Comparing sexual self-concept in women with obesity pre- and post-bariatric surgery.

BACKGROUND: Obesity leads to increased disease burden, decreased life expectancy, and disrupted sexual life. One of the most effective ways of obesity treatment is bariatric surgery. This study was conducted aiming to determine and compare sexual self-concept in women with obesity pre- and post-bariatric surgery. METHOD: A longitudinal study comparing sexual self-concept pre and post- surgery was conducted on women with obesity referring to obesity clinics in the city of Tehran in 2020-2021. Data collection was performed using Snell's Multidimensional Sexual Self-Concept Questionnaire (MSSCQ), which was completed online. Data were analyzed using SPSS version 16 statistical software and Fisher's exact test, chi-square, Mann-Whitney, independent t, and logistic and linear regression tests. A p-value of less than 0.05 was considered significant. RESULTS: According to the findings, the mean (standard deviation) score of sexual self-concept was 240.26 (26.82) in the post-surgery group and 200.26 (32.24) in the pre-surgery group (P = 0.001), and the highest mean (standard deviation) score of sexual self-concept both in the pre-surgery group (13.06 [4.00]) and in the post-surgery group (15.46 [2.16]) was related to the area of sexual depression (P = 0.05). Also, with increasing educational level, the odds of bariatric surgery increased by 33%, and those who had no private bedroom had lower odds of bariatric surgery by 65%. In those who did not have other individuals living in their house and their spouse was not a smoker, the self-concept score was 52.35 and 23.11 units higher. CONCLUSION: In general, bariatric surgery can improve sexual self-care. Considering the issue of sexual self-concept in bariatric surgery, it is recommended to design appropriate counseling and planning before surgery according to the culture of each country.

Educational interventions for promoting sexual and reproductive health in school counselors: a three-arm, randomized control trial comparing lecturing, buzz group and role-play.

BACKGROUND AND OBJECTIVE: School-based sexual and reproductive health (SRH) education is often reported as being inadequate and/or inconsistent. This study aimed to investigate the educational interventions for promoting SRH in school counselors and compare the results in three groups: lecturing, buzz group and role-play. MATERIALS AND METHODS: An intervention quasi-experimental design was employed to evaluate the usefulness of educating SRH topics by using interactive teaching methods for 120 school counselors. Changes in the participants' knowledge, attitudes and self-efficacy toward SRH education were evaluated by each group using a pretest and a posttest. RESULTS: The results of this study revealed that 75% of counselors deemed SRH training vital and felt that the best SRH educators are health care providers and the reason might be their lack of educational skills. They also stated that the most significant barriers to education in schools include concerns about parental feedback and lack of appropriate abilities. CONCLUSION: The present study showed that the use of all three methods (lecturing, buzz groups and role-play) in SRH training improves the level of knowledge, attitude and self-efficacy; although role-play could have been more effective than lecturing in improving counselors' knowledge.

Relationship between human papillomavirus and serum vitamin D levels: a systematic review.

BACKGROUND: Human papillomavirus (HPV) is one of the most prevalent sexually transmitted diseases worldwide. The present review was conducted to accumulate evidence on the relationship between cervicovaginal human papillomavirus infection and serum vitamin D status. METHODS: Electronic databases including Web of Science, Embase, Scopus, and PubMed were searched by different combinations of keywords related to "human papillomavirus" and "vitamin D", obtained from Mesh and Emtree with AND, and OR operators without any time restriction until December 24, 2022. Selection of articles was based on the inclusion and exclusion criteria. Newcastle-Ottawa Scale was used for quality assessment. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist was applied for reporting. RESULTS: In total, 276 citations were retrieved. After removing duplicates, and non-related articles, the full texts of 7 articles were reviewed including 11168 participants. Three studies reported that there was a positive relationship between vitamin D deficiency and cervicovaginal human papillomavirus while three studies did not. One study showed a significant positive association between higher vitamin D stores and short-term high-risk human papillomavirus persistence. CONCLUSIONS: The findings showed no firm evidence for any association between serum vitamin D level and cervicovaginal human papillomavirus infection, although the possible association could not be discarded. Further investigations are needed to reach sound evidence.

Sexual health literacy and its related factors among couples: A population-based study in Iran.

Sexual health literacy is one of the factors that affect sexual health. Several factors can influence sexual health literacy. As a result, the current study was carried out to determine sexual health literacy and its associated factors among Iranian couples. In 2022, 410 couples of reproductive age were referred to comprehensive health service centers and private clinics in Kerman city for the descriptive-analytical study. The study questionnaires included sexual health literacy for adults, sexual knowledge and attitude scale, marital intimacy scale, sexual intimacy scale, depression anxiety stress scale, sexual self-efficacy, the multidimensional scale of perceived social support, and socioeconomic status. Finally, multiple linear stepwise regression models were used to determine the factors related to sexual health literacy using the SPSS software version 22. According to the findings of this study, the mean(SD) of sexual health literacy in couples was 68.76(12.96), which was a desirable level. Furthermore, the findings revealed that sexual self-efficacy (B = 0.649، P<0.001), sexual knowledge and attitude (B = 0.217، P<0.001), the ability to identify reliable and non-reliable sources (B = -3.116، P<0.001), feelings of shame and embarrassment for obtaining sexual information (B = 1.860، P = 0.011), social support (B = 0.127، P<0.001) and the obscenity of sexual issues in family (B = 1.764، P = 0.015) were the final predictors of sexual health literacy in couples. It is suggested that researchers and health managers consider these factors when designing interventions to promote sexual health literacy.

The relationship between coping strategies with sexual satisfaction and sexual intimacy in women with multiple sclerosis.

BACKGROUND: Multiple sclerosis profoundly affects the sexual aspects of patients' life, especially in women. Various coping strategies are used by women with multiple sclerosis to overcome, tolerate, or minimize these sexual effects. The present study aimed to assess the relationship between sexual satisfaction, sexual intimacy, and coping strategies in women with multiple sclerosis. METHODS: This cross-sectional study was performed on a sample of 122 married women who were members of Iran's MS society in Tehran, Iran. The study was conducted from December 2018 to September 2019. Data were collected using the Index of Sexual Satisfaction (ISS), the Sexual Intimacy Questionnaire (SIQ), and the Folkman and Lazarus Coping Strategies Questionnaire. Frequency, percentage, mean and standard deviation were used to explore the observations. Independent t-test and logistic regression were applied to analyze the data using the SPSS-23. RESULTS: The majority (n = 71, 58.2%) used an emotion-focused coping strategy with the highest score for the escape-avoidance subscale [mean (SD): 13.29 (5.40)]. However, 41.8% of the patients (n = 51) used a problem-focused coping strategy with the highest score for the positive reappraisal strategy subscale [mean (SD): 10.50 (4.96)]. The sexual satisfaction in women with problem-focused coping strategies was significantly higher than women who used emotion-focused coping strategies (95.6 vs. 84.71, P-value = 0.001). There was a negative association between sexual intimacy and higher emotion-focused coping strategy (OR = 0.919, 95% CI 0.872-0.968, P = 0.001). CONCLUSIONS: Problem-focused coping strategy in women with multiple sclerosis increases sexual satisfaction, while the emotion-focused coping strategy has a significant negative relationship with sexual intimacy.

Development of an educational guide for postpartum sexual health promotion: The Delphi method.

BACKGROUND: The Promotion of sexual health has been emphasized in Sustainable Development Goals (SDGs). As a primary prevention strategy, the promotion of sexual knowledge can reduce the incidence of postnatal sexual disorders. This study aimed to develop an educational guide for postpartum sexual health promotion. MATERIALS AND METHODS: This qualitative study was conducted in 2021 in Tehran. The steps of developing the educational guide were based on the model of the National Institute for Health and Clinical Excellence (NICE). First, the related guidelines, books, booklets, and original articles were comprehensively reviewed. Based on the scientific evidence, the educational content was compiled. Then, the quality of this content was evaluated using the Delphi method; It was performed using expert opinions with the Appraisal of Guidelines for Research and Evaluation (AGREE) tool. RESULTS: The educational content was developed in three chapters as follows: basic sexual education, postpartum changes and prevalent sexual problems of this period, and strategies for solving or adapting to postpartum sexual problems. This guide was developed in two separate sections for healthcare providers and mothers. The content was of excellent quality in all 6 domains of the AGREE tool (>90%); and evaluated to be optimal in terms of scientificity, significance, and feasibility with the consensus of experts (>95%). CONCLUSIONS: In this research, the steps of developing a comprehensive evidence-based educational guide for sexual health services in postpartum care were described, and its content was presented. The validity of the compiled content was also confirmed.

Factors Related to Health Literacy Among the Iranian Population: A Scoping Review.

Background: The identification of the determinants of health literacy is an essential prerequisite for developing health literacy promotion programs. While these factors have been reported in previous studies, there is a lack of a comprehensive review specifically focused on the Iranian population. Therefore, this review aimed to identify the factors related to health literacy in Iran. Methods: This scoping review used the Arksey and O'Malley methodological framework and the Joanna Briggs Institute framework. A search was performed in English-language databases-Web of Science, Scopus, and PubMed-using the MeSH keyword of "health literacy," and in Persian-language databases-Magirean and SID-using the related keywords. A narrative synthesis was conducted to describe all included studies' characteristics and explore factors associated with health literacy. Results: A total of 76 studies were included. Based on the results of the study, related factors included personal factors-including sex, age, education level, field of study, parents' education level, marital status, occupation, work experience, employment status, ethnicity, income, socioeconomic status, medical history, duration of disease, addiction, number of children, media literacy, information literacy, computer literacy, and self-efficacy-situational factors-including use of the internet, use of social networks, social support, source of information, and participation in health education classes-and societal and environmental factors-including place of residence and type of insurance. Conclusion: Modifiable factors identified in this study were self-efficacy, social support, information sources, media literacy, information literacy, computer literacy, internet or social networks, and participation in health education classes. Planners can consider these factors when developing interventions to promote health literacy.

Primary ovarian insufficiency quality of life scale (POIQOLS): development and psychometric properties.

BACKGROUND: Primary ovarian insufficiency is menopause before the age of 40. It can affect the quality of life of afflicted women. Because there is no instrument available for measuring the quality of life of these women, the present study was carried out to develop and assess the psychometric properties of the quality of life scale for women with primary ovarian insufficiency. METHODS: This exploratory sequential mixed method study was performed in two phases. In the qualitative phase (item generation), semi-structured in-depth interviews were conducted with 16 women having primary ovarian insufficiency, and a literature review was performed to generate initial items pool. In the quantitative phase (psychometric evaluation), the face, content, and construct validity (exploratory factor analysis), as well as reliability (internal consistency and test-retest methods), were evaluated. Besides, the responsiveness and interpretability were investigated. RESULTS: During the first phase of the study, the initial item pool was generated with 132 items. After the face and content validity, the number of items was reduced to 40. The results of exploratory factor analysis yielded a 28 item scale with six factors. These factors explained 58.55% of the total variance. The Cronbach's alpha for each factor was more than 0.7. Furthermore, the intraclass correlation coefficient for the entire scale was 0.95. CONCLUSIONS: The primary ovarian insufficiency quality of life scale (POIQOLS) is a valid and reliable tool for accessing the quality of life of women with primary ovarian insufficiency.

The effect of PLISSIT based counseling model on sexual function, quality of life, and sexual distress in women surviving breast cancer: a single-group pretest-posttest trial.

BACKGROUND: Diagnosis and treatment of breast cancer potentially leads to sexual dysfunction and sexual distress in women and negatively affects their quality of life (QoL). This study aimed at determining the effect of PLISSIT based counseling on sexual function, sexual distress, and QoL in women surviving breast cancer. METHODS: In this pre-test, post-test, single-group semi-experimental study, 65 women surviving breast cancer who were referred to the selected centers were included in the study via the available sampling method. Data gathering tools included a researcher-made demographic questionnaire, female sexual function index, beck depression inventory-II, State-Trait Anxiety Inventory, World Health Organization QoL-Brief, and Female Sexual Distress Scale-Revised. The counseling program (7 sessions 60 min each) was designed based on the PLISSIT model. The sexual function, sexual distress, and QoL were evaluated before, and 2 and 4 weeks after the intervention. To compare the mean scores of variables before and after the intervention, repeated-measured ANOVA was used. RESULTS: The findings showed that PLISSIT based counseling significantly reduced sexual distress and increased the scores of QoL and all its domains, as well as sexual function and all its domains in women surviving breast cancer (p < 0.05). There was no significant difference in the mean scores of variables 2 and 4 weeks after the intervention. CONCLUSIONS: It seems that PLISSIT based counseling reduces sexual dysfunction and sexual distress and improves the QoL of women surviving breast cancer. So, it is recommended that these counseling programs be integrated into the health care program of this group of women. TRIAL REGISTRATION: TCTR202103170010, 17 March 2021, Retrospectively registered, at https://www.thaiclinicaltrials.org/ .

Exploring Iranian married working women's experiences regarding sexual health challenges.

BACKGROUND: Considering that the quality of personal life and the quality of sexual life of working women interact with each other and considering that job as one of the dimensions that can play a direct role in the quality of life and also due to increasing women's participation in professional activities in today's society, this study was designed and conducted to explain the experiences of working women considering sexual health challenges. MATERIALS AND METHODS: This research was a qualitative study that the information of which was obtained through face-to-face interviews with semi-structured and open-ended questionnaires. Interviews were conducted with 32 working women working in public and private offices in Tehran, Iran, to explore their experiences of the role of jobs in sexual challenges. The sampling method was purposive. Data analysis was performed using a qualitative content analysis method with a conventional approach by MAXQDA software version 10, and to establish the reliability and validity of findings, Graneheim and Lundman criteria were considered. RESULTS: Data analysis from 32 interviews resulted in the formation of 223 primary inferential codes and 1 main category and 4 subcategories. The results of data analysis were presented in one main category, including sexual health challenges among working women. This main category consisted of four subcategories such as sexual problems due to employment, job harassment, the essential needs for sexual relationship, need for the better job management, and married sex life. CONCLUSIONS: Explaining the experiences of working women showed that sexual problems due to employment and job harassment are among the factors that cause sexual health challenges in working women. It also seems that meeting the essential needs for sexual relationship and the better management of job and married sex life can interact with the sex lives of working women.

An exploration of factors affecting the quality of life of women with primary ovarian insufficiency: a qualitative study.

BACKGROUND: Menopause before the age of 40 years is known as primary ovarian insufficiency (POI). Besides physical effects, being diagnosed with this disorder adversely affects the psychological health and quality of life (QOL). The present study aimed at shedding light on the factors affecting the QOL of women with POI. METHODS: The present study is a qualitative one. The data were collected using semi-structured in-depth interviews with 16 women having POI, selected purposively. Data rigor was ensured using Lincoln and Guba's criteria. The recorded data were transcribed verbatim and then analyzed constantly at the same time as gathering the data using conventional content analysis. RESULTS: Three themes emerged regarding the QOL of women with POI, i.e. disease effect (physical and psychological effects), distorted self-concept (threatened identity and disease stigma), and hormone replacement therapy effect (positive and negative physical/psychological effects). CONCLUSIONS: Due to the profound effects of the disease on different aspects of the biopsychosocial health of women with POI, a multifaceted health care approach is recommended to improve their QOL.

Sexual Compatibility with Spouse Questionnaire: Development and Psychometric Property Evaluation.

BACKGROUND: Sexual compatibility between husband and wife is an effective factor in both sexual and marital satisfaction. However, there is limited valid and reliable questionnaire to measure the degree of sexual compatibility between the couples. METHODS: In this exploratory mixed method study, 54 individuals were interviewed in the qualitative phase and 448 persons participated in the quantitative phase. Totally 502 participants (261 woman, 241 men) took part in this study. According to 205 final codes derived from the qualitative phase, 102 initial items were developed, the number of which reached 69 items after deletion and merging performed by the research team. After face validity, content validity and construct validity, 68 items were introduced into the construct validity phase. RESULTS: Following exploratory factor analysis and promax rotation, the items were reduced to 35 in 4 factors: "Requirements of a sexual relationship", "Sexual agreement", "Contextual obstacles" and "Outcomes of sexual compatibility". The questionnaire Cronbach alpha and correlation coefficient of the test-retest method were 0.90 and 0.91, respectively. CONCLUSION: Final Questionnaire included 35 items in 4 point-Likert scale with total score of between 35-140. This valid and reliable questionnaire is brief, easily interpreted and can measure the main factors affecting sexual compatibility with the spouse in clinics and research fields.

Explaining Perceived Priorities in Women with Breast Cancer: A Qualitative Study.

OBJECTIVE: Cancer is a stressful event in life, and the dreadful impact and problems created for patients and families
by cancer negatively affect their quality of life. Therefore, regarding the increasing number of cancer patients and the
nature of this disease, the need to recognize and understand the priorities and problems of patients after the diagnosis of
cancer is of high importance. This study was designed and implemented with the aim of identifying the perceived
priorities of women with breast cancer. METHODS: This study is a qualitative research of content analysis type. To collect
data, purposeful sampling and deep semi-structured individual interviews were used. The subjects were women with
breast cancer who visited the Breast Disease Research Center of Shahid Motahari Clinic in Shiraz, and the data were
saturated after 15 interviews. The four criteria presented by Lincken and Guba were used to evaluate the validity and
reliability. To analyze the qualitative data, conventional qualitative data analysis and MAXQDA10 software were used.
Two themes were obtained in the assessment of interviews and analysis of data: 1) Supportive relief; 2) Therapeutic
support. RESULTS: Some of the participants highlighted the role of social and family support in coping with the disease,
and considered social communication and continued support in the form of empathic relationship as a turning point
in their lives. The absence of a fertility specialist in the cancer treatment system was the main complaint of most
participants. The results showed that receiving support from family and the healthcare system is the most important
perceived priorities in breast cancer patients. CONCLUSION: The results of this study show the importance of social support
as a perceived priority in breast cancer patients to improve their quality of life. Development and reinforcement of the
supportive network seem to be essential to provide the best possible help to these patients.

Knowledge and Attitude Toward Human Papillomavirus and HPV Vaccination in Iranian Population: A Systematic Review.

Background and objective: Human papillomavirus (HPV) is the main cause of cervical cancer. This systematic review was performed to provide an overview of knowledge and attitude about HPV infection and HPV vaccine in Iranian population. Materials and Methods: The information was identified by searching international and national databases; pubmed/MEDLINE (NCBI), Embase (Elsevier), Google Scholar, Scientific Information Database, MagIran, and IranDoc. The current research was performed using the terms of medical subject headings (MeSH) and combinations of the keywords including: "human papillomavirus" or "human papillomavirus vaccine" with the words "knowledge," "awareness," "attitude" and "Iran." Studies were evaluated according to the checklist of STrengthening the Reporting of OBservational Studies in Epidemiology (STROBE). Results: A total of 10 observational studies that met the inclusion criteria were included in this review. The overall knowledge and awareness of the Iranian population (parents, women, university students, medical students, nurses and hospital staff) about HPV and HPV vaccination was low; however, the attitude toward this issue was positive and strong. Conclusion: Due to the low levels of knowledge about HPV infection and its methods of prevention, efforts should be increased to enhance the knowledge of the general population about HPV infection and vaccination in order to prevent its incidence and complications.

Conflicts women with breast cancer face with: A qualitative study.

BACKGROUND AND AIM: The prevalence of cancer in women under 50 years of age has been increased in recent years. Cancer treatment methods can lead to infertility in women with cancer. Fertility and childbearing, as the most important conflicts in the life of women with breast cancer, significantly affect their quality of life. MATERIALS AND METHODS: This research is a qualitative study of content analysis type. Purposeful sampling and semi-structured individual interviews were performed for data collection. The participants were women with breast cancer referred to the Breast Disease Research Center of Shahid Motahari Clinic in Shiraz. The data were saturated after 15 interviews. To assess the validity and reliability, we used the four criteria provided by Lincoln and Guba. The conventional qualitative data analysis and MAXQDA10 software were used to analyze the qualitative data. RESULTS: Explaining the conflicts which women with breast cancer are faced has led to the extraction of four main categories: (1) paradox of decision-making to childbearing, (2) fear, (3) sinister emotions, and (4) challenges. The results showed that the paradox of decision-making on childbearing is the most important challenge with which the patients with breast cancer are faced, causing a state of fear, anxiety, and the emergence of sinister emotions in them. CONCLUSION: It seems that paying more attention to preserving reproductive capacity before starting the treatment plays an important role in solving the biggest conflict in the life of breast cancer patients.

Factors affecting women's sex preference in multiethnic society in North Khorasan Province, Iran.

BACKGROUND: Sex preference is one of the cultural problems of countries in the field of demographic issues. It can increase the number of pregnancies, reduce the interval between births and delay in seeking prenatal care, which can threaten the health of mother, baby, child and family, especially in traditional societies. OBJECTIVES: To determine the role of ethnicity on sex preference of different ethnicities living in North Khorasan Province (Iran). METHODS: This cross-sectional study was conducted using a multistage cluster sampling method and a researcher-made questionnaire of reproductive behavior on 1,000 women from 5 ethnicities (Fars, Turk, Kurd, Turkman and Tat) in North Khorasan Province in the summer of 2016. Data were analyzed by IBM-SPSS version 21, using descriptive statistics, ANOVA, t-test, and logistic regression. A significance level of ≤0.05 was set for examining the study hypotheses. RESULTS: The results showed sex preferences among different ethnicities of North Khorasan Province. The highest level of preference for sons was seen in Turkman (66% vs. 23%). Unlike other ethnic groups, Turkman (21%) and Kurdish people (29.7%) were under pressure from the spouse's family to give birth to sons. CONCLUSION: Sex preference, especially among the Turkman ethnic group, which are different in terms of geographical, economic and social conditions, affects the fertility and reproductive behavior of the respondents; and it is necessary to reduce son preference for the health and well-being of children and women.

Effect of Hydroalcoholic Extracts of Capsella Bursa-Pastoris on Heavy Menstrual Bleeding: A Randomized Clinical Trial.

OBJECTIVES: Heavy menstrual bleeding (HMB) is one of the leading causes of low quality of life and iron deficiency anemia in women. This study aimed to determine the effect of hydroalcoholic extracts of Capsella bursa-pastoris on HMB. DESIGN: This study is a triple-blinded, randomized clinical trial. SETTING: The study was conducted in gynecology clinics affiliated to Shahid Beheshti University of Medical Sciences, Tehran, Iran. SUBJECTS: Our patients affected to a complaint of HMB. After obtaining a complete medical history of the women and filling out the demographic forms, the participants were assigned randomly into the experimental (n = 42) and control groups (n = 42). INTERVENTION: The eligible participants were given a pictorial blood loss assessment chart (PBLAC) to confirm HMB during the menstrual cycle. The experimental group received two capsules of mefenamic acid (500 mg) every 8 h and two Capsella bursa-pastoris capsules every 12 h. The intervention started from the first day of menstruation to the end of this period up to 7 days for two consecutive cycles. In the control group, the patients received mefenamic acid and placebo instead of Capsella bursa-pastoris capsules. OUTCOME MEASUREMENTS: The PBLAC score and number of bleeding days, incidence of any possible problems, as well as participant satisfaction were measured. The data were analyzed using t-test, Chi-square, repeated-measures ANOVA, and ANCOVA tests in PASW Statistics ver. 18. RESULTS: After the intervention, there was observed significant decrease in the amount of menstrual bleeding in both groups. However, the mean decrease in the amount of bleeding was significantly more in the Capsella bursa-pastoris group (p < 0/001). CONCLUSION: Compared with control group, hydroalcoholic extracts of Capsella bursa-pastoris capsule appeared to be effective in reducing menstrual bleeding in this study. Further research regarding the efficacy and safety of Capsella bursa-pastoris is required.

Women's orgasm obstacles: A qualitative study.

BACKGROUND: Woman's orgasm plays a vital role in sexual compatibility and marital satisfaction. Orgasm in women is a learnable phenomenon that is influenced by several factors. OBJECTIVE: The aim of this study is exploring obstacles to orgasm in Iranian married women. MATERIALS AND METHODS: This qualitative study with directed content analysis approach was conducted in 2015-2016, on 20 Iranian married women who were individually interviewed at two medical clinics in Tehran, Iran. RESULTS: Orgasm obstacles were explored in one category, 4 subcategories, and 25 codes. The main category was "Multidimensionality of women's orgasm obstacles". Subcategories and some codes included: Physical obstacles (wife's or husband's boredom, vaginal infection, insufficient vaginal lubrication), psychological obstacles (lack of sexual knowledge, shame, lack of concentration on sex due to household and children problems), relational obstacles (husband's hurry, having a dispute and annoyance with spouse) and contextual obstacles (Irregular sleep hours, lack of privacy and inability to separate children's bedroom from their parents, lack of peace at home). CONCLUSION: For prevention or treatment of female orgasm disorders, attention to physical factors is not enough. Obtaining a comprehensive history about physical, psychological, relational and contextual dimensions of woman's life is necessary.

Factors affecting adaptation to the role of motherhood in mothers of preterm infants admitted to the neonatal intensive care unit: a qualitative study.

AIM: The aim of this study was to explore factors affecting adaptation to the role of motherhood in mothers of preterm infants admitted to the neonatal intensive care unit. BACKGROUND: Transition to motherhood often causes significant issues in terms of adaptation to the role of motherhood. The main factors leading to parental stress, especially in the neonatal intensive care unit, have shown that the greatest source of stress is the loss of women's role as mothers. DESIGN: It was a qualitative study with content analysis approach. METHODS: Semi-structured in-depth interviews were used for data collection. Interviews were conducted with 17 mothers of preterm infants (under 36 weeks) who had been hospitalized for at least one week in the neonatal intensive care unit. Purposive sampling with maximum diversity was used to recruit mothers in Kermanshah province (west of Iran). Data was collected during 2013-2014. Interviews were recorded and transcribed verbatim. Data were analysed using conventional content analysis. FINDINGS: Explanation of the mothers' perspective towards factors affecting adaptation to the role of motherhood led to two main categories of individual factors (emotional distress, self-efficacy, interaction and alienation) and social factors (support, prejudice). CONCLUSION: Adaptation to the role of motherhood can be promoted through supporting mothers of preterm infants, empowering them and increasing their self-efficacy, to eliminate negative factors and emotions.

Venom Components of Iranian Scorpion Hemiscorpius lepturus Inhibit the Growth and Replication of Human Immunodeficiency Virus 1 (HIV-1).

BACKGROUND: During the recent years, significant progress has been achieved on development of novel anti-viral drugs. Natural products are assumed as the potential sources of novel anti-viral drugs; therefore, there are some previous studies reporting the anti-viral compounds from venomous animals. Based on the significant value for tracing of non-toxic anti-viral agents from natural resources, this study was aimed to investigate the anti-viral activity of some HPLC purified fractions derived from the venom of Iranian scorpion, Hemiscorpius lepturus, against human immunodeficiency virus 1 (HIV-1) and herpes simplex virus 1 (HSV-1). METHODS: H. Lepturus crude venom was subjected to reverse phase HPLC analysis to determine its active components precisely where four dominant fractions obtained at retention time of 156-160 minutes. The phospholipase A2 and hemolytic activities of the purified fractions were first evaluated. Then the anti-viral activity was measured using single cycle HIV (NL4-3) replication and HSV (KOS) plaque reduction assays. RESULTS: The H. lepturus crude venom inhibited HIV replication by 73% at the concentration of 200 µg/ml, while it did not show significant anti-HSV activity. It also inhibited the cell-free viral particles in a virucidal assay, while it showed no toxicity for the target cells in a proliferation assay. The four HPLC fractions purified from H. lepturus inhibited HIV with IC50 of 20 µg/ml. CONCLUSION: H. lepturus venom contains components with considerable anti-HIV activity insofar as it has virucidal activity that offers a novel therapeutic approach against HIV infection. Our results suggest a promising pilot for anti-HIV drug discovery with H. lepturus scorpion venom.