Comparison the efficacy of Hypericum perforatum and vitex agnus-castus in hot flushes: A double-blinded randomized controlled trial

BACKGROUND: Treating hot flushes in middle-aged women is an important health issue. Recently, Hypericum perforatum and vitex agnus-castus were investigated to decrease hot flushes. This study was conducted to compare the efficacy of Hypericum perforatum and vitex agnus-castus in hot flushes among menopausal women. METHODS: This was a randomized, double-blinded, controlled trial. The Hypericum perforatum group received 330 µg Hypericum perforatum and second group received vitex agnus-castus in the same tablet forms. Data were analyzed using repeated measurement for comparing Greene Climacteric Scale. RESULTS: Trend of Greene Climacteric Scale and hot flushness attack were decreased in both groups and it presented a decreasing trend within two months; however, no statistically significant difference was observed between the two groups. CONCLUSION: It seems that Hypericum perforatum and vitex agnus-castus could be similarly effective in decreasing hot flushes. These two medicines did not have any special severe side effects.

Influenza: A Unique Disease

Dear Editor-in-Chief, Influenza, commonly known as the flu, is an infectious disease caused by an influenza virus (1). Symptoms can be mild to severe (2). The most common symptoms include: high fever, runny nose, sore throat, muscle pains, headache, coughing, sneezing, and feeling tired (1). Three of the four types of influenza viruses affect people, Type A, Type B, and Type C (3, 4). Type D has not been known to infect people, but is believed to have the potential to do so (4, 5). Usually, the virus is spread through the air from coughs or sneezes (1). Influenza spreads around the world in yearly outbreaks, resulting in about three to five million cases of severe illness and about 250,000 to 500,000 deaths (1). About 20% of unvaccinated children, and 10% of unvaccinated adults are infected each year (6). In the northern and southern parts of the world, outbreaks occur mainly in the winter, while around the Equator, outbreaks may occur at any time of the year (1). Death occurs mostly in the young, the old, and those with other health problems (1). Larger outbreaks known as pandemics are less frequent (3). In the 20th century, three influenza pandemics occurred: Spanish influenzain 1918 (~50 million deaths), Asian influenza in 1957 (two million deaths), and Hong Kong influenza in 1968 (one million deaths) (7). The World Health Organization (WHO) declared an outbreak of a new type of influenza A (H1N1) to be a pandemic in June 2009 (8)

Curriculum Development in Pediatric Education: A Systematic Review ‏

Training of Pediatric residents is a dynamic process which should be changed as the nature and epidemiology of pediatric diseases change. We aimed to determine the educational needs of Pediatric residents. Materials and Methods: In this systematic review after choosing appropriate keywords and their combinations,, an extensive search was done in databases of Medline, EMBASE, ProQuest and Ovid, Web of Science, Cochrane Library, Scopus, and CINAHL as well as Persian databases, such as Magiran, Medlib, and SID, using equivalent keywords in Persian, to find related articles to Pediatric education, until October 2018. The full text of the articles was studied by two reviewer and their main findings were extracted and categorized. Quality of studies was evaluated using STROBE statement. Results: Data from nine studies were entered in this study. According to the findings, the necessity of changing Pediatric resident curriculum seems to be necessary in accordance with the conditions of the community. So, subspecialties for Pediatric resident training should be considered; these items include: cardiology, development, hematology and oncology, endocrinology, infectious diseases, respirology, palliative care of neurology, emergency, neonatology, gastroenterology, nephrology, gynecology, child psychiatry, behavioral psychology, surgical specialties, orthopedics and adolescents, dermatology, ophthalmology, and otolaryngology.Conclusion: Pediatric residents need sufficient, specific training to enable them to competently investigate and manage of children complaints. So, Pediatric resident curriculum should be developed to be in according to Pediatric educational needs, and also to support the learner’s personal development by contributing to enhancing their self-respect and confidence, motivation and aspirations

Explanation of the Midwifery Lecturers’ Experiences of the Challenges in an Undergraduate Midwifery Program: A Phenomenological Study

Background: Continuing professional development is an essential component of educational organizations in health care systems around the world. Such development has received attention in recent years with a broader perspective in the field of midwifery. Accordingly, the internal evaluation approach used to identify educational strengths and weaknesses can pave the way for a more purposeful future. This study aims to explore the experiences of midwifery lecturers of the challenges of the undergraduate educational program. Methods: This study employed a qualitative phenomenological approach using the data collected through individual interviews with midwifery lecturers at Kerman University of Medical Sciences, and analyzed from October to December 2020 for three months. To this end, eight semi-structured and in-depth interviews were conducted with eight midwifery lecturers who were selected using purposive sampling. The sampling was continued until the data were saturated. All interviews were analyzed after transcription using Colaizzi’s seven-step approach. Results: Analysis of the data revealed seven categories including inefficient policymaking, lack of motivation and confidence, lack of educational equipment and facilities (network of shortcomings), challenges of the curriculum and teaching methods, poor clinical conditions, disinterest in research activities, and inadequate academic output. Each category was divided into several subcategories. Conclusion: Along with achieving the fifth Millennium Development Goals, it is necessary to improve the quality of midwifery education. The challenges pointed out by midwifery lecturers highlight the need to make changes in the clinical and educational environment of the midwifery department to improve clinical skills and achieve the goals of the educational program following international education standards and consequently train skilled and educated midwifery staff

Psychotherapy for Depression and Anxiety in Premenstrual Syndrome (PMS): A Systematic Review and Meta-Analysis

Background: There are several therapeutic methods for the premenstrual syndrome (PMS). Although psychotherapy has been introduced for women with PMS, no regular reconsiderations of these treatments are available. Aim of the present meta-analysis was conducted to evaluate the effect of psychotherapy interventions on the PMS. Materials and Methods:  The present systematic review and meta- analysis was conducted no restriction in date of publication until 13th March 2018 on electronic international databases of Medline (via PubMed), Scopus, Web of Science, and Cochrane Library as well as Iranian databases, such as Magiran, Medlib, and SID, using equivalent keywords in Persian. The quality of studies and data extraction was assessed by two authors. The standardized mean difference (SMD) measure was applied to calculate the main effect size. Results: Seven trials were included in systematic review. Depression level [SMD =-0.978;

The Relationship between Body Fat Distribution and Postmenopausal and Menopausal Women’s Quality of Life

Introduction: Considering the issue in the population of postmenopausal women, no study has been conducted in Iran so far on the relationship between body fat distribution and quality of life. This study aimed to investigate the correlation between body fat distribution and quality of life in menopausal women.Methods: The present descriptive study was conducted on 250 premenopausal and menopausal women aged 40-65 years. Samples were selected by a multi-stage random sampling method. Data were collected through a two-part questionnaire including demographic variables and a questionnaire on the postmenopausal women’s life quality in health centers. The data were analyzed using Statistical tests, distribution, frequency percentage mean score, Standard deviation, and independent sample t-tests.Results: The mean age of participants was 55.17 years. There was a statistically significant difference between the two forms of body fat distribution in the vasomotor domain (p = 0.021), the physical domain (p = 0.044), and the sexual domain (p = 0.001), but no statistically significant difference was observed for the psychological domain (p = 0.148).Conclusion: The results of the present study showed a significant difference in some aspects of the postmenopausal women’s life quality with pear-shaped and gynoid fat distribution

Factorial Structures of Postpartum Bonding Questionnaire (PBQ): A Systematic Review

Background Postpartum Bonding Questionnaire (PBQ) is a remarkable tool to assess impairments in the mother-infant bonding. The purpose of the present study was to review the factorial structure of the PBQ cross different versions. Materials and Methods The search strategy was implemented on databases of Medline (via PubMed), Scopus, Cochran library and Web of Science through electronic databases. The quality assessment was fulfilled by COSMIN checklist. Results: The four factors were identified in original English version of PBQ. Theses consisted of "impaired bounding", "rejection and anger", "anxiety about care of the baby", and "risk of abuse". Three-factor-solution was confirmed by other English versions. In the Italian version of PBQ, three factors emerged including "annoyance and anger toward the infant", "detachment and rejection" and "anxiety about infant care". In the Spanish version of the PBQ, four factors including "impaired bonding", "anxiety about care", "lack of enjoyment and affection for the baby", and "rejection and risk of abuse". Three studies assessed factorial structure of Japanese version of PBQ. In the first Japanese version, four factors with 14 items were emerged including "impaired bonding ", "rejection and anger" and "anxiety about care", and "lack of affection". In second adapted Japanese version, exploratory factor analysis (EFA) identified a three factor solution: "mother's annoyance with anger toward their baby", "lack of affection" and" rejection and fear". The third version identified one-single solution. In the German version, one single factor emerged that explained 31 of the total variance.  Conclusion Original English version of PBQ was not confirmed in Japanese, Italian, Spanish and other English versions

Psychometric Properties of Breastfeeding Attrition Prediction Tool (BAPT): A Systematic Review

Background It is necessary to identify women who discontinue the breastfeeding to achieve the purpose of increasing the length of breastfeeding. To this end, Breastfeeding Attrition Prediction Tool (BAPT) has been developed. The current systematic review aimed to comprehensively review the validity and reliability of BAPT scale with different versions to give comprehensive information for authorities in this field. Materials and Methods Three English databases including Medline (via PubMed), Scopus, and Cochran library until May 2018 with no date restriction were searched. The search strategy was developed based on main terms of (Breastfeeding Attrition Prediction Tool OR BAPT) AND (Reliability OR validity OR Psychometrics OR Factor Analysis). Two reviewers separately extracted the required data available in full-text of all the quality of related studies was investigated using COSMIN checklist. Results All Cronbach alpha coefficient (both overall and subscale) were in excess of 0.7 except for subscale "NBS" in American version and subscale PBS in Persian version. In term of discriminant and predictive validity, BAPT revealed a good ability to classify women with or without breastfeeding. BAPT predicted breastfeeding status at postpartum period but it was not able to predict breastfeeding status in the third trimester of pregnancy. In term construct validity, four-factor solution of original English version was confirmed in Turkish, Persian and English other version. Conclusion Overall, the findings of systematic review supported that BAPT may be a valid (content, predictive and construct validity), and reliable (internal consistency and re-test reliability) instrument to use in both researches and clinics to identify mothers who are at risk of breastfeeding stop

A Systematic Review of Instruments Measuring Family and Social Support of Breastfeeding Mothers

Background: Due to the low rate of breastfeeding among working mothers and support of interventions to increase the duration of breastfeeding, this systematic review conducted to evaluate psychometric properties of instruments measured mother’s perception of Breastfeeding Support. Materials and Methods: The search was carried in English language databases including Medline (via PubMed), Scopus, Cochran library and Web of Science since inception to March 2018 regarding published studies evaluating the psychometric properties of the Breastfeeding Self-Efficacy. The COSMIN checklist was used to assess the quality of related studies. Results Authors of Perceived Breastfeeding Support Assessment Tool’ (PBSAT) suggested that instrument seem to should be two factors "workplace environmental support for breast-feeding working mother" and "the available social environmental support for working mothers". Total Cronbach's alpha was 0.85. In exclusive breastfeeding social support (EBFSS) instrument, based on exploratory factor analysis, 16 items grouped into three factors "instrumental", "emotional" and "informational factors" accounted 66% of total variance. EFA were followed by confirmatory factors analysis showed Modified model was partially fitted to the data. In the Workplace Breastfeeding Support Scale (WBSS), EFA identified four dimensions of breastfeeding support at workplace. These four factors labeled "technical support", "breastfeeding-friendly environment", "facility support" and "peer support". Cronbach’s alpha was 0.77 and split-half reliability was r=0.86. In Employee Perceptions of Breastfeeding Support Questionnaire (EPBS-Q), data scaled by the Multidimensional Random Coefficients Multinomial Logit Model. A two-dimensional model (company polices/work culture and manager and her co-workers) were emerged. Cronbach’s alpha was excellent (almost 0.90). Conclusion: Four instruments found to assess breastfeeding was valid and reliable to measure breast feeding in social and workplaces

A Systematic Review of Psychometric Properties of the Edinburgh Postnatal Depression Scale in Iranian Population

Background: Regarding adverse effects of postpartum depression on maternal mental health and the reduction of mother-infant attachment, there is a need to comprehensively understand Edinburgh Postnatal Depression Scale (EPDS). We aimed to review the validity and reliability of the EPDS in Iranian population to provide comprehensive information for the health providers. Materials and Methods The search procedure was fulfilled on the databases of Medline (via PubMed), Scopus, Cochran Library and Web of Science from inception to April 2018. The quality of studies was assessed by COSMIN checklist. Search keywords include (Edinburgh Postnatal Depression Scale) AND (Psychometric Properties). Results: Three studies identified a two-factor structure and one study found a three-factor structure. Discriminant validity of the EPDS was able to differentiate three groups (minor depression, major depression, and healthy women); but failed to distinguish between women with caesarean section, and women with normal delivery. Internal consistency was reported by four studies. Cronbach’s alpha ranged from 0.7 to 0.79 for total EPDS score. Test-retest reliability was reported only in a study with Intraclass Correlation Coefficient (ICC) > 0.80. In terms of convergent validity, the EPDS was significantly positively correlated with General Health Questionnaire (GHQ) (r=0.76;