Changes in screening, diagnosis, management, and outcomes of gestational diabetes during the COVID-19 pandemic: A systematic review.

Background: Gestational diabetes mellitus (GDM) is the most common medical complication of pregnancy, and it can lead to complications for the mother and the infant/fetus. This was especially evident during the COVID-19 pandemic. Therefore, the present systematic review aimed to describe the changes in screening, diagnosis, management, and outcomes of gestational diabetes during the COVID-19 pandemic. Methods: The systematic review was conducted from December 2019 until January 1, 2022. To find articles related to the purpose of the study, PubMed, Scopus, Web of Science, and WHO were searched using relevant and validated keywords using MeSH/Emtree. Results: In total, 675 entries were ascertained from the database inquiry, and 17 scholarly works were deemed suitable for inclusion in the final review. The salient conclusions derived from this review were as follows: (a) During the COVID-19 pandemic, there was a significant decrease in the use of OGTTs and a rise in the use of HbA1c assays for both GDM screening and diagnosing. (b) A predominant number of physicians incorporated some variation of telemedicine to remotely supervise and conduct follow-up evaluations of patients with GDM. Various strategies are presented for the provision of prenatal care to women afflicted with GDM, such as concentrating on high-risk demographics, the initiation of lifestyle modifications at early stages, and the implementation of remote patient monitoring techniques. The 'single test procedure' is identified as the most suitable for the preliminary screening of GDM. The OGTT should be assigned clinical precedence in patients at high risk during the ongoing COVID-19 pandemic. Additionally, Medical Nutrition Therapy (MNT) was established as the primary management strategy, and the most influential determinant of the transition from dietary adjustments to pharmacotherapy was the Fasting Blood Glucose (FBG) levels during the second trimester. Conclusion: Suggested strategies for GDM screening and management during the pandemic integrated into routine antenatal care, emphasized the importance of remote diabetes education and technology utilization during health emergencies.

A qualitative study on the health system-related needs in women survivors of rape.

BACKGROUND: Rape, as an adverse incidence, leads to irreparable complications and consequences in women. Provision of health services to women survivors of rape requires catering for their real needs and identifying current deficits as well as barriers. The present study aimed to explore health system-related needs in women survivors of rape. METHODS: In the present qualitative study, the participants consisted of 39 individuals, including 19 women survivors of rape and 20 individuals with work experience in providing services to women survivors of rape. The participants were selected using the purposive sampling method with a maximum variation in Isfahan, Iran. Data were collected through in-depth interviews as well as field notes and were concurrently analyzed via conventional qualitative content analysis method. RESULTS: After analyzing the interviews, the health system-related needs of women survivors of rape were classified into two main categories: 1- The need for efficient medical care services with three sub-categories, namely "receiving services with respect for privacy and confidentiality", "non-judgmental behavior and approach", and "the need to receive empathy and the feeling of not being alone", and 2- The need for desirable conditions and structure to provide services with two sub-categories, namely "the need to receive comprehensive and integrated services", and "establishing specialized centers for providing services to survivors". CONCLUSIONS: Overall, explaining and highlighting the health system-related needs of women survivors of rape could provide a suitable basis for policy-making and planning according to their real needs. Receiving continuous services in separate centers with confidentiality and empathy could reduce the worries and concerns of women survivors of rape and help improve their health.

A qualitative exploration of the psychological needs of women survivors of rape in Iran.

BACKGROUND: Rape is one of the principal forms of sexual violence leading to numerous psychological consequences for women. Providing effective psychological services to women survivors of rape requires identifying and considering their real needs. This study aimed to explore the psychological needs of women survivors of rape. METHODS: In this exploratory-descriptive qualitative study, the participants consisted of 19 women survivors of rape and 20 people with experience in providing services to survivors of rape, selected via purposive sampling method in Isfahan, Iran. In-depth individual semi-structured interviews and field notes were used to collect data, which were then analyzed using the conventional content analysis method. RESULTS: Based on the analysis of the interviews, the psychological needs of women survivors of rape were classified into three main categories: facing psychological problems, attention to emotional reactions, and the need to accept and adapt to reality. CONCLUSIONS: The results revealed that women survivors of rape have different psychological needs. Thus, to meet these needs, supportive and psychological interventions can be considered at both individual and environmental levels. Also, eliminating gender stereotypes affecting the occurrence of rape in the dimensions of Iranian culture can lead to the liberation of the society from the culture of rape.

Development and psychometric evaluation of the need assessment tool for women survivors of rape: Protocol for a mixed methods study.

BACKGROUND: Rape can lead to various physical and psychological consequences. Thus, survivors should receive immediate interventions and need-based care. The present study aims to design and psychometric evaluation of needs in women survivors of rape. MATERIALS AND METHODS: This mixed methods study is conducted using a sequential exploratory approach. In the first phase, the participants (women survivors of rape and healthcare providers) are selected through purposive sampling in Isfahan. Data are collected through in-depth semi-structured interviews and field notes and are analyzed using conventional qualitative content analysis. The draft of the questionnaire is prepared based on the findings of the qualitative phase and literature review. Then, the face validity, content validity, and reliability of the questionnaire are assessed. Construct validity is assessed using the exploratory factor analysis through a descriptive cross-sectional study on women survivors of rape in the quantitative phase. Using a convenience sampling method, the data are collected in the research environment and analyzed via descriptive and inferential statistical methods. Cronbach's alpha coefficient is used to assess the internal correlation of the questionnaire. CONCLUSION: The valid and reliable questionnaire that is developed in this study can be used by planners to provide services and care according to the needs of women survivors of rape.

Gender bias in antidepressant direct-to-consumer pharmaceutical advertising.

BACKGROUND: Direct to consumer pharmaceutical advertising (DTCPA) may have significant impacts on public perception of diseases and treatments. Our objective was to examine whether DTCPA for antidepressants disproportionately portray and hence target women in the United States. METHODS: DTCPA for branded medications for depression, psoriasis and diabetes were analyzed to determine the gender of the main "patient" portrayed, as well as the content of the disease depiction. RESULTS: DTCPA for antidepressants included only women in 82% of ads, only men in 10.1% of ads, and both genders in 7.8% of ads. There were significantly higher representations of women versus men in DTCPA for antidepressants (82%) compared to either psoriasis (50.4%) or diabetes (37.6%) medications. These differences remained statistically significant even after adjusting for gender disparities in disease prevalence. CONCLUSIONS: Antidepressant DTCPA in the United States disproportionately target women. There are potential adverse consequences for both women and men resulting from unequal representations in DTCPA for antidepressant medications.

The sociological basis of the skin cancer epidemic.

Given the precipitous rise in its incidence in recent decades, skin cancer has been recognized as a growing epidemic. We explore the sociological underpinnings of this epidemic, including: (1) aging of the demographic; (2) human ecologic factors (residing in areas with high ambient ultraviolet levels and a depleted ozone layer); (3) large-scale European migration to more equatorial latitudes; (4) social structures that for centuries minimized miscegenation and maximized segregation; (5) gender-based differences in sunbathing, tanning, sunscreen use, and clothing choice; (6) occupational ultraviolet exposure; (7) the complex interplay of socioeconomic status, race, and urbanization on skin cancer incidence and mortality; (8) the effects of war on skin cancer incidence; (9) cultural shifts in clothing, travel, outdoor sports, recreation, and attitudes towards being tan; and (10) the indirect effects of religion. We show that without these sociological factors, the most common type of cancer would not be nearly as common.

The Needs of Women Survivors of Rape: A Narrative Review.

Background: Rape is a serious global problem linked to long-term physical health complications in women. Women survivors of rape have different needs, the identification of which ensures optimal services and improves their health conditions. This study aimed to explore the needs of women survivors of rape through a narrative review. Materials and Methods: This review was conducted by searching databases of ISI Web of Science, Scopus, Science Direct, Cochrane, PubMed, Scientific Information Database (SID), the Iranian Magazine Database (Magiran), Iranian Research Institute for Information Science and Technology (IranDoc), Iranian Medical Articles Database (IranMedex), and the Google Scholar engine. All English and Persian articles published from January 2000 to August 2022 were searched using the keywords rape, sexual assault, sexual violence, victim, survivor, demands, and needs. Two independent researchers conducted all steps of article extraction and review to avoid possible bias, and a third person reviewed the articles in the case of disagreement between the two researchers. The final related articles were selected and evaluated using a pre-prepared checklist. Results: Out of 112 articles, 26 articles were selected for final evaluation. The needs of women survivors of rape were divided into six categories, including sociocultural, educational, legal and judicial, psychological, spiritual and religious, and healthcare. Conclusions: Women survivors of rape need survivor-centered, culturally appropriate services, necessitating careful planning and policymaking to address health and judicial issues from different dimensions considering their real-world needs.

Prenatal and clinical characteristics of pregnant women infected with COVID-19 in Yazd, Iran: A multicenter cross-sectional study.

Background: Coronavirus infection has caused widespread concern among mothers and physicians about the health of pregnant women and infants. Objective: The aim of this study was to evaluate the clinical and prenatal findings of pregnant women with coronavirus disease-2019 (COVID-19) virus. Materials and Methods: The present study was a descriptive study that was conducted in 6 mother and child care centers. In this study, 81 pregnant women with COVID-19 admitted to centers in the period from March 2020-September 2020 were studied. Clinical and prenatal findings of the pregnant mothers were recorded using a data collection form with details of demographic characteristics and these were analyzed. Results: The gestational age of the affected women was between 4 and 40 wk. 48 deliveries were performed and 25% of deliveries were preterm. Coronavirus infection was the cause of termination of pregnancy in 4 cases. The most common symptoms of women when visiting the medical centers were: dry cough (58.0%), muscle pain and myalgia (56.8%) and fever (51.9%). The most common laboratory findings in the women were: increased C-reactive protein (67.90%), lymphopenia (18.51%), decreased white blood cells (27.16%), and increased liver enzymes (18.51%). Regarding the status of the newborns, out of the 33 neonates examined, 3 neonates were diagnosed with COVID-19. Conclusion: The most common symptoms of pregnant women with COVID-19 are similar to those of other adults. In relation to neonatal infection, given that a number of the neonates tested positive, there appears to be evidence of vertical transmission, which requires further investigation.

The relationship between sexual function and emotional intelligence and its components based on fertility status in women referring to health centers in Yazd.

BACKGROUND: Sexual function is affected by many psychological factors and emotions. The impact of emotion management varies in different fertility situationsThis can affect women's sexual function. Therefore, the aim of this study was to investigate the relationship between sexual function and emotional intelligence and its components based on fertility status in women referring to health centers in Yazd. MATERIALS AND METHODS: The present study is a correlational study that was performed on 165 women with inclusion criteria and referred to 4 selected health centers in Yazd in 2017. The study tools include demographic questionnaire, Female Sexual Function Index sexual function, and Bar-On emotional intelligence. The fertility status of women in the present study included a history of infertility, number of children, and history of abortion. The analysis was performed using descriptive statistical methods and analytical tests with SPSS software version 18. RESULTS: The mean score of all components of emotional intelligence except the components of self-expression, independence, and emotional self-awareness and also the total score of emotional intelligence infertile people was significantly higher than infertile people (P < 0.05). Regarding the relationship between emotional intelligence and sexual function in terms of fertility variables, a significant correlation was observed between the mean scores of all components of emotional intelligence except interpersonal relationships, flexibility, responsibility, empathy, and self-expression with sexual performance score in fertile individuals.(P = 0.000). Conclusion: As a result, it is suggested that the institutions in charge of women's affairs try to increase emotional intelligence and improve women's sexual function by holding workshops and classes for women, especially in women with infertility, childlessness, and history of abortion.

Evaluation of the effect of narrative writing on the stress sources of the fathers of preterm neonates admitted to the NICU.

OBJECTIVE: Identification of the nurses and fathers' understanding of the stress sources facilitates nursing interventions and increases parental satisfaction. MATERIALS AND METHODS: The quasi experimental study with pretest and posttest was administered to a sample size of 70 fathers with preterm neonates hospitalized in the NICUs of Gorgan University of Medical Sciences in 6 months. The Parental Stressor Scale (PSS) was used. The data were analyzed using descriptive and analytical statistical methods. RESULTS: Evaluation of the differences in the domains showed that narrative writing had significant effects on all three domains. The results showed that the highest stress reduction was observed in parents' relationship followed by infant behavior and appearance while the lowest stress reduction was observed in the sights and sounds in the intervention group. CONCLUSION: Narrative writing may be considered an efficient supportive intervention to reduce the fathers' stress, infant behavior and appearance in the NICUs.

Clinical error management training for midwifery students in Shahid Sadoughi University of Medical Sciences, Yazd.

INTRODUCTION: Today, the quality of health services is considered to be providing "error-free" services, at the right time, by the right person and with the least resources. In recent years, education through evidence-based care has been emphasized by health system policymakers as a way to improve care standards. Therefore, the purpose of this study is to teach clinical error management to midwifery students in Shahid Sadoughi University of Medical Sciences in Yazd. METHODS: The present study was performed using consensus-based methods based on Delphi technique to identify the most common errors and the best educational solution for its management with the participation of 21 midwives by purposive sampling method in Shahid Sadoughi University of Medical Sciences in Yazd in 2018. The rate of agreement was 75% or more. Descriptive statistical methods and SPSS-18 software were used for analysis. RESULTS: The most important errors mentioned were as follows: In the field of hospital care, it was the scope of care during labor and in clinical care, it was the scope of prenatal care. The most important error reduction strategies that were considered in the clinical guide in general were emphasizing the following: active supervision of instructors during the provision of students' clinical services, paying attention to the evaluation of service provision with the least incidence of errors in end-of-course evaluation, make changes in clinical teaching methods, attention to the use of active teaching methods and the use of educational software. The cases were considered separately in each of the mentioned errors. DISCUSSION AND CONCLUSION: Incidence of errors in pregnancy and childbirth as the most errors of midwifery students in the field of hospital and clinical care was agreed on. Therefore, considering this issue and the importance of preventing errors to provide quality services to mothers and infants, it seems that it is time to make changes in clinical education in this field by emphasizing the use of active educational methods.

The effect of narrative writing on fathers' stress in neonatal intensive care settings.

Objective: This study was conducted to examine the effect of narrative writing on fathers' stress in the Neonatal Intensive Care Units (NICUs) during infants' hospitalization.Methods: A quasi-experimental study was conducted among two groups of fathers with preterm infants in the NICUs of two teaching hospitals of Gorgan University of Medical Sciences. Pre- and post-tests were administered to a sample size of 70 during 6 months. The Parental Stressor Scale (PSS) was used. The data were analyzed using descriptive and analytical statistical methods.Results: The mean total stress score was 74.05 ± 17.39 in the control and 80.11 ± 15.82 in the intervention group on the 3rd day, suggesting no significant difference. In other words, both groups had a similar stress level before the intervention (p-value = .13, t = 1.52). However, the mean total stress score was 85.45 ± 16.91 in the control group and 48.00 ± 10.49 in the intervention group on the 10th day, suggesting a significant reduction in the stress level in the intervention group following the intervention (p-value = .001, t = -11.01).Conclusion: According to the findings, the narrative writing may be considered as an efficient supportive intervention to reduce the fathers' stress in the NICUs. However, more research is needed to justify its implementation.

Investigating the effect of health literacy level on improving the quality of care during pregnancy in pregnant women covered by health centers.

BACKGROUND: Health literacy is the capacity to acquire, process, and understand basic information and services necessary for appropriate health decisions. Given the importance of health literacy in women, the aim of the present study was to determine the effect of health literacy level on improving the quality of care during pregnancy in pregnant women. MATERIALS AND METHODS: The present study was a cross-sectional analytical study. In this study, 130 women referred to Yazd health centers were examined. Health literacy questionnaires and a researcher-made checklist of the quality of pregnancy care were used to gather information. The researcher-made checklist of the quality of pregnancy care was in accordance with the standard protocol of the Ministry of Health and Medical Education, entitled Integrated Health Care for Pregnant Mothers, which was validated and reliable. SPSS statistical software version 19 and t-test and ANOVA statistical tests were used to analyze the data. RESULTS: According to the findings, the average score of health literacy in pregnant women was 74.09, which showed that the level of health literacy was in the marginal or border range. People with higher health literacy received significantly more prenatal counseling than other women and had a planned pregnancy (P = 0.04). CONCLUSION: The level of health literacy in pregnant women is unfavorable. Given that the high level of health literacy in women in society can lead to an increase in the quality of pregnancy care, so to increase health literacy in women, it is recommended that regular training in society by health-care providers be given more attention.

Evaluation of the relationship between emotional intelligence and sexual function of reproductive age women.

BACKGROUND: Desirable sexual function is one of the symptoms of mental and physical health. Many causes can cause sexual dysfunction. Emotional problems in marriage are one of the main causes of sexual dysfunction. The purpose of this study was to investigate the relationship between emotional intelligence and its components with sexual function of women of reproductive age. MATERIALS AND METHODS: The present study was a co-relational-analytic study that was performed on 165 women of childbearing age in the second half of 2018 in selected health centers. Data were collected using a three-part questionnaire including demographic questionnaire, FFI standardized sexual function questionnaire, and Bar-On Emotional Intelligence Questionnaire. Data were analyzed using descriptive statistics, Spearman, and Pearson correlation. RESULTS: Most of the study participants were in the age group of 26-30 years (30.4%). The results showed a positive correlation and a statistically significant relationship between the mean score of all the components of emotional intelligence except the interpersonal relationships, responsibility, empathy, and self-esteem with sexual performance score (P < 0.05). CONCLUSIONS: Based on the positive correlation between some components of emotional intelligence and sexual function, emotional intelligence can be considered as an important and effective variable in improving women's sexual function, so focus on emotional intelligence in counseling and education Individuals and emphasis on promotion are recommended.

Comparison of the effect of narrative writing and art therapy on maternal stress in neonatal intensive care settings.

Objective: This study was conducted to examine the effect of narrative writing and art therapy on maternal stress in the neonatal intensive care units (NICUs) during infants' hospitalization.Material and Methods: randomized controlled clinical trial with three parallel arms study was conducted among three groups of mothers with preterm infants in the NICUs of two teaching hospitals of Shahroud University of Medical Sciences. Pre- and post-tests were administered to a sample size of 105 during 9 months. The parental stressor scale (PSS) was used. The data were analyzed using descriptive and analytical statistical methods.Results: The mean maternal stress score was 54.94, 47.08, and 47.57 in the art therapy, narrative writing, and control before the intervention respectively, indicating no significant difference between the groups (p = .28). There was also no significant difference in the mean score of stress between the groups after the intervention (p = .92). Also, we found no significant difference in the mean score of parental role and parents' relationship and sights and sounds between the three groups on the second day (p = .22 and p = .12, respectively) but there was a significant difference in the mean score of infant behavior and appearance between the three groups (p = .05). There was no significant difference in parental role and parents' relationship (p = .31), infant behavior and appearance (p = .58), and sights and sounds (p = .67) between the three groups on the sixth day of intervention.Conclusions: Narrative writing and art therapy are only effective on the subscale of infant behavior and appearance in the PSS: NICU.

Evidence-based Draft Guideline for Prevention of Midwifery Malpractices based on Referred Cases to the Forensic Medicine Commission and the Medical Council from 2006-2011.

BACKGROUND: Medical errors are the main concerns in health systems, which considering their ascending rate in the recent years, especially in the field of midwifery, have caused a medical crisis. Considering the importance of evidence-based health services as a way to improve health systems, the aim of this study was to suggest a guideline for preventing malpractice in midwifery services. MATERIALS AND METHODS: In this cross-sectional study that was conducted in 2013, we investigated 206 cases that were referred to the Isfahan Legal Medicine Organization and Medical Council of Forensic Medicine from 2006-2011. Data were collected by a checklist and were analyzed using SPSS-16 software. Descriptive statistical tests (mean, maximum, minimum, standard deviation, frequency, and percentage agreement) were used to describe the data. Then, we used the Delphi technique with the participation from 17 experts in midwifery, gynecology, and legal medicine to provide an evidence-based draft guideline for prevention of midwifery errors. RESULTS: A total of 206 cases were reviewed. In 66 cases (32%) the verdict for malpractice in midwifery services was approved. A practical draft guideline for preventing clinical errors for midwifery in the fields of pregnancy, delivery, and postpartum period was developed. CONCLUSIONS: This evidence-based draft guideline can improve the attention of all the healthcare providers, especially midwives and physicians to prevent urgent problems and offer effective health services for mothers and infants.

Evaluating different types of malpractices in midwifery that were referred to the forensic medicine commission and the medical council between 2006 and 2011 in Isfahan province, 2013.

BACKGROUND: Medical malpractices in obstetrics are one of the main health concerns since in addition to the mortalities and morbidities caused for the two susceptible groups of mothers and neonates, they may lead to difficulties for the accused gynecologists and midwives in returning to their routine medical career and giving services to the patients. Hence, this study was conducted to evaluate different types of malpractices in midwifery that were referred to the legal medical commission and medical council in Isfahan province. MATERIALS AND METHODS: In this cross-sectional descriptive study, we evaluated the data from all midwifery cases referred to the forensic medicine commission and medical council in Isfahan province between 2006 and 2011, with at least one lawsuit confirmed by the jury. RESULTS: The results showed that in a total of 206 investigated cases at the medical council and forensic medicine commission in Isfahan, 66 cases of medical error sentences including 38 cases in medical council and 28 cases in forensic medicine commission were proved, which revealed 32% of malpractice in midwifery services in 2006-2011 in Isfahan. Negligence (39.2%), imprudence (23.5%), and disobedience of governmental regulations (19.6%) stood among the most commonly reported malpractices. Our findings also suggest that the most common malpractices happened in the postpartum period with a frequency of 44.7%; in addition, governmental hospitals were shown to have the most frequent malpractices with a frequency of 50%. CONCLUSIONS: Our results reveal that malpractices in midwifery services during and after delivery are so common, leading to irreversible complications to the mothers' and neonates' health in the society. On the other hand, considering the fact that most of these malpractices are preventable, related education, pertinent plans, and proper supervision sys.