Can human papillomavirus vaccination during pregnancy result in miscarriage and stillbirth? A meta-analysis and systematic review

NTRODUCTION Contradictory results regarding the safety of human papillomavirus (HPV) vaccination during pregnancy have been obtained, which has cast doubt on the use of this method. This review and meta-analysis were conducted to evaluate the safety of HPV vaccination during pregnancy. METHODS Complying with the inclusion and exclusion criteria, we searched Web of Science, Scopus, Medline, EMBASE, PubMed and Google Scholar databases for articles published in the past decade using the following keywords: `papilloma human virus', `HPV vaccine', `pregnancy' and `safety and prevention'. The minimum report quality of the articles was 16 based on the STROBE checklist. RESULTS Seven articles were included in the study, three of which were included in the meta-analysis, and the rest were reviewed systematically. The results of the meta-analysis showed that vaccination against HPV during pregnancy or around this period does not increase the risk of miscarriage (RR= 2.01; 95% CI: 0.66-6.13) and stillbirth (RR=2.02: 95% CI: 0.65-6.27). No significant difference between miscarriage and stillbirth was observed in women vaccinated against HPV versus those not vaccinated. CONCLUSIONS The study of 1380424 individuals showed that HPV vaccination during pregnancy is better postponed until after this period. However, no significant evidence was found to indicate that vaccination was dangerous and unsafe during pregnancy. Further studies are needed to draw a more definitive conclusion

Exploring the factors affecting the motivation for learning from the perspective of public health students: A qualitative study

Objective. Despite the significant role of motivation in achieving success among public health students, students often do not demonstrate adequate motivation for learning and education. This study was performed to determine factors affecting the motivation for learning from the perspective of public health students via content analysis approach. Methods. This qualitative study was conducted at Kurdistan University of Medical Sciences in Sanandaj, Iran in 2017. 15 students were included in the study by using purposive sampling. Data were collected through personal interviews, group discussions, and field notes, and they were analyzed through conventional content analysis. Several parameters were taken into account to support the accuracy and the strength of the data: acceptability, confirmability, and transferability. Results. Five categories were derived from the data analysis, including “University Policy”, “Health Status”, “Teacher’s Role”, “Student-Related Factors” and “University Facilities”. Attention to the health status and its priority in the opinion of people, authorities, and educational system were the most important factors involved in the students’ motivation for learning. Conclusions. To increase motivation for learning, students have diverse needs that should be met. Attention to the components of motivation for learning not only enhances academic achievement but also promotes the formation of health behaviors in the society

Factors related to cervical cancer screening among Asian women

Objective Cervical cancer is largely preventable. Although routine Pap smear screening has reduced cervical cancer-related mortality by 70-80% in all countries and by approximately 90% in developing countries, the gynecologist is still confronted with women in advanced stages of the disease. The eradication of cervical cancer depends on identifying the disease early and removing barriers to its timely detection. Given the significant burden of cervical cancer in Asian countries, we investigated factors related to its screening in Asia. Materials and methods A comprehensive search was carried out in databases such as Medline, Web of Science and Scopus for articles published until September 2020. The following keywords were used: vaginal smear, Pap smear, cervical cancer screening, barriers, obstacles, challenge, early detection, the name of each Asian country, and a combination of these words. Results Seventy-five articles were included in the study. The investigation revealed various factors related to cervical cancer screening in Asian women, including sociodemographic factors, awareness, attitudes and beliefs, perceived risk, psychological factors, self-efficacy, previous experiences, time, household, culture, fatalism, social support, access, cost, safety, insurance and health system-related factors. Conclusions Several barriers hinder the efficacy of a screening program. Its success requires the use of educational interventions, professional and inter-professional cooperation, allocation of sufficient resources, and policymakers focusing on the elimination of barriers

Postpartum sexual quality of life in two cultures : a qualitative study

Sexuality is a key aspect of human life and has a fundamental role in quality of life and general well-being. Postpartum quality of life comprises health- and non-health-related factors that need to be considered within the cultural context in which the individual lives. Many couples experience childbirth and the transition into parenthood as a stressful time with consequences for both health and quality of life. Sexual activity has been found to be an important factor for postpartum quality of life, which is often negatively affected after a woman has given birth. In this paper we focus on the sexual quality of life experienced after childbirth in Iran and Switzerland

Exploring the factors affecting the motivation for learning from the perspective of public health students: A qualitative study

Objective. Despite the significant role of motivation in achieving success among public health students, students often do not demonstrate adequate motivation for learning and education. This study was performed to determine factors affecting the motivation for learning from the perspective of public health students via content analysis approach. Methods. This qualitative study was conducted at Kurdistan University of Medical Sciences in Sanandaj, Iran in 2017. 15 students were included in the study by using purposive sampling. Data were collected through personal interviews, group discussions, and field notes, and they were analyzed through conventional content analysis. Several parameters were taken into account to support the accuracy and the strength of the data: acceptability, confirmability, and transferability. Results. Five categories were derived from the data analysis, including “University Policy”, “Health Status”, “Teacher’s Role”, “Student-Related Factors” and “University Facilities”. Attention to the health status and its priority in the opinion of people, authorities, and educational system were the most important factors involved in the students’ motivation for learning. Conclusions. To increase motivation for learning, students have diverse needs that should be met. Attention to the components of motivation for learning not only enhances academic achievement but also promotes the formation of health behaviors in the society

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

Diagnosis of Cervical Cancer and Pre-Cancerous Lesions by Artificial Intelligence: A Systematic Review

The likelihood of timely treatment for cervical cancer increases with timely detection of abnormal cervical cells. Automated methods of detecting abnormal cervical cells were established because manual identification requires skilled pathologists and is time consuming and prone to error. The purpose of this systematic review is to evaluate the diagnostic performance of artificial intelligence (AI) technologies for the prediction, screening, and diagnosis of cervical cancer and pre-cancerous lesions

Assessment of the Versius Robotic Surgical System in Minimal Access Surgery: A Systematic Review

Background: Despite the superiority of minimal access surgery (MAS) over open surgery, MAS is difficult to perform and has a demanding learning curve. Robot-assisted surgery is an advanced form of MAS. The Versius&reg; surgical robot system was developed with the aim of overcoming some of the challenges associated with existing surgical robots. The present study was designed to investigate the feasibility, clinical safety, and effectiveness of the Versius system in MAS. Materials and Methods: A comprehensive search was carried out in the Medline, Web of Science Core Collection (Indexes = SCI-EXPANDED, SSCI, A &amp; HCI Timespan), and Scopus databases for articles published until February 2022. The keywords used were Versius robot, visceral, colorectal, gynecology, and urologic surgeries. Articles on the use of the Versius robot in minimal access surgery (MAS) were included in the review. Results: Seventeen articles were reviewed for the study. The investigation comprised a total of 328 patients who had been operated on with this robot system, of which 48.3%, 14.2%, and 37.5% underwent colorectal, visceral, and gynecological procedures, respectively. Postoperative and major complications within 30 days varied from 7.4% to 39%. No major complications and no readmissions or reoperations were reported in visceral and gynecological surgeries. Readmission and reoperation rates in colorectal surgeries were 0&ndash;9%. Some procedures required conversion to conventional laparoscopic surgery (CLS) or open surgery, and all procedures were completed successfully. Based on the studies reviewed in the present report, we conclude that the Versius robot can be used safely and effectively in MAS. Conclusions: A review of the published literature revealed that the Versius system is safe and effective in minimal access surgery. However, the data should be viewed with caution until randomized controlled trials (RCTs) have been performed. Studies on the use of this robotic system in oncological surgery must include survival as one of the addressed outcomes

The prevalence of human immunodeficiency virus infection and the perceptions of sexually transmitted infections among homeless women

Background: Homeless women can provide valuable information about the prevalence of sexually transmitted infections (STIs), especially human immunodeficiency virus (HIV) infection, in Iran. However, they are not readily accessible for epidemiological studies and hence, there is limited information about HIV infection prevalence among them. Objectives: The aim of the present study was to assess the prevalence of HIV infection and the perceptions of STIs among homeless women in Tehran, Iran. Methods: This cross-sectional study was conducted in 2014. Participants were 241 homeless women who were recruited through quota sampling from twelve drop-in centers and night shelters affiliated to a local welfare organization in Tehran, Iran. Data were collected using the perception of STIs Questionnaire as well as serological testing for HIV infection using DS-EIA-HIV-Ag/Ab-Screen kit (manufactured in Italy). Descriptive statistics measures and the independent-samples t-test were used for data description and analysis. Results: The prevalence of HIV infection was 8.3. There were significant differences between HIV-positive and HIV-negative women respecting their overall STI risk perception (P = 0.003) and its two subscales, namely insufficient knowledge (P = 0.007) and inconsistent condom use (P = 0.030). Conclusion: Homeless women have low STI risk perception. Training and counseling programs are necessary to improve their STI-related knowledge, perception, and attitudes