Maternal mid- and late-pregnancy distress and birth outcome: A causal model of the mediatory role of pregnancy-specific distress

Background: There is lack of information about the effect of general distress and pregnancy-specific distress in mid- and late-pregnancy separately on neonatal outcome. Objective: The aim of this study was to assess the effects of mid-maternal distress on late-maternal distress and birth outcomes with a causal model of relationships among general distress and pregnancy-specific distress. Materials and Methods: In this longitudinal descriptive study, 100 low-risk pregnant women participated. Participants completed three questionnaires at mid-pregnancy (13–26 wk) and at late pregnancy (27–40 wk). Pregnancy-general distress was assessed by the Perceived Stress Scale and the Hospital Anxiety Depression Scale. Pregnancy specific distress was evaluated by the Prenatal Distress Questionnaire. The pregnant women were followed to after birth and neonatal outcome were assessed. Results: All total effect pathways were significant as predictors of birth outcomes (height, weight, and head circumference). Mid-pregnancy-specific distress had a significant relationship with late pregnancy-specific distress. However, mid-maternal distress was not related directly to birth outcomes. The effect of mid-maternal distress on birth outcomes was related indirectly to late-maternal distress. Both late general distress and late pregnancy-specific distress had direct negative effects on three indexes of birth outcome. The negative effect of late general-pregnancy distress and mid-pregnancy-specific distress on birth outcome was mediated through late pregnancy-specific distress. Conclusion: Both late pregnancy-general distress and pregnancy-specific distress have negative effects on birth outcomes. These findings support a role for negative effect as mediating the relationship between late pregnancy-specific distress and birth outcomes

Is psychosexual therapy a reliable alternative to bupropion extended-release to promote the sexual function in infertile women? An RCT

Background: Various treatment methods are used to deal with sexual problems. Objective: This study was applied to answer the question of whether psychosexual therapy (PST) can be a reliable alternative to bupropion extended-release (BUP ER) to promote sexual function in infertile women. Materials and Methods: In this randomized clinical trial, 105 infertile women with sexual dysfunction were randomly allocated to three groups: PST, BUP ER, and a control group. The PST group participated in a total of eight 2-hr group sessions. In BUP ER group, 150 mg/day Bupropion ER was administered for eight weeks. The control group did not receive any interventions. The female sexual function index (FSFI) and a clinical interview were used to assess their sexual dysfunction. Results: The mean pre-to-post treatment scores of FSFI and its subscales increased significantly in PST and BUP ER groups (except in the subscale of sexual pain) (p = 0.0001, p = 0.0001). The changes in the subjects were not significant in the control group. After adjusting for the baseline values, the results remained significant for the mean FSFI (p = 0.0001), and its subscales between the groups. Compared to the control group, a significant increase was observed in the mean FSFI (p = 0.0001, p = 0.002) and its subscales in the PST group and in the BUP ER group (except in the subscale of sexual pain). Comparison of two intervention methods showed that PST had the better effect on the sexual function improving (p = 0.0001) and its subscales (exempting the subscale of orgasm) than BUP ER. Conclusion: PST can be considered not only a reliable alternative to pharmacotherapy; it also produces better results in terms of improving sexual function in infertile women. Key words: Infertility, Sexual activities, Drug therapy, Psychotherapy, Bupropion

The Spatial Distribution of Cancer Incidence in Fars Province: A GIS-Based Analysis of Cancer Registry Data

Background: Cancer is a major health problem in the developing countries. Variations of its incidence rate among geographical areas are due to various contributing factors. This study was performed to assess the spatial patterns of cancer incidence in the Fars Province, based on cancer registry data and to determine geographical clusters. Methods: In this cross sectional study, the new cases of cancer were recorded from 2001 to 2009. Crude incidence rate was estimated based on age groups and sex in the counties of the Fars Province. Age standardized incidence rates (ASR) per 100,000 was calculated in each year. Spatial autocorrelation analysis was performed in measuring the geographic patterns and clusters using geographic information system (GIS). Also, comparisons were made between ASRs in each county. Results: A total of 28,411 new cases were diagnosed with cancer during 2001 2009 in the Fars Province, 55.5% of which were men. The average age was 61.6 ± 0.5 years. The highest ASR was observed in Shiraz, which is the largest county in Fars. The Moran\u27s Index of cancer was significantly clustered in 2004, 2005, and 2006 in total, men, and women. The type of spatial clustering was high high cluster, that to indicate from north west to south east of Fars Province. Conclusions: Analysis of the spatial distribution of cancer shows significant differences from year to year and between different areas. However, a clear spatial autocorrelation is observed, which can be of great interest and importance to researchers for future epidemiological studies, and to policymakers for applying preventive measures

Ionic Liquids and their Toxicity on the Enzyme Activity and Stability

Molecular interactions are crucial between the enzyme molecules and the surrounding solution in an enzymatic catalysis. Although aqueous solutions used as conventional enzymatic reaction media, non-aqueous enzymology emerges as a major area of biotechnology research and development. Ionic liquids, as new generation of promising alternatives to traditional organic solvents, possess potential industrial enzymatic applications. Enzymes in ionic liquids present enhanced activity, stability, and selectivity. In addition, the potential of ionic liquids in bio-catalysis is raised by high ability of dissolving a wide variety of substrates and their extensively tunable solvent properties through appropriate modification of the cations and anions. However, despite the bio-friendly nature of ionic liquids for enzymatic reactions, their growing interests increase concerns associated with toxicity and environmental pollution of such compounds. This mini-review presents a brief highlight of the contemporary knowledge of enzymes activity and stability in ionic liquids and the environmental influences regarding the potential risks related to the growing applications of these green solvents.HIGHLIGHTS•Conventional organic solvents can be replaced by ionic liquids as green solvents.•Ionic liquids are used as additives, catalysts, or reaction media in industries.•Advantages and disadvantages of ionic liquids are discussed.•Potential environmental hazards linked to application of ionic liquids are highlighted.•The environmental fate needs to be considered in designing safer ionic liquids

Quality of Mother–Infant Attachment after Physiological Birth

Background Childbirth affects the quality of mother–neonate attachment after delivery. The aim of this study was to compare the quality of mother–infant attachment in physiological delivery with non-physiological delivery after birth. Materials and Methods A case-control study was conducted on 60 women (n = 30 non- physiological delivery, 30 physiological delivery) referred to Shahid YahyaNejad Hospital (Babol city, Iran) durring 2015 to 2016. Subjects in the physiological delivery group received special care from the midwife or significant other, labor mobility, spontaneous progress of labor, and non-pharmacological methods. Subjects in the non-physiological delivery group received medical interventions including birth aids, use of analgesics, and local anesthesia. Quality of mother-infant attachment after delivery was assessed with a valid Persian version of Avant’s mother-infant attachment. Multivariate analysis of variance (MANCOVA) was also used to assess the differences in two groups. Results The mean of mother–infant attachment scores in the physiological delivery compared with non-physiological delivery group were as follows: emotional behavior (2.29 ± 38.7 vs. 1.56 ± 27.23), proximity behavior (1.82 ± 27.30 vs. 1.49 ± 20.70), caring behavior (1.17 ± 15.77 vs. 1.13 ± 10.80), and total score (4.58 ± 81.72 vs. 3.66 ± 58.73). Results showed that in all three dimensions of attachment (emotional, caring, and proximity behavior), physiological delivery showed higher scores than did non-physiological delivery (P < 0.05). Conclusion Thequality of mother–infant attachment (emotional, proximity, and caring behaviors) was higher in women with physiological birth than non-physiological birth

Pharmacological and Non-pharmacological Therapeutic Strategies for Improvement of State-Trait Anxiety: A Randomized Controlled Trial Among Iranian Infertile Women With Sexual Dysfunctions

Objective: To compare the effects of pharmacological and non-pharmacological therapeutic strategies for improvement of state-trait anxiety among Iranian infertile women with sexual dysfunctions (SDs). Material and Methods: In a randomized controlled clinical trial, 105 women with infertility suffering from SDs were randomly assigned to participate in a 2-hour group weekly session of psychosexual therapy (PST) (n = 35), took a tablet of bupropion ER 150 mg/d (BUP ER) (n = 35), or control (n = 35) for 8 weeks during 2014–2015. The Female Sexual Function Index (FSFI) and Spielberger State-Trait Anxiety Inventory (STAI) were completed before and after of the study. Results: State and trait anxiety levels had mean values of 47.80 ± 10.93 and 48.78 ± 11.34, respectively. Mean values of state and trait anxiety levels observed at baseline significantly decreased toward the end of the study in each of the treatment groups (PST, P < 0.0001 and P < 0.0001; BUP, P < 0.005 and P < 0.001, respectively), and the decrease was more significant in the PST group than in the BUP ER group (P < 0.001 and P < 0.007, respectively) and the control group (P < 0.0001) and P < 0.0001, respectively). Significantly high improvement in state and trait anxiety levels was observed in the PST group than the BUP and control groups. However, the decrease in the BUP group was not significant than the control group (P < 0.076 and P < 0.186, respecttively). Conclusion: PST compared to bupropion ER treatment was found to be a more favorable strategy for improvement of state and trait anxiety symptoms

Mental and personality disorders in infertile women with polycystic ovary: a case-control study

Background: Polycystic Ovarian Syndrome (PCOS) is one of the most common causes of infertility in women. Objective: The current study investigated mental and personality disorders in infertile women with and without PCOS. Methods: This case-control study evaluated 400 infertile women who referred to the Infertility Center in Babol city (North of Iran). Participants were categorized into the case group (201 PCOS) and the control group (199 without PCOS). All of the participants completed the Millon Clinical Multi-axial Inventory-III (MCMI-III). Results: The mean scores for clinical personality patterns were significantly higher for six personality disorders (schizoid, avoidant, antisocial, depressive, sadistic, and negativistic) and for three classes of severe personality disorder patterns (schizotypal, borderline, and paranoid) in infertile women with PCOS than in women without PCOS. The mean scores for eight clinical disorders (somatoform, manic disorder, dysthymia, alcohol-dependence, drug-dependence, post-trauma stress disorder, major depression, and delusion disorder) were also higher in infertile women with PCOS than in women without PCOS. Conclusion: The scores of many mental and personality disorders are higher in infertile women with PCOS than in women without PCOS. Thus, clinicians should prioritize recognizing and treating psychological problems of infertile women with PCOS

Effectiveness of Group Psychosexual Training for Marital Adjustment and Sexual Self-Efficacy of Infertile Women: A Randomized Controlled Trial

Objective: Infertility can be associated with unfavorable psychological consequences such as a sense of marital incompatibility and sexual inadequacy. To address these issues, this study aimed to assess the effectiveness of group psycho-sexual training in improving marital adjustment and sexual self-efficacy of infertile women. Method: A randomized controlled clinical trial (RCT) study was conducted in Babol, Iran, with 72 infertile women, randomly assigned to either the intervention group (n = 36) or the control group (n = 36). The intervention group underwent psychosexual training, while the control group received routine care. The Dyadic Adjustment Scale (DAS) and Sexual Self-Efficacy Scale (SSES) were used to assess their marital adjustment and sexual self-efficacy. Data analysis was performed using various tests, including the independent t-test, Chi-squared test, paired t-test, ANCOVA, and MANCOVA. Results: Most infertile women had moderate sexual self-efficacy (80%). The intervention group had a significantly better response to group psycho-sexual training compared to the control group. This intervention improved sexual self-efficacy and marital adjustment and its subscales including marital consensus, satisfaction, cohesion (P < 0.0001), and affectional expression (P < 0.001). The mean pre-to-post treatment scores of sexual self- efficacy, marital adjustment, and its subscales increased significantly in the intervention group, while no significant difference was observed in the control group (P < 0.0001). Conclusion: Based on the findings, it is recommended to provide educational services alongside the infertility treatment process for enhancing the quality of marital adjustment and promoting sexual self-efficacy

Psychosocial Predictors of Cognitive Impairment in the Elderly: A Cross-Sectional Study

Objective: Cognitive impairment is a major public health problem among elderly population. The aim of this study was to assess some psychosocial predictors of cognitive impairment (age, education, living alone, smoking, depression and social support) in the Iranian elderly population. Method: A total of 1612 elderly (over 60 years) were enrolled in this cross-sectional study. Cognitive function was assessed using Mini Mental State Examination (MMSE). In addition, data from psychological tests and demographic characteristics were analyzed. Results: Older age, low education level, living alone, smoking, depressive symptoms, and lower social support were associated with an increased risk of cognitive impairment. Ages 70 to 74 (OR = 3.47; 95% CI, 2.13-5.65), 75 to79 (OR = 3.05; 95% CI, 2.11-4.41) and 80 to 85 (OR = 5.81; 95% CI, 2.99-11.22) and depression symptoms (OR = 1.64; 95% CI, 1.27-2.13) were significant positive predictors, whereas social support with scores ranging from 26 to 30 (OR =0. 32; 95% CI, 0.16-0.62) and 31 to 33 (OR =0.29; 95% CI, 0.14-0.61) and more than 5 years of education (OR = 0.19; 95% CI, 0.14-0.27) were the negative predictors of cognitive impairment. Conclusion: The findings suggest older age and depression as positive predictive factors and higher education level and social support as negative predictive factors of cognitive impairment in the elderly population

Expert opinions on informational and supportive needs and sources of obtaining information in patients with inflammatory bowel disease: a Delphi consensus study

BackgroundThe present study introduces informational and supportive needs and sources of obtaining information in patients with inflammatory bowel disease (IBD) through a three-round Expert Delphi Consensus Opinions method.MethodsAccording to our previous scoping review, important items in the area of informational and supportive needs and sources of obtaining information were elucidated. After omitting duplicates, 56 items in informational needs, 36 items in supportive needs, and 36 items in sources of obtaining information were retrieved. Both open- and close-ended questions were designed for each category in the form of three questionnaires. The questionnaires were sent to selected experts from different specialties. Experts responded to the questions in the first round. Based on the feedback, questions were modified and sent back to the experts in the second round. This procedure was repeated up to the third round.ResultsIn the first round, five items from informational needs, one item from supportive needs, and seven items from sources of obtaining information were identified as unimportant and omitted. Moreover, two extra items were proposed by the experts, which were added to the informational needs category. In the second round, seven, three, and seven items from informational needs, supportive needs, and sources of obtaining information were omitted due to the items being unimportant. In the third round, all the included items gained scores equal to or greater than the average and were identified as important. Kendall coordination coefficient W was calculated to be 0.344 for information needs, 0.330 for supportive needs, and 0.325 for sources of obtaining information, indicating a fair level of agreement between experts.ConclusionsOut of 128 items in the first round, the omission of 30 items and the addition of two items generated a 100-item questionnaire for three sections of informational needs, supportive needs, and sources of obtaining information with a high level of convergence between experts' viewpoints