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Breast cancer is one of the most prevalent malignancies worldwide. This study aimed to compare the level of knowledge and attitude of females regarding Breast cancer and to determine the role of knowledge, attitude and barriers in performing regular self-examination.

Non-physician females aged 18 years old or above were enrolled in this cross-sectional study in two groups of usual clients and healthcare staff from January 2018 to January 2019 from a healthcare center in Sari, a major city in the northern district of Iran. A questionnaire was used to score the participants’ knowledge and attitude levels using questions about the participants' knowledge and attitude towards Breast cancer along with their status on Breast self-examination and barriers. Mean scores were used for statistical analysis using SPSS V25. p < 0.05 was considered significant.

A final dataset of 279 females were collected. A significant difference in the knowledge and attitude regarding breast cancer was found between the two study groups (p < 0.001). The practice of BSE was significantly lower in the usual clients compared to non-physician healthcare staff (p < 0.001). The most frequent barriers for not performing a regular BSE were fear of finding a mass in usual clients (17.8%) and lack of confidence in healthcare staff (3.8%).

Limitations include single-centered sample selection.

Given the importance of early detection in breast cancer prevention and the general taboo regarding breast cancer screening methods in certain parts of the world, leading to poor results in early detection and prevention, the authors believe that it is of superior importance to address and promote positive attitudes in general population towards breast self-examination.

Given the importance of early detection in breast cancer prevention, and the general taboo regarding breast cancer screening methods in certain parts of the world, leading to poor results in early detection and prevention, the authors believe that it is of superior importance to address and promote positive attitudes in general population toward breast self-examination. The authors of this study believe that the manuscript represents honest and original work.

Improving early diagnosis of cancer through system change initiatives is endemic in England’s NHS cancer services. These initiatives, however, often fail to gain traction due to the complexities of health system structures. The purpose of this paper is to explore whether using a change framework grounded in systems thinking could be of help to system leaders.

A portfolio of geographically independent projects, all implementing cancer service changes as part of the Accelerate, Coordinate, Evaluate Programme, was used for the study. Eight projects were purposively selected to give a varied case-mix. Two semi-structured interviews were conducted with each project. Analysis of interviews was carried out using the Framework Method.

Processes working for (growth processes) and against (limiting processes) change were evident in and common across all eight projects. Projects commonly encountered challenges of relevance, time and bounded thinking. Having a network of committed people was vital for both initiating and sustaining change. Furthermore, understanding stakeholders’ emotional responses to change helped mitigate emergent challenges.

Leaders should pay constant attention to the dynamics of change, taking time to anticipate and diffuse challenges whilst simultaneously working to create the conditions that help change flourish. A change framework rooted in complex systems theory can help leaders understand the contradictory and non-linear processes inherent in transformational change.

Few studies seek to understand change dynamics by comparing the experiences of separate change initiatives implemented contemporaneously. The findings offer leaders practical insights on how to implement transformation.

The purpose of this paper is to investigate healthcare customer complaints concerning interpersonal matters in cancer care.

Complaints from cancer patients and their relatives (n=116) that dealt with interpersonal matters registered between 2009 and 2011 at four local Patients’ Advisory Committees in Western Sweden were sampled and analyzed using qualitative content analysis.

Complaints concerned lack of information and consideration from healthcare providers. Lack of empathy and civility also caused dissatisfaction, the latter particularly for women. Relatives complained that they did not feel included in the care process or were not offered proper support. Most complaints by relatives were filed by a female relative and concerned a male patient.

Information about patient demographics other than gender could not be investigated due to database limitations. Hence, factors such as age, country of birth, and geographical residence were not included for analysis. In addition, neither the type nor stage of cancer among the sampled patients was able to be addressed.

Patient complaints should not only be viewed as a post-consumption judgment, but also as a service interaction activity. This may require healthcare providers to enhance their interpersonal skills, allowing patients and relatives to provide feedback during service interaction to satisfactorily address dissatisfaction. Visualizing gender disparities may help healthcare providers prevent stereotypical encounters. In addition, the provider should be invited to participate in the customer’s value creating network, which may also include knowledge and skills from other sources, such as relatives.

Value co-creation offers a different view on patient complaints. Incorporating social construction into value co-creation may reveal socially constructed disparities. The paper provides aggregated information on cancer patients’ and relatives’ complaints concerning interpersonal issues, which can increase knowledge about patient healthcare service perceptions.

This chapter is a comprehensive discussion of autism spectrum disorder (ASD) across the globe (e.g., United States, China, Brazil, Japan and Turkey). Topics that are discussed include the following: diagnostic criteria and approaches; international perspectives of ASD; western and eastern assessment practices; cultural considerations of assessment of ASD; educational and medical interventions; behavioral and emotional interventions; complementary and alternative medical interventions; variations in educational services among countries; early intervention practices; adult services; national and international resources; and current needs and future directions.

Congenital hearing disabilities among children are associated with lifetime discrepancies in the attainment of speech, poor academic-performance, socio-individual isolation and emotional-maladjustments. The present study aims to combine evidence from randomized, controlled trials to assess the accuracy of hearing-screening procedures and relative diagnostic-tests concomitant with partial/permanent hearing loss (HL) among neonatal and under-five children.

The steps in this process were conducted according to the PRISMA (Preferred-Reporting-Items-for-Systematic-reviews-and-Meta-Analysis) guidelines. The PubMed, ProQuest, Science-Direct, Cochrane-Library and secondary reference databases were searched. Analyses were carried out by using fixed/random-effects-models for calculating the summary estimates on hearing-screening and test-procedure. Meta-regression-analysis is performed to explore the influence of confounders on the net-pooled effect.

A total of 1,656 articles were identified, and 1,575 were excluded as they were not relevant to the purpose of the study. Further, out of 81 studies, 67 were excluded with reasons and 14 were included in the final analysis. Three independent reviewers have assessed the titles/abstracts for their potential relevance. The results from meta-analysis indicate that hearing-screening was significantly higher in the intervention group (n 8,102; OR 0.52, 95% CI 0.34, 0.79; p < 0.00001), as depicted via forest plot. Meta-regression analysis indicates a positive relationship between the age and effect size (regression-coefficient 0.638, 95% CI 0.005, 0.731; p < 0.05).

The evidence from the present study can be used as reference for identifying the associated risk indicators, improved hearing-screening and reduction of hearing disability among under-five children.

The results of this review will be used for implementation of a new-born hearing screening, diagnostic accuracy and understanding the risk indicators for HL among under-five children in the South-Asian region. The evidence will be helpful for strategic directions for improved hearing screening and reduction of hearing disability among under-five children.

By understanding the underlying dynamics of hearing-screening procedures, hearing-impairments can be identified at an early stage and required treatment can be provided to the children.

The findings of this study indicate that early detection, screening and diagnosis of the HL among the children, especially among the infants and new-born (0–2 years of age), will be of utmost importance in reducing the prevalence of HL, especially among the South-Asian region. This study can be used as a reference for other future studies in the area of hearing-screening, diagnostic accuracy and associated risk indicators among children.

The purpose of this paper is to identify neurodevelopmental disorders and difficulties (NDD) in a male prison. The study used standardised tools to carry out screening and diagnostic assessment of the attention deficit hyperactivity disorder (ADHD), autism spectrum disorder (ASD) and intellectual disability (ID).

The ADHD self-report scale, 20-item autism quotient and the Learning Disability Screening Questionnaire were used to screen 240 male prisoners. Prisoners who screened positive on one or more of these scales or self-reported a diagnosis of ADHD, ASD or ID were further assessed using the diagnostic interview for ADHD in adults, adapted Autism Diagnostic Observation Schedule and the Quick Test.

Of the 87 prisoners who screened positive for NDD and were further assessed, 70 met the study’s diagnostic criteria for ADHD, ASD or ID. Most of those with NDD (51 per cent) had previously gone unrecognised and a high proportion (51 per cent) were identified through staff- or self-referral to the study.

The study demonstrated that improving awareness and providing access to skilled, standardised assessment within a male prison can result in increased recognition and identification of NDD.

Child welfare services (CWSs) globally continue to absorb high rates of children living with or suspected of fetal alcohol spectrum disorder (FASD). Such high prevalence rates render CWS with major ethical and moral dilemmas of meeting complex needs. Currently, many jurisdictions are challenged by diagnostic capacity and cost implications of formal FASD diagnosis. This paper aims to recommend a screening protocol to address management gap between FASD initial presentation and formal diagnosis.

This is a follow-up paper from a grounded-theory study of a sample (N = 18) of child welfare social workers (CWSWs), allied health professionals and foster parents. A stepwise protocol was developed through systematical interpretation of the final data.

The application of a five-step screening protocol would greatly support CWSW in meeting the needs of children with suspected FASD. This CWSWs-led assessment model incorporates a clinical evaluation to exclude neurodevelopmental conditions caused by known genetic disorders, followed by behavioral and neurocognitive psychosocial assessments.

This study had several limitations. Firstly, as a specific social work-based sample, it is not necessarily representative of the wider population of social workers globally due to different cultural responses to FASD in CWSs. The transferability of findings will have to be considered due to cultural variations concerning FASD.

By offering a management and nonlabeling approach, this five-step screening protocol offers a delineated pathway for CWSW and addresses the major professional frustrations while seeking to plan safe care for a child suspected of having FASD.

The research offers a pragmatic low-cost to society to alleviate the mounting social and monetary implications of FASD. A large percentage of children impacted by prenatal alcohol exposure do not qualify under formal clinical diagnostic guidelines. Leaving these children without intervention is problematic. The recommendation of this study addresses this critical gap in services. The primary aim is to alleviate the burden on this cohort of vulnerable children by offering nonlabeling neurodevelopmental screening.

The direct implications of FASD and how it impacts CWS are well documented. However, few studies focus on the critical interface of FASD and the role of CWSW responsible for planning their safe care. This paper offers a novel pragmatic and functional multistep protocol to aid CWSW in this complex area of practice.

Assessment is at the core of high-quality education. When educators purposefully engage in assessment, the learning experiences and outcomes of all students, especially of students diagnosed with specific learning disabilities (SLDs), are improved. In this chapter, we discuss assessment as unfolding within a framework that includes purposes, processes, and tools of assessment existing in the educational context. We open the chapter with an explanation of this framework. Then, in Part 1, we review the construct of SLD and detail how assessment is used within prominent approaches to diagnosis. In Part 2, we discuss how assessment is used to inform instruction before and after diagnosis. We ground our discussion in a vignette that follows Tess, a student who, at the beginning of third grade, has undiagnosed SLD in the area of reading. We show how educators at Tess's school collaborate in the purposeful use of assessment to inform instruction before and after Tess's diagnosis of SLD, highlighting traditional and innovative assessment techniques along the way.

This paper aims to investigate the dyadic relationships of actors engaged in public–private (P-P) collaboration in health-care prevention. The purpose is to characterize a new type of actor as an intermediary that connects different actors in P-P collaboration and to compare P-P collaboration based on results expected with and without the inclusion of this new actor.

For the investigation, the Industrial Marketing and Purchasing Group approach to business relationships is used. The substance (activities-resources-actors) and the functions (dyadic, single actor and network) of business relationships are applied as a research framework. The analysis is based on these theories through a case study.

This study delivers four important findings: the relationship with this new type of actor results in new resources for all of the participants that are involved, the new actor is a key channel for generating corporate social responsibility recommendations for private actors, relationships with this new type of actor are a great basis on which private firms may build relationships with the public that involve higher levels of health care and also generate sponsorship for public causes, thereby increasing social welfare and the new type of actor can cause potential tensions that require constant and coordinated management.

The paper contributes to the conceptualization of the “interacted actor” through characterizing a new type of actor and its renewing network in P-P collaboration.

Diagnosing autism spectrum disorder (ASD) is important over the whole life span. Standardized instruments may support the assessment process. The purpose of this paper is to describe English- and German-screening tools for ASD.

PubMed was used to search for published tools and evidence on their diagnostic validity.

Searches identified 46 screening tools for ASD. Most are designed for children, while only few measures are available for adults, especially those with additional intellectual disabilities. Many instruments are under-researched, although a small number such as the Modified Checklist for Autism in Toddlers and the SCQ have been widely examined in a variety of populations.

The study identified and described a number of ASD screeners that can support clinicians or researchers when deciding whether to carry out a more comprehensive ASD assessment.