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Exploring breast cancer memoirWagner, Gina Marie. January 2008 (has links)
Thesis (Ph.D.)--University of Nebraska-Lincoln, 2008. / Title from title screen (site viewed Feb. 17, 2009). PDF text: iv, 173 p. ; 687 K. UMI publication number: AAT 3325857. Includes bibliographical references. Also available in microfilm and microfiche formats.
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Evaluation of an instructional program for breast self-examination (BSE)Vargas de Robles, Perla Amalia, 1955- January 1989 (has links)
Two hundred and three patients participated in a study designed to evaluate a structured learning package for teaching competent breast self-examination (BSE) at a Screening Center. The package consisted of modeling, practice without feedback on a breast model, and limited practice and feedback on the patients' own breasts. Performance proficiency was evaluated by an observer as the number of BSE's steps correctly practiced during pre and post-training evaluations. A questionnaire to gather information about patients history, knowledge, and attitudes toward BSE and breast cancer was also used. Results show that more than 80% of the patients who could improve did so in most steps of both components, visual inspection and palpation. In addition, only 31% of the patients performed a perfect and complete BSE immediately after the teaching session. The two steps patients failed the most were checking the axillary-tail and covering the complete breast. A corrective procedure to improve the teaching package is discussed.
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New drug development in breast cancer郭心鈴, Kwok, Sum-ling. January 2008 (has links)
published_or_final_version / Community Medicine / Master / Master of Public Health
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A clinical audit of mammography screening簡適悠, Kan, Sik-yau, Anita. January 2008 (has links)
published_or_final_version / Community Medicine / Master / Master of Public Health
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A vitamin and mineral mega-dose treatment for non-metastatic breast cancer patients : a historical comparison studyVanderlaan, Angelia Selena May. 10 April 2008 (has links)
No description available.
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Receptor status in recurrent breast cancer-a retrospective studyAlly, Zain January 2017 (has links)
MBBCh Department of Surgery University of the Witwatersrand
08 March 2017 / Background: Breast cancer recurrence is a major clinical event and represents a principal cause of breast cancer related death. A discordance rate between receptor status of primary and matched recurrence tumours has been reported in the literature but the extent of this in our population is unknown. Repeating Immuno-histochemistry (IHC) and fluorescent in-situ hybridization (FISH) studies have financial and workforce implications in a resource-constrained environment. However, the results of these receptor studies have prognostic implications. Therefore it is important to determine the extent of change in receptors in the recurrence. Aim: To compare the hormone receptor profile between breast cancer primary and matched loco-regional recurrence and to ascertain the extent of receptor discordance. Methods: All patients who presented to the respective breast care facilities for breast cancer recurrences between 2006 and 2014 were identified using the mammography department records. The specimens for each patient were scrutinized. Oestrogen receptor (ER) and progesterone receptor (PgR) status as well as the Human Epidermal growth factor type 2 receptor (HER2) receptor statuses were noted for each patient and a comparison was made between primary and matching recurrence, with loss and gain being noted. Results: In the analysis, significant discordance was found for matching hormone receptor status. Discordance in oestrogen receptor status occurred in 14.3% of cases: change occurred both from ER-positive to -negative and vice versa. For progesterone receptor status this occurred in 25.7% of cases. A discordance of 14.8% was noted for HER2 receptor status. These results are not dissimilar to what has been previously reported in the literature. Of note, adverse receptor discordance: positive to negative was noted in a total of 19 receptors (ER 4; PgR 11; HER2 4)
Conclusion: These results confirm the phenomenon of receptor discordance between breast cancer primary and recurrence. The results support the necessity of confirming receptor status on all loco-regional recurrent disease. This reinforces the importance of obtaining a confirmatory biopsy in patients where recurrence is suspected and therefore allowing the appropriate targeted therapy to be selected. / MT2017
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Knowledge, attitudes, and practice of exclusive breast feeding amongst mothers attending postnatal clinic in Tswaing sub-district, North West ProvinceAhmadu-Ali, Umaru 23 February 2012 (has links)
M.Fam.Med., Faculty of Health Sciences, University of the Witwatersrand, 2011
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The influence of family members on adherence to exclusive breastfeeding; experiences of women in prevention of mother to child transmision of HIV programme in extension 8 clinic (Mhluzi)Mphego, Zodwa Joyce January 2013 (has links)
Thesis (MPH) -- University of Limpopo (Medunsa Campus),2013. / Introduction
HIV positive post natal women on a PMTCT program who have opted for exclusive
breastfeeding are experiencing pressures from families to give solids, water based fluids,
traditional medicines, and complimentary medicines as early as the first 48 hours of life of a
newborn baby. The early feeding practice is in contradiction with the PMTCT recommended six months of exclusive breastfeeding or formula feeding
Aim
The aim of the study was to explore the influence of the family on adherence to exclusive
breastfeeding among post natal women on PMTCT programme
Objectives of the study were:
To explore the influence of the family on adherence to exclusive breastfeeding among women
on PMTCT Programme in Extension 8 clinic.
To explore the ways in which women on PMTCT programme in Extension 8 clinic deal with
the family influences on exclusive breastfeeding.
Methodology
Focus group discussions (FGDs) and in-depth interviews (IDls) were conducted with post
natal women enrolled in the PMTCT program of a community health centre at the Steve
Tshwete Local Municipality in Mpumalanga. A focus group guide developed by researcher in
English and translated to IsiZulu was used to conduct the FGDS and IDls with 40 HIV
positive women who opted for exclusive breastfeeding. A total of five FGDs and seven IDls
$J were conducted. .
Data analysis
The data was analyzed using contents analysis which allowed the categories to emerge from
the data. Data analysis began with the verbatim transcription of the transcript in IsiZulu which
were later translated into English. This was followed by the identification and definition of
emerging themes and the development of a code list. The initial application on themes on the
transcripts was done manually to identify themes and subthemes, and new themes that
emerged during this process were defined and added to the code list,transcriptswererecoded if a new theme emerged or if a theme was redefined. The fmal code list was adapted from seven codes to thirteen codes. The transcripts were then imported to NVivo 9 and the researcher started applying the codes to the remaining transcripts.
Findings
The study found that though it was a norm that babies must be given solids, water, traditional, and complementary medicines, most participants adhered to exclusive feeding. Good infant
feeding coun~elling, and good knowledge and understanding of MTCT also served as a strong motivation for participants to adhere to their feeding options. The study also found that the family interfered in infant feeding throughout the exclusive breastfeeding life of the babies. Even when families supported exclusive breastfeeding, they still wanted the mother to give solids and water. The data suggest that the concept of exclusive breastfeeding is not well
understood by the family and is contextualised as meaning breastfeeding.
The data further show that participants had some fears and uncertainties about exclusive breast feeding, and lived in constant fear that they might infect their babies with HIV and that
they were starving the babies. In addition, participants had fears of the consequences of delaying and or ignoring cultural practices.
Conclusion:
The study concludes that the family interfered in infant feeding throughout the exclusive breastfeeding life of the babies. They struggled to understand exclusive breastfeeding concept and expected the mother to give the baby solids and water because it was a norm.
Recommendations
~
Given that the family lacks understanding of exclusive breastfeeding, it is recommended that
the family be involved in the education and counselling for exclusive infant feeding practices to promote knowledge and understanding ofMTCT ofHIV. Involving the family in PMTCT will also highlight the risks of some of the cultural practices in transmission of HIV to the
baby.
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Determinants of the initiation and duration of breast-feeding.Scott, Jane A. January 1997 (has links)
The primary objectives of this study were to determine the initiation and prevalence, up to six months post-partum, of breast-feeding amongst Perth women and to identify factors that influence the initiation and duration of breast-feeding. A self-administered baseline questionnaire was completed by 556 mothers prior to discharge. Those mothers who were breast-feeding at the time of completing the baseline questionnaire were followed-up by telephone interview at 2, 6, 10, 14, 18 and 24 weeks postpartum, or until they ceased to breast-feed.In total, 88.1% of mothers commenced breast-feeding whilst in hospital. On discharge from hospital 83.8% of women were breast-feeding either fully (77.7%) or partially (6.1%) but by six months this figure had decreased to 49.9% of mothers breast-feeding.Multivariate logistic regression analysis was used to determine which factors were associated with the initiation of breast-feeding. There was a strong association between the father's reported preference for breast-feeding and the initiation of breast-feeding (OR=10.18). The Cox's proportional hazards model was used to estimate the effect of independent variables on the duration of breast-feeding. The factor most strongly associated with breast-feeding duration was intended duration. Women who intended to breast-feed for less than four months were more likely to stop breast-feeding at any time compared with women who intended to breast-feed for at least four months (RR=5.01).The results of this study suggest that breast-feeding initiation and duration rates in Perth have remained relatively stable over the last decade. However, breast-feeding duration continues to fall well short of the target of 80% of infants being either partially or fully breast-fed at six months. Recommendations are made for interventions which actively promote increased breast-feeding duration. In particular, ++ / emphasis should be placed on those strategies which will influence intended duration; influence the attitudes and beliefs of the mother's support network, particularly partners; and promote breast-feeding as the social norm.
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Post-mastectomy self-perceptions and breast restoration decision- making in women who wear external breast prostheses and women who have had breast reconstructions : implications for health professionalsLewis Reaby, Linda, n/a January 1996 (has links)
Women diagnosed with breast cancer and who have the disease surgically treated by
mastectomy experience a health crisis. This thesis focused on the behaviours, feelings
and attitudes of women during their breast cancer and mastectomy experiences. The
overall purpose was to identify therapeutic factors that can be used by health
professionals to improve the psychological and physiological well-being of women with
this disease. The conceptual scaffolding for the thesis was drawn from the fields of
perceptual psychology and decision-making.
The thesis was supported by a study that examined specific areas concerning the breast
cancer and mastectomy experience. These areas were self-perceptions, the
psychological milieu resulting from a breast cancer diagnosis, and post-mastectomy
breast restoration decision-making. The population included: a prosthesis group of 64
women who had mastectomies and wore external breast prostheses, a reconstruction
group of 31 women who had mastectomies and underwent breast reconstructions, a
control A group of 75 women who had not experienced mastectomy, and a control B
group of 65 women who also had not experienced mastectomy.
Self-perceptions:
The perceptions of the prosthesis, reconstruction and control A groups regarding their
body-image, self-concept, total self-image, and self-esteem were compared by using
Polivy's (1977) Body-Image Scale and Rosenberg's (1965) Self-Esteem Scale. The
body-image, total self-image, and self-esteem mean scores indicated that the prosthesis
and reconstruction groups had more positive feelings regarding their bodies than did the
control group. There were no significant differences in self-concept among the three
groups. These findings challenge a common assumption that mastectomy automatically
results in psychiatric morbidity caused by an altered body-image and suggest that health
professionals should not make assumptions about how a woman will psychologically
respond to mastectomy.
Quality of life perceptions were compared among the prosthesis, reconstruction and
control B groups using the Ferrans and Powers (1985) Quality of Life Index. The mean
scores of the prosthesis and reconstruction groups were higher than the control group's
scores, with higher scores indicating more positive quality of life perceptions. The
findings suggest that the women in the mastectomy samples had found ways to cope
with their health crises. Over time, they learned not to define all existence in terms of a
cancer diagnosis and had gained or maintained a positive perspective on life.
Post-mastectomy attitudes in the prosthesis and the reconstruction groups were
compared. Using the Mastectomy Attitude Scale the results indicated that both groups
were satisfied with their bodies, had a positive outlook towards their lives, implied that
sexuality entailed more than having breasts, and felt that mastectomy treatment was
necessary to save their lives. Neither group concealed that they had a mastectomy, nor
were the women prone to discuss their mastectomy experiences. The findings from the
study indicate that the women post-mastectomy already had or developed positive
attitudes towards themselves and life in general and the method chosen for breast
restoration had no apparent impact on these attitudes.
The self-perception data indicated that women do adjust and cope with breast cancer
surgically treated by mastectomy. These women should be encouraged by health
professionals to develop a helping relationship with other women who are newly
diagnosed with the disease. This alliance could engender hope in those women who are
beginning their journey along a similar road to survival. More hope for these women
and less fatalism would decrease their sense of crisis and facilitate their abilities to take
an active part in the decision-making processes relating to their treatment.
Psychological Milieu:
The women in the prosthesis and the reconstruction groups were interviewed about their
breast cancer and mastectomy experiences. The findings supported the premise that
receiving a diagnosis of breast cancer plunged the women into a health crisis and caused
an instant disruption to their lives. The women found that they had to suddenly deal
with several complex issues all at the same time, such as what must be done in the
immediate future to treat the cancer, as well as the more frightening issues of the
meaning of the illness on their ultimate life expectancy. All of this turmoil played
havoc with their ability to make informed decisions regarding their breast cancer
treatment alternatives. This finding suggests the need for more individualised
interventions and support for women when they are making decisions during this
stressful period. Health professionals need to keep in mind that simply hearing the
word "cancer" often prevents a person from assimilating the complete diagnosis,
indicated treatments, and possible prognosis. Therefore, care-givers must be prepared
to repeat and elaborate upon information previously given to the affected individual and
the family.
Breast Restoration Decision-Making:
To evaluate the prosthesis and the reconstruction groups' abilities to undertake
competent breast restoration decision-making, a 5 Stage process was devised, modelled
after Janis and Mann's (1977) seven criteria for competent decision-making. Analysis
of the data revealed that both groups displayed passive information seeking behaviour
in relation to breast restoration alternatives. They had either no knowledge or limited
knowledge regarding the alternatives. Their lack of knowledge was due either to (1)
anxiety about their disease, or (2) deficiencies in the interpersonal skills of individuals
presenting information to them, or (3) the perceptions that they had insufficient time to
gather information, or (4) a combination of these factors.
Because the prosthesis and the reconstruction groups were under stress they used coping
styles to accomplish decision-making. To measure their coping styles five categories
were defined, based on Janis and Mann's (1977) conflict model of emergency decisionmaking
and Simon's (1957) notion of "bounded rationality". Two styles emerged. The
prosthesis group used the "Sideliner" style that allowed the women to make a quick,
conflict-free decision. They were not aware of alternative choices resulting in their
decision-making experience being uncomplicated and effortless. The reconstruction
group used the "Contented" style that also allowed them an uncomplicated and
effortless decision-making experience. The women decided that breast reconstruction
was their only viable option. Many of them did not even think that they had made a
decision about an alternative because of the strong salience towards breast
reconstruction.
A breast restoration decision-making model has been developed and proposed for
women to use when considering their alternatives. This model offers to health
professionals and women a realistic and useable decision-making process that can be
implemented when individuals are experiencing a health crisis. The model can be
modified and used for numerous situations that require decisions regarding treatment
alternatives.
This inquiry has demonstrated that there is a need for a specific health professional to
assist women newly diagnosed with breast cancer. This individual would assume
several roles that include one of advocacy for the women, and the important role of
ensuring that these individuals have the information and knowledge to make competent
decisions regarding their breast cancer treatments.
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