Young breast cancer patients have a lower rate of survival than old breast cancer patients due to being diagnosed at advanced stages. Breast self-examination makes women more "breast aware", which in turn may lead to an earlier diagnosis of breast cancer. The purpose of this study was to investigate knowledge and practice of breast self-examination and to determine knowledge of risk factors for breast cancer among high school students. This is a descriptive and cross-sectional study. It was conducted in a high school in Manisa, Turkey. The study sample included 718 female high school students. A socio-demographic characteristics data form, knowledge of breast self examination and risk factors for breast cancer form and breast self examination practice form were used to collect data. The female high school students had insufficient knowledge about breast self-examination and a low percentage of students reported that they had performed breast self examination monthly. The most common reason for not doing breast self- examination was "not knowing how to perform breast self-examination" (98.5%). Most of the students had little knowledge of the risk factors for breast cancer. The most widely known risk factor by the students was personal history of breast cancer (68.7%). There was a significant relation between breast self-examination practice and age, school grade, knowledge about breast cancer and knowledge about breast self- examination. There is a need to increase knowledge of adolescent females about the risks of breast cancer and benefits of early detection. In fact, health care professionals can develop effective breast health care programs and help young women to acquire good health habits.

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Awareness of breast cancer risk factors and practice of breast self examination among high school students in Turkey

Factors associated with breast self-examination practices and beliefs in female workers at a Muslim community

Objective To assess level and determinants of knowledge about risk factors and utilization of screening methods used for breast cancer early detection among adult Saudi women in Al Hassa, KSA. Study design cross-sectional descriptive. Participants and methods A total of 1,315 Saudi adult females were included, selected through a multistage stratified sampling method from ten primary health care centers. No previous history of breast cancer, attendance for routine services or accompanying patients were prerequisites for eligibility. Participants were invited to personal interview with pre-tested validated questionnaire including inquiries regarding knowledge, screening practices including clinical breast examination (CBE), mammography, individual breast cancer risk factors and perceived barriers towards (CBE). Both descriptive and inferential statistics were applied; logistic regression was conducted to determine the possible correlates of knowledge. Results Overall level of knowledge regarding risk factors and appropriate screening was low and dependent upon educational and occupational status. Early screening is underutilized among participants due to several perceived barriers. Clinical breast examinations were employed by less than 5% and mammography by only 3% of cases. A positive family history was found in 18% of cases among first and second degree relatives, and 2 % had a prior history of benign breast lesions. Conclusion Included women, irrespective of their educational status, had knowledge deficits regarding breast cancer risk factors and underutilization of the recommended breast cancer screening. Several barriers are contributing to such knowledge deficits and screening behavior.

Breast cancer knowledge, risk factors and screening among adult Saudi women in a primary health care setting.

In the Kingdom of Saudi Arabia, breast cancer (BC) usually presents at advanced stages and more frequently in young pre-menopausal women in comparison to western countries. There is controversy surrounding the efficacy of breast self examination (BSE) for early detection of BC in countries where other methods are available. This study aims to explore the perception towards breast cancer and towards BSE among Saudi women, using the Health Belief Model (HBM). A convenient sample of adult Saudi female employees, working at King Abdulaziz Medical City, Riyadh, Saudi Arabia (n = 225), and their non-working adult female family members (n = 208), were subjected to the Arabic version of revised Champion’s Health Belief Model Scale (CHBMS) and the Arabic version of Breast Cancer Awareness Measure (CAM), to assess their knowledge and attitude on BC respectively. Percentage mean score (PMS) for each HBM domain was calculated. Significant predictors of BSE practice were identified using logistic regression analysis and significance was considered at p < 0.05. The majority of women heard about BSE (91.2 %), only 41.6 % reported ever practicing BSE and 21 % performed it regularly. Reported reasons for not doing BSE were: not knowing how to examine their breast (54.9 %), or untrusting themselves able to do it (24.5 %). Women were less knowledgeable about BC in general, its risk factors, warning signs, nature and screening measures (PMS:54.2 %, 44.5 %, 61.4 %, 53.2 %, 57.6 % respectively). They reported low scores of; perceived susceptibility, seriousness, confidence and barriers (PMS: 44.8 %, 55.6 %, 56.5 % & 41.7 % respectively), and high scores of perceived benefits and motivation (PMS: 73 % & 73.2 % respectively) to perform BSE. Significant predictors of  BSE performance were: levels of perceived barriers (p = 0.046) and perceived confidence (p = 0.001) to BSE, overall knowledge on BC (p < 0.001), work status (p = 0.032) and family history of BC (p = 0.011). Saudi women had poor knowledge on BC, reported negative attitude towards BSE and their practice was poor. Working women and those with family history of BC, higher perceived confidence and lower perceived barriers on HBM, and those with high level of knowledge on BC were more likely to perform BSE. Breast awareness as an alternative to BSE needs further investigations. HBM was shown as a valid tool to predict BSE practice among Saudi women.

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Using the health belief model to predict breast self examination among Saudi women

A cross-sectional study was carried out to determine the knowledge and practices of 425 female secondary school teachers from 20 selected secondary schools in Selangor, Malaysia on breast cancer screening (BCS). A self-administered, structured questionnaire was used for data collection. This study showed moderate to low knowledge on breast cancer (BC) and BCS among teachers. Only 19%, 25% and 13.6% eligible women performed breast self-examination (BSE), clinical breast examination (CBE) and mammography respectively, on a regular basis. Level of breast cancer knowledge was significantly associated with BSE (p 0.05) and age, family history of breast cancer, marital status or having health insurance. Efforts are needed to increase knowledge and remove misconceptions about breast cancer and screening practices among Malaysian women.

Knowledge and behavior regarding breast cancer screening among female teachers in Selangor, Malaysia

Breast cancer appears to be a disease of both the developing and developed worlds. Among Turkish women, breast cancer is the second leading cause of cancer-related deaths. The aims of this cross-sectional study were to determine levels of knowledge about breast cancer and to evaluate health beliefs concerning the model that promotes breast self- examination (BSE) and mammography in a group of women aged 20–64 in a rural area of western Turkey. 244 women were recruited by means of cluster sampling in this study. The questionnaire consisted of sociodemographic variables, a risk factors and signs of breast cancer form and the adapted version of Champion's Health Belief Model Scale (CHBMS). Bivariate correlation analysis, Chi square test, Mann-Whitney U test and logistic regression analysis were performed throughout the data analysis. The mean age of the women was 37.7 ± 13.7. 49.2% of women were primary school graduates, 67.6% were married. Although 76.6% of the women in this study reported that they had heard or read about breast cancer, our study revealed that only 56.1% of them had sufficient knowledge of breast cancer, half of whom had acquired the information from health professionals. Level of breast cancer knowledge was the only variable significantly associated with the BSE and mammography practice (p = 0.011, p = 0.007). BSE performers among the study group were more likely to be women who exhibited higher confidence and perceived greater benefits from BSE practice, and those who perceived fewer barriers to BSE performance and possessed knowledge of breast cancer. By using the CHBMS constructs for assessment, primary health care providers can more easily understand the beliefs that influence women's BSE and mammography practice.

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The knowledge and attitudes of breast self-examination and mammography in a group of women in a rural area in western Turkey.

Evaluation of PM10 concentration by using Mars and XGBOOST algorithms in Iğdır Province of Türkiye

’étude Alors que l’épidémie de maladie à coronavirus (COVID-19) impacte le monde entier, l’effet préventif de la vaccination est de première importance. Le but de cette étude était d’évaluer les souhaits de vaccination des patients et d’apprécier combien d’entre eux étaient persuadés de l’intérêt de celle ci après avoir bénéficié d’un parcours éducatif auprès des allergologues. Une étude transversale a été menée parmi 200 patients adultes suivis en ambulatoire entre février 2021 et janvier 2022. Les patients renseignaient une échelle analogique de refus de vaccination et un questionnaire élaboré par des allergologues. Une éducation thérapeutique sur les vaccins pour la COVID-19 était dispensée aux patients refusant la vaccination. Les patients étaient ensuite contactés par téléphone pour savoir s’ils avaient été ou non vaccinés après 22 semaines. Parmi les 200 patients, 60,5 % étaient considérés comme vaccinés. Les patients non vaccinés concernaient 45 % des femmes et 31 % des hommes. Alors que 52,4 % des patients ayant suivi une scolarité primaire étaient vaccinés, 75 % des patients de, niveau lycée et 60,8 % de niveau université se déclaraient vaccinés. Les raisons principales de refus de vaccination concernaient la crainte d’effets secondaires et le risque allergique. Alors que la majorité des femmes (47,2 %) refusant la vaccination alléguait le risque d’effets secondaires, la majorité des hommes (34,6 %) ne souhaitait pas être vaccinée pour non confiance dans l’efficacité du vaccin. Les désirs de vaccination étaient augmentés après éducation thérapeutique chez les patients ne souhaitant pas être vaccinés. Ainsi 76 patients ont pu être joints par téléphone et 81,6 % d’entre eux avaient pu être vaccinés et 18,4 % ne l’étaient pas. Les taux de vaccination des patients allergiques qui ne souhaitaient pas être vaccinés ont été augmentés après l’information fournie par les allergologues. Ainsi les allergologues devraient apporter toute leur attention à donner des informations visant à augmenter la vaccination pour la COVID-19. As the impact of coronavirus disease (COVID)-19 arises worldwide, the effect of vaccines is protecting its importance. The aim of this study was to investigate the vaccination perspectives of patients and learn how many patients were persuaded to get vaccinated with the effect of the education provided by allergists. A cross-sectional study was carried out among 200 adult patients in the outpatient clinic between February 2021 and January 2022. Patients filled out the anti-vaccination scale form and a questionnaire form developed by allergists. The training about COVID-19 vaccines has been given to the patients who did not consider getting vaccinated. The patients were called by phone and questioned whether they have been vaccinated or not, after 22 weeks. Out of 200 patients participants, 60.5% were considering getting vaccinated. Patients who did not consider getting vaccinated comprised 45.7% of women and 31% of men. While 52.4% of primary school graduates considered getting vaccinated, 75% of high school graduates and 60.8% of higher education graduates were considering getting vaccinated. Major reasons for rejecting vaccination were concerns about side effects and allergy. While the majority of women (47.2%) who did not want to get vaccinated were concerned about vaccine side effects, the majority of men (34.6%) did not want to get vaccinated because they did not trust the efficacy of the vaccine. Vaccination rates have been increased with the training we provided to our patients who did not consider getting the vaccine. 76 patients could be reached by phone and 81.6% of them were vaccinated, and 18.4% were not. The vaccination rates of allergy patients who did not consider getting vaccinated were increased with the information provided by allergists. So, the allergists should give more attention for giving information and increasing the vaccination rates of covid-19. 

https://doi.org/10.1016/j.reval.2022.09.004

The percentage of hesitation and factors associated with acceptance or refusal for COVID-19 vaccine: Does training about vaccines by allergist affect personal decision?

Although exposure during drug administration and susceptibility to coronavirus disease-19 (COVID-19) infection secondary to immunomodulatory effects constitute potential risks for patients with chronic spontaneous urticaria (CSU) or asthma on omalizumab (OMZ), there is a risk of loss of response following discontinuation of OMZ. There are few studies describing the clinical course of COVID-19 in patients receiving OMZ.A total of 103 patients on OMZ were included in the study between February 2021 and January 2022.Fourteen (13.6%) of the patients participating in the study had SARS-CoV-2 infection, of whom 3 (21.4%) required hospitalization and 11 (78.6%) were treated in an outpatient clinic. During the pandemic, 17 (16.5%) of the patients interrupted their OMZ treatment. Patients on OMZ for six months or less had a lower rate of interruption (2.5%) than those on OMZ for more than 6 months (25.4%). Patients interrupted treatment for the following reasons: 3 (17.6%) had COVID-19, 10 (58.9%) did not attend the hospital visit due to concern about contamination with SARS-CoV-2, and 4 (23.5%) thought that OMZ treatment would facilitate contamination with SARS-CoV-2. After interrupting OMZ, 3 (25%) female patients and 5 (100%) male patients presented no worsening of their symptoms. Three (13%) of the patients on OMZ for asthma and 11 (13.8%) of those on the drug for urticaria had COVID-19 infection. Patients presenting CSU and severe asthma are completely different, with different potential consequences of OMZ interruption. Nine (52.9%) patients had aggravated symptoms following interruption of OMZ treatment. Three of them described worsening of asthma symptoms and a need to increment their maintenance therapy due to asthma exacerbation after nearly three weeks of interruption, and 6 of them had hives and pruritus as urticaria exacerbation nearly four weeks after interruption of OMZ. The asthma patients did not stop their other treatments, including inhaled corticosteroids.Use of OMZ does not increase the risk of SARS-CoV-2 infection, COVID-19-related pneumonia, or COVID-19-related hospitalization. We advise patients not to interrupt OMZ treatment during the COVID-19 pandemic unless advised to do so by their doctors, and we recommend that they receive instruction concerning self-administration of OMZ to avoid visiting hospitals in the event of a pandemic.Bien que l’exposition lors de l’administration du médicament et la susceptibilité individuelle à l’infection par le coronavirus-19 (COVID-19) secondaire aux effets immunomodulateurs soient des risques potentiels pour le patient victime d’urticaire chronique idiopathique (UCI) ou d’asthme recevant de l’omalizumab (OMZ), il existe également un risque de perte de réponse au traitement à la suite de l’arrêt de l’OMZ.Un total de 103 patients recevant de l’OMZ ont été inclus dans l’étude entre février 2021 et janvier 2022.Quatorze (13,6 %) patients participant à l’étude ont été victimes d’une infection à coronavirus, 3 d’entre eux (21,4 %) ont été hospitalisés et 11 (78,6 %) ont été traités en ambulatoire. Durant la pandémie, 17 (16,5 %) patients arrêtèrent le traitement par OMZ. Le taux d’arrêt était plus faible (2,5 %) chez les patients recevant l’OMZ depuis 6 mois ou moins par rapport aux patients recevant l’OMZ depuis plus de 6 mois (25,4 %). L’arrêt du traitement était motivé par l’infection COVID-19 dans 3 cas (17,6 %), par une non-fréquentation de l’hôpital par crainte de contagion dans 10 cas (58,9 %), et dans 4 cas (23,5 %) parce qu’ils pensaient que l’OMZ favorisait l’infection COVID-19. Après l’arrêt de l’OMZ, 3 (25 %) femmes et 5 (100 %) hommes n’ont présenté aucune aggravation de leurs symptômes. Trois (13 %) patients recevant de l’OMZ pour asthme et 11 (13,8 %) pour de l’UCI présentèrent une infection par COVID-19. Les patients souffrant d’UCI ou d’asthme sévère étaient totalement différents, avec des conséquences potentielles différentes de l’interruption de l’OMZ. Neuf (52,9 %) patients aggravèrent leurs symptômes à l’arrêt de l’OMZ. Trois d’entre eux décrivirent une accentuation des symptômes d’asthme avec besoin d’augmenter leur traitement de fond pour exacerbation d’asthme après près de 3 semaines d’arrêt, et 6 d’entre eux présentèrent une exacerbation de l’urticaire avec papules et prurit après près de 4 semaines d’arrêt de l’OMZ. Les asthmatiques n’arrêtèrent pas les autres médicaments dont les corticostéroïdes inhalés.L’OMZ n’augmente pas les risques d’infection par COVID-19, ni les pneumopathies liées à l’infection COVID-19, ni les hospitalisations dues au COVID-19. Nous prévenons les patients de ne pas interrompre leur traitement par OMZ pendant la pandémie par COVID-19 sans avis médical, et nous recommandons une éducation thérapeutique pour l’auto-administration d’OMZ pour éviter les séjours hospitaliers en cas de pandémie. 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9812821

Beyhan Öztürk

Papers

The knowledge and attitudes of breast self-examination and mammography in a group of women in a rural area in western Turkey.

Evaluation of PM10 concentration by using Mars and XGBOOST algorithms in Iğdır Province of Türkiye

The percentage of hesitation and factors associated with acceptance or refusal for COVID-19 vaccine: Does training about vaccines by allergist affect personal decision?

The effect of COVID-19 on patients recieving omalizumab treatment

Evaluation of hospital acquired infections in intensive care unit