Effectiveness of online sexual education based on the extended PLISSIT model on sexual function and sexual satisfaction in women undergoing breast cancer treatment.

BACKGROUND: Despite therapeutic interventions having increased the survival rate of women with breast cancer, sexual dysfunction occurs in cancer survivors due to treatment. The aim of this study is to determine the effect of online sexual education, based on the Ex-PLISSIT model on sexual function and satisfaction, on women undergoing breast cancer treatment. MATERIALS AND METHODS: The present study was a quasi-experimental and interventional control study. It was conducted with a pretest-posttest design between April and July 2022 in Isfahan, Iran. The participants were divided into an intervention (n = 40) and a control group (n = 40). The intervention group received sexual education based on the Ex-PLISSIT model that consisted of four levels of intervention, namely, permission (P), limited information (LI), specific suggestions (SS), and intensive therapy (IT), presented in four sessions. The Female Sexual Function Index (FSFI) and Larson's Sexual Satisfaction Questionnaire were used to measure the sexual function and sexual satisfaction of the participants. Data were analyzed using the Statistical Package for the Social Sciences (SPSS) version 21. P values below 0.05 were considered statistically significant. RESULTS: The results showed that the mean of sexual satisfaction and function scores in the intervention group significantly increased after intervention. Moreover, the results showed a statistically significant difference in the mean of sexual satisfaction scores between the intervention and control groups after intervention (P = 0.020). Although there was a difference between the mean of sexual function scores in the intervention and control groups after the intervention, the t-test showed no statistically significant difference (P = 0.176). CONCLUSIONS: According to the results of the study, sexual education based on the Ex-PLISSIT model could effectively enhance sexual satisfaction of women undergoing breast cancer treatment. It seems that this model can help health care providers evaluate the sexual needs of the patients and provide appropriate suggestions in order to decrease sexual problems.

Psychological Experiences in Women with Polycystic Ovary Syndrome: A Qualitative Study.

Background: Polycystic Ovary Syndrome (PCOS) is the most common endocrine disorder among women of reproductive years. In addition to multiple physical problems, this syndrome has many psychological complications. Thus, the present study attempted to explore the psychological experiences of women with PCOS in Iran's sociocultural context. Materials and Methods: The study was carried out in Isfahan, Iran, using a qualitative content analysis method. The participants were selected through purposive sampling from women with PCOS, their spouses, and healthcare providers in hospitals, clinics, workplaces, universities, and physicians' offices between September 2018 and November 2019. Data collection was performed through semi-structured interviews until data saturation. Data analysis was based on conventional content analysis. The interviews were transcribed and coded. Afterward, categories and concepts were extracted by grouping similar codes. Results: A total of 13 women with PCOS, four spouses, and 13 healthcare providers participated in this study. Data analysis yielded five main categories, including the patient's psychological reactions following infertility and its probability, psychological issues following menstrual disorders, patients' fear and concerns about the probability of developing chronic diseases, psychological problems following the disease, and psychological problems resulting from body appearance. Conclusions: The results of this study showed that women with PCOS were exposed to multiple psychological problems. Therefore, preventing and controlling the psychological consequences of PCOS and its complications requires healthcare providers' support and comprehensive and long-term planning to promote the mental health of these women.

Cardiovascular surgical experiences of IVC tumor and thrombus: Operative strategies Based on 51 consecutive patients.

BACKGROUND: The only beneficial treatment option for the management of inferior vena cava (IVC) tumor thrombus is complete tumor removal. The aim of this study was to report our experience in surgical and clinical outcomes in patients with tumor thrombosis in IVC. METHODS: A retrospective chart review of patients who underwent surgical resection of IVC tumor at our institution over the past 10 years was performed. The patients were identified using a prospectively maintained database. RESULTS: We identified 51 patients, the mean age was 53.4 ± 16.8 years, and 25.4% were female. They were divided into three groups based on tumor thrombosis level. Twenty patients (39.2%) required sternotomy, and cardiopulmonary bypass (CPB) was used in 19 (37.2%) patients, and 2 (3.9%) cases underwent coronary artery bypass graft. The perioperative complications were severe bleeding (3 patients), pulmonary embolism (2 patients), and duodenal perforation (1 patient). Three (5.8%) in-hospital deaths occurred, and all were due to severe abdominal bleeding. After a mean follow-up time of 46.5 ± 42.0 months, 29 (56.9%) patients were alive. The mean survival time was 75.2 ± 8.4 months. In multivariate analysis, higher age (p = 0.033) and male gender (p = 0.033) proved to be independent prognostic factors. CONCLUSIONS: Tumor thrombus extending to the IVC is a rare and challenging event. Although using CPB may be safe and result in long-term survival with acceptable function, excessive bleeding during surgery may limit the use of this method.

Sonification as a reliable alternative to conventional visual surgical navigation.

Despite the undeniable advantages of image-guided surgical assistance systems in terms of accuracy, such systems have not yet fully met surgeons' needs or expectations regarding usability, time efficiency, and their integration into the surgical workflow. On the other hand, perceptual studies have shown that presenting independent but causally correlated information via multimodal feedback involving different sensory modalities can improve task performance. This article investigates an alternative method for computer-assisted surgical navigation, introduces a novel four-DOF sonification methodology for navigated pedicle screw placement, and discusses advanced solutions based on multisensory feedback. The proposed method comprises a novel four-DOF sonification solution for alignment tasks in four degrees of freedom based on frequency modulation synthesis. We compared the resulting accuracy and execution time of the proposed sonification method with visual navigation, which is currently considered the state of the art. We conducted a phantom study in which 17 surgeons executed the pedicle screw placement task in the lumbar spine, guided by either the proposed sonification-based or the traditional visual navigation method. The results demonstrated that the proposed method is as accurate as the state of the art while decreasing the surgeon's need to focus on visual navigation displays instead of the natural focus on surgical tools and targeted anatomy during task execution.

Successful Pregnancy after a Heart Transplant in Iran: A Case Report.

Pregnancy after a heart transplant is a concern for many female recipients, and it remains a medical challenge that raises many questions. A 24-year-old woman, gravida 3, para 0, contacted us for obstetric care in the first trimester of gestation, about 3 years after an orthotopic cardiac transplant. She was a known case of dextrocardia with congenitally corrected transposition of the great arteries. The transplant had been performed for severe retractable heart failure, manifesting during her previous lost pregnancy. The course of the current gestation was uneventful. The patient's cardiovascular function was good throughout the pregnancy. She was admitted to the hospital for dyspnea at 35 weeks and 4 days of gestational age. A cardiovascular consult and echocardiography were performed. The results were within the normal range, and labor pains explained the patient's dyspnea. Because of labor pain, a repeat Cesarean section was performed at 35 weeks and 4 days of gestational age. A male baby weighing 2700 g, with an Apgar score of 7/9, was delivered. The patient was discharged after delivery with enoxaparin (40 mg), prednisolone (5 mg), levothyroxine, and mycophenolate mofetil (500 mg) without any complications. Follow-up was carried out at 1 month, and no abnormality was found. Here, we report a case of a successful pregnancy in a young woman after a heart transplant.

A silence full of words: sociocultural beliefs behind the sexual health of Iranian women undergoing breast cancer treatment, a qualitative study.

PURPOSE: Therapeutic interventions lead to impaired sexual health in women undergoing breast cancer treatment. There are some problem such as vaginal dryness, decreased libido, decreased sexual satisfaction, and decreased frequency of sexual intercourse among breast cancer survivors. This study was conducted to discover the sexual experiences of women undergoing breast cancer treatment. METHODS: A total of 39 semi-structured interviews were held with the women undergoing breast cancer treatment, husbands, and health care providers. Recorded interviews were transcribed and analyzed using qualitative content analysis. RESULTS: Three categories of cultural and gender taboos, adherence to subjective norms, and hidden values in sexuality were revealed. The cultural and gender taboos category consisted of subcategories of learned sexual shame, fear of judgment, sexual schemas, and gender stereotypes. The adherence to subjective norms category consisted of subcategories of sexual socialization, being labeled as a disabled woman and the priority of being alive to sexuality. The hidden values in sexuality category consist of subcategories of Task-based sexuality, Tamkin, and Sexuality prevents infidelity. CONCLUSIONS: Socio-cultural beliefs affect the sexual health of women undergoing breast cancer treatment, so paying attention to this issue can improve the quality of sexual health services.

Effect of using 5A's model for lifestyle counseling on psychological symptoms in women with polycystic ovary syndrome: a randomized field trial.

Lifestyle modification in women with polycystic ovary syndrome (PCOS) could be associated with increased psychological symptoms. This study aimed to evaluate the effect of lifestyle modification counseling using 5A's model on the psychological symptoms of women with PCOS. This double-blind, randomized field trial was performed on 70 women with PCOS in two groups of lifestyle modification counseling based on 5A's model and counseling without using the model. The intervention was performed based on five stages of the 5A's model (Assess, Advise, Agree, Assist, Arrange) during a week, and psychological symptoms were assessed using Symptom Checklist-90-R before the intervention and one and three months after the intervention. The results showed that one and three months after the intervention, the level of psychological symptoms, except obsessive-compulsive level, were significantly lower in the intervention group than in the control group (p < 0.05). Moreover, the level of these symptoms decreased over time in the intervention group (p < 0.0001). Using the 5A's model in lifestyle modification counseling is associated with the promotion of psychological health in women with PCOS, and this model is recommended for lifestyle counseling in women with polycystic ovary syndrome.

ColibriDoc: An Eye-in-Hand Autonomous Trocar Docking System.

Retinal surgery is a complex medical procedure that requires exceptional expertise and dexterity. For this purpose, several robotic platforms are currently under development to enable or improve the outcome of microsurgical tasks. Since the control of such robots is often designed for navigation inside the eye in proximity to the retina, successful trocar docking and insertion of the instrument into the eye represents an additional cognitive effort, and is therefore one of the open challenges in robotic retinal surgery. For this purpose, we present a platform for autonomous trocar docking that combines computer vision and a robotic setup. Inspired by the Cuban Colibri (hummingbird) aligning its beak to a flower using only vision, we mount a camera onto the endeffector of a robotic system. By estimating the position and pose of the trocar, the robot is able to autonomously align and navigate the instrument towards the Trocar Entry Point (TEP) and finally perform the insertion. Our experiments show that the proposed method is able to accurately estimate the position and pose of the trocar and achieve repeatable autonomous docking. The aim of this work is to reduce the complexity of the robotic setup prior to the surgical task and therefore, increase the intuitiveness of the system integration into clinical workflow.

Sexual health promotion interventional program for women undergoing breast cancer treatment: Protocol for a mix-methods study.

BACKGROUND: Women undergoing breast cancer treatment, especially those of reproductive age, experience sexual health challenges. The aim of this study is to design an interventional program for promoting the sexual health of women undergoing breast cancer treatment. MATERIALS AND METHODS: This is a mixed qualitative-quantitative exploratory study consisting of four phases. In the first phase, the needs and strategies for promoting sexual health of Iranian women with breast cancer in Isfahan city will be identified through a qualitative study. The patients will be selected using purposive sampling method and the data will be collected through semi-structured interviews. In the second phase of the study, the relevant literature will be reviewed. In the third phase, the initial version of the program will be designed based on the results of qualitative study and review of literature, the appropriate strategies are prioritized by the members of the panel of experts, and then, the final interventional program is prepared. In the fourth phase, the designed interventional program will be conducted as a quasi-experimental study in two groups of intervention and control and the effectiveness of the program on sexual quality of life, sexual satisfaction, and sexual function of women undergoing breast cancer treatment will be evaluated. The type of the intervention will be selected based on the results of the previous phases and the opinion of the expert panel. CONCLUSIONS: The results of this study are expected to contribute to the design of an interventional program based on the needs of women undergoing breast cancer treatment and promote health and meet the sexual health needs of breast cancer patients.

The Effects of Oxytocin on Craving, Mental Health Parameters, and Stress Hormones in Methamphetamine-Dependent Patients Undergoing Matrix Treatment Model: A Randomized, Double-Blind Clinical Trial.

BACKGROUND: Methamphetamine (METH) dependence is an increasing public health problem with a wide range of mental and physical adverse effects. Recent studies report that oxytocin (OXT) has potential therapeutic properties in drug dependence. Hence, the present study was designed to evaluate the effects of OXT on craving, mental health (depression and anxiety), and stress hormones (ACTH and cortisol) in METH-dependent patients undergoing matrix treatment model (MTM), an intensive outpatient approach for stimulant abuse treatment. METHODS: This randomized placebo-controlled clinical trial was conducted in 42 METH-dependent patients undergoing MTM to receive either intranasal OXT 40 IU (n = 21) or normal saline as placebo (n = 21) for 4 weeks. Clinical and biochemical parameters were measured at baseline and end of trials in METH-dependent patients. RESULTS: Our findings indicated that OXT administration for 4 weeks is associated with a significant improvement in the craving and depression scores, respectively (p < 0.001 and p < 0.001), but there was no significant difference for anxiety scores compared with the placebo group. In addition, OXT administration significantly decreased cortisol (p < 0.001) and ACTH levels (p < 0.002). CONCLUSIONS: These findings suggest that OXT can be considered as a new potential therapeutic for the treatment of METH-dependent patients undergoing MTM. Further studies are required to explore the effectiveness and safety of OXT.

Comparing the effect of two educational interventions on mothers' awareness, attitude, and self-efficacy regarding sexual health care of educable intellectually disabled adolescent girls: a cluster randomized control trial.

BACKGROUND: Sexual problems of intellectually disabled adolescents are associated with their inability to understand sexuality. Given the important role of parents in forming the attitude of their adolescents towards sexuality, the present study aimed to compare the effect of two educational interventions on mothers' awareness, attitude and self-efficacy regarding sexual health care of intellectually disabled adolescent girls. MATERIALS AND METHODS: This cluster randomized control trial was conducted in six intellectually disabled adolescent education centers in Isfahan, Iran in 2018. The centers were randomly assigned to intervention groups (group training and training through booklet) and control group. Mothers of educable intellectually disabled adolescent girls (n = 81) were entered into the three groups using convenience sampling and their awareness, attitude and self-efficacy regarding sexual health care of adolescent girls were assessed using questionnaires before and after the educational intervention. Data were analyzed using descriptive and inferential statistical methods. RESULTS: The mean score of mothers' awareness, attitude and self-efficacy in each of the "group training", "training through booklet group" and "control group" was significantly different after the intervention compared to before the intervention (p < 0.05). The mean score of mothers' awareness and self-efficacy after the intervention in the "group training" was higher than the "control group" and "training through booklet group" (p < 0.001). The mean score of mothers' awareness and self-efficacy after the intervention in the "training through booklet group" was higher than in "control group" (p = 0.005, p = 0.02). Also, after the intervention, the mean score of mothers' attitude in the "group training" was higher than the "control group" and the "training through booklet group" (p < 0.001), but there was no significant statistical difference between the mean score of mothers' attitude in "control group" and "training through booklet group" (p > 0.05). CONCLUSION: Implementation of the group training intervention for mothers of intellectually disabled adolescent girls in comparison with training through booklet was associated with a greater increase in their awareness, attitude and self-efficacy regarding sexual health care of adolescent girls. Therefore, group training is suggested as a suitable way to educate mothers about sexual health care of intellectually disabled adolescent girls. Trial registration IRCT, IRCT20160224026756N5. Registered 22 June 2018, https://en.irct.ir/user/trial/31704/view .

Quantification of aortic valve area: comparison of different methods of echocardiography with 3-D scan of the excised valve.

Accurate determination of severity of aortic valve stenosis (AS) by aortic valve area (AVA) is essential for choosing the best treatment strategy. We compared AVA quantified by 4 different in vivo echocardiographic methods with AVA measured by 3D ex vivo scanning of the excised AV. The data on 38 patients who underwent aortic valve replacement were assessed. The AVA was determined by 4 echocardiographic methods of planimetry in 2D transesophageal echocardiography [planimetry (2D-TEE)], plainemetry by multiplanar reconstruction approach in 3D transesophageal echocardiography [MPR (3D-TEE)], and two continuity equation (CE) approaches; conventional CE (2D-TTE) in which left ventricular outflow tract [LVOT] area derived by LVOT diameter obtained in 2D transthoracic echocardiography and CE (3D-TEE) in which LVOT area obtained by 3D MPR. After the surgical removal of the AV, AVA was determined by 3D ex vivo scanning. Lowest AVA mean difference with 3D ex vivo scanning was found between CE (2D-TTE), followed by CE (3D-TEE). Planimetry (2D-TEE) in male patients as well as severely and non-severely calcified valves revealed a significant higher AVA mean difference with 3D ex vivo scanning than CE (2D-TTE) and CE (3D-TEE) methods. However, with a nonsignificant effect, CE (2D-TTE) and planimetry (2D-TEE) had the least mean difference with 3D ex vivo scanning possibly due to less frequent bicuspid AV in females. CE (2D-TTE) was more accurate than other methods of AVA calculation. Moreover, CE (3D-TEE) and MPR (3D-TEE) methods had acceptable accuracy in comparison with planimetry (2D-TEE) for definition of AS severity.

Iranian Society of Cardiac Surgeons COVID-19 task force version II, restarting elective surgeries.

Given the nature of heart disease and the importance of continuing heart surgery during the pandemic and its aftermath and in order to provide adequate safety for the surgical team and achieve the desired result for patients, as well as the optimal use of ICU beds, the medical team, blood, blood products, and personal protective equipment, it is essential to change the usual approach during the pandemic. There are still a lot of evidences and experiences needed to produce the perfect protocol. Some centers may have a special program for their centers during this period of epidemics that can be respected and performed. Generally, in pandemic conditions, the use of non-surgical approaches is preferred if similar outcomes can be obtained.

Association between Illness Perception and Emotional Status in Iranian Patients after Heart Transplantation.

Background: Heart transplantation is a major procedure which imposes high emotional stress on patients. Illness perception (IP) is a psychological issue which affects psychological adjustment after transplantation. This study aimed to investigate the association between IP and emotional status in Iranian post-heart transplantation patients. Methods: The present cross-sectional study, conducted between 2018 and 2019 in Imam Khomeini Hospital, Tehran, Iran, recruited 121 post-heart transplantation patients. IP was measured using the Brief Illness Perception Questionnaire (B-IPQ), and emotional status was measured using the Hospital Anxiety and Depression Scale. The association between IP and depression/anxiety was assessed. Results: Men comprised 80.2% of the study population. The mean age of the participants was 43.9±12.95 years. Definite caseness for depression and anxiety was reported in 11.6% and 18.2% of the participants, respectively. The median score of IP was 55. The association between anxiety and IP in total IP and the 3 dimensions of IP was statically significant (P=0.015, P=0.018, P=0.002, and P=0.023 for the cognition, emotion, and understanding dimensions and the total IPQ, respectively). Additionally, the association between depression and IP was significant (P=0.001, P=0.029, and P=0.002 for the cognition and emotion dimensions and the total IPQ, correspondingly, except for the understanding dimension). Furthermore, lower levels of anxiety in the patients showed a greater impact on IP than did depression. Conclusion: There was a significant association between IP and depression and anxiety in our study population. Therefore, the diagnosis and management of anxiety and depression in heart transplantation patients may improve IP. The cross-sectional design of the present study precluded an investigation of the causality between IP and emotional status.

Parental Experiences about the Sexual and Reproductive Health of Adolescent Girls with Intellectual Disability: A Qualitative Study.

BACKGROUND: Intellectually disabled persons, as compared with normal people, experience different changes during the adolescence period including the appearance of secondary sexual characteristics. However, owing to their low intelligence quotient, these changes are usually accompanied by more problems and challenges. The present study was conducted to determine the experiences of parents regarding the sexual and reproductive health of educable intellectually disabled adolescent girls. MATERIALS AND METHODS: This qualitative study was carried out on 52 participants (adolescent girls, parents, teachers, healthcare providers, and managers) who were selected via purposeful sampling in Isfahan between July 2016 and April 2017. Data were collected through semi-structured interviews, focus group discussions and field notes, and analyzed using conventional content analysis. RESULTS: Five sub-categories were extracted: "unawareness about sexual needs of the adolescent girl and her potential vulnerability," "inappropriate actions in directing the sexual behaviors of the adolescent," "insufficient supervision and care over the adolescent's sexual health," "inappropriate actions toward marrying off the adolescent," and "inappropriate actions regarding the menstrual and genital health" which formed the main category of "parents' inefficiency in maintaining adolescent girls' sexual and reproductive health." CONCLUSIONS: Based on the results, parents face different challenges about the sexual and reproductive health of intellectually disabled adolescent girls. Hence, empowering the parents especially mothers through teachers and healthcare providers with the knowledge and skills to maintain the sexual and reproductive health of intellectually disabled adolescent girls would make them emboldened to find the ability to protect themselves in different situations.

What thought to be a cardiac tumor turns out to be a remnant of former surgery.

BACKGROUND: A textiloma is a rare retained surgical swab with probable serious post-operation complications. CASE REPORT: Here, we reported an asymptomatic patient who had past history of coronary artery bypass grafting (CABG) fourteen months ago and referred to our institute for left atrial mass removal. Echocardiography and chest computed tomography (CT) scan revealed a non-homogenous non-mobile mass and a heterogeneous lesion with low-density as well as high-density areas with spot calcification and gas bubbles at left atrium level, respectively. CONCLUSION: Despite being rare after CABG, textiloma should be considered in the differential diagnosis in case of any suspicious chest mass even in asymptomatic patients.

Gender identity development in the shadow of socialization: a grounded theory approach.

Gender identity is one of the basic forms of identity which has a key role in the mental health during adolescence. The present study was conducted to determine the process of gender identity development among Iranian female adolescents. In this grounded theory study, semi-structured interviews were conducted with 55 purposefully and theoretical selected participants including 30 female adolescents and 25 key informants who lived in urban society of Isfahan, Iran, in 2016-2018. Data were analyzed using Strauss and Corbin's mode of analysis (2008), through constant comparative method, applying levels of open, axial, and selective coding with MAXQDA software. Development of gender identity in the shadow of socialization was presented as the core category extracted from the data in this study. Female adolescents would use "sexual self-expression during puberty," "attachment to parents and peers," "tendency towards the opposite sex," and "effort for social acceptance" as the main strategies in the development of gender identity until achieving "stabilized gender identity." "Girls' communicational skills" and "parents' empowerment" were the causal conditions in this process. "Gender differences" and "sociocultural texture of the society" were the contextual conditions and the influence of "peers" and "media" was the interventional conditions in the development of gender identity in female adolescents. Improving girls' communicational skills, empowering parents for managing their interactions with their daughters, adjusting gender roles in the society, and creating appropriate content by the media could have an important role in helping female adolescents achieving stabilized gender identity.

Scorpions and Scorpionism in Roudan County, Southern Iran.

BACKGROUND: Every year, thousands of cases and many deaths from scorpion sting are reported in tropical areas of South and Southwestern parts of Iran. The aim of this study was to identify the fauna and dangerous species of scorpions in Roudan County, southern Iran. METHODS: This descriptive study was conducted in 10 stations in Hormozgan Province. Scorpion sampling was done randomly by searching for their shelter and digging out their nests during day, and with the use of UV light during night from February 2013 to October 2014. Data of scorpion stings were obtained from health center of Hormozgan Province during 2014-2016. RESULTS: Overall, 155 scorpions were collected on a set of eight species belonging to Buthidae and Hemiscorpiidae families. These species were identified as Mesobuthus persicus, Mesobuthus phillipsi, Hottentotta schach, Odontobuthus doriae, Compsobuthus persicus, Orthochirus farzanpayi, Androctonus crassicauda and Hemiscorpius acanthocercus. One thousand and twenty-seven cases of scorpion sting were recorded during 2014-2016 with a peak period in summer. Most of cases were <44yr old. Five out of six medically important scorpions in Iran were actively identified in the study area. CONCLUSION: Results of this study would greatly help to identify risk factors of scorpion sting in high-risk areas for planning, management and treatment of patients with scorpion sting in these areas.

Effectiveness of Emotion Regulation Group Therapy on Craving, Emotion Problems, and Marital Satisfaction in Patients with Substance Use Disorders: A Randomized Clinical Trial.

Objective: Psychological and environmental factors, such as difficulties in emotion regulation (ER) and marital problems, are involved in relapse and craving in patients with substance use disorders. Emotional regulation therapy can help maintain opioid withdrawal and improve marital relations by focusing on appropriate adjustment of emotions. This study aimed to evaluate the effectiveness of emotion regulation therapy on craving, emotion regulation, and marital satisfaction in patients with substance use disorders. Method : This randomized controlled clinical trial with pretest and posttest was performed in 2014 in Noor hospital, Isfahan, Iran. In this study, 30 patients who were admitted to the addiction center of Noor hospital were selected using purposive sampling. They were assigned into two groups randomly: (1) 15 patients in treatment as usual (TAU group); (2) 15 patients in emotion regulation group therapy (ERGT). The ERGT group received eight weekly treatments, based on Gross model, to learn recognize emotions and their effects, overcome obstacles of positive emotions, accept emotions, identify regulatory maladaptive and adaptive strategies of emotions, and modify behavior. Before and after the emotion regulation sessions in experimental group, Craving Beliefs Questionnaire (CBQ), Emotion Regulation Questionnaire, and Dyadic Adjustment Scale (DAS) were administered in both groups. Results: The results of analysis of variance indicated that mean scores of marital adjustment increased in ERGT (93.66 ± 15.81) compared to TAU group (55.26 ± 20.98) and the mean scores of craving were decreased in ERGT compared to TAU group (56.66 ± 18.39 and 105.2 ± 34.5, respectively). Also, most aspects of ER improved in ERGT compared to TAU group, and the total score of ER was increased in ERGT significantly (96.69 ± 5.38 in ERGT versus 73.70 ± 5.05 in TAU). Conclusion: Based on the findings of this study, emotion regulation group therapy has a significant effect on reducing Craving and improving marital adjustment and emotion regulation in Patients with Substance Use Disorders. So, it can use as a useful psychotherapy in addiction treatment centers.

A comprehensive sexual health care program for educable intellectually disabled adolescent girls: protocol for a mixed methods study.

BACKGROUND: Protection and promotion of sexual health is of great importance for educable intellectually disabled adolescent girls; since they are prone to high risk sexual vulnerabilities and consequences, such as unwanted pregnancy, sexually transmitted infections, and acquired immune deficiency syndrome. Although the rights of intellectually disabled adolescents have been emphasized through the recent years, their sexual health care is still a challenge for parents, teachers, caregivers, and service providers. This study aims to present a comprehensive sexual health care program for educable intellectually disabled adolescent girls. METHODS: This study is carried out by an exploratory sequential mixed qualitative-quantitative methods approach including three sequential phases. The researcher represents sexual health state of educable intellectually disabled adolescent girls using a qualitative approach. In the onset of the second phase, a comprehensive sexual health care program is designed for educable intellectually disabled adolescent girls. In this regard, in addition to qualitative studies, some related papers and texts are used. The suggested program of expert panel is approved based on prioritization guidelines. Then, in the third phase and after different stages of finalization of the program, its affectability is evaluated regarding improvement of sexual health state of educable intellectually disabled adolescent girls. DISCUSSION: It is expected that from the results of the present mixed methods study, by presenting a comprehensive sexual health program for educable intellectually disabled adolescent girls, lead to improvements in the sexual health of these girls. Moreover, it wants to reduce risky sexual behaviors, sexual abuse and harassment, and their consequences in adolescent girls in order to improve sexual health state of the society. If this program works, it can become one of the leading education and care guidelines for sexual health care of intellectually disabled adolescent girls. TRIAL REGISTRATION: IRCT20160224026756N5 . Registered 22 June 2018.