Background: Despite our awareness of the significant effect of Social Determinant of Health (SDoH) such as Socio Economic Status (SES), income and education on breast cancer survival, there was a serious lack of information about the effect of different level of these factors on breast cancer survival. So far, no meta-analysis has been conducted with this aim, but this gap was addressed by this meta-analysis. Methods: Main electronic databases such as PubMed, Web of Science, and Scopus were investigated up to January 2019. Epidemiological studies focusing on the association between SDoH and breast cancer were singled out. Q-test and I2 statistic were used to study the heterogeneity across studies. Begg's and Egger's tests were applied to explore the likelihood of the publication bias. The results were reported as hazard ratio (HR) with 95% confidence intervals (CI) through a random-effects model. Results: We identified 7,653 references and included 25 studies involving 1,497,881 participants. The HR estimate of breast cancer survival was 0.82 (0.67, 0.98) among high level of SES, 0.82 (0.70, 0.94) among high level of income and 0.72 (0.66, 0.78) among academic level of education. Conclusion: The SES, income, and education were associated with breast cancer survival, although the association was not very strong. However, there was a significant association between the levels of these factors and breast cancer survival.
This systematic review followed the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement. The primary aim of this research was to identify risks and protective factors for the mental health of forced migrants. The secondary aim was to suggest an alternative, more comprehensive approach in social work that surpasses usual diagnoses and intrinsically contradicts the medicalization of mental health issues of forced migrants. The search was conducted between January 2015 and January 2021. As a result, 29 studies met inclusion criteria. Medicalizing mental health issues by relying solely on the effectiveness of medicine was a controversial risk factor that negatively affected daily life activities of refugees and reduced their willingness for seeking professional mental health services. Empowering vulnerable minorities by giving them back their power and agency to be able to speak for themselves and raise voices of trauma and recovery was the missing protective factor for a sustainable mental health practice. The benefits of group-based interventions were highlighted in which communities and individuals address mental health issues as well as isolation through building collective identities and support networks. Information and communication technologies (ICTs) can add more strength to any kind of mental health interventions. Finally, the benefits of applying an ecological perspective for the study of the mental health of refugees, and its implications for a sustainable intercultural practice, were discussed. Social workers in this model are the representatives of at-risk groups, and thus require more agency and creativity in reflecting client’s concrete needs.
Background: We evaluated the effect of socioeconomic status (SES) inequality on metastasis, recurrence, stage, grade, and selfrated health (SRH) in patients with gastrointestinal cancers (GIC). Methods: This cohort study was conducted on 409 patients suffering from GIC (April to October, 2018), who were referred to one of the hospitals of Arak University of Medical Sciences (Arak, Iran). They were entered to the study, using non-random sampling (accessible sampling). The SES was calculated by an asset-based questionnaire. The principle component analysis (PCA) was performed to estimate the household SES. The concentration index (C) was used to measure the SES inequality, and the binary logistic regression was employed to investigate the association of recurrence and metastasis with other variables. The variance analysis was also used to investigate the relationship between SES and other variables. The data were analyzed with Stata (V. 13) software. Results: The total C index for metastasis, recurrence, stage, grade, SRH, and SRH-age was obtained as 0.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.