How do I deal with breast cancer: a qualitative inquiry into the coping strategies of Iranian women survivors.

BACKGROUND: Breast cancer is the most frequent cancer in Iran. Understanding the coping strategies employed by cancer survivors can provide valuable information for designing interventions to help them adapt to the problems produced by cancer and its treatment. This study aimed to explore the coping strategies of BC survivors in Iran. METHODS: This qualitative study was conducted in Mashhad, Northeast Iran, between April and December 2021. Fourteen BC survivors were selected through purposive sampling. The data were collected using semi-structured interviews. Data were analyzed using conventional content analysis adopted by Graneheim and Lundman. MAXQDA 12 software was used for data organization. Components of trustworthiness, including credibility, dependability, confirmability, and transferability, were considered. RESULTS: The main categories that emerged from the participants' data analysis were "behavioral coping strategies" and "emotional coping strategies." Behavioral coping strategies included efforts to adopt healthy nutrition, attempts to improve a healthy lifestyle, maintenance of everyday activities, use of specialized cancer support consultation services, and seeking to increase health literacy about BC. The emotional coping strategies consisted of denial as a temporary escape route, positive thinking and focusing on the positive aspects of life, reinforcement of spirituality, and seeking the support of relatives. CONCLUSION: Our findings provide an in-depth understanding of Iranian women's strategies for coping with BC. A trained team of oncologists, psychiatrists, mental health professionals, and reproductive health specialists needs to contribute significantly to improving the coping ability of patients with cancer, which could lead to enhanced health promotion and a higher quality of life.

Understanding breast cancer risk factors: is there any mismatch between laywomen perceptions and expert opinions.

BACKGROUND: Women's perception and knowledge of breast cancer signs, symptoms, and risk factors could be conducive to breast cancer risk management and interventions. The present study aimed to explore Iranian laywomen perceptions and expert opinions regarding breast cancer risk factors. METHODS: This qualitative study was conducted from March to November 2019 in Mashhad, northeast of Iran. Through purposive sampling, 24 laywomen (women with and without BC) and 10 experts of different fields including oncology, surgery, gynecology and reproductive health were selected. Data collection was carried out using semi-structured interviews, which was mainly focused on the participants' understanding and perception of BC risk factors. The data was analyzed utilizing conventional content analysis developed by Graneheim & Lundman. Components of trustworthiness, including credibility, dependability, confirmability, and transferability were considered. RESULTS: The main category of risk factors, which emerged from the lay participants' data analysis, were "unhealthy lifestyle and habits" , "hormonal influences", "environmental exposures", "Individual susceptibility "and "belief in supernatural powers". The experts had similar perspectives for certain risk factors, yet not for all. The category of "Individual history of disease" was emerged only from experts' interviews. CONCLUSION: In the present study, the lay participants' perception concerning BC risk factors was found to be a mixture of cultural beliefs and the scientific knowledge dispersed by the media, internet, and health services. Primary prevention approaches, including awareness of breast cancer risk factors, are required for women to make improved health-related choices.

Night-shift work duration and breast cancer risk: an updated systematic review and meta-analysis.

BACKGROUND: The International Agency for Research on Cancer (IARC) has classified shift work as a possible human carcinogen. The results of systematic on this topic is contradictory. This systematic review and meta-analysis, therefore, aimed to update the current evidence regarding the relationship between night-shift work duration and breast cancer risk. METHODS: PubMed, Web of Science, and Scopus as well as reference list of included studies were searched until December 19, 2020. Observational case-control or cohort studies investigating the relationship between the duration of night-shift work and breast cancer in women were included, which all quantified night-shift work exposure. All statistical analyses were done by Stata version 11.2. RESULTS: Our literature search was resulted in retrieval of 4854 publications from which 26 eligible studies with 1,313,348 participants were included in the meta-analyses. The pooled relative risk (RR) and 95% confidence intervals (CIs) of breast cancer for short-term night-shift workers (< 10 years) was 1.13 (95% CI 1.03-1.24, p = 0.008, I2 = 71.3%), and for long-term night-shift workers (≥ 10 years) was 1.08 (95% CI 0.99-1.17, p = 0.09, I2 = 42.2%), with moderate to substantial statistical heterogeneity observed in both analyses. The results of subgroup analysis showed that flight attendants with long overnight flights were at an elevated risk of breast cancer, but unmeasured confounders limited these results. The risk of breast cancer in case control studies, adjusted for reproductive factors and family history of breast cancer as well as studies with high quality was increased in both short term and long term night-shift workers. CONCLUSIONS: This systematic review found a positive statistical relationship between night work and breast cancer risk in short-term night-shift workers but no increase was observed in the long-term night-shift workers.

Barriers to Adherence to Medical Care Programs in Liver Transplant Recipients: A Qualitative Study.

BACKGROUND: Non-adherence to medical care programs in transplant recipients is considered one of the life-threatening factors in transplant recipients, which can prevent achieving the desired levels of health care. OBJECTIVE: To determine perceptions of liver transplant recipients about the barriers to their adherence to medical care programs. METHODS: This study was conducted based on a qualitative content analysis method using semi-structured interviews with 23 liver transplant recipients, their families, and the transplant teams. A purposive sampling method was used in liver transplant clinics affiliated to Tehran University of Medical Sciences, Tehran, Iran, from May to November 2017. RESULTS: Three main categories including factors related to therapeutic problems (educational problems and medication challenges), personal factors (self-management disability), as well as social problems (cultural conditions and passive family) were identified as the barriers to adherence to medical care programs. CONCLUSION: Paying attention to barriers to adherence to medical care and planning for moderating them in a collaborative effort between transplant recipients and health care providers could increase the likelihood of survival and quality of life in these patients.

The global prevalence of primary ovarian insufficiency and early menopause: a meta-analysis.

Objective: The aim of this study was to estimate the global prevalence of primary ovarian insufficiency (POI) and early menopause (EM). Methods: A comprehensive literature search was performed in several databases to retrieve relevant English articles published between 1980 and 2017. To assess the methodological quality of the studies, the Newcastle-Ottawa Scale was used. The heterogeneity of results across the studies was assessed using Cochran's Q test and quantified by the I2 statistic. Prevalence estimates of all studies were pooled using a random-effects meta-analysis model at a confidence level of 95%. Results: A total of 8937 potentially relevant articles were identified from the initial searches. Thirty-one studies met the inclusion criteria and were included in this meta-analysis. The pooled prevalence of POI and EM was calculated as 3.7% (95% confidence interval: 3.1, 4.3) and 12.2% (95% confidence interval: 10.5, 14), respectively. The prevalence of POI was higher in medium and low Human Development Index countries. The prevalence trend did not change over time. Conclusion: The prevalence of POI and EM in women is considerable. The results of this study could contribute to consciousness-raising of health policy-makers toward the necessity of prioritizing, planning, and allocating health resources as preventive and treatment interventions for these women.

Development and psychometric properties of the Hookah Smoking Initiation for Women Questionnaire (HIWQ).

The aims of this study were to design the Hookah Smoking Initiation for Women Questionnaire (HIWQ) and determine its psychometric properties. This was a sequential exploratory mixed-methods design consisting of qualitative and quantitative phases. This study was conducted from August 2012 to July 2013 in Tehran. In the qualitative phase, semi-structured interviews were held with 36 Iranian women for developing a preliminary item pool. Consequently, during the quantitative phase, the psychometric properties of the questionnaire were determined with the collaboration of 323 women living in various geographical locations in Tehran, Iran. Content validity of the questionnaire was examined by a panel of experts. The questionnaire's construct validity was assessed using exploratory factor analysis and confirmatory factor analyses. The Cronbach's alpha coefficient was calculated to check the questionnaire's internal consistency reliability. Moreover, its stability was tested using the test-retest method. Exploratory factor analysis indicated that the HIQW could best be explained by a six-factor solution: 'drawing the attention of other people', the need to having fun and being relaxed, 'hookah smoking in the family', 'availability of hookah', 'curiosity' and 'having a positive attitude toward hookah'. It also was found that the construct and content validity, and the reliability of the questionnaire were satisfactory (α = 0.83, ICC = 0.94). The HIQW was valid and reliable. Therefore, healthcare professionals can use it for evaluating the hookah smoking initiation in women. Future studies are required to refine this questionnaire and assess its applicability in different cultures and contexts.

Tools for the Measurement of Psychological Aspects of Organ Donation among the Families of Brain-dead People.

BACKGROUND: According to the basic ethical principle of non-maleficence, organ procurement systems need to be accountable to donor families. As organ donation can be potentially traumatic, donor families are at risk of developing psychological damage. Appropriate measurement tools are needed to diagnose such disorders and develop appropriate treatment measures. OBJECTIVE: To examine the appropriateness of measurement tools and approaches used in previous studies for assessing donor families' psychological well-being. METHODS: A structured online search was conducted in electronic databases namely ScienceDirect, PubMed, ProQuest, Scopus, Ovid, and Web of Science. The main inclusion criterion was the use of psychological assessment tools for data collection. RESULTS: 10 studies were included in which different tools had been used for measuring donor families' psychological well-being in the following 5 dimensions: stress, depression, grief, general health, and positive legacy of trauma. The major pitfalls of the reviewed studies were failure to specifically assess complicated grief and differentiating it from other psychological disorders, diversity of the tools used for psychological well-being assessment, and lack of clear definitions of donor families' psychological well-being and its dimensions. CONCLUSION: Donor families' psychological well-being is a complex and multidimensional concept and the existing measurement tools cannot accurately assess it. Therefore, the concept needs to be clearly explored and defined. Developing a comprehensive measurement tool or a set of scales is necessary for the early diagnosis of any impairment in donor families' psychological well-being.

A time for psycho-spiritual transcendence: The experiences of Iranian women of pain during childbirth.

BACKGROUND: The description of women's experiences of childbirth improves our understandings of the nature of childbirth, women's suffering and pain during childbirth. AIM: This study aimed to explore women's experiences of pain during childbirth. METHOD: A qualitative study was conducted using a conventional content analysis method proposed by Graneheim and Lundman (2004). In-depth face to face semi-structured interviews were held with 17 women who met inclusion criteria for participation in this study. FINDINGS: The women's experiences of pain during childbirth was described as 'a time for psycho-spiritual transcendence'. Categories developed during the data analysis were 'conflicting emotions towards pain', 'new insight towards labor pain', 'self-actualization' and 'spiritual development'. CONCLUSION: Most participants had positive experiences and attitudes towards pain during childbirth influenced by cultural, context and religious factors. According to this study, 'transcendental progression' was an eminent feeling that created positive inner feelings along with self-actualization in women. This provides a new insight on labor pain and helps healthcare providers understand the effect of pain during childbirth on women's spiritual, mental and psychological needs.

Assessment of Rice Associated Bacterial Ability to Enhance Rice Seed Germination and Rice Growth Promotion

ABSTRACT The application of beneficial bacteria has recently been used for sustainable agriculture. In current research, 71 bacterial isolates were obtained from rice plant and the rhizosphere soil of different paddy fields in Guilan province, Iran. After primitive investigation, 40 bacteria with typical predominant characteristics were selected. By PCR-RFLP of their 16S r-DNA gene, 8 Operational Taxonomic Units (OTUs) totally consisted of 33 isolates were obtained. From all of them, 8 isolates were selected for rice seed germination experiment, then, effective isolates were used for pot experiment to evaluate their ability for promoting rice growth. All of them were able to increase rice growth and yield, but in different potential. These tested isolates were identified as Alcaligenes faecalis (DEp8, O1R4), Pantoea ananatis (AEn1), Bacillus vietnamensis (MR5), Bacillus idriensis (MR2) and Stenotrophomonas maltophilia by partial sequencing of their 16S r-DNA gene. Among them, AEn1 and MR5 produced indole-3- acetic acid (IAA) in larger amounts than the other isolates and the isolates AEn1 and O1R4 were able to solubilize phosphate in higher amounts. According to the results obtained, it can be concluded that AEn1, O1R4 and MR5 can be considered as bacterial inoculants to use as alternatives for chemical fertilizers.

The additive effect of excimer laser on non-cultured melanocyte-keratinocyte transplantation for the treatment of vitiligo: a clinical trial in an Iranian population.

BACKGROUND: Non-cultured cellular grafting is specified for stable vitiligo treatment as a novel surgical technique, however, the additive effect of excimer laser on melanocytes-keratinocytes transplantation (MKT) have not experienced yet. OBJECTIVE: To assay the additive effect of excimer laser on MKT for the treatment of vitiligo in an Iranian population. METHODS AND MATERIALS: In this non-randomized clinical trial, 39 patches were evaluated. Nine patches treated by MKT alone, 10 patches treated by MKT and excimer laser, 10 patches treated with excimer alone and 10 patches left without any treatments as control patches. RESULTS: In the patches treated with excimer, the percentage reduction of depigmented area from baseline varied, ranging from 0 to 43.9%. In the nine patches treated with non-cultured MKT, the median percentage reduction of depigmented area from baseline was 15.9%. The median percentage reduction of depigmented area in excimer + MKT was 41.9% .In the untreated patches, the median percentage reduction of depigmented area was 0.1%. After controlling for the effect of 'depigmented area at baseline', significant reductions were observed in depigmented area of the patches treated with combination therapy of excimer and non-cultured MKT in comparison with the other therapies and untreated patches. CONCLUSION: Although pigmentation in our patients was lower than previous reports from Iran and other countries, however, we signified adding excimer to MKT increased the pigmentation rate in treated patches. Further investigations are recommended with longer follow-up and larger series to validate the findings reported here.

Comparison of therapeutic effect of topical Nigella with Betamethasone and Eucerin in hand eczema.

BACKGROUND: Nigella sativa has been used in traditional medicine. Although it was investigated in different studies, its effect on hand eczema has not been studied yet. OBJECTIVE: To compare the effects of Nigella, Betamethasone and Eucerin on severity of hand eczema and patients' life quality. METHODS: In this randomized, controlled, double-blinded clinical trial, we allocated new cases of hand eczema with 18-60 years of age in three therapeutic groups (Nigella, Betamethasone and Eucerin) by using permuted blocks for randomization. Patients applied medications twice a day and followed in a 4-week period. The primary outcome of the study was changes in severity and life quality, which were assessed at the beginning, 14th and 28th days of the study by Hand Eczema Severity index (HECSI) and Dermatology Life Quality Index (DLQI) respectively. RESULTS: Sixty patients recruited in the study with 20 patients allocated in each study arm. Eighteen, 19 and 15 patients in Eucerin, Nigella and Betamethasone groups, respectively, attended at least one of the therapy sessions. Nigella and Betamethasone showed significantly more rapid improvement in hand eczema compared with Eucerin (P = 0.003 and P = 0.012 respectively); Nigella and Betamethasone ointments caused significant decreases in DLQI scores compared with Eucerin (P < 0.0001 and P = 0.007 respectively). No significant difference was detected in mean DLQI and HECSI of the Nigella and Betamethasone groups over time (P = 0.38 and P = 0.99 respectively). CONCLUSION: It seems that Nigella might have the same efficacy as Betamethasone in improvement of life quality and decreasing severity of hand eczema.

Cadmium concentration in muscle, liver and kidney of sheep slaughtered in Falavarjan abattoir, Iran.

The aim of the present study was to investigate the levels of cadmium in sheep's muscle, liver and kidney from Isfahan and also to compare them with the levels reported in several other countries and with the maximum tolerance levels for the human consumption. The samples of muscle, liver and kidney of 60 animals around 1 to 6 years old were collected from the carcasses slaughtered in Flavarjan abattoir, Isfahan. Samples (acid digested and cadmium concentrations) were determined by graphite furnace atomic absorption spectrophotometry (GFAAS). The mean fresh weight concentrations in muscle, liver and kidney were about 0.0017 mg/kg, 0.0743 mg/kg and 0.02290 mg/kg, respectively. The mean concentration of cadmium in tissue samples was generally lower than the maximum acceptable concentration in European Commission (EC). Statistical analysis revealed a significant difference in cadmium concentration of liver and kidney between various age groups (p < 0.05).

Biological treatment of a dye solution by Macroalgae Chara sp.: effect of operational parameters, intermediates identification and artificial neural network modeling.

The potential of a macroalgae Chara sp. was investigated as a viable biomaterial for biological treatment of Malachite Green (MG) solution. The effects of operational parameters such as temperature, pH, initial dye concentration, reaction time and amount of algae on biological decolorization efficiency were studied. Biological treatment of MG solution by live and dead algae was compared. The reusability and efficiency of the live algae in long-term repetitive operations were also examined. The batch experiments results revealed the ability of algal species in biological degradation of the dye. The biological degradation compounds formed in this process were analyzed by UV-Vis, FT-IR and GC-Mass techniques. The degradation pathway of MG was proposed based on the identified compounds. In addition, an artificial neural network model was developed to predict the biological degradation efficiency. The findings indicated that ANN provides reasonable predictive performance (R(2)=0.970). The influence of each parameter on the variable studied was assessed, reaction time being the most significant factor, followed by temperature of the solution.

Study of two main approaches-electrophoresis and chromatography as varietal identification methods in rice.

Rice is a major worldwide crop that cultivated in the most areas of the north of Iran (Mazandaran and Gillan Province). An increase in the assortment of rice varieties is making it progressively more difficult to distinguish between the many cultivars by traditional visual identification methods. The more advanced identification techniques of electrophoresis and chromatography offer an effective solution to this emerging identification dilemma. This paper reviews the application of these two evaluation techniques. An Electrophoresis analysis includes gel electrophoresis and capillary electrophoresis and compares them with a popular chromatography technique, namely reversed-phase, size exclusion anion-exchange high performance liquid chromatography (HPLC). This paper will also include an interpretation of the results.

A survey and measurement of residues of lindane (organochlorine pesticides) in four species of the most consumed fish in the Caspian Sea (Iran).

In this study, samples of four species of the most consumed fish (sefid, koli, kilca and kafal fish) were analysed for concentrations of lindane (organochlorine pesticides). Fish were caught using electric fishing at four sites (Chalous and Babolsar cities, Khazar Abad and Miankaleh regions) in the Mazandaran provinces of Iran. Quantitative determination of the lindane was performed by gas chromatography electron-capture detection (GC-ECD). Samples contained detectable concentrations of lindane, but at concentrations below the maximum residue limit (MRL). No differences were found in the lindane concentrations between the types of fish at each site, but there were two groups of sites that were significantly different from one another in terms of lindane concentrations: sites II-IV < site I (P <0.05). However, the concentrations of lindane residues in the muscle were found to be less than the FAO/WHO (1993) recommended permissible intake and should not be of public concern in Mazandaran province.

Isolation of Brucella organisms from the milk of seronegative cows.

During an investigation of bovine brucellosis in Iran, conducted by the Razi Institute over a twelve-month period, samples of serum and milk were collected simultaneously from 6,472 cows in eight infected herds for serological and bacteriological testing. A total of 1,056 cows were serologically positive and 1,632 of 6,472 milk samples were positive to the milk ring test (MRT). Culture of the positive milk samples yielded 397 isolates of Brucella, 119 of which came from the 5,686 seronegative cows. The isolates belonged to Brucella abortus biotypes 2 (one isolate), 3 (356 isolates) and 9 (40 isolates).