Knowledge, Attitude, and Practice about Emergency Contraception among Health Staff in Bushehr State, South of Iran

Emergency Contraception (EC) is used within a few days of unprotected sex to prevent an unintended pregnancy. About one quarter of pregnancies in south of Iran are unintended. EC is important option that women can use after unprotected sex or contraceptive failure for preventing of unplanned pregnancies and adverse maternal and perinatal health outcomes. Health staff have influence on women’s contraceptive behavior and their knowledge and attitudes about EC can affect women’s contraceptive behaviors. Data are lacking about the knowledge, attitude and practice of hormonal EC method among health staff in Bushehr state, south of Iran. A cross-sectional study using self administered questionnaire was conducted. A sample of 170 health staff were surveyed. The mean age of respondents was 30.6±5.1. Overall 6.5% of participants had poor knowledge, 25.2% moderate knowledge, 68.3% good knowledge about EC. Half of participants had positive and half had negative attitude towards the EC method. Midwives and family health workers were more knowledgeable (p<0.05) and more frequently counseled women about EC than general practitioners (GPs) (p<0.001). The most cited reason for EC prescriptions were rupture condom and none use of contraception. Our findings showed despite of majority of health staff had good knowledge about EC, their knowledge about the indications for prescription of EC and its side effects was inadequate. The educational efforts for health staff should be focused more on the specific aspects of EC method. GPs also should be more involved in family planning program

Knowledge, Attitude, and Practice about Emergency Contraception among Health Staff in Bushehr State, South of Iran

Emergency Contraception (EC) is used within a few days of unprotected sex to prevent an unintended pregnancy. About one quarter of pregnancies in south of Iran are unintended. EC is important option that women can use after unprotected sex or contraceptive failure for preventing of unplanned pregnancies and adverse maternal and perinatal health outcomes. Health staff have influence on women’s contraceptive behavior and their knowledge and attitudes about EC can affect women’s contraceptive behaviors. Data are lacking about the knowledge, attitude and practice of hormonal EC method among health staff in Bushehr state, south of Iran. A cross-sectional study using self administered questionnaire was conducted. A sample of 170 health staff were surveyed. The mean age of respondents was 30.6±5.1. Overall 6.5% of participants had poor knowledge, 25.2% moderate knowledge, 68.3% good knowledge about EC. Half of participants had positive and half had negative attitude towards the EC method. Midwives and family health workers were more knowledgeable (p<0.05) and more frequently counseled women about EC than general practitioners (GPs) (p<0.001). The most cited reason for EC prescriptions were rupture condom and none use of contraception. Our findings showed despite of majority of health staff had good knowledge about EC, their knowledge about the indications for prescription of EC and its side effects was inadequate. The educational efforts for health staff should be focused more on the specific aspects of EC method. GPs also should be more involved in family planning progra

Marriage related suicide fatality rates

Objective: The present study aimed at estimating the case fatality rates of suicide acts in different marital status subgroups and to find interrelation with a population living in Bushehr province along the coastal region of the Persian Gulf coast in southwest of Iran. Method: In this analytical and observational study, suicidal data were gathered in 5 successive years (2008–2012) in the population of Bushehr. Data were extracted from suicide registration forms provided by the Psychiatric Health Unit of Ministry of Health. Questions mainly focused on demographic characteristics, including age, sex, literacy, residency, marital status, birth rank, the number of previous suicide attempts, and probable reasons of suicide, such as family conflicts or/and psychiatric complications. Fatality rates in different subgroups (male/female; married/unmarried; etc.) were compared and odds ratios were computed. The main limitation of this study was the lack of a specific grouping for those who cohabited together (Those who live together and have a sexual relationship without being married). The logistic regression model was used in data analysis. Results: Case mortality rates of suicides were found to be 3.5% for both sexes, 5.2% in males and 2.7% in females. However, among the single population, either divorced or widowed, the probability of death due to suicide was 3.5 times higher (95% CI: 1.5–2.9) as compared to the unmarried. Age as a confounding factor in fatality rates made a significant difference between married and unmarried people, and differences disappeared after adjusting for age. However, fatality rate was still higher in the widowed/divorced group compared to other groups even after adjusting for age. Conclusion: Fatality rate was higher in married people compared to the unmarried, however, after adjusting for age as a determinant factor, no significant difference was observed between the 2 groups. The highest death rate belonged to the age-specific widowed/divorced individuals as compared to all other marital status subgroups

A Bayesian analysis with informative prior on disease prevalence for predicting missing values due to verification bias

AIM: Verification bias is one of the major problems encountered in diagnostic accuracy studies. It occurs when a standard test performed on a non-representative subsample of subjects which have undergone the diagnostic test. In this study we extend a Bayesian model to correct this bias. METHODS: The study population is patients that have undergone at least two repeated failed IVF/ICSI (in vitro fertilization/intra cytoplasmic sperm injection) cycles. Patients were screened using ultrasonography and those with polyps were recommended for hysteroscopy. A Bayesian modeling was applied on mechanism of missing data using an informative prior on disease prevalence. The parameters of the model were estimated through Markov Chain Monte Carlo methods. RESULTS: A total of 238 patients were screened, 47 of which had polyps. Those with polyps were strongly recommended to undergo hysteroscopy, 47/47 decide to have a hysteroscopy and in 37/47 polyps confirmed. None of the 191 patients with no polyps detected in ultrasonography underwent a hysteroscopy. A model using Bayesian approach was applied with informative prior on polyp prevalence. False and true negatives were estimated in the Bayesian framework. The false negative was obtained 14 and 177 true negatives were obtained, so sensitivity and specificity was estimated easily after estimating the missing data. Sensitivity and specificity were equal to 74% and 94% respectively. CONCLUSION: Bayesian analyses with informative prior seem to be powerful tools in the simulation of experimental spac

Comparison of the effect of typical firefighting activities, live fire drills and rescue operations at height on firefighters’ physiological responses and cognitive function

This study examined the impact of various types of firefighting activities on firefighters’ physiological responses and cognitive function. Each firefighter was engaged in three conditions: (1) Live-fire activities (LFA), (2) Typical firefighting activities (TFA), and (3) Rescue operations at height (ROH). The effects of various types of firefighting activities on the physiological responses and cognitive function were evaluated by heart rate (HR), temporal artery temperature (TT), and the correct response (CR) on a cognitive test. The results indicated that, compared to the baseline, physiological response increased, while information processing performance decreased after the activity. Furthermore, HR and TT were significantly lower at the end of the firefighting activity in the LFA (149.33 bpm; 38.08 °C) compared with the TFA (152.22 bpm; 38.17 °C) and ROH (159.28 bpm; 38.24 °C) conditions. Also, CR was significantly higher at the end of the activity in the LFA and TFA compared with the ROH condition. The results showed that rescue at height was more intensive than the other firefighting tasks in decreasing physiological and cognitive function capacity after the experiment. Practitioner Summary: We assumed that various types of firefighting activities would have different effects on physiological and cognitive functions during firefighting activities. The Findings suggest that rescue at height operations, performed without the use of special protective equipment, was more influential than other firefighting duties in changing firefighters’ physiological and cognitive capacity. Abbreviations: CR: correct response; LFA: live-fire activities; TFA: typical firefighting activities; ROH: rescue operations at height; HR: heart rate; TT: temporal artery tempearture; PASAT: pased auditory serila addition teat; FPC: firefighting protective clothin