Sexual health literacy level and its related factors among married medical sciences college students in an Iranian setting: a web­based cross­sectional study.

BACKGROUND: Sexual health literacy (SHL) leads to the development of personal ability, understanding, evaluation and use of information related to sexual health. The purpose of this study was to assess the sexual health literacy level and its related factors among married college students at Mazandaran University of Medical Sciences (MAZUMS). METHODS: A web-based cross-sectional online study was conducted on married college students at Mazandaran University of Medical Sciences between January and November 2020. All students were included in the study by census, and the study method was explained by telephone. If they agreed to participate in the study, the online link to the questionnaire, including sociodemographic and clinical information and Sexual Health Literacy for Iranian Adults (SHELIA), was emailed. The Statistical Package for the Social Sciences (SPSS) software version 26 was used for data analysis. Univariate and multivariate logistic regression tests were used to assess factors related to sexual health literacy. RESULTS: The sample consisted of 277 male and 123 female students. Sexual Health Literacy Level and all subscales are at the sufficient level (66.1-88). Among the participants, 20.5% had limited sexual health literacy. Multivariate analysis found factors related to sexual health literacy among students: economic status (OR 0.03; 95% CI 0.0-0.55) and faculty (OR 0.07; 95% CI 0.01-0.52) is related to decrease and subscription to social media for sexual health (OR 3.27; 95% CI 1.53-7.01), information source of channels and cyberspace (OR 3.23; 95% CI 1.41-7.39), educational level (OR 16.39; 95% CI 2.16-32.70), Internet search information source (OR 1.91; 95% CI 1.00-3.64) is related to increase, were statistically significant factors. CONCLUSION: In Iran, medical sciences college students, who constitute a significant portion of the country's population, are responsible for sexual health education. Government agencies, with the collaboration of all stakeholders, should develop policies and programs for implementing and evaluating integrated and comprehensive sexual health literacy promotion programs for them.

Development of the short form Iranian women childbirth experience questionnaire: a confirmatory factor analysis approach item reduction.

INTRODUCTION: Considering that childbirth experience has short- and long-term effects on women's lives, it is necessary to examine their delivery experiences. This study aimed to prepare the short form of a 52-item Iranian women's childbirth experience questionnaire with seven factors: professional support, preparation, control, positive perception, baby, family support, and fear. METHODS: This methodological research was conducted on women aged 15 to 49 years (n = 770) with uncomplicated vaginal delivery. The short form of the Iranian women's childbirth experience questionnaire was prepared in four stages. The first stage was exploratory factor analysis, conducted on 250 samples, the second stage was confirmatory factor analysis which was performed on 260 samples, independent of the first stage, to report goodness and fit indices, and the third stage employed items from modification indices, expected parameter change, and standardized residual covariance, leading to the short form of Iranian women childbirth experience questionnaire. Finally, confirmatory factor analysis was run on 260 samples, independent of the previous two stages, to confirm the short form and compare it with the original questionnaire for psychometric analysis. RESULTS: In the exploratory factor analysis stage, nine items with a factor load of less than 0.4 were removed, and the number of domains was reduced to five. The second stage showed that the questionnaire had a goodness of fit index. However, the third stage resulted in removing 11 overlapping items and making a short questionnaire with 33 items. Finally, the confirmatory factor analysis in the last stage showed appropriate goodness of fit for the short form of the Iranian women's childbirth experiences questionnaire (𝛘2/df = 2.352, CFI = 0.881, PCFI = 0.750, RMSEA = 0.072, SRMR = 0.0862). CONCLUSION: The short form of the Iranian women's childbirth experiences questionnaire enjoyed from an appropriate psychometric evaluation. It is recommended when applying the original questionnaire is not feasible due to lack of time.

Pregnancy Health Among Breast Cancer Survivors: Development and Validation of an Educational Package in Iran.

Reproductive-aged breast cancer (BC) survivors are concerned about their fertility potential after BC treatment. No specific and comprehensive educational and clinical package examines pregnancy health in BC survivors. This study aimed to develop and validate a pregnancy health educational package for BC survivors who intend to experience pregnancy after completing cancer treatment. The present study is a mixed methods study conducted in three phases. The researchers, in phase 1, performed a qualitative content analysis study to explore the perceived needs and experiences of pregnancy among Iranian BC survivors. Then in the second phase, the authors conducted a systematic literature review to search all available packages, guidelines, documents, and published papers on pregnancy or fertility status among BC survivors worldwide. In the third phase, the intervention type was selected according to the opinions of the expert's team during two sessions of online meetings using the Delphi technique. The package quality was assessed by an expert team using the Appraisal of Guidelines for Research and Evaluation Instrument II (AGREE II) tool. The pregnancy health package for BC survivors was developed in seven separate chapters based on the qualitative study and literature review findings. The results of the validity or quality assessment of the package according to the six domains of the AGREE II tool were reported as follows: the score for the scope and purpose domain was 95.55%, the stakeholder involvement domain was 89.16%, the score for the rigor of development domain was 92.97%, clarity of presentation domain was 94.44%, the score of applicability domain was 87.06%, and the score of editorial independence domain was calculated 93.75%. The pregnancy health package was designed with high quality and validity and, as an excellent cost-effective resource, is proposed to BC survivors to increase their awareness regarding their fertility issues before attempting to conceive.

Effect of a social network-based supportive program (WhatsApp) on the sexual self-concept of women with breast cancer: A single-blind-randomized controlled trial.

OBJECTIVES: Sexual self-concept has an influence on the sexual behaviors of women with breast cancer. Supportive programs for these women have demonstrable empirical efficacy; however, their effectiveness has not been examined. The aim of this study was to investigate the effect of a supportive program based on social networks on the sexual self-concept of women with breast cancer. METHODS: In this randomized controlled single-blind trial, 60 women were assigned to the intervention (n = 30) and control (n = 30) groups using permuted block randomization. Overall, eight 45-min intervention sessions were held (twice a week). The primary outcome was sexual self-concept, and the secondary outcomes were women's sexual quality of life and participants' satisfaction. The questionnaires were completed by patients before the intervention and immediately and 1 month after the intervention. RESULTS: The generalized equation estimation test showed that the positive sexual self-concept score of the intervention group versus the control group had increased by 15.67 points (P < 0.001, effect size = 2.00) 1 month after the intervention. The negative sexual self-concept score had decreased by 2.65 points (P < 0.001, effect size = 0.74), and the situational sexual self-concept score had upturned by 6.82 points (P < 0.001, effect size = 2.08) in the intervention group at the same period. Also, the sexual quality of life score in the intervention group compared to the control group generally increased by 13.82 points (P < 0.001, Effect size = 2.08) 1 month following the intervention. SIGNIFICANCE OF THE RESULTS: A social networking support program can be a promising approach to improve the sexual self-concept of women with breast cancer. CLINICAL TRIALS.GOV IDENTIFIER: Iranian Clinical Trial Register, IRCT20150608022609N8. Registered on 2 July 2020.

Worldwide prevalence of maternal methicillin-resistant Staphylococcus aureus colonization: A systematic review and meta-analysis.

Methicillin-resistant Staphylococcus aureus (MRSA) infection during pregnancy can adversely influence the well-being of pregnant women, fetuses, and neonates. To our knowledge, there is no global data on the maternal prevalence of MRSA colonization. We conducted a systematic review and meta-analysis to estimate the global and regional prevalence rates of MRSA colonization among pregnant women. We searched international databases (i.e., MEDLINE/PubMed, EMBASE, Scopus, Web of Science collection, and SciELO) for studies published from inception to March 10, 2022. Observational population-based studies reporting MRSA colonization among pregnant women were eligible to be included. We utilized the random-effects meta-analyses to compute the pooled prevalence estimates of maternal colonization across studies at 95% confidence intervals (CIs). The heterogeneity was assessed by I2 statistic and the Cochran's Q test. Subgroup and meta-regression analyses were used to adjust for potential sources of heterogeneity. The data source regarding maternal MRSA colonization included 55 studies from 24 countries and 110,654 pregnant women. The worldwide pooled prevalence for maternal MRSA colonization was 3.23% (95% CI, 2.40-4.17%), with the highest and lowest colonization rates for Africa (9.13%, 4.36-15.34%) and Europe (0.79%, 0.28-1.51%), respectively. We estimated that nearly 4.5 million pregnant women are colonized with MRSA worldwide. MRSA colonization rates were higher among black ethnicity, multiparous women, pregnant women with prior MRSA infection, women with lower personal hygiene, and those living in lower-income and human development indices countries or regions. MRSA colonizes substantial numbers of pregnant women worldwide, with varying prevalence rates in different regions; however, further investigations are needed to recognize regional differences. Our findings emphasized the need for prevention efforts against MRSA to reduce the health risks among women and newborns.

The effect of midwifery-led counseling on expectant fathers' fear of childbirth: a smartphone- based randomized controlled trial.

BACKGROUND: Expectant fathers experience a range of different emotions during their wife's pregnancy; one of these feelings is fear. It has adverse consequences on both the father and his family. The aim of this study was to investigate the effect of midwifery-led counseling on the fear of childbirth among expectant fathers. METHODS: A two-armed parallel design randomized controlled trial was conducted from July to August 2020. Fifty expectant fathers with severe fear of childbirth at the 24th-27th weeks of gestation, in the Iranian setting, were assigned to intervention and control groups (allocation ratio1:1) using permuted block randomization. Participants assigned to the intervention group were engaged in six 60-90-min midwifery-led counseling sessions (twice a week) in the Skyroom platform. Measures were administered at recruitment, post-intervention, and one-month follow-up. The primary outcome was the change in fear of childbirth score between groups over time. Secondary outcomes were changes in the General Self-Efficacy score as well as changes in the frequency of the preferred type of delivery between groups over time. RESULTS: The mean age of the participants was 31.64 (3.33) years. In the intention-to-treat analysis, the fear of childbirth score in the intervention group significantly decreased (ß = - 11.84; 95% Confidence Interval: - 21.90 to - 1.78; P = 0.021) compared to that of the control group. In terms of secondary outcomes, the intervention group showed a significant increase in General Self-Efficacy compared to the intervention group at one-month follow-up measurement (ß = 1.43; 95% Confidence Interval: 0.28 to 2.58; P = 0.014). However, the frequency of preferred delivery type was not significantly different between the intervention and control groups (P = 0.139). CONCLUSIONS: Midwifery-led counseling can be an effective approach in reducing expectant fathers' childbirth fear with potential clinical significance. Although the inconclusive results imply more research on this issue. TRIAL REGISTRATION: Registration number: IRCT20150608022609N6 . Registered 12/04/2019.

Psychometric Properties of the Persian Version of the Personal Meaning Profile in Iran.

The Personal Meaning Profile (PMP) is a widely used instrument to measure people's perceptions of personal meaning in their lives. This study aimed to evaluate the psychometric properties of the Persian version of the PMP. First, the researchers developed the Persian version of this scale using the forward-backward procedure. Then, they examined the face and content validities by both qualitative and quantitative approaches. To evaluate the construct validity, researchers administered the instrument to a sample of 482 medical sciences students and performed exploratory and confirmatory factor analyses. The reliability was assessed using loading factors, Cronbach's alpha coefficients, and composite reliability. An average scale-level of content validity index of the PMP with 57 items was 0.80. The findings revealed that the Persian version of the PMP comprises five factors explaining 50.57% of the total variance. The confirmatory factor analysis indices showed a moderate fit for the data. Reliability of the Iranian version of PMP was demonstrated with a Cronbach's alpha of 0.893. Consistency was established with test-retest reliability with an interval of 2 weeks (Intracluster Correlation Coefficient = 0.983, p < 0.001). Moreover, the criterion validity demonstrated a significant inverse relationship between the PMP and General Health Questionnaire (r = - 0.34, p < 0.001). This study indicated that the Persian version of the PMP is an acceptable, reliable, and valid measurement to evaluate the meaning in life in Iranian medical sciences students.

Design and psychometric evaluation of the fathers' fear of childbirth scale: a mixed method study.

BACKGROUND: Fear of childbirth is reported in 13% of fathers, and it may have adverse consequences for the fathers' health as well as their families. To reduce the fear of childbirth in the expectant fathers, an appropriate screening tool is needed. Due to the lack of a valid and reliable questionnaire to measure fathers' fear of childbirth, this study was conducted to develop the Fathers' Fear of Childbirth Scale and evaluate its psychometric properties. METHODS: This mixed method study was conducted in two phases. In the qualitative phase (or item generation), semi-structured interviews were conducted with 20 expectant fathers, and a literature review was performed to generate the Fathers' Fear of Childbirth Scale items pool. In the quantitative phase (or psychometric evaluation), reliability as well as face, content, and construct validity of this scale were evaluated. To establish construct validity, exploratory and confirmatory factor analyses were performed. Reliability was evaluated through internal consistency and composite reliability measures. RESULTS: The primary version of Fathers' Fear of Childbirth Scale contained 32 items, which were reduced to 17 items while establishing construct validity. Exploratory factor analysis extracted two factors, namely fear of childbirth process (12 items) and fear of hospital (5 items). These factors explained 50.82% of the total variance. Goodness of fit indices within the confirmatory factor analysis was acceptable. Internal consistency and composite reliability indices of all the factors were greater than 0.70. CONCLUSION: The Fathers' Fear of Childbirth Scale has a suitable validity and reliability for assessing fear of childbirth in fathers. It is a simple report instrument that can be easily implemented by health care professionals.

The Effect of Psychological Interventions on the Quality of Life in Women with Fibromyalgia: A Systematic Review.

Fibromyalgia refers to a painful type of rheumatological clinical syndrome, and its prevalence varies from 0.7% to 6.6%. This syndrome is associated with different physical and psychological symptoms, which ultimately leads to a decline in women's quality of life. A wide range of pharmacological and non-pharmacological interventions are conducted to mitigate these symptoms and improve the quality of life. Therefore, the present study aims to investigate the effect of psychological interventions on the quality of life in women with fibromyalgia. This systematic review with comprehensive search was carried out on Google Scholar, Scopus, PubMed, Web of Science, Science Direct, Cochrane Library, PsycINFO, and Scientific Information Database (SID), databases using the suitable keywords, and a total of 3125 articles from 2000 to 2019 were retrieved. Finally, the quality of 16 experimental and semi-experimental clinical trials was evaluated using the Jadad scale. The psychological interventions affecting the quality of life in women with fibromialgia included cognitive-behavioral therapy and behavioral therapy, coping strategies training, mindfulness, acceptance and commitment treatment, hypnosis, meditation, music therapy, short-term psychodynamic psychotherapy and writing emotions. The results of the study showed that except four studies, the studies generally improved the quality of life and reduced the symptoms in women with fibromyalgia. The results of the study suggest that most psychological interventions affect the quality of life in women with fibromyalgia. Therefore, besides pharmacological therapy, psychological interventions can be used by health-care providers to reduce the symptoms of fibromyalgia and improve the quality of their life.

Relationship between DMFT index and number of pregnancies: a cross-sectional study on enrollment phase of the Tabari Cohort Study.

BACKGROUND: People of all age and gender groups are at risk of dental diseases; however, some groups, such as pregnant women, are more vulnerable than others due to their specific physiological situations. The protection of maternal and fetal is critical. Therefore, the present study intended to investigate the relationship between the Decayed, Missing, and Filled Teeth (DMFT) index and the number of pregnancies. METHODS: The present cross-sectional study was performed using the Tabari Cohort Study (T.C.S.) data. Data of 5,496 women enrolled in the T.C.S. were included in the study. After obtaining the approval of the Ethics Committee, the related data on the variables of age, age at the first pregnancy, number of pregnancies, total number of teeth at the time of examination, number of DMFT, employment status, socioeconomic status, educational level, residence location, body mass index, and the status of diabetes mellitus, hypertension, and cardiovascular diseases were extracted. Finally, data analysis was performed in the STATA software (version 14). RESULTS: The mean DMFT index in women with 1, 2, 3, 4, 5, 6, and more than six pregnancies were obtained at 12.74 ± 7.11, 13.09 ± 7.06, 14.80 ± 7.81, 17.07 ± 8.11, 19.82 ± 9.02, 22.89 ± 8.98, and 26.17 ± 8.01, respectively (P < 0.001). Using the multivariate linear regression and adjusting the effect of potential confounding variables, it was found that the DMFT index increased by 34% for each unit increase in the number of pregnancies (ß = 0.34, P < 0.001). CONCLUSIONS: According to our results, there was a significant relationship between the DMFT index and the number of pregnancies. The DMFT index was increased with an increased number of pregnancies. Therefore, oral healthcare promotion should receive special attention in healthcare planning and related policies by raising awareness and providing easy access to dental services for women of childbearing age, especially pregnant women.

How do Iranian female adolescents express their health education needs? A needs assessment with qualitative thematic analysis.

BACKGROUND: Adolescent girls have little knowledge about health information, especially about more sensitive issues. We know little about the perspectives of adolescents about their educational health needs. OBJECTIVE: The aim of this study is to explore the perceptions of Iranian female adolescents about their educational health needs. SUBJECTS: The study participants were 67 female adolescents aged 12-19 years currently in junior high and high schools in the city of Sari, located in northern Iran. METHODS: The present study is a qualitative study of thematic analysis. The 67 female adolescents participated in eight focus group discussions (FGDs). The participants were selected from schools in Mazandaran, Iran. The sampling methods were purposeful sampling and a maximum variance sampling method. All tape-recorded data was fully transcribed, and thematic analysis was performed to identify key themes. RESULTS: The findings of this research around adolescent health education needs emphasized four overarching themes, including appropriate content, suitable method, well-informed sources and an appropriate age for education. CONCLUSION: Our results show that the promotion of reproductive health knowledge and life skills are the most important health education needs. Education about these issues via parents, schools and health care providers could promote the health status of adolescents.

Iranian university students' perceived reproductive health needs.

AIM: One proposed strategy to improve youth health is needs assessment, a process for determining and addressing the needs of individual groups. The aim of this study was to explore the attitudes and perceptions of Iranian university students toward reproductive health needs, in order to promote the provision of reproductive health services. METHODS: Using an anonymous self-administered questionnaire, a cross-sectional survey was conducted among 548 students who were randomly selected from eight universities in Sari City, Iran. Topics covered the participants' attitudes towards reproductive health needs as well as their opinion about proper sources of information in this area, as measured using a 5-point Likert scale. RESULTS: The mean age of participants was 21.57 years, and 57.82% were female. The maximum score of perceived reproductive health needs was related to "Be informed about appropriate behavior with my spouse", and the majority of students (82.82%) supported family-based reproductive health education with emphasis on the mothers' role. Although 65.14% of the participants agreed that "When a young has been raped, it's better that she/he counsel with her/his family", 11.67% of them stated that she/he must hide the problem. Finally, we found that 60.40% of the students preferred someone in a health care center as the one to explain how to use any contraception that may be provided for them. CONCLUSION: Taken as a whole, these findings support the critical importance of programming for university students as part of a comprehensive strategy to improve the health and development of young adults.

University students' point of views to facilitators and barriers to sexual and reproductive health services.

AIM: The right to health is a universal human right, and this includes sexual and reproductive health services. The aim of this study is to explore the opinions of Iranian university students toward facilitators and barriers to sexual and reproductive health services. MATERIALS AND METHODS: In 2012, a random sample of 548 university students completed anonymous, self-administered questionnaires. Topics covered the participants' attitudes towards facilitators and barriers to sexual and reproductive health services in personal, interpersonal, and structural domains. RESULTS: Mean age of participants was 21.57 years and 57.82% were female. The maximum score of facilitators and barriers to sexual and reproductive health services was related to "Young people's participation in sexual and reproductive health services provision" and "Fear of stigmatization", respectively. The results showed that among female university students, the mean score of personal and structural facilitators was significantly higher than the mean score of interpersonal ones (F=12.23, p<0.001). This difference was also reported in barrier factors (F=5.51, p=0.004). CONCLUSION: Results highlight the roles of policy makers and health service providers in improving accessibility to provided services for young people through the enforcement of facilitators and reduction of barriers, particularly in the areas of personal and structural facilitators focusing on female services.

A structural equation model analysis of the relationship between expectant fathers' fear of COVID-19 and their fear of childbirth: The mediating role of maternal fear of childbirth.

BACKGROUND: Pregnancy and childbirth may provoke various emotional responses in expectant fathers including excessive fear of childbirth. It is not unreasonable to assume that fear of contracting the virus during the COVID-19 pandemic, may have intensified fathers' fear of childbirth. This study aims to determine the mediating role of the expectant mothers' fear of childbirth in the relationship between expectant fathers' fear of COVID-19 and their fear of childbirth. METHODS: This cross-sectional study was conducted on 270 pregnant women and their spouses attending health centers from Aug 2021 to April 2022. Fathers' fear of childbirth scale (FFCS), Wijma Delivery Expectancy/Experience Questionnaire (W-DEQ-A), and Fear of COVID-19 Scale (FCV-19S) were used to collect data. To examine the relationships between variables and to develop the final model, we used the structural equation model (SEM). RESULTS: The prevalence of severe fear of childbirth in fathers and their female spouses were 40.9% and 22.4%, respectively. The mean score and standard deviation of fear of childbirth in the fathers and their female spouses were 49.2 ± 17.1 and 62.5 ± 29.4, respectively. Results showed that fathers' fear of COVID-19 was directly (B = 0.44, p = 0.004) and indirectly (B = 0.13, p = 0.015) associated with fathers' fear of childbirth. Also, women's fear of childbirth was positively associated with fathers' fear of childbirth (B = 0.45, p = 0.030). In the final model, the values of χ2/df, CFI, PCFI, RMSEA, and SRMR were equal to 2.32, 0.94, 0.76, 0.07, and 0.06, respectively. CONCLUSIONS: We found a high prevalence of severe fear of childbirth in Iranian expectant fathers which means that fathers' fear of childbirth is a national health concern that needs to be addressed. The findings of the present study indicate that mothers' fear of childbirth has a mediating role in the relationship between fathers' fear of COVID and fear of childbirth. Therefore, to alleviate fathers' fear of childbirth, interventions to reduce fathers' fear of COVID-19 and women's fear of childbirth should be developed and implemented. The impact of fathers' mental health on the fear of childbirth in expectant couples should be further investigated.

Pain-focused psychological interventions in women with endometriosis: A systematic review.

AIMS: As a chronic inflammatory disease, endometriosis (EMS) is often associated with pain affecting different aspects of women's lives. Up to now, a wide variety of interventions have been implemented to alleviate pain in patients with this condition, including pharmacological, surgical, and rarely non-pharmacological ones. Against this background, this review aimed to investigate pain-focused psychological interventions among EMS women. METHODS: A systematic review of the articles published in this field was conducted through a comprehensive search on the databases of Scopus, PubMed, MEDLINE, Web of Science, ScienceDirect, the Cochrane Library, PsycINFO, Google Scholar, and Scientific Information Database (SID). The quality of studies was then assessed by the Jadad Scale. RESULTS: In total, 10 articles were entered into this systematic review. The findings further revealed that the pain-focused psychological interventions in patients with EMS were cognitive-behavioral therapy (CBT) (n = 2), mindfulness therapy (n = 4), yoga (n = 2), psychoeducation (n = 1), and progressive muscle relaxation (PMR) training (n = 1). Besides, the findings established that all the given interventions had improved and reduced pain in women living with this condition. Moreover, five articles were of good quality based on the Jadad Scale. CONCLUSION: The study results demonstrated that all the listed psychological interventions had affected pain relief and improvement in women suffering from EMS. Considering the limited number of studies in this field and the fact that there were only five articles endowed with good quality, more high-quality studies could provide stronger evidence to support the implementation of the mentioned interventions influencing pain in patients.

The prevalence of moderate-severe premenstrual syndrome and premenstrual dysphoric disorder and the related factors in high school students: A cross-sectional study.

OBJECTIVE: Premenstrual syndrome (PMS) is a clinical condition with physical and psychological symptoms affecting female students' quality of life, social activity, and school performance. Since most studies have focused on adult women, this study aimed to evaluate the prevalence of moderate-severe PMS, premenstrual dysphoric disorder (PMDD), and their related factors in high school students. METHODS: The participants of this cross-sectional study, conducted in 2019, were 900 high school students in Sari, north of Iran. They were selected by census method from six high schools. Data were collected using Premenstrual Syndrome Screening Tool and General Health Questionnaire. RESULTS: The prevalence of moderate-severe PMS and PMDD were 33.9% and 12.3%, respectively. According to the logistic regression model, dysmenorrhea was significantly associated with a higher prevalence of moderate-severe PMS [adjusted odds ratio (AOR) 2.356, confidence interval (CI): 1.706-3.254, p < 0.0001] and PMDD (AOR: 1.924, CI: 1.186-3.120, p = 0.0008). Moreover, optimal general health was associated with a lower prevalence of moderate-severe PMS (AOR: 0.326, CI: 0.221-0.480, p < 0.0001) and PMDD (AOR: 0.309, CI: 0.161-0.593, p < 0.0001). The findings revealed that a family history of PMS and adding excess salt to the food were associated with a higher prevalence of PMDD (p < 0.05). CONCLUSION: Although many high school students do not meet the criteria for PMDD, many experience PMS, which could be diminished with proper diet and improved general health.

The association between early menarche and higher-risk cardiometabolic profile: a dose-response analysis of the Tabari cohort at enrollment phase.

Objectives: The association between age at menarche and higher-risk cardiometabolic factors is controversial and more strands of evidence are required. Therefore, in this study, we aimed to investigate the effect of early menarche on cardiometabolic profile in a large-scale cohort population. Study design: Data collected in the enrollment phase of the Tabari cohort study were utilized for the present study. We analyzed data from 6,103 women aged 35-70 years. Logistic regression and dose-response (trend) analyses were used to investigate the effect of early menarche on prevalence of diabetes, dyslipidemia, obesity, high waist circumference (WC), high waist-to-hip ratio (WHR), and high waist-to-height ratio (WHtR). Results: The results of the adjusted logistic regression analysis showed that women who experienced early menarche had significantly higher odds of obesity (odds ratio: 1.64, 95% CI: 1.36-1.99, P for trend <0.001), high WC (odds ratio: 1.34, 95% CI: 1.07-1.67, P for trend = 0.035), high WHR (odds ratio: 1.32, 95% CI: 1.05-1.66, P for trend = 0.057), and high WHtR (odds ratio: 1.83, 95% CI: 1.22-2.74, P for trend = 0.006) compared to those aged ≥14 at menarche. The prevalence of dyslipidemia was also higher among women who experienced early menarche than in women aged ≥14 at menarche (79.9% vs. 76.6%), but the difference was not statistically significant (P = 0.098). Additionally, each year of earlier menarche was significantly associated with an increase in the chance of diabetes (by 5%), obesity (10%), high WC (5%), and high WHtR (13%). Conclusion: The present study showed that early menarche is a strong predictor for later development of obesity and diabetes, and for high WC, WHR, and WHtR. Among all factors examined, age at menarche had the greatest predictive power for WHtR. As an age-dependent anthropometric index for central obesity, WHtR is more suitable as an index for identification of individuals with increased cardiometabolic risk.

The effect of peer education compared to education provided by healthcare providers on premenstrual syndrome in high school students: A social network-based quasi-experimental controlled trial.

AIM: This study aimed to compare the effect of peer education and education provided by healthcare providers on PMS in high school students. MATERIALS AND METHODS: This quasi-experimental non-randomized controlled trial with a three-armed parallel design was performed on 90 students allocated in three groups, namely, education by peer (intervention group 1 = 30), education by a healthcare provider (intervention group 2 = 30), and a control group (n = 30). The primary outcome was a change in the score of PMS, and the secondary outcomes were changes in the general health score and the frequency of premenstrual dysphoric disorder (PMDD). Education about PMS management was held in WhatsApp messenger in six sessions (two sessions per week) for both intervention groups. All three groups received routine school counseling. The researchers applied repeated-measures ANCOVA, McNemar, and post-hoc Bonferroni tests. RESULTS: Education in intervention group 1 (Partial Eta Squared = 0.67, p < 0.0001) and intervention group 2 (Partial Eta Squared = 0.82, p < 0.0001) significantly reduced the PMS score compared to the control group. In addition, the change in general health score in the intervention groups compared to the control group showed the effectiveness of the intervention (p < 0.001). Education did not significantly reduce PMDD frequency in the intervention groups compared to the control group (p > 0.05). CONCLUSION: This study suggests education by peers and healthcare providers effects on PMS and general health in adolescents. It suggested that the effectiveness of these approaches be investigated in other adolescents' health conditions.

Pregnancy rate, maternal and neonatal outcomes among breast cancer survivors: A systematic review.

AIM: This study investigated the pregnancy rate, maternal and neonatal outcomes, and breast cancer (BC) recurrence status after pregnancy among BC survivors. DESIGN: A systematic review. METHODS: Electronic databases such as PubMed, Web of Science [WOS], Scopus, ScienceDirect, Google Scholar, and Scientific Information Database were systematically searched. The quality of included studies was evaluated using the Newcastle-Ottawa Scale (NOS). Observational studies reported the pregnancy rate, maternal and neonatal outcomes among reproductive-aged BC survivors, and the recurrence status of BC after pregnancy were eligible to include in this study. RESULTS: Of the 29 included studies, 13 studies were prospective cohorts or prospective multicenter or population-based cohorts, 14 studies were retrospective cohort or retrospective population-based cohort studies, and two studies were cross-sectional retrospective surveys or population-based descriptive studies. This systematic review showed that the pregnancy rate was estimated at 3.1%-48.5% among BC survivors who attempted to conceive. The most prevalent maternal outcomes of pregnancy were miscarriage (1.8%-33.3%) and induced abortion (5.0%-44%) as well as preterm birth (PTB) or very PTB (1.2%-21.1%), and twin birth (1.1%-38.8%) were the most prevalent neonatal outcomes occurring among BC survivors, respectively. In addition, most of the included studies indicated that pregnancy had no adverse effect on the status of BC recurrence among survivors. Surviving women can be encouraged and receive a carefully multidisciplinary approach regarding healthy pregnancy. No Patient or Public Contribution.