Designing, implementation and evaluation of story reading: a solution to increase general empathy in medical students.

BACKGROUND: Communication and mutual understanding among healthcare providers is a significant concern within the healthcare system, and enhancing empathy is one way to foster effective communication and mutual understanding. The aim of this research is to evaluate and compare the impact of story reading on the level of empathy in medical students at Mazandaran University of Medical Sciences. METHODS: The study employed an intervention educational design (a quasi-experimental), with a convenience sample of 51 medical students selected as the statistical population. The process of story reading was conducted over six two-hour virtual sessions in the students' classroom, spanning six weeks. Selected stories were discussed in an online virtual class under the supervision of an instructor, focusing on story elements. To assess students' empathy in this educational program, the Davis General Empathy Questionnaire was administered before each of the six sessions, after, and one week later at the end of the course. Statistical analysis of the collected data was performed using repeated measures analysis of variance and Bonferroni's post hoc test through SPSS version 28 software, with a significance level set at 0.05. RESULTS: The findings revealed that 27 participants (58.7%) were female students, with the remaining being male students, having an average age of 19.5 ± 0.86 years. The level of general empathy among the students significantly increased after the intervention compared to before the intervention (P<0.001). Furthermore, the analysis of variance with repeated measures indicated a significant effect of the story reading program on enhancing empathy in terms of emotional and cognitive transfer among students in the intervention group (P<0.001). CONCLUSIONS: The research findings suggest that the story reading program effectively enhances the overall sense of empathy among medical students at the University of Medical Sciences. Therefore, implementing this method in universities, higher education centers, libraries, and psychology centers for teaching empathy can be valuable in fostering empathy skills and improving healthcare.

Socio-demographic determinants of low sexual desire and hypoactive sexual desire disorder: a population-based study in Iran.

BACKGROUND: Various socio-demographic factors have been introduced as the determinants of Low Sexual Desire (LSD), but whether these variables can also contribute to the Hypoactive Sexual Desire Disorder (HSDD), remains uncertain. In this study, we sought to identify the socio-demographic determinants of LSD and HSDD in Iranian women of reproductive age. METHODS: This was a population-based, cross-sectional study of 1000 married Iranian women of reproductive age (16-49 years) who met the inclusion criteria. The participants were chosen using the systematic random sampling method from all the healthcare centres in the city of Sari, Iran. LSD was defined as a score no higher than 33 on the Sexual Interest and Desire Inventory-Female (SIDI-F). The sexually-related personal distress was considered as a score of at least 11.0 on the Female Sexual Distress Scale-Revised (FSDS-R), and HSDD was determined based on the sum of those scores. Descriptive statistics were used to describe the socio-demographic characteristics and a chi-square test was run for data analysis using grouping variables. Multivariate logistic regression test was also employed to adjust the effect of confounding variables. RESULTS: The mean score of sexual interest/desire among women was 30.6 ± 10.5. After adjusting the effect of confounding variables, logistic regression showed that socio-demographic variables including age at first intercourse, length of marriage and the level of satisfaction with income were significantly associated with both LSD and HSDD (P < 0.01). While advancing age (P < 0.001) and body mass index (P < 0.01) were just predictors of LSD. CONCLUSION: Some socio-demographic factors could predict LSD in women, while they were not associated with HSDD. In other words, some factors associated with LSD do not instigate sexually-related personal distress, which is one of the criteria necessary for the diagnosis of HSDD.

Assessment of the efficacy of group counselling using cognitive approach on knowledge, attitude, and decision making of pregnant women about modes of delivery.

The choice of casarean deliveries by mothers is highly influenced by inadequate knowldge and negative attitudes towards vaginal birth. In this semi-experimental study, we compared knowledge, attitude, and decision making about modes of delivery between nulliparous pregnant women who received eight sessions of group consultation and those who took routine prenatal education. Contrary to the control group, the improvement of knowledge and attitudes were significant in the consultation group (p < 0.001), as well as mothers' decisions for vaginal birth (p = 0.03). Group consultation is an appropriate approach to improving knowledge, attitudes, and tendencies of mothers toward natural birth.

Can Binaural Beat Music Be Useful as a Method to Reduce Dental Patients' Anxiety?

BACKGROUND: One of the main issues in dentistry and a barrier to offering dental treatment is anxiety. The usage of music is one of the nonmedical ways to reduce anxiety. Binaural beat technology is used as a music treatment technique. The goal of this study wasto determine whether employing binaural beat technology during and after dental appointments can help patients feel less anxiety and pain. METHODS: In this clinical trial, 80 patients who were candidates for mandibular wisdom tooth surgery (in 2 test and control groups) were examined. In the control group, after the injection of anaesthesia and before surgery, they waited for 10 minutes and during this time no intervention was done. In the test group, thought, after the injection of anaesthesia, the patients were asked to listen to binaural beat music with headphones for 10 minutes. The level of anxiety of the patients before and after the intervention was checked with the Spielberger State-Trait Anxiety Inventory and finally the data were entered into SPSS version 21 software. RESULTS: The score of overt anxiety (P = .524) and covert anxiety (P = .118) before the start of the study was not significant between the 2 groups, but overt anxiety (P = .001) and covert anxiety (P = .000) after the intervention in the test group decreased significantly. CONCLUSIONS: The research showed that the use of binaural beat music has significantly reduced the level of overt and covert anxiety in patients and can be used as an alternative nonpharmacologic method to reduce anxiety.

Prevalence and predictors of sexual distress in married reproductive-age women: A cross-sectional study from Iran.

Background and Aim: Although various surveys have been conducted for sexual problems, there is a lack of population-based studies on sexual distress in Iran. Thus, we sought to determine the prevalence and predictive factors of sexual distress in this population. Methods: Overall, 1000 married women aged 16-49 years were enrolled in this study using the two-stage cluster sampling method. To identify sexual distress, the female sexual distress scale-revised (FSDS-R) was completed. The predictive factors were assessed using a checklist. Results: A total of 318 women (31.8%) suffered from sexual distress. Among socio-demographic factors, satisfaction with marriage (p = 0.001), among personal factors history of infertility and fear of contracting sexually transmitted infections (p < 0.01), and among sexual and interpersonal factors satisfaction with the level of sexual desire (p = 0.01), pain during sexual intercourse (p < 0.01), premature ejaculation disorders in the partner (p < 0.05), and sexual satisfaction (p < 0.001) were significantly associated with sexual distress. Conclusion: Clinicians should evaluate sexual distress comprehensively and consider all the related dimensions. The high overall prevalence of sexual distress, with or without an identifiable dysfunction, signals the importance of health professionals being adequately prepared to discuss sexual health concerns.

Simvastatin prevents morphine antinociceptive tolerance and withdrawal symptoms through antioxidative effect and nitric oxide pathway in mice.

Oxidative stress and the nitric oxide (NO) pathway are involved in the development of opioid analgesic tolerance and dependence. Simvastatin modulates NO and oxidative stress, so the present study aimed to investigate its effect on the development and expression of morphine analgesic tolerance and withdrawal signs in mice. Morphine tolerance and dependence were induced by twice daily morphine injection (10 mg/kg, s.c.) for 5 consecutive days. Tolerance was assessed by the hot-plate test and dependence by naloxone challenge, on the sixth day. To determine if the NO is involved in the effects of simvastatin, mice were pre-treated with l-arginine (200 mg/kg) or the NO synthesis inhibitors (L-NAME; 30 mg/kg) along with simvastatin (300 mg/kg). The results showed that acute and chronic administration of simvastatin reversed the antinociceptive tolerance of morphine and attenuated withdrawal signs in morphine-dependent mice, and this effect is reversed by l-arginine and augmented by l-NAME. Also, the concentration of NO and oxidative stress factors such as malondialdehyde content, total thiol, and glutathione peroxidase (GPx) activity in brain tissues was evaluated. Chronic administration of simvastatin reduced NO and malondialdehyde, and increased total thiol and GPx levels in the cerebral cortex and hippocampus of morphine-dependent mice which were antagonized by l-arginine, and augmented by l-NAME. In summary, simvastatin attenuates morphine-induced antinociceptive tolerance and withdrawal symptoms, at least partly, through antioxidative properties and nitric oxide pathway.

Body Image and Hypoactive Sexual Desire Disorder Relationship in a Representative Sample of Iranian Women.

Objective: Hypoactive Sexual Desire Disorder (HSDD) among women is a complicated one which is created by various factors playing roles. One of the potential concerns related to Body Image (BI) is lack of sexual appeal in women. Body Image is often described as what a person perceives of their body encompassing the biological, psychological and social factors. The present research pursues the goal to investigate the association between BI and HSDD among the reproductive age women in Iran. Materials and methods: The current study is a cross-sectional (descriptive -analytical) research done on 1000 reproductive age included woman (15-49 years), performed by systematic random sampling method. The data collection tool includes the socio-demographics and the sexual desire scale in addition to the revised sexual distress scale to measure HSDD completed as self-report by the samples. Univariate and multivariate regression tests have been used in order to analyze the data. Results: The mean ± SD age of the women participating in the study was 32.09 ± 7.33. Having adjusted the confounder variables' effect by logistic regression multivariate analysis; the odd ratio for HSDD has been analyzed. The findings suggested that the odd ratio for HSDD in those not satisfied or slightly feeling fulfilled with their BI has been OR: 4.2 (95% CI: 1.98-9.05) and OR: 3.9 (95% CI: 2.29-6.65), respectively, times more than the ones highly satisfied with their body image. Conclusion: The present study results indicate that being dissatisfied with BI is a determinant factor of HSDD that is more probable in the people with negative image of their body structure and feeling lack of bodily appeal. Thus it is imperative to pay attention to this factor when analyzing HSDD.

Evolutionary puzzle of Toxoplasma gondii with suicidal ideation and suicide attempts: An updated systematic review and meta-analysis.

The World Health Organization has reported an annual global suicide rate of 14.5 per 100,000 people. On the other hand, it is estimated that approximately one-third of the global population are infected with Toxoplasma gondii (T. gondii) parasite. It is widely assumed that microbial pathogens, such as T. gondii, are probably associated with affective and behavioural modulation. The present article aimed to assess the proposed role of toxoplasmosis in raising the risk of suicidal ideation (SI) and suicide attempts (SA) using the available epidemiological data. Seven major electronic databases and the Internet search engine Google were searched for all the studies published between the 1st of January 1950 and 31st of October 2019. The heterogeneity and the risk of bias within and across studies were assessed. Following data extraction, pooled odds ratios (ORs) with 95% confidence interval (CI) across studies were calculated using the random-effects models. A total number of 9,696 articles were screened and 27 studies were regarded as eligible in our systematic review (SI with five papers and 22 papers on SA). A significant association was detected between antibodies against T. gondii with TA (ORs = 1.57; 95% confidence interval [CI] 1.23-2.00, p = .000). Exploration of the association between T. gondii and SA yielded a positive effect of seropositivity for IgG antibodies but not IgM. Despite the limited number of studies, a statistical association was detected between suicidal behaviours and infection with latent T. gondii.

Comparison of group cognitive behavioral therapy and interactive lectures in reducing anxiety during pregnancy: A quasi experimental trial.

BACKGROUND: Anxiety during pregnancy and its adverse effects on mother and baby is a health concern worldwide. This study aimed to investigate the effects of group cognitive behavioral therapy (GCBT) compared with interactive lectures (IL) on anxiety during pregnancy. METHODS: This quasi experimental trial was conducted in Sari city, in north Iran, from March to July 2015. Participants were 91 obstetrically and medically low-risk nulliparous women with a mild to moderate anxiety level, as assessed by Spielberger's State-Trait Anxiety Inventory. Participants were selected from the general population by cluster sampling and assigned to 3 groups: a cognitive behavioral therapy (CBT) group (n = 31), an IL group (n = 30), and a control group (n = 30). All participants completed a demographic characteristics form and the Speilberger State-Trait Anxiety Inventory. The inventory was completed again by the CBT and IL groups 4 weeks after the interventions, and 4 weeks after the initial questionnaire by the control group. Data were analyzed with chi-squared tests, independent t-tests, paired t-tests, ANOVA, and Dunnett post hoc test. RESULTS: A significant decline in state and trait anxiety was found in the CBT and IL groups at 4 weeks (P < 0.001). GCBT was more effective than IL in reducing participants' anxiety, but the difference was not significant (P > 0.05). CONCLUSION: GCBT and IL had beneficial effects in reducing anxiety in pregnancy. The psychological status of pregnant women in prenatal care services should be investigated and either of these methods used to manage maternal anxiety, depending on the available healthcare service resources.

Psychometric Properties of the Sexual Interest and Desire Inventory-Female for Diagnosis of Hypoactive Sexual Desire Disorder: The Persian Version.

Objective: Hypoactive sexual desire Disorder (HSDD) is a common sexual problem among women. Sexual interest and desire inventory -female (SIDI-F) has been widely validated and used to measure sexual desire in women. The aim of this study was to determine the psychometric properties of the Persian version of SIDI-F for Iranian population. Method: This was a methodological study on the psychometric properties of SIDI -F. This report describes the process and principles used in the translation and cultural adaptation of the SIDI-F on 40 women of reproductive age who were selected using convenience sampling method. The content validity of this inventory was proved by analyzing the feedback solicited from women of reproductive age; professions specialized in health, sociology and psychology. Reliability was assessed through test-retest and internal consistency reliability. Results: Few cultural differences were identified and considered during the process of translation and validation. In Content Validity Ratio (CVR) measurement, the total score of SIDI-F was higher than Lawsche table (%51 for 14 experts), indicating the importance of including the mentioned items in the tool. CVR scores for all items were equal or more than 0.79. The internal consistency reliability measured for the whole tool was 0.89, showing considerable total reliability. Conclusion: The Persian version of the SIDI-F seems to be valid and reliable and can be used to identify women with low sexual desire through research and sexual health programs provided by the health centers in Iran, and to design appropriate interventions to treat HSDD.

Couples Communication Skills and Anxiety of Pregnancy: A Narrative Review.

BACKGROUND: physical problems during pregnancy including Anxiety disorders form a large share of health problems. On the other hand, healthy relationship and communication skills are vital to raise a family. For couples who enjoy communication skills, parenthood will be the best and most pleasant experiences in their lives. High levels of positive communication will lead to couples and their children's mental health and couples' good relationship can have a protective effect against stressors including anxiety of pregnancy. The current study reviewed the studies on the relationship between communication skills and the anxiety of pregnancy. METHODS: The current study is a review where the researcher browsed the available databases like Google Scholar, Pubmed, Magiran, SID, and Science Direct and using key words of Communication skills, marital satisfaction, and the anxiety of pregnancy, & the researcher has searched the articles of 2000-2014 & read 150 abstracts & 93 full papers and ultimately, chose 50 to write this study. RESULTS: By reviewing the findings literature in three general categories as Communication Skills as the Significant Component to Get Marital Satisfaction, Improving Marital Satisfaction as Pregnancy Anxiety Reducing Factor, and Communication Skills Quality as Component Influencing Pregnancy Anxiety. CONCLUSIONS: Having communication skills will lead to promotion of marital satisfaction and increased mental health in life. It is, therefore, recommended that communication skills be trained in routine programs for pre-marriage counseling, pre-pregnancy cares and pregnancy so that the mental health of community can be improved.

A Review of the Effects of Anxiety During Pregnancy on Children's Health.

BACKGROUND: Although pregnancy is often portrayed as a time of great joy, that's not the reality for all women. The adverse, long-term, stable, and sometimes, irreparable effects of anxiety during pregnancy can change pregnancy into an agonizing and unpleasant event of women's life span. AIM: The aim of this study was to explore the adverse effects of anxiety in pregnancy on children's health in order to promote child health. METHODS: In this narrative review the researchers searched in public databases like Google Scholar general search engine, and then more specific: Science Direct, Scientific Information Database, Magiran, Irandoc, Pubmed, Scopus, Cochrane library, and Psych info using Medical Subject Headings (MeSH) keywords: anxiety, maternal anxiety, pregnancy, pregnancy outcome, control and prevention restricted to English / Persian language, during the 20 years ago. Then those articles written by renowned experts were selected. At first, a list of 60 papers generated from the initial search. Then reviewers studied titles and abstracts and finally, quality assessment of full text studies was performed by two independent reviewers. Researchers reviewed summary of all articles sought, ultimately used data from 25 full articles to compile this review paper. RESULTS: The findings were classified into four groups Biological, Mental, Behavioral, and Medical effects of anxiety during pregnancy. CONCLUSIONS: The effects of anxiety during pregnancy on offspring's health are serious and thought-provoking to which the need for identifying and screening of anxiety disorders in prenatal care is necessary.

BIOPSYCHOSOCIAL DETERMINANTS OF HYPOACTIVE SEXUAL DESIRE IN WOMEN: A NARRATIVE REVIEW.

BACKGROUND: As a mental response to sexual stimuli, sexual desire determines human sexual behavior and represents the cognitive capacity of sexual stimulation, so that avoiding sexual activity has a very negative effect on the discharge of intimacy and joy in couple's relationship and threatens the stability relationship, which can finally end in sexual dissatisfaction and divorce; it may even affect the reproduction. This study, reviews the literature on biopsychosocial determinants of hypoactive sexual desire disorder in women in childbearing ages. METHOD: The search was done from January to March 2015 by the use of the data bases ProQuest, Pubmed, CINAHL, Ovid and Medline and the words sexual desire, related factors and biopsychosocial determinants were used as free text words. The words reduce sexual desire, hypoactive sexual desire disorder, dyadic relationship, biopsychosocial factors and women were used as keywords in the search. Also, the articles focusing on any aspects of sexual desire such as biological, social and psychological factors and relationship factors alone or integrated, were included in the study. The articles which specifically targeted the hypoactive sexual desire disorder in pregnant and lactating women and also the articles targeting biopsychosocial factors related to other types of sexual function disorder such as arousal disorder, orgasm disorder and dyspareunia, were all excluded from this study. FINDINGS: After reviewing the literature, the findings were categorized in three main class of effect of biologic factors on sexual desire and sexual hypoactivity, the effect of psychological factors on sexual desire and the effect of cultural factors and couple's relationship on sexual desire, each of these domains cover a wide range (such as hormonal changes, chronic diseases, psychological difficulties (perceived stress, anxiety, depression). Incompatibility of couples, the spouse's sexual function disorder) which may overlap. Because of the complexity of etiology and the difficulty of treating hypoactive sexual desire disorder, it is necessary to use biopsychosocial approaches to diagnose and treat the disorder. CONCLUSION: According to the findings of this reviewing study, the factors able to affect sexual desire and activity are not distinct and often overlap, therefore, the complicated etiology of hypoactive sexual desire disorder often needs multidimensional intervention to use biopsychosocial approach; Multi factor assessment with a combination of psychological, physical, social and hormonal intervention can be effective in making strategies to treat the symptoms of HSDD.

A review of affecting factors on sexual satisfaction in women.

BACKGROUND: Sex is a complex, important and sensitive issue in human being and interwoven with the whole of human existence. Given the serious changes in attitude, function and behavior in sex, the need to address sexual function, especially sexual satisfaction, is felt completely. Sexual satisfaction has a very important role in creating marital satisfaction and any defect in sexual satisfaction is significantly associated with risky sexual behaviors, serious mental illness, social crimes and ultimately divorce. AIM: The aim of this study was to explore affecting factors on sexual satisfaction in women based on an overview in scientific database. METHODS: In this narrative review the researchers searched MEDLINE database, Google Scholar and Science Direct as well as Persian database like Scientific Information Database with search terms of sexual satisfaction and sexual function, restricted to English/ Persian language, during the 20 years ago. Then those articles written by renowned experts were selected. In this regard, 57 articles have been reviewed, which 30 articles related to this research have been extracted. RESULTS: The findings were divided in to four categories including: Demographic factors, Pathophysiological factors, Psychological factors and Sociocultural factors. CONCLUSIONS: Sexuality, especially sexual intimacy is sophisticated and yet elegant affair that the other persons has different definitions and different functions. Discrepancies in the results of the studies show that analysis of factors affecting sexual satisfaction regardless of the women's' sociocultural context, religious beliefs, and personal attitudes is undoubtedly inefficient, unscientific and irrational.

Effects of intermittent aerobic training on passive avoidance test (shuttle box) and stress markers in the dorsal hippocampus of wistar rats exposed to administration of homocysteine.

OBJECTIVE: Elevated amino acid homocysteine (Hcy) levels and insufficient physical activity are the risk factors in Alzheimer disease (AD) development. The effect of intermittent aerobic training on memory retention test and Thiobarbituric Acid Reactive Substances (TBARS) and superoxide dismutase (SOD) levels in the dorsal hippocampus of rats which were stimulated with Hcy is investigated. METHODS: In order to determine the dose at which using Shuttle Box Test recognizes degenerative changes and/or memory impairment, 40 rats were injected by different dosages of Hcy to the dorsal hippocampus. It was observed that the required Hcy dose is 0.6 M. Then 44 rats were divided into four groups including training and control groups at 4 weeks of aerobic exercise in training and control groups at 8 weeks. To determine the effect of homocysteine on the memory impairment, Shuttle Box Test was used on treadmill (5 sessions/week, 12-18 m/min and 10-58.5 min). RESULTS: Hcy administration caused memory impairment and significant increase in TBARS. Significant decrease in TBARS level was noted after 8 weeks of aerobic exercise, but not after just 4 weeks of exercise compared with control group. In addition, performing 8 weeks of aerobic training led to significantly increased superoxide dismutase (SOD) level and the time of avoidance learning test. CONCLUSION: Hyperhomocysteinemia caused learning and memory deficits probably by generating reactive oxygen species (ROS) and the present study showed that regular moderate intensity intermittent exercise may reverse this process and exercise is recommended as a strategy to improve symptoms of senile neurodegenerative disease . DECLARATION OF INTEREST: None.

The Efficacy of Intermittent Walking in Water on the Rate of MHPG Sulfate and the Severity of Depression.

OBJECTIVE: Many studies evaluated the efficacy of exercise on some depression indices, but the effect of physical exercise in exhilarating milieu on urine 3-Methoxy-4-Hydroxyphenylglycol (MHPG) sulfate-the main metabolite of norepinephrine is not clear. The purpose of this research was to study the effect of a six-week intermittent walking in the water on 24-hour urine MHPG sulfate in depressed female teenagers. METHODS: Twenty-four high school female students with depression were divided randomly into case and control group. Pool walking exercise program was implemented 3 sessions weekly for 6 weeks and with a rate of 60-70% of the maximum heart rate. The control group didn't enter any exercise protocol and did not receive any other anti-depressant therapy. HPLC-fluorometric detection assay was used to measure 24-hour urine MHPG sulfate values. The data was analyzed with t-test and Pierson's correlation tests. RESULTS: Twenty hour urine MHPG sulfate increased from 1.93 (±0.59) to 4.66 (±0.85) micromole in case group (P ≤ 0.001), and in control group from 1.67 (±0.58) to 1.80 (±0.58) micromole. Increase of 24-hour urine MHPG sulfate and increasing of maximum oxygen consumption showed significant positive correlation (r = 0.65), and a significant negative correlation (r = 0.65) was observed between urine MHPG sulfate and Hamilton Rating Scale for Depression (Ham-D) score. CONCLUSION: Aerobics training in exhilarating environments shows desirable influence over reduction of depression. This reduction of depression is correlated with MHPG sulfate elevation.