Dramatic rise in cesarean birth in Iran: A coalition of private medical practices and women�s choices

Objectives: Cesarean delivery without medical indication has regularly increased among Iranian women in the last three decades, and Iran has one of the highest rates of cesarean in the world. The present study aimed at reviewing the studies regarding the increase of cesarean in Iran and discussing the root causes for such an increase. Methods: This literature review focused on the existing quantitative and qualitative studies conducted from January 1990 to January 2019 regarding the reasons for an increase in the cesarean section in Iran. The combination of keywords including �cesarean section�, �C-section�, �cesarean delivery�, and �Iran� was searched in several databases such as MEDLINE/PubMed, Embase, ISI Web of Science and Scopus, along with national databases (e.g., SID, MagIran, Iran Medex, and IranDoc). Results: A dramatic rise in cesarean birth stems from a number of factors including the role of health care professionals, insurance companies, socio-cultural factors, and the health policies, all of which have their roots in the medicalization of birth. Conclusions: In general, reducing the cesarean on maternal request necessitates the de-medicalization of birth, cultural awareness through the mass media, informing women of the long-term complications of cesarean, and physical and mental preparation of the mother. In addition, other contributing factors include encouraging inter-professional teamwork and collaboration between midwives and obstetrician-gynecologists, transforming the current curriculum of the midwifery and residency education, applying the midwifery-led care models, and decreasing the fear of litigation in midwifery and obstetrics-gynecology. Otherwise, maternal and fetal mortality will rise in the near future due to increased complications in subsequent pregnancies. © 2020 The Author(s)

The impact of third party reproduction on family and kinship

The development of in vitro fertilization (IVF) in the UK, in 1978, proved a major breakthrough in the process of human reproduction, which had remained constant in human history. The impact of IVF and the ensuing assisted reproductive technologies (ARTs) has not been limited in revolutionizing the "natural" practice of biological reproduction, but has reached out to and affected almost every institution in society. Family and kinship, as the social expression of reproduction and the institutions which are the most transparently structured realm of human life are those most profoundly affected by ARTs. Although literature on the implications of ARTs is in general abundant, this article presents new insights on their impact on family and kinship in Iran, which remains a unique case in the Muslim world. It explores the particular way ARTs, especially third-party donation, have been endorsed and practiced in Iran, and their consequences for the family, the infertile individuals, and their position vis-à -vis their kin and social group. The conclusion points to the lack of clarity concerning the initial rulings by the Islamic jurists, who allowed the practice of ARTs, and which has led to a number of unintended consequences regarding the legal, religious, cultural, and ethical issues, affecting the family, its structure and the relationship between the kin group. These consequences range, inter alia, from the question of the anonymity of third-party donor, to the permissibility of gamete donation between blood relatives, and to the absence of enforceable legislation. © 2021 Avicenna Research Institute. All rights reserved

Prevalence, awareness and risk factors of hypertension in a large cohort of Iranian adult population

Background: There is considerable variation in hypertension prevalence and awareness, and their correlates, across different geographic locations and ethnic groups. We performed this cross-sectional analysis on data from the Golestan Cohort Study (GCS). Methods: Enrollment in this study occurred in 2004-2008, and included 50 045 healthy individuals from Golestan Province in northeastern Iran. Hypertension was defined as a SBP at least 140 mmHg, a DBP at least 90 mmHg, a prior diagnosis of hypertension, or the use of antihypertensive drugs. Potential correlates of hypertension and its awareness were analyzed by logistic regression adjusted for sex, age, BMI, place of residence, literacy, ethnicity, physical activity, smoking, black and green tea consumption and wealth score. Results: Of the total cohort participants, 21 350 (42.7) were hypertensive. Age-standardized prevalence of hypertension, using the 2001 WHO standard world population, was 41.8 (95 confidence interval: 38.3-45.2). Hypertension was directly associated with female sex, increased BMI, Turkmen ethnicity, and lack of physical activity, and inversely associated with drinking black tea and wealth score. Among hypertensive patients, 46.2 were aware of their disease, 17.6 were receiving antihypertensive medication, and 32.1 of the treated patients had controlled hypertension. Hypertension awareness was greater among women, the elderly, overweight and obese patients, and those with a higher wealth score. Conclusion: Hypertension is highly prevalent in rural Iran, many of the affected individuals are unaware of their disease, and the rate of control by antihypertensive medications is low. Increasing hypertension awareness and access to health services, especially among less privileged residents are recommended. © Lippincott Williams and Wilkins

Review Paper- Transition stages from a traditional city to an industrial city(Social and cultural environment of Tehran)

Some of Iran's cities, specially Tehran that is the capital city of Iran have faced sudden changes of industrialization due to political, economic and ecological considerations. There is no doubt that it is not possible to conduct a thorough investigation of the cultural structures of these cities by theoretical models and they shall be evaluated in comparative and combinational terms. Because of the consideration mentioned above, different ethnicities and groups from different cultural backgrounds have been attracted to these cities and subcultures are highly influential in socialization, acculturation, solidarity, and integration of the individuals in the society. Although, one of the problems of the industrial cities all over the world, including Tehran is migration (from towns and villages), inflexible solutions and approaches to the migration problem are not logical. In addition, recourse to the weakness of the villages and attractions of the capital can not solve the problem (as shown by the author's experience). Therefore, it seems that creating occupational opportunities in villages and towns is one of the practical and useful ways for the survival of small towns and reduction of the migration to big cities, including Tehran

Influences of rural industries on sustainable social and environmental developments

This article is a case study among the owners of cheese-making industry in Lighvan Village of Tabriz City, located in the northwestern part of Iran in Azerbaijan Province, dealing with the effect of rural industry and socio-cultural indices influencing sustainable environmental development. The results were based on two different studies. The volume of the sample denotes the volume of the statistical population (N = 150). The present survey was conducted by means of some questionnaires and interviews during spring 2011. The results of testing the hypothesis as well as the correlation indicated: (a) significant correlation between the rates of empathy and rural environment sustainable development; (b) significant correlation between the rate of innovation and rural environment sustainable development; (c) significant correlation between the rate of providence and rural environment sustainable development; (d) significant correlation between the rates of social trust and rural environment sustainable development; (e) significant negative correlation between the rate of fatalism and rural environment sustainable development; (f) significant negative correlation between the rate of nepotism and rural sustainable environmental development; (g) significant correlation between rural industry and sustainable environmental development; and (h) significant correlation between rural industry and socio-cultural indices

The Leisure Time Environments and Antisocial Behavior Indices amongst Youth

The present study aims to explore the social pathology of the leisure time environments amongst 404 sampled youth (both girls and boys) from 15 to 29 years old throughout Tabriz city located in the northwestern Iran in Azerbaijan Province. The present survey was conducted by means of some questionnaires and the focus group interviews during summer 2009. The survey attempted to investigate the effect of youth leisure time activities such as sports, artistic, socio-cultural and educational, scientific, practical and entertaining activities on committing social deviance. However, two kinds of antisocial behavior including vandalize behavior and gambling were investigated among the youth. The results of testing the hypothesis as well as the Regression and path Analysis indicated that: a) there is a negative significant correlation between the rates of operational activities and gambling; b) there is a negative significant correlation between the rates of operational activities and vandalize behavior; c) there is a negative significant correlation between the rate of social-cultural and educational activities and gambling; d) there is a negative significant correlation between the rates of social-cultural and educational activities and vandalize behavior and e) finally, there is a significant correlation between the leisure time environments and gambling and vandalize behavior.

Polypill for the prevention of cardiovascular disease (PolyIran): Study design and rationale for a pragmatic cluster randomized controlled trial

Background The complexity of treatment regimens, costs and pill burden decrease the medication adherence and contribute to shortfall in cardiovascular preventive drug coverage. The polypill, a fixed dose combination pill of established drugs, is expected to increase adherence and reduce the costs whilst preventing major cardiovascular events (MCVE). Design and methods The PolyIran trial is a pragmatic cluster randomized trial nested within the Golestan Cohort Study (GCS). Subjects were randomized to either non-pharmacological preventive interventions alone (minimal care arm) or together with a polypill (polypill arm) comprising hydrochlorothiazide, aspirin, atorvastatin and either enalapril or valsartan. This study benefits from the infrastructure of the primary health care system in Iran and the interventions are delivered by the local auxiliary health workers (Behvarz) to the participants. The primary outcome of the study is the occurrence of first MCVE within five years defined as non-fatal and fatal myocardial infarction, unstable angina, sudden death, heart failure, coronary artery revascularization procedures, and non-fatal and fatal stroke. Trial status From February 2011 to April 2013, 8410 individuals (236 clusters) attended the eligibility assessment. Of those, 3421 in the polypill arm and 3417 in the minimal care arm were eligible. The study is ongoing. Conclusion The infrastructure of GCS and the primary health care system in Iran enabled the conduct of this pragmatic large-scale trial. If the polypill strategy proves effective, it may be implemented to prevent cardiovascular disease in developing countries. © European Society of Cardiology 2014