Empowerment and Sense of Adequacy in Infertile Couples: A Fundamental Need in Treatment Process of Infertility - A Qualitative Study

Many Iranian couples are suffering from infertility, and their needs have remained unexplored thus far; therefore, the purpose of this study was to explore the infertile couples’ needs and experiences during diagnosis and different stages of infertility treatment. Specific research question included: What are infertile couples’ viewpoints and perceptions about their needs in treatment process of infertility? Researchers used a qualitative design, based on a content analysis approach to analyze in-depth unstructured interviews conducted with seventeen infertile couples. The participants’ needs were categorized into five categories. All five categories had one theme in common which was identified as “empowerment and sense of adequacy” as a fundamental need during diagnosis and treatment processes of infertility. The study findings showed that the under-studied fertility care centers were not patient-centered; and patients’ needs were not recognised appropriately. Perhaps, addressing patients’ needs and expectations is the first step toward more paying attention to infertile couples and empowering them

Odontogenic keratocysts in Nevoid basal cell carcinoma syndrome: a case report

Nevoid basal cell carcinoma syndrome, a rare autosomal dominant disorder, comprises a number of abnormalities such as multiple nevoid basal cell carcinomas, skeletal abnormalities and multiple odontogenic keratocysts. Considering the rarity of this syndrome, we present a 12-year-old boy affected by this syndrome. He had multiple okcs, calcification of falx cerebri, bifid ribs, frontal bossing and hypertelorism. Characteristic cutaneous manifestation (nevoid basal cell carcinoma) was not present in this patient. The jaw cysts were treated with marsupialization then enucleation. The dental clinician may be the first to encounter and identify this syndrome, when the multiple cystlike radiolucencies are discovered on panoramic view

Patient-centered Fertility Care: From Theory to Practice

Background & aim: Healthcare areas, especially fertility care (commonly accompanied with high emotions, as well as long-term and recurring treatment periods) could exclusively benefit from patient-centered care (PCC). Despite evident advantages of PCC, this approach has not been practiced as a routine procedure in current clinical environments yet, even in western developed countries. Therefore, this review aimed to evaluate the significance and different aspects of PCC, while emphasizing on patient-centered fertility care, its challenges, and applicable recommendations in this regard. Methods: This narrative review was conducted on 29 relevant medical and clinical papers (published during 1990-2015) collected using various national and international databases (e.g., SID, Magiran, Medlib, Google scholar, Proquest, Pubmed, Wiley, Science direct, and Scopus). Key words and phrases used in this review were “infertility”, “fertility care”, “childlessness”, “patient-centered care”, “patient-centered fertility care” “shared decision-making”, “infertile patient preferences”, and “patient involvement in fertility care”. Results: According to the literature, implementation challenges of patient-centered fertility care were reported as different individual and organizational factors. These factors include lack of professional motivation to change, underestimating the significance of patient-centeredness by healthcare professionals, difficulty in translation of feedback into concrete measures, lack of time and financial resources, insufficient experience of healthcare professionals with regard to identification of needs and preferences of patients, traditional organizational culture, and common misconceptions. Conclusion: Promotion of patient-centered fertility services requires the identification of infertile needs and priorities of individuals, designation of interventional and supportive programs based on sociocultural characteristics of the community to fulfill such preferences, and considering patients as the most significant stakeholders of each healthcare center. This review might provide important data for healthcare professionals and policymakers aiming to improve patient-centered fertility care

Exploration of the counseling needs of infertile couples: A qualitative study

Background: Identification of the main needs of infertile patients is essential to provision of appropriate supportive services and care based on their needs. Thus, the present study aims to explore infertile couples' counseling needs. Materials and Methods: This study was carried out with an inductive qualitative content analysis approach during 2012–2013. The participants of this study included 26 Iranian infertile couples and 7 medical personnel (3 gynecologists and 4 midwives). The infertile couples were selected through purposive sampling and considering maximal variation from patients attending state-run and private infertility treatment centers as well as infertility specialists, offices in Isfahan and Rasht, Iran. Unstructured in-depth interviews and field notes were utilized for data gathering and replying to this research main question, "What are the counseling needs of infertile couples?" The data from medical personnel was collected through semi-structured interviews. Data analysis was carried out through conventional content analysis. Results: Data analysis revealed two main themes. The first theme was "a need for psychological counseling," which included four subthemes: Emotional distress management, sexual counseling, marital counseling, and family counseling. The second theme was "a need for guidance and information throughout treatment process," which included three subthemes: Treatment counseling, financial counseling, and legal counseling. Conclusions: The counseling needs of infertile couples are varied, and they require various psychosocial support and counseling interventions. The participants of this study identified clearly the significance of psychological counseling and information throughout the long and onerous journey of infertility and its treatment

Flood Detection and Susceptibility Mapping Using Sentinel-1 Remote Sensing Data and a Machine Learning Approach : Hybrid Intelligence of Bagging Ensemble Based on K-Nearest Neighbor Classifier

Mapping flood-prone areas is a key activity in flood disaster management. In this paper, we propose a new flood susceptibility mapping technique. We employ new ensemble models based on bagging as a meta-classifier and K-Nearest Neighbor (KNN) coarse, cosine, cubic, and weighted base classifiers to spatially forecast flooding in the Haraz watershed in northern Iran. We identified flood-prone areas using data from Sentinel-1 sensor. We then selected 10 conditioning factors to spatially predict floods and assess their predictive power using the Relief Attribute Evaluation (RFAE) method. Model validation was performed using two statistical error indices and the area under the curve (AUC). Our results show that the Bagging–Cubic–KNN ensemble model outperformed other ensemble models. It decreased the overfitting and variance problems in the training dataset and enhanced the prediction accuracy of the Cubic–KNN model (AUC=0.660). We therefore recommend that the Bagging–Cubic–KNN model be more widely applied for the sustainable management of flood-prone areas.Validerad;2020;Nivå 2;2020-01-24 (johcin)</p