Exploring neighborhood inequality in female breast cancer incidence in Tehran using Bayesian spatial models and a spatial scan statistic / 한국역학회지

OBJECTIVES: The aim of this study was to explore the spatial pattern of female breast cancer (BC) incidence at the neighborhood level in Tehran, Iran.METHODS: The present study included all registered incident cases of female BC from March 2008 to March 2011. The raw standardized incidence ratio (SIR) of BC for each neighborhood was estimated by comparing observed cases relative to expected cases. The estimated raw SIRs were smoothed by a Besag, York, and Mollie spatial model and the spatial empirical Bayesian method. The purely spatial scan statistic was used to identify spatial clusters.RESULTS: There were 4,175 incident BC cases in the study area from 2008 to 2011, of which 3,080 were successfully geocoded to the neighborhood level. Higher than expected rates of BC were found in neighborhoods located in northern and central Tehran, whereas lower rates appeared in southern areas. The most likely cluster of higher than expected BC incidence involved neighborhoods in districts 3 and 6, with an observed-to-expected ratio of 3.92 (p < 0.001), whereas the most likely cluster of lower than expected rates involved neighborhoods in districts 17, 18, and 19, with an observed-to-expected ratio of 0.05 (p < 0.001).CONCLUSIONS: Neighborhood-level inequality in the incidence of BC exists in Tehran. These findings can serve as a basis for resource allocation and preventive strategies in at-risk areas.

Exploring neighborhood inequality in female breast cancer incidence in Tehran using Bayesian spatial models and a spatial scan statistic / 한국역학회지

OBJECTIVES: The aim of this study was to explore the spatial pattern of female breast cancer (BC) incidence at the neighborhood level in Tehran, Iran. METHODS: The present study included all registered incident cases of female BC from March 2008 to March 2011. The raw standardized incidence ratio (SIR) of BC for each neighborhood was estimated by comparing observed cases relative to expected cases. The estimated raw SIRs were smoothed by a Besag, York, and Mollie spatial model and the spatial empirical Bayesian method. The purely spatial scan statistic was used to identify spatial clusters. RESULTS: There were 4,175 incident BC cases in the study area from 2008 to 2011, of which 3,080 were successfully geocoded to the neighborhood level. Higher than expected rates of BC were found in neighborhoods located in northern and central Tehran, whereas lower rates appeared in southern areas. The most likely cluster of higher than expected BC incidence involved neighborhoods in districts 3 and 6, with an observed-to-expected ratio of 3.92 (p < 0.001), whereas the most likely cluster of lower than expected rates involved neighborhoods in districts 17, 18, and 19, with an observed-to-expected ratio of 0.05 (p < 0.001). CONCLUSIONS: Neighborhood-level inequality in the incidence of BC exists in Tehran. These findings can serve as a basis for resource allocation and preventive strategies in at-risk areas.

effect of rehabilitation method based on existential approach and olson's model on marital satisfaction

Mastectomy as a treatment for breast cancer can disturb marital satisfaction of many couples. In this way, existential anxieties stemming from this potentially deleterious event, and inefficient responses to them, could be mediating. The purpose of this study is to investigate the effectiveness of a rehabilitation method based on existential approach and Olson's marital enrichment model on marital satisfaction of women who had undergone mastectomy and their husbands. In this study, a single subject research design is used. The study population comprised couples who had referred to Radiotherapy department of Imam Hussein hospital in Tehran, that among them three couples whose average age was 20 to 50 years old, wife's had undergone mastectomy, tumor has not spread to other parts of the body, and had no prior history of psychiatric disorders before cancer, were selected through purposeful sampling and Intervention in 12 sessions of 90 minutes once a week, has been designed to suit their specific needs. The level of couple's marital satisfaction was evaluated using Dyadic Adjustment Scale. Comparing couple's scores on the diagram during 9 time measurement [3 times baseline, 4 times during intervention, and 2 times follow up assessment] and calculating recovery percentage, represent increasing in score of marital adjustment scale. So it seems that, this kind of an eclectic couple therapy, by considering couples existential anxiety, has been promoted their marital satisfaction. Explanations are given in discussion part

[Quality of life of cervical cancer survivors and its association with clinical and pathological factors]

Cervical cancer is one of the most common cancers of women in developing countries. Disease and its treatments affect different aspects of patients' life. The aim of the present study was to assess the quality of life among long term cervical cancer survivors and its association with clinical and pathological features in patients attended to cancer centers in Shahid Beheshti university of medical sciences,Tehran,Iran. A descriptive correlational design was used. 65 cervical cancer survivors who had completed their treatment during the time period from 2001 to 2008 participated in the study. Data were collected by two questionnaires: European Organization for Research and Treatment of Cancer Quality of Life Questionnaire "Cervix 24" and European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core30-Version 3[rd]. Medical records were reviewed for pathologic and clinical features of these patients. Validity of these questionnaires was assured by content validity. Questionnaires were completed by phone interview with the patients. Reliability of these questionnaires was obtained by computing internal consistency [Cronbach alpha] and test re test. Data were analyzed by SPSS 17.: Mean age of participants was 57.85 with standard deviation 11.02. Mean age of participants' at the time of diagnosis was 54.83 with standard deviation of 11.33. Quality of life scores for these patients was 46.98 with standard deviation of 7.60, which is considered a moderate level of quality of life. Scores of physical functioning ,emotional ,and social functioning sub scales were 25 +/- 9.61-53.8 +/- 14.53 and 61.34 +/- 18.33 respectively.Therer was a significant association between quality of life scores and socioeconomic status .A significant association was also found between quality of life scores and duration of time from diagnosis and treatment completion. Findings of this study showed that quality of life of cervical cancer survivals was affected by cancer. Improving physical function and recovery form symptoms may improve quality of life of these patients