Herbal prevention and treatment of nipple trauma and/or pain in Iranian studies: a systematic review

Introduction: Adequate nutrition during infancy is essential for lifelong health and wellbeing. However, painful nipple trauma is problematic for mothers and may lower the prevalence of breastfeeding. This systematic review was conducted to assess herbal prevention and treatment of nipple trauma and/or pain in Iranian studies. Methods: All the Iranian indexed publications in English and in Persian were searched with the key words of “nipple trauma” and “nipple pain” from inception to 26 December 2017 on indexing sites of PubMed, Proquest, Scopus, Science Direct, Medline, SID, IranMedex, Magiran, and Google Scholar. The results were reported qualitatively. Eleven randomized clinical trials (RCTs) with total sample size of 1218 were included in this systematic review. Different herbal remedies were used in included articles. The articles were investigated through Jadad scale. Studies that scored 3 or more on Jadad scale were selected. The results were reported qualitatively. Only RCTs were considered. Results: Pistacia atlantica (Saqez), Ziziphus jujuba, curcumin, menthol, Aloe vera, Calendit – E (Calendula officinalis and Echinacea angustifolia) were the most effective treatments of nipple trauma and/or pain. In one study, peppermint water was more effective than breast milk in preventing nipple cracks and in another study nipple crack was less in women using peppermint compared with those who used lanolin ointment or placebo. Conclusion: As each study used a special medicinal plant in this review, judgement about the definitive efficacy of these remedies needs further precise studie

Effect of portfolio assessment on student learning in prenatal training for midwives

The tendency to use portfolios for evaluation has been developed with the aim of optimizing the culture of assessment. The present study was carried out to determine the effect of using portfolios as an evaluation method on midwifery students’ learning and satisfaction in prenatal practical training. In this prospective cohort study, all midwifery students in semester four (n=40), were randomly allocated to portfolio and routine evaluation groups. Based on their educational goals, the portfolio groups prepared packages which consisted of a complete report of the history, physical examinations, and methods of patient management (as evaluated by a checklist) for women who visited a prenatal clinic. During the last day of their course, a posttest, clinical exam, and student satisfaction form were completed. The two groups’ mean age, mean pretest scores, and their prerequisite course that they should have taken in the previous semester were similar. The mean difference in the pre and post test scores for the two groups’ knowledge and comprehension levels did not differ significantly (P>0.05). The average scores on questions in Bloom’s taxonomy 2 and 3 of the portfolio group were significantly greater than those of the routine evaluation group (P=0.002, P=0.03, respectively). The mean of the two groups’ clinical exam scores was significantly different. The portfolio group’s mean scores on generating diagnostic and therapeutic solutions and the ability to apply theory in practice were higher than those of the routine group. Overall, students’ satisfaction scores in the two evaluation methods were relatively similar. Portfolio evaluation provides the opportunity for more learning by increasing the student’s participation in the learning process and helping them to apply theory in practice

Evaluation of Group Consulting on Pregnancy Anxiety: A Randomized Clinical Trial

Introduction: Anxiety is a disorder of mental health in pregnant women reported by 20 percent of health care providers and is accompanied by adverse pregnancy outcomes. This study aimed to determine the effect of obstetric counseling on the anxiety of pregnant women. Methods: In this randomized, double-blind controlled trial, 90 pregnant women attending to Sheibani Health Care Center in Tehran aging from 18 to 35 years old and with a gestational age of 8 to 18 weeks were evaluated first pregnancy. They were randomly assigned to counseling (group counseling with routine perinatal care) and control (only routine perinatal care) groups. The group counseling was designed according to different needs of pregnancy for five sessions in five weeks (a duration of 60 to 90 minutes for each session). The questionnaires of demographic information, Beck Depression, and Spielberg spiel Berger State-trait anxiety were used. The data analysis was performed by SPSS software version 13 using parametric and non-parametric tests. Results: According to the results, there was a significant difference between post-intervention scores in state anxiety (P = 0.014); however, there was no significant difference in trait anxiety (P = 0.19). Also, the changes in trait anxiety were more in the consoling group compared with the control group (P = 0.002), which is also seen for the state anxiety group (P = 0.0001). Conclusions: It is concluded from this study that group counseling is effective in the reduction of state anxiety and trait anxiety in pregnant women

Comparison of generalized estimating equations (GEE), mixed effects models (MEM) and repeated measures ANOVA in analysis of menorrhagia data

     Menorrhagia is one of the most common gynecological problem and leading causes of poor quality of life and iron deficiency anemia in women of reproductive age. Research in gynecological field relies heavily on repeated measure designs. Repeated measure studies are helpful in understanding how factors of interest change over time. Our goal is to apply statistical methods which are appropriate for analyzing repeated measure data such as gynecological data. Three statistical methods were performed by data collection from 100 patients with menorrhagia. One-hundred patients were randomly assigned to two groups, i.e. intervention group (Urtica Dioica and mefenamic acid) and control group (placebo and mefenamic acid) with an equal size of 50. In this study, generalized estimating equations (GEE) and mixed effects models (MEM) were used for analyzing menorrhagia data to determine the effect of hydroalcoholic extract of Urtica Dioica on Menorrhagia. Finally, these methods are compared to the conventional repeated measures ANOVA (RM-ANOVA).Based on the results, the three methods are found to be similar in terms of statistical estimation, the amount of bleeding before and after treatment between and within groups was compared. Results showed the average amount of bleeding was reduced significantly (P˂0/001). The average menorrhagia score in the third month (second cycles after intervention) were 91.38(71.432) and 149.40(127.823) in Urtica Dioica and control groups, respectively. The difference between the two groups was statistically significant (p =0.036). Because their advantages, GEE and MEM should be strongly considered for the analysis of repeated measure data. In particular, GEE should be utilized to explore overall average effects. When in addition to overall average effects, subject-specific effects are of primary interest, MEM should be utilized. With respect to these methods, it seems the extract of Urtica Dioica can be effective in reducing the amount of menstrual bleeding in women of reproductive age with Menorrhagia.

The role of the Coronavirus pandemic on childbearing intentions in Iranian women based on path analysis: A cross-sectional study

Background: The Coronavirus disease (COVID-19) may lead to couples not being physically and mentally ready to assume a parenting role. Objective: Given the changes in reproductive behaviors and the lack of accurate information about childbearing factors during the Coronavirus pandemic, this study was conducted to investigate the role of the COVID-19 pandemic in Iranian couples’ childbearing intentions based on the theory of planned behavior model. Materials and Methods: This cross-sectional study was conducted on 400 married Iranian women from July to October 2020 using official online popular social networks. Data were collected using a demographic checklist and the researchermade questionnaire, which was designed based on the main constructs of the planned behavior model. Results: Testing the indirect relationships of the mediation model effect showed a positive relationship between knowledge (β = 0.226, p < 0.001) and subjective norms (β = 0.155, p = 0.001) about COVID-19. Anxiety about COVID-19 mediated the relationship of knowledge (β = 0.105, p = 0.009), attitude (β = -0.125, p = 0.002), subjective norms (β = 0.238, p < 0.001), and perceived behavioral control (β = 0.513, p < 0.001) about COVID-19 with childbearing intentions. Conclusion: The results showed that COVID-19-induced anxiety can affect the relationship between the components of the theory of planned behavior model and childbearing intentions. Therefore, it is suggested that by designing appropriate interventions through anxiety-reducing and relaxation techniques, a fundamental step can be taken in increasing childbearing desires. Key words: Iran, Delayed childbearing, Reproductive behavior, COVID-19, Attitude

Iranian Adolescent Girls\u27 Perceptions of Premarital Sexual Relationships: A Qualitative Study

Sexual perception refers to the attitudes, expectations, beliefs, and values associated with sexual behaviors. Adolescents’ sexual behaviors is affected by the knowledge, attitudes, values, beliefs, and social norms in their society. In this respect, the sexual perception of adolescents can be studied from a cultural perspective. The present study was designed to identify factors affecting Iranian adolescent girls’ perceptions of premarital sexual relationships. A qualitative study was conducted using a conventional content analysis approach. Data was collected using in-depth unstructured interviews with 18 adolescents recruited through purposive sampling. Data analysis resulted in the development of a primary main theme, meaning and value of sexual self-care, and three main categories: significant others, sexual norms, and attitudes, and perceived risks. Overall, findings of the present study revealed that the sexual perceptions of Iranian adolescent girls motivated them to abstain from premarital sexual relationships. However, apart from the perceived double standards involved in social norms and attitudes identified in the study, the presence of a conflict caused by their families, schools, and peers necessitated the importance of establishing and consolidating parent-adolescent communication about sexual issues. Findings of this study point to the need for appropriate sexual education for adolescents and parents to promote adolescent sexual literacy and health

Poziom hemoglobiny w pierwszym trymestrze u ciężarnej z cukrzycą ciążową

Objective: The objective of this study was to determine the relationship between the hemoglobin levels during the first trimester of pregnancy with gestational diabetes incidence in pregnant women. Materials and methods: This is a prospective cohort study on 700 pregnant women with gestational ages of 1-13 weeks. Sampling was performed using the convenience method. For each pregnant woman, the hemoglobin level of the first trimester of pregnancy was measured. All the cases were followed up to delivery due to gestational diabetes. Results: Hemoglobin levels were categorized into three groups (Cel pracy: Celem pracy była ocena związku pomiędzy poziomem hemoglobiny w pierwszym trymestrze u ciężarnej z cukrzycą ciążową. Materiał i metoda: Prospektywne kohortowe badanie przeprowadzono na 700 kobietach w 1-13 tygodniu ciąży. U każdej kobiety badano poziom hemoglobiny w pierwszym trymestrze ciąży. Wszystkie przypadki kontrolowano aż do porodu ze względu na cukrzycę. Wyniki: Wyznaczono trzy grupy w zależności od poziomu hemoglobiny

Factors Affecting the Decline in Childbearing in Iran: A Systematic Review

AbstractIntroduction: The decline in fertility and childbearing tendency in Iran is due tovarious demographic, economic, social, and cultural variables. The present research wasconducted to review studies carried out on factors affecting the decline in childbearing.Methods: This systematic review searched for articles published from 2011 to 2017in all the available Iranian and foreign databases, including SID, Magiran, Irandoc,Medlib, Pubmed, Google Scholar, Science Direct, and Proquest using the followingkeywords, “childbearing”, “fertility”, “fertility decline” and “population decline”. Thesearch ultimately led to the inclusion of 53 studies.Results: The main factors affecting the decline in childbearing discussed in the 53reviewed articles were divided to three general categories: 1. Personal and familyfactors, including aging, older age at marriage, current number of children, theduration of marriage, the mean birth spacing, gender preferences, hopefulness, maritalsatisfaction, and quality of life, 2. Socioeconomic factors, including social support,education, occupation and social participation, especially of females, place of residenceand the effect of social networks, 3. Cultural factors, including modernity, urbanizationand industrialization, attitude change towards the value of children, changes in familyvalues and religion.Conclusions: To intervene in the decline in childbearing and to increase the successrate of the designed plans and strategies, policy-makers and planners should providestrategies to deal with all the three noted groups of factors affecting childbearing

Translation and Psychometric Assessment of the Persian Version of Patient Trust in Midwifery Care Scale

Background: Patients’ trust in their physicians can affect therapeutic outcomes. Measurement of patient’s trust levels is a helpful approach for policymakers in healthcare systems. Aim: The present study was targeted toward the translation and psychometric assessment of patients’ trust in midwifery care questionnaire. Method: This cross-sectional study was conducted on 210 female patients referring to the midwifery offices of Tehran, Iran, in 2017. After the translation and back translation of the original version of patient’s trust questionnaire, exploratory and confirmatory factor analyses were performed to measure the structural validity and reliability (through Cronbach's alpha coefficient and intra-class correlation) of the instrument. Results: Measurement of the questionnaire validity by exploratory factor analysis revealed three factors with the eigenvalues of > 1. The three extracted factors accounted for 73.24% of total variance. The goodness of fit indices revealed that the fitness of the three-factor model was at a desirable level, rendering a χ2/degree of freedom of 2.34, comparative fit index of 0.96, and root mean square error of approximation of 0.07. The reliability of the scale was confirmed with a Cronbach's alpha coefficient of 0.81 and intra-cluster correlation of 0.96. Implications for Practice: The patients’ trust questionnaire, measuring the extent of patient’s trust in midwifery offices in Tehran, is a proper tool, enjoying appropriate validity and reliability. The results of the study also showed that the Persian version of the tool can be used to measure the trust rate of the patients referring to the midwifery offices in Iran

Prediction of low birth weight using Random Forest: A comparison with Logistic Regression

Low birth weight (neonate weighing less than 2500 g) is associated with several maternal and fetal factors, all interrelated with each other [1]. This study is aimed to survey maternal risk factors associated with low birth weight neonates using data mining (Random Forest) to account for interactions between them. We also intended to compare Random Forest with traditional Logistic regression. The dataset used in the present study consisted of 600 volunteer pregnant women.  This cross-sectional study was carried out in Milad hospital, Tehran, during 2005-2009. Ten potential risk factors that are commonly associated with low birth weight were selected by using Random Forest technique. Several criteria such as the area under ROC curve were considered in comparing Random Forest with Logistic Regression.According to both criteria, four top rank variables identified by Random Forest were pregnancy age, body mass index during the third three months of pregnancy, mother’s age and body mass index during the first three months of pregnancy, respectively. In addition, in terms of different criteria the Random Forest technique outperformed the Logistic regression (area under ROC curve: 93% ; Total Accuracy:95% ; Kappa Coefficient: 66%).The results of the present study showed that using Random Forest improved the prediction of low birth weight compared with Logistic Regression. This is because of the fact that the former accounts for all interactions between covariates. Therefore, this approach is a promising classifier for predicting low birth weight