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BACKGROUND: The COVID-19 pandemic posed significant challenges for managers overseeing women's harm reduction centers. This study seeks to capture managers' perspectives on the service providing in women's harm reduction centers during the COVID-19 pandemic. METHODS: This convergent mixed-method study conducted in three provinces of Iran: Tehran, Khuzestan, and Kermanshah. The study was carried out between January and May 2023. In the quantitative part, the researchers utilized reports from 10 center managers. A researcher-designed questionnaire was employed to collect data on a wide range of services and referrals provided by the centers. The qualitative part of the research involved conventional content analysis and included 12 individual interviews. Two directors from the Ministry of Health and ten managers of women's harm reduction centers participated in the interviews. During the interpretation phase, the researchers compared the quantitative and qualitative findings to obtain a comprehensive understanding of the topic. RESULTS: During the quantitative stage of the study, it was observed that all the managers were women, with an average age of 40.7 ± 7 years. More than half of the managers had obtained a postgraduate education (n = 6, 60%), and a majority of them were married (n = 7, 70%). Additionally, 40% of the managers (n = 4) were working as contractors. During the non-COVID-19 period, there were higher coverage by centers and residents, more referrals of non-injecting drug users and sex workers, and a higher number of group counseling sessions in all three provinces compared to the COVID-19 period. The qualitative analysis revealed two primary themes: "challenges" and "capabilities." CONCLUSIONS: During the COVID-19 pandemic, providing some services and client referrals decreased in the centers, and center managers faced increased challenges. Many of these challenges were in the communication, executive, management, structure, education, financial, civilization, facilities, and socio-cultural sectors. Managers used their skills to manage and control these challenges. It is important to focus on these challenges and managerial capabilities to effectively handle future crises.
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COVID-19 , Reducción del Daño , Humanos , COVID-19/epidemiología , COVID-19/prevención & control , Femenino , Adulto , Irán/epidemiología , Persona de Mediana Edad , Encuestas y Cuestionarios , Actitud del Personal de Salud , Servicios de Salud para Mujeres/organización & administración , Investigación Cualitativa , PandemiasRESUMEN
BACKGROUND: The COVID-19 pandemic has posed significant challenges to nations worldwide, affecting various sectors of society. Women's HIV harm reduction centers, which provide critical services, have also been affected by these difficulties. This study aimed to examine the challenges of the COVID-19 pandemic on the services offered by women's HIV harm reduction centers from the perspective of clients. METHODS: A convergent mixed-method design was utilized to gain in-depth insights into the challenges of COVID-19 on the services provided by women's HIV harm reduction centers, counseling centers, and night shelters that cater to women at risk, such as drug users, sex workers, and the homeless population, in three provinces (Tehran, Khuzestan, and Kermanshah) in Iran. The study was conducted from January to May 2023. The quantitative aspect of the study employed a cross-sectional method with a sample size of 430 individuals. A researcher-developed questionnaire was used to assess a range of services. The qualitative part of the study involved traditional content analysis and included 32 individual interviews. The integration of qualitative and quantitative results was performed during the interpretation phase to provide a comprehensive understanding of the challenges of COVID-19 on women's HIV harm reduction centers. RESULTS: In the quantitative phase, the mean age of women was 39.0 ± 10.2 years. 165 women reported a history of COVID-19, which accounts for 38.4% of the total. More than half of them (n = 102, 61.8%) recovering at home. The majority of women (n = 365, 84.9%) mentioned receiving the COVID-19 vaccine. COVID-19 diagnostic tests were conducted for 74.2% (n = 319) of women. Women expressed higher satisfaction with the services (HIV prevention services, and accommodation services) before the COVID-19 pandemic compared to the satisfaction during the pandemic. The qualitative analysis identified emerging challenges related to the COVID-19 pandemic in two categories: personal challenges and mismanagement of services, comprising nineteen subcategories. CONCLUSION: The findings of this study highlight the adverse impact of the COVID-19 pandemic on the services provided by women's HIV harm reduction centers, in contrast to the pre-pandemic period. To mitigate these negative effects, it is crucial to implement preventive measures and practical solutions. This may involve addressing the personal and management challenges of the centers.
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COVID-19 , Infecciones por VIH , Reducción del Daño , Humanos , Femenino , COVID-19/epidemiología , COVID-19/prevención & control , Infecciones por VIH/epidemiología , Infecciones por VIH/prevención & control , Adulto , Irán/epidemiología , Estudios Transversales , Persona de Mediana Edad , Personas con Mala Vivienda/estadística & datos numéricos , Adulto Joven , Trabajadores Sexuales/estadística & datos numéricos , Pandemias/prevención & control , Encuestas y CuestionariosRESUMEN
PURPOSE: This study aims to review the literature to explore some factors affecting sexual and partnership adjustment in individuals with spinal cord injury (SCI). METHODS: This study was based on the methodological framework of scoping reviews, including 3 methodological steps: (1) identifying relevant studies (searching for related studies); (2) selecting related studies; (3) collecting key findings, summarizing, and reporting the results. The electronic databases were searched including Medline (PubMed), Scopus, Web of Science, Embase, and Cochrane Library. Studies were included if they reported data about the related factors of sexual and partnership adjustment in individuals with SCI. No limitations were considered in terms of time or methodology of the search. RESULTS: After the full-text screening, 52 studies were included from the year of 1978 - 2019 with various methodologies. The present review demonstrated that proper sexual health among individuals with SCI is related to several factors including the anatomical factor, level of the injury, completeness of the injury, psycho-social factor, socio-economic status, and type of relationship. CONCLUSION: With consideration of factors affecting sexual and partnership adjustment in individuals with SCI, a better estimation of sexual health can be achieved in clinical to improve the relationship and quality of life.
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BACKGROUND: Sexuality plays a critical role in a woman's postpartum quality of life and also has a strong impact on the quality of her relationship. Given the sparse body of published literature on the subject, we aimed to explore how new mothers explain their postpartum sexual quality of life. METHOD: A qualitative study was carried out in Iran and Switzerland from December 2018 to March 2019. Focus groups and semi-structured in-depth interviews (IDIs) were conducted with mothers in the first four months after parturition. Mothers who were older than 18 years, were married or in a stable relationship, and experienced a low-risk vaginal birth or cesarean section participated in the study. We used Graneheim and Lundman's approach for analyzing the data. Multiple data collection methods, maximum variation sampling, and peer checks were applied to enhance the rigor of the data. RESULTS: We achieved data saturation after two focus group discussions (FGDs), 15 IDIs in Iran, and 13 IDIs in Switzerland. We extracted three themes for postpartum sexual quality of life: (a) sexual worldview, (b) interpersonal relationship, and (c) postpartum sex storm. The participants described sexual worldview as "sexual beliefs", "sexual perceptions", and "sexual behaviors". The interpersonal relationship consists of "changes in postpartum interpersonal relationships" and "supportive role of the husbands/partners". The last one, postpartum sex storm, has three categories including "direct changes in sexual life", "indirect changes in sexual life", and "resumption of sexual intercourse". Differences between the two cultures were identified in some subcategories such as "sexual interests", "comparable to the first intercourse in life", "negative sexual behaviors of husbands/partners", "positive sexual behavior of mothers", "helping with child care and housework", and "emotional support". CONCLUSION: New mothers explained postpartum sexual quality of life as a three-theme phenomenon. Although most results were similar in both cultures, there were some differences. Our study's results suggest that sexual quality of life is a topic that encompasses international as well as cultural aspects.
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Cesárea , Calidad de Vida , Embarazo , Humanos , Femenino , Madres , Conducta Sexual , Periodo PospartoRESUMEN
BACKGROUND: Changes in sex hormones during menopause may have detrimental effects on a woman's sexual function and cause mood disorders. The treatment of both conditions is a challenge in gynecology. AIM: To review the published literature on sexual function and mood disorders among peri- and postmenopausal women. METHODS: The review is based on the methodological framework of scoping reviews. We searched electronic databases including Medline (PubMed), Scopus, Embase, and Web of Science (WoS). Publications that reported data about the relationship between sexual function and mood disorders among menopausal women were included in the review. The search was not subject to any limitation in terms of time or method. OUTCOMES: The main outcome measures used for the review were sexual dysfunction and mood disorders. RESULTS: We found 106 total records. After a full-text screening we included 19 studies from 1986 to 2020 based on various methodologies; the majority of the studies16 were cross-sectional. Investigations that addressed the symptoms of mood disorders and some domains of sexual function showed a close relationship between sexual dysfunction and mood disorders among menopausal women. CLINICAL IMPLICATIONS: In clinical practice, it would be appropriate to screen women for at least one mood disorder or sexual dysfunction. If a woman suffers from either, it will be necessary to assess for a further disorder as well. STRENGTHS & LIMITATIONS: The review was based on a detailed search of the published literature concerning mood disorders and sexual dysfunction among menopausal women compared to women of reproductive age. Despite the clinical importance of the subject, the number of studies eligible for inclusion in the review are rather small. Further investigation of the topic is clearly warranted. CONCLUSIONS: While the association between sexual dysfunction and mood disorders appears to be bidirectional, future studies will have to investigate the specific mechanisms by which sexual dysfunction could lead to mood disorders (or vice versa). Future studies should specifically address sexual dysfunctions and attitudes of partners, BMI, family support, sleep, and multiparity. Azam Rahmani, Elahe Afsharnia, Julia Fedotova, Shirin Shahbazi, Arezoo Fallahi, Leila Allahqoli, Reza GhaneipoklGheshlagh, Sarah Abboud, Ibrahim Alkatout. Sexual Function and Mood Disorders Among Menopausal Women: A Systematic Scoping Review. J Sex Med 2022;19:1098-1115.
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Trastornos del Humor , Disfunciones Sexuales Fisiológicas , Femenino , Humanos , Menopausia , Trastornos del Humor/complicaciones , Disfunciones Sexuales Fisiológicas/etiología , SueñoRESUMEN
OBJECTIVE: Despite the importance of oral health during pregnancy and its consequences for mother and child, dental cleaning behaviour is ineffective among pregnant women; therefore, the prevalence of gingivitis is high in this group. The aim of this study was to determine the factors affecting dental cleaning behaviour among pregnant women with gingivitis. METHODS: This cross-sectional study was carried out in Sanandaj city, in the west of Iran in 2017. Using simple random sampling, 340 pregnant women from five health comprehensive service centres were recruited in the study. Data were gathered by a two-section questionnaire. The first section included demographic information, and the second section involved variables of trans-theoretical model, fear of dental care and social support. Analysis of data was done by SPSS software by frequency, descriptive, Student t-test, ANOVA, chi-square, correlation coefficient and regression. RESULTS: About 50% of the pregnant women were in the first stages of dental cleaning behaviour change. The mean score of gingival index (P = 0.01), perceived barriers (P < 0.001) and fear of dental care (P = 0.04) was higher in the initial stages of behaviour change (P < 0.001). Perceived self-efficacy was directly correlated with social support and perceived benefits (P < 0.01). Dental cleaning behaviour increased 1.59 times and 1.42 times when perceived self-efficacy and social support were increased one unit, respectively. CONCLUSIONS: The results showed the majority of pregnant women had a low perception of the benefits of dental cleaning behaviour, did not have adequate incentive for doing the behaviour and did not receive the required social support.
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Dispositivos para el Autocuidado Bucal , Gingivitis , Niño , Estudios Transversales , Femenino , Humanos , Irán , Índice Periodontal , EmbarazoRESUMEN
Background: Sexual health education is a controversial issue within the Iranian context. Thus, the present study was conducted to explore the necessity of sex education among young single women and develop and examine the psychometric properties of the Sexual Health Education Necessity Scale. Methods: This was an exploratory mixed method study. Young single women (51 women in the first phase and 110 women in the second phase of the study) aged 18-34 years were recruited in the study. In the first phase, qualitative methods were applied to generate items. In the second phase, psychometric properties, such as face, content, and construct validity, and reliability of the Sexual Health Education Necessity Scale were evaluated. In the first phase, an item pool was developed that included 17 statements related to sexual health education necessity. In the second phase, item reduction was applied using exploratory factor analysis and the final version of the questionnaire containing 9 items was developed. Also, content, face, and construct validity were assessed. Moreover, Cronbach's alpha coefficient and test-retest were calculated to evaluate the reliability of the questionnaire. SPSS software (version 21) was used for data analysis and p value less than 0.05 was considered as significant. Results: In the qualitative phase, 4 key themes emerged regarding sex education, which included the effects of sex education, principles of sex education, content of sex education, and organizations responsible for sex education. An item pool containing 17 statements was generated and used for psychometric evaluation. The results of the exploratory factor analysis showed a 2-factor solution for the scale, which collectively accounted for the 56.04% of the variance. Final CVR and CVI were found to be 0.96 and 0.97, respectively. The Cronbach's alpha coefficient and test-retest of the instrument was found to be 0.78 and 0.80, respectively. Conclusion: Sexual Health Education Necessity Scale can be used for exploring dominant beliefs that may be obstacles for providing sex education in conservative societies; therefore, correcting these beliefs could help to design an appropriate sexual health education program.
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BACKGROUND: Premarital sexual behaviors are important issue for women's health. The present study was designed to develop and examine the psychometric properties of a scale in order to identify young women who are at greater risk of premarital sexual behavior. METHOD: This was an exploratory mixed method investigation. Indeed, the study was conducted in two phases. In the first phase, qualitative methods (focus group discussion and individual interview) were applied to generate items and develop the questionnaire. In the second phase, psychometric properties (validity and reliability) of the questionnaire were assessed. RESULTS: In the first phase an item pool containing 53 statements related to premarital sexual behavior was generated. In the second phase item reduction was applied and the final version of the questionnaire containing 26 items was developed. The psychometric properties of this final version were assessed and the results showed that the instrument has a good structure, and reliability. The results from exploratory factory analysis indicated a 5-factor solution for the instrument that jointly accounted for the 57.4% of variance observed. The Cronbach's alpha coefficient for the instrument was found to be 0.87. CONCLUSION: This study provided a valid and reliable scale to identify premarital sexual behavior in young women. Assessment of premarital sexual behavior might help to improve women's sexual abstinence.
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Conducta Sexual/psicología , Salud de la Mujer , Adolescente , Adulto , Escolaridad , Femenino , Grupos Focales , Humanos , Psicometría , Proyectos de Investigación , Asunción de Riesgos , Encuestas y CuestionariosRESUMEN
OBJECTIVES: Oral health-related behaviors in hemodialysis patients are reduced, potentially leading to adverse consequences. The aim of the present study was to evaluate dental cleaning behavior (DCB) and related factors among hemodialysis patients. METHODS: This cross-sectional study was carried out in Sanandaj city, in the west of Iran in 2022. Using the census method, 115 hemodialysis patients from the dialysis center of Tohid Hospital were recruited. Data were gathered by a three-section questionnaire. The first section included demographic characteristics, the second section involved variables related to the health belief model (HBM), and the third section assessed stages of DCB change based on the trans-theoretical model. Analysis of data was done by assessing frequency, descriptive and inferential statistics such as t test, correlation coefficient, and regression. RESULTS: Only 26.1% of participants reported DCB, defined as tooth brushing at least twice daily; 30.4% were in the precontemplation stage, 26.1% in contemplation, and 17.4% in the preparation stage. Perceived self-efficacy was lower among patients who did not perform DCB. The odds of DCB increased with perceived self-efficacy (odds ratio [OR] = 1.51, 95% confidence interval [CI] = 1.19-1.92, p < .05), cues to action (OR = 1.63, 95% CI = 1.03-2.55, p < .05), and decreased with perceived barriers (OR = 0.68, 95% CI = 0.47-0.97, p < .01). CONCLUSIONS: DCB of patients on hemodialysis requires improvement. Perceived self-efficacy, cues to action, and perceived barriers constructs of the HBM should be considered in interventional programs targeting to increase oral health as well as in future research in the field.
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Conductas Relacionadas con la Salud , Cepillado Dental , Humanos , Estudios Transversales , Irán/epidemiología , Modelos TeóricosRESUMEN
OBJECTIVE: Positron emission tomography with 2-deoxy-2-[fluorine-18] fluoro- D-glucose integrated with computed tomography (18F-FDG PET/CT) or magnetic resonance imaging (18F-FDG PET/MRI) has emerged as a promising tool for managing various types of cancer. This review study was conducted to investigate the role of 18F- FDG PET/CT and FDG PET/MRI in the management of gynecological malignancies. SEARCH STRATEGY: We searched for relevant articles in the three databases PubMed/MEDLINE, Scopus, and Web of Science. SELECTION CRITERIA: All studies reporting data on the FDG PET/CT and FDG PET MRI in the management of gynecological cancer, performed anywhere in the world and published exclusively in the English language, were included in the present study. DATA COLLECTION AND ANALYSIS: We used the EndNote software (EndNote X8.1, Thomson Reuters) to list the studies and screen them on the basis of the inclusion criteria. Data, including first author, publication year, sample size, clinical application, imaging type, and main result, were extracted and tabulated in Excel. The sensitivity, specificity, and diagnostic accuracy of the modalities were extracted and summarized. MAIN RESULTS: After screening 988 records, 166 studies published between 2004 and 2022 were included, covering various methodologies. Studies were divided into the following five categories: the role of FDG PET/CT and FDG-PET/MRI in the management of: (a) endometrial cancer (n = 30); (b) ovarian cancer (n = 60); (c) cervical cancer (n = 50); (d) vulvar and vagina cancers (n = 12); and (e) gynecological cancers (n = 14). CONCLUSIONS: FDG PET/CT and FDG PET/MRI have demonstrated potential as non-invasive imaging tools for enhancing the management of gynecological malignancies. Nevertheless, certain associated challenges warrant attention.
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Introduction: Abnormal uterine bleeding (AUB) is a major healthcare problem in females of reproductive age and impacts women's health and quality of life (QoL). This study aimed to test the equivalence of Persian Golnar (PG) and tranexamic acid (TA) for the treatment of excessive menstrual bleeding. Method: A triple-blind randomized equivalence trial with parallel design and block randomization technique was performed. A total of 80 patients with AUB were randomly allocated to receive either PG or TA for three consecutive menstrual cycles. Blood loss was measured by the Pictorial Blood Loss Assessment Chart (PBAC). Hematological evaluations were done before the intervention and after treatment. QoL and premenstrual dysphoric disorder (PMDD) as secondary outcomes were assessed using the menorrhagia questionnaire (MQ) and Premenstrual Symptoms Screening Tool (PSST). Statistical analysis was performed using an independent t-test, paired t-test, χ2 test, Mann-Whitney test, and Wilcoxon signed-rank test. Results: Seventy-six women completed the 12-week follow-up. Both PG and TA groups experienced a significant reduction in blood loss. Furthermore, the serum level of hemoglobin in the PG group enhanced significantly (P < 0.001). QoL and PMDD scores were significantly improved in both groups (P< 0.001). Conclusion: The findings of the current trial supposed that the Golnar product is as effective as tranexamic acid in controlling bleeding and enhancing the quality of life and premenstrual symptoms.
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The enzyme 11ß-hydroxysteroid dehydrogenase type 1 (11ß-HSD-1) is an NADPH-dependent reductase, responsible for the activation of cortisol by reducing cortisone. Resveratrol (RES), a type of natural polyphenol, is reported to be able to slow the progression of cancer and cardiovascular disease and improve the health of mice on a high-calorie diet. In this article, we applied molecular docking and molecular dynamics simulations to investigate the possibility of binding RES to 11ß-HSD-1. The 11ß-HSD-1:RES complex is stable on the µs time scale, and backbone RMSD-based clustering identified three conformations. Special attention was paid to the interaction pattern between the ligand and the target molecule, revealing hydrogen bonds between the hydroxyl group of RES and Thr124, as well as hydrophobic interactions responsible for the binding. In vivo studies demonstrated the ability of resveratrol at a dose of 40 mg/kg to reduce 11ß-HSD-1 activity in the liver of rats under conditions of experimental post-traumatic stress disorder (PTSD), as well as in non-stressed animals. In both cases, the resveratrol-induced reduction in 11ß-HSD-1 activity was accompanied by an increase in plasma corticosterone levels and a decrease in anxiety levels in the plus maze test.
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Background: Female breast cancer (FBC) is the most common type of cancer and is associated with a considerable disease burden as well as significant mortality rates. The present study aimed to provide an update on the incidence, mortality, and burden of FBC in 2019, based on the Global Burden of Disease (GBD) Study. Materials: The incidence, death rate, disability-adjusted life years (DALYs), years of life lost (YLLs), years lived with disability (YLDs), the age-standardized rates (ASR) of FBC in 204 countries, and a variety of classifications, were retrieved from the Global Burden of Disease Study. Data on tobacco use, alcohol consumption, and drug use were collected. The incidence, mortality, and burden of FBC were registered and compared between regions. Associations between age-standardized incidence rates and age-standardized mortality rates of FBC with smoking, drinking, and drug use were determined. Results: The highest incidence of FBC was observed in countries with a high socioeconomic status such as those of the European continent. Despite the lower incidence of FBC in countries with a low socio-demographic index (SDI), mortality rates secondary to FBC are higher in these countries than in high-income countries. The highest age-standardized mortality rate has been reported in the Eastern Mediterranean Region (EMRO), followed by the African Region (AFRO). The highest age-standardized rates of DALY and YLL per 100,000 population in 2019 were observed in lower-income countries, while the highest ASR of YLD per 100,000 population was reported in high-income countries. Conclusion: The present GBD-based study provides a comprehensive review of the incidence, mortality, and burden of FBC in 2019. The incidence of FBC is higher in regions with a higher socioeconomic status, whereas mortality rates and DALYs are higher in poorly developed regions. We suggest better screening measures and early detection programs for the latter regions.
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OBJECTIVE: The likelihood of timely treatment for cervical cancer increases with timely detection of abnormal cervical cells. Automated methods of detecting abnormal cervical cells were established because manual identification requires skilled pathologists and is time consuming and prone to error. The purpose of this systematic review is to evaluate the diagnostic performance of artificial intelligence (AI) technologies for the prediction, screening, and diagnosis of cervical cancer and pre-cancerous lesions. MATERIALS AND METHODS: Comprehensive searches were performed on three databases: Medline, Web of Science Core Collection (Indexes = SCI-EXPANDED, SSCI, A & HCI Timespan) and Scopus to find papers published until July 2022. Articles that applied any AI technique for the prediction, screening, and diagnosis of cervical cancer were included in the review. No time restriction was applied. Articles were searched, screened, incorporated, and analyzed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. RESULTS: The primary search yielded 2538 articles. After screening and evaluation of eligibility, 117 studies were incorporated in the review. AI techniques were found to play a significant role in screening systems for pre-cancerous and cancerous cervical lesions. The accuracy of the algorithms in predicting cervical cancer varied from 70% to 100%. AI techniques make a distinction between cancerous and normal Pap smears with 80-100% accuracy. AI is expected to serve as a practical tool for doctors in making accurate clinical diagnoses. The reported sensitivity and specificity of AI in colposcopy for the detection of CIN2+ were 71.9-98.22% and 51.8-96.2%, respectively. CONCLUSION: The present review highlights the acceptable performance of AI systems in the prediction, screening, or detection of cervical cancer and pre-cancerous lesions, especially when faced with a paucity of specialized centers or medical resources. In combination with human evaluation, AI could serve as a helpful tool in the interpretation of cervical smears or images.
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INTRODUCTION: HIV and hepatitis C virus (HCV) are major health concerns globally. This systematic review and meta-analysis protocol study aims to estimate the incidence of HIV and HCV among people who inject drugs (PWIDs) by reviewing studies that have applied mathematical modelling. The primary purpose of this systematic review is to identify and review mathematical modelling studies of HIV and HCV incidence in PWIDs.Methods and analysis cohort, cross-sectional and clinical trial studies conducted to estimate the incidence of HIV and HCV based on mathematical models or have evaluated the effectiveness of mathematical models will be considered for inclusion in the review. A comprehensive search applying a Cochrane approach will be used to identify relevant primary studies, published between January 2000 and July 2020, and indexed in PubMed, EMBASE, Opengrey, WOS, SCOPUS and Cochrane Library with no restriction on language. This protocol was prepared according to the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P). Study selection and data extraction will be performed by two independent reviewers. Assessment of risk of bias will be implemented using forms of the Critical Appraisal Skills Programme. Publication bias will be assessed by funnel plots, Begg's and Egger's tests. A meta-analysis will be conducted to answer the first research question, 'What is the incidence of HIV and HCV when applying mathematical model in PWID?'. Clinical heterogeneity will be assessed by looking at the characteristics of participants, method of diagnosis and case definitions in the included primary studies. In addition, subgroup analyses will be conducted for population and secondary outcomes. ETHICS AND DISSEMINATION: There are no ethical issues related to this study. The findings will be published in peer-reviewed scientific journals and presented at international and national conferences. PROSPERO REGISTRATION NUMBER: CRD42019126476.
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Infecciones por VIH , Hepatitis C , Preparaciones Farmacéuticas , Estudios Transversales , Infecciones por VIH/epidemiología , Hepacivirus , Hepatitis C/epidemiología , Humanos , Incidencia , Metaanálisis como Asunto , Prevalencia , Proyectos de Investigación , Revisiones Sistemáticas como AsuntoRESUMEN
BACKGROUND: Despite the World Health Organization (WHO) recommendations concerning the use of alternative tests for the detection of cervical cancer precursor lesions in low-income countries, the accuracy of these tests is a debated issue. In the present study we compare the diagnostic accuracy of the triple test with that of colposcopy for the diagnosis of premalignant and malignant cervical lesions. METHODS: A cross-sectional study was performed in 328 women referred to the gynecology clinic at Shahid Sadoughi Hospital, affiliated to Yazd University of Medical Sciences (SSUMS), Yazd, Iran, from March 2016 to June 2018. As the first step, a Pap smear was obtained from all participants. Visual inspection with acetic acid (VIA) and Lugol's iodine (VILI) was performed in accordance with the known protocol. A colposcopy was then conducted in all participants, biopsy samples were obtained, and histological features studied. Finally, the results were compared by statistical analysis. RESULTS: The age range of the participants was 30 - 50 years. Of 328 women, 60 (18.3 %) were postmenopausal. Two-hundred and five patients (62.5 %) had an abnormal Pap smear, 165 (50.3 %) had abnormal results on colposcopy, and 141 (43 %) had abnormal histopathology reports. The VIA was positive in 129 patients (39.3 %) and the VILI in 177 (54 %). The results of the triple test were reported to be positive in 205 cases (51.52 %). The sensitivity of the triple test in the detection of premalignant and malignant cervical lesions was 78.7 % and 69 %, respectively. The sensitivity and specificity of colposcopy in the detection of premalignant and malignant cervical lesions was 80.1 % and 72.2 %, respectively. The diagnostic accuracy of the triple test and colposcopy in the detection of premalignant and malignant cervical lesions was 73 % versus 75 %. CONCLUSION: Since the results of the study showed that the diagnostic accuracy of the triple test is equivalent that of colposcopy, the former may be used in low-income countries and areas lacking access to colposcopy.
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Colposcopía/métodos , Detección Precoz del Cáncer/métodos , Prueba de Papanicolaou/métodos , Lesiones Precancerosas/diagnóstico , Neoplasias del Cuello Uterino/diagnóstico , Frotis Vaginal/métodos , Adulto , Estudios Transversales , Femenino , Estudios de Seguimiento , Humanos , Persona de Mediana Edad , Pronóstico , Displasia del Cuello del Útero/diagnósticoRESUMEN
BACKGROUND: Drug abuse influences the quality of life significantly. Thus, the present study is designed to compare the quality of life of adolescents and young adults who have voluntarily referred to addiction treatment centers at different time slots of upon admission, and 1, 4, and 8 months after maintenance therapy. METHODS: The present paper is a longitudinal study on 141 of adolescents and young adults who had referred to various addiction treatment centers throughout Isfahan voluntarily. The population was selected through convenience sampling method and 137 of adolescents and young adults continued the research until the end. The results were analyzed using descriptive and analytic statistics (frequency, mean, standard deviation, repeated measure test, and post-hoc test) in SPSS 17. RESULTS: Results showed that the average of quality of life total score was sequential and not the same in the 4 times slots under study. The total quality of life score upon admission was significantly different from 1, 4, and 8 months after maintenance treatment. However, quality of life at 1-month was not significantly different to that at 4 and 8 months after the treatment; quality of life at 4 months after the treatment was not significantly different to that at 8 months after. DISCUSSION: According to the present study, it can be concluded that the quality of life of adolescents and young adults referring to addiction treatment centers increases 1-month after the treatment; nevertheless, it is worth to note that the degree of quality of life increase in 4 and 8 months after the treatment is not as much as that in 1-month after the treatment.
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BACKGROUND: Premarital sexual relationships could harm youth's health in terms of sexually transmitted infections or increased risk of unprotected sexual behaviors. Sexual abstinence has been recommended to prevent young adolescents from adverse outcomes of premarital sexual relationships. OBJECTIVES: The aim of this study was to explore the viewpoints of sexually active single women about premarital sexual relationships in the Iranian context. PATIENTS AND METHODS: In this qualitative study, we recruited 41 young women aged 18 to 35 years. Data were collected using focus group discussions and individual interviews. We employed conventional content analysis to analyze the data. Multiple data collection methods, maximum variation sampling, and peer checks were applied to enhance the reliability of the findings. RESULTS: Eight themes emerged from the data analysis: 'acceptance of sexual contact in the context of opposite-sex relationships, 'sexual activity as a guarantee for keeping the boyfriend in the relationship', 'premarital sexual relationship as an undeniable personal right', 'having successful marriage in spite of premarital sexual relationships', 'virginity as an old fashioned phenomenon', 'love as a license for premarital sexual behaviors', 'goal-oriented relationship as a license for premarital sexual behaviors', and 'experiencing premarital sexual relationships in order to gain perfection'. CONCLUSIONS: Results of this study could be applied to designing interventions, such as promotion of preventive beliefs or educational programs regarding premarital sexual relationships in conservative societies. These interventions could start within families and continue at schools and universities.
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BACKGROUND: Research on sensitive topics, such as sexuality, could raise technical, methodological, ethical, political, and legal challenges. The aim of this paper was to draw the methodological challenges which the authors confronted during sexuality research with young population in the Iranian culture. METHODS: This study was an exploratory mixed method one conducted in 2013-14. We interviewed 63 young women aged 18-34 yr in qualitative phase and 265 young women in quantitative phase in (university and non-university) dormitories and in an Adolescent Friendly Center. Data were collected using focus group discussions and individual interviews in the qualitative phase. We employed conventional content analysis to analyze the data. To enhance the rigor of the data, multiple data collection methods, maximum variation sampling, and peer checks were applied. RESULTS: Five main themes emerged from the data: interaction with opposite sex, sexual risk, sexual protective, sex education, and sexual vulnerability. Challenges while conducting sex research have been discussed. These challenges included assumption of promiscuity, language of silence and privacy concerns, and sex segregation policy. CONCLUSION: We described the strategies applied in our study and the rationales for each strategy. Strategies applied in the present study can be employed in contexts with the similar methodological and moral concerns.