The impact of education on the use of breat self- examination among Canadian women

The purpose of this study was to examine the relationship between the level of education that Canadian women have and their use of breast self-examination (BSE). The secondary objective of this study was to do some exploratory research to measure how the demographic characteristics of these women, and the behaviours that they chose to participate in, might be associated to their use of BSE. This exploratory research was done to gain a better understanding of what kinds of lifestyle and behavioural factors are associated with the use of BSE, and how these factors impact on the relationship that education has on women's use of BSE. The data for the women in the sample were taken from the 1990 Population Health Survey, conducted by Statistics Canada. This survey included questions related to both the demographic characteristics of this population, and their behavioural choices in regards to various healthy lifestyle factors. Education was found to be significantly related to the use of BSE. Many of the demographic variables (age, income, marital status and language) were also found to be significantly related to the use of BSE. The behavioural variables (tobacco use, alcohol use) did not reflect such a strong relationship.

Dépistage du cancer du sein par l'examen physique: qui en bénéficie? [Physical examination in screening for breast cancer: who benefits?].

A survey was undertaken among a representative sample of the female population, aged 20 to 74, of the Canton of Vaud, Switzerland (total population 550,000) to assess the knowledge, attitudes and practices of women in respect to breast cancer and its prevention. The present study focuses on access by women to medical preventive measures (breast examination by physician and information on breast self-examination). The data are analyzed in relation to the individual risk factors affecting women, in particular age. While with age the risk of breast cancer grows in a linear fashion, the proportion of women having their breast examined by a physician declines. Women over 50 who had no children before the age of 30 constitute an especially high risk category, with the lowest access to information and prevention. This is explained in large part by the fact that they consult gynecologists less often. In this regard it should be noted that a visit to a gynecologist's office is associated much more often with breast examination than a visit to a family physician. It is important to take such findings into account in providing more appropriate and complete care for those groups. This involves sensitization of the physician and improved information for the women themselves.

Long-term outcomes of genetic counseling in women at increased risk of developing hereditary breast cancer Information,

This multicenter study evaluated the impact of genetic counseling in 218 women at risk of developing hereditary breast cancer. Women were assessed prior to counseling and 12-month post-counseling using self-administered, mailed questionnaires. Compared to baseline, breast cancer genetics knowledge was increased significantly at follow-up. and greater increases in knowledge were associated with educational level. Breast cancer anxiety decreased significantly from baseline to follow-up, and these decreases were associated with improvements in perceived risk. A significant decrease in clinical breast examination was observed at the 12-month follow-up. Findings suggest that women with a family history of breast cancer benefit from attending familial cancer clinics as it leads to increases in breast cancer genetics knowledge and decreases in breast cancer anxiety. The lowered rates of clinical breast examination indicate that the content of genetic counseling may need to be reviewed to ensure that women receive and take away the right message. (C) 2001 Elsevier Science Ireland Ltd. All rights reserved.

Aplicación del modelo Discovering Hands en Argentina

Discovering Hands (DH) es un proyecto que nace en Alemania en el 2006, liderado por el doctor Frank Hoffmann. El programa se desarrolla pensando en el importante problema de salud pública en el cual se ha convertido en el cáncer de mama, pues según la Organización Mundial de la Salud es el mayor causal de muerte en mujeres, tanto en países desarrollados como en vía de desarrollo, y en Alemania esta enfermedad acaba con la vida de aproximadamente 18.000 mujeres cada año. (The Global Journal, 2014) DH entrena y capacita mujeres visualmente impedidas para detectar de manera temprana los signos de cáncer de mama, dado que estas poseen un sentido del tacto más desarrollado que el de una persona que no se encuentre limitada visualmente. Esto les permite localizar el cáncer de forma más rápida que un médico general ya que son capaces de identificar los tumores más pequeños, logrando así reducir notablemente los costos totales del tratamiento de esta enfermedad. Adicional a esto, el capacitar y preparar a mujeres con discapacidad visual para la detección temprana de cáncer de mama, incrementa la fuerza laboral del país, pues estas mujeres pasarían a ser parte de la población económicamente activa del mismo (PEA) y lograrían que las personas dejen de percibir esta condición como una discapacidad y por el contrario la vean como una ventaja. Después de unos años de prueba, el programa ha sido mejorado y extendido tanto en Alemania como en otros países (Austria), razón por la cual se realizó el estudio de factibilidad del proyecto en países como Colombia - donde se quiere llevar a cabo un proyecto piloto en la ciudad de Cali - México y Argentina. El presente trabajo se enfoca en Argentina, por medio del cual se busca proponer aportes para disminuir las causas de muertes originadas por esta enfermedad y los altos costos que estas le generan al sector de la salud de este país. Con el estudio se logró identificar la factibilidad de la implementación del modelo de negocio, evidenciando que Argentina cuenta con unas particularidades en su sistema de gobierno que pueden hacer que la puesta en práctica del proyecto sea más compleja que en otros países.

Fatores associados a não realização da mamografia e do exame clínico das mamas: um estudo de base populacional em Campinas, São Paulo, Brasil

O objetivo deste estudo é analisar a prevalência da não realização do exame clínico das mamas e da mamografia segundo variáveis sócio-econômicas, demográficas e de comportamentos relacionados à saúde, em mulheres com 40 anos ou mais, residentes na cidade de Campinas, São Paulo, Brasil. O estudo foi do tipo transversal, de base populacional em uma amostra de 290 mulheres. Os fatores associados à não realização da mamografia, encontrados na análise multivariada, foram: ter 70 anos ou mais, ser de raça/cor negra e pertencer ao segmento de menor renda familiar per capita; e para a não realização do exame clínico das mamas foram: não ter companheiro e pertencer ao segmento de menor renda familiar per capita. O SUS foi responsável pela realização de 28,8% das mamografias e 38,2% dos exames clínicos das mamas. Verificou-se que a não realização dos exames preventivos para o câncer de mama está associada à existência de desigualdade racial e social, apontando para a necessidade de implementação de estratégias para a ampliação da cobertura das práticas preventivas para o câncer de mama, especialmente para os segmentos sociais mais vulneráveis.

Factors related to inadequate cervical cancer screening in two Brazilian state capitals

OBJECTIVE:To analyze factors associated with cervical cancer screening failure. METHODS:Population-based cross-sectional study with self-weighted two-stage cluster sampling conducted in the cities of Fortaleza (Northeastern Brazil) and Rio de Janeiro (Southeastern Brazil) in 2002. Subjects were women aged 25-59 years in the last three years prior to the study. Data were analyzed through Poisson regression using a hierarchical model. RESULTS: The proportion of women who did not undergo the Pap smear test in Fortaleza and Rio de Janeiro was 19.1% (95% CI: 16.1;22.1) and 16.5% (95% CI: 14.1;18.9), respectively. Higher prevalence ratios of cervical cancer screening failure in both cities were seen among women with low education and low per capita income, old age, unmarried, who never underwent mammography, clinical breast examination, and blood glucose and cholesterol level testing. Smokers also had lower screening rates compared to non-smoker women and this difference was only statistically significant in Rio de Janeiro. CONCLUSIONS:The study findings point to the need of intervention focusing particularly women in worse socioeconomic conditions and access to healthcare, old-aged and unmarried. Education activities must prioritize screening of asymptomatic women and early diagnosis for symptomatic women and access to adequate diagnostic methods and treatment should be provided.

Fatores associados a não realização da mamografia e do exame clínico das mamas: um estudo de base populacional em Campinas, São Paulo, Brasil

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Análise das oportunidades de diagnóstico precoce para as neoplasias malignas de mama

OBJETIVOS: O estudo procurou identificar e analisar as oportunidades de diagnóstico precoce para neoplasias malignas de mama, disponíveis para as mulheres do município de Botucatu. MÉTODOS: Foram entrevistadas por telefone, segundo sorteio aleatório, 261 mulheres com idade de 30 anos ou mais. RESULTADOS: A média de idade foi de 51 anos e 49,45% das entrevistadas apresentaram escolaridade de nove anos ou mais; 80% receberam orientações gerais sobre prevenção do câncer de mama e 86,9% orientações específicas sobre autopalpação; 78,9% das mulheres realizaram o auto-exame das mamas e destas somente 27% o fizeram corretamente. O exame clínico das mamas foi realizado em 76,2% das entrevistadas e a mamografia em 35,6%; se o exame de mamografia fosse solicitado por médicos e estivesse disponível, 83,1% das mulheres estariam dispostas a realizá-lo. CONCLUSÃO: A prevalência e a mortalidade da doença são maiores nas mulheres idosas. Neste estudo observou-se que estas apresentaram uma taxa menor de oportunidades de diagnóstico precoce, pois eram menos informadas sobre a periodicidade correta da autopalpação e apresentaram uma menor freqüência de mamografia e de exame clínico das mamas do que as mais jovens. O grau de escolaridade mostrou também significância estatística, visto que as mulheres com mais anos de estudo tiveram melhores oportunidades do que as com pouco estudo.

Primeiro rastreamento organizado regional no Brasil: barreiras relacionadas á realidade do exame de mamografia

Pós-graduação em Pesquisa e Desenvolvimento (Biotecnologia Médica) - FMB

Desigualdade social no adoecimento e morte por câncer de boca e orofaríngeo no Município de São Paulo, Brasil: 1997 a 2008

A ocupação do espaço geográfico é determinada historicamente pelo modelo socioeconômico e pelo dinamismo de suas relações sociais, políticas e ideológicas. O objetivo deste trabalho é avaliar a distribuição espacial e o efeito de indicadores socioeconômicos no adoecimento e morte por câncer de boca e orofaríngeo no Município de São Paulo, Brasil, no período de 1997 a 2008. Os dados foram coletados no Registro de Câncer de Base Populacional e no Programa de Aprimoramento das Informações de Mortalidade - PRO-AIM e georreferenciados pelos softwares Terraview e GeoDa. O referencial teórico para avaliação dos resultados foi baseado na teoria de Milton Santos. As taxas de incidência apresentaram um índice de autocorrelação Global de Moran de 0,226 e as taxas de mortalidade de 0,337. A Incidência de câncer de boca e orofaríngeo não apresenta um padrão espacial bem definido no Município de São Paulo, mas é bastante desigual no que se refere à Mortalidade, concentrando as suas menores taxas na área central, mais rica e economicamente menos desigual.

Towards a just community: an examination of the development of cultural citizenship rights in Canada from a communitarian perspective

The notion of citizenship, while a basic human right, has come under scrutiny. It was once assumed a liberal inspired regime of citizenship rights would reign as the primary ideological perspective in the Western world, however this has not been the case. Numerous competing paradigms have questioned the premise upon which liberal guarantees of citizenship rights are based. In particular, communitarianism has subjected liberal rights discourse to a closer examination. Communitarian theory holds that universalist principles negate any articulation of community and its internal diversity, such as cultural citizenship. It is this understanding of citizenship that has taken hold in Canada. The Canadian political experience illustrates a number of attributes associated with communitarian thought. It is a collectivist society that articulates a notion of the common good, acknowledges the internal diversity of its citizens and possesses a highly developed deliberative democratic process. To this end, Canada can be described as being more communitarian than liberal in nature in the process it has adopted to address citizenship rights. However, the type of commuIiitarianism displayed in Canada differs from the political models examined by such scholars as Michael Sandel, Iris Marion Young or Will Kymlicka. Cultural citizenship rights are fluid and malleable in Canada. While no clear guarantees of citizenship rights exist, there is a common commitment by Canadians to engage in a fair, open and inclusive deliberative process. This model is unique to Canada; it cannot be exported in that it is a product of Canadian political culture. As a result, the contemporary demands of cultural citizenship are dealt with effectively and democratically in Canada in that the proper mechanisms for public deliberation exist.

An Examination of the Development of Online Higher Education in Canada and China: Keeping Pace and Making Space

This study examined the similarities and differences that currently exist between Chinese and Canadian online higher education, and explored the economic, political, and sociocultural environments that have shaped online education in these two jurisdictions. Furthermore, this paper discussed the efficacy of, and potential for, future development of online learning in higher education in both Canada and China. The research employed a collective case study design to gather information and data on the development of online higher education. The analysis on Contact North in Canada and the One-Man University in China provide a comparative perspective on the development of 2 typical online higher educational institutions in these two countries. The study revealed that the development of online higher education is influenced by the economic, political, and sociocultural factors of environment. Contact North and the One-Man University share similarities in many aspects, but are characteristically different. The Contact North can set an example for establishing and operating a self-regulated MOOCs platform. The study also generated implications for both organizations.

Examination of faecal Bifidobacterium populations in breast- and formula-fed infants during the first 18 months of life.

Bifidobacteria in the infant faecal microbiota have been the focus of much interest, especially during the exclusive milk-feeding period and in relation to the fortification of infant formulae to better mimic breast milk. However, longitudinal studies examining the diversity and dynamics of the Bifidobacterium population of infants are lacking, particularly in relation to the effects of weaning. Using a polyphasic strategy, the Bifidobacterium populations of breast- and formula-fed infants were examined during the first 18 months of life. Bifidobacterium-specific denaturing gradient gel electrophoresis demonstrated that breast-fed infants harboured greater diversity than formula-fed infants and the diversity of the infants' Bifidobacterium populations increased with weaning. Twenty-seven distinctive banding profiles were observed from ∼1100 infant isolates using ribosomal intergenic spacer analysis, 14 biotypes of which were confirmed to be members of the genus Bifidobacterium. Two profiles (H, Bifidobacterium longum subsp. infantis; and I, Bifidobacterium bifidum) were common culturable biotypes, seen in 9/10 infants, while profile E (Bifidobacterium breve) was common among breast-fed infants. Overall, inter- and intra-individual differences were observed in the Bifidobacterium populations of infants between 1 and 18 months of age, although weaning was associated with increased diversity of the infant Bifidobacterium populations. Breast-fed infants generally harboured a more complex Bifidobacterium microbiota than formula-fed infants.

Evaluation of frozen-section analysis of surgical margins in the treatment of breast cancer

Objective: To evaluate surgical margins in cases of ductal carcinoma through a histopathological exam using frozen sections. Materials and Methods: Retrospective study encompassing 242 conservative surgeries, 179 of which included intraoperative frozensection histopathology and 63 intraoperative nonfreezing techniques (macroscopy/gross examination and cytology). The results of such analyses were compared with those of the histology processing following paraffin embedment and hematoxylin and eosin (H & E) staining. A margin was deemed free when the distance between the tumor and the surgical border was equal to or greater than two millimeters. The factors given consideration for possibly affecting the results were: age, surgical aspects (skin removal and widening of surgical margins), histopathological findings (size, affected lymph nodes, and angiolymphatic invasion), and extensive intraductal and immunohistochemical components (estrogen, progesterone, Ki-67, and HER-2 receptors). In the statistical analyses, the chi-square test was used and negative predictive values were calculated. Results: The negative predictive values were 87.1% and 79.3% for frozen and nonfrozen sections, respectively. There was no significant difference between the two groups (p = 0.14). The factors under consideration had no influence on the results of the intraoperative exam of the margins. Conclusion: The present study allowed to conclude that the intraoperative exam of the surgical margins by frozen section is not superior to a macroscopy and / or cytology exam.