Background and Objective: Breast cancer remains one of the top leading morbidity and mortality among women within the country and around the world. Breast self-examination has been considered as a safe and easy to perform screening procedure to detect breast lumps and swelling. This study was conducted to determine knowledge on breast cancer and breast self-examination among public-school teachers. Methodology: A cross-sectional design was employed involving 348 professional teachers in Aurora, Philippines in April 2019. Self-report questionnaire derived from literatures was used to generate participants' knowledge on breast cancer and breast self-examination. Descriptive statistics like frequency, percentages and averages were used in data analysis. Results: Majority of the participants are females (83.3%) whose age is between 31-40 years old (37.9%). Three hundred twenty-seven (94%) participants have knowledge on breast cancer while two hundred ninety four (84.48%) of them have knowledge on breast self-examination. Conclusion Professional teachers have knowledge on breast cancer and breast self-examination however, health care providers and concerned health agencies need to continue and enhance comprehensive health education about breast cancer and breast self-examination to teachers. It is essential that awareness program about these need to be integrated to teacher's training programs or professional development activities.
Breast Neoplasms ; Breast Self-Examination ; Health Education

OBJECTIVES: To design and validate a computer application for the diagnosis of shoulder locomotor system pathology. METHODS: The first phase involved the construction of the application using the Delphi method. In the second phase, the application was validated with a sample of 250 patients with shoulder pathology. Validity was measured for each diagnostic group using sensitivity, specificity, and positive and negative likelihood ratio (LR(+) and LR(−)). The correct classification ratio (CCR) for each patient and the factors related to worse classification were calculated using multivariate binary logistic regression (odds ratio, 95% confidence interval). RESULTS: The mean time to complete the application was 15 ± 7 minutes. The validity values were the following: LR(+) 7.8 and LR(−) 0.1 for cervical radiculopathy, LR(+) 4.1 and LR(−) 0.4 for glenohumeral arthrosis, LR(+) 15.5 and LR(−) 0.2 for glenohumeral instability, LR(+) 17.2 and LR(−) 0.2 for massive rotator cuff tear, LR(+) 6.2 and LR(−) 0.2 for capsular syndrome, LR(+) 4.0 and LR(−) 0.3 for subacromial impingement/rotator cuff tendinopathy, and LR(+) 2.5 and LR(−) 0.6 for acromioclavicular arthropathy. A total of 70% of the patients had a CCR greater than 85%. Factors that negatively affected accuracy were massive rotator cuff tear, acromioclavicular arthropathy, age over 55 years, and high pain intensity (p < 0.05). CONCLUSIONS: The developed application achieved an acceptable validity for most pathologies. Because the tool had a limited capacity to identify the full clinical picture in the same patient, improvements and new studies applied to other groups of patients are required.
Classification ; Diagnosis ; Humans ; Logistic Models ; Medical Informatics Applications ; Methods ; Pathology ; Radiculopathy ; Rotator Cuff ; Self-Examination ; Sensitivity and Specificity ; Shoulder ; Tears ; Tendinopathy

OBJECTIVES: In women, breast cancer is the most common cancer and the leading cause of cancer death. Screening tests are the basis for early diagnosis. In Iranian women, the mortality rate of breast cancer is high due to insufficient screening examinations and delayed visits for care. Therefore, this study aimed to determine the factors affecting breast self-examinations among Iranian women employed in medical careers. METHODS: This cross-sectional study included 501 women working in the medical professions at Hamadan University of Medical Sciences in western Iran in 2018. The subjects were selected by stratified random sampling. Data were collected using a researcher-developed, self-report questionnaire that contained demographic information and questions based on protection motivation theory and social support theory. Descriptive data analysis was conducted using SPSS version 23 and model fitting with PLS version 2. RESULTS: The mean age of the participants was 37.1±8.3 years, and most of the women (80.4%) were married. Most women had a bachelor's degree (67.5%). The findings of this study showed that the coping appraisal construct was a predictor of protection motivation (β=0.380, p<0.05), and protection motivation (β=0.604, p<0.05) was a predictor of breast self-examination behavior. Additionally, social support theory (β=0.202, p<0.05) had a significant positive effect on breast self-examination behavior. CONCLUSIONS: The frequency of practicing self-examinations among women employees in the medical sector was low; considering the influence of social support as a factor promoting screening, it is necessary to pay attention to influential people in women's lives when designing educational interventions.
Breast Neoplasms ; Breast Self-Examination ; Breast ; Cross-Sectional Studies ; Delivery of Health Care ; Early Diagnosis ; Female ; Humans ; Iran ; Mass Screening ; Mortality ; Motivation ; Self-Examination ; Statistics as Topic

BACKGROUND: Clear and proper feedback is necessary to decrease the gap between knowledge and practice. Feedback can improve clinical competence of medical students up to expertise level.METHODS: A total of 180 4th-year students of Daegu-Kyungbuk consortium area participated in the scheduled feedback program of clinical performance examination on August 26th in 2017. Among them, 167 students filled out the questionnaire on helpfulness of the direct observation and feedback of faculty and standardized patient (SP), helpfulness for history taking (Hx), physical examination (PE), and patient-physician interaction (PPI), and any change of clinical competence and clinical reasoning of the students preand post-feedback. All the responses were measured on 5-point Likert scale.RESULTS: Among the total students, 88.6% responded that direct feedback at the practice is helpful, particularly 95.2% of faculty and 76.6% of SP. A 37.3% answered that it was helpful for all the categories of feedback, but only 25.3% for PE and 24.7% for Hx. A 56.3% responded that feedback is helpful for both disease questions and counseling practice. Mean score of self-assessment by the students increased from 2.52 to 3.36 for Hx, 2.30 to 3.24 for PE, 2.46 to 3.33 for clinical reasoning, 2.84 to 3.59 for PPI, and 2.44 to 3.28 for overall competence. And all these differences were found to be statistically significant (P <0.001)CONCLUSION: A majority of students responded that the direct feedback from faculty and SP was helpful at the clinical practice of Hx, PE, and PPI, and increased the level of clinical competence.
Clinical Competence ; Counseling ; Humans ; Mental Competency ; Physical Examination ; Self-Assessment ; Students, Medical

OBJECTIVE: To explore the screening value of osteoporosis self-assessment tool for Asians (OSTA) and the optimal cut-off value in Chinese healthy physical examination population. METHODS: We selected a healthy physical examination population for bone mineral density screening at the Health Examination Center in Peking University Third Hospital from 2013 to 2016. Quantitative ultrasound (QUS) results were used as the gold standard, and T value ≤-2.5 was defined as osteoporosis patients. Diagnostic test methods were used to analyze the sensitivity, specificity, likelihood ratio and area under curve (AUC) of different cut points of OSTA. The screening accuracy of OSTA at different cut points was compared and the optimal cut-point value determined. RESULTS: A total of 5 833 subjects were included in the study, with an average age of (48.3±17.5) years and 2 594 women (44.5%). The QUS test showed 403 patients with osteoporosis (6.9% of the total population), 343 female osteoporosis patients (13.22% of the female population). In the whole age group, AUC at the international routine cut-off value (OSTA ≤-1) screening for osteoporosis was 0.815 (95%CI: 0.804-0.825), and screening accuracy was higher in the women (AUC=0.837, 95%CI: 0.823-0.851) than that in the men (AUC=0.767, 95%CI: 0.752-0.781; P<0.05). In the whole age group, when the optimal cut-off value was 0, its AUC 0.842 (95%CI: 0.832-0.851) was significantly higher than that when the cut-off value was -1 (P<0.01), and net reclassification improvement (NRI) increased by 5.5%. In the 40 to 65-year-old group, when OSTA cut-off value ≤0, the screening accuracy was significantly higher (NRI=19.5%, P=0.003) than that when it was -1. CONCLUSION The OSTA screening tool had good osteoporosis screening value in healthy people, and the screening accuracy in women is higher than that in men. Increasing the screening cut-off value of OSTA would be helpful to improve the screening accuracy in the whole and 40 to 65-year-old population. There may be different optimal cut-off values for different age group population.
Absorptiometry, Photon ; Adult ; Aged ; Asians ; Bone Density ; Female ; Humans ; Male ; Middle Aged ; Osteoporosis ; Physical Examination ; Risk Assessment ; Self-Assessment ; Sensitivity and Specificity

BACKGROUND: An increase of access to knowledge about early detection techniques of breast cancer can reduce this mortality rate. This study aimed to determine the knowledge and source of information about early detection techniques of breast cancer among Iranian women. METHODS: Both International (PubMed, Web of Science, and Google Scholar) and national (scientific information database [SID] and Magiran) databases were reviewed launching to September, 2017 to obtain related articles. Steps involving the screening, analysis of quality of the studies and extraction of papers were performed by two researchers. RESULTS: Of the 749 studies searched initially, 25 studies performed on 11,756 people were selected for the final stage. General knowledge for breast cancer screening among women ranged from 4.5% to 45%. The number of people with sufficient knowledge about breast self-examination in various studies was between 5% and 79.8%. The most important source of information was the Healthcare team. CONCLUSIONS: Considering the poor knowledge and different source of information, it is suggested that educational programs be conducted around the country especially in at-risk populations.
Breast Neoplasms ; Breast Self-Examination ; Breast ; Early Detection of Cancer ; Female ; Humans ; Iran ; Mass Screening ; Mortality ; Patient Care Team

STUDY DESIGN: Retrospective, case series. PURPOSE: The purpose of this study is to determine morbidity, complications, and patient reported outcomes from minimally invasive sacroiliac joint (SIJ) fusion. OVERVIEW OF LITERATURE: Lumbar back pain emanating from the SIJ can be surgically treated via a percutaneous approach in the appropriately selected patient with minimal morbidity and acceptable functional outcomes. METHODS: Patients diagnosed by >2 physical examination maneuvers and subjective relief from a computed tomography–guided lidocaine-bupivacaine-steroid injection underwent SIJ fusion after failing conservative management with a combination of oral anti-inflammatory medications, physical therapy, and pelvic belt stabilization. Perioperative data collected include estimated blood loss (EBL) and operative time. Oswestry disability index, 12-item short form health survey (SF-12), visual analogue score, and functional status were analyzed. All complications were noted. RESULTS: The study cohort of 45 cases (69% female) achieved postoperative survey follow-up at 9.9 and 32.3 months. SF-12 physical component summary statistically improved while all other scores were equivalent. Mean EBL and operative time were 22 mL and 36 minutes, respectively. Initial survey showed that 64% of patients discontinued narcotics (29/45), 71% do not use an assistive device (32/45), and 15.6% do not work due to pain (7/45). 73% of patients stated they would have the surgery again (33/45). For the second survey, 65% of patients discontinued narcotics (26/40), 70% did not use an assistive device (28/40), and 17.5% did not work due to pain (7/40). A history of thoracolumbar instrumentation (16/45) did not significantly affect outcomes. Three complications described by screw malposition with neurologic deficit (6.7%) were treated with screw repositioning (1 case) and removal of a single superior implant (2 cases) with time to revision of 2.2 months. All three ultimately had resolution of radicular pain. CONCLUSIONS: Percutaneous SIJ fusion offers minimal morbidity and acceptable functional outcomes. While women and those with a prior history of lumbar instrumentation may be at increased risk of having SIJ dysfunction requiring surgical intervention, it was not found to affect postoperative functional outcomes when compared to the non-instrumented group.
Back Pain ; Cohort Studies ; Female ; Follow-Up Studies ; Health Surveys ; Humans ; Narcotics ; Neurologic Manifestations ; Operative Time ; Physical Examination ; Retrospective Studies ; Sacroiliac Joint* ; Self-Help Devices

PURPOSE: This study was done to investigate the relationship between knowledge, attitude, and practice toward breast self-examination (BSE) among middle and high school girls. METHODS: A cross-sectional descriptive study was conducted using self-report questionnaires. Participants were 412 students, 137 middle and 275 high school girls. Data were collected from December 7 to 23, 2016 and analyzed using t-test and Spearman correlation coefficient. RESULTS: The percentage of correct answers for knowledge about breast self-examination among middle and high school girls was 29.2%. The mean score for practice (5.89±0.10) among middle and high school girls was low. For knowledge, there were significant differences according to grade (t=5.93, p<.001), having heard about BSE (t=4.02, p<.001), experience of BSE (t=2.51, p=.012), and need for education (t=3.37, p=.001). In practice, there were significant differences according to having heard about BSE (t=3.64, p<.001), experience of BSE (t=2.64, p=.017). Knowledge level of BSE positively correlated with practice of BSE (r=.21, p<.001). CONCLUSION: Research results suggest that education on BSE for middle and high school girls is needed to increase the possibility of early detection of breast cancer.
Breast Neoplasms ; Breast Self-Examination ; Education ; Female* ; Humans

This study was conducted to analyze the strengths and weaknesses of a 3-week family medicine clerkship program based on the results of an online survey taken by the students (N=127) and a structured interview with a focus group (n=10), aimed to improve the quality of the clerkship program. The online survey contained questions pertaining to goals, schedule, contents, arrangement, atmosphere, environment, evaluation, and satisfaction regarding the clerkship. The focus group interview addressed the schedule and achievements of the program. Scores were reported on a 5-point Likert scale. Most students were highly satisfied with the overall quality of the clerkship. The structured interview results showed that 97.6% of the clerkship program was executed according to the schedule. The focus group reported a perfect score of 5 points on several measures including: accomplishment of the educational goals of the family medicine clerkship, providing many chances to obtain medical histories and perform physical examinations on real patients, experience with various symptoms and diseases, positive attitudes of faculty members when teaching, notification of the guidelines for evaluation beforehand, well-constructed and effective clerkship schedule, and reflection of student feedback. However, the focus group gave low scores on: support for health accidents of students, access to patient information, enough opportunities to practice clinical skills, appropriate rest facilities for students, and fairness of clerkship evaluation process. In conclusion, the structured evaluation performed after the 3-week clerkship program motivated students and helped them ensure an efficient clerkship. This structured evaluation also suggested basic data to make the professor who is subject of the assessment. This study shows that structured assessment is an effective method which can be used to improve the quality of clerkships.
Appointments and Schedules ; Atmosphere ; Clinical Clerkship ; Clinical Competence ; Family Practice ; Focus Groups ; Humans ; Methods ; Physical Examination ; Self-Evaluation Programs ; Surveys and Questionnaires

The aim of this study is to examine the effect of recorded video monitoring on students' self-reflection after completing their clinical performance examination. Taking into account the particular cases involved in the examination, the present study utilized history-taking, physical examination, and patient education as bases for evaluating information-establishment ability, and asking, listening, understanding, explaining, and connectedness as the bases for evaluating patient-physician interaction ability. Student self-monitoring through recorded video feedback was carried out three days after completion of their clinical performance examination. Students self-evaluated their performance with a 10-point scale before and after self-monitoring. The results of this study show that students have a general tendency to lower their own self-evaluation scores after self-monitoring. Although there was not a statistically significant change of interrelationship in the information-establishment ability evaluation, there was a meaningful change of interrelationship in the patient-physician interaction ability evaluation after self-monitoring; specifically, in the case of acute lower abdominal pain, a high correlation was found (r=0.31, p=0.02) between the evaluation scores of standardized patients and students related to patient-physician interaction ability. This implies that self-monitoring enables the students to acquire a reflective viewpoint from which to evaluate their own performance. Therefore, it can be said that self-monitoring through recorded video feedback is a valuable method for students to use in reviewing their performance in patient-physician interactions.
Abdominal Pain ; Diagnostic Self Evaluation ; Humans ; Methods ; Patient Education as Topic ; Patient Simulation ; Physical Examination ; Physician-Patient Relations ; Self-Assessment