scholarly journals Presentation Intervals And The Impact Of Delay On Breast Cancer Progression In A Black African Population

2020 ◽  
Author(s):  
Olayide Agodirin ◽  
Samuel Olatoke ◽  
Ganiyu Rahman ◽  
Julius Olaogun ◽  
Olalekan Olasehinde ◽  
...  

Abstract BACKGROUND: The help-seeking interval or the primary-care interval are points of delays in breast cancer presentation. To inform future breast cancer down-staging intervention, we described the contribution of each interval to the delay and the impact of delay on tumor progression.METHOD: Multicentered survey from June 2017 to May 2018. We hypothesized that most patients visited the First Healthcare Provider within 60days of tumor detection. Inferential statistics were by t-test, chi-square test, and Wilcoxon-Signed Rank test at p-value 0.05 or 95% confidence limits. Time-to-event was by survival method. Multivariate analysis was by logistic regression.RESULTS: Respondents were females between 24 and 95 years (n=420). Most respondents visited FHP within 60 days of detecting symptoms (230(60%, 95% CI 53-63). Most had long primary-care(237 of 377(64% 95%CI 59-68) and detection-to-specialist(293 (73% (95%CI 68-77)) intervals. The primary care interval(median 106days) was longer than the help-seeking interval( median 42days )Wilcoxon signed-rank test p= 0.001. There was strong correlation between length of primary care interval and the detection-to-specialist interval(r= 0.9, 95%CI 0.88- 0.92). Patronizing the hospital, receiving the correct advice, and having a big tumor(>5cm) were associated with short intervals. Tumors were detected early, but most became advanced before arriving at the specialist clinic. The difference in tumor size between detection and arriving at a specialist clinic was 5.0±4.9cm(95%CI 4.0-5.0). The instantaneous hazard of progressing from early to locally advanced disease was least in the first 30days(3%). The hazard was 31% in 90days.CONCLUSION: Most respondents presented early to the first healthcare provider, but most arrived late at a specialist clinic. The primary care interval was longer than the help-seeking interval. Most tumors were early at detection but locally advanced before arriving in a specialist clinic. Interventions aiming to shorten the primary care interval will have the most impact on time to breast cancer presentation for specialist oncology care in Nigeria.

2020 ◽  
Author(s):  
Olayide Agodirin ◽  
Samuel Olatoke ◽  
Ganiyu Rahman ◽  
Julius Olaogun ◽  
Olalekan Olasehinde ◽  
...  

Abstract BACKGROUND: The help-seeking interval or the primary-care interval are points of delays in breast cancer presentation. To inform future breast cancer down-staging intervention, we described the contribution of each interval to the delay and the impact of delay on tumor progression.METHOD: Multicentered survey from June 2017 to May 2018. We hypothesized that most patients visited the First Healthcare Provider within 60days of tumor detection. Inferential statistics were by t-test, chi-square test, and Wilcoxon-Signed Rank test at p-value 0.05 or 95% confidence limits. Time-to-event was by survival method. Multivariate analysis was by logistic regression.RESULTS: Respondents were females between 24 and 95 years (n=420). Most respondents visited FHP within 60 days of detecting symptoms (230 (60%, 95% CI 53-63). Most had long primary-care (237 of 377 (64% 95%CI 59-68) and detection-to-specialist (293 (73% (95% CI 68-77)) intervals. The primary care interval (median 106days) was longer than the help-seeking interval ( median 42days ) Wilcoxon signed-rank test p= 0.001. There was strong correlation between length of primary care interval and the detection-to-specialist interval (r= 0.9, 95% CI 0.88- 0.92). Patronizing the hospital, receiving the correct advice, and having a big tumor (>5cm) were associated with short intervals. Tumors were detected early, but most became advanced before arriving at the specialist clinic. The difference in tumor size between detection and arriving at a specialist clinic was 5.0±4.9cm (95% CI 4.0-5.0). The instantaneous hazard of progressing from early to locally advanced disease was least in the first 30 days(3%). The hazard was 31% in 90 days.CONCLUSION: Most respondents presented early to the first healthcare provider, but most arrived late at a specialist clinic. The primary care interval was longer than the help-seeking interval. Most tumors were early at detection but locally advanced before arriving in a specialist clinic. Interventions aiming to shorten the primary care interval will have the most impact on time to breast cancer presentation for specialist oncology care in Nigeria.


2020 ◽  
Author(s):  
Olayide Agodirin ◽  
Samuel Olatoke ◽  
Ganiyu Rahman ◽  
Julius Olaogun ◽  
Olalekan Olasehinde ◽  
...  

Abstract BACKGROUND: The help-seeking interval and primary-care interval are points of delays in breast cancer presentation. To inform future intervention targeting early diagnosis of breast cancer, we described the contribution of each interval to the delay and the impact of delay on tumor progression. METHOD: We conducted a multicentered survey from June 2017 to May 2018 hypothesizing that most patients visited the first healthcare provider within 60 days of tumor detection. Inferential statistics were by t-test, chi-square test, and Wilcoxon-Signed Rank test at p-value 0.05 or 95% confidence limits. Time-to-event was by survival method. Multivariate analysis was by logistic regression. RESULTS: Respondents were females between 24 and 95 years (n=420). Most respondents visited FHP within 60 days of detecting symptoms (230 (60%, 95% CI 53-63). Most had long primary-care (237 of 377 (64% 95% CI 59-68) and detection-to-specialist (293 (73% (95% CI 68-77)) intervals. The primary care interval (median 106 days, IQR 13-337 ) was longer than the help-seeking interval ( median 42 days, IQR 7-150 ) Wilcoxon signed-rank test p= 0.001. There was a strong correlation between the length of primary care interval and the detection-to-specialist interval (r= 0.9, 95% CI 0.88- 0.92). Patronizing the hospital, receiving the correct advice, and having a big tumor (>5cm) were associated with short intervals. Tumors were detected early, but most became advanced before arriving at the specialist clinic. The difference in tumor size between detection and arriving at a specialist clinic was 5.0±4.9cm (95% CI 4.0-5.0). The hazard of progressing from early to locally advanced disease was least in the first 30 days (3%). The hazard was 31% in 90 days. CONCLUSION: Most respondents presented early to the first healthcare provider, but most arrived late at a specialist clinic. The primary care interval was longer than the help-seeking interval. Most tumors were early at detection but locally advanced before arriving in a specialist clinic. Interventions aiming to shorten the primary care interval will have the most impact on time to breast cancer presentation for specialist oncology care in Nigeria.


2018 ◽  
Vol 21 (1) ◽  
pp. 39-49 ◽  
Author(s):  
Cecile A. Lengacher ◽  
Richard R. Reich ◽  
Carly L. Paterson ◽  
Melissa Shelton ◽  
Steve Shivers ◽  
...  

Breast cancer survivors (BCS) often experience psychological and physiological symptoms after cancer treatment. Mindfulness-based stress reduction (MBSR), a complementary and alternative therapy, has reduced subjective measures of stress, anxiety, and fatigue among BCS. Little is known, however, about how MBSR affects objective markers of stress, specifically the stress hormone cortisol and the pro-inflammatory cytokine interleukin-6 (IL-6). In the present study, BCS ( N = 322) were randomly assigned to a 6-week MBSR program for BC or usual-care control. Measurements of cortisol, IL-6, symptoms, and quality of life were obtained at orientation and 6 weeks. Cortisol and IL-6 were also measured prior to and after the MBSR(BC) class Weeks 1 and 6. The mean age of participants was 56.6 years and 69.4% were White non-Hispanic. Most had Stage I (33.8%) or II (35.7%) BC, and 35.7% had received chemotherapy and radiation. Cortisol levels were reduced immediately following MBSR(BC) class compared to before the class Weeks 1 and 6 (Wilcoxon-signed rank test; p < .01, d = .52–.56). IL-6 was significantly reduced from pre- to postclass at Week 6 (Wilcoxon-signed rank test; p < .01, d = .21). No differences were observed between the MBSR(BC) and control groups from baseline to Week 6 using linear mixed models. Significant relationships with small effect sizes were observed between IL-6 and both symptoms and quality of life in both groups. Results support the use of MBSR(BC) to reduce salivary cortisol and IL-6 levels in the short term in BCS.


2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Emily S. Kowalski ◽  
Rahul Khairnar ◽  
Anton A. Gryaznov ◽  
Vivek Kesari ◽  
Antony Koroulakis ◽  
...  

Abstract Background and purpose Meningiomas express the somatostatin receptor (SSTR), which normal bone and brain lack. PET imaging with SSTR ligands such as 68 Ga-DOTATATE have been recently shown to aid in the imaging and identification of menginiomas. We hypothesize that 68 Ga-DOTATATE PET/CT in conjunction with MRI aids in radiation (RT) target volume delineation and evaluating treatment response. Materials and methods Nineteen patients with meningiomas underwent 68 Ga-DOTATATE PET/CT and MRI for RT planning and/or post-treatment follow-up. Meningiomas were grade I (n = 9) or not biopsied (n = 8) and frequently involved base of skull (n = 10). Ten (53%) patients received post-operative RT and 9 (47%) received fractaionted RT. In the subgroup that underwent both pre- and post-RT 68 Ga-DOTATATE PET as well as MRI (n = 10), ROVER (ABX GmbH, Radeberg, Germany) adaptive thresholding software was utilized to measure total lesion activity (mean and max) before and after treatment. Tumor volume based on MRI was calculated before and after treatment. Total lesion activity and tumor volume changes were compared using Wilcoxon signed rank test. Results 68 Ga-DOTATATE PET/CT identified intraosseous (n = 4, 22%), falcine (n = 5, 26%) and satellite lesions (n = 3, 19%) and clarified the diagnosis of meningioma, resulting in a change in management in three patients. Mean total lesion activity decreased 14.7% (median), from pre to post-RT 68 Ga-DOTATATE PET [range 97–8.5% (25–75%),S = − 26.5, p = 0.0039]. Max total lesion activity decreased 36% (median) over the same period [range 105–15% (25–75%), S = − 26.5 p = 0.0039]. In contrast, meningioma volumes based on MRI measurements did not significantly change per RECIST criteria and Wilcoxon signed rank test (S = − 3, p = 0.7422). Conclusion 68 Ga-DOTATATE PET/CT helped confirm suspected diagnoses and delineate target volumes particularly when lesions involved osseous structures and the falx. Mean and max total tumor 68 Ga-DOTATATE activity on PET/CT decreased at three months following RT despite stable tumor volumes on MRI. Future studies are warranted to (1) assess the sensitivity and specificity of 68 Ga-DOTATATE PET/CT, (2) evaluate the impact of 68 Ga-DOTATATE PET/CT-based planning on treatment outcomes, and (3) assess the prognostic significance of these post-treatment imaging changes.


2015 ◽  
Vol 46 (4) ◽  
pp. 43-52 ◽  
Author(s):  
J. Islam ◽  
S. Sathye ◽  
H. Hu

Previous research has studied the impact of corporate governance on bank performance, but only a few aspects of the impact were reported. The present study develops a unique corporate governance index to provide a comprehensivemeasure of corporate governance and examines the relationship between this comprehensive measure and bank performance. We apply the Wilcoxon signed rank test to examine whether the introduction of the Code of CorporateGovernance in Bangladesh has significantly promoted the improvement of corporate governance practices in Bangladeshi banks. Our results provide support for the hypothesis that corporate governance practices of Bangladeshi banks have been significantly improved since the introduction of the code. Further, the present study adopts regression analysis and reveals that the comprehensive measure of corporate governance is not significantly related to Bangladeshi banks’ performance.


2020 ◽  
Vol 11 (1) ◽  
pp. 1386-1395
Author(s):  
Ani Susiani ◽  
Rizkiatun Magfiroh

ABSTRAKPeningkatan jumlah lansia yang pesat sebagai dampak keberhasilan pembangunan di Indonesia harus mendapat perhatian lebih dari seluruh masyarakat.  Hal ini disebabkan karena pada proses menua terjadi peningkatan insiden penyakit kronis diantaranya adalah hipertensi. Kegiatan prolanis yang dilakukan secara teratur dapat mencegah kekambuhan hipertensi. Penelitian ini bertujuan untuk mengetahui pengaruh pelaksanaan kegiatan prolanis dengan  kekambuhan penyakit hipertensi pada anggota Kelompok Prolanis Bunda Ceria Losarang. Metode peneltian menggunakan desain quasi eksperimen dengan bentuk pre and post test without control. Populasi penelitian berjumlah 94 orang dan sampel penelitain berjumlah 26 responden yang dipilih dengan teknik purposive sampling: mengikuti penyuluhan kesehatan tentang hipertensi dan senam prolanis selama 4 minggu berturut-turut. Analisa data menggunakan Wilcoxon Signed Rank Test. Hasil penelitian menunjukkan adanya pengaruh kegiatan prolanis dengan kekambuhan penyakit hipertensi (terdapat pengaruh senam prolanis terhadap tekanan darah sistolik responden dengan nilai p-value sebesar 0,000 dan terdapat pengaruh senam prolanis terhadap tekanan darah diastolik dengan nilai p-value 0,000). Disarankan kepada Puskesmas Losarang untuk melakukan pelatihan kader prolanis sehingga masyarakat dapat secara mandiri melakukan kegiatan prolanis secara teratur.Kata kunci: lansia, kekambuhan, hipertensi, prolanis    ABSTRACTThe increasing number of elderly people as the impact of development success in Indonesia has gained more attention from the whole community.  This is due to the aging process occurs increased incidence of chronic diseases including hypertension. Prolanis activities conducted regularly can prevent the recurrence of hypertension. This research aims to determine the influence of the implementation of prolanis activities with recurrence of hypertension disease in the members of the group Prolanis Bunda Ceria Losarang. The study was a quasi experimental with a pre and post test group without control. The research population amounted to 94 peoples and the samples was 26 respondents selected with the purposive sampling technique: following the health education on hypertension and prolanis gymnastics for 4 consecutive weeks. Data were analyzed with Wilcoxon Signed Rank Test. The results showed that there was an effect of prolanis activities with the recurrence of hypertension disease (there was an effect of prolanic exercise on respondent's systolic blood pressure with a p-value of 0,000 and there was an effect on prolanic exercise on diastolic blood pressure with a p-value of 0,000). The author suggests to Puskesmas Losarang to conduct prolanist cadre training so that the community can independently carry out prolanist activities on a regular basis..Keywords: elderly,  recurrence, hypertension, prolanis 


2019 ◽  
Vol 7 (1) ◽  
pp. 33-40
Author(s):  
Isworo Isworo ◽  
Marjes Tumurang ◽  
Dorce Sarimin ◽  
Dwita Marasi ◽  
Rolly Rondonuwu

Background: The lifestyle of Indonesian people that shifts towards an instant and fast food lifestyle affects the health of everyone, coupled with factors such as lack of physical activity, fast food consumption and the impact of stress, which can trigger factors stroke that can lead to death. Aims: This study is to determine the effect of health education on the handling of pre-hospital stroke emergencies on family knowledge. Method: This research is a pre-experimental design using a one-group pre-test-post-test design. The population in this study amounted to 120 family members and 30 samples were determined using the purposive sampling method. Respondents were given treatment in the form of health education about the handling of pre-hospital stroke emergencies. The measured variable is family knowledge before and after treatment and measured using a questionnaire that has been tested for the validity and reliability of the instrument, by processing data using editing, coding, processing, and cleaning techniques. Data analysis is presented in tabular form and tested with the Wilcoxon Signed Rank Test. Results: The Wilcoxon Signed Rank Test statistical test showed family knowledge before and after treatment with pValue = 0,000 (α = 0.05). Conclusion: health education has a significant effect on family knowledge about the handling of pre-hospital stroke emergencies. Suggestions from this research, health workers can provide health promotion in the form of providing health education or ongoing training in order to add insight to families about emergency care.


2019 ◽  
Vol 3 (1) ◽  
pp. 25
Author(s):  
Dewi Nurhanifah ◽  
Desy Noor Latifah Sari ◽  
Rahmawati Rahmawati

Salah satu masalah kesehatan yang sering dialami adalah penyakit gastritis. Gejala yang sering dikeluhkan oleh penderita gastritis adalah mual. Salah satu penatalaksanaan keperawatan yang dapat mengurangi rasa mual adalah tirah baring. Penelitian ini bertujuan untuk mengetahui pengaruh tirah baring terhadap penurunan rasa mual pada klien gastritis di Pelayanan Kesehatan. Metode penelitian menggunakan eksperimental dengan bentuk penelitian one group pretest-posttest design. Populasi dan sampel adalah klien yang mengalami mual di Wilayah Kerja Puskesmas  yang berjumlah 15 orang. Sampel diambil dengan teknik purposive sampling. Alat pengumpul data menggunakan observasi. Analisa data melalui uji Wilcoxon Signed Rank Test. Hasil penelitian menujukkan klien gastritis sebelum tirah baring mengalami mual ringan sebanyak 7 orang (46,7%), sesudah tirah baring mengalami tidak mual sebanyak 7 orang (46,7%). Ada pengaruh tirah baring terhadap penurunan rasa mual pada klien gastritis di Pelayanan Kesehatan (ρ value = 0,001).


2017 ◽  
Vol 5 (1) ◽  
Author(s):  
Ferawato Ferawati

ABSTRAKReumatoid Artritis (RA) merupakan penyakit muscoloskelektal yang sering terjadi pada usia lanjut. Gangguan pada system muscoloskelektal yang ditandai dengan munculnya nyeri sendi dan kekakuan yang mengakibatkan penurunan kemampuan fisiologis atau kualitas hidup lansia. Dampak dari Reumatoid Artritis dapat menimbulkan beberapa keluhan dan dapat menyebabkan kelumpuhan. Untuk menganalisis efektifitas kompres jahe merah hangat dan kompres serai hangat terhadap penurunan intensitas nyeri artitris remauthoid pada lanjut usia.Metode Penelitian: Jenis penelitian adalah quasy experimental dengan two group pre – post test design. Subjek adalah sebagian lansia yang penderita Arthritis Remathoid di Desa Sumberagung Kecamatan Dander Kabupaten Bojonegoro. Subjek dibagi menjadi dua kelompok yaitu kelompok I (n=15) diberi perlakuan kompres jahe hangat dan II (n=15) diberi perlakuan kompres serai hangat. Analisis yang digunakan uji Mann Whitney U Test dan Wilcoxon Signed Ranks Test dengan ingkat kemaknaan α = 0,05.Hasil uji Wilcoxon Signed Rank Test, didapat keduanya mempunyai nilai kemaknaan yaitu ρ value = 0,000. Nilai ρ = 0,031 pada kelompok kompres serai hangat dan kelompok kompres jahe merah ρ value = 0,165. Hasil uji Mann Withney U Test pada Post perlakuan kedua terapi diperoleh selisih nilai nyeri pada kompres jahe ρ= 0,003 dan selisih nilai nyeri kompres serai ρ value = 0,001.Penggunaan kompres jahe merah lebih efektif dibandingkan dengan kompres serai terhadap penurunan intensitas nyeri arthritis remathoid. Kata Kunci: usia lanjut, Reumatoid Artritis (RA), jahe merah, serai, perbedaan efektifitas.    ABSTRACTReumatoid Artritis (RA) is a musculoskeletal which frequently occurs in the elderly. The disorders in the musculoskeletal system are noted by the occurrence of pain in the joints and stiffness which reduces the physiological abilities or life quality of the elderly. The disease causes many such complaints and  consequences of the disease rheumatoid arthritis may experience paralysis. The aims of this study is to analyze the effect of warm red ginger compress therapy and warm lemongrass compress therapy against of  Decreased pain intensity in  the elderly  with  artitris remauthoid. The study was Queasy experimental with two group pre – post test design. Subjects were some elderly people with Arthritis Remathoid in Sumberagung Village, Dander Sub District, Bojonegoro District. Subjects were divided into two groups: group I (n-15) with warm ginger compress therapy, and II (n=15) with warm lemongrass compress therapy. The analyses used in this study were the Mann Whitney U Test and Wilcoxon Signed Ranks Test with α of 0.05. Results of Wilcoxon Signed Rank Test obtained Both have meaning p value of  0.000. ρ value = 0,031 in a warm lemongrass compress therapy group and obtained of warm ginger compress therapy group ρ value = 0,165. The results of Mann Withney U Test on Post treatment second therapy, obtained difference of warm ginger compress therapy with ρ value= 0,003 and difference of warm lemongrass compress therapy with ρ value = 0,001.The use of warm ginger compresses therapy are more effective than a warm lemongrass compress therapy against decreased pain intensity in  the elderly  with  artitris remauthoid.  Keywords: elderly, artitris remauthoid, red ginger, lemongrass, differences in effectiveness


2010 ◽  
Vol 1 (1) ◽  
Author(s):  
Sri Sumaryani ◽  
Indri Nurasa

PENGARUH PEMBACAAN DZIKIR PADA IBU MELAHIRKAN TERHADAP TINGKAT NYERI INTRA NATAL DI RUMAH BERSALIN FAJAR YOGYAKARTAEffect of Reading Dhikr Women On The Level Of Birth Pain Intra Christmas At Home Delivery Dawn YogyakartaSri Sumaryani1 & Indri Nurasa21, 2)Program Studi Ilmu Keperawatan Fakultas Kedokteran Universitas Muhammadiyah YogyakartaJl. Lingkar Barat Taman Tirto Kasihan Bantul Yogyakarta 55182*)e-mail: [email protected] atau yang biasa disebut dengan proses persalinan merupakan suatu proses membuka dan menipisnya serviks, dan janin turun ke dalam jalan lahir. Gejala awal persalinan akan menimbulkan nyeri yang sangat hebat karena adanya kontraksi uterus dan otot abdomen. Nyeri intra natal adalah suatu nyeri yang dirasakan saat terjadinya proses persalinan (melahirkan). Saat nyeri persalinan muncul, ada baiknya bagi ibu untuk membaca dzikir. Dzikir adalah mengingat Allah SWT dan menghadirkan apa yang tadinya ada di dalam benak untuk kemudian dilafadzkan atau disebut-sebut yang dapat dilakukan secara lisan dengan menggunakan lidah atau bisa juga diucapkan tanpa adanya keterlibatan lidah, yaitu melalui hati. Penelitian ini bertujuan untuk mengetahui pengaruh pembacaan dzikir pada ibu melahirkan terhadap tingkat nyeri intra natal. Teknik pengambilan sampel menggunakan purposive sampling. Desain penelitian pra eksperimen, dengan rancangan pre test-post test tanpa kelompok kontrol. Sampel penelitian berjumlah 30 responden. Pengumpulan data dilakukan dengan observasi langsung kepada responden untuk mengukur tingkat nyeri. Analisa data menggunakan uji statistik wilcoxon signed rank test dan regresi linier dengan menggunakan SPSS 14. Hasil penelitian menunjukkan bahwa hasil uji statistik untuk nilai pre test dan post test tingkat nyeri diperoleh nilai signifikansi 0,02 dengan p < 0,05.Kata kunci: pembacaan dzikir, melahirkan, nyeri intra natal, tingkat nyeriABSTRACTThe delivery or usually called labor process is a process open and thin the cervix, and descent of the fetus into the way of birth. The early symptom of delivery will be appearing very heavy because there are uterus contraction and abdomen muscle. In partum pain is a pain which feel when delivery process happening (labor). When labor pain appears, there is a good for the mother to read dzikir. Dzikir is remembering Allah SWT and make present what before in the mind and then pronounced or make cal can do spoken by tongue or pronounced without there are involving tongue, by heart. The purpose of this research is to know about the influence of reading dzikir to the delivery mother toward in partum level of pain. Technique sampling used purpose sampling. The research of design pre experiment, with pre test-post test without control group design. The sample in this research’s total is 30 respondents. The manner of data was did by direct observation to the respondents to measure pain level. Data analysis used statistic test wilcoxon signed rank test and regression linier in SPSS 14. The results of research showed that results of the statistic pretest and posttest of pain level show significance value 0,02 with p < 0,05.Keywords: reading dzikir, delivery, in partum pain, pain level


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