Need for Staging Investigations in Newly Diagnosed Breast Cancer: Establishing Local Guidelines for Radiological Staging in Bahrain.

Objective: Staging workup and detection of distant metastases is important in newly diagnosed breast cancer in order to make treatment decisions and establish the prognosis. There is wide variation in current recommendations for staging investigations in breast cancer. Routine staging is performed for all patients in Bahrain because of lack of consistent guidelines. Optimization of the criteria for staging is important for identification of metastases, while minimizing harm and costs. The aim of this study was to evaluate factors associated with distant metastases in newly diagnosed patients with breast cancer, in order to establish local guidelines for proper selection of patients for systemic staging. Materials and Methods: Patients with newly diagnosed breast cancer at Salmaniya Medical Complex in Bahrain who underwent staging investigations between January 2016 and December 2022 were identified from a pathology database. Patients with previous history of cancer, synchronous tumors, bilateral breast cancer and ductal carcinoma in situ were excluded. Clinical, radiological and pathological data were retrospectively analyzed. Results: A total of 593 patients underwent staging computed tomography and bone scans or a PET scan. Distant metastases were identified in 20.7% of cases. M1 disease was significantly associated with multifocality/multicentricity, high grade tumors, hormone receptor-negative cancers, high Ki67 index, advanced tumor stage, node-positive disease, triple-negative breast cancer, use of PET scans and those who underwent neoadjuvant chemotherapy. Age was not associated with identification of distant metastases. Conclusion: The prevalence of distant metastases in this population of newly diagnosed patients with breast cancer was higher than previously reported. Routine staging of all patients at presentation was not indicated, especially for asymptomatic patients with early breast cancer. This study identified certain groups of patients with a higher risk of distant metastasis, in whom metastatic workup should be performed. These findings may allow for the development of a local guideline that addresses the question of which breast cancer patients need staging investigations for distant metastases.

Nutrition education and its relationship to body image and food intake in Asian young and adolescents: a systematic review.

Background: The literature brings to light the unhealthy nutritional habits prevalent among Asian adolescents and their high level of body image dissatisfaction. This study aims to conduct a systematic review of the literature on the effect of nutritional education interventions on their nutritional knowledge and food intake behavior, attitude, practice, and body image. Methods: We searched relevant published studies in PubMed, Web of Science, Scopus, Science Direct, and Springer using the PICO framework and performed a quality assessment using the 10-point checklist adapted from the National Institutes for Health tool. Results: The majority of the nutritional education interventions improve unhealthy food intake and body image misperception, particularly on nutritional knowledge/self-efficacy, healthy dietary habits, physical activities, and fruit and vegetable intake. We also found a negative association with excess weight gain, obesity, and unethical weight reduction practices, leading to dissatisfaction with body image. Conclusion: These interventions can help address dietary problems and body image perception and support the development of future interventions.

The Use of Natural Language Processing Elements for Computer-Aided Diagnostics and Monitoring of Body Image Perception in Enterally Fed Patients with Head and Neck or Upper Gastrointestinal Tract Cancers.

BACKGROUND: Psycho-oncology care has emerged as a significant concern in contemporary oncology practice, given its profound impact on patient psychological well-being. Patients undergoing treatment for head-neck or upper gastrointestinal tract cancers often experience complex emotional and psychological challenges, necessitating specialized support and intervention. Traditional approaches to psycho-oncological care may be limited in their ability to comprehensively assess and address patients' needs. Therefore, exploring innovative methodologies, such as leveraging natural language processing (NLP) elements, is crucial to enhancing the effectiveness of psycho-oncological interventions. METHODS: In this study, we developed a method utilizing natural language processing (NLP) elements to augment psycho-oncological care for patients with head-neck or upper gastrointestinal tract cancers. The method aimed to facilitate vocabulary, sentiment, and intensity analysis of five basic emotions (happiness, sadness, anger, disgust, and fear), as well as to explore potential areas of difficulty such as body image, pain, and self-esteem. We conducted research involving 50 patients across three treatment stages. RESULTS: Our method facilitated the identification of characteristic features at each treatment stage, aiding in the tailoring of appropriate therapies to individual patient needs. The results offer insights valuable to psychologists and psychiatrists for expedited diagnosis and intervention, potentially influencing therapy outcomes. Additionally, the data may inform treatment decisions by addressing patient-specific concerns. Furthermore, our method holds promise for optimizing the allocation of psychological care resources, particularly at the initial stages of patient contact. LIMITATIONS: The main problem in the research was the fairly wide age range of participants, which explains the potential diversity of vocabulary. CONCLUSION: In conclusion, our study demonstrates the potential utility of integrating natural language processing (NLP) elements into psycho-oncological care for patients with head-neck or upper gastrointestinal tract cancers. The developed method offers a novel approach to comprehensively assessing patients' emotional states and areas of difficulty, thereby facilitating tailored interventions and treatment planning. These findings underscore the importance of continued research and innovation in psycho-oncology to enhance patient care and outcomes.

Comparative Investigation of Genital Self-image and Sexual Function in Women with and Without a History of Female Genital Cosmetic Procedures: A Cross-sectional Study.

Background: Despite the increasing growth of female genital cosmetic procedures, the long-term effects of these procedures are not clearly understood. This study was conducted to compare the genital self-image and sexual function in women with and without female genital cosmetic procedures. Methods: This cross-sectional study was conducted on 315 participants (210 women without a history of genital cosmetic surgery and 105 women with it) in Alborz province, Iran, from early February 2023 to mid-May 2023. The sampling was done conveniently. Data collection instruments were Female Genital Self Image Scale and Female Sexual Function Index. Statistical analysis was done in SPSS 16 software using t-test, chi-square, and logistic regression, and P<0.05 was considered statistically significant. Results: The use of laser to tighten the vagina with 77.77% and Perineoplasty with 29.2% were the main cosmetic procedures. The mean duration passed from the surgical procedures was 4.79±3.60 years, while it was 1.13±0.74 years for non-surgical procedures. Women with a history of genital procedures had a higher mean age (39.45±10.38, P=0.023). However, they were lower regarding the level of education (P<0.001), family income (P<0.001), and exercise (P<0.001). Also, they showed a higher number of pregnancies (P<0.001), deliveries (P<0.001), vaginal delivery (P<0.001), episiotomy (P<0.001), and neonates with a weight of ≥3.5 kg (P=0.002). In both groups, midwives and doctors were the most important sources of information about the appearance and function of reproductive system. However, the genital self-image and sexual function of the two groups did not differ significantly (P>0.05). Conclusion: No difference in sexual self-image and lack of difference in sexual function after cosmetic procedures show the need to pay attention to recommending and selecting these procedures. Public awareness about the diverse and natural forms of the female genitalia, education about the variety of the factors affecting sexual function, reduction of unnecessary interventions, increase in physiological births, retraining doctors and midwives, and multidimensional counseling can help to choose more appropriate candidates for cosmetic procedures.

Percepção e satisfação corporal de estudantes universitários vegetarianos / Perception and body satisfaction of vegetarian students / Percepción y satisfacción corporal de los estudiantes vegetarianos

INTRODUÇÃO: A percepção e satisfação corporal têm sido amplamente estudadas em diversos públicos, principalmente em estudantes universitários; porém, existem poucas investigações com vegetarianos, sendo assim, torna-se necessário avaliar se o padrão alimentar vegetariano está relacionado com os fenômenos inerentes à imagem corporal. OBJETIVO: Avaliar a percepção e a satisfação corporal entre estudantes universitários vegetarianos. MÉTODO: Trata-se de um estudo transversal com 123 participantes, no qual foram aplicados o Questionário de Imagem Corporal - BSQ (Body Shape Questionnaire) e a Escala de Silhuetas de Stunkard. RESULTADOS: Os dados mostraram que 86,2% dos participantes eram eutróficos (IMC=22,4±3,3), sendo o score obtido no BSQ foi de 84,6 pontos (±36,0) correspondente à leve insatisfação com a imagem corporal. Cerca de 82,1% dos estudantes se mostravam insatisfeitos com a silhueta, dentre estes, 61,4% desejavam diminuí-la. CONCLUSÃO: O padrão alimentar (ovolactovegetariano, lactovegetariano, vegetariano estrito e vegano) não se relacionou com a insatisfação corporal, mas sim o desejo de ter silhuetas magras que são valorizadas pelo padrão de beleza vigente.

INTRODUCTION: For Body perception and satisfaction have been widely studied among different publics, especially among college students; however, there are few investigations with vegetarians. Therefore, it is necessary to evaluate whether the vegetarian eating pattern is related to the phenomena inherent to body image. OBJECTIVE: To evaluate body perception and body satisfaction among vegetarian college students. METHOD: This is a cross-sectional study with 123 participants, in which the Body Image Questionnaire (BSQ) and the Stunkard Silhouette Scale were applied. RESULTS: The data showed that 86.2% of the participants were eutrophic (BMI=22.4±3.3), and the score obtained in the BSQ was 84.6 points (±36.0) corresponding to a mild dissatisfaction with body image. About 82.1% of the students were dissatisfied with their silhouette, and 61.4% of them wanted to reduce it. CONCLUSION: Dietary patterns (ovolactovegetarian, lactovegetarian, strict vegetarian, and vegan) were not related to body dissatisfaction, but rather the desire to have thin silhouettes that are valued by the prevailing beauty standard.

INTRODUCCIÓN: La percepción y satisfacción corporal han sido ampliamente estudiadas entre diferentes públicos, especialmente entre estudiantes universitarios; sin embargo, existen pocos estudios sobre vegetarianos, por lo que es necesario evaluar si el patrón alimentario vegetariano está relacionado con los fenómenos inherentes a la imagen corporal. OBJETIVO: Evaluar la percepción corporal y la satisfacción corporal entre estudiantes universitarios vegetarianos. MÉTODO: Se trata de un estudio transversal con 123 participantes, en el que se aplicaron el Cuestionario de Imagen Corporal - BSQ (Body Shape Questionnaire) y la Escala de Siluetas de Stunkard. RESULTADOS: Los datos mostraron que el 86,2% de los participantes eran eutróficos (IMC=22,4±3,3), y la puntuación obtenida en el BSQ fue de 84,6 puntos (±36,0) correspondiente a una insatisfacción leve con la imagen corporal. Alrededor del 82,1% de los estudiantes estaban insatisfechos con su silueta, entre ellos, el 61,4% deseaba reducirla. CONCLUSIÓN: El patrón alimentario (ovolactovegetariano, lactovegetariano, vegetariano estricto y vegano) no estaba relacionado con la insatisfacción corporal, sino con el deseo de tener siluetas delgadas que son valoradas por el estándar de belleza vigente.

What is the relationship between body image and the quality of life of women who underwent surgery for breast cancer? A scoping review.

PURPOSE: This review aimed to identify, characterize, map, and summarize existing knowledge about the relationship of perceived body image with the quality of life (QoL) of women who have undergone surgical treatment for breast cancer. METHODS: A scoping review was conducted following the PRISMA-ScR guidelines. PubMed, PsycINFO and Scopus databases were searched, and articles published until August 2022 were included. RESULTS: The search resulted in 796 records, and 51 articles were included for analysis. A significant negative impact on body image perception and QoL after surgical treatment for breast cancer was found in the majority of studies. Sociodemographic variables such as age, education, socioeconomic status, unstable attachment styles and time after the surgery may have an effect on a worsening of the overall body image and QoL score of women. It was found that there was greater dissatisfaction with body image in women who underwent mastectomy compared to those who underwent conservative surgery. CONCLUSION: Evidence has shown that breast cancer surgery affects the perceived body image and QoL of patients worldwide. Age, education, socioeconomic status, and the type of surgery are potential factors influencing these outcomes. It is worth noting that the review encompassed articles from various countries, reflecting a significant cultural diversity among the studied populations. However, most of these articles did not delve into an analysis of these cultural disparities. This review also indicated insufficient details regarding the assessment instruments used to assess perceived body image.

Adults diagnosed with gynecologic cancer and their relationship with their body: A study on the supportive role of yoga using interpretative phenomenological analysis.

The purpose of this qualitative study was to explore the thoughts, feelings, attitudes, and perceptions of adults diagnosed with gynecologic cancer on their body, and the role of yoga in shaping these aspects. A phenomenological research design was used. Fifteen women (Mage=50.1 ± 13.5 years, range=28-66) who practice yoga at least once/week completed a sociodemographic survey online, two semi-structured interviews, and a 30-day journal online. Quantitative data were analysed using descriptive statistics. Qualitative data were analysed using interpretative phenomenological analysis. Participants' responses and the authors' interpretations were summarized into four main superordinate themes: (1) internal monologue of the changed body, (2) balancing act between acceptance and improvement, (3) value of taking time to prioritize oneself by practicing yoga, and (4) transformative catalysts of expectation and mindset on body-related self-perceptions after yoga. Body functionality and appearance, and their sexual health were often deeply interconnected, and impacted participants' self-perceptions and behaviours. Yoga was a vehicle for growth and acceptance; however, participants' expectations and mindsets before and during yoga could lead to negative self-perceptions after yoga. The findings underscore the importance of integrating yoga - a holistic practice - into survivorship care programs, while emphasizing the need to address expectations and attitudes that could hinder positive outcomes.

'My goal was to become normal'-A qualitative investigation of coping with stigma, body image and self-esteem long-term after bariatric surgery.

Improved self-esteem and body image, as well as reduced experiences of weight stigma are important patient-reported obesity treatment outcomes. However, more knowledge is needed about how individuals who have undergone metabolic and bariatric surgery (MBS) perceive themselves and their bodies and use different coping strategies in relation to body image and self-esteem long-term after MBS. In this qualitative study body image, self-esteem, weight stigma and coping strategies were explored among 18 individuals who underwent MBS more than 10 years ago when interviewed. Using reflexive thematic analysis, two primary themes were identified: 'Experiences of living with a stigmatised body' and 'Coping with weight stigma, body image and self-esteem', and eight sub-themes. Findings capture frequent experiences of weight stigma before bariatric surgery, the need for coping with stigma and body dissatisfaction before and after MBS, and how different coping strategies are related to participants' perceptions of their bodies and self-concepts. More adaptive coping strategies, such as confrontation and cognitive restructuring may facilitate more positive body image outcomes, than more ruminative and avoidant strategies. Understanding adaptive coping strategies can be useful to develop interventions to reduce negative consequences of weight stigma on body image and self-esteem.

Changes in patient-reported satisfaction and quality-of-life 6 months after rhinoplasty.

BACKGROUND: Rhinoplasty is a challenging and demanding procedure in plastic surgery. Surgical success, patient satisfaction, and improved quality-of-life are important outcomes. OBJECTIVES: This study aimed to evaluate patient-reported satisfaction with appearance, treatment, and decision outcomes as well as quality-of-life after rhinoplasty using validated questionnaires. The role of patient demographics on outcomes was also studied. METHODS: Patients who underwent a primary rhinoplasty were selected for this cohort study. Patient-reported satisfaction with appearance, treatment, and decision as well as quality-of-life were evaluated with the Utrecht Questionnaire and FACE-Q at intake and 6 months postoperatively. RESULTS: Overall, 380 patients were included. Patients reported a more positive subjective perception of nasal appearance (VAS score) at 6 months post-surgery compared with preoperative scores (7.9 ± 1.6 vs 3.2 ± 1.4, p < 0.05). Furthermore, higher quality-of-life and body image scores were observed at 6 months postoperatively compared with preoperative scores (7.7 ± 3.5 vs 15.2 ± 4.4, p < 0.05). Patients reported high satisfaction with treatment outcome (70.3 ± 23.4) as well as with their decision to undergo surgery (75.9 ± 23.4) on a scale of 0-100 at 6 months postoperatively. Patients reached similar postoperative scores regardless of their intake scores. Patients ≥30 years and patients with a history of cosmetic surgery were less satisfied postoperatively. CONCLUSION: Despite differences in appearance satisfaction at intake, most patients showed greater satisfaction with appearance, treatment, and decision outcomes as well as quality-of-life 6 months postoperatively. However, older age and a history of cosmetic surgery influenced these outcomes negatively. These factors should be considered during preoperative management of outcome expectations.

Keep calm and keep rowing: the psychophysical effects of dragon boat program in breast cancer survivors.

PURPOSE: Dragon Boat discipline has become a popular type of physical exercise among women with breast cancer. The present study aims to investigate the effects of Dragon Boat activity on body composition, physical function, and psychosocial aspects (i.e., body appreciation and quality of life [QoL]) in women operated for breast cancer. METHODS: Thirty-one women (age, 57.88 ± 7.88 years; BMI, 27.86 ± 6.38 kg·m-2) with a previous breast removal surgery were recruited and randomized into two groups: Dragon Boat group (DB, N = 18) or a home-based non-supervised training program (home exercise group; HG, N = 13). All participants underwent body composition, handgrip test, 30-s chair stand test (30CST), 6-min walking test (6MWT), and shoulder mobility measurements at baseline and after 12 weeks of intervention. Participants also filled out the Body Appreciation Scale-2 (BAS-2) and the Short Form Health Survey-12 (SF-12) self-report questionnaires. RESULTS: Dragon Boat activity significantly improved the 30CST (+ 6%, p = .011) and 6MWT performance (+ 30%, p = .011) compared to a home-based non-supervised training program. Moreover, 20% (3/15 women) of women in the DB group obtained a reliable change from pre- to post-intervention in the BAS-2 and in the mental QoL component of the SF-12 (vs 15% and 0% of the HC group). No reliable change emerged for the physical component of the SF-12. CONCLUSION: Dragon Boat activity is efficient to improve lower limb strength in women operated for breast cancer. Furthermore, Dragon Boat activity emerged to improve body appreciation and mental QoL in some of the women assigned to this activity. Importantly, no adverse events were documented during the intervention. TRIAL REGISTRATION: NCT05206526 (10/02/2022).

Sexuality, intimacy, and body image among adolescents and young adults with cancer: a qualitative, explorative study.

AIM: The aim of this study was threefold: (1) to explore Danish adolescents and young adults' (AYAs) thoughts concerning sexual health particularly focusing on sexuality, intimacy, and body image throughout a cancer trajectory, (2) to investigate how AYAs experience healthcare professionals address of- and respond to sexual health issues, and (3) to identify AYAs' suggestions on how to support conversation about sexual health. METHODS: A qualitative, single-center study was conducted, including AYAs (18-29 years) diagnosed with cancer recruited at the University Hospital of Copenhagen, Rigshospitalet. Individual semi-structured interviews were conducted from January-February 2023, recorded, transcribed verbatim, and analyzed using thematic analysis. RESULTS: Twelve participants were interviewed, aged 20-29; five were diagnosed with hematological- and seven with oncological cancer. Our analyses yielded three themes: (1) sexuality and body image as part of the identity, (2) excluding relatives in conversations about sexual health, and (3) uncertainty how to discuss sexual health with healthcare professionals. Finally, the AYAs' suggestions to support conversations about sexual health were organized into six thematic categories. CONCLUSION: In this study, participants experienced altered sexual subsequent impacts on body image and self-esteem during their cancer trajectory. While some adapted to these changes, discussing them with healthcare providers was difficult, especially in the presence of relatives, as the AYAs wanted to shield them from additional concerns. To enhance support, AYAs suggest regular discussions on sexual health and the use of a dialog tool by healthcare professionals.

Breast cancer survivors suffering from lymphedema: What really do affect to corporeality/body image? A qualitative study.

Breast cancer-related lymphedema is currently one of the most serious complications that most affect the quality of life of women undergoing breast cancer. The aim of this study was to explore in-depth the experience of women who suffer from lymphoedema after breast cancer and how does this condition affect corporeality, with no judgements. For this purpose, a qualitative methodology was followed. In-depth interviews, interviewer's field notes and participants' letters were used for data collection. The participants were twenty Spanish women with lymphoedema after overcome a breast cancer in the past. Healthcare specialists with experience in the topic were also included. Results showed 2 main categories: "From cancer to lymphedema, another disease another disease" and "Potential for transition and transformation towards a new way of life". As a conclusion, the difficulty in accessing adequate treatment, the need for greater awareness of lymphedema and the importance of the emotional and psychological dimension of this chronic disease. Highlighting the attitudes that these women develop for self-care and the concept of new corporeality. After breast cancer, women with lymphedema experience a drastic change that affects all areas of their lives. The adaptation process, and the search for resources and aid, play a fundamental role in overcoming this process.

A Social Media-Delivered Melanoma Prevention Program for Young Women Engaged in Frequent UV Tanning: Protocol for a Randomized Controlled Trial.

BACKGROUND: Rates of melanoma have increased dramatically in the United States over the past 25 years, and it has become among the most prevalent cancers for young adult women. Intentional skin tanning leads to a pattern of intense and intermittent UV radiation exposure that is associated with increased risk of melanoma. Frequent tanning is most common among young women and is linked to a variety of sociocultural pressures that negatively impact body image and drive appearance control behaviors. Unfortunately, there are no established interventions designed for frequent tanners. This intervention addresses this gap with unique content informed by body image and acceptance-based interventions. The intervention is delivered using Facebook secret groups, an approach designed to support behavior change and ensure scalability. OBJECTIVE: This study aims to describe the rationale and methodology of a randomized controlled trial of a melanoma prevention program targeting young women engaged in frequent indoor or outdoor UV tanning. METHODS: Participants are women aged 18-25 years who report high-risk tanning (ie, at least 10 indoor tanning sessions in the past 12 months or 10 outdoor sessions in the previous summer). After recruitment and screening, participants completed a baseline survey and were randomly assigned to receive the intervention or an attention-matched control condition. Both conditions were 8-week-long Facebook groups (approximately 25 members each) with daily posting of content. Follow-up surveys are administered at 3, 8, and 18 months after baseline. The primary trial outcome is the combined number of indoor and outdoor tanning sessions reported at the 8-month follow-up. Hypothesized intervention mediators are assessed at the 3-month follow-up. RESULTS: This project was funded by a National Cancer Institute award (R01 CA218068), and the trial procedures were approved by the University of Kentucky Institutional Review Board in February 2020. Trial recruitment and enrollment occurred in 6 waves of data collection, which started in February 2022 and closed in May 2023. The study is closed to enrollment but remains open for follow-ups, and this protocol report was prepared before data analyses. As of February 2024, all participants have completed the 8-month follow-up assessment, and data collection is scheduled to close by the end of 2024 after the collection of the 18-month follow-up. CONCLUSIONS: This trial will contribute unique knowledge to the field of skin cancer prevention, as no fully powered trials have examined the efficacy of an intervention designed for frequent indoor or outdoor tanning. The trial may also contribute evidence of the value in translating principles of body image and acceptance-based interventions into the field of skin cancer prevention and beyond. If successful, the use of the Facebook platform is intended to aid in dissemination as it provides a way to embed the intervention into individuals' everyday routines. TRIAL REGISTRATION: ClinicalTrials.gov NCT03441321; https://clinicaltrials.gov/study/NCT03441321. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/56562.

An investigation of the effect of mindfulness-integrated cognitive behavior therapy on demoralization, body image, and sexual function in Iranian women with breast cancer: a randomized controlled trial.

BACKGROUND: Breast cancer is an extremely unpleasant and unbearable experience that can have a profound impact on a person's life. Compared to other types of cancer, breast cancer has a more severe psychological impact on women. PURPOSE: This study aimed to investigate the effect of mindfulness-integrated cognitive behavior therapy on demoralization, body image, and sexual function in Iranian women with breast cancer. METHOD: A sample of 30 women with breast cancer were randomly divided into intervention and control groups. The research was conducted in the oncology division of Imam Reza Hospital in Kermanshah by the clinical trial method with a two-group pretest-posttest design and a 2 month follow-up. Participants in the intervention group received Mindfulness-integrated cognitive behavior therapy for eight sessions. The intervention was carried out individually in weekly 60 min sessions. While the control group received self-help treatment (through an educational book). A demographic questionnaire, Demoralization Scale (DS-II), Body Image Scale (BIS), and Female Sexual Function Index (FSFI) were used to collect data. For data analysis, means and standard deviations were calculated and repeated measures and the Bonferroni test was conducted using SPSS 26. RESULTS: The results showed the effectiveness of mindfulness-integrated cognitive behavior therapy on demoralization, body image, and sexual function (p < 0.05). Concerning demoralization in the intervention group, the pre-test mean was 16.73 ± 3.33, and it reduced to 11.93 ± 1.49 in the post-test. The body image mean score showed a decreasing trend in the intervention group, from 12.47 ± 1.88 in the pre-test to 8.80 ± 3.21 in the post-test. The mean score for sexual function showed an increasing trend, increasing from 18.06 ± 2.29 in the pre-test to 23.07 ± 0.91 in the post-test. There was no significant difference in the mean score of the post-test compared to the pre-test and follow-up in the control group (p < 0.05). CONCLUSION: MICBT can be used in conjunction with pharmaceuticals and medical treatments to improve the psychological symptoms of women with breast cancer, according to this study's results. Trial registration (IRCT20160103025817N6). 2022-04-06.

Sociocultural pressures and engagement with cosmetic products and procedures in adult women.

Previous studies have shown that cosmetic procedures and products that perpetuate Western hegemonic beauty standards among women have become increasingly popular, and pressures from sociocultural agents to utilize them are significant. However, little work has documented the relationship between perceived sociocultural pressures and use of cosmetic procedures and products among a larger age range of adult women. A community sample of 308 women aged 18-66, mean (SD) age of 35.7 (9.7), reported on the cosmetic procedures they had considered or used, as well as perceived pressures from the media, peers, romantic partners, and health and beauty professionals. Findings revealed that, among those investigated, the most frequently utilized products and procedures were supplements and hair removal. However, a significant minority reported considering more invasive procedures, including cosmetic surgery. Media was the predominant source of pressure, while partners were the least frequently endorsed. While pressure from professionals and peers had small-to-moderate associations with utilization of cosmetic products and procedures, pressure from partners had the largest association with their use. This work frames important future directions for examining the impact of sociocultural pressures on women's willingness to utilize cosmetic products and procedures that are sometimes underregulated and risky for physical and mental health.

Long-Term Satisfaction with Breast Augmentation and Augmentation Mastopexy in the Latin American Population.

OBJECTIVE: The primary objective of this study was to determine the long-term satisfaction levels of women who have undergone breast augmentation and augmentation mastopexy procedures, while identifying the factors influencing patient satisfaction. METHODS: A self-reported retrospective case study design was used to collect data from women with breast implants. The study employed a survey that included demographic information, preoperative diagnosis, implant details, and patient-reported outcomes measured using the Breast-Q Instrument, which evaluates satisfaction with breasts, self-esteem, sexual well-being, and physical symptoms. Statistical analyses were conducted to identify correlations and differences in outcomes between the different variables. RESULTS: The survey was completed by 1022 women from 19 countries, with Chile, Mexico, and Colombia being the most represented. Augmentation was performed on 72.2% of the patients, while 27.7% underwent augmentation mastopexy. Patient satisfaction with breast size and shape varied significantly between the two procedures, with patients undergoing augmentation mastopexy showing less satisfaction. In addition, patients who were unaware of their implant shape or placement reported lower satisfaction scores. The study also found that patient satisfaction decreased over time in the augmentation mastopexy cases and that patients with high body mass index had lower satisfaction. CONCLUSION: Augmentation mastopexy in patients with breast ptosis yields lower satisfaction than augmentation alone. Dissatisfaction escalates with overweight/obesity (BMI), post-surgery time, and misinformation. Implant pocket (pre-vs. subpectoral), shape (round vs. anatomical), and size did not impact satisfaction. LEVEL OF EVIDENCE III: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Health-related quality of life, psychological issues and concerns among sarcoma survivors: a mixed method study.

Purpose: We aimed to explore the health-related quality of life (HRQoL), psychological issues and concerns among sarcoma survivors in India and assess their satisfaction with nursing care. Methods: This study employed a sequential mixed-methods design, enrolling 100 sarcoma survivors from July to December 2021, with data collected using standardised questionnaires for HRQoL, depression, anxiety, stress, cognitive impairment and self-structured satisfaction with nursing care. Qualitative data were gathered through focused group discussions. Results: The mean global health score among sarcoma survivors was 79.48 ± 16.26. A significant number of survivors had symptoms of mild-to-moderate depression (30%), severe anxiety (12%), stress (16%) and mild cognitive impairment (5%). Significant mean rank differences were observed between anxiety and financial difficulty (p < 0.05), emotional functioning (p < 0.001), cognitive functioning (p < 0.001), pain (<0.05), insomnia (p < 0.001), fatigue (p < 0.001), anorexia (p < 0.05) and nausea/vomiting (p < 0.001). Educational qualification had a significant association with depression and anxiety while family history of cancer emerged as a significant factor associated with anxiety and stress among survivors. Qualitative analysis revealed themes related to body image, societal discrimination, socio-economic impact, marriage concerns and fertility issues. Survivor satisfaction with nursing care was good. Conclusion: A substantial number of sarcoma survivors had an average HRQoL and experienced depression, anxiety and stress. Our study emphasizes the importance of holistic survivorship care, involving nurses in post-treatment support, and addressing societal discrimination and psychosocial concerns to enhance their quality of life. Implications for cancer survivors: Our study calls for a holistic approach to sarcoma survivor care and emphasizes the importance of personalised survivorship care plans led by nurses to address the diverse needs of sarcoma survivors in India. Such plans should encompass strategies for managing depression, anxiety and stress, along with addressing body image concerns and social support.

Patient experience of bladder cancer: A data linkage study.

Introduction: Bladder cancer is one of the most common cancers worldwide and can be managed with a range of approaches, including conservative, medical and surgical therapies. Treatment may be associated with considerable morbidity, but despite this, little data exist to reflect patients' subsequent experience. This study aims to evaluate patients' experiences of bladder cancer care by linking data from a national cancer experience survey with data routinely collected from National Health Service (NHS) sources. This study considers patient perspectives and makes recommendations to improve the patient experience of bladder cancer care. Methods: Anonymised data from the National Cancer Patient Experience Survey (NCPES) for patients who had received care for bladder cancer were collated and linked with demographic and treatment data. Questions from the NCPES were then categorised into different themes based on their content. This study focused on themes relating to lifestyle, activities of daily living (ADL), symptoms, psychological impact and body perception. Statistical analyses were used to investigate the relationship between patient reported experience, demographics and type of care received. Results: NCPES data from 673 patients (487 male, 29 undisclosed) with at least T1 bladder cancer were analysed. Statistically significant differences were identified across the five investigated patient experience themes. No significant difference was seen in patient reported experience between bladder cancer drug treatments (such as intravesical BCG vs. intravesical chemotherapy vs. systemic chemotherapy) and radiotherapy types (curative vs. palliative). Patients treated with cystectomy had significantly worse experiences relating to body image and ADL but not when compared with patients treated with radical radiotherapy. Patients with long-term health conditions reported worse experiences for all five themes compared with those without. Conclusion: The literature surrounding the experience of patients with bladder cancer is limited. This data linkage study demonstrates the impact of bladder cancer care on five patient experience themes, including the effect of different treatment types and the presence of long-term health conditions. While limited by sample size and data comprehensiveness, this study aims to inform clinicians and service providers of factors affecting patient experience of bladder cancer care, to stimulate service review and development.

Anxiety, depression, and body image among infertile women with and without polycystic ovary syndrome.

STUDY QUESTION: In women undergoing fertility treatment, do those with polycystic ovary syndrome (PCOS) have a higher prevalence of symptoms of anxiety and depression and lower body appreciation than women without PCOS? SUMMARY ANSWER: Having PCOS was not associated with symptoms of anxiety and depression but was associated with somewhat lower body appreciation. WHAT IS KNOWN ALREADY: PCOS has been associated with a higher chance to develop mental health problems, like anxiety, and body image concerns. The International Guidelines on PCOS recommend that all women with PCOS should routinely be screened for anxiety and depressive disorders. In most studies in this field, the comparison group included healthy women without fertility problems. STUDY DESIGN, SIZE, DURATION: We conducted a cross-sectional survey study between May 2021 and July 2023, using an online questionnaire. We informed women about this study at fertility clinics in the Netherlands through posters and leaflets and on the websites of the Dutch patient organizations Freya and Stichting PCOS. PARTICIPANTS/MATERIALS, SETTING, METHODS: This study included women with infertility, with and without PCOS, who were undergoing fertility treatment. Women completed two assessment tools: the Hospital Anxiety and Depression Scale (HADS) and the Body Appreciation Scale-2 (BAS-2). Primary outcomes were clinically relevant symptoms of anxiety (score ≥ 11) and depression (score ≥ 11), and BAS-2 scores. Secondary outcomes were mean anxiety and depression scores and anxiety and depression scores of 8 and higher. Dichotomous outcomes and continuous outcomes were analysed using logistic and linear regression analyses adjusted for age, BMI, and duration of infertility. MAIN RESULTS AND THE ROLE OF CHANCE: A total of 1025 women currently undergoing infertility treatment participated, of whom 502 (49.0%) had PCOS and 523 (51.0%) had other infertility diagnoses. We found self-reported clinically relevant symptoms of anxiety in 33.1% of women with PCOS and in 31.0% of women with other infertility diagnoses (adjusted OR: 0.99, 95% CI 0.74-1.31). Clinically relevant symptoms of depression were reported in 15.5% of women with PCOS versus 14.5% of women with other infertility diagnoses (adjusted OR: 1.04, 95% CI 0.71-1.50). Women with PCOS reported slightly less body appreciation (adjusted mean difference: -1.34, 95% CI -2.32 to -0.36). LIMITATIONS, REASONS FOR CAUTION: Results are based on self-report and may have been affected by sampling bias. WIDER IMPLICATIONS OF THE FINDINGS: Although guidelines recommend screening women with PCOS, feelings of anxiety and depression can be present in any woman undergoing fertility treatments. We advise fertility clinics to be aware of women's mental health issues and to offer support accordingly, as a part of routine care. STUDY FUNDING/COMPETING INTEREST(S): This study did not receive specific funding. All authors report no conflict of interest related to the current research. TRIAL REGISTRATION NUMBER: This study was pre-registered at OSF: https://osf.io/qbeav.

Distress, illness perception and coping style among thyroid cancer patients after thyroidectomy: A cross-sectional study.

PURPOSE: Thyroid cancer generally has a good prognosis, and thyroidectomy is the main treatment given to thyroid cancer patients. Almost every cancer patient experiences varying degrees of distress, which can reduce their quality of life. This study aims to explore the level of distress and its relationship with illness perception and coping style among Chinese thyroid cancer patients after thyroidectomy and to identify the influencing factors on distress. METHODS: A cross-sectional study with convenience sampling method was conducted. Totally 184 thyroid cancer patients after thyroidectomy were recruited in a tertiary hospital in Southern China with the response rate being 94.4% . The participants were investigated by a self-designed demographic and disease-related questionnaire, the Distress Management, the Brief Illness Perception Questionnaire, and the Medical Coping Modes Questionnaire. Descriptive statistics, univariate analysis, and multivariate linear regression were applied for data analysis. RESULTS: In total, 99 (53.8%) thyroid cancer patients after thyroidectomy scored 4 or higher on the DT. Illness perception, emotional problem, body image loss by surgical scars, and acceptance-resignation were the influencing factors of distress and could explain 67.6% of the variance of distress among thyroid cancer patients after thyroidectomy. CONCLUSIONS: Healthcare professionals should not ignore the distress among thyroid cancer patients after thyroidectomy and should take effective measures to alleviate the distress of thyroid cancer patients after thyroidectomy by enhancing their accurate and positive illness perceptions, decreasing their emotional problems, alleviating their body image loss by surgical scars, and avoiding acceptance-resignation coping style.