Primary caregivers need to be financially supported by the relevant organizations. Care skills training and providing palliative care seem helpful in reducing the pain and the burden of family caregivers for patients with breast cancer.

Objectives This study aimed to identify coping strategies used by family caregivers of patients with schizophrenia and their determinants. Methods This was a descriptive correlational study. Participants were 225 family caregivers of patients with schizophrenia who were referred to the psychiatric clinic at one large teaching referral hospital in Iran. They were selected through purposive sampling method. Data collection tools were demographic and clinical data form, the Zarit Burden Interview (ZBI) and the Family Coping Questionnaire (FCQ). Results The score of caregiver burden was 65.14 ± 9.17. Of 225 family caregivers, 23.11% used an avoiding coping strategy. There was a significant relationship between caregiver burden and coping strategies ( P < 0.001). The regression model showed that adaptive coping strategies were significantly associated with some demographic characteristics including age, education level, gender, employment status, losing the job because of caregiving responsibilities, perceived income adequacy, duration of illness, duration of caregiving and caregiver burden ( P < 0.05). Conclusion Family caregivers of patients with schizophrenia experience a high level of burden, which can put them at risk of using maladaptive coping strategies. Mental health professionals should plan programs that support both family caregivers and patients in clinical and community settings.

PurposeBreast cancer is the most common cancer in women worldwide and the leading cause of cancer death among women. In Asian countries such as Iran, the incidence of breast cancer is increasing. The present study aimed to assess the risk factors for breast cancer of women in Tabriz, Iran.MethodsA hospital-based case-control study was undertaken to identify breast cancer risk factors. The study consisted of 140 cases confirmed via histopathological analysis and 280 group-matched controls without any malignancy. Data were analyzed using descriptive and inferential statistical methods via the SPSS software version 18.ResultsIn a multivariate analysis, educational level (odds ratio [OR], 4.7; 95% confidence interval [CI], 2.11-10.83), menopausal status (OR, 2.54; 95% CI, 1.41-4.59), a high-fat diet (OR, 2.76; 95% CI, 1.51-5.04), abortion (OR, 2.13; 95% CI, 1.20-3.79), passive smoking (OR, 2.76; 95% CI, 1.51-5.04), oral contraceptive use (OR, 3.18; 95% CI, 1.80-5.59), stress (OR, 3.05; 95% CI, 1.74-5.36), and migration (OR, 3.09; 95% CI, 1.39-6.90) were factors associated with a significantly increased risk of breast cancer. Breastfeeding (OR, 0.39; 95% CI, 0.16-0.97) and a diet containing sufficient fruit and vegetables (OR, 0.22; 95% CI, 0.12-0.39) had protective roles against breast cancer.ConclusionThe study revealed that the risk factors for breast cancer among women in the Tabriz area of Iran are related to the lifestyle. Therefore, the provision of education to change unhealthy lifestyle choices and periodic check-ups for early breast cancer detection are recommended.

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Background: The primary objective of the present study was to assess changes in the nutritional status and quality of life in acute leukaemia patients, aged ! 15 years, who had undergone induction chemotherapy. Methods: A preliminary and post-induction chemotherapy assessment of patients' nutritional status, quality of life, sociodemographic status and medical characteristics was conducted using the Patient Generated Subjective Global Assessment (PG-SGA) and the European Organization for Research and Treatment of Cancer quality of life (QOL-C30, version 3) questionnaires. The PG-SGA is a clinical nutrition assessment tool used to evaluate oncology patients. Patients with newly-diagnosed acute laeukaemia, aged ! 15 years, at three hospitals in Tehran (from May 2009 to March 2010), were recruited for the present study. Results: Sixty-three acute leukaemia patients [65% men and 35% women with a mean (SD) age of 33 (15.4) years] participated in the present study. A total of 19.4% were found to be malnourished prior to chemotherapy. After chemotherapy, 76.1% of patients were considered moderately malnourished, whereas 6.3% were severely malnourished. After induction chemotherapy, both the nutritional status and quality of life deteriorated in the majority of patients, as demonstrated by a paired t-test. Conclusions: A deteriorated nutritional status and quality of life was the result of the side effects posed by induction chemotherapy in the patients investigated in the present study. These findings highlight the need for an appropriate nutritional support programme to improve the nutritional status and quality of life in patients with leukaemia undergoing chemotherapy.

Breastfeeding mothers returning to work often feel exhausted as they must feed on demand and attend to family and employment responsibilities, leading to concerns for their personal health. This study was prompted by a desire to understand and identify barriers to mothers' health. We describe the experiences of 12 Iranian breastfeeding and employed mothers through in-depth and semi-structured interviews and thematic analysis. Two main themes emerged: (i) working and mothering alone and (ii) facing concerns about health. The findings highlight the need for a support system for breastfeeding mothers within the family and in the workplace. Familyfriendly policies targeting mothers' and employers' views are needed to support working mothers and promote breastfeeding.

Objectives Breastfeeding mothers returning to work undertake multiple conflicting roles at home and work that can result in high levels of stress. Exploring coping skills amongst these mothers can help in planning useful programmes to promote family wellbeing. This study aims to explore the experiences of working breastfeeding mothers and their coping mechanism against high levels of daily stress. Methods In this qualitative study, we described the experiences of 20 Iranian breastfeeding mothers through in-depth and semi-structured interviews. All interviews were recorded, transcribed and analysed using thematic analysis. Results Two main themes emerged as follows: 1) self-management with subthemes of a) attitude reconstruction, b) order and planning, c) creating a boundary between work and family and d) reprioritising life affairs; and 2) seeking help with subthemes of a) family member support, b) childcare facilities and c) spirituality. Conclusions Findings suggest that women need support from family members and family-friendly policies at the workplace. Breastfeeding mothers may benefit from educational programmes that focus on effective coping strategies.

MALIHI Z., KANDIAH M., CHAN Y.M., ESFANDBOD M., VAKILI M., HOSSEINZADEH M. & ZARIF YEGANEH M. (201 ) European Journal of Cancer Care The effect of dietary intake changes on nutritional status in acute leukaemia patients after first induction chemotherapyThis study aimed to evaluate how changes in dietary intake among acute lymphoblastic and acute myeloid leukaemia (ALL and AML) patients affect nutritional status after the first induction chemotherapy. Dietary intake was assessed using 24-h recall and a 136-item food frequency questionnaire. Nutritional status was assessed by Patients Subjective Global Assessment questionnaire before starting induction therapy and again after 1 month. All newly diagnosed acute leukaemia patients aged 15 years old and older who attended three referral hospitals for initiation of their induction chemotherapy were included in the sample selection provided that they gave informed consent. A total of 30 AML and 33 ALL patients participated in the study. Dietary intake and nutritional status worsened after the chemotherapy treatment. Dietary intake in terms of macronutrients, micronutrients, food variety and diet diversity score changed significantly after the induction chemotherapy. No significant relationship was found between the changes in dietary indices and nutritional status. Chemotherapy-related side effects as an additional factor to cancer itself could affect dietary intake of leukaemia patients. The effectiveness of an early assessment of nutritional status and dietary intake should be further investigated in order to deter further deterioration.