Development and psychometric testing of a new instrument to measure factors influencing women's breast cancer prevention behaviors (ASSISTS)

Background: Breast cancer preventive behaviors have an extreme effect on women's health. Despite the benefits of preventive behaviors regarding breast cancer, they have not been implemented as routine care for healthy women. To assess this health issue, a reliable and valid scale is needed. The aim of the present study is to develop and examine the psychometric properties of a new scale, called the ASSISTS, in order to identify factors that affect women's breast cancer prevention behaviors. Methods: A multi-phase instrument development method was performed to develop the questionnaire from February 2012 to September 2014. The item pool was generated based on secondary analyses of previous qualitative data. Then, content and face validity were applied to provide a pre-final version of the scale. The scale validation was conducted with a sample of women recruited from health centers affiliated with Tehran University of Medical Sciences. The construct validity (both exploratory and confirmatory), convergent validity, discriminate validity, internal consistency reliability and test-retest analysis of the questionnaire were tested. Results: Fifty-eight items were initially extracted from the secondary analysis of previous qualitative data. After content validity, this was reduced to 49 items. The exploratory factor analysis revealed seven factors (Attitude, supportive systems, self-efficacy, information seeking, stress management, stimulant and self-care) containing 33 items that jointly accounted for 60.62 % of the observed variance. The confirmatory factor analysis showed a model with appropriate fitness for the data. The Cronbach's alpha coefficient for the subscales ranged from 0.68 to 0.85, and the Intraclass Correlation Coefficient (ICC) ranged from 0.71 to 0.98; which is well above the acceptable thresholds. Conclusion: The findings showed that the designed questionnaire was a valid and reliable instrument for assessing factors affecting women's breast cancer prevention behaviors that can be used both in practice and in future studies

Exploring breast cancer preventive lifestyle and social support of Iranian women : a study protocol for a mixed-methods approach

Abstract Background It is widely accepted that a healthy lifestyle may decrease the probability of developing cancer. This study aimed to describe a study protocol that makes it possible to explore preventive health lifestyles of Iranian women and their received social support for the purpose of developing cultural strategies to increase breast cancer prevention. Methods A mixed-methods study will be accomplished in two sequential parts. First, a cross-sectional study will be conducted in which 2,250 Iranian women are recruited by using a random multistage cluster sampling of 20 health care centers. Structured face-to-face interviews will be conducted to obtain information on the participants’ health lifestyle and perceived social support. Data will be analyzed using both multivariate regression and structural equation modeling techniques. Then, a qualitative study will be conducted among employed women using a purposive sampling design. Data will be collected by means of focus groups and semi-structured interviews and will be analyzed using a conventional content analysis approach. The results of the quantitative and qualitative study will be used to develop breast cancer preventive strategies. Discussion Researchers need to acquire knowledge regarding the lifestyle and perceived social support of Iranian women that will foster culturally competent approaches to promote healthy lifestyles to develop breast cancer preventive strategies. Examining breast cancer preventive lifestyles provides valuable information for designing applicable intervention programs for improving women’s health

Predictors of time to relapse in amphetamine-type substance users in the matrix treatment program in Iran : a Cox proportional hazard model application

Background: The aim of this study was to determine which predictors influence the risk of relapse among a cohort of amphetamine-type substance (ATS) users in Iran. Methods: A Cox proportional hazards model was conducted to determine factors associated with the relapse time in the Matrix treatment program provided by the Iranian National Center of Addiction Studies (INCAS) between March 2010 and October 2011. Results: Participating in more treatment sessions was associated with a lower probability of relapse. On the other hand, patients with less family support, longer dependence on ATS, and those with an experience of casual sex and a history of criminal offenses were more likely to relapse. Conclusion: This study broadens our understanding of factors influencing the risk of relapse in ATS use among an Iranian sample. The findings can guide practitioners during the treatment program

Image-based estimation of myocardial acceleration using TDFFD: a phantom study

International audienceIn this paper, we propose to estimate myocardial acceleration using a temporal di↵eomorphic free-form deformation (TDFFD) algorithm. The use of TDFFD has the advantage of providing B-spline parameterized velocities, thus temporally smooth, which is an asset for the computation of acceleration. The method is tested on 3D+t echocar-diographic sequences from a realistic physical heart phantom, in which ground truth displacement is known in some regions. Peak endocardial acceleration (PEA) error was 20.4%, the main hypothesis for error being the low temporal resolution of the sequences. The allure of the acceleration profile was reasonably preserved. Our method suggests a non-invasive technique to measure cardiac acceleration that may be used to improve the monitoring of cardiac mechanics and consecutive therapy planning

Image based cardiac acceleration map using statistical shape and 3D+t myocardial tracking models; in-vitro study on heart phantom

International audienceIt has been demonstrated that the acceleration signal has potential to monitor heart function and adaptively optimize Cardiac Resynchronization Therapy (CRT) systems. In this paper, we propose a non-invasive method for computing myocardial acceleration from 3D echocardiographic sequences. Displacement of the myocardium was estimated using a two-step approach: (1) 3D automatic segmentation of the myocardium at end-diastole using 3D Active Shape Models (ASM); (2) propagation of this segmentation along the sequence using non-rigid 3D+t image registration (temporal diffeomorphic free-form-deformation, TDFFD). Acceleration was obtained locally at each point of the myocardium from local displacement. The framework has been tested on images from a realistic physical heart phantom (DHP-01, Shelley Medical Imaging Technologies, London, ON, CA) in which the displacement of some control regions was known. Good correlation has been demonstrated between the estimated displacement function from the algorithms and the phantom setup. Due to the limited temporal resolution, the acceleration signals are sparse and highly noisy. The study suggests a non-invasive technique to measure the cardiac acceleration that may be used to improve the monitoring of cardiac mechanics and optimization of CRT

The effects of trans-theoretical model and fear of dental care on dental cleaning behavior among students

Background: Fear of dental care prevents dental cleaning behavior and increases the prevalence of dental caries. This study was conducted to determine the effect of Trans-Theoretical Model constructs and fear of dental care on the dental cleaning behavior of students. Materials and Methods: This cross-sectional study was carried out in Sanandaj City, Iran, in 2017. Using multi-stage sampling, 1,344 male and female students were included in the study. They completed a self-report questionnaire, including demographic information, Trans-Theoretical Model constructs and fear of dental care. Data were analyzed using SPSS software (version 22.0). Results: A total of 1,344 male and female students with a mean age of 15.22±2.64 years participated in the study; from the perspective of students, dental caries (88.4%) was the most frequent illness and tongue inflammation (0.6%) was the least frequent disease. Overall, 32.9% of the students used no tools for cleaning their teeth. Fear of dental care and perceived barriers were reduced significantly during the stages of dental cleaning behavior (p<0.05) and perceived self-efficacy and perceived benefits were significantly increased (p<0.001). The odds of dental cleaning behavior increased with self-efficacy (OR=1.34, 95%CI=1.22-1.48, p<0.05), and decreased with fear of dental care (OR=0.90, 95%CI=0.80-0.98, p<0.01). Conclusion: The findings showed dental cleaning behavior among students was at a low level and various factors such as perceived self-efficacy, benefits and barriers and fear of dental care influenced its performance

Model generation of coronary artery bifurcations from CTA and single plane angiography

International audiencePurpose: To generate accurate and realistic models of coronary artery bifurcations before and after percutaneous coronary intervention (PCI), using information from two image modalities. Because bifurcations are regions where atherosclerotic plaque appears frequently and intervention is more challenging, generation of such realistic models could be of high value to predict the risk of restenosis or thrombosis after stent implantation, and to study geometrical and hemodynamical changes. Methods: Two image modalities have been employed to generate the bifurcation models: computer tomography angiography (CTA) to obtain the 3D trajectory of vessels, and 2D conventional coronary angiography (CCA) to obtain radius information of the vessel lumen, due to its better contrast and image resolution. In addition, CCA can be acquired right before and after the intervention in the operation room; therefore, the combination of CTA and CCA allows the generation of realistic prepro-cedure and postprocedure models of coronary bifurcations. The method proposed is semiautomatic, based on landmarks manually placed on both image modalities. Results: A comparative study of the models obtained with the proposed method with models manually obtained using only CTA, shows more reliable results when both modalities are used together. The authors show that using preprocedure CTA and postprocedure CCA, realistic postprocedure models can be obtained. Analysis carried out of the Murray's law in all patient bifurcations shows the geometric improvement of PCI in our models, better than using manual models from CTA alone. An experiment using a cardiac phantom also shows the feasibility of the proposed method. Conclusions: The authors have shown that fusion of CTA and CCA is feasible for realistic generation of coronary bifurcation models before and after PCI. The method proposed is efficient, and relies on minimal user interaction, and therefore is of high value to study geometric and hemo-dynamic changes of treated patients