Personal History Research Articles

Secondary Traumatic Stress in Mental Health Professionals

Mental health professionals working with traumatic stress may experience post-traumatic stress disorder symptoms, similar to their patients. For these professionals, secondary traumatic stress can be an important concept. It involves emotions, thoughts, and actions that emerge when a mental health worker becomes aware of a catastrophic event experienced by someone familiar, valued, and connected. In the literature, terms such as vicarious trauma, occupational burnout, and compassion fatigue are associated with secondary traumatic stress. Growing research presents that secondary traumatic stress is associated with personal trauma history, temperament, type of coping with stress, and levels of social support. The aim of this paper is to review and present the current situation of secondary traumatic stress and related concepts in mental health workers such as psychiatrists, psychologists, psychiatry nurses, social workers, and so forth. In Türkiye, where several traumatic experiences (such as earthquake) are currently common, studying secondary traumatic stress in mental health workers is also significant. Healthy coping strategies, a resilient personality, and the display of signs of post-traumatic growth can contribute to the psychological well-being of mental health professionals. In this investigation the concept of secondary traumatic stress in mental health professionals, associated factors with this concept, coping mechanisms of secondary traumatic stress are explained in the light of the literature. Based on the emerging research, some recommendations are stated.

Current situation and influencing factors of wheezing among children and adolescents aged 3-18 years in 11 cities in China from 2022 to 2023

Objective: To explore the incidence and influencing factors of wheezing among children and adolescents aged 3-18 years in 11 cities in China from 2022 to 2023. Methods: From October 2022 to August 2023, 11 cities including Xishuangbanna in Yunnan Province, Suqian in Jiangsu Province, Chifeng and Hohhot in Inner Mongolia, Tangshan in Hebei Province, Changzhi in Shanxi Province, Yinchuan in Ningxia Province, Lanzhou and Dingxi in Gansu Province, Linyi in Shandong Province, and Tonghua in Jilin Province were selected as research sites to recruit kindergarten children and primary and secondary school adolescents in local urban areas. A total of 21 959 children and adolescents were included in this study. Demographic information, wheezing data (whether wheezing has occurred in the past and whether wheezing attacks have occurred in the past one year), personal history, family history and other information were collected through questionnaires. The multivariate logistic regression model was used to analyze the influencing factors of wheezing attacks in the past one year. Results: The mean age of 21 959 children and adolescents was (12.09±3.65) years old, and 52.3% (11 480) were boys. The incidence of wheezing history was 3.7% (816 cases), and the incidence of wheezing attacks in the past year was 2.5% (556 cases). The multivariate logistic regression model analysis results showed that compared with older age, girls, full-term natural delivery, no allergic rhinitis, no family history of allergic diseases, no passive smoking, partial diet, natural conception and childbirth, the children aged 3-18 years with young age, male, partial diet, passive smoking, family history of allergic diseases, allergic rhinitis, cesarean section, premature birth, and assisted reproduction had a higher risk of wheezing [OR (95%CI): 0.86(0.84-0.88), 1.27(1.07-1.51), 2.31(1.95-2.75), 2.09(1.76-2.47), 3.5(2.80-4.37), 4.05(3.39-4.83), 1.20(1.02-1.43), 2.26(1.66-3.09), and 1.67(1.01-2.78)]. Conclusion: From 2022 to 2023, the incidence of wheezing among children aged 3-18 years in China is not significantly higher than before, and childhood wheezing may be related to factors such as children's age, gender, dietary habits, family and personal history of allergic diseases, passive smoking, and perinatal period.

Analysis of clinical characteristics and risk factors of chest tightness variant asthma in children

Objective: To analyze the clinical features and risk factors of chest tightness variant asthma (CTVA) in children, so as to provide basis for the prevention and management of the disease. Methods: A cross-sectional study was conducted to analyze 178 children aged 6-17 years old who were admitted to the Department of Allergy, Capital Institute of Pediatrics Affiliated Children's Hospital from January 2021 to January 2023 due to chest tightness. The age was 8.83(7.50, 11.58) years old, with 89 males (50%) and 89 females (50%). According to the diagnosis of CTVA, 130 cases were divided into CTVA group and 48 non-CTVA cases were divided into control group. Demographic data, personal history, family history, clinical features, auxiliary examination results and other data were collected. The clinical characteristics, allergens, FeNO level and pulmonary function parameters of the two groups were analyzed. Logistic regression analysis was used to explore the risk factors of the disease. Results: The proportion of school-age children (6-11 years old) in CTVA group was higher than that of adolescent children (≥12 years old) [(113/130,86.9%) vs (26/48,54.2%),Z=21.985,P<0.01]. The proportion of CTVA combined with eczema [(74/130,56.9%) vs (19/48,39.6%), χ2=4.225,P<0.05] and rhinitis symptoms [(98/130,75.4%) vs (27/48,56.2%), χ2=6.138,P<0.05] was higher. The positive rates of mold sensitization [(52/130,40.0%) vs (11/48,22.9%), χ2=4.474,P<0.05] and multiple sensitization [(71/130,54.6%) vs (18/48,37.5%), χ2=4.108,P<0.05] in inhaled allergens were significantly higher than those of control group. The proportion of elevated FeNO (>20 ppb) in CTVA children was 20.8% (27/130), which was significantly higher than that in control group 4.2%(2/48)(χ2=7.086,P<0.01). There were no statistical differences in spirometry parameters FEV1 and FVC between CTVA group and control group (P both>0.05). FEV1/FVC, PEF, FEF25, FEF50, FEF75 and MMEF were significantly lower than those in control group (P all<0.05). Logistic regression analysis showed that rhinitis symptoms (OR=2.351, 95%CI 1.105-5.002, P=0.026), multiple sensitizations (OR=2.184, 95%CI 1.046-4.557, P=0.038), tIgE>60 kU/L(OR=3.080, 95%CI 1.239-7.654, P=0.015), FeNO>20 ppb (OR=6.734, 95%CI 1.473-30.796, P=0.014) and small airway dysfunction (OR=3.164, 95%CI 1.089-9.194, P=0.034) were risk factors for chest tightness variant asthma. FeNO combined with FEF50 has the largest area under the curve (Z=2.744, P<0.01) in diagnosing CTVA. Conclusion: CTVA is more common in school-age children than in adolescent children. Rhinitis symptoms, multiple sensitization, tIgE>60 kU/L, FeNO>20 ppb and small airway dysfunction are risk factors for chest tightness variant asthma. FeNO combined with small airway indexes can improve the diagnostic value of CTVA.

Doing reflexivity in educational research: identifying perspectives to inform positionality

ABSTRACT This paper presents an innovative approach to examine reflexivity in educational research. Adapting Brookfield’s autobiographical lenses to identify the four perspectives from a personal life history (as the mother of a child with multiple chronic illnesses who died aged 18) and professional perspectives (as a paediatric nurse, a teacher, and a researcher) provided a clear structure to identify and articulate reflexivity. The paper draws on my doctoral thesis, a case history which explored how practitioners in early childhood education and care settings created inclusive environments for young children with chronic health conditions. The participants included parents of children with chronic health conditions, thus presenting ethical dilemmas regarding reflexivity. The paper includes vignettes from my thesis which include deeply personal accounts to illustrate how the four perspectives influenced my research. This scholarly engagement set the foundations for my subsequent academic career and for my personal development. The paper concludes with the assertion that engaging with reflexivity is not only a vital ingredient of educational research but also has implications for improving practice, as well as being a tool for personal development.

Development of a risk prediction score for screening for HBV, HCV and HIV among migrants in France: results from a multicentre observational study (STRADA study)

ObjectivesMigrants from high HIV, hepatitis B virus (HBV) or hepatitis C virus (HCV) endemicity regions have a great burden of these infections and related diseases in the host countries. This...

POT1 tumour predisposition: a broader spectrum of associated malignancies and proposal for additional screening program

Protection of Telomeres Protein 1 (POT1) protein is an essential subunit of the shelterin telomere binding complex, regulating telomere length. Some POT1 gene pathogenic variants (PV) lead to telomere elongation, genomic instability and higher risk of cancer. POT1 tumour predisposition syndrome (POT1-TPD) has autosomal dominant inheritance and unknown penetrance. It is associated with increased risk of cutaneous melanoma, chronic lymphocytic leukaemia, angiosarcoma and gliomas. In this work, we aim to describe a broader cancer phenotype related to POT1-TPD, in three families (two with a four generation pedigree, one with a five generation pedigree). The three index cases were referred to our oncogenetic centre for genetic counselling due to their personal history of cancer. Two underwent clinical exome sequencing of 4,867 genes associated with Mendelian genetic diseases, and another underwent gene panel sequencing including POT1, which identified three different POT1 PV: NC_000007.14(NM_015450.2):c.349C>T; NC_000007.14(NM_015450.2):c.233T>C and NC_000007.14(NM_015450.2):c.818G>A; already described in the literature. Referenced relatives, did a target genetic test (according to the POT1 PV identified in the family). In total, 37 individuals were tested (51.4% females), median age of 46 (22–81) years, with POT1 PV detected in 22. POT1-TPD was observed, but also a higher incidence of other cancers (other sarcomas, papillary thyroid cancer, early onset prostate cancer and leukaemia). These findings contribute to an increase in our knowledge about POT1 PV, and it can play a role in the definition of future POT1 PV screening criteria, POT1 carrier surveillance protocols (possibly considering screening for all types of sarcomas) and in genetic counselling.

Alcohol: a cardiovascular friend or foe?

This review comprehensively explores the multifaceted implications of alcohol consumption on health. While acknowledging the potential cardiovascular benefits of moderate alcohol intake, concerns arise with excessive use, especially related to some specific cancer types. The detailed evidence emphasizes the importance for healthcare professionals to convey a balanced message, advocating moderation for cardiovascular benefits while acknowledging potential cancer risks linked to excessive consumption. Regarding moderate consumption, the overall balance favors intake, supported by studies like the Global Burden of Disease Study 2020. The intricate risk-benefit ratio of alcohol use demands tailored explanations based on individual characteristics and habits, considering overall risk profiles for cardiovascular diseases, alcohol-related cancers (for example, breast cancer has been associated with moderate alcohol consumption, although the evidence is not conclusive), and other health issues. Factors such as age, pregnancy, cognitive tasks, and personal history influencing the likelihood of alcohol abuse should inform personalized advice on moderate alcohol consumption. Collaborative efforts among stakeholders, including government agencies and healthcare organizations are crucial for providing up-to-date, comprehensive information. Clinical guidelines stress the complexities of the alcohol-heart healthy relationship, advocating moderation and individualized advice. Within personalized advice, the significance of moderate alcohol consumption, particularly in the form of wine within a Mediterranean diet, is highlighted. Wine is seen as a fundamental component of a wholesome diet, aligning with healthy dietary patterns, rather than a medicinal remedy. Acknowledging wine's integration into sound nutrition contributes to heart-healthy lifestyles, in line with Mediterranean dietary traditions. Healthcare professionals play a pivotal role in guiding patients on alcohol intake, considering specific health status and risk factors. Public health campaigns focus on educating individuals to make informed choices about alcohol consumption in the broader context of cardiovascular health. In conclusion, achieving cardiovascular health without undue risks necessitates a balanced and personalized approach to alcohol consumption, guided by healthcare professionals and public health recommendations.

Comparison of Clinical Characteristics in Patients with Febrile Seizures Based on Prior COVID-19 Infection

Purpose: Febrile seizures (FSs) are neurological events associated with fever, typically occurring in children between 6 months and 5 years of age in the absence of central nervous system infection. Growing evidence suggests that coronavirus disease 2019 (COVID-19) can cause immune system dysregulation. This study compared the clinical characteristics of patients with FS based on whether they had experienced prior COVID-19 infection.Methods: A retrospective analysis was conducted of the medical records of 114 patients with FS who visited Inje University Sanggye Paik Hospital between January 2019 and December 2022. Results: The study cohort included 70 (61.4%) boys and 44 (38.6%) girls, with a mean age of 22.99±11.68 months at seizure onset. Among the 114 patients with FS, 19 had a history of COVID-19, while 95 did not. These groups differed significantly in the interval between the onset of fever and seizure. Specifically, when using a 12-hour threshold for analysis, a significantly greater proportion of patients with a history of COVID-19 exhibited intervals exceeding 12 hours compared to those without such a history. No significant differences were noted regarding sex, age, seizure frequency, personal history of FS, or family history of FS or epilepsy between the groups.Conclusion: Pediatric patients with FS and prior COVID-19 infection exhibited longer intervals between the onset of fever and seizure compared to those without previous COVID-19 infection. This finding suggests that COVID-19 may influence the mechanisms underlying FS. To better understand this relationship, long-term follow-up studies with larger cohorts are warranted.

The Use of Expanded Carrier Screening in Reproductive Medicine: Scientific Impact Paper No. 74.

Expanded carrier screening (ECS) is a genetic screening test carried out by analysing a blood sample. This screen can be used to detect whether the individual unknowingly carries gene variants associated with common genetic conditions, such as cystic fibrosis, that may be passed on to their children. It is typically performed in reproductive medicine for those who are considering having a family either naturally or via fertility treatment. Many donor sperm and egg banks, particularly in the USA and Europe, also perform blanket ECS testing on all their prospective sperm and egg donors. ECS is not currently routine practice in the UK, but a growing number of patients are requesting it before treatment. All of us carry gene variants of some sort that may cause autosomal recessive disease in their children if their partner or donor also carry a variant in the same gene. An autosomal recessive disease means two copies of an abnormal gene must be present in order for the disease or trait (such as cystic fibrosis or sickle cell disease) to develop. One copy of the variant means the person is a carrier but does not have the condition. Two copies, i.e. from the mother and father, means the child has a 25% chance of having the genetic disease. Carrying a gene variant does not mean that the individual would necessarily have any symptoms of the disease or any features of the condition. Genetic tests for specific conditions are currently available either before or during pregnancy for prospective parents who have a family or personal history of a genetic condition, or for those from ethnic backgrounds where certain conditions - such as haemoglobinopathies (blood disorders) - are common, prompting referral to a clinical genetics department. Expanded carrier screens may test for more than 100 genetic conditions. The list of conditions screened for is called a panel. Common panels are 250 or 600 genes. Not all expanded carrier screens that are available analyse the same genes. Some may test for genes that do not cause serious disease, or cause diseases that occur in later life; others test for genes that cause severe conditions in childhood. There is no agreement as to which panel of genes should be tested for in an ECS. Understanding the screening that is being offered, and the meaning of any results, is complicated and requires support from appropriately trained professionals to best inform the prospective parent or parents.

PENERAPAN METODE ICONIX PROCESS DALAM PENGEMBANGAN SISTEM INFORMASI KEPEGAWAIAN UNIVERSITAS CATUR INSAN CENDEKIA

Accurate and precise information plays a crucial role in producing high-quality Human Resources (HR) or employees at Universitas Catur Insan Cendekia. Higher education institutions have various needs in managing HR data, including personal information, educational history, rank classification, and other important employee details. The Iconix Process methodology is employed in the development of the Human Resource System at Universitas Catur Insan Cendekia, starting with requirements analysis, diagram creation, initial design, detailed design, coding, testing, and implementation. The result is a more structured, easily accessible, and efficient management of HR data through a website. Keywords: Iconix Process, Development, Information Systems, Personnel

Medical Maximizing Preferences and Beliefs About Cancer Among US Adults

Medical overutilization contributes to significant health care expenditures and exposes patients to questionably beneficial surgery and unnecessary risk. To understand public attitudes toward medical utilization and the association of these attitudes with beliefs about cancer. In this cross-sectional survey study conducted from August 26 to October 28, 2020, US-based, English-speaking adults were recruited from the general public using Prolific Academic, a research participant platform. Quota-filling was used to obtain a sample demographically representative of the US population. Adults with a personal history of cancer other than nonmelanoma skin cancer were excluded. Statistical analysis was completed in July 2022. Medical utilization preferences were characterized with the validated, single-item Maximizer-Minimizer Elicitation Question. Participants preferring to take action in medically ambiguous situations (hereafter referred to as "maximizers") were compared with those who leaned toward waiting and seeing (hereafter referred to as "nonmaximizers"). Beliefs and emotions about cancer incidence, survivability, and preventability were assessed using validated measures. Logistic regression modeled factors associated with preferring to maximize medical utilization. Of 1131 participants (mean [SD] age, 45 [16] years; 568 women [50.2%]), 287 (25.4%) were classified as maximizers, and 844 (74.6%) were classified as nonmaximizers. Logistic regression revealed that self-reporting very good or excellent health status (compared with good, fair, or poor; odds ratio [OR], 2.01 [95% CI, 1.52-2.65]), Black race (compared with White race; OR, 1.88 [95% CI, 1.22-2.89]), high levels of cancer worry (compared with low levels; OR, 1.62 [95% CI, 1.09-2.42]), and overestimating cancer incidence (compared with accurate estimation or underestimating; OR, 1.58 [95% CI, 1.09-2.28]) were significantly associated with maximizing preferences. Those who believed that they personally had a higher-than-average risk of developing cancer were more likely to be maximizers (23.6% [59 of 250] vs 17.4% [131 of 751]; P = .03); this factor was not significant in regression analyses. In this survey study of US adults, those with medical maximizing tendencies more often overestimated the incidence of cancer and had higher levels of cancer-related worry. Targeted and personalized education about cancer and its risk factors may help reduce overutilization of oncologic care.

Large cohort analysis of incidental CDH1 PVs among patients undergoing MGPT.

10618 Background: Hereditary diffuse gastric cancer (HDGC) is an autosomal dominant condition caused by a heterozygous pathogenic variant (PV) in CDH1.HDGC is associated with an increased risk for DGC (33-70%) and invasive lobular breast cancer (LBC) (~64%) [1]. The National Cancer Center Network (NCCN) and International Gastric Cancer Linkage Consortium (IGCLC) recommend consideration of CDH1 germline testing based on personal and family history of DGC and LBC. However, with the advent of next generation sequencing and the inclusion of CDH1 in multigene panels (MGP), several cohort studies have identified CDH1+ patients who do not meet criteria [2,3,4,5]. Our group previously analyzed a cohort of patients with a personal or family history of BC who had CDH1 testing through MGPT and did not observe a significant association between CDH1 PVs and suspicion for HDGC (p-value=0.2066) [6]. In this expanded study, we aim to evaluate a larger cohort of patients of all cancer histories to gain a more comprehensive picture of the prevalence of incidental CDH1 PV among patients undergoing MGPT. Methods: 14,891 individuals who underwent CDH1 testing within MGPT were seen at MD Anderson’s Clinical Cancer Genetics (CCG) program between August 2013 and January 2024. This cohort was obtained from a prospectively maintained patient database within MD Anderson’s CCG program. Individuals were stratified based on CDH1 germline status (PV vs. negative or variant of uncertain significance) and meeting modified criteria for HDGC. Results: Within our expanded cohort, 1,716 individuals (11.5%) met criteria for suspicion for HDGC, while 13,715 did not meet criteria. Of the 70 individuals who tested positive for CDH1 (0.47%), 39 (0.28%) met criteria while 31 (0.23%) did not. We observed a statistically significant relationship between meeting our modified criteria for suspicion for HDGC and testing positive for a pathogenic variant in CDH1 (p-value &lt;0.0001). Conclusions: Among patients who underwent CDH1 testing within MGPT, we observed a correlationbetween having a CDH1PV and meeting criteria for suspicion for HDGC. This contrasts with prior findings from our breast cancer cohort, potentially due to the limited number of CDH1 positive patients (n=3). These results suggest that while perhaps not robustly capturing HDGC families within a sub-population of patients undergoing MGPT, overall, NCCN and IGCLC guidelines closely reflect the clinical picture of a significant number of HDGC families. Meanwhile, the presence of incidental CDH1 PVs in this cohort portrays the variable expressivity and incomplete penetrance among patients with HDGC, including the detection of occult signet ring cell carcinomas during endoscopies or total gastrectomies [7]. We seek to expand this analysis by comparing these findings to rates of incidental CDH1 PVs in a subset of patients who meet NCCN guidelines for CDH1 testing based on suspicion for hereditary breast cancer syndromes.

The Epidemiological, Clinical, and Therapeutic Profile of Bipolar Patients in Eastern Morocco.

Bipolar disorder is a severe psychiatric disorder. The objective of our study is to describe the epidemiological, clinical, and therapeutic profile of patients followed for bipolar disorder in this hospital. This is a cross-sectional, descriptive study conducted over a period of two yearswithin the mental health and psychiatric diseases department of the Mohammed VI University Hospital in Oujda,Morocco, including 206 patients followed for bipolar disorder on an outpatient basis or hospitalized in one of the departments of the hospital. We included in our study 206 patients with an average age of 37.34+/-12.53 and a male predominance. About 17% of our patients reported a personal medical history and 18.4%, a personal surgical history. Regarding the family history, 40.3% have a medical and surgical history and 63.1%, a psychiatric family history. The consumption of psychoactive substances is present in 49.5% of our patients. About 26.7%reported psychological trauma during childhood. Our patients have reported a history of suicide attempts with a prevalence of 26.6% in several settings: depressive (15%), delusional (5.8%), hallucinatory (3.9%), and anxious (1.9%). Several means were used during these suicide attempts, in particular, defenestration (40%), drug ingestion (36.4%), caustic ingestion (16.4%), strangulation (16.4%), and hanging (10.9%). It is important to develop a personalized approach to the patient wherever possible and, if necessary, to involve other specialists in diagnosis and treatment.

Pathogenic germline variant discovery in plasma cell disorders: Insights from genetic counseling referrals and testing.

10619 Background: Our research has shown that 10% of multiple myeloma (MM) patients harbor pathogenic or likely-pathogenic germline variants (PGVs) in cancer predisposition genes, with a significant enrichment observed in BRCA1/2 genes. PGVs are notably more common in younger MM patients and those with a personal or familial cancer history. This study presents our experience in referring plasma cell disorder (PCD) patients at increased risk for carrying PGVs, due to either clinical history or suspicious tumor NGS findings, for genetic counseling and subsequent germline testing. Methods: This retrospective study reviewed patient records from our institution's PCD clinic, focusing on those referred for a genetic evaluation between 2020 and 2024 due to suspected cancer predisposition. We compiled demographic and clinical data for these patients, reasons for referral, and cancer history of patients and their families. The uptake of germline testing, identified mutations, and subsequent recommendations for advanced cancer surveillance and prevention, including cascade testing, were also analyzed. Germline testing utilized targeted hereditary cancer panels from five companies and was conducted on DNA samples extracted from peripheral blood, saliva/buccal swabs, or skin biopsies. Results: 52 PCD patients underwent a genetic evaluation and were included in this review, comprising 31 MM, 9 smoldering MM, and 12 MGUS cases. Median age at the time of referral was 63, and 54% of patients were female. Racial composition was 62% White, 15% Black/African-American, 12% Hispanic, 2% Asian, with 10% undisclosed. 8 patients were referred due to suspicious findings in tumor NGS, while the rest were referred due to clinical suspicion. A personal history of cancer was reported by 19 patients (37%), and 49 had a first- or second-degree relative with cancer (94%). 38 patients (73%) underwent germline testing, of which 15 (39%) harbored PGVs (11 had MM, 4 had smoldering MM). 8 PGV carriers had well-established founder variants. The remaining 7 had PGVs in genes including BRCA2 (n=3), PALB2 (n=1), BLM (n=1), SMAD4 (n=1) and NTHL1 (n=1). Of note, all 8 referred for suspicious findings in tumor NGS were confirmed to harbor PGVs. All PGV-positive patients were recommended for cascade testing and enhanced cancer screening. Conclusions: Our findings indicate a 39% PGV detection rate in PCD patients referred for genetic evaluation, underscoring the potential benefit of implementing screening guidelines in this population. PGV detection led to recommendations for intensified surveillance and cascade testing in all cases, impacting both patients and their families. The discovery of BRCA2PGVs in 20% (3/15) of cases reinforces its potential role as a predisposition gene in MM, corroborating our prior findings.

La situation projective du modelage comme instrument clinique dans une recherche sur un dispositif de médiation sensorielle

ObjectivesThis article examines the use of clay modeling as an instrument for clinical analysis of the relation to one's own body and to the object. While modeling is a widely-used medium in therapeutic work, we present here the use of the modeled self-portrait as a projective method in a research situation involving sensorial mediation using touch. The aim is to understand how the subject invests and engages a relation with this object, based on the way s/he invests and represents her/his body and sensations. MethodThe modeling situation was proposed individually to 19 participants at the first of six meetings. The choice of the modeled self-portrait in this research project is inspired by a psychoanalytical epistemology that enables us to understand the unconscious psychic dimensions of body image and the relation to the object, as well as the concepts of mediation, the projective situation, and transference. In the absence of a pre-existing reference to a systematized methodology for analyzing the self-portrait with modeling clay, we referred to psychoanalytic work on projective tests to construct a qualitative analysis grid based on the material collected. ResultsThe modeled self-portrait enabled us to take into consideration, from an economic, dynamic, and topical point of view, on the one hand, the content that emerged in the modeling and in the verbalizations that accompanied it, and, on the other hand, the characteristics of the modeling process itself. The modeling situation gave rise to regressive and projective movements, leading the participants to express key elements of their personal history, their sensory situation, and the areas of the body invested or disinvested, as well as their psychic behaviors in relation to the object in the present of this research encounter. We identified four ways in which participants related to modeling, depending on their subjectivity and their position in the research process. The form given to the modeling, its structure, and the parts represented or not provided us with indications of certain features of the participants’ body image and the way in which they were able to express it in the space-time of this encounter. We hypothesize that through its connections with the subject's body image, the three-dimensional self-portrait expresses the way in which participants invest their bodies, and sometimes body zones linked to the senses, such as touch, through the modeling activity itself, but also other senses through the elements represented or not, verbalized or not, about the created-modeled object. DiscussionWe present some considerations on the complex connections between the relationship to modeling, to the object of sensory mediation through touch, and to autobiographical speech in the interview situation, considering the participants’ verbal and non-verbal productions during the process of this research. Finally, we present the limits of the collection and analysis of results in the context of this research and the present article. ConclusionThe use of the modeled self-portrait has brought out elements that enable us to better understand the psychological underpinnings of the different relations to the mediating object that the participants expressed in this research. Insofar as self-portrait calls upon unconscious elements of both body image and relation to the object, it encounters resistance and defensive modalities in the subject's own psychic functioning.

Breast cancer awareness in reproductive women in the low- and middle-income countries: a scoping review

Abstract Objective This study aimed to assess breast cancer (BC) awareness among reproductive women in low- and middle-income countries (LMICs), identify influencing factors, and propose feasible interventions or programs. Methods We followed a 5-step process using a modified version of Arksey and O’Malley framework methodology. A comprehensive search was conducted on the Embase, PubMed, and CINAHL electronic databases for literature published within 10 years (from 2012 to 2022). Results Thirty-three papers published between 2012 and 2020, spanning 18 countries, were included. Of these, 45.6% described a good level of knowledge, while 24.2% reported that women at reproductive ages had good awareness. Twelve influencing factors were identified in 3 categories: socio-demographic (family history, personal history, marital status, age, religion, income status, living place, and occupation), personal (self-efficacy, education, and perceived level), and external (advertisements promoting awareness). Educational programs were recommended in most (&gt;72%) of the included studies. Conclusions While most studies reported high levels of knowledge and awareness, some found low prevalence among certain groups. Factors affecting knowledge and awareness were classified into socio-demographic, personal, and external categories, with socio-demographic factors such as age, education, income, and marital status being the most frequently cited. The studies recommended implementing educational programs, health prevention strategies, and social interventions to increase BC knowledge and awareness

Hematologic malignancies in Li-Fraumeni syndrome.

10613 Background: Li-Fraumeni Syndrome (LFS) is a hereditary cancer predisposition syndrome caused by mutations in the tumor suppressor gene TP53. Since its discovery, a growing list of cancers have been described in association with LFS, predominantly solid tumors. However, hematologic malignancies (HMs) cumulatively account for 4-10% of cancer diagnoses in LFS. In this study, we present the largest series of HMs in families with LFS with detailed clinical courses. Methods: This was a two-center retrospective observational cohort study conducted at the University of Utah and the University of Wisconsin-Madison with IRB approval. Cancer genetics clinic registries were reviewed to identify all families with LFS who also had a confirmed diagnosis of a HM. To meet criteria for LFS, the patient had to have a confirmed germline pathologic or likely pathologic TP53 variant. Patients with a TP53 variant of unknown significance (VUS) were also included if they met classical LFS testing criteria. Data was gathered by manual chart review of both the families’ histories and electronic health records. Results: Among the 121 families identified with LFS, 35 (29%) families had one or more HM. Of these, 17 individuals from 16 families (13%) had confirmed germline TP53 mutations. The most frequent HMs found were acute lymphoblastic leukemia (ALL) (n=6), non-Hodgkin lymphoma (NHL) (n=5), myelodysplastic syndromes (MDS) (n=3), and chronic lymphocytic leukemia (CLL) (n=2). Acute myeloid leukemia (AML), Langerhans cell histiocytosis (LCH), and chronic myeloid leukemia (CML) were each diagnosed once. Most cases were identified in adulthood (n=12, 71%). Of the 19 total HMs, the minority (n=5, 26%) were diagnosed post-cytotoxic therapy and only six (35%) individuals had received a diagnosis of LFS prior to HM diagnosis. The MDS/AML cohort (n=4) all exhibited bi-allelic inactivation of TP53. Two of these four patients achieved long term survival after matched-unrelated donor (MUD) hematopoietic stem cell transplant (HSCT). All three patients who underwent MUD donor HSCT had immune-mediated adverse events. Conclusions: In this study we found a significantly higher incidence of HMs in LFS than previously described, with a predominance of lymphoid over myeloid malignancies. The majority of patients had excellent outcomes after standard of care therapy pointing towards more favorable outcomes for patients with LFS and HMs than previously reported. We also report several unusual immune-mediated adverse events in our patients indicating possible immunogenicity of some TP53 variants. Most patients did not have prior exposure to cytotoxic treatments and were diagnosed with the HM prior to their LFS diagnosis. We also show that 38% of individuals with an HM have multiple family members with an HM, consistent with a familial HM pattern. This underscores the importance of detailed family and personal histories in HM patients found to carry a somatic TP53 variant.

Autobiographical motifs in the "silent books" of contemporary Chinese artists (using the example of Sean Tan and Guojin)

The object of the study is “silent books” – books without text; the plot and author’s position are revealed exclusively through a sequential series of illustrations. The subject of the study is the graphic novels of young but already internationally recognized authors – Sean Tan and Guojin. "Silent books" are a relatively new direction in children's book illustration. The prototype of “silent books” – comics – was distinguished by rather primitive graphics, so although they were popular, but they were considered a “low genre” in the professional community. Then the comic went beyond kitsch culture and became an element of middle-class culture, and at the end of the century the comic was reinterpreted in pop art and included in the formation of neo-elite culture. The individuality of the authors is manifested in the choice of a plot related to personal and family history, as well as in the choice of a character of a certain psychological make-up – “silent heroes”, endowed with a rich imagination, the ability to empathize and equal friendly relationships. The technique in the “silent books” of Sean Tan and Guojin has the syncretism and dualism of Western and Chinese traditions. It can be interpreted both in terms of Chinese writing with “dry” ink, and in the European style of “chiaroscuro”; in all cases we had clearly defined contour and a sharp contrast of light and shadow. The author's self-expression in a graphic novel is very specific to book illustration. “The Quiet Book” can be considered as a special type of author’s utterance, similar to improperly direct speech in literature. All this distinguishes the graphic novels under consideration from other forms of children's book illustration, as an example of new paths in art, as well as an original and modern interpretation of social problems of society.

Evaluation of a polygenic risk score as a predictor of early onset triple-negative breast cancer in Black women.

10501 Background: Black women in the U.S. often develop early, biologically aggressive breast cancer (BC). Triple-negative breast cancer (TNBC) is a particularly aggressive type that occurs more frequently in Black than white women and often develops before recommended regular screening. More accurate risk prediction methods are urgently needed to identify young Black women with elevated risk of TNBC. Incorporating polygenic risk scores (PRS) into clinical models can substantially improve risk assessment, but most PRS have demonstrated poor performance among non-European ancestries. We previously described a multiple-ancestry PRS (MA-PRS), based on 56 ancestry-informative and 329 BC-associated single-nucleotide polymorphisms (SNPs), that predicts overall BC risk for diverse populations by characterizing genetic ancestry at each BC SNP and applying ancestry-specific SNP risks and frequencies. Here, we evaluated the extent to which MA-PRS improves upon clinical factors for the prediction of TNBC and early onset ( &lt; 50 years) TNBC in a large, independent cohort of self-reported Black women. Methods: We examined clinical and genetic records from self-reported Black women referred for hereditary cancer testing from 8/22 - 9/23 and negative for pathogenic variants in BC-associated genes. The association of MA-PRS with TNBC was analyzed using multivariable logistic regression adjusted for personal and family cancer history, age and genetic ancestry. Analyses were conducted within the full cohort and the subpopulation of patients &lt; 50 years old. Odds ratios (OR) are reported per standard deviation (SD) with 95% confidence intervals (CI). Results: We identified 14728 Black women who met study eligibility criteria. Nearly 70% (9895/14728) of patients were under the age of 50. In the full cohort, 629 (4.3%) patients were diagnosed with TNBC, and 173 (1.7%) were younger than 50 years old. MA-PRS significantly improved TNBC risk prediction over clinical factors in the full cohort and in the subpopulation of women under 50 (Table). The effect of MA-PRS on risk stratification was comparable to the 1.4 OR per SD reported in current literature for mammographic density, which is widely recognized as an important risk factor. Women in the top 5% of the MA-PRS distribution were at roughly 2-fold increased risk of TNBC (Table). Conclusions: MA-PRS substantially improved upon clinical factors for the prediction of TNBC and early-onset TNBC in a large cohort of Black women. MA-PRS appears to be equally as important for managing risk of early-onset TNBC as mammographic density for overall BC. Incorporation of MA-PRS into BC risk assessment has the potential to improve TNBC survival through more accurate identification of women at high risk. [Table: see text]

Public awareness of the association between the risk of breast cancer (BC) development and alcohol consumption (AC) among women aged 18–75 years.

e22547 Background: Worldwide, 4·4% of all new cases of female BC are attributable to alcohol use. Alcohol is recognized as a group 1 carcinogen, as classified by the International Agency for Research on Cancer. However, public awareness of the association remains low. We aim to look at the awareness of the association between AC and the risk of BC development among female employees of a community hospital in the United States. Methods: We sent an 8-item survey to 100 randomly selected adult females working in a community hospital via an online link. The survey was voluntary, with no incentives. We captured the following measures: age, alcohol use, awareness of AC as a BC risk factor, education level, screening for BC, and personal or family history(FH) of BC. Analyses examined correlates of associations between awareness and conceptual predictors. Results: Sixty females (60% response rate) responded to the survey. The age groups were: 28%(17): 18-39 years, 25%(15): 40-49 years, and 47%(28): 50-75 years. 22%(13) had a graduate(Gr), 56%(34) had an undergraduate(UG), and 22% (13) had a high school level of education. 33% (20/60) consumed alcohol. 61% (37/60) did not consider AC as a risk factor(RF) for BC development. 54% with Gr, 62% with UG, and 71% with a high school level of education did not consider AC to be a RF for BC. 41% among 18-39, 67% among 40-49, and 72% among 50-75 year-olds did not consider AC an RF for BC. 92% (55/60) never received education about the association of BC with alcohol intake. 23% with Gr, 5% with UG, and 0% with high school received education about the association of Alcohol and BC. 86% of 40-49 years and 75% of 50-75 years had undergone screening mammograms in the last three years. Mammogram rates were 75% in women with positive FH, compared to 45% without positive FH. Conclusions: The results revealed a low level of awareness of the risk of alcohol use with BC, with just 40% of females considering it as a risk factor. Younger age and higher academic levels were the variables that had the strongest association with better awareness. A further lower level of education was reported, with more than 90% never having received education about the association. We must orchestrate awareness of this association with attention to individuals with lower educational levels.