Risk perception regarding social determinants of health among women with breast cancer in Iran: a qualitative study.

OBJECTIVES: Breast cancer is the most common cancer among women all around the world. Today, in addition to factors including hormones and genetics that are involved in the occurrence of breast cancer, special attention is paid to the role of social and non-medical determinants of health. This study aims to explore the perception of Social Determinants of Health (SDH) in women with breast cancer. DESIGN: Qualitative study design with a conventional thematic analysis approach. SETTING: The study was conducted in Tehran, Iran, between December 2021 and February 2023. PARTICIPANTS: 19 women with breast cancer were selected through purposeful and snowball sampling with maximum variation. Sampling continued until data saturation was reached. PRIMARY AND SECONDARY OUTCOME MEASURES: The study categorised the extracted codes from interviews into three main categories and 12 subcategories related to SDH in women with breast cancer. RESULTS: The study identified factors such as personal and family health records, health behaviours and lifestyles and medical screening and follow-up as key themes in the perception of SDH among women with breast cancer. The main categories were also categorised into 12 subcategories, 'including family history', 'environmental factors', 'hormonal and medicinal changes', 'metaphysical factors', 'traditional medicine-related factors', 'stress', 'body weight', 'physical activity', 'nutrition', 'smoking and tobacco use', 'screening', 'self-examination' and 'barriers to medical follow-up'. 'Near the telecommunications tower', 'Improper use of supplements', 'Being subjected to the evil eye regularly', 'Eating cold nature foods', 'Breast weight' and 'Being ashamed of the doctor' were some examples of the codes. CONCLUSIONS: Participants identified a number of environmental, personal and cultural factors as contributing to the disease. Woman's screening behaviours were influenced by factors such as fear of disease and death, disbelief in getting sick and shame, depending on cultural context. The study suggests the need for further research to explore the impact of these factors on screening behaviours and outcomes in different cultural contexts.

Horizontal ridge augmentation with particulate cortico-cancellous freeze-dried bone allograft alone or combined with injectable-platelet rich fibrin in a randomized clinical trial.

OBJECTIVES: The objective of this study is to assess the effectiveness of horizontal ridge augmentation using FDBA in combination with injectable-platelet rich fibrin (i-PRF) versus FDBA alone. To fulfill this aim, the radiographic and histomorphometric outcomes are compared. METHOD: The study involved 41 patients who had horizontal alveolar ridge defects categorized as either B (2.5-7 mm) or C (0-2.5 mm). The control group received FDBA alone (n = 20), while the test group received FDBA in combination with i-PRF (n = 21). The horizontal dimensions of the alveolar ridge were measured at 0, 2, 4, and 6 mm from the bone crest using CBCT before and 6 months after alveolar ridge augmentation. In the second-stage surgery, 24 biopsies were taken from the augmented bone - 13 from the control group and 11 from the test group, and were examined histologically and histomorphometrically. The data were analyzed using Pearson correlation coefficient, chi-square, paired-t, and two-sample t tests. RESULTS: There was no significant difference (p > 0.05) in the increase of mean ridge width between the test group and the control group after 6 months at distances of 0, 2, 4, and 6 mm from the crest, with differences of -0.28, 0.12, 0.52, and 1.04 mm, respectively. However, the amount of newly formed bone and material residues was significantly higher in the FDBA + i-PRF group compared to the FDBA alone group (45.01% and 13.06% vs 54.03% and 8.48%, respectively). There was no significant difference in the amount of soft tissue between the two groups (41.02% and 37.5%, p > 0.05). CONCLUSION: The study found that there was no statistically significant difference in the increase of horizontal ridge width between the FDBA + i-PRF group and the FDBA group. However, the histomorphometric analysis revealed that the FDBA + i-PRF group had a higher proportion of newly formed bone, less connective tissue, and fewer residual particles. This suggests a superior quality of bone formation compared to the FDBA group.

Prevalence of Domestic Violence Against Women Undergoing Methadone Maintenance Therapy Programs and its Related Risk Factors.

Background: This study aimed to investigate the prevalence of domestic violence (DV) against women who are undergoing methadone maintenance therapy (MMT) and its related risk factors. Methods: This case-control study was conducted on 195 women who were under MMT and a control group consisting of 195 women who were not under it in the city of Zahedan from 22 May to 1 December 2019. Data were collected using a questionnaire for the measurement of violence against women and a sociodemographic questionnaire. In order to analyze the data, the t test, analysis of variance (ANOVA), Pearson's correlation, and multiple regression analysis were used. Findings: In the case group, 67.2% of participants had experienced DV during the past year. In the control group, the prevalence was 78.5%. The rate of more than one occasion of DV was significantly higher in the group who were under MMT (P<0.05). The most common type of violence was mental abuse. Physical, sexual, and economic abuses were in the next ranks. Important predictors of DV, in order of importance, were: the women's low educational level, smoking, income level, and polygamy (P<0.05). Conclusion: MMT is not a risk factor for DV. It seems that the rate of DV against women in Zahedan is very high. The prevalence of recurrent DV in women under MMT was higher than in the general population.

The effect of a group cognitive behavioral therapy on the quality of life and emotional disturbance of women with breast cancer.

PURPOSE: While the rate of survival has increased in the past decade, the diagnosis of breast cancer is an extremely stressful experience for patients and it is associated with the manifestation of several psychological problems. To examine the effect of a group cognitive behavioral therapy (CBT) on the quality of life and emotional disturbance of women with breast cancer. METHODS: The study was a randomized controlled clinical trial. Samples were 48 women who had been diagnosed with breast cancer and had undergone mastectomy and chemotherapy. Study variables were measured before and after the intervention and 1 month after the end of the intervention as a follow-up. Controls received nothing and were just followed-up. Repeated measure ANOVAs were used to compare the effectiveness of the intervention on the study variables. RESULTS: The results of 32 women were analyzed. The increase in quality of life scores was significantly higher in the intervention group compared to the control group (P < 0.05). There were also significantly lower changes in the depression, anxiety, and stress scores of the intervention group (P < 0.05). However, the changes in the score of death anxiety were not significantly lower in the intervention group in comparison to controls (P > 0.05). CONCLUSION: Group cognitive behavioral therapy was effective in the improvement of quality of life and decreases some aspects of emotional disturbance. Findings of this study suggest that women with breast cancer can benefit from group CBT. Yet, some aspects of the mental health of these women may need more attention and individualized methods. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: IRCT20100911004728N4.

The relationship between personality traits of cancer patients and their preferences when receiving bad news.

OBJECTIVE: This study aimed to determine the relationship between the personality traits of cancer patients and their preferences when receiving bad news. METHODS: In this descriptive correlational study, 200 cancer patients who were selected by the continuous sampling method participated. Patients self-reportedly completed the demographic and medical information questionnaire, the Measure of Patients' Preference (MPP) scale, and the short form of the Eysenck Personality Inventory (EPI). RESULTS: The majority of participants were female (73%), 42.5% had higher education, and 47.5% suffered from breast cancer. In this study, the mean scores of extraversion and neuroticism in patients were 14.59 ± 2.47 and 15.17 ± 3.43, respectively. Regarding patients' preferences for receiving bad news, the score obtained by them in the content category was greater compared to two categories of context and support. This study showed a significant and negative correlation between neuroticism and patients' preferences in the support category (P < 0.001 and r = - 0.265). Regarding the categories of the MPP, there was a significant relationship between gender (P = 0.018) and marital status (P = 0.049) with context category, education (P = 0.011) with content category, and marital status (P = 0.003) and employment (P = 0.009) with support category. CONCLUSION: Personality traits and demographic characteristics of cancer patients can influence their preferences for receiving bad news. Therefore, the consideration of these traits by health care team members is of particular importance to communicate with and deliver bad news to patients.

Radiological and histological evaluation of horizontal ridge augmentation using corticocancellous freeze-dried bone allograft with and without autogenous bone: A randomized controlled clinical trial.

PURPOSE: The purpose of this study was radiological and histological evaluation of horizontal ridge augmentation using corticocancellous freeze-dried bone allograft (FDBA) with and without autogenous bone (AB). MATERIALS AND METHODS: The present research was conducted on 42 patients (27 females and 15 males) with insufficient width of edentulous ridge. The patients were randomly assigned into two groups, FDBA alone + collagen membrane (n = 21) and the combined FDBA and AB + collagen membrane (n = 21). The horizontal alveolar ridge dimensions were measured using cone-beam computerized tomography before and 6 months after alveolar ridge augmentation. At the time of insertion of implants, biopsy of new bone was taken from 11 patients in each group and was analyzed histologically. The obtained data were statistically analyzed with paired t test and two-sample t test. The registration number was IRCT201109165305N3. RESULTS: The mean ± SD ridge width gain after 6 months at the distance of 0, 2, 4, and 6 mm from crest of alveolar ridge was 2.78 ± 1.44, 3.05 ± 1.21, 2.82 ± 1.62, and 2.23 ± 1.95 mm in the FDBA group and 2.40 ± 1.60, 3.10 ± 1.80, 3.60 ± 1.87, and 2.65 ± 2.39 mm in the combined group, respectively, which was statistically significant in both groups using paired t test (P < .001). However, the difference between two groups analyzed by two-sample t test was not statistically significant (P > .05). Amount of new bone generation, remained particles, and connective tissue was not statistically different between two groups (P = .367, P = .428, and P = .598, respectively). CONCLUSION: Based on the results of this study, corticocancellous FDBA granules along with collagen membrane can successfully be used for horizontal augmentation of edentulous ridge, and adding AB to the granules of FDBA does not significantly increase the quality and quantity of regenerated bone.

Horizontal continuous and apical stretching sutures does not reduce FGG shrinkage: a split-mouth randomized controlled clinical trial.

PURPOSE: This study aimed to evaluate whether horizontal continuous and apical stretching sutures could reduce FGG shrinkage. MATERIALS AND METHODS: In this randomized controlled clinical trial ten patients (20 sites, seven females and three males) ranging from 18 to 53 years (average 39 years) with insufficient keratinized and attached gingiva received FGG in two quadrants of mandible (splitmouth design). Horizontal continuous and apical stretching sutures were used in test sites in addition to common suturing techniques. Clinical parameters including probing depth (PD), the width of keratinized and attached gingiva (KG, AG), the horizontal and vertical dimension of the graft (HD, VD), and graft area (GA) were recorded at baseline and 1, 3, and six months after the operation. RESULTS: PD did not differ significantly for six months. The average change of other parameters in test and control sites respectively was as follows: KG increased 5.5 mm and 5.1 mm, AG increased 5.3 mm and 5.1 mm, HD shrinkage was 21.6% and 15.8%, VD shrinkage was 33.7% and 33.2%, GA shrinkage was 47.3% and 43.3%. There were no significant differences between test and control sites in clinical parameters six months after surgery. CONCLUSION: Application of horizontal continuous and apical stretching sutures does not reduce FGG shrinkage.

Factors associated with caregiver burden for mothers of children undergoing Acute Lymphocytic Leukemia (ALL) treatment.

OBJECTIVE: The present study examined the extent to which social support (SS) availability and satisfaction could predict the extent of caregiver burden (CB) among mothers of children with Acute Lymphocytic Leukemia (ALL). METHOD: The study was a cross-sectional, descriptive-correlative study. It was conducted on a sample of 117 mothers whose children were undergoing treatment in a public hospital in Bam, Iran. The Norbeck Social Support Scale and the Caregiver Burden Scale were used to measuring study variables. The data were analyzed using Pearson's correlations, t-tests, ANOVAs, and linear regressions. RESULTS: Significant correlations were observed between CB and SS availability (r = -0.499, p < 0.001), SS satisfaction (r = -0.543, p < 0.001), the age of the child with cancer (r = -0.22, p = 0.01), and duration of treatment (r = 0.336, p < 0.001). Married mothers experienced less CB than those that were widowed or divorced. Within the regression equation, SS satisfaction, SS availability, marital status, and duration of treatment were the predictors of CB. SIGNIFICANCE OF RESULTS: Based on the results of the current study, mothers who have less SS, especially those who are single mothers, with younger children, and who have taken care of their child for an extended duration should be given special attention. Furthermore, it appears that there are distinct cultural variations amongst Iranian mothers which suggest that culture may impact upon SS availability. Results also suggest a need for interventions that enhance nurses' ability to provide support to caregivers and the broader family unit as a whole. Nurses in cancer care need to have psychological competencies to help family members of cancer patients especially mothers and more so those that are single mothers. As integral members of the patient care experience, nurses may be uniquely positioned to provide this needed psychosocial support.