Effect of Sexual Health Education of Mothers on Their Comfort and Intention to Discuss Sex-Related Topics with Adolescent Girls: A Controlled Intervention Study.

Sex education is one of the most challenging topics for mothers. Therefore, we examined the effect of sexual health education of mothers on their comfort and intention to discuss sex-related topics with adolescent girls. In this controlled intervention study, 160 mothers of 13- to 16-year-old girls were randomly assigned to either the intervention or control groups. The intervention group underwent sexual health training, while the control group received routine care. Paired t-test, chi-square, analysis of covariance, and multivariate analysis of covariance were used for the analysis of data. There was a significant increase in mean parents' comfort in discussing sex topics in the intervention group compared to the control group (p < .001). The intervention group had spoken with their child to a higher extent than the control group in all 13 items of parents' Intention index for discussing sex topics with the child (except for delivery and menstruation) (p < .05).There was no significant difference between groups for the mean age appropriate for discussing sex topics with the child, Sense of Competence as well as its dimensions, such as self-efficacy and satisfaction. Mean pre-to-post scores of sense of Competence in child rearing (p = .04) and self-efficacy (p = .037) significantly increased in the intervention groups, while they were not significant in the control group. Sexual health education was effective in the feeling of interest and comfort of mothers to discuss sex topics. Therefore, counseling services on mothers' speech interactions are recommended to promote adolescent girl's sexual health.

Risk factors for postpartum readmission: a prediction model in Iranian pregnant women.

BACKGROUND: Postpartum readmissions (PPRs) are an important indicator of maternal postpartum complications and the quality of medical services and are important for reducing medical costs. The present study aimed to investigate the risk factors affecting readmission after delivery in Imam Ali Hospital in Amol, Iran. METHODS: This retrospective cohort study was conducted on the mothers who were readmitted after delivery within 30 days, at Imam Ali Hospital (2019-2023). The demographic and obstetrics characteristics were identified through the registry system. Univariate and multivariate logistic regressions with odds ratios (ORs) and 95% CIs were carried out. To identify the most important variables by machine learning methods, a random forest model was used. The data were analyzed using SPSS 22 software and R (4.1.3) at a significant level of 0.05. RESULTS: Among 13,983 deliveries 164 (1.2%) had readmission after delivery. The most prevalent cause of readmission after delivery was infection (59.7%). The chance of readmission for women who underwent elective cesarean section and women who experienced labor pain onset by induction of labor was twice and 1.5 times greater than that among women who experienced spontaneous labor pain, respectively. Women with pregnancy complications had more than 2 times the chance of readmission. Cesarean section increased the chance of readmission by 2.69 times compared to normal vaginal delivery. CONCLUSION: The method of labor pain onset, mode of delivery, and complications during pregnancy were the most important factors related to readmission after childbirth.

Health-promoting lifestyle in mothers with vaginal childbirth and cesarean section in the postpartum period.

BACKGROUND: In the postpartum period, there are numerous changes in the physical and psychological dimensions of women, which reduce the quality of life of women. The aim of this study was to compare the health-promoting lifestyle of mothers with vaginal delivery and cesarean delivery in the postpartum period. METHODS: This cross-sectional study was conducted on 77 pregnant women who had delivered vaginal or by cesarean section at Shohadaye Behshahr Hospital and were selected based on inclusion criteria. If the women were willing to participate in the study, a demographic questionnaire was completed, and the telephone numbers of the subjects were recorded so that the Porsline health-promoting lifestyle questionnaire could be sent to them. Data were analyzed with SPSS 22 using the T test, chi-square test and Repeated Measure ANOVA. RESULTS: There was no difference in the average score of health-promoting lifestyle and its dimensions between the two groups of vaginal delivery and cesarean section at two and six weeks after delivery. However, in both groups, the total score of health-promoting lifestyle decreased significantly over time (P < 0.001). CONCLUSIONS: There was no difference in health-promoting lifestyle between mothers with vaginal and mothers with cesarean delivery at two weeks and six weeks after delivery. This requires more attention from policy makers to make vaginal childbirth more convenient, and by reducing complications after vaginal childbirth, they can improve women's healthy lifestyles and, in turn, families. Also, it seems that the other variables apart from the method of delivery should be considered, and it is necessary to distinguish these variables such as routine episiotomy in order to prevent the decrease in the level of health-promoting behaviors among women during puerperium period.

Depression, anxiety, stress, and PTSD symptoms during the first and second COVID-19 waves: a comparison of elderly, middle-aged, and young people in Iran.

BACKGROUND: A widespread outbreak of epidemics like Covid-19 is a lethal threat to physical and mental health. Recent studies reported a higher prevalence of mental problems in younger individuals, contrary to the general assumption expected in older people. Therefore, it is necessary to compare anxiety, stress, depression and PTSD (post-traumatic stress disorder) symptoms in different age groups during the Covid-19 crisis. METHODS: A cross-sectional online survey was performed (from Dec. 2020 to Feb. 2021) on three age groups of elderly, middle-aged and young people. Data were collected by DASS-21 (Depression, Anxiety and Stress Scale) and IES-R (Impact of Event Revised Scale) and analyzed using ANOVA, χ2 test and logistic regression analysis. RESULTS: Overall, 601 participants completed the questionnaires, including 23.3% of the elderly (≥ 60 years), 29.5% of the young (18-29 years) and 47.3% of the middle-aged (30-59 years) with 71.4% of women. The logistic regression analysis revealed that the risk of PTSD in young people was higher than in the elderly (ß = 2.242, CI: 1.03-4.87, P = 0.041), while the risk of depression, anxiety and stress did not differ significantly among the three age groups. Female gender, occupation, lower economic status, solitary life, and chronic disease were risk factors for psychological symptoms during the Covid-19 pandemic. CONCLUSION: Findings on the higher odds ratio of PTSD symptoms in younger individuals have interestingly potential implications to meet the needs of mental health services during Covid-19.

Coping strategies and depression during the COVID-19 pandemic in pregnant women: a cross sectional study.

BACKGROUND: Pregnant women are vulnerable to psychological problems depending on the adaptive capacities of their personality and coping strategies. This study aimed to investigate the association between coping strategies of pregnant women during the COVID-19 pandemic and depression. METHODS: This web-based cross-sectional study was conducted in 2021 on 318 pregnant women in Amol, Iran. Data collection was performed via questionnaires (Brief cope, Edinburgh Postnatal Depression Scale, CDA, and Demographic questionnaire). The questionnaires were completed through the WhatsApp and Telegram applications. Data were analyzed using the hierarchical regression analysis and SPSS software (v. 21) at the significance level of 0.05. RESULTS: About 40% of participants had depression. The most prevalent coping strategy used by pregnant women was the avoidance strategy. Hierarchical regression revealed that the coping strategy of avoidance was a significant predictor of depression (ß = 0.226, p = 0.046) after controlling background characteristics. CONCLUSIONS: The findings of this study suggest that avoidance style associated with depression in pregnant women. Therefore, obtaining further knowledge about impacts of coping strategies on pregnant women seems to be essential.

Acceptance of COVID-19 vaccine and determinant factors in the Iranian population: a web-based study.

BACKGROUND: Iran had a high rate of death in several COVID 19 waves. Vaccination is a method for prevention and control of the COVID-19 pandemic. Success in controlling the pandemic is not solely dependent on the effectiveness of the vaccines. It is also dependent on the global acceptance and vaccine coverage rate. This study aimed to determine the acceptance rate of COVID-19 vaccination in the Iranian population and the factors affecting it. METHODS AND MATERIALS: This study was a cross-sectional research on 1564 Iranian people above 18. Study data were collected using a web-based questionnaire and analyzed using linear regression analysis and logistics at a significance level of 0.05 using SPSS. RESULTS: Approximately 70% of the participants reported acceptance of the vaccines. Ten percent of the people were against and 20% were hesitant to get vaccinated. The results showed that risk perception (P = .003), Knowledge of the disease (P < .001), trust in the health system (P < .001), attitude towards vaccination (P < .001), and vaccination literacy (P < .001) were predictors of vaccine acceptance. People with higher levels of education and mistrust towards the health system had a reduced vaccine acceptance rate. CONCLUSIONS: The acceptance rate of the COVID-19 vaccine in Iran was higher than in the other countries in the Middle East. Extensive interventions are important to increase the trust in the health system and improve the knowledge of vaccine efficacy and literacy.

Pregnancy-related anxiety and its associated factors during COVID-19 pandemic in Iranian pregnant women: a web-based cross-sectional study.

BACKGROUND: Pregnancy is a risk factor for coronavirus disease 2019 (COVID-19). Pregnant women suffer from varying levels of pregnancy-related anxiety (PRA) which can negatively affect pregnancy outcomes. The aim of this study was to assess PRA and its associated factors during the COVID-19 pandemic. METHODS: This web-based cross-sectional study was conducted in 2020 on 318 pregnant women purposively recruited from primary healthcare centers in Sari and Amol, Iran. Data were collected using questionnaires (PRAQ, Edinburg, KAP of COVID-19, CDA-Q and Demographic questionnaire), which were provided to participants through the social media or were completed for them over telephone. Data were analyzed with the linear regression and the logistic regression analysis, at the significance level of 0.05 using the SPSS software (v. 21). RESULTS: Around 21% of participants had PRA, 42.1% had depression, and 4.4% had COVID-19 anxiety. The significant predictors of PRA were number of pregnancies (P = 0.008), practice regarding COVID-19 (P < 0.001), COVID-19 anxiety (P < 0.001), depression (P < 0.001), and social support (P = 0.025) which explained 19% of the total variance. Depression and COVID-19 anxiety increased the odds of PRA by respectively four times and 13%, while good practice regarding COVID-19 decreased the odds by 62%. CONCLUSION: Around 21% of pregnant women suffer from PRA during the COVID-19 pandemic and the significant predictors of PRA during the pandemic include number of pregnancies, practice regarding COVID-19, COVID-19 anxiety, depression, and social support. These findings can be used to develop appropriate strategies for the management of mental health problems during pregnancy in the COVID-19 pandemic.

COVID-19 preventive behaviors and influencing factors in the Iranian population; a web-based survey.

BACKGROUND: COVID19 is a respiratory disease caused by a novel coronavirus. As there has been no definitive treatment for the disease so far, the only way to control the spread is to break the chain of infection. Our study aimed to analyze the preventive behaviors and influencing factors in the Iranian population. METHODS: This cross-sectional study was a web-based survey in the Iranian population. We performed the study during the first peak of COVID-19 outbreak (from March 25th, 2020 to April 5th). We used demographic and Preventive behaviors questionnaires to collect the data. This web-based survey was publicized on the internet through the common platforms used by the Iranian population. This survey was released on the website " Porsline.com ". A total of 2097 acceptable questionnaires were filled. All data were analyzed, using Statistical Package for Social Sciences (SPSS) version 19. RESULTS: 61.9% of the participants checked the hand-washing question as "Always". 55.7 and 58.2% checked the wearing masks and gloves as "Always", respectively. We found a significant relationship between gender and hand washing behavior (P = 0.006) and the use of masks and gloves (P < 0.001). Results showed that wearing gloves had a significant relation with the education status (P = 0.029) and economic status (P = 0.011). Wearing masks had a significant relation with economic status (P = 0.032). Overall women had better preventive behaviors. CONCLUSIONS: Preventive behaviors have a significant relation with some socio-demographic characteristics. According to the 3 main preventive behaviors of hand-washing, wearing masks and gloves 50% of the population has not taken these behaviors seriously.

Nutrition assessment and geriatric associated conditions among community dwelling Iranian elderly people.

BACKGROUND: Although malnutrition risk is well documented in elderly care institutions, few studies have been conducted to address concerns regarding community-dwelling elderly people. This study has been aimed to describe the nutritional status and its related socioeconomic and geriatric factors in community-dwelling elders with malnutrition. METHOD: For this study, a randomized sampling among people aged 60 has been done (n = 326). Information on nutrition status (full MNA) and health information, like cognitive status (MMSE), daily functional status (ADL and IADL scales) and frailty was obtained. Multiple logistic regression analyses have been carried out, in order to identify the association of demographical and clinical factors with malnutrition. RESULTS: 28.1% of the participants suffered from poor nutrition. In the binary analysis, low MNA scores were associated with increasing age, female gender, lower education level, financial dependence, solitary life, poor self-rated health, multiple physical disabilities and chronic disease, polypharmacy, smoking, functional and cognitive decrease and frailty. In the final model of the multivariate analysis, living alone (OR:1.249,CI:1.105-2.620), multiple physical disabilities (OR:2.183,CI:1.246 ± 3..250) and chronic disease (OR: 2.148,CI:1.167-2.879) were independently associated with malnutrition. Also financial independency (OR:0.625,CI:0.233-0.938), functional ability on ADL (OR:0.536,CI:0.327-0.976) and IADL (OR:0.319,CI:0.194-0.856), normal cognitive (OR:0.456,CI:0.293-0.934) and no frailty (OR:0.253,CI:0.117-0.729) independently were inversely associated with malnutrition. The model was adjusted for all socio- demographic and health variables that were significantly related in the previous models. CONCLUSIONS: Our results indicated a strong correlation between malnutrition and health status. Identifying predictive factors can potentially improve prevention and management strategies used for malnutrition in elderly.

Does Religion Predict Health-Promoting Behaviors in Community-Dwelling Elderly People?

As the aging phenomenon gains importance in many societies, regular health-promoting activities by the elderlies become more crucial for disability reduction and their health promotion. Religious viewpoints and perspectives can have an influence on the individuals' assessment of life events. Recent studies show a correlation between religiosity and mental health. However, there is limited number of studies on the relationship between religiosity and health behaviors, especially in elderly. The purpose of this research is to evaluate religion's predictive power in health-improving behaviors of the elderly. This cross-sectional study was conducted on 316 community-dwelling elderly with the mean age of 67.9 ± 6.6 years, who were functionally independent without cognitive or mental impairments. Health-promoting lifestyle profile 2 assessment (HPLP2) and Alport questionnaires were used to assess health behaviors and religious orientation, respectively. Data analysis was performed by independent T test and multiple linear regression models with SPSS version 23. An internal religious orientation was found in 71 elderly; this accounts for 22.5% of the study population. Based on the health behavior scoring 154 individuals, 48.8% of the study population obtained a score of higher or equal to 139. These individuals were placed on third quartile and higher. Among the health behavior components, "the health responsibility" was the only component related to religious orientation [internal 25.1 ± 6.6 (P < 0.001, r = 0.78) vs. external 22.6 ± 6.5 (P > 0.05, r = 0.22)]. Based on the multiple linear regression models, no significant relationship was found between total health behavior score and religious orientation. However, a significant relationship existed between the participants' health behaviors and some of their profile. The results indicate that despite good health behaviors in nearly half of the elderlies, no significant relationship was found between health behavior and religious orientation. The results suggest possible impact of other religion-related concepts including private religious behaviors, devotion, spiritual transcendence, religious adaptation, and religious traditions and experiences on the health behaviors. These concepts require further study for better understanding of their impact.

Health-Promoting Behaviors and Their Predictors in Iranian Women of Reproductive Age: A Cross-Sectional Study.

Health-promoting behaviors are one of the main determinative components of health in the prevention of many diseases. This cross-sectional study aimed to determine health-promoting behaviors and their relationship to sociodemographic variables on 330 women of reproductive age admitted to the selected primary health-care centers in Qom city (one of the biggest cities in Iran) from March 2016 to July 2016. Data were collected using the health-promoting lifestyle profile II (HPLP-II) questionnaire and the sociodemographic characteristics and also were analyzed by one-way analysis of variance, with post hoc (if necessary), and multivariable linear regression. The total HPLP-II mean score of women was 136.64 ± 22.37. The highest score in the HPLP-II subscales of women was found for interpersonal relations subscale (26.43 ± 4.21) and the lowest score for physical activity subscale (14.66 ± 4.62). The educational level and income had significant association with some subscales ( p < .05).

Do health-promoting lifestyle approaches manage mental health among adolescent/young college students?

OBJECTIVES: College students are often still relatively young, making their mental health more likely to be overlooked. A healthy lifestyle is considered the key to preventing and controlling mental health problems nowadays. This study aimed to investigate whether health-promoting lifestyle approaches manage mental health among adolescent/young college students. METHODS: This cross-sectional study was conducted on 187 adolescent/young college students at Babol Medical Science University, Babol, Iran. Characteristic demographics, health-promoting lifestyle profile (HPLP), and general health questionnaire-28(GHQ-28) were filled out by students. The data were analyzed using correlation coefficient and simple and multiple linear regressions. RESULTS: The majority of participants were adolescents (66.8%), single (97.9%), and bachelor's students (70.1%). The mean of the HPLP and GHQ scores was 125.09±18.12, and 33.58±10.50, respectively. HPLP was a negative significant predictor of mental health (ß = -.261, P= .0001). There was a negative significant association between HPLP dimensions (except physical activity) and mental health. After adjusting for other variables, there was a significant relationship between HPLP with mother occupation (ß =.186, P=.038), and mother education (ß = -.219, P= .034). Furthermore, gender (ß = .175, P= .031), and occupation (ß =-.157, P= .040) were predictors of GHQ in adolescent/young college students. CONCLUSIONS: Regarding the health-promoting lifestyle situation among students and its relation with the better mental health, the design and implementation of HPLP education programs is recommended.

Effectiveness of an educational intervention on knowledge and practice of young midwifery college students about IUD and Pap smear, Babol, Iran.

OBJECTIVES: The high status of midwifery within the Millennium Development Goals (MDGs) is closely tied to enhancing clinical education. The purpose of this study was to review the effect of education on the knowledge and practice of midwifery students about Intrauterine Device (IUD) and Pap smears. METHODS: This quasi-experimental study was conducted over the course of four semesters, involving 128 bachelor of midwifery students. The sampling method was non-random, utilizing convenience sampling. Four consecutive 45 min weekly sessions were held, which included three theory sessions and one practical training session. Education was conducted in face-to-face training sessions using different methods such as lectures, question and answer, slide shows, educational films and brochures, and training participants with moulage. The data were gathered using a questionnaire covering demographic characteristics, various aspects of IUD and Pap smear knowledge, along with checklists for IUD insertion and Pap smear. Paired-samples T-test and multiple regression test were used to analyze the data. A significance level of p<0.05 was set for the analysis. RESULTS: The results of this study showed that there was a significant difference in the average knowledge across various aspects of IUD and Pap smear before and after the intervention (p<0.001). On multiple regression analysis, residence and income significantly influenced knowledge (ß=0.313, p=0.001 and ß=-0.384, p=0.001, respectively). Also, multiple regression analysis indicated that the use of IUD among family or friends and age significantly impacted practice (ß=-0.450, p=0.005 and ß=-0.206, p=0.030, respectively). CONCLUSIONS: The educational intervention yielded a noticeable enhancement in the knowledge and practical skills of midwifery students. These students tend to achieve higher levels of success and deliver superior services to both patients and clients.

Exploring the relationship between mothers' competence and comfort in sexual and reproductive health discourse with adolescent girls and its related factors.

OBJECTIVES: The mothers-adolescent discussion regarding sexual and reproductive health (SHR) issues plays an important role in preventing negative outcome associated with sexual risk behaviors. The present study aimed to explore the relationship between mothers' competence and comfort in SHR discourse with adolescent girls and its related factors. METHODS: A cross-sectional study was conducted involving 160 mothers from July to September 2020. Data were collected through questionnaires covering demographic characteristics, Mother's Comfort in Sexual Discourse (MCSD), Mother's Interest in Sexual Discourse (MISD), and Parenting Sense of Competence (PSOC). The collected data were analyzed using simple and multiple linear regression models. RESULTS: The mean scores for MCSD, MISD, and PSOC were 45.49±16.15 (13-78), 7.9±4.2 (0-13), and 64.07±9.44 (45-94), respectively. The primary topics of mother-adolescent discourse on SRH were menstruation (5.61±0.98) and the delivery process (4.55±1.57). The mean age for "sex talks" and age-appropriate "sex talks" with daughters was 11.76±1.85 (range: 6-15) and 17.05±1.86 (range: 14-23) years, respectively. Significant associations were found between MCSD and MISD (ß=0.482, p<0.0001), PSOC (ß=0.223, p<0.005), self-efficacy (ß=0.202, p<0.011), mother's job (ß=0.185, p<0.019), mother's education (ß=0.173, p<0.029), and father's age (ß=0.161, p<0.042). After adjusting for other variables, major influencing factors on MCSD included MISD (ß=0.487, p<0.0001), self-efficacy (ß=0.143, p<0.039), satisfaction (ß=0.169, p<0.015), daughter number (ß=-0.235, p<0.014), son number (ß=-0.219, p<0.024), birth rank (ß=0.263, p<0.008), and residency (ß=0.172, p<0.014). CONCLUSIONS: MISD, PSOC, and certain demographic characteristics emerge as significant factors influencing MCSD in mother-daughter sexual discourse. As such, it is imperative to consider these determinants when devising strategies to maintain and enhance the sexual health of teenage girls.

Depression and anxiety in adolescents and young women with polycystic ovary syndrome: a systematic review and meta-analysis.

OBJECTIVES: To evaluate the depression and anxiety symptoms, or both in adolescents and young women with polycystic ovary syndrome (PCOS) to those without PCOS. CONTENTS: A comprehensive electronic search was conducted to identify observational studies on PCOS patients (January 1991-December 2020). The population study included adolescents and young women (14-29 years of age) in two groups of cases (with PCOS) and controls (without PCOS) who were diagnosed with PCOS using the Rotterdam or National Institutes of Health criteria (NIH). Symptoms of depression, anxiety, or both, reported separately, were of interest. Mean (SD) of depression or anxiety symptoms, or both, as measured by a quantitatively validated scale for both the case and control groups. All eligible studies were quality assessed using the Newcastle-Ottawa Scale (NOS) tool. The initial database search resulted in the discovery of 1,582 papers, of which 806 were selected after screening the titles and abstracts and removing duplicates. A total of 49 papers were found to be suitable for full-text reading. This meta-analysis included ten studies comprising 941 adolescent/young women (391 with PCOS and 550 without PCOS). The standard mean difference (SMD) and its corresponding confidence interval (CI) at 95 % were used to compare depression or anxiety symptoms, or both, between two groups. SUMMARY AND OUTLOOK: The results, which included 192 cases, demonstrated that adolescents/young women with PCOS had significantly more depressive symptoms than those without PCOS (n=360) (SMD 0.72; 95 % CI, 0.09-1.34; Z=2.25, p=0.025; Heterogeneity: I2=89.7 %; p=0.000). Also, the results which included 299 cases demonstrated that adolescents/young women with PCOS had significantly more anxiety symptoms than those without PCOS (n=421) (SMD 0.59; 95 % CI, 0.13-1.05; Z=2.51, p=0.012; Heterogeneity: I2=86.1 %; p=0.000). This meta-analysis demonstrates that adolescent/young women with PCOS have significantly more depression or anxiety symptoms than those without PCOS.

Effectiveness of Group Psychosexual Training for Marital Adjustment and Sexual Self-Efficacy of Infertile Women: A Randomized Controlled Trial.

Objective: Infertility can be associated with unfavorable psychological consequences such as a sense of marital incompatibility and sexual inadequacy. To address these issues, this study aimed to assess the effectiveness of group psycho-sexual training in improving marital adjustment and sexual self-efficacy of infertile women. Method : A randomized controlled clinical trial (RCT) study was conducted in Babol, Iran, with 72 infertile women, randomly assigned to either the intervention group (n = 36) or the control group (n = 36). The intervention group underwent psychosexual training, while the control group received routine care. The Dyadic Adjustment Scale (DAS) and Sexual Self-Efficacy Scale (SSES) were used to assess their marital adjustment and sexual self-efficacy. Data analysis was performed using various tests, including the independent t-test, Chi-squared test, paired t-test, ANCOVA, and MANCOVA. Results: Most infertile women had moderate sexual self-efficacy (80%). The intervention group had a significantly better response to group psycho-sexual training compared to the control group. This intervention improved sexual self-efficacy and marital adjustment and its subscales including marital consensus, satisfaction, cohesion (P < 0.0001), and affectional expression (P < 0.001). The mean pre-to-post treatment scores of sexual self- efficacy, marital adjustment, and its subscales increased significantly in the intervention group, while no significant difference was observed in the control group (P < 0.0001). Conclusion: Based on the findings, it is recommended to provide educational services alongside the infertility treatment process for enhancing the quality of marital adjustment and promoting sexual self-efficacy.

The Effectiveness of Information-Motivation-Behavioral Skills Model on Self-Care Practices in Early Pregnancy to Prevent Gestational Diabetes Mellitus in Iranian Overweight and Obese Women: A Randomized Controlled Trial.

BACKGROUND: Gestational diabetes mellitus (GDM) is one of the most common metabolic dysfunction in pregnancy and as overweight and obesity are of the major risk factors. The aim of this study was to determine the effect of Information-Motivation and Behavioral skills (IMB) model-based counseling on preventing GDM in overweight and obese pregnant women. METHODS: This randomized controlled trial study was conducted on 137 pregnant women in two groups; education and counseling IMB model-based for four sessions (n = 70), and antenatal usual care (AUC) (n = 67). This study was conducted on overweight and obese pregnant women, at the 12 to 16 weeks' gestation and recruited from the Prenatal Clinic of Rohani Hospital in north of Iran. Blood glucose was measured before and 8 weeks after the intervention. Descriptive and inferential statistics including mean, frequency, t-test, chi-square and ANCOVA were used. RESULTS: The prevalence of GDM was lower in the intervention group than the control group (10% and 29.9%, respectively, RR = 0.33, CI 95% (0.15- 0.74) p = .004) as well as mean fasting blood glucose (Cohen's d = 0.28, p = .07), and glucose tolerance test at the first and second hour (d = 0.41 and Cohen's d = 0.73, respectively, p < .01). CONCLUSIONS: A lifestyle intervention in early pregnancy by IMB counseling in overweight and obese pregnant women can be effective in decrease GDM.

The relationship between perceived stress and pregnancy distress with self-care of pregnant women: The mediating role of social support-A cross-sectional study.

Background and Aims: Pregnancy is a stressful experience, which can affect different aspects of a woman's life. Yet, women with a supportive network of friends and family may experience lower stress and improved self-care behavior. The study aimed to investigate the relationship between perceived stress and pregnancy distress with the self-care of pregnant women, as well as the mediating role of social support. Methods: This cross-sectional study was conducted from February to May 2022 in Babol, Iran. A total of 157 pregnant women participated in the study. The participants completed five questionnaires, including a demographic and obstetric questionnaire, a Self-care questionnaire, Perceived Social support (PSS), Perceived Stress Inventory (PSI), and Pregnancy Specific Distress. Structural equation modeling was used to test the hypothesis relationships among the variables. Results: We found that Perceived stress (ß = -0.221, p = 0.012ß) and pregnancy distress (ß = -0.203, p = 0.002ß) had a negative and significant effect on the self-care of pregnant women. Also, perceived stress (ß = -0.429, p < 0.001ß) and pregnancy distress (ß = -0.381, p < 0.001ß) had a negative and significant effect on the social support of pregnant women. The results exhibited a significant specific indirect effect between pregnancy distress, perceived stress, and pregnancy self-care, with social support as the mediator: standardized indirect effect = -0.068, -0.076, respectively. Conclusion: According to the findings, social support plays a direct and mediating role in improving self-care behaviors among pregnant women. Therefore, providing strategies and measures to improve perceived social support by maternal health professionals may be expected to reduce the impact of stress on pregnant women's self-care. The implementation of policies and social interventions to improve the social support of pregnant women can be one of the applications of the findings.

The quality of sleep and daytime sleepiness and their association with quality of school life and school achievement among students.

BACKGROUND: Sleep quality is an important factor in adolescents' health; physical as well as psychological. The aim of this study was to determine sleep quality and daytime sleepiness and their effect on the quality of school life (QSL) and achievement. MATERIALS AND METHODS: This cross-sectional study was conducted in high schools. The data collection was done on a random sample of 500 students from 15 to 19 years. The questionnaires included the Pittsburgh Sleep Quality Index (PSQI) to measure sleep quality and the Epworth Sleepiness Scale to measure daytime sleepiness as well as QSL. Data were analyzed by SPSS 25. Linear and logistic regressions were used to obtain adjusted and unadjusted odds ratios as well as predictors. RESULTS: The mean PSQI score was 6.2 ± 2.4. It was realized that 377 participants (75.4%) were poor sleepers; 6.2% had excessive daytime sleepiness. There was a significant association between age and quality of sleep (P < 0.04). No association between gender and quality of sleep or between the quality of sleep and school achievement was found. Linear regression exhibited a significant relationship between the quality of sleep and daytime sleepiness (ß = 0.218; t = 4.982, P = 0.000). There was a significant, inverse correlation between sleepiness and the total score of QSL (P = 0.000). Stepwise linear regression analysis exhibited that daytime sleepiness (P = 0.002) and school achievement (P = 0.001) were predictors of QSL. CONCLUSION: According to the study results, sleepiness affects school performance and QSL, and on the other hand, daytime sleepiness is under the effect of sleep quality.

Anxiety, Depression, and Predictors amongst Iranian Students Aged 8 to 18 Years during the COVID-19 Outbreak First Peak.

Objective: This study aimed to assess anxiety and depression during the COVID-19 outbreak among students aged 8 to 18 years and to determine related demographic and other related factors. Method : A descriptive and analytical cross sectional study was conducted through web-based data collection which included 348 students aged 8 to 18 years in the state of Mazandaran, Iran during the first peak of COVID-19. Demographic and Revised Children's Anxiety and Depression Scale (RCADS-P) questionnaires were used to collect the data. The statistical tests including independent sample t test, ANOVA as well as linear regression were employed. Results: The average age of the subjects was reported to be 12.2 ± 3.59 years. Age, father's occupation, following COVID-19 related news, and also nervousness related to infection were predictors of anxiety (11%). Moreover, age, mother's occupation, family communication and also the safety protocols practiced by the family were found to be predictors of depression in students (17%). A significant relationship was also found between the effect of quarantine on family communication and the anxiety and depression in students (P < 0.001). Conclusion: Demographic characteristics affect student mental health during the COVID-19 outbreak. Moreover, family preventive protocols can predict depression in students aged 8 to 18 years. Better preventive precautions encourage less anxiety and depression.