The effect of the collaborative infertility counseling model on coping strategies in infertile women undergoing in vitro fertilization: A randomized controlled trial

Objectives: Infertility is a stressful condition influencing interpersonal and social relationships among infertile couples. Various strategies have been suggested for coping with infertility. This study examined the effect of the collaborative infertility counseling model on coping strategies in infertile women undergoing in vitro fertilization (IVF) in an urban area of Iran. Materials and Methods: This clinical controlled trial was conducted on 60 women with primary infertility selected from Milad Infertility Center in Mashhad, Iran. They were randomly allocated to the intervention and control groups with 29 and 31 samples in each group. The intervention group received individual counseling based on the collaborative reproductive healthcare model. The counseling was provided with the collaboration of a midwife, a gynecologist and a clinical psychologist in 5 sessions during a 2-month period. The control group received only routine care. The fertility problem inventory (FPI) and general health questionnaire were used to measure perceived fertility-related stress and general health, respectively. Moreover, the ways of coping-revised questionnaire was used to collect data regarding the women’s coping strategies at the beginning of the study and at the day of the embryo transfer. The student t test, Fisher exact test, Mann-Whitney U test and analysis of variance (ANOVA) were used for data analysis. Results: A statistically significant difference was reported between the two groups in terms of problem-focused coping strategies (P = 0.037). However, no statistically significant difference was reported between the groups with regard to emotion-focused coping strategies (P = 0.947). There were statistically significant differences between the 2 groups in the mean scores of seeking social support (P = 0.022) and planful problem-solving strategies (P = 0.045) as the subscales of problem-focused coping strategies. Conclusion: The collaborative reproductive healthcare model promoted the use of problem-focused coping strategies. Therefore, the use of collaborative counseling approaches by healthcare professionals is suggested for assisting infertile women to cope with infertility. © 2018 The Author (s)

The effect of hand reflexology on anxiety in patients undergoing coronary angiography: A single-blind randomized controlled trial

Background This study aimed to evaluate effects of hand reflexology on anxiety level in coronary angiography patients. Materials and methods This clinical trial recruited 80 eligible patients >6 months. The patients were randomly assigned to receive routine care plus either hand reflexology or a simple hand massage. Data were collected using the Spielberger State-Trait Anxiety Inventory. Both groups' anxiety levels were measured before (T0) and 30 min (T1) and 1 h after the intervention (T2). Findings The mean anxiety level in the intervention group decreased from 57.54 at baseline to 55.47 after the intervention (P = 0.0001). The values in the control group were 54.27 and 51.4, respectively. The two groups had statistically significant differences in the mean scores of anxiety at T0 and T1 (P = 0.003), T1 and T2, and T0 and T2 (P = 0.0001). Conclusion Hand reflexology could effectively decrease anxiety in coronary angiography patients

Incidence of Snake Bites in Kashan, Iran During an Eight Year Period (2004-2011)

Background: Snake bites are one of the significant health problems in the tropical and subtropical regions. Snake bite is a common medical emergency in Iran, and the epidemiological features and management of such cases vary from region to region. Objectives: This present research study was conducted to obtain new information about the epidemiology of snake bites in the region of Kashan, located in the central part of Iran. Patients and Methods: This research was a descriptive retrospective study. Data from 2004 to 2011 of snakebite cases were collected from case reports. Information included; age and sex of the victim, district, month of incident, mortality, and time of bite. Results: The results of this study showed that the majority of snake bite patients were male (96%). The age distribution of patients indicated that the greatest rate of snake bites occurred among the 15-24 year old group. Data collected in this study revealed that the highest incidence of snake bite cases took place in summer (60%) and the lowest number occurred in winter, with no snake bite cases being recorded. The peak number of snakebite cases was seen during June-September. Conclusions: It was concluded that snake bite cases in Kashan are similar to other areas in Iran from an epidemiological point of view, including; age distribution rates, gender and site of the bites. The existence of Macrov ipera lebetina, a dangerous venomous snake, can cause a range of clinical effects among residents in central parts of Iran, such as Kashan area

Assessing the efficiency of countries in making progress towards universal health coverage: a data envelopment analysis of 172 countries

Introduction: Maximising efficiency of resources is critical to progressing towards universal health coverage (UHC) and the sustainable development goal (SDG) for health. This study estimates the technical efficiency of national health spending in progressing towards UHC, and the environmental factors associated with efficient UHC service provision. Methods: A two-stage efficiency analysis using Simar and Wilson’s double bootstrap data envelopment analysis investigates how efficiently countries convert health spending into UHC outputs (measured by service coverage and financial risk protection) for 172 countries. We use World Bank and WHO data from 2015. Thereafter, the environmental factors associated with efficient progress towards UHC goals are identified. Results: The mean bias-corrected technical efficiency score across 172 countries is 85.7% (68.9% for low-income and 95.5% for high-income countries). High-achieving middleincome and low-income countries such as El Salvador, Colombia, Rwanda and Malawi demonstrate that peer-relative efficiency can be attained at all incomes. Governance capacity, income and education are significantly associated with efficiency. Sensitivity analysis suggests that results are robust to changes. Conclusion: We provide a 2015 baseline for cross-country UHC technical efficiency scores. If countries wish to improve their UHC outputs within existing budgets, they should identify their current efficiency and try to emulate more efficient peers. Policy-makers should focus on strengthening institutions and implementing known best practices to replicate efficient systems. Using resources more efficiently is likely to positively impact UHC coverage goals and health outcomes, and without addressing gaps in efficiency progress towards achieving the SDGs will be impeded

Power-law Parameterized Quintessence Model

We introduce a power-law parameterized quintessence model for the dark energy which accelerate universe at the low redshifts while behaves as an ordinary matter for the early universe. We construct a unique scalar potential for this parameterized quintessence model. As the observational test, the Supernova Type Ia (SNIa) Gold sample data, size of baryonic acoustic peak from Sloan Digital Sky Survey (SDSS), the position of the acoustic peak from the CMB observations and structure formation from the 2dFGRS survey are used to constrain the parameters of the quintessence model. The best fit parameters indicates that the equation of state of this model at the present time is less than one $(w_0<-1)$ which violates the energy condition in General Relativity. Finally we compare the age of old objects with age of universe in this model.Comment: 11 pages, 17 figures, submitted to Phys. Rev.

Acute and subchronic dermal toxicity of nanosilver in guinea pig

Silver has been used as an antimicrobial agent for a long time in different forms, but silver nanoparticles (nanosilver) have recently been recognized as potent antimicrobial agents. Although nanosilver is finding diverse medical applications such as silver-based dressings and silver-coated medical devices, its dermal and systemic toxicity via dermal use has not yet been identified. In this study, we analyzed the potential toxicity of colloidal nanosilver in acute and subchronic guinea pigs. Before toxicity assessments, the size of colloidal nanosilver was recorded in sizes <100 nm by X-ray diffraction and transmission electron microscopy. For toxicological assessments, male guinea pigs weighing 350 to 400 g were exposed to two different concentrations of nanosilver (1000 and 10,000 μg/mL) in an acute study and three concentrations of nanosilver (100, 1000, and 10,000 μg/mL) in a subchronic study. Toxic responses were assessed by clinical and histopathologic parameters. In all experimental animals the sites of exposure were scored for any type of dermal toxicity and compared with negative control and positive control groups. In autopsy studies during the acute test, no significant changes in organ weight or major macroscopic changes were detected, but dose-dependent histopathologic abnormalities were seen in skin, liver, and spleen of all test groups. In addition, experimental animals subjected to subchronic tests showed greater tissue abnormalities than the subjects of acute tests. It seems that colloidal nanosilver has the potential to provide target organ toxicities in a dose- and time-dependent manner