Skin Staining After Injection of Superparamagnetic Iron Oxide for Sentinel Lymph Node Dissection: A Retrospective Study of Two Protocols for Injection and Long-Term Follow-Up.

OBJECTIVE: Sentinel lymph node (SLN) dissection is a highly accurate surgical procedure allowing detection of lymph node invasion in patients with clinically negative axilla in early breast cancer. Superparamagnetic iron oxide (SPIO) is a marker used during SLN procedure, allowing the same detection rate as isotopes (Tc-99). A drawback of SPIO is skin staining that can occur around the injection site. The goal of this retrospective study was to assess the frequency of skin staining after oncological breast surgery with SPIO, and the impact of two different injection protocols on the rate of skin staining. MATERIALS AND METHODS: Data from breast cancer patients undergoing magnetic tracer SLN detection (SLND) procedure in a single department between 2020 and 2022 was reviewed. Injection protocol P1 consisted of retro-areolar injection of Magtrace 0.8 mL. Injection protocol P2, consisted of retro-tumoral injection with 1 mL. Presence of skin staining was assessed at day 10 after surgery. The evolution and satisfaction of the patients was assessed at six and 12 months. RESULTS: In total 175 sentinel lymph node biopsy procedures were performed (P1: 141/P2: 34), consisting of breast conservative surgery (BCS) (P1: 70%/P2: 53%) or mastectomy (P1: 30%/P2: 47%) with SLN. SLN detection rate was 97.7%. Skin staining was reported in 23% and occurred more often after BCS (31.6%) compared to mastectomy (6.8%). When BCS was performed, peritumoral injection was associated with a decreased risk of skin staining compared with retro-areolar injection (22.2% vs. 33.3%, respectively). When present skin staining persisted for 12 months, but most of the patients described only a slight discomfort. The low rate of discoloration after mastectomy, as previously reported, can be explained by the removal of skin and glandular tissue in which the tracer accumulates. Less skin staining in P2 may be because of a shorter interval between injection and surgery and the removal of the excess of SPIO during the lumpectomy. CONCLUSION: SPIO injection is a safe surgical technique. After mastectomy, the rate of discoloration was low. Despite the persistent skin discoloration in 58.6% in our study, patient satisfaction was high. Deeper injection, reduced doses, massage of the injection site and peritumoral injection may reduce skin staining.

The effectiveness of interventions on improving body image for pregnant and postpartum women: a systematic review of randomized clinical trials.

BACKGROUND: Body image dissatisfaction, leading to a variety of negative emotions and adverse pregnancy or birth outcomes. Studies on body image interventions for pregnant and postpartum women have been reported, yielding mixed results. Existing evidence lacks a comprehensive review of the effectiveness of body image interventions for pregnant and postpartum women. OBJECTIVE: The aim of this study was to systematically review interventions which aimed at improving body image during pregnancy and postpartum in women of childbearing age, and further to explore their effectiveness. METHODS: A comprehensive literature search was conducted using electronic databases, including PubMed, Embase, Web of Science, Cochrane Library, CINAHL, SinoMed, CNKI, and Wanfang Database, to retrieve relevant studies. Body image was reported employing descriptive analysis, whereas the Cochrane Handbook tool was used to evaluate the quality and potential bias of each included study. RESULTS: Following established inclusion and exclusion criteria, 11 studies were identified from an initial 1,422 records for further analysis, involving 1290 participants. This systematic review grouped body image interventions into lifestyle interventions and psychological interventions based on their content. These interventions yielded more pronounced positive effects on improving body image in pregnant and postpartum women when compared to control groups. And, the statistical difference on psychological interventions is more significant on the whole. CONCLUSIONS: Our work offers a comprehensive overview of the effectiveness of body image interventions for pregnant and postpartum women. Psychological interventions are considered to be a suitable measure to improve body image for pregnant or postpartum women. Additional research and practical applications are recommended to enhance the mental health and well-being of perinatal women. TRIAL REGISTRATION: PROSPERO registry: CRD42024531531.

An Overview of Body Size Preference, Perception and Dissatisfaction in Sub-Saharan Africans Living in the United States.

Purpose: Body image affects health practices. With acculturation superimposed on globalization, 21st century body size preferences of African immigrants, one of the fasting growing populations in the United States, are unknown. Therefore, in African immigrants living in America we assessed: 1) body size preference; and 2) body size dissatisfaction. Methods: Participants chose two silhouettes from the Stunkard Figure Rating Scale: one for body size preference and one for perceived body size. Each silhouette corresponds to a BMI category: (a) Underweight: 1 and 2; (b) Normal weight: 3 and 4; (c) Overweight: 5, 6 and 7; (d) Obesity: 8 and 9. Dissatisfaction was defined as the difference between silhouette numbers for perceived and preferred body size. Results: Characteristics of the 412 participants were: women: 42% (174/412), age 40±11y (mean±SD), range 20-69 y, BMI 27.9±4.6, range 19.5-47.3 kg/m2. As a body size of preference, no one (0/412) chose obese silhouettes. Normal weight silhouettes were chosen as their body size of preference by 75% (131/174) of women and 60% (143/238) of men. Overweight silhouettes were chosen as their preferred body size by 11% (19/174) of women and 26% (62/238) of men. Combining normal and overweight silhouettes into one group, 86% (150/174) of women and 86% (205/238) of men preferred to be either normal or overweight. Underweight silhouettes were preferred by 14% (24/174) of women and 14% (33/238) of men. Dissatisfaction because body size was too large occurred in 78% (135/174) of women and 53% (126/238) of men. Dissatisfaction because body size was too small occurred in 6% (11/174) of women and 16% (38/238) of men. Conclusion: African immigrants prefer body sizes which are normal or overweight. However, and presumably attributable to the combined influence of globalization and acculturation, a worrisome fraction of African immigrants favor an underweight silhouette.

Understanding the attitudes of Africans towards body size is important because these attitudes affect health behaviors. The 20th century consensus was that Africans viewed large body sizes as a sign of the health, beauty, fertility, and prosperity. In addition, underweight silhouettes were viewed with fear and considered to be a sign of poverty, malnutrition, and HIV infection. In the 21st century, African attitudes towards body size are unknown. African immigrants are a rapidly growing segment of the American population. Their attitudes toward body size are influenced by both globalization and acculturation. In our cohort, we found 86% of the Africans living in America wanted to be either normal or low range overweight. However, and very concerning, 14% of African immigrants chose underweight silhouettes to represent their body size of preference. As weight loss programs are brought forward in and by African communities living in the United States, the emphasis must be on achieving a healthy weight and not glorification of underweight silhouettes.

Quantifying body size estimation accuracy and body dissatisfaction in body dysmorphic disorder using a digital avatar.

BACKGROUND: A core feature of body dysmorphic disorder (BDD) is body image disturbance. Many with BDD misperceive and are dissatisfied with the sizes and shapes of body parts, but detailed quantification and analysis of this has not yet been performed. To address this gap, we applied Somatomap 3D, a digital avatar tool, to quantify body image disturbances by assessing body size estimation (BSE) accuracy and body dissatisfaction. METHODS: Sixty-one adults (31 with BDD, 30 healthy controls) created avatars to reflect their perceived current body and ideal body by altering 23 body part sizes and lengths using Somatomap 3D. Physical measurements of corresponding body parts were recorded for comparison. BSE accuracy (current minus actual) and body dissatisfaction (ideal minus current) were compared between groups and in relation to BDD symptom severity using generalized estimating equations. RESULTS: Individuals with BDD significantly over- and under-estimated certain body parts compared to healthy controls. Individuals with BDD overall desired significantly thinner body parts compared to healthy controls. Moreover, those with worse BSE accuracy had greater body dissatisfaction and poorer insight. CONCLUSION: In sum, this digital avatar tool revealed disturbances in body image in individuals with BDD that may have perceptual and cognitive/affective components.

The relationships between body image, self-esteem and quality of life in adults with trauma-related limb loss sustained in the Syrian war.

BACKGROUND: Numerous military soldiers have lost limbs as a result of the Syrian War. While there are variations between trauma-related amputations in military and civilian populations, both scenarios result in life-changing injuries. OBJECTIVE: To explore the relationship between body image, self-esteem, and quality of life (QOL) domains following trauma-related major amputation. It will be the first study in Syria on the correlation between self-esteem and body image. It will help improve our quality of care to meet patient needs and increase well-being, which in turn will help to address body image, self-esteem, and QOL. METHOD: A cross-sectional study that recruited 235 soldiers with amputations in two centers and two military hospitals in Latakia and Tartous. Patients were given an 81-item questionnaire that included the Amputee Body-Image Scale (ABIS), the Rosenberg Self-esteem (RSE) scale, the WHOQOL-BREF questionnaire, and unidimensional pain measures. The ANOVA test, a student's t-test, multiple linear regression, internal consistency, and test-retest reliability were utilized for statistical analysis. RESULTS: There was a strong relationship between body image, self-esteem, and QOL, with the presence of body image concerns significantly associated with lower self-esteem scores and lower QOL scores (p=0.001). Patients with phantom pain sensation had significantly reduced self-esteem (p =0.001), greater body image concerns (p =0.001), and lower scores in all domains of QOL. We found that body image and self-esteem impacted the psychological, social, and environmental domains. After controlling for pain level and number of co-morbid conditions, body image and self-esteem did not predict WHOQOL-BREF scores, with the exception of the environmental domain, where no pain and low self-esteem predicted better environmental domain scores. CONCLUSION: Patients' body image and self-esteem were greatly impacted by lower-limb amputations. Additionally, phantom pain further impacted self-esteem, body image, and QOL. The image of the body had a profound effect on psychological, social, and environmental domains, and self-esteem was influenced by almost all aspects of QOL.

Prevalence of disturbance of body image perception and engagement in risky behaviors for eating disorders motivated by the Korean wave.

BACKGROUND: the global expansion of the Korean wave (hallyu) has led to the idealization of Korean beauty standards among fans. Celebrities share extreme diets and exercise routines through social media that help them lose weight and adhere to this standard, which has been shown in some studies conducted in Asia to significantly influence negative body image perception and risk for eating disorders. AIM: to describe the prevalence of disturbance of body image perception and engagement in risky behaviors for eating disorders among Spanish-speaking fans residing in Western countries, motivated by the Korean wave. METHOD: this cross-sectional and descriptive study employed a quantitative method for data collection. The data were collected through an anonymous online survey created by the author on the Google Forms platform; the survey included demographic questions, information about exposure to hallyu, body perception, body image perception disturbance and engagement in risky behaviors motivated by the Korean wave. A total of 121 participants were recruited to answer through social network X Prevalence was then calculated for each category. RESULTS: a total of 67.8% of the participants reported comparing their bodies to those of Korean celebrities, and 53.7% experienced a disturbance in their body image perception after exposure to hallyu. Risk behaviors related to exercise were more prevalent among participants than were those related to eating. The majority of participants engaging in these behaviors were females aged 18 years or younger. CONCLUSION: disturbance of the body image perception and engagement in risky behaviors for EDs motivated by the Korean wave are prevalent among its fans, especially female adolescents. More research is needed to understand the extent of this influence on body image perception and the risk of ED, which have a negative impact on physical and mental health.

The relationship among body image, psychological distress, and quality of life in young breast cancer patients: a cross-sectional study.

Purpose: The aim of this study is to explore the interrelationships among body image perception, levels of psychological distress, and the quality of life (QOL) experienced by young breast cancer patients. Methods: This study analyzed data from 339 young female breast cancer patients aged between 18 and 40 years (mean age was 33.47 years) from August 2023 to February 2024. Data on demographic characteristics, psychological distress, body image, medical coping, and QOL of young breast cancer patients were collected. Psychological distress, body image, medical coping, and QOL were measured using the Distress Thermometer (DT), Hospital Anxiety and Depression Scale (HADS), Body Image Scale (BIS), Medical Coping Modes Questionnaire (MCMQ), and Functional Assessment of Cancer Therapy-Breast (FACT-B), respectively. Multiple regression analysis was conducted to examine factors influencing QOL. Results: After adjusting for covariates, significant predictors of QOL in young survivors included psychological distress (ß = -3.125; p = 0.002), anxiety and depression (ß = -4.31; p < 0.001), cognitive dimension of body image (ß = -0.218; p = 0.027), behavioral dimension of body image (ß = 0.579; p = 0.047), and confrontational dimension of medical coping (ß = -0.124; p = 0.01). Conclusion: The findings suggest that higher levels of body image concerns and psychological distress are associated with poorer QOL among young female breast cancer patients. Furthermore, breast cancer patients facing with more positive medical coping strategies predicted a higher QOL.

The effect of mindfulness-based art therapy (MBAT) on the body image of women with polycystic ovary syndrome (PCOS): a randomized controlled trial.

BACKGROUND: The prevalence of polycystic ovary syndrome (PCOS) has increased in the last decade, resulting in enduring psychological effects, including negative body image. This study explored the effect of mindfulness-based art therapy (MBAT) on body image in women with PCOS. METHODS: In a randomized, single-blind, controlled trial conducted in Kerman, Iran, women of reproductive age (18-45) who were diagnosed with PCOS and met specific inclusion criteria were randomly allocated to either the MBAT intervention group or a control group placed on a therapy waiting list. The main focus of the study involved evaluating alterations in body image scores as the primary measure. Additionally, the study assessed secondary outcomes, which encompassed various domains of the Multidimensional Body-Self Relations Questionnaire (MBSRQ) before, immediately after, and one month after the intervention. The trial is registered with www.irct.ir (Registration code (25/01/2020): IRCT20170611034452N9). RESULTS: Between August 2020 and January 2021, 66 participants were randomly assigned to the MBAT or waiting list group, and the study was completed by 60 women. At the end of the intervention, body image (adjusted mean difference from baseline (AMD) of 29.22 [95% CI 19.54, 38.90], P < 0.05) and at the one-month follow-up (AMD of 34.77 [95% CI 24.75, 44.80], P < 0.05) were greater in the MBAT group than in the waiting list group. At certain time points, some MBSRQ domains, including body area satisfaction (BASS) (p < 0.05), appearance evaluation (p < 0.05), fitness orientation (p > 0.05), health orientation (p < 0.05), and self-classified weight (p > 0.05), had higher scores than did the control group. However, only BASS had a conclusive effect size (large). Additionally, appearance orientation (p > 0.05), illness orientation (p > 0.05), health evaluation (p < 0.05), fitness evaluation (p > 0.05), and overweight preoccupation (p < 0.05) had lower scores with variable and inconclusive effect sizes. CONCLUSIONS: The MBAT has potential as an effective approach for enhancing body image in women with PCOS. However, some MBSRQ domain results were inconclusive, likely due to the small sample size. Therefore, further research with a larger sample size is recommended.

Gender differences in the association between body shame and binge eating: Body image flexibility as a moderator in women.

BACKGROUND: Body shame is an established antecedent and maintaining factor of binge eating, beyond global negative affect and body weight, and partly through the effects of dietary restriction. These associations have mainly been established in women and are understudied in men. Body image flexibility, a concept from Acceptance and Commitment Therapy, may be a protective psychological process against the effects of negative body image on binge eating. METHODS: Using structural equation modeling and a non-clinical sample of 244 women and 185 men, this cross-sectional study tested an integrated model of the association between body shame and binge eating, mediated by dietary restriction and moderated by body image flexibility, controlling for depressive symptoms and BMI. RESULTS: Body shame predicted binge eating in women but not in men, whereas depressive symptoms predicted binge eating in men but not in women. Body image flexibility moderated the association between body shame and binge eating in women. CONCLUSIONS: These cross-sectional findings highlight the importance of considering gender differences in current negative affect models of binge eating, and further support the role of body image flexibility in attenuating the influence of body shame on binge eating in women. Longitudinal studies are required to examine the temporal dynamics between these variables.

Body Image Concerns in patients with an Implantable Cardioverter Defibrillator: Association with other PRO measures.

AIM: To investigate associations between Body Image concerns (BICs) measured by the ICD Body Image Concerns Questionnaire (ICD-BICQ) and other Patient-Reported-Outcomes (PROs), in a cohort of patients with an Implantable Cardioverter Defibrillator (ICD). METHODS AND RESULTS: In a cross-sectional survey, we included patients >18 years implanted with a first-time ICD (VVI, DDD and CRT-D) who had lived with their ICD from 3-24 months. They completed the 39-item ICD-BICQ together with the Generalized Anxiety Disorder-scale, Patient Health-Questionnaire, Type D-Scale, Health Status-Questionnaire and the Florida Patient Acceptance-Survey. Data were analyzed using linear regression to compare personality constructs between patients with and without BICs. Logistic repression and receiver operating characteristic curves were used to predict patients with BICs based on other PROs.A total of 330 patients completed the survey. Five patients were excluded due to re-operations leaving 325 patients in the analyses. A total of 20% reported BICs at the recommended cut-off at 36-points. Patients with BICs reported higher anxiety and depression levels, lower device acceptance and health status, had a Type D personality as compared to patients without BICs. FPAS was moderately able to predict BICs, while other PROs only had limited ability to predict BICs. CONCLUSION: Patients with BICs reported poorer PROs. The PRO instruments were not able to predict patients with BICs, indicating that the ICD-BICQ provides independent relevant clinical information. In clinical practice, healthcare professionals can use the ICD-BICQ to identify and obtain information on possible BICs. The ICD-BICQ can also be used to evaluate new operation techniques.

Exploring the reciprocal relationships between body image flexibility and body fat and muscularity dissatisfaction: An 18-month longitudinal study in Chinese adolescents.

Body image flexibility has shown robust negative associations with body dissatisfaction. However, research in this area is confined to cross-sectional studies on adults in Western cultural contexts. Responding to these gaps and the unique cultural nuances and increasing prevalence estimates of body dissatisfaction in China, we examined the bi-directional nature of body image flexibility and body fat and muscularity dissatisfaction in Chinese adolescent boys and girls (N = 1381, 57.3 % girls) at two points over 18 months (Wave [W] 1=baseline, W2=18 months later). We also explored sex differences in longitudinal models. In boys, higher W1 body image flexibility was associated with lower W2 body fat dissatisfaction, and higher W1 body fat dissatisfaction was associated with lower W2 body image flexibility. Null prospective associations between body image flexibility and muscularity dissatisfaction were identified in boys. In girls, higher W1 body fat and muscularity body dissatisfaction were associated with lower W2 body image flexibility. Higher W1 body image flexibility was associated with lower W2 body fat and muscularity dissatisfaction in girls. We found no significant sex differences in the models. Findings advance a multicultural understanding of the temporal and bi-directional links between body image flexibility and body fat and muscularity dissatisfaction in Chinese adolescents.

Introducing the Arabic inflammatory bowel disease disk as a tool for assessing disability in patients with inflammatory bowel disease in Jordan.

BACKGROUND AND STUDY AIM: Inflammatory bowel diseases (IBD) are chronic relapsing-remitting disorders of the gastrointestinal tract. IBD causes significant impairment in the patient's quality of life that should be assessed and monitored in a flexible and easy way. The IBD-Disability Index (IBD-DI) is the only validated tool to assess disability in IBD patients, but it is difficult to use in clinical practice. The IBD Disk is a new shortened, self-administering version of the IBD-DI that allows quick assessment of IBD patients and tracks changes in disease burden over time. However, the IBD Disk has not been used yet in clinical practice in Jordan. The aim of the study was to translate the IBD Disk to Arabic language and introduce it in clinical practice in Jordan. PATIENTS AND METHODS: After translating the original IBD Disk to Arabic language, IBD patients referred to outpatient clinic or admitted to the medical department at the new Al-Hussein hospital, Al-Salt, Jordan, from September 2021 until March 2022, filled the translated IBD Disk. RESULTS: A total of 50 IBD patients (52 % males) were included in the study and filled the IBD Disk. The IBD Disk was easy to complete by the patients. Energy, regulating defecation, and emotions were the most disabling domains for relapsing patients. Polygonal shape area of the mean for IBD Disk scores decreased during remission. Education & work and energy had the strongest correlation at relapse. CONCLUSION: The IBD Disk is a reliable visual representation of IBD disability. In this study, a translated version of IBD Disk to Arabic language was introduced for the first time in clinical practice in Jordan. The reduction in the polygonal shape area of the scores' mean represents decreased disease burden.

Ideal body image and socioeconomic factors: exploring the perceptions of Kenyan women.

BACKGROUND: Non-communicable diseases are an increasing threat in sub-Saharan Africa (SSA), and overweight and obesity are affecting people across all socioeconomic groups. Some studies suggest that big body sizes may be perceived as desirable among women in SSA and that high prevalence of obesity and overweight are especially present in low socioeconomic societies. This study explores the role of socioeconomic factors in the perception of the ideal body among Kenyan women and whether perceptions and beliefs about the ideal body should be considered relevant when targeting the prevention of obesity and overweight. METHOD: In-depth interviews were conducted with 8 Kenyan women with varying educational backgrounds, aged between 21 and 48, using a qualitative study design. The interviews were conducted in December 2022 and January 2023 in Nairobi, audio-recorded, transcribed and analysed through qualitative content analysis and a coding system using deductive and inductive codes. RESULTS: The participants reported that conclusions about a person's health and wealth status are drawn based on different body sizes. Furthermore, traditional views about the ideal body size, societal pressure, as well as the women's own experience with their body size play a role in the perception of an ideal body. CONCLUSION: Small-sized women desire to gain weight as society may view them as weak and sick. Big-sized women aim to reduce weight primarily due to health complications. Nevertheless, traditionally, a big-sized woman is considered strong and wealthy, creating external pressure on women to fulfil this body image-these findings emphasise traditional aspects in designing culturally sensitive prevention and intervention methods to address overweight and obesity.

The Mediating Effects of Symptom Experiences on the Relationship between Body Image and Quality of Life among Hemodialysis Patients in a Single Center.

This study aimed to confirm the mediating effects of symptom experiences on the relationship between the body image and quality of life of hemodialysis patients. Data were collected from 153 patients who were diagnosed with ESRD at a tertiary general hospital and receiving regular hemodialysis in Korea. The data were collected between 20 July and 11 August 2023. The following statistical analyses were conducted: t-test, ANOVA, Scheffé test, Pearson's correlation coefficient analysis, and Hayes' Process Macro Model 4 (to test the mediating effect). The factors influencing quality of life were body image (ß = 0.46, p < 0.001), monthly family income (over KRW 3 million) (ß = 0.22, p = 0.002), and symptom experiences (ß = -0.20, p = 0.001). The mediation analysis indicated that the symptom experiences mediated the relationship between body image and quality of life. Based on the results, education, counseling, and symptom management programs that can improve body image and reduce symptom experience should be developed, and customized programs that reflect the characteristics of a target population, such as economic level, should be developed and provided.

A few reflections on positive body image and body neutrality (aided by Tom Cash's model).

The paper offers a commentary on the distinction between positive body image and body neutrality by applying Cash's cognitive-behavioral perspective. In particular, the two dimensions of valence and importance are used to position the body image constructs. It is concluded that positive body image and body neutrality are much more similar than different.

The feeling is mutual: A randomised controlled trial testing the positive body image process of reciprocity among close friends.

This study investigated the positive body image process of reciprocity and tested whether promoting positive body image can improve one's own and the others' body image. To this end, 124 pairs of female friends (N = 248) were randomised to the experimental or control group. Within each pair, friends were randomised to be the "letter writer" or "letter receiver." Letter writers wrote a letter expressing appreciation for their friend's body functionality (experimental group) or for their shared memories (control group) and read their letter to their friend. Body appreciation, functionality appreciation, and self-objectification were measured at pretest, midtest (after letter writing), and posttest (after reading). Letter writers in the experimental group reported higher body appreciation and lower self-objectification at midtest and posttest, and higher functionality appreciation at posttest, compared to the control group. Further, both groups reported higher body appreciation and functionality appreciation from midtest to posttest. Similarly, letter receivers in both groups reported higher body appreciation and functionality appreciation from midtest to posttest, and letter receivers in the control group reported decreased self-objectification. The findings suggest that promoting positive body image can improve one's own and others' body image, but the effects of the control activity must be considered.

We will be different forever: A qualitative study of changes of body image in women with breast cancer.

OBJECTIVE: This study explores the experience of body-image changes throughout the trajectory of breast cancer. METHODS: We conducted qualitative in-depth interviews with 53 women (n = 53) representing diverse age groups, with a mean age of 48.61 years (SD = 13.12), from various regions across the Czech Republic. The interviews were audio/video recorded and divided into two phases. The initial phase consisted of a narrative part, followed by a semi-structured interview. Thematic analysis was employed to identify and explore the topics that held significant importance to the participants. RESULTS: This research investigated how body image and emotional responses evolve in women with breast cancer during various stages of the illness. Throughout the breast cancer journey, women undergo diverse body image changes, with some of them being described as particularly traumatic, such as hair loss and preventive operations. The effects of breast cancer extend beyond physical scars, influencing femininity and womanhood in the long run. The experience of womanhood is marked by visible and non-visible effects that persist for years after treatment. CONCLUSION: Study has provided valuable insights into the emotional journey that women experience during breast cancer diagnosis, treatment, and survivorship. The illness trajectory framework has proven to be a valuable tool for understanding the complexities of body image concerns and the emotional implications faced by breast cancer patients. By acknowledging the significance of body image issues and providing targeted interventions, healthcare providers can improve the psychosocial well-being and overall quality of life for breast cancer survivors. Further research in this area is needed to develop and refine supportive interventions that address the unique challenges women face during their breast cancer journey. Ultimately, by fostering a sensitive and comprehensive approach to care, we can empower women to navigate their breast cancer journey with greater resilience and confidence.

Diet culture on TikTok: a descriptive content analysis.

OBJECTIVE: To investigate how dieting is portrayed on TikTok and the potential implications for public health considering the effect of diet culture on eating disorders amongst young people. DESIGN: A cross-sectional descriptive content analysis of 250 videos from the five most popular diet-related hashtags. A codebook was developed to analyse the content of the videos and collect the engagement for each video (likes, comments and shares). SETTING: TikTok website. PARTICIPANTS: There were no participants in this study. RESULTS: More than half of the videos portrayed 'body checking', a potentially harmful practice for body image. Of the videos that represented body image, almost half represented body image negatively. However, most videos promoted the idea of 'healthy eating', and only 6·4 % displayed disordered eating behaviours. Over half of the videos provided dietary advice, and of those videos, most content creators claimed to be experts (64 %). Claiming expertise was not significantly associated with engagement; however, the use of humour was significantly associated with engagement. Additionally, males were more likely than females to disclose their goals of the diet. CONCLUSIONS: Overall, it appears that TikTok is commonly used to share nutrition tips and personal experiences around dieting and eating in general, often employing humour as an effective technique. The popularity of the platform and rapid dissemination of information would be a useful tool for health professionals, especially those working with eating disorders, to utilise.

Exercise interventions for self-perceived body image, self-esteem and self-efficacy in women diagnosed with breast cancer: a systematic review with meta-analysis and meta-regressions.

PURPOSE: To synthesise the effectiveness of exercise interventions on self-perceived body image, self-esteem and self-efficacy in women diagnosed with breast cancer who are undergoing or have completed primary adjuvant treatments. METHODS: A systematic review was conducted with meta-analysis and meta-regressions. Five electronic databases were searched from inception to June 2023, and hand searches were performed to explore the reference lists of similar systematic reviews. The established selection criteria were randomised clinical trials that evaluated any type of physical exercise intervention with self-perceived body image, self-esteem and self-efficacy as outcomes. No restrictions were imposed with respect to the control group. Main characteristics were extracted for each study. Meta-analyses, meta-regressions and sensitivity analyses were performed. The certainty of evidence for each outcome was graded using the GRADE approach. The risk of bias was evaluated using the RoB2 Cochrane tool. RESULTS: Twenty studies, comprising 19 different samples (n = 2030), were included. In general, meta-analysis indicated that physical exercise interventions were not superior to controls for improving self-esteem and body image in women diagnosed with breast cancer. However, subgroup meta-analysis showed a significant difference in self-esteem improvement for resistance exercise (SMD = 0.31; 95% CI = 0.07, 0.55; p = 0.01; I2 = 0%) and supervised exercise (SMD = 0.25; 95% CI = 0.08, 0.42; p = 0.0004; I2 = 0%) compared with controls. Self-efficacy results were scarce and controversial. In addition, serious concerns were mainly detected in terms of the risk of bias and indirectness of the evidence, which caused the certainty of evidence to be very low for all outcomes. CONCLUSION: Supervised exercise and resistance training appear to be effective exercise modalities for improving self-esteem in women diagnosed with breast cancer. In contrast, exercise interventions are not significantly associated with improvements in body image, while results on self-efficacy are controversial. However, due to the study's limitations, further research is needed.

The effectiveness of pubertal health group counseling based on problem-solving, on body image concerns and anxiety in adolescent girls: Study protocol.

BACKGROUND: Body image concerns are accepted as a pervasive problem by a large segment of society. Problem-solving counseling is one of the practical counseling techniques that mainly focuses on improving people's adaptability in stressful situations. We intend to determine the effectiveness of pubertal health group counseling based on problem-solving on body image concerns and anxiety in adolescent girls. MATERIALS AND METHODS: A semi-experimental study will be conducted on 12-13 years old students in Babol (Mazandaran, Iran). One hundred people were determined as the final Sample size (50 people in each group) and will be selected to enter the study. A multistage sampling method will be used. The students of the intervention group will receive the necessary training in the problem-solving method regarding pubertal health, once a week for six weeks. Students in the control group will not receive education during the intervention period. Sociodemographic questionnaire, Littleton's body image concern, and Zong's anxiety will be used to evaluate students' body image concerns and anxiety. Analyzes will be done by statistical package for the social sciences (SPSS) version 25 software and a significance level of 5% will be considered. Descriptive statistics and frequency percentage will be determined for classification variables. Median, range, and mean along with standard deviations (SD) will be calculated. The Chi-square test, Repeated Measures ANOVA and ANCOVA test will be used in this study. Percentage prevalence for each categorical variable is calculated with 95% confidence interval (CI). DISCUSSION: The effectiveness of counseling based on problem-solving has been reported in various studies on adolescent puberty health concerns and common adolescent mental health problems, hence its application on girls' body image can be effective.