type I (P=0.070; adjusted odds ratio [OR]=1.990), exclusive breast-feeding in feeding type II (P=0.095; adjusted OR=1.495) and breast-feeding duration (P=0.430; adjusted OR=1.013) were not significantly related to AD. Conclusions Breast-feeding was not found to be associated with an occurrence of AD in young children. Rather, parents with histories of allergic diseases tended to prefer breast-feeding and extend its duration. To clarify the role of breast-feeding in the development of AD, a nation-wide prospective study is needed. PMID:28497917

Relevancy of an In-Service Examination for Core Knowledge Training in a Surgical Subspecialty.

PubMed

Silvestre, Jason; Chang, Benjamin; Serletti, Joseph M

2016-01-01

To facilitate knowledge acquisition during plastic surgery residency, we analyzed the breast curriculum on the Plastic Surgery In-Service Training Exam (PSITE). Breast-related questions on 6 consecutive PSITEs were analyzed (2008-2013). Topics were categorized by the content outline for the American Board of Plastic Surgery written board examination. Question vignettes were classified by taxonomy and clinical setting. References for correct answer choices were categorized by source and publication lag. A total of 136 breast-related questions were analyzed (136/1174, 12%). Questions tended to appear more in the Breast and Cosmetic (75%) section than the Comprehensive (25%) section (p < 0.001). Most question vignettes were written in a clinical setting (64%, p < 0.001). Question taxonomy was evenly distributed among recall (34%), interpretation (28%), and decision-making (37%, p > 0.05). Only 6% of questions required photographic evaluation. Breast-related topics focused on esthetic problems (35%), traumatic deformities (22%), and tumors (21%). Answer references comprised 293 citations to 63 unique journals published a median of 6 years before PSITE administration. Plastic and Reconstructive Surgery (57%) was the most cited journal (p < 0.001) and Surgery of the Breast: Principles and Art by Spear was the most referenced textbook (22%). The PSITE affords a curriculum that reflects breast-related topics on the American Board of Plastic Surgery written board examination. These data may optimize knowledge acquisition in esthetic and reconstructive breast surgery. Copyright © 2015. Published by Elsevier Inc.

Factors associated with breast self-examination practices and beliefs in female workers at a Muslim community.

PubMed

Avci, Ilknur Aydin

2008-04-01

The purpose of this descriptive correlational study was to identify knowledge levels and performance frequency of breast self-examination (BSE) and to examine variables related to breast cancer screening behaviors in a sample of Turkish women. Data were collected from a convenience sample of 103 Muslim female workers at a hazelnut factory in Ordu city, Turkey, using an adapted version of Champion's revised Health Belief Model Scale. Results showed that 26.2% of the women reported knowledge of BSE and 4.3% reported that they perform BSE. Higher health motivation, higher perceived self-efficacy of BSE, marital status, and familial breast cancer history were significantly associated with BSE performance. Higher levels of health motivation and higher perceived self-efficacy of BSE were also significantly associated with knowledge of BSE.

Effect of methylparaben in Artemia franciscana.

PubMed

Comeche, Amparo; Martín-Villamil, María; Picó, Yolanda; Varó, Inma

2017-09-01

In this study, the toxicity of methylparaben (MeP) an emerging contaminant, was analysed in the sexual species Artemia franciscana, due to its presence in coastal areas and marine saltworks in the Mediterranean region. The acute toxicity (24h-LC 50 ) of MeP in nauplii was tested and its chronic effect (9days) evaluated by measuring survival and growth under two sublethal concentrations (0.0085 and 0.017mg/L). Also, the effect on several key enzymes involved in: antioxidant defences (catalase (CAT) and gluthathion-S-transferase (GST)), neural activity (cholinesterase (ChE)) and xenobiotic biotransformation (carboxylesterase (CbE), was assessed after 48h under sublethal exposure. The results of acute exposure indicate that MeP is harmful to A. franciscana (24h-LC 50 =36.7mg/L). MeP causes a decrease in CAT activity after 48h exposure to both concentration tested, that points out at the oxidative stress effect of MeP in A. franciscana. However, no significant effect on ChE, CbE and GST activities was found. In addition, MeP does not affect survival and growth in chronic exposure at the sublethal concentrations tested. The results of this study indicate that MeP is not a threat for A. franciscana under the experimental conditions used. Additional studies should be done considering long-term exposure and reproduction studies to analyse the potential risk of MeP as emerging contaminant in marine and hypersaline environments. Published by Elsevier Inc.

Contrast-enhanced spectral mammography (CESM) versus breast magnetic resonance imaging (MRI): A retrospective comparison in 66 breast lesions.

PubMed

Li, L; Roth, R; Germaine, P; Ren, S; Lee, M; Hunter, K; Tinney, E; Liao, L

2017-02-01

The purpose of this study was to retrospectively compare the diagnostic performance of contrast-enhanced spectral mammography (CESM) with that of breast magnetic resonance imaging (BMRI) in breast cancer detection using parameters, including sensitivity, positive predictive value (PPV), lesion size, morphology, lesion and background enhancement, and examination time. A total of 48 women (mean age, 56years±10.6 [SD]) with breast lesions detected between October 2012 and March 2014 were included. Both CESM and BMRI were performed for each patient within 30 days. The enhancement intensity of lesions and breast background parenchyma was subjectively assessed for both modalities and was quantified for comparison. Statistical significance was analyzed using paired t-test for mean size of index lesions in all malignant breasts (an index lesion defined as the largest lesion in each breast), and a mean score of enhancement intensity for index lesions and breast background. PPV, sensitivity, and accuracy were calculated for both CESM and BMRI. The average duration time of CESM and MRI examinations was also compared. A total of 66 lesions were identified, including 62 malignant and 4 benign lesions. Both CESM and BMRI demonstrated a sensitivity of 100% for detection of breast cancer. There was no statistically significant difference between the mean size of index lesions (P=0.108). The enhancement intensity of breast background was significantly lower for CESM than for BMRI (P<0.01). The mean score of enhancement intensity of index lesions on CESM was significantly less than that for BMRI (P<0.01). The smallest lesion that was detected by both modalities measured 4mm. CESM had a higher PPV than BMRI (P>0.05). The average examination time for CESM was significantly shorter than that of BMRI (P<0.01). CESM has similar sensitivity than BMRI in breast cancer detection, with higher PPV and less background enhancement. CESM is associate with significantly shorter exam time thus a more accessible alternative to BMRI, and has the potential to play an important tool in breast cancer detection and staging. Copyright © 2016 Éditions françaises de radiologie. Published by Elsevier Masson SAS. All rights reserved.

Follistatin is a metastasis suppressor in a mouse model of HER2-positive breast cancer.

PubMed

Seachrist, Darcie D; Sizemore, Steven T; Johnson, Emhonta; Abdul-Karim, Fadi W; Weber Bonk, Kristen L; Keri, Ruth A

2017-06-05

Follistatin (FST) is an intrinsic inhibitor of activin, a member of the transforming growth factor-β superfamily of ligands. The prognostic value of FST and its family members, the follistatin-like (FSTL) proteins, have been studied in various cancers. However, these studies, as well as limited functional analyses of the FSTL proteins, have yielded conflicting results on the role of these proteins in disease progression. Furthermore, very few have been focused on FST itself. We assessed whether FST may be a suppressor of tumorigenesis and/or metastatic progression in breast cancer. Using publicly available gene expression data, we examined the expression patterns of FST and INHBA, a subunit of activin, in normal and cancerous breast tissue and the prognostic value of FST in breast cancer metastases, recurrence-free survival, and overall survival. The functional effects of activin and FST on in vitro proliferation, migration, and invasion of breast cancer cells were also examined. FST overexpression in an autochthonous mouse model of breast cancer was then used to assess the in vivo impact of FST on metastatic progression. Examination of multiple breast cancer datasets revealed that FST expression is reduced in breast cancers compared with normal tissue and that low FST expression predicts increased metastasis and reduced overall survival. FST expression was also reduced in a mouse model of HER2/Neu-induced metastatic breast cancer. We found that FST blocks activin-induced breast epithelial cell migration in vitro, suggesting that its loss may promote breast cancer aggressiveness. To directly determine if FST restoration could inhibit metastatic progression, we transgenically expressed FST in the HER2/Neu model. Although FST had no impact on tumor initiation or growth, it completely blocked the formation of lung metastases. These data indicate that FST is a bona fide metastasis suppressor in this mouse model and support future efforts to develop an FST mimetic to suppress metastatic progression.

TGF-Alpha Expression During Breast Tumorigenesis

DTIC Science & Technology

1999-07-01

contributors to breast tumorigenesis. Therefore, we examined TGFa expression in normal and transformed epithelium. We also examined TOFa and EGFR protein in...patient samples it is difficult to determine what effect tissue culture has on normal T(3Fa protein synthesis and processing. TOFa protein expression

Depression and Anxiety Disorders among Hospitalized Women with Breast Cancer.

PubMed

Vin-Raviv, Neomi; Akinyemiju, Tomi F; Galea, Sandro; Bovbjerg, Dana H

2015-01-01

To document the prevalence of depression and anxiety disorders, and their associations with mortality among hospitalized breast cancer patients. We examined the associations between breast cancer diagnosis and the diagnoses of anxiety or depression among 4,164 hospitalized breast cancer cases matched with 4,164 non-breast cancer controls using 2006-2009 inpatient data obtained from the Nationwide Inpatient Sample database. Conditional logistic regression models were used to compute odds ratios (ORs) and 95% confidence intervals (CI) for the associations between breast cancer diagnosis and diagnoses of anxiety or depression. We also used binary logistic regression models to examine the association between diagnoses of depression or anxiety, and in-hospital mortality among breast cancer patients. We observed that breast cancer cases were less likely to have a diagnosis of depression (OR=0.63, 95% CI: 0.52-0.77), and less likely to have a diagnosis of anxiety (OR=0.68, 95% CI: 0.52-0.90) compared with controls. This association remained after controlling for race/ethnicity, residential income, insurance and residential region. Breast cancer patients with a depression diagnosis also had lower mortality (OR=0.69, 95% CI: 0.52-0.89) compared with those without a depression diagnosis, but there was no significant difference in mortality among those with and without anxiety diagnoses. Diagnoses of depression and anxiety in breast cancer patients were less prevalent than expected based on our analysis of hospitalized breast cancer patients and matched non-breast cancer controls identified in the NIS dataset using ICD-9 diagnostic codes. Results suggest that under-diagnosis of mental health problems may be common among hospitalized women with a primary diagnosis of breast cancer. Future work may fruitfully explore reasons for, and consequences of, inappropriate identification of the mental health needs of breast cancer patients.

Knowledge of Breast Density and Awareness of Related Breast Cancer Risk

PubMed Central

Duric, Neb; Littrup, Peter; Bey-Knight, Lisa; Penner, Louis; Albrecht, Terrance L.

2013-01-01

Little is known about women’s knowledge of breast density or between-race differences in this knowledge. In the current study, we examined knowledge of breast density and awareness of its role as a breast cancer risk factor among women who had previously taken part in a breast imaging study. Seventy-seven women (54.5 % Black) returned a survey assessing perceptions and accuracy of breast density knowledge, knowledge of one’s own breast density, and breast cancer risk awareness. White women had greater perceived knowledge of breast density compared to Black women; however, differences in the accuracy of definitions of breast density were due to education. Black women were less likely to know how dense their own breasts were. Black and White women both lacked awareness that having dense breast increased breast cancer risk. The results highlight the need to disseminate information regarding breast density to women, while ensuring that the information is equally accessible to both Black and White women. PMID:23467999

Knowledge of breast density and awareness of related breast cancer risk.

PubMed

Manning, Mark A; Duric, Neb; Littrup, Peter; Bey-Knight, Lisa; Penner, Louis; Albrecht, Terrance L

2013-06-01

Little is known about women's knowledge of breast density or between-race differences in this knowledge. In the current study, we examined knowledge of breast density and awareness of its role as a breast cancer risk factor among women who had previously taken part in a breast imaging study. Seventy-seven women (54.5 % Black) returned a survey assessing perceptions and accuracy of breast density knowledge, knowledge of one's own breast density, and breast cancer risk awareness. White women had greater perceived knowledge of breast density compared to Black women; however, differences in the accuracy of definitions of breast density were due to education. Black women were less likely to know how dense their own breasts were. Black and White women both lacked awareness that having dense breast increased breast cancer risk. The results highlight the need to disseminate information regarding breast density to women, while ensuring that the information is equally accessible to both Black and White women.

Form or Flesh: Social Factors That Impact Women's Practice of Breast Self-Examination.

ERIC Educational Resources Information Center

London, Patricia A.

The social factors that impact Caucasian middle-class women's practice of breast self-examination (BSE) were examined through in-depth interviews with 15 women who were selected to represent a mix of women who practiced BSE monthly, occasionally, or never. The meaning of BSE was analyzed in relation to body image and the social definition of being…

Demonstration of an algorithm to overcome health system-related barriers to timely diagnosis of breast diseases in rural Zambia

PubMed Central

Nzayisenga, Jean-Baptiste; Shibemba, Aaron; Kusweje, Victor; Chiboola, Hector; Amuyunzu-Nyamongo, Mary; Kapambwe, Sharon; Mwaba, Catherine; Lermontov, Pavlo; Mumba, Chibamba; Henry-Tillman, Ronda; Parham, Groesbeck P.

2018-01-01

Background Long delays to diagnosis is a major cause of late presentation of breast diseases in sub-Saharan Africa. Aims We designed and implemented a single-visit breast care algorithm that overcomes health system-related barriers to timely diagnosis of breast diseases. Methods A multidisciplinary team of Zambian healthcare experts trained a team of mid- and high-level Zambian healthcare practitioners how to evaluate women for breast diseases, and train trainers to do likewise. Working collaboratively, the two teams then designed a clinical platform that provides multiple breast care services within a single visit. The service platform was implemented using a breast outreach camp format, during which breast self-awareness, psychosocial counseling, clinical breast examination, breast ultrasound, ultrasound-guided biopsy, imprint cytology of biopsy specimens and surgical treatment or referral, were offered within a single visit. Results Eleven hundred and twenty-nine (1129) women attended the camps for breast care. Mean age was 35.9 years. The majority were multiparous (79.4%), breast-fed (76.0%), and reported hormone use (50.4%). Abnormalities were detected on clinical breast examination in 122 (10.8%) women, 114 of whom required ultrasound. Of the 114 who underwent ultrasound, 48 had identifiable lesions and were evaluated with ultrasound-guided core needle biopsy (39) or fine-needle aspiration (9). The concordance between imprint cytology and histopathology was 100%, when breast specimens were classified as either benign or malignant. However, when specimens were classified by histopathologic subtype, the concordance between imprint cytology and histology was 85.7% for benign and 100% for malignant lesions. Six (6) women were diagnosed with invasive cancer. Eighteen (18) women with symptomatic breast lesions had next-day surgery. Significance Similar to its impact on cervical cancer prevention services, a single visit breast care algorithm has the potential to overcome health system-related barriers to timely diagnosis of breast diseases, including cancer, in rural African settings. PMID:29746541

Breast Cancer Screening Beliefs Questionnaire: Psychometric properties assessment of the Arabic version.

PubMed

Kwok, Cannas; Endrawes, Gihane; Lee, Chun Fan

2016-02-01

The aim of the study was to report the psychometric properties of the Arabic version of the Breast Cancer Screening Beliefs Questionnaire (BCSBQ). A convenience sample of 251 Arabic-Australian women was recruited from a number of Arabic community organizations. Construct validity was examined by Cuzick's non-parametric test while Cronbach α was used to assess internal consistency reliability. Explanatory factor analysis was conducted to study the factor structure. The results indicated that the Arabic version of the BCSBQ had satisfactory validity and internal consistency. The Cronbach's alpha of the three subscales ranged between 0.810 and 0.93. The frequency of breast cancer screening practices (breast awareness, clinical breast-examination and mammography) were significantly associated with attitudes towards general health check-up and perceived barriers to mammographic screening. Exploratory factor analysis showed a similar fit for the hypothesized three-factor structure with our data set. The Arabic version of the BCBSQ is a culturally appropriate, valid and reliable instrument for assessing the beliefs, knowledge and attitudes to breast cancer and breast cancer screening practices among Arabic-Australian women. Copyright © 2015 Elsevier Ltd. All rights reserved.

Real-Time Evaluation of Breast Self-Examination Using Computer Vision

PubMed Central

Mohammadi, Eman; Dadios, Elmer P.; Gan Lim, Laurence A.; Cabatuan, Melvin K.; Naguib, Raouf N. G.; Avila, Jose Maria C.; Oikonomou, Andreas

2014-01-01

Breast cancer is the most common cancer among women worldwide and breast self-examination (BSE) is considered as the most cost-effective approach for early breast cancer detection. The general objective of this paper is to design and develop a computer vision algorithm to evaluate the BSE performance in real-time. The first stage of the algorithm presents a method for detecting and tracking the nipples in frames while a woman performs BSE; the second stage presents a method for localizing the breast region and blocks of pixels related to palpation of the breast, and the third stage focuses on detecting the palpated blocks in the breast region. The palpated blocks are highlighted at the time of BSE performance. In a correct BSE performance, all blocks must be palpated, checked, and highlighted, respectively. If any abnormality, such as masses, is detected, then this must be reported to a doctor to confirm the presence of this abnormality and proceed to perform other confirmatory tests. The experimental results have shown that the BSE evaluation algorithm presented in this paper provides robust performance. PMID:25435860

Real-time evaluation of breast self-examination using computer vision.

PubMed

Mohammadi, Eman; Dadios, Elmer P; Gan Lim, Laurence A; Cabatuan, Melvin K; Naguib, Raouf N G; Avila, Jose Maria C; Oikonomou, Andreas

2014-01-01

Breast cancer is the most common cancer among women worldwide and breast self-examination (BSE) is considered as the most cost-effective approach for early breast cancer detection. The general objective of this paper is to design and develop a computer vision algorithm to evaluate the BSE performance in real-time. The first stage of the algorithm presents a method for detecting and tracking the nipples in frames while a woman performs BSE; the second stage presents a method for localizing the breast region and blocks of pixels related to palpation of the breast, and the third stage focuses on detecting the palpated blocks in the breast region. The palpated blocks are highlighted at the time of BSE performance. In a correct BSE performance, all blocks must be palpated, checked, and highlighted, respectively. If any abnormality, such as masses, is detected, then this must be reported to a doctor to confirm the presence of this abnormality and proceed to perform other confirmatory tests. The experimental results have shown that the BSE evaluation algorithm presented in this paper provides robust performance.

Chemical Beam Epitaxial Growth of Indium Phosphide Using Alternative, Safer Phosphorus Sources

NASA Astrophysics Data System (ADS)

Kim, Chungwoo

1995-11-01

Chemical beam epitaxy (CBE) is a relatively new III-V semiconductor growth technique that combines important advantages of molecular beam epitaxy (MBE) and organometallic vapor phase epitaxy (OMVPE). Although CBE grown-InP using phosphine (PH_3) combined with trimethylindium (TMIn) or triethylindium (TEIn) has produced high quality material comparable to OMVPE-and gas source MBE-grown InP, the highly hazardous and toxic nature of PH_3 is becoming a main obstacle to mass production of semiconductor devices. In this dissertation, InP epilayers were grown using tertiarybutylphosphine (TBP) and bisphosphinoethane (BPE) as possible replacements for PH_3, together with ethyldimethylindium (EDMIn) as the indium source. For the first time, InP epilayers have been grown using TBP and EDMIn by CBE. The surface morphology and the electrical and optical properties improved with increasing substrate and cracker cell temperatures and input V/III ratio. High quality n-type InP epilayers with electron mobilities of up to 3830 cm^2/Vs and net carrier concentrations of approximately 6 times 10^{14} cm^{-3} at room temperature were achieved at a growth temperature of 500^ circC using a V/III ratio of 70 and a TBP cracker cell temperature of 900^circ C. Strong band-edge emission was observed at growth temperatures between 460 and 500^circ C. The bound exciton halfwidth of the sample grown at 500^circC was as narrow as 3.6 meV at 14 K with a barely observable acceptor related peak indicating a very low concentration of acceptors. For growth of InP using BPE and EDMIn, good surface morphologies were obtained at a substrate temperature of 485^circC using V/III ratios of >=q53. At fixed growth and cracker cell temperatures of 485 and 800^circ C, respectively, the net carrier concentration at a V/III ratio of 53 was 7.8 times 10 ^{15} at room temperature and 3.2 times 10^{15} cm^{-3} at 77 K with respective electron mobilities of 3,630 and 21,800 cm^2 /Vs. The 14 K PL spectra were dominated by band -edge emission and exhibited very weak acceptor related peak intensities for InP layers grown at 485^ circC for several different V/III ratios and cracker cell temperatures. The narrowest value of FWHM for the band edge emission was 3.5 meV at 14 K.

Plasma B-esterase activities in European raptors.

PubMed

Roy, Claudie; Grolleau, Gérard; Chamoulaud, Serge; Rivière, Jean-Louis

2005-01-01

B-esterases are serine hydrolases composed of cholinesterases, including acetylcholinesterase (AChE) and butyrylcholinesterase (BChE), and carboxylesterase (CbE). These esterases, found in blood plasma, are inhibited by organophosphorus (OP) and carbamate (CB) insecticides and can be used as nondestructive biomarkers of exposure to anticholinesterase insecticides. Furthermore, B-esterases are involved in detoxification of these insecticides. In order to establish the level of these enzymes and to have reference values for their normal activities, total plasma cholinesterase (ChE), AChE and BChE activities, and plasma CbE activity were determined in 729 European raptors representing 20 species, four families, and two orders. The diurnal families of the Falconiforme order were represented by Accipitridae and Falconidae and the nocturnal families of the Strigiforme order by Tytonidae and Strigidae. Intraspecies differences in cholinesterase activities according to sex and/or age were investigated in buzzards (Buteo buteo), sparrowhawks (Accipiter nisus), kestrels (Falco tinnunculus), barn owls (Tyto alba), and tawny owls (Strix aluco). Sex-related differences affecting ChE and AChE activities were observed in young kestrels (2-3-mo-old) and age-related differences in kestrels (ChE and AChE), sparrowhawks (AChE), and tawny owls (ChE, AChE, and BChE). The interspecies analysis yielded a negative correlation between ChE activity and body mass taking into account the relative contribution of AChE and BChE to ChE activity, with the exception of the honey buzzard (Pernis apivorus). The lowest ChE activities were found in the two largest species, Bonelli's eagle (Hieraaetus fasciatus) and Egyptian vulture (Neophron percnopterus) belonging to the Accipitridae family. The highest ChE activities were found in the relatively small species belonging to the Tytonidae and Strigidae families and in honey buzzard of the Accipitridae family. Species of the Accipitridae, Tytonidae, and Strigidae families were characterized by a BChE contribution that dominated the total ChE activity, while in the species of the Falconidae family, AChE activity dominated. With the exception of the barn owl, CbE activity (eserine-insensitive alpha-naphthyl acetate esterase [alpha-NAE] activity) in all species was almost absent or very low. The values obtained in this study for ChE, AChE, and BChE activities and the AChE:BChE ratios for buzzard, kestrel, barn owl, and tawny owl provide a good estimate of the normal values in free-living individuals of these European species. They can be used as a baseline to evaluate the effect of anticholinesterase insecticides in the field.

Passion in breast cancer survivors: examining links to emotional well-being.

PubMed

Burke, Shaunna M; Sabiston, Catherine M; Vallerand, Robert J

2012-11-01

This study (1) identified the activities that breast cancer survivors report as passionate; (2) examined whether levels of passion differed based on the types of passionate activities reported and; (3) examined the association between harmonious and obsessive passion and emotional well-being. Early post-treatment breast cancer survivors (N = 177) reported passionate physical activities as most prevalent, and reported higher harmonious passion scores compared to women reporting relaxing and social leisure activities. Harmonious passion was associated with higher positive affect and lower cancer worry. Obsessive passion was linked to higher negative affect, cancer worry, and posttraumatic growth. Passion is important for enhanced well-being.

Vitamin C and survival among women with breast cancer: a meta-analysis.

PubMed

Harris, Holly R; Orsini, Nicola; Wolk, Alicja

2014-05-01

The association between dietary vitamin C intake and breast cancer survival is inconsistent and few studies have specifically examined vitamin C supplement use among women with breast cancer. The purpose of this study was to summarise results from prospective studies on the association between vitamin C supplement use and dietary vitamin C intake and breast cancer-specific mortality and total mortality. Studies were identified using the PubMed database through February 6, 2014 and by examining the references of retrieved articles. Prospective studies were included if they reported relative risks (RR) with 95% confidence intervals (95% CIs) for at least two categories or as a continuous exposure. Random-effects models were used to combine study-specific results. The ten identified studies examined vitamin C supplement use (n=6) and dietary vitamin C intake (n=7) and included 17,696 breast cancer cases, 2791 total deaths, and 1558 breast cancer-specific deaths. The summary RR (95% CI) for post-diagnosis vitamin C supplement use was 0.81 (95% CI 0.72-0.91) for total mortality and 0.85 (95% CI 0.74-0.99) for breast cancer-specific mortality. The summary RR for a 100mg per day increase in dietary vitamin C intake was 0.73 (95% CI 0.59-0.89) for total mortality and 0.78 (95% CI 0.64-0.94) for breast cancer-specific mortality. Results from this meta-analysis suggest that post-diagnosis vitamin C supplement use may be associated with a reduced risk of mortality. Dietary vitamin C intake was also statistically significantly associated with a reduced risk of total mortality and breast cancer-specific mortality. Copyright © 2014 Elsevier Ltd. All rights reserved.

Neurofibromatosis and breast cancer: Do we need to revise the mammographic screening schedule in patients of neurofibromatosis?

PubMed

Pradhan, Dinesh; Kaur, Neeraj; Gami, Ashmita; Hura, Kanwaljeet S; Garg, Garima; Mohanty, Sambit K

2017-01-01

Neurofibromatosis type 1 (NF-1) is a neurocutaneous syndrome with autosomal dominant mode of inheritance and has a high propensity to develop benign and malignant nervous system tumors. Although uncommon, case reports describing the association of NF-1 and breast cancer are available in the literature. We illustrate one such case of NF-1, with no family history of the disorder and presenting with multifocal invasive carcinoma of the right breast, in an attempt to describe the association between these two entities. We also attempt to extensively review the current literature on the subject. Since patients with NF-1 are at an increased risk of developing breast cancer, we recommend strict adherence to careful clinical breast examination and annual screening mammographic examination starting at 40 years of age in all patients of NF-1.

[Metastatic signet ring cell carcinoma to the breast from stomach].

PubMed

Krichen Makni, S; Abbes, K; Khanfir, A; Frikha, M; Sellami Boudawara, T

2007-09-01

Metastatic tumors in the breast are quite rare and constitute 0.5 to 6% of all breast malignancies. They often occur in a polymetastatic context. The most frequent primitive tumors are lymphoma, leukaemia and malignant melanoma. The gastric origin is seldom reported. We report here the observation of a 40-years woman operated in urgency for an acute abdominal syndrome. A gastric tumor was discovered intraoperatively with ovarian metastasis and peritoneal carcinosis. The pathological examination revealed a gastric signet ring cell carcinoma with an infiltration of the right ovary. Four months later, the patient presented with a lump of the right breast. The histologic examination corresponded to a mammary metastasis by a signet ring cell carcinoma from stomach. The objective of our work is to discuss through this observation the anatomoclinical and evolutionary characteristics of breast metastasis.

Uncovering an Existential Barrier to Breast Self-exam Behavior

PubMed Central

Goldenberg, Jamie L.; Arndt, Jamie; Hart, Joshua; Routledge, Clay

2008-01-01

The present research applies an analysis derived from terror management theory to the health domain of breast examination, and in doing so uncovers previously unrecognized factors that may contribute to women’s reluctance to perform breast self-examinations (BSEs). In Study 1, when concerns about mortality were primed, reminders of human beings’ physical nature (i.e., creatureliness) reduced intentions to conduct BSEs compared to reminders of humans’ uniqueness. In Study 2, women conducted shorter exams on a breast model (an experience found to increase death-thought accessibility) when creatureliness was primed compared to a uniqueness and no essay condition. In Study 3, after a creatureliness prime, women performed shorter BSEs when a placebo did not provide an alternative explanation for their discomfort compared to when it did. Advances for theory and breast self-exam promotion are discussed. PMID:19255593

Epidemiologic Studies of Isoflavones & Mammographic Density

PubMed Central

Maskarinec, Gertraud; Verheus, Martijn; Tice, Jeffrey A.

2010-01-01

Isoflavones, phytoestrogens in soy beans with estrogen-like properties, have been examined for their cancer protective effects. Mammographic density is a strong predictor of breast cancer. This review summarizes studies that have examined the association between isoflavones and breast density. Observational investigations in Hawaii and Singapore suggest slightly lower breast density among women of Asian descent with regular soy intake, but two larger studies from Japan and Singapore did not observe a protective effect. The findings from seven randomized trials with primarily Caucasian women indicate that soy or isoflavones do not modify mammographic density. Soy foods and isoflavone supplements within a nutritional range do not appear to modify breast cancer risk as assessed by mammographic density. PMID:22253990

[Cellular immunity indices in benign breast tumors].

PubMed

Baisheva, S A; Zhalgasbaeva, G T; Kaliev, Iu Sh; Mezinova, N N

1980-01-01

Patients with breast cancer, localized fibroadenomatosis and healthy females were examined for the initial state of cell immunity: the reaction of delayed hypersensitivity to DNCB, the absolute and relative amount of rosette forming cells (T-lymphocytes) and the stimulation of lymphocytes under exposure to PHA. A considerable suppression of cell immunity was shown both in breast cancer patients and in patients with benign tumors. The indices of skin allergic test and reaction of spontaneous rosette formation were nearly identical in both groups of the patients under examination. In case of the reaction of lymphocytes blasttransformation in breast cancer patients the stimulation was found to be much lower than in patients with local fibroadenomatosis.

Breast cancer and primary systemic therapy. Results of the Consensus Meeting on the recommendations for pathological examination and histological report of breast cancer specimens in the Marche Region.

PubMed

Santinelli, A; De Nictolis, M; Mambelli, V; Ranaldi, R; Bearzi, I; Battellpi, N; Mariotti, C; Fabbietti, L; Baldassarre, S; Giuseppetti, G M; Fabris, G

2011-10-01

Primary systemic therapy (PST) adds some practical problems to the pathologic examination of neoplastic breast tissue obtained from patients before and after chemotherapy. Pathologists, oncologists, breast surgeons, radiotherapists and radiologists in the Marche Region held a Consensus Meeting in Ancona on May 13, 2010, in which 15 statements dealing with neoadjuvant chemotherapy were approved by all participants. The first two statements are related to the pre-PST phase and concern the technical procedures and the histological report of the core biopsy. The other statements deal with similar issues of the post-PST surgical specimen.

Managing cancer and employment: Decisions and strategies used by breast cancer survivors employed in low-wage jobs

PubMed Central

Swanberg, Jennifer E.; Nichols, Helen M.; Ko, Jungyai; Tracy, J. Kathleen; Vanderpool, Robin C.

2017-01-01

Advances in breast cancer screening and treatment have led to an overall 5-year survival rate of 90%. Many of these cancer cases are diagnosed in working women. Few studies have explicitly examined the cancer–work interface, as experienced by low-wage earning women with breast cancer. This study uses in-depth, semistructured interviews with 24 low-wage breast cancer survivors to identify employment decisions and factors that influenced or enabled these decisions, and examine the individual strategies and workplace supports used to manage the cancer–work interface among a subset of women (n = 13) who continued to work. Future research areas and clinical implications are discussed. PMID:28045595

Managing cancer and employment: Decisions and strategies used by breast cancer survivors employed in low-wage jobs.

PubMed

Swanberg, Jennifer E; Nichols, Helen M; Ko, Jungyai; Tracy, J Kathleen; Vanderpool, Robin C

2017-01-01

Advances in breast cancer screening and treatment have led to an overall 5-year survival rate of 90%. Many of these cancer cases are diagnosed in working women. Few studies have explicitly examined the cancer-work interface, as experienced by low-wage earning women with breast cancer. This study uses in-depth, semistructured interviews with 24 low-wage breast cancer survivors to identify employment decisions and factors that influenced or enabled these decisions, and examine the individual strategies and workplace supports used to manage the cancer-work interface among a subset of women (n = 13) who continued to work. Future research areas and clinical implications are discussed.

Concomitant endometrial and gallbladder metastasis in advanced multiple metastatic invasive lobular carcinoma of the breast: A rare case report.

PubMed

Bezpalko, Kseniya; Mohamed, Mohamed A; Mercer, Leo; McCann, Michael; Elghawy, Karim; Wilson, Kenneth

2015-01-01

At time of presentation, fewer than 10% of patients have metastatic breast cancer. The most common sites of metastasis in order of frequency are bone, lung, pleura, soft tissue, and liver. Breast cancer metastasis to the uterus or gallbladder is rare and has infrequently been reported in the English literature. A 47 year old female with a recent history of thrombocytopenia presented with abnormal vaginal bleeding. Pelvic ultrasound revealed multiple uterine fibroids and endometrial curettings revealed cells consistent with lobular carcinoma of the breast. Breast examination revealed edema and induration of the lower half of the right breast. Biopsy of the right breast revealed invasive lobular carcinoma. Bone marrow aspiration obtained at a previous outpatient visit revealed extensive involvement by metastatic breast carcinoma. Shortly after discharge, the patient presented with acute cholecystitis and underwent cholecystectomy. Microscopic examination of the gallbladder revealed metastatic infiltrating lobular carcinoma. The final diagnosis was invasive lobular carcinoma of the right breast with metastasis to the bone marrow, endometrium, gallbladder, regional lymph nodes, and peritoneum. The growth pattern of invasive lobular carcinoma of the breast is unique and poses a challenge in diagnosing the cancer at an early stage. Unlike other types of breast cancer, it tends to metastasize more to the peritoneum, ovary, and gastrointestinal tract. Metastasis to the endometrium or gallbladder is rare. Metastatic spread should be considered in the differential diagnosis of patients with invasive lobular breast carcinoma presenting with abnormal vaginal bleeding or acute cholecystitis. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

Breast cancer incidence rates in U.S. women are no longer declining.

PubMed

DeSantis, Carol; Howlader, Nadia; Cronin, Kathleen A; Jemal, Ahmedin

2011-05-01

Several publications reported breast cancer incidence rates continued to decrease among white women, following the decline of about 7% from 2002 to 2003. However, none of these reports exclusively examined the trend after 2003. In this paper, we examined breast cancer incidence rates among non-Hispanic (NH) white women from 2003 to 2007 to determine whether the decrease in breast cancer incidence rates indeed persisted through 2007. In addition, we present breast cancer incidence trends for NH black and Hispanic women and postmenopausal hormone use for all three racial/ethnic groups. Breast cancer incidence rates were calculated by race/ethnicity, age and ER status using data from the Surveillance, Epidemiology, and End Results (SEER) 12 registries for 2000 to 2007. Prevalence of postmenopausal hormone use was calculated using National Health Interview Survey data from 2000, 2005, and 2008. From 2003 to 2007, overall breast cancer incidence rates did not change significantly among NH white women in any age group. However, rates increased (2.7% per year) for ER+ breast cancers in ages 40 to 49, and decreased for ER- breast cancers in ages 40 to 49 and 60 to 69. Similarly, overall breast cancer incidence rates did not change significantly for black and Hispanic women. Hormone use continued to decrease from 2005 to 2008 in all groups, although the decreases were smaller compared to those from 2000 to 2005. The sharp decline in breast cancer incidence rates that occurred from 2002 to 2003 among NH white women did not continue through 2007. Further studies are needed to better understand the recent breast cancer trends. ©2011 AACR.

Does Breast-feeding Relate to Development of Atopic Dermatitis in Young Korean Children?: Based on the Fourth and Fifth Korea National Health and Nutrition Examination Survey 2007-2012.

PubMed

Lee, Kyung Suk; Rha, Yeong Ho; Oh, In Hwan; Choi, Yong Sung; Kim, Young Eun; Choi, Sun Hee

2017-07-01

There have been conflicting reports concerning the relationship between breast-feeding and the development of atopic dermatitis (AD) in early childhood. The objective of this study was to investigate the associations between breast-feeding and the risk of AD in early childhood in Korea. We combined the fourth and fifth Korea National Health and Nutrition Examination Survey data collected from 2007 to 2012 and analyzed 2,015 children at 1 to 3 years old. Regression analysis was used to determine the association of the following variables: AD, feeding types, duration of breast-feeding, and others. The annual prevalence of exclusive breast-feeding and AD decreased. Parents with allergic diseases preferred breast-feeding and extended duration of feeding compared with those without. In multiple logistic regression analyses, exclusive breast-feeding in feeding type I (P=0.070; adjusted odds ratio [OR]=1.990), exclusive breast-feeding in feeding type II (P=0.095; adjusted OR=1.495) and breast-feeding duration (P=0.430; adjusted OR=1.013) were not significantly related to AD. Breast-feeding was not found to be associated with an occurrence of AD in young children. Rather, parents with histories of allergic diseases tended to prefer breast-feeding and extend its duration. To clarify the role of breast-feeding in the development of AD, a nation-wide prospective study is needed. Copyright © 2017 The Korean Academy of Asthma, Allergy and Clinical Immunology · The Korean Academy of Pediatric Allergy and Respiratory Disease

Breast cancer literacy and health beliefs related to breast cancer screening among American Indian women.

PubMed

Roh, Soonhee; Burnette, Catherine E; Lee, Yeon-Shim; Jun, Jung Sim; Lee, Hee Yun; Lee, Kyoung Hag

2018-08-01

The purpose of this article is to examine the health beliefs and literacy about breast cancer and their relationship with breast cancer screening among American Indian (AI) women. Using the Health Belief Model (HBM) and hierarchical logistic regression with data from a sample of 286 AI female adults residing in the Northern Plains, we found that greater awareness of breast cancer screening was linked to breast cancer screening practices. However, perceived barriers, one of the HBM constructs, prevented such screening practices. This study suggested that culturally relevant HBM factors should be targeted when developing culturally sensitive breast cancer prevention efforts.

Screening for Breast Cancer.

PubMed

Niell, Bethany L; Freer, Phoebe E; Weinfurtner, Robert Jared; Arleo, Elizabeth Kagan; Drukteinis, Jennifer S

2017-11-01

The goal of screening is to detect breast cancers when still curable to decrease breast cancer-specific mortality. Breast cancer screening in the United States is routinely performed with mammography, supplemental digital breast tomosynthesis, ultrasound, and/or MR imaging. This article aims to review the most commonly used breast imaging modalities for screening, discuss how often and when to begin screening with specific imaging modalities, and examine the pros and cons of screening. By the article's end, the reader will be better equipped to have informed discussions with patients and medical professionals regarding the benefits and disadvantages of breast cancer screening. Copyright © 2017 Elsevier Inc. All rights reserved.

Necrotizing fasciitis of the breast: a case managed without mastectomy.

PubMed

Soliman, M O; Ayyash, E H; Aldahham, A; Asfar, S

2011-01-01

To report a rare presentation of necrotizing fasciitis (NF) in the breast and its management. A 61-year-old non-diabetic lady presented with a painful swollen right breast and yellowish discharge associated with fever for the last few days. Based on clinical examination and haematological parameters, a provisional diagnosis of breast abscess was made that later proved to be a case of NF. She was managed conservatively with repeated debridement followed by split-skin grafting with preservation of the breast. This case showed that NF of the breast can present as a simple breast abscess which was managed conservatively. Copyright © 2011 S. Karger AG, Basel.

Primary actinomycosis of the breast caused by Actinomyces turicensis with associated Peptoniphilus harei.

PubMed

Abdulrahman, Ganiy Opeyemi; Gateley, Christopher Alan

2015-01-01

Actinomycosis of the breast is a rare disease which may mimic malignancy in presentation. Clinical presentation may make it difficult to distinguish primary actinomycosis from mastitis and inflammatory carcinoma. A 22-year-old lady presented with a 3-week history of right breast pain and greenish discharge through her nipple piercing. Physical examination revealed a palpable fluctuant lump in the upper inner quadrant of the right breast and a nipple jewelry in-situ in the upper inner quadrant of the right breast with an abscess at the edge of the areola. Needle aspiration was performed and microbiological examination of the aspirate isolated Actinomyces turicensis and Peptoniphilus harei. Actinomycosis of the breast is rare and the specie, Actinomyces turicensis, is even rarer especially in association with Peptoniphilus harei. Actinomyces is a difficult organism to treat due to its relative indolent course with potential scarring and disruption of local tissue. However, surgical intervention could be avoided with an intensive course of high-dose intravenous antibiotics and prolonged oral antibiotics afterwards.

Infant feeding practices and prevalence of obesity in eight European countries - the IDEFICS study.

PubMed

Hunsberger, Monica; Lanfer, Anne; Reeske, Anna; Veidebaum, Toomas; Russo, Paola; Hadjigeorgiou, Charalampos; Moreno, Luis A; Molnar, Dénes; De Henauw, Stefaan; Lissner, Lauren; Eiben, Gabriele

2013-02-01

To assess the association between exclusive breast-feeding and childhood overweight. Cross-sectional data are from the baseline survey of the longitudinal cohort study IDEFICS. Exclusive rather than partial breast-feeding is the focus of the study due to the theoretical relationship between exclusive breast-feeding and development of dietary self-regulation. Children's measured heights and weights were used to calculate weight status, while waist-to-height ratio (WtHR) and skinfold measures were examined as alternative indicators of adiposity and fat patterning. Examination centres in eight European countries (Italy, Estonia, Cyprus, Belgium, Sweden, Hungary, Germany and Spain). The analysis included 14 726 children aged 2-9 years for whom early feeding practices were reported by parents in standardized questionnaires. After controlling for education, income and other potential confounders, breast-feeding exclusively for 4-6 months was protective of overweight (including obesity) when compared with children never exclusively breast-fed (OR = 0·73; 95 % CI 0·63, 0·85) across all measures of overweight. Exclusively breast-feeding for 6 months offered slightly more protection than for 4 and 5 months combined (OR = 0·71; 95 % CI 0·58, 0·85). The associations could not be explained by socio-economic characteristics or maternal overweight. This multi-country investigation indicated that exclusive breast-feeding for 4-6 months may confer protection against overweight in addition to other known benefits. There was no demonstrated benefit of exclusive breast-feeding for more than 6 months or combination feeding for any duration across all measures of overweight examined.

Reconstruction of Absorbed Doses to Fibroglandular Tissue of the Breast of Women undergoing Mammography (1960 to the Present)

PubMed Central

Thierry-Chef, Isabelle; Simon, Steven L.; Weinstock, Robert M.; Kwon, Deukwoo; Linet, Martha S.

2013-01-01

The assessment of potential benefits versus harms from mammographic examinations as described in the controversial breast cancer screening recommendations of the U.S. Preventive Task Force included limited consideration of absorbed dose to the fibroglandular tissue of the breast (glandular tissue dose), the tissue at risk for breast cancer. Epidemiological studies on cancer risks associated with diagnostic radiological examinations often lack accurate information on glandular tissue dose, and there is a clear need for better estimates of these doses. Our objective was to develop a quantitative summary of glandular tissue doses from mammography by considering sources of variation over time in key parameters including imaging protocols, x-ray target materials, voltage, filtration, incident air kerma, compressed breast thickness, and breast composition. We estimated the minimum, maximum, and mean values for glandular tissue dose for populations of exposed women within 5-year periods from 1960 to the present, with the minimum to maximum range likely including 90% to 95% of the entirety of the dose range from mammography in North America and Europe. Glandular tissue dose from a single view in mammography is presently about 2 mGy, about one-sixth the dose in the 1960s. The ratio of our estimates of maximum to minimum glandular tissue doses for average-size breasts was about 100 in the 1960s compared to a ratio of about 5 in recent years. Findings from our analysis provide quantitative information on glandular tissue doses from mammographic examinations which can be used in epidemiologic studies of breast cancer. PMID:21988547

Breast ultrasound in the management of gynecomastia in Peutz-Jeghers syndrome in monozygotic twins: two case reports.

PubMed

Di Grezia, Graziella; Romano, Tiziana; De Francesco, Francesco; Somma, Francesco; Rea, Gaetano; Grassi, Roberto; Gatta, Gianluca

2014-12-18

Peutz-Jeghers syndrome is an autosomal dominant disease with incomplete penetrance and variable expression caused by germline mutation of serine threonine kinase 11/liver kinase B1; it is characterized by hamartomatous polyps in the gastrointestinal tract, mucocutaneous melanin pigmentation, and increased predisposition to neoplasms. In Peutz-Jeghers syndrome, bilateral Sertoli cell testicular tumors cause endocrine manifestations including gynecomastia and feminization. This study aimed to assess the role of breast ultrasound in the evaluation of the effectiveness of an innovative surgical approach. This report presents a pair of European 9-year-old identical male twins with Peutz-Jeghers syndrome, bilateral prepubertal gynecomastia, and testicular multifocal calcifications. Both twins were treated with anastrozole for 2 years. After finishing treatment, both underwent subcutaneous mastectomy performed by the "modified" Webster technique. Breast examination and ultrasound were performed before and after the pharmacological and surgical treatment. A breast ultrasound scan before surgery showed bilateral gynecomastia in both patients. No solid nodular or cystic formations were present on either side. After pharmacological therapy and surgical glandular removal, a breast examination showed a significant reduction in breast volume; 1 year after surgery, a breast ultrasound scan of both patients showed a total absence of glandular parenchyma, with muscle planes well represented. Breast examination and ultrasound have proved to be a valid approach in the assessment of the treatment of prepubertal gynecomastia because they allow the efficacy of the pharmacological and surgical treatment to be evaluated in a multidisciplinary approach to one of the most frequent endocrine manifestations of Peutz-Jeghers syndrome.

Are Irregular Hypoechoic Breast Masses on Ultrasound Always Malignancies?: A Pictorial Essay

PubMed Central

Kim, Youe Ree; Kim, Hun Soo

2015-01-01

Irregular hypoechoic masses in the breast do not always indicate malignancies. Many benign breast diseases present with irregular hypoechoic masses that can mimic carcinoma on ultrasonography. Some of these diseases such as inflammation and trauma-related breast lesions could be suspected from a patient's symptoms and personal history. Careful ultrasonographic examination and biopsy could help to differentiate these from malignancies. PMID:26576116

An Investigation of the Facilitative and Inhibitory Variables Impacting Breast Health Practices in Low-Socioeconomic Status Black Women of African American and Caribbean Descent

DTIC Science & Technology

2003-10-01

Honestly, it’~> been a very difficult tim~p here ... pancreatic cancer is a bumpy ride of lingering pain and suffering. I hope every day that my time...TELEPHONE NUMBER (include area code) 14. ABSTRACT Black women of low-socioeconomic status (SES) demonstrate a high incidence of breast cancer ...mortality associated with late-state diagnosis. Breast cancer screening, including mammography, breast self-examination, and clinical breast

[Selection criteria for breast conservation in patients with early breast carcinoma].

PubMed

Baĭchev, G

2002-01-01

During the past two decades, breast-conserving therapy (excision of the tumor and axillary lymphadenectomy followed by irradiation) for early stage breast carcinoma has become firmly established as an equivalent treatment approach to mastectomy. The purpose of this review as to examine the risk factors for local recurrence after breast-conserving therapy. Better mammographic evaluation, better margin assessment, recognition of an extensive intraductal component and the use of adjuvant systemic therapy has improved the logo-regional control.

Breast cancer screening behavior, attitude, barriers among middle-aged Chinese women in Macao, China.

PubMed

Gan, Yan Xiang; Lao, Cheng-Kin; Chan, Alexandre

2018-05-08

Breast cancer is the third leading cause of death from cancer among females in Macao, but little is known about local practice of breast cancer screening. The study aims to evaluate breast cancer screening behaviors and to identify the predictors of insufficient knowledge and attitudes towards breast cancer and its screening among female residents. This was a cross-sectional study conducted from April to June 2016 in Macao. Quota sampling of women completed the modified Chinese Breast Cancer Screening Beliefs questionnaire (CBCSB) to assess their breast cancer-related perceptions, screening attitudes and behaviors. Univariate and multivariate logistic regressions were performed to identify the predictors of poor-screening practices, attitudes, knowledge and perceived barriers to mammography. A total of 417 women (mean age±SD: 50.5±5.7) completed surveys, with 160 (38.4%), 196 (47.0%) and 103 (24.7%) women received breast self-examination, clinical breast examination and mammography as recommended, respectively. Nulliparity (OR=2.56, 95% CI = 1.14-5.73) and low education (OR = 1.72, 95% CI = 1.04-2.84) were significantly associated with negative attitude towards health check-ups. Women did not know anyone with breast cancer (OR = 2.30, 95% CI = 1.50-3.55) were more likely to have insufficient knowledge about breast cancer. Low education (OR = 1.95, 95% CI = 1.25-3.04) and not knowing anyone with breast cancer (OR = 2.02, 95% CI = 1.31-3.13) were identified as predictors for perceived barriers to mammography. Recommendations for breast cancer screening are poorly followed by the residents in Macao, and a culturally tailored educational program is urgently needed to raise the public's awareness of the disease and the screening practices.

Breast Cancer Screening among Older Hispanic Women: Knowledge, Attitudes, and Practices.

ERIC Educational Resources Information Center

Saint-Germain, Michelle A.; Longman, Alice J.

1993-01-01

Data from 409 Hispanic-American and 138 Anglo older women in Tucson identified few differences in their use of breast cancer screening and low levels of risk knowledge. Both groups fell well below recommended frequency of screening. Clinical examination and self-examination were used more than mammography. (SK)

Correlates of Breast-Feeding in a Rural Population

ERIC Educational Resources Information Center

Hanson, Michelle B.; Hellerstedt, Wendy L.; Desvarieux, Moise; Duval, Susan J.

2003-01-01

Objective: To examine the associations of education and employment with breast-feeding initiation and duration in rural mothers, in the context of environmental, social, and intrapersonal factors. Methods: Data from a telephone survey of 414 mothers from rural Minnesota were examined with regression analyses. Results: Education and employment had…

Test-retest agreement and reliability of quantitative sensory testing 1 year after breast cancer surgery.

PubMed

Andersen, Kenneth Geving; Kehlet, Henrik; Aasvang, Eske Kvanner

2015-05-01

Quantitative sensory testing (QST) is used to assess sensory dysfunction and nerve damage by examining psychophysical responses to controlled, graded stimuli such as mechanical and thermal detection and pain thresholds. In the breast cancer population, 4 studies have used QST to examine persistent pain after breast cancer treatment, suggesting neuropathic pain being a prominent pain mechanism. However, the agreement and reliability of QST has not been described in the postsurgical breast cancer population, hindering exact interpretation of QST studies in this population. The aim of the present study was to assess test-retest properties of QST after breast cancer surgery. A total of 32 patients recruited from a larger ongoing prospective trial were examined with QST 12 months after breast cancer surgery and reexamined a week later. A standardized QST protocol was used, including sensory mapping for mechanical, warmth and cold areas of sensory dysfunction, mechanical thresholds using monofilaments and pin-prick, thermal thresholds including warmth and cold detection thresholds and heat pain threshold, with bilateral examination. Agreement and reliability were assessed by Bland-Altman plots, descriptive statistics, coefficients of variance, and intraclass correlation. Bland-Altman plots showed high variation on the surgical side. Intraclass coefficients ranged from 0.356 to 0.847 (moderate to substantial reliability). Between-patient variation was generally higher (0.9 to 14.5 SD) than within-patient variation (0.23 to 3.55 SD). There were no significant differences between pain and pain-free patients. The individual test-retest variability was higher on the operated side compared with the nonoperated side. The QST protocol reliability allows for group-to-group comparison of sensory function, but less so for individual follow-up after breast cancer surgery.

Clinical Data as an Adjunct to Ultrasound Reduces the False-Negative Malignancy Rate in BI-RADS 3 Breast Lesions

PubMed Central

Ackermann, S.; Schoenenberger, C.-A.; Zanetti-Dällenbach, R.

2016-01-01

Purpose: Ultrasound (US) is a well-established diagnostic procedure for breast examination. We investigated the malignancy rate in solid breast lesions according to their BI-RADS classification with a particular focus on false-negative BI-RADS 3 lesions. We examined whether patient history and clinical findings could provide additional information that would help determine further diagnostic steps in breast lesions. Materials and Methods: We conducted a retrospective study by exploring US BI-RADS in 1469 breast lesions of 1201 patients who underwent minimally invasive breast biopsy (MIBB) from January 2002 to December 2011. Results: The overall sensitivity and specificity of BI-RADS classification was 97.4% and 66.4%, respectively, with a positive (PPV) and negative predictive value (NPV) of 65% and 98%, respectively. In 506 BI-RADS 3 lesions, histology revealed 15 malignancies (2.4% malignancy rate), which corresponds to a false-negative rate (FNR) of 2.6%. Clinical evaluation and patient requests critically influenced the further diagnostic procedure, thereby prevailing over the recommendation given by the BI-RADS 3 classification. Conclusion: Clinical criteria including age, family and personal history, clinical examination, mammography and patient choice ensure adequate diagnostic procedures such as short-term follow-up or MIBB in patients with lesions classified as US-BI-RADS 3. PMID:27689181

Primary epidermoid carcinoma of the breast presenting as a breast abscess and sepsis.

PubMed

Damin, Andrea Pires; Nascimento, Fernanda Costa; Andreola, João Batista; Cerutti, Talita Haubert; Roehe, Adriana; Damin, Daniel Carvalho

2011-12-01

Squamous cell carcinoma (SCC) of the breast is an extremely rare form of cancer, accounting for approximately 0.04% of all malignant breast tumors. To date, only a limited number of cases of SCC of the breast have been reported, and most of them presented like the usual breast carcinomas. A 39-year-old woman presented with a large breast abscess and signs of sepsis. After surgical debridement of the lesion, histopathological examination of the abscess capsule revealed the presence of SCC of the breast. The definitive treatment for the tumor consisted of modified radical mastectomy with resection of the residual lesion in the right breast. This unusual case illustrates how an apparently benign disorder such as a breast abscess might be related to a clinically occult malignancy. A review of the literature on SCC of the breast is presented.

Effects of Environmental Estrogens on Apoptosis in Normal and Cancerous Breast Epithelial Cells

DTIC Science & Technology

2001-03-01

breast cancer in population which consume diets rich in these flavonoid phytoestrogens has prompted us to further examine the effects of these...chemicals on apoptosis. Initial studies revealed certain flavonoid phytochemicals possessed potent antiestrogenic effects (Appendix documents #4,5...of specific aim 1 to include examination of the flavonoid phytochemical environmental estrogens. Examination of Bcl-2 expression and effects on

Radiologic and histopathologic review of rare benign and malignant breast diseases

PubMed Central

Dağıstan, Emine; Kızıldağ, Betül; Gürel, Safiye; Barut, Yüksel; Paşaoğlu, Esra

2017-01-01

High social awareness of breast diseases and the rise in breast imaging facilities have led to an increase in the detection of even rare benign and malignant breast lesions. Breast lesions are associated with a broad spectrum of imaging characteristics, and each radiologic imaging technique reflects different characteristics of them. We aimed to increase familiarity of the radiologist with these uncommon lesions as well as correlate histopathologic findings with the radiologic imaging features of the tumors. Histopathologic examination is necessary in the evaluation of such breast lesions, particularly when radiologic images are not definitive for a specific diagnosis. PMID:28508760

A Novel Model System to Examine Agents Used in Breast Cancer Therapy.

DTIC Science & Technology

1996-07-01

DNA replication (DNA synthesome) isolated from MDA MB 468 human breast cancer cells, human breast tumor tissue and human breast tumor cell xenografts In the presence of the viral large T-antigen and simian virus 40 (SV40) origin sequences, the DNA synthesome executes all of the steps required for the in vitro replication of the SV40 genome. Furthermore, the DNA synthesome isolated from human breast cancer cells possesses a lower fidelity for DNA synthesis in vitro than the synthesome purified from a non-malignant breast cell line. Our studies indicate that the following

Assessment of disease extent on contrast-enhanced MRI in breast cancer detected at digital breast tomosynthesis versus digital mammography alone.

PubMed

Chudgar, A V; Conant, E F; Weinstein, S P; Keller, B M; Synnestvedt, M; Yamartino, P; McDonald, E S

2017-07-01

To compare the utility of breast magnetic resonance imaging (MRI) in determining the extent of disease in patients with newly diagnosed breast cancer detected on combination digital breast tomosynthesis (DBT) versus digital screening mammography (DM). Review of 24,563 DBT-screened patients and 10,751 DM-screened patients was performed. Two hundred and thirty-five DBT patients underwent subsequent MRI examinations; 82 to determine extent of disease after newly diagnosed breast cancer. Eighty-three DM patients underwent subsequent MRI examinations; 23 to determine extent of disease. MRI examinations performed to assess disease extent were considered true positives if additional disease was discovered in the contralateral breast or >2 cm away from the index malignancy. Differences in cancer subtypes and MRI outcomes between the DM and DBT cohorts were compared using chi-squared tests and post-hoc Bonferroni-adjusted tests for equal proportions. No differences in cancer subtype findings were observed between the two cohorts; however, MRI outcomes were found to differ between the DBT and DM cohorts (p=0.024). Specifically, the DBT cohort had significantly (p=0.013) fewer true-positive findings (7/82, 8.5%) than did the DM cohort (7/23; 30%), whereas the false-positive rate was similar between the cohorts (not statistically significant). When stratifying by breast density, this difference in true-positive rates was primarily observed when evaluating women with non-dense breasts (p=0.001). In both the DM- and DBT-screened populations with new cancer diagnoses, MRI is able to detect additional cancer; however, in those patients who have DBT screen-detected cancers the positive impact of preoperative MRI is diminished, particularly in those women with non-dense breasts. Copyright © 2017 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

Primary breast leiomyosarcoma and synchronous homolateral lung cancer: a case report

PubMed Central

Meroni, Stefano; Voulaz, Emanuele; Alloisio, Marco; De Sanctis, Rita; Bossi, Paola; Cariboni, Umberto; De Simone, Matilde; Cioffi, Ugo

2017-01-01

Radiological and histological features of breast leiomyosarcoma can mimic a wide variety of other breast lesions, such as mesenchymal tumors, breast lymphomas, poorly differentiated carcinomas and metaplastic breast carcinomas. The authors present the case of a 62-year-old woman with a primary breast leiomyosarcoma with synchronous ipsilateral lung adenocarcinoma. The latter was an incidental finding during pre-surgical staging examinations. Clinicopathological, immunophenotypic and imaging features cancer are described. A brief review of the literature on imaging findings and management of breast leiomyosarcoma is presented. The authors discuss the differential diagnoses in breast imaging and of the extra-mammary incidental findings. Surgical resection remains the cornerstone of treatment, while radiation therapy and chemotherapy remain to be defined on a single-patient basis. PMID:29312765

Yazd Breast Cancer Project Profile; A Community Based Trial for the Evaluation of Self-Examination and Physical Examination of the Breast Cancer Disease.

PubMed

Miller, Anthony B; Harirchi, Iraj; Lotfi, Mohammad Hassan; Noori, Mahmoud; Mirzaei, Mohsen; Jafarizadea, Majid; Sadeghian, Mohammad Reza; Minosepehr, Mojgan

2015-11-01

There is some evidence to suggest that a benefit might be derived from a program that incorporated both annual physical examination of the breast (BPx) and the teaching of breast self-examination (BSE). Current investigation presents the profile of a multicenter community based intervention for evaluating the effect of BSE+BPx on the reduction of morbidity and mortality due to breast cancer amongst women residing in urban areas of Yazd (Iran) from 2008 to 2018. There were three distinctive phases in this trial with 10 years duration: pilot phase with the duration of 1 year, active intervention phase with 4 rounds of annual screening of BPx+BSE and follow up phase with 5 years duration. Tools of enquiry included a pre-tested questionnaire, repeated annual physical examination of the breast and more importantly mammography, sonography, and fine needle aspiration (FNA). Data were analyzed using descriptive statistics such as frequencies, percent, mean (SD), tests of chi-square and student t-test with 95% confidence level. Comparison of socio-demographic and socio-economic factors such as age, age at marriage, family size, number of live births, occupation, education level, total family income and marital status showed that no significant difference was seen between the groups (P>0.05). A response rate of 84.5% was seen by participants of the experiment group visiting the health centers for the first BPx. Our results showed that except for the education and marital status, the difference in other main demographic and socio-economic factors between the groups were not significant, and the response rate of individuals in the experiment group was at an acceptable level.

Contribution of problem-solving skills to fear of recurrence in breast cancer survivors.

PubMed

Akechi, Tatuo; Momino, Kanae; Yamashita, Toshinari; Fujita, Takashi; Hayashi, Hironori; Tsunoda, Nobuyuki; Iwata, Hiroji

2014-05-01

Although fear of recurrence is a major concern among breast cancer survivors after surgery, no standard strategies exist that alleviate their distress. This study examined the association of patients' problem-solving skills and fear of recurrence and psychological distress among breast cancer survivors. Randomly selected, ambulatory, female patients with breast cancer participated in this study. They were asked to complete the Concerns about Recurrence Scale (CARS) and the Hospital Anxiety and Depression Scale. Multiple regression analyses were used to examine their associations. Data were obtained from 317 patients. Patients' problem-solving skills were significantly associated with all subscales of fear of recurrence and overall worries measured by the CARS. In addition, patients' problem-solving skills were significantly associated with both their anxiety and depression. Our findings warrant clinical trials to investigate effectiveness of psychosocial intervention program, including enhancing patients' problem-solving skills and reducing fear of recurrence among breast cancer survivors.

Evoked fear and effects of appeals on attitudes to performing breast self-examination: an information-processing perspective.

PubMed

Ruiter, R A; Kok, G; Verplanken, B; Brug, J

2001-06-01

The effect of fear arousal on attitude toward participating in early detection activities [i.e. breast self-examination (BSE)] was studied from an information-processing perspective. It was hypothesized that fear arousal motivates respondents to more argument-based processing of fear-relevant persuasive information. Respondents first read information about breast cancer in which fear was manipulated. After measuring fear arousal, respondents read a persuasive message about performing BSE. Analyses with reported fear, but not manipulated fear, found support for the hypothesis. Respondents who reported mild fear of breast cancer based their attitude toward BSE more on the arguments provided than respondents who reported low fear of breast cancer. This finding suggests that the use of fear arousal may be an efficient tool in health education practice. However, alternative interpretations are provided, in addition to the suggestion to be careful with using fear arousal in health education messages.

Awareness and current knowledge of breast cancer.

PubMed

Akram, Muhammad; Iqbal, Mehwish; Daniyal, Muhammad; Khan, Asmat Ullah

2017-10-02

Breast cancer remains a worldwide public health dilemma and is currently the most common tumour in the globe. Awareness of breast cancer, public attentiveness, and advancement in breast imaging has made a positive impact on recognition and screening of breast cancer. Breast cancer is life-threatening disease in females and the leading cause of mortality among women population. For the previous two decades, studies related to the breast cancer has guided to astonishing advancement in our understanding of the breast cancer, resulting in further proficient treatments. Amongst all the malignant diseases, breast cancer is considered as one of the leading cause of death in post menopausal women accounting for 23% of all cancer deaths. It is a global issue now, but still it is diagnosed in their advanced stages due to the negligence of women regarding the self inspection and clinical examination of the breast. This review addresses anatomy of the breast, risk factors, epidemiology of breast cancer, pathogenesis of breast cancer, stages of breast cancer, diagnostic investigations and treatment including chemotherapy, surgery, targeted therapies, hormone replacement therapy, radiation therapy, complementary therapies, gene therapy and stem-cell therapy etc for breast cancer.

CT breast dose reduction with the use of breast positioning and organ-based tube current modulation.

PubMed

Fu, Wanyi; Tian, Xiaoyu; Sturgeon, Gregory M; Agasthya, Greeshma; Segars, William Paul; Goodsitt, Mitchell M; Kazerooni, Ella A; Samei, Ehsan

2017-02-01

This study aimed to investigate the breast dose reduction potential of a breast-positioning (BP) technique for thoracic CT examinations with organ-based tube current modulation (OTCM). This study included 13 female anthropomorphic computational phantoms (XCAT, age range: 27-65 y.o., weight range: 52-105.8 kg). Each phantom was modified to simulate three breast sizes in standard supine geometry. The modeled breasts were then morphed to emulate BP that constrained the majority of the breast tissue inside the 120° anterior tube current (mA) reduction zone. The OTCM mA value was modeled using a ray-tracing program, which reduced the mA to 20% in the anterior region with a corresponding increase to the posterior region. The organ doses were estimated by a validated Monte Carlo program for a typical clinical CT system (SOMATOM Definition Flash, Siemens Healthcare). The simulated organ doses and organ doses normalized by CTDI vol were used to compare three CT protocols: attenuation-based tube current modulation (ATCM), OTCM, and OTCM with BP (OTCM BP ). On average, compared to ATCM, OTCM reduced breast dose by 19.3 ± 4.5%, whereas OTCM BP reduced breast dose by 38.6 ± 8.1% (an additional 23.8 ± 9.4%). The dose saving of OTCM BP was more significant for larger breasts (on average 33, 38, and 44% reduction for 0.5, 1, and 2 kg breasts, respectively). Compared to ATCM, OTCM BP also reduced thymus and heart dose by 15.1 ± 7.4% and 15.9 ± 6.2% respectively. In thoracic CT examinations, OTCM with a breast-positioning technique can markedly reduce unnecessary exposure to radiosensitive organs in anterior chest wall, specifically breast tissue. The breast dose reduction is more notable for women with larger breasts. © 2016 American Association of Physicists in Medicine.

General Breast Cancer Awareness among Women in Riyadh City

PubMed Central

Al Otaibi, Shibl; Al Harbi, Mutaz; Al Kahmoas, Abdulaziz; Al Qhatani, Fahad; Al Mutairi, Fahad; Al Mutairi, Talal; Al Ajmi, Refan; Al Mousawi, Fatimah

2017-01-01

Breast cancer is the most common cancer among women globally as well as in Saudi Arabia. Early diagnosis can improve prognosis and breast self-examination (BSE) may be a cost effective way to achieve this. In Saudi Arabia, only a few studies have been conducted to address breast cancer awareness. Most showed a suboptimal level of understanding. During the last few years, Saudi Arabia has established many national campaigns to increase awareness of the disease and facilitate learning about different diagnostic procedures. This cross-sectional survey study was conducted in accordance to assess the current knowledge and practices of women regarding breast self-examination and mammography screening in Riyadh, Saudi Arabia. The sample comprised of 137 females aged 18 and older. Data were collected using face-to-face interviews with a modified Arabic version of a validated questionnaire and analyzed using SPSS. Similar to previous studies’, the results were suboptimal. Out of the 137, about 54% claimed they are aware of breast cancer and BSE, however, only 62% of them knew how to conduct self-examination. Far fewer were aware of mammography screening (38%). When asked about the source of breast cancer information, most of the women answered awareness campaigns (39%) while school/university and TV (22% each) were the sources for others. This highlights the importance and urgent need for continued awareness campaigns. Moreover, special awareness sessions need to be conducted in institutions like colleges, universities, and hospitals where the proportion of females is higher. PMID:28240511

Community-based breast cancer intervention program for older African American women in beauty salons.

PubMed Central

Forte, D A

1995-01-01

African American women are at high risk for morbidity and mortality from breast cancer. African American women ages 50 and older have been a difficult group to reach through conventional breast cancer intervention programs. Cultural and health beliefs that differ from mainstream society are reported to be factors contributing to the low rates of breast screening among this group. In addition to these attitudinal factors, older African American women are disproportionately represented among uninsured and under-insured Americans. As a result, cost becomes a barrier to mammography screening for many of these women. This project proposes to increase breast cancer screening awareness and provide a referral or free breast screening, or both, for African American women ages 50 and older. This information will be offered in the culturally familiar setting of local beauty salons. The culturally sensitive educational pamphlets developed by the National Cancer Institute (NCI) and video developed by the NCI-funded project, Cancer Prevention Research Unit, will be used to promote mammography, clinical breast examinations, and breast self-examination. Providers staffing a mobile mammography van provided by Dr. Anitha Mitchell of the Association of Black Women Physicians through a grant from the Breast and Cervical Cancer Control Program, funded by the Centers for Disease Control and Prevention, will perform mammograms for women on site during scheduled intervals. A followup telephone survey will be conducted. PMID:7630996

Detection of aberrant methylation of a six-gene panel in serum DNA for diagnosis of breast cancer

PubMed Central

Li, Junnan; Li, Xiaobo; Wang, Dong; Su, Yonghui; Niu, Ming; Zhong, Zhenbin; Wang, Ji; Zhang, Xianyu; Kang, Wenli; Pang, Da

2016-01-01

Detection of breast cancer at an early stage is the key for successful treatment and improvement of outcome. However the limitations of mammography are well recognized, especially for those women with premenopausal breast cancer. Novel approaches to breast cancer screening are necessary, especially in the developing world where mammography is not feasible. In this study, we examined the promoter methylation of six genes (SFN, P16, hMLH1, HOXD13, PCDHGB7 and RASSF1a) in circulating free DNA (cfDNA) extracted from serum. We used a high-throughput DNA methylation assay (MethyLight) to examine serum from 749 cases including breast cancer patients, patients with benign breast diseases and healthy women. The six-gene methylation panel test achieved 79.6% and 82.4% sensitivity with a specificity of 72.4% and 78.1% in diagnosis of breast cancer when compared with healthy and benign disease controls, respectively. Moreover, the methylation panel positive group showed significant differences in the following independent variables: (a) involvement of family history of tumors; (b) a low proliferative index, ki-67; (c) high ratios in luminal subtypes. Additionally the panel also complemented some breast cancer cases which were neglected by mammography or ultrasound. These data suggest that epigenetic markers in serum have potential for diagnosis of breast cancer. PMID:26918343

Consumption of soy foods and the risk of breast cancer: findings from the Japan Collaborative Cohort (JACC) Study.

PubMed

Nishio, Kazuko; Niwa, Yoshimitsu; Toyoshima, Hideaki; Tamakoshi, Koji; Kondo, Takaaki; Yatsuya, Hiroshi; Yamamoto, Akio; Suzuki, Sadao; Tokudome, Shinkan; Lin, Yingsong; Wakai, Kenji; Hamajima, Nobuyuki; Tamakoshi, Akiko

2007-10-01

The association between a lower incidence of breast cancer within the Asian population and the consumption of a diet high in soy has recently been the subject of much attention. To examine whether soy foods really have protective effects against breast cancer and how their influence on breast cancer is modified according to menopausal status, we conducted a population-based, prospective cohort study in Japan. We analyzed the data from the Japan Collaborative Cohort (JACC) Study. From 1988 to 1990, 30,454 women aged 40-79 years, completed a questionnaire on diet and other lifestyle features. Hazard ratios (HRs) were computed to examine the association between soy intake and the risk of breast cancer. During the mean follow-up of 7.6 years, 145 cases of breast cancer were documented. We found no significant association between the risk of breast cancer and consumption of tofu, boiled beans, and miso soup; the multivariate HRs (95% CI) in the highest category of consumption were 1.14 (0.74-1.77), 0.77 (0.47-1.27) and 1.01 (0.65-1.56), respectively. Only among postmenopausal women, we found no significant associations between soy foods and the risk of breast cancer. This prospective study suggests that consumption of soy food has no protective effects against breast cancer. Further large-scale investigations eliciting genetic factors may clarify different roles of various soybean-ingredient foods on the risk of breast cancer.

Breast and cervical cancers diagnosed and stage at diagnosis among women served through the National Breast and Cervical Cancer Early Detection Program.

PubMed

Miller, Jacqueline W; Royalty, Janet; Henley, Jane; White, Arica; Richardson, Lisa C

2015-05-01

To assess cancers diagnosed and the stage of cancer at the time of diagnosis among low-income, under-insured, or uninsured women who received services through the National Breast and Cervical Cancer Early Detection Program (NBCCEDP). Using the NBCCEDP database, we examined the number and percent of women diagnosed during 2009-2011 with in situ breast cancer, invasive breast cancer, and invasive cervical cancer by demographic and clinical characteristics, including age, race and ethnicity, test indication (screening or diagnostic), symptoms (for breast cancer), and screening history (for cervical cancer). We examined these characteristics by stage at diagnosis, a new variable included in the database obtained by linking with state-based central cancer registries. There were 11,569 women diagnosed with invasive breast cancer, 1,988 with in situ breast cancer, and 583 with invasive cervical cancer through the NBCCEDP. Women who reported breast symptoms or who had diagnostic mammography were more likely to be diagnosed with breast cancer, and at a later stage, than those who did not have symptoms or who had screening mammography. Women who had been rarely or never screened for cervical cancer were more likely to be diagnosed with cervical cancer, and at a later stage, than women who received regular screenings. Women served through the NBCCEDP who have not had prior screening or who have symptoms were more often diagnosed with late-stage disease.

Association of FGFR3 and FGFR4 gene polymorphisms with breast cancer in Chinese women of Heilongjiang province

PubMed Central

Jiang, Yongdong; Sun, Shanshan; Wei, Wei; Ren, Yanlv; Liu, Jing; Pang, Da

2015-01-01

Background The fibroblast growth factor (FGF) receptor pathway is activated in many tumors. FGFR2 has been identified as a breast cancer susceptibility gene. Common variation in other FGF receptors might also affect breast cancer risk. We carried out a case-control study to investigate associations of variants in FGFR3 and FGFR4 with breast cancer in women from Heilongjiang Province. Methods SNP rs2234909 and rs3135848 in FGFR3 and rs1966265 and rs351855 in FGFR4 were successfully genotyped in 747 breast cancer patients and 716 healthy controls using the SNaPshot method. The associations between SNPs and breast cancer were examined by logistic regression. The associations between SNPs and disease characteristics were examined by chi-square tests or one-way ANOVA as needed. Results The minor alleles of rs1966265 and rs351855 in FGFR4 were strongly associated with breast cancer in the population, with odds ratios of 1.335 (95%CI = 1.154-1.545) and 1.364 (95%CI = 1.177-1.580), respectively. However, no significant associations were detected between other SNPs and breast cancer. Analyses of the disease characteristics showed that SNP rs351855 was associated with lymph-node-positive breast cancer with a dose-dependent effect of the minor allele (P = 0.008). Conclusions SNPs rs1966265 and rs351855 in FGFR4 were associated with breast cancer in a northern Chinese population. PMID:26431494

Consumer Health Education. Breast Cancer.

ERIC Educational Resources Information Center

Arkansas Univ., Fayetteville, Cooperative Extension Service.

This short booklet is designed to be used by health educators when teaching women about breast cancer and its early detection and the procedure for breast self-examination. It includes the following: (1) A one-page teaching plan consisting of objectives, subject matter, methods (including titles of films and printed materials), target audience,…

Visible/near-infrared spectroscopy to predict water holding capacity in broiler breast meat

USDA-ARS?s Scientific Manuscript database

Visible/Near-infrared spectroscopy (Vis/NIRS) was examined as a tool for rapidly determining water holding capacity (WHC) in broiler breast meat. Both partial least squares (PLS) and principal component analysis (PCA) models were developed to relate Vis/NIRS spectra of 85 broiler breast meat sample...

Breast-Feeding Attitudes and Behavior among WIC Mothers in Texas

ERIC Educational Resources Information Center

Vaaler, Margaret L.; Stagg, Julie; Parks, Sharyn E.; Erickson, Tracy; Castrucci, Brian C.

2010-01-01

Objective: This study explored the influence of demographic characteristics on attitudes toward the benefits of breast-feeding, approval of public breast-feeding, and the use of infant formula. Additionally, the study examined whether attitudes were related to infant feeding practices among mothers enrolled in the Special Supplemental Nutrition…

Breast SeIf-Examination Behavior Among High and Low Risk Women

DTIC Science & Technology

1986-04-10

Paige & Asire , 1985) and despite progress in its treatment, breast cancer at present cannot be prevented. When a diagnosis of breast cancer is made, the...predi’sposition, socioeconomic status, exposure to viruses, and exposure to diet and hormone-containing drugs. Paige and Asire (1985) in considering the

Metastatic Breast Cancer in Uterine Cervix: A Rare Presentation.

PubMed

Proença, Sara; Reis, Maria Inês; Cominho, Joana; Conde, Pedro Casado; Santos E Pereira, Helena; Ribeiro, Filipa Castro

2016-01-01

Uterine cervix involvement by a distant primary tumor is a rare event. We report the following 2 cases of breast tumor metastasis to the uterine cervix with different presentations: case 1 is an isolated cervix metastasis and case 2 is a disseminated metastatic disease with cervix involvement. In both, clinical examination raised the suspicion of cervical tumor, which was confirmed to be a metastatic adenocarcinoma.The poor outcome and lack of symptoms suggest that although its rareness, all patients with breast cancer should undergo a careful routine gynecologic examination.

Bilateral breast enlargement in a male toddler: an unusual cause.

PubMed

Sharma, Rajni; Jain, Vandana

2009-11-01

We report a case of a two and a half yr old boy who presented with complaint of bilateral asymmetrical breast enlargement since infancy. On examination, he had features of neurofibromatosis type 1 (NF1). Complete endocrinological evaluation was normal. Trucut biopsy of the breast revealed overgrowth of fibrocollagenous and adipose tissue without hyperplasia of breast parenchyma. Thus a diagnosis of NF1 with pseudogynecomastia was made.

Infant breast-feeding and childhood caries: a nine-year study.

PubMed

Hong, Liang; Levy, Steven M; Warren, John J; Broffitt, Barbara

2014-01-01

This study's purpose was to assess the association between infant breast-feeding and caries experience of primary second molars in a nine-year longitudinal cohort study. Study sample was 509 subjects recruited at birth. Information about breast-feeding duration and other factors was collected through parents' responses to periodic questionnaires. Primary teeth were examined for dental caries at five years old and nine years old by calibrated dentist examiners. Caries experience (yes/no) and number of decayed and/or filled surfaces (dfs) were determined for five- and nine-year-olds. For primary second molars at five years old, 18 percent of children who were breast-fed less than six months had caries (mean dfs=0.55) while only 9 percent of children who were breast-fed at least six months had caries (mean dfs=0.33). From five to nine years old, caries incidence was 32 percent and 31 percent, respectively, for children breast-fed less than six months and at least six months. In multivariable regression analyses, shorter breast-feeding duration was positively associated with caries experience of primary second molars at five years old (P=.005), both before and after controlling for other important factors. Shorter duration of breast-feeding is suggested to be associated with increased risk for early childhood caries, but its impact might diminish with age.

Women's perceptions of heart disease and breast cancer and the association with media representations of the diseases

PubMed Central

Berry, Tanya R.; Stearns, Jodie A.; Courneya, Kerry S.; McGannon, Kerry R.; Norris, Colleen M.; Rodgers, Wendy M.; Spence, John C.

2016-01-01

Abstract Background This research examined differences in perceptions of heart disease compared with breast cancer and if the differences are reflected in media presentations of the diseases. Relationships of differences in perceptions to demographic groups, heart disease risk factors and health behaviors were examined. Methods Study 1 was a quantitative content analysis of articles and advertisements related to heart disease or breast cancer. Results There were greater perceptions of susceptibility, preventability and controllability of heart disease and lower perceptions regarding seriousness, fearfulness and extent to which family history determines disease development of heart disease compared with breast cancer. Five times more pieces related to breast cancer were found compared with heart disease. Study 2 was a survey of 1524 women. More articles and advertisements about breast cancer than heart disease were found, and survey participants reported seeing significantly more breast cancer than heart disease media. Younger women had greater perceived susceptibility of breast cancer relative to heart disease while the content analysis revealed that the heart disease pieces were more likely to feature women older than 40 years of age. Conclusions This research is an important step in the development of theories regarding causal effects of media on health perceptions and behaviors. PMID:28158680

Screening mammography--early detection or over-diagnosis? Contribution from Australian data.

PubMed

Bell, R J

2014-12-01

The aim of this review was to examine the benefits and harms of organized screening mammography, with particular reference to data from Australia. Published literature was examined relating to the impact of screening mammography on breast cancer-specific mortality, the trends in use of adjuvant treatments for breast cancer, the effectiveness of adjuvant treatment in terms of breast cancer-specific mortality, the impact of breast cancer treatment on non-breast cancer mortality and the magnitude of the issue of over-diagnosis. Most of the recent reduction in breast cancer-specific mortality is explained by use of adjuvant therapy rather than screening mammography. The impact of screening mammography in countries where women present with early disease and have access to adjuvant treatment is modest. There is a wide range of estimates for the magnitude of over-diagnosis. All-cause mortality (rather than breast cancer-specific mortality) should be used when assessing the impact of mammographic screening as otherwise the harm of breast cancer treatment in women who are over-diagnosed will be missed. The benefits and harms of screening mammography are finely balanced. The impact of screening mammography is at best neutral but may result in overall harm. Women should be informed of the issue of over-diagnosis. It is time to review whether organized mammographic screening programs should continue.

An Infantile Case of Transient, Severe Hypercholesterolemia with Normalization after Complete Weaning from Breast-feeding.

PubMed

Yamamoto, Yukiyo; Saito, Reiko; Goto, Motohide; Araki, Shunsuke; Kubo, Kazuyasu; Kawagoe, Rinko; Kawada, Yasusada; Kusuhara, Koichi

2012-04-01

A 20-d-old boy was referred to our department because of hyperthyrotropinemia at neonatal mass screening and diagnosed with neonatal transient hyperthyrotropinemia. A follow-up examination when the patient was 5 mo old revealed severe hypercholesterolemia. Familial hypercholesterolemia was first suspected because of the patient's significantly high levels of total and low-density lipoprotein cholesterol. The parent's serum lipid profiles were examined and found to be normal. He was completely breast-fed until 6 mo of age. Breast milk was still the main source of food for a period following weaning. At 14 mo old, the patient was weaned completely from breast milk, and his serum cholesterol levels decreased dramatically. According to the normal lipid profiles of the patient's parents and the spontaneous normalization of serum cholesterol levels after complete weaning from breast milk, breast-feeding was suggested to be responsible for his transient severe hypercholesterolemia. It is well documented that breast-fed infants have higher serum cholesterol levels than formula-fed infants. However, there is no reported case with severe hypercholesterolemia equivalent to or higher than the levels observed in the case of familial hypercholesterolemia. Although the exact mechanism is unknown, it is necessary to consider that a small number of cases develop severe hypercholesterolemia related to breast-feeding.

Oestrogen exposure and breast cancer risk

PubMed Central

Travis, Ruth C; Key, Timothy J

2003-01-01

Epidemiological and experimental evidence implicates oestrogens in the aetiology of breast cancer. Most established risk factors for breast cancer in humans probably act through hormone-related pathways, and increased concentrations of circulating oestrogens have been found to be strongly associated with increased risk for breast cancer in postmenopausal women. This article explores the evidence for the hypothesis that oestrogen exposure is a major determinant of risk for breast cancer. We review recent data on oestrogens and breast cancer risk, consider oestrogen-related risk factors and examine possible mechanisms that might account for the effects of oestrogen. Finally, we discuss how these advances might influence strategies for reducing the incidence of breast cancer. PMID:12927032

Screening US in patients with mammographically dense breasts: initial experience with Connecticut Public Act 09-41.

PubMed

Hooley, Regina J; Greenberg, Kathryn L; Stackhouse, Rebecca M; Geisel, Jaime L; Butler, Reni S; Philpotts, Liane E

2012-10-01

To determine performance and utilization of screening breast ultrasonography (US) in women with dense breast tissue who underwent additional screening breast US in the 1st year since implementation of Connecticut Public Act 09-41 requiring radiologists to inform patients with heterogeneous or extremely dense breasts at mammography that they may benefit from such examination. Informed consent was waived for this institutional review board-approved, HIPAA-compliant retrospective review of 935 women with dense breasts at mammography who subsequently underwent handheld screening and whole-breast US from October 1, 2009, through September 30, 2010. Of 935 women, 614 (65.7%) were at low risk, 149 (15.9%) were at intermediate risk, and 87 (9.3%) were at high risk for breast cancer. Of the screening breast US examinations, in 701 (75.0%), results were classified as Breast Imaging Reporting and Data System (BI-RADS) category 1 or 2; in 187 (20.0%), results were classified as BI-RADS category 3; and in 47 (5.0%), results were classified as BI-RADS category 4. Of 63 aspirations or biopsies recommended and performed in 53 patients, in nine, lesions were BI-RADS category 3, and in 54, lesions were BI-RADS category 4. Among 63 biopsies and aspirations, three lesions were malignant (all BI-RADS category 4, diagnosed with biopsy). All three cancers were smaller than 1 cm, were found in postmenopausal patients, and were solid masses. One cancer was found in each risk group. In 44 of 935 (4.7%) patients, examination results were false-positive. Overall positive predictive value (PPV) for biopsy or aspirations performed in patients with BI-RADS category 4 masses was 6.5% (three of 46; 95% confidence interval [CI]: 1.7%, 19%). Overall cancer detection rate was 3.2 cancers per 1000 women screened (three of 935; 95% CI: 0.8 cancers per 1000 women screened, 10 cancers per 1000 women screened). Technologist-performed handheld screening breast US offered to women in the general population with dense breasts can aid detection of small mammographically occult breast cancers (cancer detection rate, 0.8-10 cancers per 1000 women screened), although the overall PPV is low. © RSNA, 2012.

Choline and betaine intake and risk of breast cancer among post-menopausal women.

PubMed

Cho, E; Holmes, M D; Hankinson, S E; Willett, W C

2010-02-02

Choline and betaine, similar to folate, are nutrients involved in one-carbon metabolism and hypothesised to reduce breast cancer risk. No prospective study among post-menopausal women has examined choline and betaine intakes in relation to breast cancer risk. We examined the intake of choline and betaine and breast cancer risk among 74 584 post-menopausal women in the Nurses' Health Study. Nutrient intake was assessed using a validated food-frequency questionnaire six times since 1984. During 20 years of follow-up from 1984 until 2004, we documented 3990 incident cases of invasive breast cancer. Overall, choline (mean+/-s.d.; 326+/-61 mg per day) and betaine (104+/-33 mg per day) intake was not associated with a reduced risk of post-menopausal breast cancer. Participants in the highest quintile of intakes had multivariate relative risks of 1.10 (95% confidence interval (95% CI): 0.99-1.22; P-value, test for trend=0.14) for choline and 0.98 (95% CI: 0.89-1.09; P-value, test for trend=0.96) for betaine, compared with those in the lowest quintiles of intakes. The results were similar in breast cancer stratified by hormone receptor (oestrogen receptor/progesterone receptor) status. The association between choline intake and breast cancer risk did not differ appreciably by alcohol intake (non-drinker, <15 or 15+ g per day) or several other breast cancer risk factors, including family history of breast cancer, history of benign breast disease, body mass index, post-menopausal hormone use, and folate intake. We found no evidence that higher intakes of choline and betaine reduce risk of breast cancer among post-menopausal women.

Choline and betaine intake and risk of breast cancer among post-menopausal women

PubMed Central

Cho, E; Holmes, M D; Hankinson, S E; Willett, W C

2010-01-01

Background: Choline and betaine, similar to folate, are nutrients involved in one-carbon metabolism and hypothesised to reduce breast cancer risk. No prospective study among post-menopausal women has examined choline and betaine intakes in relation to breast cancer risk. Methods: We examined the intake of choline and betaine and breast cancer risk among 74 584 post-menopausal women in the Nurses' Health Study. Nutrient intake was assessed using a validated food-frequency questionnaire six times since 1984. During 20 years of follow-up from 1984 until 2004, we documented 3990 incident cases of invasive breast cancer. Results: Overall, choline (mean±s.d.; 326±61 mg per day) and betaine (104±33 mg per day) intake was not associated with a reduced risk of post-menopausal breast cancer. Participants in the highest quintile of intakes had multivariate relative risks of 1.10 (95% confidence interval (95% CI): 0.99–1.22; P-value, test for trend=0.14) for choline and 0.98 (95% CI: 0.89–1.09; P-value, test for trend=0.96) for betaine, compared with those in the lowest quintiles of intakes. The results were similar in breast cancer stratified by hormone receptor (oestrogen receptor/progesterone receptor) status. The association between choline intake and breast cancer risk did not differ appreciably by alcohol intake (non-drinker, <15 or 15+ g per day) or several other breast cancer risk factors, including family history of breast cancer, history of benign breast disease, body mass index, post-menopausal hormone use, and folate intake. Conclusion: We found no evidence that higher intakes of choline and betaine reduce risk of breast cancer among post-menopausal women. PMID:20051955

Effects of tailored message education about breast cancer risk appraisal for obese Korean women.

PubMed

Park, Somi; Chung, ChaeWeon; Cochrane, Barbara B

2013-11-01

To examine the effects of tailored message education about breast cancer risk in obese Korean women. Pretest/post-test with two comparison treatments. Rural community settings in South Korea. Non-random sample of 64 obese women. Based on the Health Belief Model, tailored message education involved a one-session individual approach addressing cognitive, emotional, and behavioral domains. The comparison group received a one-time standard education group session. Data on breast cancer risk factors and mammography findings were recorded. Knowledge, awareness, emotional barriers, self-efficacy, and intent to screen and prevent breast cancer. Compared to standard education, tailored message education showed significantly higher score changes on awareness of personal risk (F = 5.21, p < 0.05), self-efficacy for breast self-examination (BSE) (F = 5.16, p < 0.001), intent to perform BSE (F = 6.24, p < 0.05), intent to have mammography (F = 5.45, p < 0.05), and intent to prevent breast cancer with eating habits (F = 7.28, p < 0.05) and exercising (F = 12.51, p < 0.001). Individually tailored education effectively enhanced awareness of personal risk for breast cancer, self-efficacy for BSE, and intent to screen and prevent breast cancer. Tailored message education targeting breast cancer and risk associated with obesity is useful in breast cancer screening education. Future studies should incorporate individualized messages on nutrition, exercise, and cultural barriers to reduce breast cancer risk in obese women. Individual educational strategies can effectively enhance breast cancer prevention and early screening. Public and preventive education should include a focus on cultural, cognitive, and emotional domains. For obese women, a heightened awareness and self-efficacy may influence screening behaviors.

Common Breast Cancer Susceptibility Variants in LSP1 and RAD51L1 Are Associated with Mammographic Density Measures that Predict Breast Cancer Risk

PubMed Central

Vachon, Celine M.; Scott, Christopher G.; Fasching, Peter A.; Hall, Per; Tamimi, Rulla M.; Li, Jingmei; Stone, Jennifer; Apicella, Carmel; Odefrey, Fabrice; Gierach, Gretchen L.; Jud, Sebastian M.; Heusinger, Katharina; Beckmann, Matthias W.; Pollan, Marina; Fernández-Navarro, Pablo; González-Neira, Anna; Benítez, Javier; van Gils, Carla H.; Lokate, Mariëtte; Onland-Moret, N. Charlotte; Peeters, Petra H.M.; Brown, Judith; Leyland, Jean; Varghese, Jajini S.; Easton, Douglas F.; Thompson, Deborah J.; Luben, Robert N.; Warren, Ruth ML; Wareham, Nicholas J.; Loos, Ruth JF; Khaw, Kay-Tee; Ursin, Giske; Lee, Eunjung; Gayther, Simon A.; Ramus, Susan J.; Eeles, Rosalind A.; Leach, Martin O.; Kwan-Lim, Gek; Couch, Fergus J.; Giles, Graham G.; Baglietto, Laura; Krishnan, Kavitha; Southey, Melissa C.; Le Marchand, Loic; Kolonel, Laurence N.; Woolcott, Christy; Maskarinec, Gertraud; Haiman, Christopher A; Walker, Kate; Johnson, Nichola; McCormack, Valerie A.; Biong, Margarethe; Alnæs, Grethe I.G.; Gram, Inger Torhild; Kristensen, Vessela N.; Børresen-Dale, Anne-Lise; Lindström, Sara; Hankinson, Susan E.; Hunter, David J.; Andrulis, Irene L.; Knight, Julia A.; Boyd, Norman F.; Figueroa, Jonine D.; Lissowska, Jolanta; Wesolowska, Ewa; Peplonska, Beata; Bukowska, Agnieszka; Reszka, Edyta; Liu, JianJun; Eriksson, Louise; Czene, Kamila; Audley, Tina; Wu, Anna H.; Pankratz, V. Shane; Hopper, John L.; dos-Santos-Silva, Isabel

2013-01-01

Background Mammographic density adjusted for age and body mass index (BMI) is a heritable marker of breast cancer susceptibility. Little is known about the biological mechanisms underlying the association between mammographic density and breast cancer risk. We examined whether common low-penetrance breast cancer susceptibility variants contribute to inter-individual differences in mammographic density measures. Methods We established an international consortium (DENSNP) of 19 studies from 10 countries, comprising 16,895 Caucasian women, to conduct a pooled cross-sectional analysis of common breast cancer susceptibility variants in 14 independent loci and mammographic density measures. Dense and non-dense areas, and percent density, were measured using interactive-thresholding techniques. Mixed linear models were used to assess the association between genetic variants and the square roots of mammographic density measures adjusted for study, age, case status, body mass index (BMI) and menopausal status. Results Consistent with their breast cancer associations, the C-allele of rs3817198 in LSP1 was positively associated with both adjusted dense area (p=0.00005) and adjusted percent density (p=0.001) whereas the A-allele of rs10483813 in RAD51L1 was inversely associated with adjusted percent density (p=0.003), but not with adjusted dense area (p=0.07). Conclusion We identified two common breast cancer susceptibility variants associated with mammographic measures of radio-dense tissue in the breast gland. Impact We examined the association of 14 established breast cancer susceptibility loci with mammographic density phenotypes within a large genetic consortium and identified two breast cancer susceptibility variants, LSP1-rs3817198 and RAD51L1-rs10483813, associated with mammographic measures and in the same direction as the breast cancer association. PMID:22454379

Toxoplasmosis presenting as a swelling in the axillary tail of the breast and a palpable axillary lymph node mimicking malignancy: a case report.

PubMed

Siriwardana, Hp Priyantha; Teare, Louise; Kamel, Dia; Inwang, E Reggie

2011-08-04

Lymphadenopathy is a common finding in toxoplasmosis. A breast mass due to toxoplasmosis is very rare, and only a few cases have been reported. We present a case of toxoplasmosis that presented as a swelling in the axillary tail of the breast with a palpable axillary lymph node which mimicked breast cancer. A 45-year-old otherwise healthy Caucasian woman presented with a lump on the lateral aspect of her left breast. Her mother had breast cancer that was diagnosed at the age of 66 years. During an examination, we discovered that our patient had a discrete, firm lump in the axillary tail of her left breast and an enlarged, palpable lymph node in her left axilla. Her right breast and axilla were normal. The clinical diagnosis was malignancy in the left breast. Ultrasound and mammographic examinations of her breast suggested a pathological process but were not conclusive. She had targeted fine-needle aspiration cytology (FNAC) and core biopsy of the lesions. FNAC was indeterminate (C3) but suggested a possibility of toxoplasmosis. The core biopsy was not suggestive of malignancy but showed granulomatous inflammation. She had a wide local excision of the breast lump and an axillary lymph node biopsy. Histopathology and immunohistochemical studies excluded carcinoma or lymphoma but suggested the possibility of intramammary and axillary toxoplasmic lymphadenopathy. The results of Toxoplasma gondii IgM and IgG serology tests were positive, supporting a diagnosis of toxoplasmosis. Toxoplasmosis rarely presents as a pseudotumor of the breast. FNAC and histology are valuable tools for a diagnosis of toxoplasmosis, and serology is an important adjunct for confirmation.

Toxoplasmosis presenting as a swelling in the axillary tail of the breast and a palpable axillary lymph node mimicking malignancy: a case report

PubMed Central

2011-01-01

Introduction Lymphadenopathy is a common finding in toxoplasmosis. A breast mass due to toxoplasmosis is very rare, and only a few cases have been reported. We present a case of toxoplasmosis that presented as a swelling in the axillary tail of the breast with a palpable axillary lymph node which mimicked breast cancer. Case presentation A 45-year-old otherwise healthy Caucasian woman presented with a lump on the lateral aspect of her left breast. Her mother had breast cancer that was diagnosed at the age of 66 years. During an examination, we discovered that our patient had a discrete, firm lump in the axillary tail of her left breast and an enlarged, palpable lymph node in her left axilla. Her right breast and axilla were normal. The clinical diagnosis was malignancy in the left breast. Ultrasound and mammographic examinations of her breast suggested a pathological process but were not conclusive. She had targeted fine-needle aspiration cytology (FNAC) and core biopsy of the lesions. FNAC was indeterminate (C3) but suggested a possibility of toxoplasmosis. The core biopsy was not suggestive of malignancy but showed granulomatous inflammation. She had a wide local excision of the breast lump and an axillary lymph node biopsy. Histopathology and immunohistochemical studies excluded carcinoma or lymphoma but suggested the possibility of intramammary and axillary toxoplasmic lymphadenopathy. The results of Toxoplasma gondii IgM and IgG serology tests were positive, supporting a diagnosis of toxoplasmosis. Conclusions Toxoplasmosis rarely presents as a pseudotumor of the breast. FNAC and histology are valuable tools for a diagnosis of toxoplasmosis, and serology is an important adjunct for confirmation. PMID:21816047

Incidence of inflammatory breast cancer in patients with clinical inflammatory breast symptoms

PubMed Central

Pons, Kelly; Mabille, Mylène; Abd alsamad, Issam; Mitri, Rana; Skalli, Dounia; Haddad, Bassam

2017-01-01

Background To describe a large cohort of women with non-puerperal inflammatory breast and to identify characteristics of inflammatory breast cancer. Methods All patients consulting for inflammatory breast syndrome in the breast unit of our tertiary University hospital between September 2013 and December 2015 were prospectively included. We excluded women who were pregnant or in the postpartum period. Patients underwent systematic clinical examination and imaging (breast ultrasonography and mammography). A biopsy was performed if the clinician suspected a malignant lesion of the breast. Clinicopathologic and radiologic data were registered. Statistics were performed using R (3.0.2 version) software. Results Among the 76 patients screened and included, 38 (50%) had a malignant lesion at final diagnosis, 21 (27.6%) were diagnosed with infectious disease and 17 (22.4%) with inflammatory disease of the breast. When compared to patients with benign disease, patients with a malignant lesion were significantly older (p = 0.022, CI95% 1.78–14.7), had a significantly bigger palpable mass (p<0.001, CI 95% 22.8–58.9), were more likely to have skin thickening (p = 0.05) and had more suspicious lymph nodes at clinical examination (p<0.001, CI 95% 2.72–65.3). Precise limits on ultrasonography were significantly associated with benign lesions. The presence of a mass (p = 0.04), micro calcifications (p = 0.04) or of focal asymmetry (p<0.001, CI95% 1.3–618) on mammography was significantly associated with malignant disease. Conclusion Inflammatory breast cancer was common in our cohort of women consulting for inflammatory breast syndrome. Identifying these patients with high-risk malignancy is crucial in the management of an inflammatory breast. PMID:29261724

Understanding Clinical Mammographic Breast Density Assessment: a Deep Learning Perspective.

PubMed

Mohamed, Aly A; Luo, Yahong; Peng, Hong; Jankowitz, Rachel C; Wu, Shandong

2017-09-20

Mammographic breast density has been established as an independent risk marker for developing breast cancer. Breast density assessment is a routine clinical need in breast cancer screening and current standard is using the Breast Imaging and Reporting Data System (BI-RADS) criteria including four qualitative categories (i.e., fatty, scattered density, heterogeneously dense, or extremely dense). In each mammogram examination, a breast is typically imaged with two different views, i.e., the mediolateral oblique (MLO) view and cranial caudal (CC) view. The BI-RADS-based breast density assessment is a qualitative process made by visual observation of both the MLO and CC views by radiologists, where there is a notable inter- and intra-reader variability. In order to maintain consistency and accuracy in BI-RADS-based breast density assessment, gaining understanding on radiologists' reading behaviors will be educational. In this study, we proposed to leverage the newly emerged deep learning approach to investigate how the MLO and CC view images of a mammogram examination may have been clinically used by radiologists in coming up with a BI-RADS density category. We implemented a convolutional neural network (CNN)-based deep learning model, aimed at distinguishing the breast density categories using a large (15,415 images) set of real-world clinical mammogram images. Our results showed that the classification of density categories (in terms of area under the receiver operating characteristic curve) using MLO view images is significantly higher than that using the CC view. This indicates that most likely it is the MLO view that the radiologists have predominately used to determine the breast density BI-RADS categories. Our study holds a potential to further interpret radiologists' reading characteristics, enhance personalized clinical training to radiologists, and ultimately reduce reader variations in breast density assessment.

A Risk Assessment Comparison of Breast Cancer and Factors Affected to Risk Perception of Women in Turkey: A Cross-sectional Study

PubMed Central

YÜKSEL, Serpil; ALTUN UĞRAŞ, Gülay; ÇAVDAR, İkbal; BOZDOĞAN, Atilla; ÖZKAN GÜRDAL, Sibel; AKYOLCU, Neriman; ESENCAN, Ecem; VAROL SARAÇOĞLU, Gamze; ÖZMEN, Vahit

2017-01-01

Background: The increase in breast cancer incidence has enhanced attention towards breast cancer risk. The aim of this study was to determine the risk of breast cancer and risk perception of women, factors that affect risk perception, and to determine differences between absolute risk and the perception of risk. Methods: This cross-sectional study was carried out among 346 women whose score in the Gail Risk Model (GRM) was ≥ 1.67% and/or had a 1st degree relative with breast cancer in Bahçeşehir town in Istanbul, Turkey between Jul 2012 and Dec 2012. Data were collected through face-to-face interviews. The level of risk for breast cancer has been calculated using GRM and the Breast Cancer Risk Assessment Form (BCRAF). Breast cancer risk perception (BCRP), has been evaluated by visual analogue 100-cm-long scale. Results: Even though 39.6% of the women considered themselves as high-risk carriers, according to the GRM and the BCRAF, only 11.6% and 9.8% of women were in the “high risk” category, respectively. There was a positive significant correlation between the GRM and the BCRAF scores (P<0.001), and the BCRAF and BCRP scores (P<0.001). Factors related to high-risk perception were age (40–59 yr), post-menopausal phase, high-very high economic income level, existence of breast cancer in the family, having regular breast self-examination and clinical breast examination (P<0.05). Conclusion: In women with high risk of breast, cancer there is a significant difference between the women’s risk perception and their absolute risk level. PMID:28435816

Vicarious and Persuasive Influences on Efficacy Expectations and Intentions To Perform Breast Self-Examination.

ERIC Educational Resources Information Center

Anderson, Ronald B.

2000-01-01

Tests the impact of symbolic modeling and persuasive efficacy information on self-efficacy beliefs and intentions to perform breast self-examinations among 147 undergraduate students. Assesses the effects of these modes of efficacy induction on fear arousal and response-outcome expectations. Finds symbolic modeling engendered greater efficacy…

Expression profiling of nuclear receptors in breast cancer identifies TLX as a mediator of growth and invasion in triple-negative breast cancer.

PubMed

Lin, Meng-Lay; Patel, Hetal; Remenyi, Judit; Banerji, Christopher R S; Lai, Chun-Fui; Periyasamy, Manikandan; Lombardo, Ylenia; Busonero, Claudia; Ottaviani, Silvia; Passey, Alun; Quinlan, Philip R; Purdie, Colin A; Jordan, Lee B; Thompson, Alastair M; Finn, Richard S; Rueda, Oscar M; Caldas, Carlos; Gil, Jesus; Coombes, R Charles; Fuller-Pace, Frances V; Teschendorff, Andrew E; Buluwela, Laki; Ali, Simak

2015-08-28

The Nuclear Receptor (NR) superfamily of transcription factors comprises 48 members, several of which have been implicated in breast cancer. Most important is estrogen receptor-α (ERα), which is a key therapeutic target. ERα action is facilitated by co-operativity with other NR and there is evidence that ERα function may be recapitulated by other NRs in ERα-negative breast cancer. In order to examine the inter-relationships between nuclear receptors, and to obtain evidence for previously unsuspected roles for any NRs, we undertook quantitative RT-PCR and bioinformatics analysis to examine their expression in breast cancer. While most NRs were expressed, bioinformatic analyses differentiated tumours into distinct prognostic groups that were validated by analyzing public microarray data sets. Although ERα and progesterone receptor were dominant in distinguishing prognostic groups, other NR strengthened these groups. Clustering analysis identified several family members with potential importance in breast cancer. Specifically, RORγ is identified as being co-expressed with ERα, whilst several NRs are preferentially expressed in ERα-negative disease, with TLX expression being prognostic in this subtype. Functional studies demonstrated the importance of TLX in regulating growth and invasion in ERα-negative breast cancer cells.

Teaching and breast self-examination: an insufficiency of instruction.

PubMed

Turnbull, Beverley J; Roberts, Kathryn

2004-01-01

Client teaching is recognised as an essential component of nursing and midwifery care, and all clinical areas provide opportunities for informal client teaching. This qualitative study aimed to explore registered nurses' professional practices with regard to teaching breast self-examination (BSE), and to identify factors that influenced their participation or non-participation in teaching about breast health. Participants' views were obtained using individual semi-structured interviews. The data were analysed inductively, that is, without imposing structure from the interview questions. Findings revealed that participants' perspectives of BSE and breast health, the dual symbolism of breasts, and the time constraints of clinical practice, were significant factors that impacted on participants' personal BSE practices and on their level of participation in teaching BSE. The results indicate that that nurses and midwives do not view teaching breast health as part of their role in client interaction, particularly in an acute care setting. Although nursing literature identifies midwives and nurses as ideally placed to promote health promotion activities, the image of BSE as linked to breast cancer, the dominant illness oriented model of care and a task orientated culture in health care facilities do not facilitate this.

Outcomes of a Breast Health Project for Hmong Women and Men in California

PubMed Central

Tanjasiri, Sora Park; Valdez, Annalyn; Yu, Hongjian; Foo, Mary Anne

2009-01-01

Objectives. We used a community-based research approach to test a culturally based breast cancer screening program among low-income Hmong women in central and southern California. Methods. We designed a culturally informed educational program with measures at baseline and 1-year follow-up in 2 intervention cities and 1 comparison city. Measures included changes in breast cancer screening, knowledge, and attitudes. Results. Compared with women in the comparison community, women in the intervention community significantly improved their attitudes toward, and increased their knowledge and receipt of, breast cancer screenings. Odds of women in the intervention group having had a mammogram, having had a clinical breast examination, and having performed breast self-examination was 6.75, 12.16, and 20.06, respectively, compared with women in the comparison group. Conclusions. Culturally informed education materials and intervention design were effective methods in conveying the importance of maintaining and monitoring proper breast health. The strength of community collaboration in survey development and intervention design highlighted the challenges of early detection and screening programs among newer immigrants, who face significant language and cultural barriers to care, and identified promising practices to overcome these health literacy challenges. PMID:19443830

Earlier detection of breast cancer by surveillance of women at familial risk.

PubMed

Tilanus-Linthorst, M M; Bartels, C C; Obdeijn, A I; Oudkerk, M

2000-03-01

A positive family history increases the risk for breast cancer which oft en occurs at a much younger age than in the general population. We stud ied whether surveillance of these women resulted in the detection of bre ast cancer in an earlier stage than in symptomatic patients with a famil y history. Between January 1994 and April 1998, 294 women with 15-25% r isk (moderate), mean age:43.3 (22-75) years, were screened with a yearly physical examination and mammography from 5 years before the youngest ag e of onset in the family and 384 women with >25% risk (high) for breast cancer, mean age: 42.9 (20-74) years were screened with a physical examination every 6 months and yearly mammography. From September 1995 breast magnetic resonance imaging (MRI) was also carried out for 109 high risk women where mammography showed over 50% density. 26 breast cancers detected under surveillance were significantly more often found in an early T1N0 stage than the 24 breast cancers in patients with a family history referred in that period because of symptoms: 81 versus 46% (P=0.018). Patients under surveillance were also less frequently node-positive than the symptomatic group: 19 versus 42% (P=0.12). 20 patients with a family history referred by our national screening programme in that period had 21 breast cancers detected, 81% in stage T1N0 and 5% node-positive, which was comparable to the results in our national screening programme T1N0 66%, N+ 24% resulting in a 30% reduction in mortality. The incidence in women under surveillance was 10.1 per 1000 in the 'high' risk group and 13.3 per 1000 in the 'moderate' risk group. Expected incidence in an average risk population aged 40-50 years is 1.5, expected if the group consisted of only gene carriers 15 per 1000. 23% of the breast cancers in the surveillance group were detected at physical examination, but occult at mammography. 38% were detected at mammography and clinically occult. Breast MRI (in the subgroup) detected 3 occult breast cancers. The results of this study show that women with a family history benefit from surveillance as breast cancer was detected significantly more often in a favourable T1N0 stage and a mortality reduction comparable to that obtained in our national screening programme may be expected also in women <50 years of age. Both physical examination and mammography contribute to this result, but the former in this study only contributed in women before menopause. Starting surveillance some years before the youngest age of onset in the family may result in higher detection rates. Screening with MRI can detect breast cancers, still occult at physical examination and mammography.

Active smoking and survival following breast cancer among African American and non-African American women in the Carolina Breast Cancer Study.

PubMed

Parada, Humberto; Sun, Xuezheng; Tse, Chiu-Kit; Olshan, Andrew F; Troester, Melissa A; Conway, Kathleen

2017-09-01

To examine racial differences in smoking rates at the time of breast cancer diagnosis and subsequent survival among African American and non-African American women in the Carolina Breast Cancer Study (Phases I/II), a large population-based North Carolina study. We interviewed 788 African American and 1,020 Caucasian/non-African American women diagnosed with invasive breast cancer from 1993 to 2000, to assess smoking history. After a median follow-up of 13.56 years, we identified 717 deaths using the National Death Index; 427 were breast cancer-related. We used Cox regression to examine associations between self-reported measures of smoking and breast cancer-specific survival within 5 years and up to 18 years after diagnosis conditional on 5-year survival. We examined race and estrogen receptor status as potential modifiers. Current (vs never) smoking was not associated with 5-year survival; however, risk of 13 year conditional breast cancer-specific mortality was elevated among women who were current smokers at diagnosis (HR 1.54, 95% CI 1.06-2.25), compared to never smokers. Although smoking rates were similar among African American (22.0%) and non-African American (22.1%) women, risk of breast cancer-specific mortality was elevated among African American (HR 1.69, 95% CI 1.00-2.85), but only weakly elevated among non-African American (HR 1.22, 95% CI 0.70-2.14) current (vs. never) smokers (P Interaction  = 0.30). Risk of breast cancer-specific mortality was also elevated among current (vs never) smokers diagnosed with ER - (HR 2.58, 95% CI 1.35-4.93), but not ER + (HR 1.11, 95% CI 0.69-1.78) tumors (P Interaction  = 0.17). Smoking may negatively impact long-term survival following breast cancer. Racial differences in long-term survival, as related to smoking, may be driven by ER status, rather than by differences in smoking patterns.

Travel Burden to Breast MRI and Utilization: Are Risk and Sociodemographics Related?

PubMed

Onega, Tracy; Lee, Christoph I; Benkeser, David; Alford-Teaster, Jennifer; Haas, Jennifer S; Tosteson, Anna N A; Hill, Deirdre; Shi, Xun; Henderson, Louise M; Hubbard, Rebecca A

2016-06-01

Mammography, unlike MRI, is relatively geographically accessible. Additional travel time is often required to access breast MRI. However, the amount of additional travel time and whether it varies on the basis of sociodemographic or breast cancer risk factors is unknown. The investigators examined screening mammography and MRI between 2005 and 2012 in the Breast Cancer Surveillance Consortium by (1) travel time to the closest and actual mammography facility used and the difference between the two, (2) women's breast cancer risk factors, and (3) sociodemographic characteristics. Logistic regression was used to examine the odds of traveling farther than the closest facility in relation to women's characteristics. Among 821,683 screening mammographic examinations, 76.6% occurred at the closest facility, compared with 51.9% of screening MRI studies (n = 3,687). The median differential travel time among women not using the closest facility for mammography was 14 min (interquartile range, 8-25 min) versus 20 min (interquartile range, 11-40 min) for breast MRI. Differential travel time for both imaging modalities did not vary notably by breast cancer risk factors but was significantly longer for nonurban residents. For non-Hispanic black compared with non-Hispanic white women, the adjusted odds of traveling farther than the closest facility were 9% lower for mammography (odds ratio, 0.91; 95% confidence interval, 0.87-0.95) but more than two times higher for MRI (odds ratio, 2.64; 95% confidence interval, 1.36-5.13). Breast cancer risk factors were not related to excess travel time for screening MRI, but sociodemographic factors were, suggesting the possibility that geographic distribution of advanced imaging may exacerbated disparities for some vulnerable populations. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Depression and Anxiety Disorders among Hospitalized Women with Breast Cancer

PubMed Central

Vin-Raviv, Neomi; Akinyemiju, Tomi F.; Galea, Sandro; Bovbjerg, Dana H.

2015-01-01

Purpose To document the prevalence of depression and anxiety disorders, and their associations with mortality among hospitalized breast cancer patients. Methods We examined the associations between breast cancer diagnosis and the diagnoses of anxiety or depression among 4,164 hospitalized breast cancer cases matched with 4,164 non-breast cancer controls using 2006-2009 inpatient data obtained from the Nationwide Inpatient Sample database. Conditional logistic regression models were used to compute odds ratios (ORs) and 95% confidence intervals (CI) for the associations between breast cancer diagnosis and diagnoses of anxiety or depression. We also used binary logistic regression models to examine the association between diagnoses of depression or anxiety, and in-hospital mortality among breast cancer patients. Results We observed that breast cancer cases were less likely to have a diagnosis of depression (OR=0.63, 95% CI: 0.52-0.77), and less likely to have a diagnosis of anxiety (OR=0.68, 95% CI: 0.52-0.90) compared with controls. This association remained after controlling for race/ethnicity, residential income, insurance and residential region. Breast cancer patients with a depression diagnosis also had lower mortality (OR=0.69, 95% CI: 0.52-0.89) compared with those without a depression diagnosis, but there was no significant difference in mortality among those with and without anxiety diagnoses. Conclusion Diagnoses of depression and anxiety in breast cancer patients were less prevalent than expected based on our analysis of hospitalized breast cancer patients and matched non-breast cancer controls identified in the NIS dataset using ICD-9 diagnostic codes. Results suggest that under-diagnosis of mental health problems may be common among hospitalized women with a primary diagnosis of breast cancer. Future work may fruitfully explore reasons for, and consequences of, inappropriate identification of the mental health needs of breast cancer patients. PMID:26035180

Gender role attitudes and other determinants of breast feeding intentions in Brazilian women.

PubMed

Paine, P; Dorea, J G

2001-01-01

This study of 230 Brazilian mothers examined the associations of several sociodemographic variables, maternal attitudes and perceptions with intended breast feeding duration. The usual relationships of sociodemographic variables such as mother's age, education, smoking, parity and infant birth weight with intended breast feeding duration were not found. However, mother's intentions were related to gender role attitudes with both the least and the most traditional women intending to breast feed longer than women with moderately traditional gender role attitudes. Mother's attitude toward breast feeding, help with household tasks, and the attitudes of friends and relatives toward breast feeding were also very significantly related to intended breast feeding duration. Women who did not work outside the home intended to breast feed significantly longer than those who were employed.

Breast Cancer Screening, Mammography, and Other Modalities.

PubMed

Fiorica, James V

2016-12-01

This article is an overview of the modalities available for breast cancer screening. The modalities discussed include digital mammography, digital breast tomosynthesis, breast ultrasonography, magnetic resonance imaging, and clinical breast examination. There is a review of pertinent randomized controlled trials, studies and meta-analyses which contributed to the evolution of screening guidelines. Ultimately, 5 major medical organizations formulated the current screening guidelines in the United States. The lack of consensus in these guidelines represents an ongoing controversy about the optimal timing and method for breast cancer screening in women. For mammography screening, the Breast Imaging Reporting and Data System lexicon is explained which corresponds with recommended clinical management. The presentation and discussion of the data in this article are designed to help the clinician individualize breast cancer screening for each patient.

Investigating the Role of Radiation Therapy Breast Cancer Clinical and Translational Research

DTIC Science & Technology

2006-05-01

radiosensitizing and anticancer properties of green tea and curcumin and found a complex response cascade in cell lines. For example, the anticancer ...this fall. 5. Arber Kodra: Effect of Green Tea and Curcumin on Breast Cancer Cell Lines Mentor: Gary Kao, MD PhD Arber examined the...Breast Cancer Elizabeth Gurney Mentor: Gary Kao, MD, PhD Effect of Green Tea and Curcumin on Breast Cancer Cell Lines Arber Kodra Mentor

Theater as a tool to educate African Americans about breast cancer.

PubMed

Livingston, Jonathan N; Smith, Nina P; Mills, Catherine; Singleton, Dorothy M; Dacons-Brock, Karen; Richardson, Ricardo; Grant, Delores; Craft, Howard; Harewood, Ken

2009-01-01

The current study examines the effectiveness of theater in educating African American women about breast cancer. Four hundred and forty-eight participants viewed a play entitled Stealing Clouds. Employing a retrospective/pre-post test design and paired sample t tests, researchers assessed the effectiveness of theater in increasing participants' knowledge about breast cancer and likelihood of participating in efforts to address and reduce breast cancer disparities. Results indicated that the play succeeded in increasing knowledge and awareness about breast cancer and intentions to improve health related behaviors. Findings suggest that theater may be an effective tool in educating African Americans about breast cancer.