Self-rated health and quality of life in female sex workers with substance use disorders in Tehran, Iran.

BACKGROUND: While self-rated health (SRH) and quality of life (QoL) has been associated with substance use disorders (SUDs) in sex-working populations, little is known about this association in Iran. This study aimed to assess QoL and SRH in Iranian female sex workers (FSWs) in Tehran. METHOD: FSWs were recruited using convenience sampling methods from substance abuse treatment centers in Tehran that exclusively provided services for women. Participants completed an interviewer-administered demographic questionnaire in Persian and the Iranian version of the Short Form Health Survey (SF-36). Descriptive analyses, means and standard deviations; frequency and percentages, t-test and one-way ANOVA, and Chi-square tests were utilized to analyze the data. RESULTS: The mean age among 161 participants clinically diagnosed with SUD was 34.09 years (SD 7.97; range: 18-57). The total mean QoL score was 41.03 (SD: 12.92). The highest and lowest mean scores were observed in the physical functioning (52.23) and role emotional (26.64) dimensions, respectively. Significant differences (p < 0.05) in QoL were observed according to education and marital status, and the average QoL score was lower in women who reported permanent marriages and women who were illiterate. The average score of QoL was significantly higher in employed women. Overall, 51.6% of the women rated their health as sub-optimal, with divorced participants and women who were illiterate more likely to rate their health as sub-optimal (p < 0.05). CONCLUSION: Results emphasize the need for mental, physical, and sexual health screening and gender-specific interventions to improve QoL in this population. Further investigation may elucidate the consequences of poor SRH and QoL on SUD treatment adherence, sexual risk behavior, and morbidity and mortality in FSWs.

Sexual health outcomes of PLISSIT-based counseling versus grouped sexuality education among Iranian women with breast cancer: A randomized clinical trial.

In-person, individual counseling using the PLISSIT model is a well-known approach to help people with sexual problems. Evidence suggests that Grouped Sexuality Education (GSE) can be as effective as in-person sexuality education. The efficacy of PLISSIT versus GSE has not previously been evaluated in women with Breast Cancer (BC). In this paper, we report on the effect of PLISSIT versus GSE on self-reported sexual behaviors experienced by women after a BC diagnosis (n = 75). The women were randomly allocated into three groups, with 25 women in each arm. Data analysis of the intention-to-treat population (n = 65) revealed efficacy of both GSE and PLISSIT in improving sexual behaviors (p < 0.0001) with a positive change in sexual capacity, motivation and performance after 6- and 12-weeks post-intervention follow ups. We found the GSE model showed a greater efficacy than the PLISSIT model. Due to the substantial needs faced by women with cancer and the cost associated with implementing the PLISST model, GSE seems to be more effective. We recommend GSE for Iranian communities where management of sexual problems is at an early stage and where the sexuality of women with cancer is routinely overlooked.

Sociodemographic Characteristics, HIV-Related Risk Behaviors and HIV Prevalence of Vulnerable Men in Tehran, Iran.

BACKGROUND: Sexual minorities, such as men who have sex with men (MSM), are disproportionately impacted by HIV/AIDS compared to heterosexual men. The increased prevalence of HIV/AIDs among this group of individuals is associated with increased participation in HIV-related risk behavior, such as multiple sexual partnerships and injection drug use. However, very little is known about the prevalence of HIV and the risk behaviors related to HIV infection among MSM in Iran. This absence of data is due to the increased discrimination and stigmatization MSM, and other vulnerable populations face in Iran. This study was conducted to identify HIV-related risks, HIV prevalence and sociodemographic characteristics of the MSM population in Iran. METHODS: A cross-sectional study was conducted among MSM attending the Sexual Health Clinic at Imam Khomeini Hospital in 2018. A sexual health screening questionnaire was used to aid in identifying HIV-related risk behaviors. HIV status was determined using an HIV rapid test and confirmed by an ELISA. RESULTS: One hundred MSM enrolled in this study, out of which 41% were 18-25 years old. The majorities were single; almost one-third had a diploma degree. Only a fifth were employed, and about a quarter (25%) reported substance abuse. Among eighty-three people (83%) reported having sex during the past three months, and only 27 (27.3%) of participants always used condoms for sex. Among 80 participants tested for HIV, two positive results were detected (2.5%). CONCLUSION: Data collected through a sexual health questionnaire indicated that the prevalence of HIV is increased among MSM in Iran. This finding sheds light on the urgent need for the implementation of social programs providing counseling and healthcare to vulnerable populations in Iran.

Assessment of malnutrition and anthropometric measurement among 0-59 months aged children in Amibara and Awash Fentale districts, afar national regional state of Ethiopia.

PURPOSE: Famines and food shortages are one of the most common long time histories of Ethiopia. Hence, malnutrition has been persisted at alarming raters in the country. Moreover, it is a major cause of morbidity and mortality in Afar National Regional State of Ethiopia. Specifically, in Amibara and Awash Fentale districts. The anthropometric data were presented on height, weight, MUAC, weight/height/Age and Body Mass Index (BMI) of under-five children. METHODS: A cross-sectional descriptive survey was conducted from March 01, 2017 to June 15, 2018. The data was collected by using anthropometric measurement. A multi stage random sampling procedure was applied in order to recruit the required sample size. The data collections were conducted at two selected districts in Afar region by trained interviewers and health care providers. The data were analyzed by using SPSS Version 23. Bivariate analysis between dependent and independent variables was employed. Multivariate analysis was also done to control for possible confounding variable by selecting variable which show statistically significant association (P< 0.05). RESULTS: Out of 410 under five children's anthropometric finding, the majorities (62.7%) of those registered under five children were male and (33.3%) were female. The majority (46.8%) of under five children were less than or equal to 50 cm by their height. Most (54.1%) of under five children were less than or equal to 12.5 cm by their MUAC. It indicated that they were diagnosed with severe malnutrition based on anthropometric measurements. Meanwhile, majority (64%) of under five children were less than 60% their weight/age. Regression analysis result indicated that all of the variables were not significant predictors of BMI for under five children (P> 0.05). Based on ANOVA result, there was significant difference between sex and other predictors (P= 0.031). This finding implies that improvement in food aid and poverty alleviation programs are very important. Based on the finding, it is important to provide high quality and quantity of food. Moreover, less access to assets and health services commonly contributed for malnutrition. Highlighting under five children's malnutrition will help to develop and design future policies and programs in Ethiopia.

Estimating the household drought driven food insecurity using system dynamics model: The case of afar national regional state of Ethiopia.

BACKGROUND: Building resilient communities has emerged as a dominant schema in the policy arena and in academia in the wake of recent disasters. Food insecurity is a complex and multidimensional phenomenon that is not appropriately captured by conventional proxy indicators currently used to assess the problem in developing countries. Ethiopia like many countries in sub-Saharan Africa, continues to experience high levels of drought driven food insecurity despite decades of implementing poverty alleviation and prevention programmes. These persistent droughts, combined with the devastating impact of climate change continue to threaten the livelihoods of thousands of men, women and children, who depend on agriculture for their livelihoods. OBJECTIVE: The overall objective of this study was to assess and analyze the drought driven food insecurity situation, malnutrition and derive policy implications in the Afar National Regional State of Ethiopia. METHODS: Mixed methods designs which include both qualitative and quantitative were used. The subjects of the study were men and women dwellers, government officials and other stakeholders in Afar Regional State of Ethiopia. Four Hundred Twenty Two (422) eligible households were enrolled consecutively from randomly selected two Districts in Afar National Regional State of Ethiopia which were selected by stratified Randomized method. The Districts were randomly allocated into 3 Keble's from Amibara and 2 Keble's from Awash Fentale. Two FGD (total of 10 FGDs participants that mean each Districts = 5 FGD) and 10 KIIs from Amibara and Awash Fentale were conducted. Standard questionnaires were used for data collection after validating the instruments. The data was analyzed by using SPSS version 23. Associated factors and multiple logistic regressions were employed. The study significance was conducted by using α 5% level. RESULTS: In this research (58.1%) of the participants agreed that lower crop yield occurred due to heavy rains/floods were not shocks among households. While (41.9%) were shocks on households who travel further loyal for grazing was the highest level of shocks among all those listed. On top of that majority (56.8%) of under five children were < 60% by their weight/age and (33.9%) between 61 and 70%. There was significant difference among MUAC (P= 0.007), BMI (P= 0.003) and height, weight, MUAC, BMI and weight/age among under five children.

Impact of climate change on community health and resilience in Ethiopia: A review article.

BACKGROUND: Drought is a serious issue which might be caused by climate change that could create famine and health problems. Drought reduces air quality, increases fungal infestation, reduces people hand washing, affects mental health, leads to malnutrition by decreasing agricultural production, and increases diseases transmitted by insects. This study aimed to determine and describe community health status through building drought resilience in Ethiopia. METHODS: This review was conducted based on the available peer-reviewed articles that were published from January 2004 to December 2018 Online databases from PubMed, MEDLINE, Scopus, EMBASE and Google Scholar were searched for studies related to the building drought and community health resilience at different regions of Ethiopia that were published in English language. The search was made by using "Emergency disaster", "prevention", "preparedness", "response", "recovery", "drought", "food insecurity", "coping strategies" and "drought health policy" as keywords. RESULTS: Most of the reviewed articles deal with the impact of climate change on the human health in relation to food security. The associated factors of the impact of drought on food security is basically due to lack of irrigation and farmland, the scarcity of water due to the direct effect of drought, flood, severe soil erosion, livestock dispossession, family size of the household and literacy of the households. Various coping strategies were employed by the households to alleviate the high and continued food insecurity problem such as reducing the number and amount of meal, scrounging cash and grain, searching for off-farm and non-farm jobs, getting food aid, vending of livestock, and partake in food for work programs. CONCLUSION: The findings explored components of the coping strategies to the building resilience create fruitful health conditions for the food insecure household. The effect of agricultural support services as reliance's on drought and community health situation was regarded as a positive outcome. Moreover, the means to get adequate food security strategies in all regions of Ethiopia should be designed. Furthermore, future researches are recommended for finding the best building strategies for each region of Ethiopia.

Validation of the partner version of the multidimensional vaginal penetration disorder questionnaire: A tool for clinical assessment of lifelong vaginismus in a sample of Iranian population.

BACKGROUND: The role of spousal response in woman's experience of pain during the vaginal penetration attempts believed to be an important factor; however, studies are rather limited in this area. The aim of this study was to develop and investigate the psychometric indexes of the partner version of a multidimensional vaginal penetration disorder questionnaire (PV-MVPDQ); hence, the clinical assessment of spousal psychosexual reactions to vaginismus by specialists will be easier. MATERIALS AND METHODS: A mixed-methods sequential exploratory design was used, through that, the findings from a thematic qualitative research with 20 unconsummated couples, which followed by an extensive literature review used for development of PV-MVPDQ. A consecutive sample of 214 men who their wives' suffered from lifelong vaginismus (LLV) based on Diagnostic and Statistical Manual of Mental Disorders 4(th) version (DSM)-IVTR criteria during a cross-sectional design, completed the questionnaire and additional questions regarding their demographic and sexual history. Validation measures and reliability were conducted by exploratory factor analysis (EFA) and Cronbach's alpha coefficient through SPSS version 16 manufactured by SPSS Inc. (IBM corporation, Armonk, USA). RESULTS: After conducting EFA PV-MVPDQ emerged as having 40 items and 7 dimensions: Helplessness, sexual information, vicious cycle of penetration, hypervigilance and solicitous, catastrophic cognitions, sexual and marital adjustment and optimism. Subscales of PV-MVPDQ showed a significant reliability (0.71-0.85) and results of test-retest were satisfactory. CONCLUSION: The present study shows PV-MVPDQ is a multi-dimensional valid and reliable self-report questionnaire for assessment of cognitions, sexual and marital relations related to vaginal penetrations in spouses of women with LLV. It may assist specialists to base on which clinical judgment and appropriate planning for clinical management.

Development and validation of the multidimensional vaginal penetration disorder questionnaire (MVPDQ) for assessment of lifelong vaginismus in a sample of Iranian women.

BACKGROUND: Vaginismus is considered as one of the most common female psychosexual dysfunctions. Although the importance of using a multidisciplinary approach for assessment of vaginal penetration disorder is emphasized, the paucity of instruments for this purpose is clear. We designed a study to develop and investigate the psychometric properties of a multidimensional vaginal penetration disorder questionnaire (MVPDQ), thereby assisting specialists for clinical assessment of women with lifelong vaginismus (LLV). MATERIALS AND METHODS: MVPDQ was developed using the findings from a thematic qualitative research conducted with 20 unconsummated couples from a former study, which was followed by an extensive literature review. Then, during a cross-sectional design, a consecutive sample of 214 women, who were diagnosed as LLV based on Diagnostic and Statistical Manual of Mental Disorders (DSM)-IV-TR criteria completed MVPDQ and additional questions regarding their demographic and sexual history. Validation measures and reliability were tested by exploratory factor analysis and Cronbach's alpha coefficient via Statistical Package for the Social Sciences (SPSS) version 16. RESULTS: After conducting exploratory factor analysis, MVPDQ emerged with 72 items and 9 dimensions: Catastrophic cognitions and tightening, helplessness, marital adjustment, hypervigilance, avoidance, penetration motivation, sexual information, genital incompatibility, and optimism. Subscales of MVPDQ showed a significant reliability that varied between 0.70 and 0.87 and results of test-retest were satisfactory. CONCLUSION: The present study shows that MVPDQ is a valid and reliable self-report questionnaire for clinical assessment of women complaining of LLV. This instrument may assist specialists to make a clinical judgment and plan appropriately for clinical management.

Validation of a Persian version of the Fibromyalgia Impact Questionnaire (FIQ-P).

The aim of this study is to translate, adapt, and validate a Persian version of the Fibromyalgia (FM) Impact Questionnaire (FIQ-P). The FIQ-P was adapted following the translation and back-translation approach; then, it was administered to thirty females with FM. Participants also completed two other validated questionnaires, the Medical Outcome Survey Short Form-36 (SF-36) and the Beck Depression Inventory (BDI). Internal consistency within the FIQ-P items and its test-retest reliability were assessed with Cronbach's alpha and Spearman's correlation coefficient, respectively. Construct validity was analyzed by Spearman's r when correlating the FIQ-P to other questionnaires. The translated version was concordant. Adaptation affected two sub-items of physical function. Participants' mean age ± standard deviation was 40.4 ± 9.0 years. Internal consistency proved good with α = 0.80. Test-retest coefficient ranged from 0.50 for the item "work days missed" to 0.79 for all FIQ-P items. Fair and statistically significant (P < 0.01) correlations were found between the FIQ-P items and two other questionnaires, SF-36 (r = -0.57) and BDI (r = 0.53). We concluded that the FIQ-P is a valid and reliable instrument for measuring health status of Persian-speaking FM patients.

Decision-making for vaginal delivery in the North of Iran: A focused ethnography.

BACKGROUND: Many factors have been mentioned to influence decision-making for different kinds of delivery. Decision-making for vaginal delivery is under the influence of culture, perceptions, beliefs, values, attitudes, personalities, and knowledge. The current study aims at exploring the determinants of decision-making for vaginal delivery in the north of Iran from women's perspective. MATERIALS AND METHODS: A focused ethnographic method with purposeful sampling method has been used. Semi-structured interviews and observation were conducted with 12 pregnant women and 10 delivered women, 7 midwives, 7 gynecologists, and 9 non-pregnant women in Tonekabon clinics. Interviews and observations were recorded and transcribed. The accuracy of the extracted codes and themes was confirmed by restoration of the arranged and coded texts to the participants (member check) and by an expert person from outside the study context. Data were analyzed using thematic analysis and MAXqda software. RESULTS: Five themes were extracted from the data: Economic influencing factors, Cultural values and norms related to normal childbirth, Positive attitudes towards vaginal delivery, Role of important others, and Facilitators of natural birth. Several sub-themes and sub-sub themes also emerged from the data (e.g. safe delivery, forming maternal feelings, painful but tolerable, maternal role facilitator, inexpensive delivery, a process with good outcome and less complications, relief messenger). CONCLUSIONS: Giving enough information about vaginal delivery for pregnant women and their family members, training pregnant women to increase tolerance during labor pain, and modifying expenses can increase economic affordability, positive cultural norms and attitudes about vaginal delivery, proper social support, use of normal delivery facilitators, and direct them toward vaginal delivery.

Reproductive factors associated to human papillomavirus infection in Iranian woman.

OBJECTIVE: In recent years, humman papilomaviruses (HPV) infection is the most common type of sexual trasmitted diseases (STD) in majority of countries. It's a significant source of morbidity and mortality worldwide. In this study, we aimed to compare the history of reproductive disease between two groups of Iranian women with and without HPV infection through colposcopy precedure. MATERIALS AND METHODS: This case -control study included 210 women reffered to a training gynecology hospital of Tehran University of Medical Science in Tehran. Case group was composed of 70 women with diagnosis of HPV infection, while control group was composed of 140 women with no sign of mentioned-infectious diseases of the control group. Reproductive history was prepared using the standard questionnaire, and obtianed data were analized by SPSS 20. RESULTS: OUR FINDINGS SHOWED THAT THE RISK FACTORS FOR HPV INFECTION WERE AS FOLLOWS: low parity (p = 0.000), reduction of number of weekly sexual intercourse (p = 0.000), no consumption of oral contraceptive pill (OCP) (p = 0.006), and history of withdrawal contraceptive method (p = 0.001). CONCLUSION: Improvement of our knowledge about reproductive factors associated with HPV may help us to identify women at risk and to develope different methods of preventive interventions.

Psychometric properties of the Farsi version of modified Multidimensional Sexual Self-concept Questionnaire.

BACKGROUND: The awareness regarding the contribution of sexual self-concept to healthy sexual well-being is on a rise. The Multidimensional Sexual Self-concept Questionnaire (MSSCQ) was developed to assess the 20 aspects related to sexual self-concept and has been widely applied in Western societies. The adequacy of its application in Iran has not been determined in order to guaranty its reliability and validity. An attempt was made here to interpret this questionnaire in Farsi and adopt it in Iran with respect to psychometric properties of the native youth. MATERIALS AND METHODS: A cross-sectional design was employed and 352 couples were recruited from a premarital consulting center in Isfahan, Iran on a random basis. The MSSCQ was translated into Farsi and back-translated by four bilingual scholars. Face and content validity of the questionnaire was determined. Internal consistency was evaluated by applying Cronbach's alpha. Pearson correlation coefficient was employed. The adopted model was tested through confirmatory factor analysis using SPSS-AMOS software (version 16). RESULTS: The mean age of couples was 25.68 years (women 23.92 ± 2.92 years and men 27.44 ± 3.14 years). The obtained Cronbach's alpha was 0.88. Twenty-two items with an impact score below 1.5 and content validity index <0.70 were omitted. Pearson correlation showed positive and negative correlations among the dimensions. Sexual anxiety, fear of sex, and sexual depression had negative correlation with the other dimensions (r = -0.36, r = -0.43, r = -0.32, respectively). The model exhibited adequate fitness: χ(2)/df = 4.95, goodness-of-fit index = 0.95, adjusted goodness-of-fit index = 0.91, normed fit index = 0.94, comparative fit index = 0.95, and root mean square error of approximation = 0.07. CONCLUSION: The Farsi version of MSSCQ with 78 items is valuable and reliable to be applied on the youth in Isfahan. This questionnaire was verified under two main categories through confirmatory factor analysis: negative sexual self-concept and positive sexual self-concept.

Episiotomy pain relief: Use of Lavender oil essence in primiparous Iranian women.

INTRODUCTION: Post-episiotomy discomfort and its consequences can affect maternal quality of life and mental health as well as the mother and baby relationship. Complementary medicine is increasingly used and Lavender oil is frequently prescribed due to its antiseptic and healing properties. METHOD: This clinical trial involved 60 qualified primiparous women admitted for labor in Kamali Hospital in Karaj, Iran. They were randomly categorized into two groups: case (using Lavender oil) and control (usual hospital protocol). Participants pain and discomfort were recorded using a Visual Analogue Scale (VAS) and a Redness, Edema, Ecchymosis, Discharge Scale (REEDA). Pain was evaluated at 4 h, 12 h and 5 days following episiotomy. Collected data was analyzed in SPSS 14 using an independent t-test and chi-square. RESULTS: There was a statistical difference in pain intensity scores between the 2 groups after 4 h (p = 0.002, and 5 days (p = 0.000) after episiotomy. However, differences in pain intensity between the two groups, at 12 h post-surgery, were not significant (p = 0.066). The REEDA score was significantly lower in the experimental group (Lavender oil group) 5 days after episiotomy (p = 0.000). CONCLUSION: According to these findings, use of Lavender oil essence can be effective in reducing perineal discomfort following episiotomy. It is suggested that Lavender oil essence may be preferably to the use of Betadine for episiotomy wound care.