Educational inequalities in self-reported health in a general Iranian population

<p>Abstract</p> <p>Background</p> <p>The aim of this study was to investigate the relationship between educational level and self-reported health in an Iranian population, in order to provide evidence on social inequalities in health from a country in which such data need to be collected.</p> <p>Methods</p> <p>This population-based study was carried out in Tehran, Iran. Individuals aged 15 years and over were interviewed. Self-reported health was measured by asking each individual to respond to the question: "In general how would you describe your health at present?" We used years of formal education as a measure of socioeconomic status and categorized the answers in five levels. Logistic regression analysis was used to estimate odds ratios and 95% confidence intervals indicating the contribution of educational level to self-reported health, adjusting for age, gender, marital status, and chronic diseases.</p> <p>Results</p> <p>In all, 4163 individuals were interviewed. The mean age of the respondents was 35.1 years (SD = 16.0); 52% were female; the mean duration of formal education was 10.0 years (SD = 4.5); and 31% rated their health 'less than good'. Overall, women rated their health more poorly than men (P < 0.0001), and the findings showed that those with higher education rated their health significantly better than those with lower educational levels after adjusting for the age, gender, marital status and chronic diseases. The odds ratio for having 'less than good' self-rated health in those at the lowest educational level compared with those at the highest was 2.65 (95% CI = 1.88–3.73).</p> <p>Conclusion</p> <p>The findings indicated an inverse relationship between educational level and self-rated health, and that age, gender, and chronic conditions had independent effects on self-reported health status. The findings of this first study from Iran suggest that health inequalities in developing countries such as Iran need to be addressed and policies for tackling the problem should be considered. In this respect, less well-educated people and women should be seen as the first target populations. It seems that although expanding the educational system might help the state to provide people with more educational options, it is also necessary to ensure that equal opportunities and access to quality education are provided for those from lower socioeconomic backgrounds; otherwise the current situation might cost the government more in the long term because of poor health among disadvantaged groups.</p

Sexual Knowledge and Attitudes Among Premarital Couples: A Need for Future Educational Programs

Background: A significant number of youths have insufficient awareness about sexual health; whereas, correct sexual information is the main factor to prevent adverse consequences. Objectives: The current study aimed to investigate the sexual knowledge and attitudes in a sample of Iranian premarital couples. Patients and Methods: In this cross-sectional study, a sequential sample of 500 males and females who met the inclusion criteria was selected. This study was conducted in Kashan, Iran. Participants were in the age range of 16 to 40 years referred for premarital testing and educational classes. Two questionnaires containing demographic data and a culturally based sexual knowledge and attitudes scale were used for data collection. Data were analyzed using the Chi-square test, independent samples t-test, Mann-Whitney U, analysis of variance and multivariate regression. Results: About 50% of premarital couples had poor sexual knowledge and attitudes. The mean score of total sexual knowledge was 12.45 ± 8.54 out of a possible score of 33; and the mean score of total sexual attitudes was 121.63 ± 14.51 out of a possible score of 170. A significant association existed between the score of sexual knowledge and the level of education (P < 0.01), participants’ age (P < 0.01) and the score of sexual attitudes (P < 0.01). Conclusions: The majority of participants had poor sexual knowledge and attitudes regarding different aspects of sexual health

The short form endometriosis health profile (EHP-5): translation and validation study of the Iranian version

<p>Abstract</p> <p>Background</p> <p>Endometriosis Health Profile (EHP-5) is a valid instrument to measure health-related quality of life in endometriosis. This study was conducted to culturally adapt and validate the EHP-5 in Iran.</p> <p>Methods</p> <p>Using a standard "forward-backward' translation procedure, the English language version of the questionnaire was translated into Persian (Iranian language). Then a sample of 199 women aged 18-50 years completed the questionnaire. To test reliability the internal consistency was assessed by Cronbach's alpha coefficient. Validity was evaluated using known groups comparison.</p> <p>Results</p> <p>The mean age of respondents was 31.4 (SD = 5.4) years. Reliability analysis showed satisfactory result (Cronbach's alpha coefficient = 0.71). The questionnaire discriminated well between sub-groups of women differing in infertility and premenstrual syndrome (PMS) in the expected direction.</p> <p>Conclusion</p> <p>This preliminary validation study of the Iranian version of the EHP-5 proved that it is an acceptable, reliable and valid measure of quality of life in endometriosis patients.</p

Association between Maternal Anaemia and Postpartum Depression in an Urban Sample of Pregnant Women in Iran

The aim of this prospective study was to determine the relationship between anaemia during pregnancy and postpartum depression. Two hundred eighty-one non-anaemic mothers with singleton and low-risk pregnancy and no history of antidepressant-use were studied. Demographic and reproductive data at week 20 were obtained. Mothers were followed up and haemoglobin (Hb) was checked at delivery. Iranian version of Edinburgh Postpartum Depression Scale (EPDS) was completed 4-6 weeks after delivery. Mean age of the mothers was 26.6\ub14 years. The prevalence of postpartum depression according to EPDS was 5.5%. Binary logistic regression analysis showed that Hb &lt;11 g/dL at delivery would increase the chance of postpartum depression (OR 4.64; 95% CI 1.33-16.08). The results show that diagnosis and treatment of physiologic factors, especially anaemia, would reduce the risk of postpartum depression

Eulerian ISPH Method for Simulating Internal Flows

In this article the possibility to use Eulerian approach in the conventional ISPH method in simulation of internal fluid flows is studied. The use of Eulerian approach makes it possible to use non-uniform particle distributions to increase the resolution in the sensitive parts of the domain, different boundary conditions can be employed more freely and particle penetration in the solid walls and tensile instability no longer require elaborate procedures. The governing equations are solved in an Eulerian framework containing both the temporal and local derivatives which make the momentum equations non-linear. Some special treatment and smaller time steps are required to remedy this non-linearity of the problem. In this study, projection method is used to enforce incompressibility with the evaluation of an intermediate velocity and then this velocity is projected on the divergence-free space. This method is applied to the internal fluid flows in a shear-driven cavity, Couette flow, a flow inside a duct with variable area and flow around a circular cylinder within a constant area duct. The results are compared with the results of Lagrangian ISPH and WCSPH methods as well as finite volume and Lattice Boltzmann grid based schemes. The results of the studied scheme have the same accuracy for velocity field and have better accuracy in pressure distribution than ISPH and WCSPH methods. Non-uniform particle distributions are also studied to check the applicability of this method and Good agreement is also observed between uniform and non-uniform particle distributions

Development and psychometric evaluation of the sexual knowledge and attitudes scale for premarital couples (SKAS-PC): An exploratory mixed method study

Background: Designing a valid and reliable questionnaire that allows a fair evaluation of sexual knowledge and attitudes and develop a proper sexual educational program is necessary. Objective: The present study was designed to develop and psychometric evaluation of the sexual knowledge and attitudes scale for premarital couples. Materials and Methods: An exploratory mixed method study was conducted in two phases; in the first, in order to develop a questionnaire an item pool was generated on sexual knowledge and attitudes through focus group discussions and individual interviews. In the second phase, the psychometric properties of the questionnaire were examined. For this purpose, face validity, content validity as well as construct validity were conducted. Reliability was assessed by the Cronbach�s alpha coefficient to assess internal consistency and test-retest reliability. Results: In the first phase an item pool with 88 questions was generated (sexual knowledge 45 items and sexual attitudes 43 items). In the second phase, the number of final items reduced to 33 and 34 items of sexual knowledge and sexual attitudes respectively, through exploratory factor analysis (EFA). Five factors for sexual knowledge and six factors for sexual attitudes identified by EFA. The Cronbach�s alpha coefficient for two sections was 0.84 and 0.81 respectively. The test- retest correlations for sexual knowledge and sexual attitude was 0.74 and 0.82 respectively. Conclusion: The findings suggest that the Sexual Knowledge and Attitudes Scale for Premarital Couples is a valid and reliable instrument. Further studies are needed to establish stronger psychometric properties for the questionnaire. © 2018, Research and Clinical Center for Infertitlity. All rights reserved

Bidirectional Psychoneuroimmune Interactions in the Early Postpartum Period Influence Risk of Postpartum Depression

More than 500,000 U.S. women develop postpartum depression (PPD) annually. Although psychosocial risks are known, the underlying biology remains unclear. Dysregulation of the immune inflammatory response and the hypothalamic–pituitary–adrenal (HPA) axis are associated with depression in other populations. While significant research on the contribution of these systems to the development of PPD has been conducted, results have been inconclusive. This is partly because few studies have focused on whether disruption in the bidirectional and dynamic interaction between the inflammatory response and the HPA axis together influence PPD. In this study, we tested the hypothesis that disruption in the inflammatory-HPA axis bidirectional relationship would increase the risk of PPD. Plasma pro- and anti-inflammatory cytokines were measured in women during the 3rd trimester of pregnancy and on Days 7 and 14, and Months 1, 2, 3, and 6 after childbirth. Saliva was collected 5 times the day preceding blood draws for determination of cortisol area under the curve (AUC) and depressive symptoms were measured using the Edinburgh Postpartum Depression Survey (EPDS). Of the 152 women who completed the EPDS, 18% were depressed according to EDPS criteria within the 6 months postpartum. Cortisol AUC was higher in symptomatic women on Day 14 (p = .017). To consider the combined effects of cytokines and cortisol on predicting symptoms of PPD, a multiple logistic regression model was developed that included predictors identified in bivariate analyses to have an effect on depressive symptoms. Results indicated that family history of depression, day 14 cortisol AUC, and the day 14 IL8/IL10 ratio were significant predictors of PPD symptoms. One unit increase each in the IL8/IL10 ratio and cortisol AUC resulted in 1.50 (p = 0.06) and 2.16 (p = 0.02) fold increases respectively in the development of PPD. Overall, this model correctly classified 84.2% of individuals in their respective groups. Findings suggest that variability in the complex interaction between the inflammatory response and the HPA axis influence the risk of PPD

Help-seeking behaviors for female sexual dysfunction: a cross sectional study from Iran

<p>Abstract</p> <p>Background</p> <p>Female sexual dysfunctions (FSD) are prevalent multifactor problems that in general remain misdiagnosed in primary health care. This population-based study investigated help-seeking behaviors among women with FSD in Iran.</p> <p>Methods</p> <p>This was a cross sectional study carried out in Kohgilouyeh-Boyer-Ahmad province in Iran. Using quota sampling all sexually active women aged 15 and over registered in primary health care delivery centers were studied. Experience of sexual problems was assessed using an ad-hoc questionnaire (Female sexual dysfunction: help-seeking behaviors survey) containing 14 items. Trained female nurses interviewed all participants after a verbal informed consent. Data were analyzed in a descriptive manner.</p> <p>Results</p> <p>In all 1540 women were studied. Of these, 786 (51%) cases had experienced at least one of the FSD problems. Results showed that 35.8% of women with FSD had sought no professional help and the most reasons for not seeking help were identified as: 'time constraints' and believing that it 'did not occur to me' (39.1 and 28.5% respectively). Sixty one percent of women who sought help for FSD reported that 'doctor gave me a definite diagnosis' and 'a definite treatment plan was given' in 57% of cases.</p> <p>Conclusion</p> <p>The study findings indicated that FSD problems were prevalent and many women did not seek help for their problem. Finding 'time constraints' and believing that the problem 'did not occur to me' as the most cited reasons for not seeking help might facilitate to understand potential barriers that exist in recognition and treatment of the female sexual dysfunctions. Since FSD might have a negative impact on interpersonal relationships and women's quality of life, it seems that there is need to address the problem both at local and national primary health care services.</p