Investigation of Factors Related to Stillbirth.

The stillbirth rate is among the most important indicators of access to and quality of care during pregnancy. This study investigated the factors related to the stillbirth rate in the Yazd province, Iran. The current research is descriptive and cross-sectional and the results of Shahdieh city cohort study which was conducted on 4756 women were used. Data related to the history of stillbirth, demographic characteristics, fertility history and, various female diseases were extracted from the results of the cohort study. The result shows that 7.2% of studied women had a history of stillbirth. Among the multiple variables, predictor variables including education level, marriage age, age of the first conception, number of children, consanguineous marriage, Employment status, and diseases like diabetes, hypertension, and history of depression had a significant relationship with a history of stillbirth (P ≤ .05). The stillbirth rate in Shahedieh is high compared to the global stillbirth Rate, but it is comparable with the stillbirth Rate in Yazd province. Although Yazd province, as one of the industrial hubs of Iran, has relatively acceptable indicators of income, employment, and medical and health facilities and welfare compared to other provinces, this study showed that factors such as diabetes, hypertension, low level of women's education, consanguineous marriage, and women's employment status and social welfare can affect Stillbirth Rate.

Strategies to meet marital intimacy needs in women infected with coronavirus 2019: A framework qualitative content analysis research.

Background: Separating women with the coronavirus 2019 from family can affect marital life. Considering psychological vulnerability of women for anxiety and depression disorders, these women may experience more stress due to the loss of work at this time or special reproductive health conditions such as pregnancy, having a baby, or other medical conditions. Objective: Considering a limited number of qualitative studies on the need for marital intimacy, this study was conducted to meet marital intimacy needs in women with coronavirus 2019. Materials and Methods: Framework qualitative content analysis was conducted through participation of 13 key informants (sex therapist, couple therapist, psychologist, and midwifery counselor) and 18 infected women from Yazd, Iran in July 2020 who were selected purposefully and interviewed through the semi-structured in-depth interviews. Results: 3 main categories were: 1) mutual resilience (subcategories: 1. coping strategies; 2. value of marital life; 3. compassionate conflict resolving). 2) skillful relationship (subcategories: 1. assertiveness in sexual expression; 2. self-efficacy in the distance physical connectivity). 3) synergy (subcategories: 1. reframing spirituality closeness; 2. empowering aesthetic creativity; 3. management of family function, and 4. prioritizing). Conclusion: Findings revealed sex and couple therapists, health providers, and policymakers should emphasize on using new forms of digital communication in these couples. Teaching skills that increase partners' creativity and empathy, enable women to fulfill their mental, sexual and reproductive health needs, and lead to more partners responsibility and loyalty, and maintenance of family function. In times of crisis, counseling should be considered in women treatment programs and care guidelines.

Online positive-oriented counseling, taking vitamin D3 tablet, online lifestyle modification training on premenstrual syndrome: a 3-armed randomized clinical trial.

Lack of absolute treatment for premenstrual syndrome (PMS), its cyclic nature, considerable prevalence (70-90%), and its mental and physical burden imply necessity of effectiveness comparison of various treatments. Although antidepressant and hormonal drugs are well-known medications for PMS, in affected women who can't tolerate, or don't have compatibility or compliance with these drugs, other effective treatments have always been important concern. This study aimed to compare effectiveness of online positive-oriented counseling, taking vitamin D3 tablet, and online lifestyle modification training on alleviating PMS. 3-armed parallel randomized clinical trial was performed on 84 20-40-year-old eligible women with PMS. 84 women were randomly ( www.random.org/sequenc ) allocated into three groups, but data of 77 women (1, n = 25) online positive-oriented counseling group (6 sessions), (2, n = 27) vitamin D3 tablet group (one vitamin D3 tablet weekly for 6 weeks), and (3, n = 25) online lifestyle training group (6 sessions) were analyzed. Vitamin D3 was measured at baseline, week6 and fallow up week10. Primary outcome variable PMS was measured with Premenstrual Symptoms Screening Tool (PSST) at baseline, week 6, and follow-up week 10. Primary outcome satisfaction with intervention method was measured using satisfaction scale at week 6 and follow-up week 10. ANOVA, Repeated Measures, and Paired samples t-test were used for statistical analysis. There was no statistically significant difference in PMS at baseline between three groups respectively (33 ± 5.8, 34.1 ± 7.1, & 35.2 ± 6.4, P = 0.500). However, at follow-up week 10, there was statistically significant difference between three groups (22.3 ± 4.3, 25.4 ± 6.5, & 31.8 ± 6.5; P < 0.001), with greatest improvement in online positive-oriented counseling group (P < 0.001). Satisfaction differed significantly among three groups at week 6 (51 ± 6.8, 46.4 ± 12, & 42.3 ± 6.3, P = 0.001) and follow-up week 10 (55.7 ± 11.6, 51.4 ± 12; & 43 ± 3.3, P < 0.001), with most satisfaction in positive-oriented counseling group (P < 0.001). All three interventions alleviated PMS, but online positive-oriented counseling was more effective and satisfying. Superiority of positive-oriented counseling implies mechanism of adaptation, better relationships, forgiveness, self-mood-regulation, and feasibility of its skills that could be continued individually by women after counseling completion. It is recommended health providers, health policymakers and managers support use of these interventions in treatment program and clinical guidelines.Trial registration: RCT registration number: IRCT20191231045967N1, Registration date:11/02/2020, Registration timing: prospective (IRCT | Survey the effect of vitamin D3 tablet intake, positivism group consulting with changing in life style in the treatment of premenstrual syndrome in women).

A comprehensive health-promoting neighborhood intervention to improve health care seeking behavior among reproductive age Iranian women.

BACKGROUND: Women's health care seeking delays remains an unresolved major public health problem in developing and underdeveloped countries. This study aimed to evaluate a health-promoting neighborhood intervention to improve health care seeking behavior (HCSB) among reproductive age Iranian women using Health Promotion Model (HPM). METHOD: This randomized controlled trial was conducted on 160 women of reproductive age in two groups: experimental and control. Data were collected by self-administered questionnaire based on HPM constructs and a medical symptom checklist. A health-promoting neighborhood intervention was performed in seven sessions for the experimental group. HCSB and HPM constructs were measured before and 3 months after intervention in the two groups. p < 0.05 was considered significant level. RESULTS: The average mean age of participants was 30.45 ± 7.80 years. After intervention, the mean score of self-efficacy, interpersonal influences, commitment to plan and HCSB was increased significantly in women in the experimental group, while negative constructs such as perceived barriers, negative activity-related affect, and immediate competing demands and preferences significantly decreased (p < 0.05). In addition, the mean score of referring for symptoms such as excessive sweating, persistent fatigue or weakness, headache, bleeding or spotting between periods, vaginal itching and irritation, unusual vaginal discharge, flashing, chest pain, rapid heartbeats, aching muscles or joints, urinary problems and some mental disorder was increased significantly in experimental group compared to control group (p < 0.05). CONCLUSIONS: The results of study show that an intervention based on the HPM have a positive impact on HCSB and its associated factors and can help improve women's health behaviors and health outcomes.

Online versus face-to-face metacognitive educational counseling program on anxiety and meta-worry in women with a history of miscarriage: A randomized clinical trial.

BACKGROUND: In the COVID-19 outbreak, women with a history of miscarriage need more mental health. Anxiety and meta-worry as consequences of miscarriage, besides concerns due to pregnancy during coronavirus, show the necessity of appropriate online and face-to-face educational counseling. This study aimed to evaluate the effectiveness of online metacognitive educational counseling versus face-to-face method on anxiety and meta-worry in these women. MATERIALS AND METHODS: In this randomized clinical trial, 80 women with a history of miscarriage, anxiety, and meta-worry referred to Imam Jafar Sadegh hospital (labor, women ward and women clinic), Meybod, Iran, were selected conveniently and randomly assigned into two groups (n = 20/each). The participants received 8-session metacognitive educational counseling package online or face-to-face. Data were collected by Beck Anxiety Inventory, Wellz meta-worry questionnaire at baseline, week eight, and follow up as primary outcomes and analyzed via SPSS software (Anova and Repeated measure statistic tests). RESULTS: Anxiety in the 12th week (online group 13.75 ± 3.59 vs. face to face 18.25 ± 5.91, P = 0.04) was statistical significantly less than baseline (respectively 22.15 ± 5.67 vs. 22.35 ± 4.93, P = 0.56); with fewer anxiety scores in the online group. Meta-worry in the 12th week (online group 11.90 ± 2.59 vs. face to face 15.70 ± 4.06, P = 0.03) was statistically significant compared to baseline (respectively 17.15 ± 2.70 vs. 18.50 ± 3.47, P = 0.36); with fewer meta-worry scores in the online group. Belief about worry in 12th week (online group 66.50 ± 14.60 vs. face to face 78.45 ± 9.27, P = 0.01) was statistical significantly less than baseline (respectively 85.50 ± 8.87 vs. 86.05 ± 8.85, P = 0.96); with less score of belief about worry in the online group. CONCLUSION: Online and face-to-face metacognitive educational counseling methods decreased anxiety, meta-worry, and belief about worry in women with miscarriage. But online educational counseling was more effective. Distance online counseling in COVID-19 can help the mental health of women with miscarriage.

Lived Experiences of Recovered COVID-19 Patients after Hospitalization: A Phenomenological Research.

Background: The deadly novel Coronavirus Disease 19 (COVID-19) epidemic has sickened and killed millions of people around the world. Accordingly, Iran has had the second highest incidence rate of COVID-19 deaths in the world. Because this disease affects all individual, familial, and social aspects, there is not enough information about experiences of COVID-19 patients. However, these experiences could be a missing link in explaining their attitudes, beliefs, and concerns for improving care and treatment processes during and after the disease. Materials and Methods: Descriptive phenomenological research was conducted in 2020 to explain experiences of 21 COVID-19 patients after post-hospitalization recovery. Semi-structured interviews were used as the data collection tool via purposeful sampling, which were continued until data saturation and analyzed using Colaizzi's seven-step method. Results: The main theme of "value of health" and the seven categories of (1) inefficient self-care, (2) overcoming the catastrophic crisis, (3) the shadow of death, (4) coping behaviors and resilience, (5) the need for support and accountability, (6) sympathy, and (7) new insights as well as 38 main codes were extracted. The patients' general explanation in the early stages of the disease, recovery, and subsequent periods included transition from the crisis to new insights into physical, mental, sexual, familial, and economic dimensions that finally led to the review value and concept of their life. Conclusions: The findings of this study can be used to fulfil care and treatment needs of the patients, their families as well as caregivers, psychologists, counselors, health planners, and managers presently and in the future for similar diseases.

Effectiveness of Online Versus Telephone Counseling of Rational-Emotional-Behavioral Therapy on Sexual Function of Women Undergoing Cardiac Rehabilitation: A Randomized Clinical Trial:.

Background:Sexual function in patients with cardiovascular disease (CVDs) is often associated with anxiety and irrational beliefs. Moreover, 60-78% of patients with CVDs report sexual problems. Some studies suggest that sexual counseling is necessary for these patients but is not usually provided for them. Online or telephone counseling may be helpful during the covid-19 pandemic, but studies on its application to sexual function appear to be limited. This study aimed to investigate the effectiveness of online vs. telephone counseling of rational-emotional-behavioral therapy (REBT) on the sexual function of women undergoing cardiac rehabilitation. Materials and Methods: In this randomized clinical trial study, 46 women diagnosed with CVDs under rehabilitation were assigned into online and telephone groups. Overall, eight 60-min intervention sessions were held (once a week). The Female's Sexual Function Index (FSFI) questionnaire was completed by the women at baseline, week 8th, and follow-up week 12th (main outcome). Results: FSFI scores between the two groups at baseline (online: 13.28±2, telephone: 12.68±1.52, P=0.254) compared to week 12th (online 28.86±2.44, telephone, 26.6±2.10, P=0.002) were significantly different. As for within-group comparison in baseline compared to week 12th statistically significant difference was observed in all subscales of FSFI (P=0.05). Conclusion: Online and telephone REBT counseling can improve the sexual function of women undergoing cardiac rehabilitation, but online counseling appears to be more effective. Thus, this method is recommended to improve the sexual function of these women during the covid-19 pandemic. [GMJ.2022;11:e2396].

The effectiveness of sexual health group counseling based on cognitive behavioral therapy on sexual satisfaction of newly married women.

BACKGROUND: The beginning of a marital relationship is very important as a part of a family relationship, and it satisfies many mental and physical necessities in a safe environment and has a great impact on people's health. The aims of this study were to investigate the effectiveness of sexual health counseling based on cognitive behavioral approach on satisfaction and excitability of newly married women. MATERIALS AND METHODS: A randomized clinical trial study was conducted in 50 newly married women who referred to the health center of Jiroft City. They randomly divided into the intervention and the control groups. All of the participants completed Linda Berg's Sexual Satisfaction Scale before intervention, 8 weeks after intervention and 4 weeks later (follow-up). The interventional group participated in CBT (8 sessions, 90 min), but the control group received routine counseling. In all tests, a significance level of 0.05 was considered. Data were analyzed by SPSS version 20. Descriptive test, t-test, and repeated measure test used to analyze data. RESULTS: In intervention group, sexual satisfaction was obtained 51.88 ± 12.27, 57.2 ± 12.88 and 62.76 ± 11.35 (P < 0.05) and in the control group was gotten 47.12 ± 9.6, 45.8 ± 8.07 and 43.48 ± 7.39 (P > 0.05) before intervention, 8 weeks after intervention and 4 weeks later (follow-up), respectively. In intervention group, sexual excitability was obtained 82.80 ± 17.24, 91.72 ± 13.07, and 99.28 ± 11.2 (P < 0.05) and in the control group was gotten 87.04 ± 12.99, 87.48 ± 11.64, and 81.96 ± 12.83 (P > 0.05). CONCLUSION: It can be concluded that cognitive-behavioral counseling can help to improve the sexual satisfaction and excitability of the newly married and can be used to improve and promote women's sexual health.

Online Compared to Face-to-Face Sexual Intimacy Enhancement Training Program Counseling with Cognitive-Behavioral Approach on Sexual Intimacy in Pregnant Women.

Studies have shown sexual intimacy enhancement-training with cognitive-behavioral can affect women's sexual intimacy. Interventional study to compare online and face-to-face sexual enhancement-training with cognitive-behavioral approach on sexual intimacy was conducted on 48 pregnant women with sexual intimacy scores < 75 who were randomly divided online (n = 25) and face-to-face (n = 23). Six 90-minute session sexual intimacy enhancement-training were conducted. Data were collected Botlani's sexual intimacy questionnaire (primary outcome) and counseling satisfaction scale (secondary outcome) measured baseline and after 6 and 10 weeks. In each group sexual intimacy in 10th week increased significantly compared to baseline (65.88 ± 5.51 vs 87.36 ± 8.39, p < 0.001) and (67.39 ± 5.26 vs 83.70 ± 5.61, p < 0.001) respectively. There was no significant difference between two groups in sexual intimacy scores in 6th (82.32 ± 9.25 vs 79.87 ± 6.35, p = 0.29) and 10th weeks (87.36 ± 8.39 vs 83.70 ± 5.61, p = 0.08) but totally intervention caused significant increase in sexual intimacy in 10th week compared to baseline (p = 0.04). Satisfaction from intervention was significantly different in 6th (65.72 ± 2.57 vs 61.21 ± 7.17, p = 0.021) and 10th weeks (68.92 ± 2.79 vs 64.26 ± 5.15, p = 0.001). Intervention improved sexual intimacy in pregnant women via both online and face-to-face counseling, with more sexual intimacy and satisfaction in online group, could be useful in COVID-19 pandemic.

PERMA model vs. integrative-behavioral couple therapy for fertility problems: A randomized clinical trial protocol.

BACKGROUND: Psychological interventions may reduce fertility problems. Positive emotion, engagement, meaning, positive relationship and accomplishment (PERMA) is a cognitive intervention and integrative-behavioral couple therapy (IBCT) is a behavioral intervention. Appropriate mental interventions are important in infertility treatment. OBJECTIVE: To investigate the effect of the PERMA model vs. IBCT in reducing the fertility problems of couples. MATERIALS AND METHODS: The content of the interventions was developed and adjusted based on a literature review and the opinions of experts. In this three-arm parallel randomized clinical trial, 42 couples undergoing infertility treatment will be allocated randomly into three groups (n = 14 couples/each). Group 1 will receive the PERMA intervention, group 2 will receive the IBCT intervention, and group 3 as the control group will receive an infertility treatment training program intervention. The primary outcome will be the fertility problems, which will be measured by completing a fertility problem inventory at baseline, as well as in the 5 th and 9 th wk as a follow-up. Another primary outcome, satisfaction with the intervention, will also be assessed in the 5 th and 9 th wk. The secondry outcome will be a positive pregnancy test at wk 12. The interventions will be conducted through a combination of face-to-face and online via WhatsApp. CONCLUSION: This study will assess social, sexual, and parenthood concerns. A combination of online and face-to-face interventions will be appropriate given the COVID-19 pandemic. Couple's counseling may provide better counseling outcomes for fertility problems in comparison with group counseling. This study will try to optimize resilience during infertility treatment through learning better relationship and problem-solving skills, and may have an indirect impact on pregnancy rate, burden of infertility, and costs of treatment due to increased effectiveness.

Understanding Interpersonal Influences on the Use of Formal Health Services among a Population of Iranian Women in Reproductive Age: A Qualitative Study.

BACKGROUND: One of the most important factors contributing to using formal health care services by women is people who are involved in the social network around them. AIM: This study aimed to understand the interpersonal influences on the use of formal health services among Iranian women of reproductive age. METHODS: This study is a deductive content analysis approach based on the Health Promotion Model. Twenty-two semi-structured interviews were done with women of reproductive age and health care staffs in Qom, Iran. Transcripts were analysed by a deductive content analysis approach based on the Health Promotion Model (HPM). RESULTS: Three main categories and eight subcategories were drawn consisting of (1) social support with 4 subcategories including "Family support and influence", "support of religious people", "support of health care providers" and "negative social support"; (2) social pressure and expectations with 2 subcategories including "feeling pressure due to role-playing" and "society's expectations regarding women's health", and (3) healthy role models with 2 subcategories including "family role models" and "modeling friends and peers in taking action for treatment". CONCLUSION: A positive interpersonal influence in women acts as a strong incentive to seek health care when they are suffering from a disease, and prevents the chronicity of the disease by timely treatment.

Correction to: Conceptual model of managing health care volunteers in disasters: a mixed method study.

In the original publication of this article [1], the percent sign at the first row of the Table 2 needs to be deleted. The updated Table 2 is shown below.

Conceptual model of managing health care volunteers in disasters: a mixed method study.

BACKGROUND: Shortage of specialized healthcare volunteers is a major challenge during disasters and one solution could be pre-identified healthcare volunteers. This study aimed to develop a conceptual model of managing Iranian healthcare volunteers in disasters. METHODS: This mixed method study was designed in two phases. A qualitative study using semi-structured interviews was conducted with 22 health professionals and key informant. The interviews were analyzed by framework analysis. In the second phase, concepts derived from the first step were evaluated in a two round Delphi study by an expert panel comprised of 42 experts. RESULTS: Two themes and eight subthemes were identified based on the results of the first phase. The theme of background requirements included three sub-themes of laws and regulations, NGOs and socio-cultural factors. The second theme was called operational requirements which included six subthemes of preparedness, response, retention, relocation, terminating and follow-up. According to the results of the Delphi study, all of the concepts were confirmed. CONCLUSION: In addition to the need for supportive legal framework and building the culture of volunteering, it seems it is crucial to identify and prepare the health care volunteers in the preparedness phase and assign them appropriately in the response phase. Furthermore, the necessary measures should be prioritized to enhance volunteers' retention rate and motivation. Plans should also be implemented for volunteers' termination and volunteers' physical and mental health follow up after their mission.

The related factors of compliance to professional codes of ethics from midwives' perspective working in healthcare centers of Tehran-Iran.

INTRODUCTION: Professional ethics is an important issue in every organization. This study was designed to define compliance level to professional codes of ethics and some of its related factors in midwives working at healthcare centers. METHODS: This cross sectional study was conducted in 2013 Tehran Iran. 125 midwives from the governmental healthcare centers of Tehran were selected through stratified quota sampling method. Data gathering tool was a self-reporting questionnaire which included: demographic characteristics, Iranian version of ethical codes of reproductive health providers, applicability of these ethical codes and awareness about the professional codes of ethical. Data analysis was conducted using SPSS v.16. p level at 0.05. RESULTS: Compliance to the professional ethical codes were directly correlated to the income level of the midwives, the applicability of the codes and the midwives' awareness about them. CONCLUSION: It is necessary to pay attention to professional ethics and its teaching as such. It is also important to monitor compliance to the ethical codes. Moreover, living conditions of the midwives should be one of the priorities to enhance their performance.

A Qualitative Approach to Women's Perspectives on Exercise in Iran.

BACKGROUND: It is believed that women of all ages do less physical activities compared to men. The development of interventional projects for increasing the women's participation in physical activity needs the recognition of resources and exploration of women's perspectives on exercise in their lives in the Iranian culture and context. METHODS: This qualitative study was conducted in an urban area of Iran on 46 women attending healthcare centers, volunteer health care providers, university students, sportswomen and one of the officials of the provincial women's sports. This study was done from April 2015 to June 2016. Four focus group discussions and one in depth semi-structured interview was conducted. A qualitative conventional content analysis approach was used for data analysis. RESULTS: Four categories were developed as follows: 'preferences', 'planning', 'motivators' and 'inhibitors'. Preferences had three distinct subcategories: preferences to do exercise in specific settings, specific exercise and group exercise. The family role, exercise as one part of daily routines, and exercise as a habit were subcategories of planning. Motivators were physical, emotional and social benefits; physician advice and encouragement; being alarmed; and championship. The inhibitors of doing exercise were various: gender issues, economical and costs issues, geographical access, making excuses, cultural infrastructures, shortage of sports experts, fears, concerns and misconceptions, inappropriate facilities and inadequate administrative cooperation and official barriers. CONCLUSION: The findings showed that the women were sensitive to and interested in doing exercise. However, barriers to exercise were multiple and complex. Nursing interventions are required to increase the individuals' awareness of misconceptions and also develop strategic programs for improving exercise among women.

Exploring the feelings of Iranian women of reproductive age about health care seeking behavior: a qualitative study.

Background: Despite the important role of feelings in health care seeking behavior (HCSB), this subject has not yet been adequately investigated. HCSB-related feelings begin with the onset of disease symptoms and persist in different forms after treatment. The aim of current study was to explore the feelings that women of reproductive age experience when they seek health care. Methods: In this deductive, qualitative content analysis, participants were selected by purposeful sampling. Semi-structured, in-depth interviews with 17 women of reproductive age and 5 health care staffs in Qom, Iran were carried out until data saturation was achieved. Qualitative data were concurrently analyzed by deductive content analysis, using the Health Promotion Model (HPM). The MAXQDA10 software was used to manage qualitative data analysis. Results: Three main categories were drawn from data to explain the HCSB-related feelings of participants consisting of (1) feeling of inner satisfaction with the treatment with 2 subcategories including "peace of mind" and "feeling alive", (2) multiple roles of fear with 5 subcategories including "fear about the consequences of delay", "fear of having hidden diseases", "fear of unknown experiences", "fear of hearing bad news" and "fear of medical errors" and (3)uncomfortable feelings with 3 subcategories including "feeling uneasy when attending health facility", "feeling embarrassed" and "feeling worthless due to dealing the doctor". Conclusion: This study revealed that the inner feelings of women varied widely, ranging from positive or motivating feelings to negative or inhibitory ones, given their experiences with the formal health care system and the current situation of medical and health services. Highlighting patients' perceived inner satisfaction and reducing fear and uncomfortable feelings by adopting culture-based practical strategies can enhance women's HCSB.

The Effect of New Model PREPARED on Obtaining Informed Consent Skill in Midwifery Students of Shahid Sadoughi University of Medical Sciences.

BACKGROUND: Professional ethics culture should be taught to students appropriately. Studies have shown that midwifery students are not entirely familiar with the skill of obtaining informed consent. Using a new and applicable model to teach this skill to midwifery students is necessary. This study was conducted to determine the effect of a new standard model, PREPARED, on the skill of obtaining informed consent in midwifery students of Shahid Sadoughi University of Medical Sciences. MATERIALS AND METHODS: This interventional study was conducted on 37 5th semester midwifery students through a census method. After determining psychometric indices, in two phases with a 4-week interval (before and after the training), the PREPARED checklist was completed by the professors of the research team in the presence of students in the delivery room while they were performing midwifery care considering their compliance to the checklist. Descriptive statistics paired t-test were used for data analysis. RESULTS: The lowest mean score before the training belonged to alternative methods (1.00) and treatment expenses (1.00). After the training, treatment plan had the highest mean score (3.54 (0.69)). The mean and standard deviation of scores before and after training the students were 9.12 (2.00) and 30.6824 (5.25), respectively. Based on the results of the paired t-test (P = 0.001), the difference was statistically significant. CONCLUSION: Results showed that the implementation of the new model of PREPARED would increase the skill of obtaining informed consent in midwifery students and could be applied for educating students of other medical majors in Iran.

An overview on ethical considerations in stem cell research in Iran and ethical recommendations: A review.

Conducting research on the stem cell lines might bring some worthy good to public. Human Stem Cells (hSCs) research has provided opportunities for scientific progresses and new therapies, but some complex ethical matters should be noticed to ensure that stem cell research is carried out in an ethically appropriate manner. The aim of this review article is to discuss the importance of stem cell research, code of ethics for stem cell research in Iran and ethical recommendation. Generation of stem cells for research from human embryo or adult stem cells, saving, maintenance and using of them are the main ethical, legal and jurisprudence concerns in Iran. Concerns regarding human reproduction or human cloning, breach of human dignity, genetic manipulation and probability of tumorogenisity are observed in adult/somatic stem cells. Destruction of embryo to generate stem cell is an important matter in Iran. In this regards, obtaining stem cell from donated frozen embryos through infertility treatment that would be discarded is an acceptable solution in Iran for generation of embryo for research. Ethical, legal, and jurisprudence strategies for using adult/somatic stem cells are determination of ownership of stem cells, trade prohibition of human body, supervision on bio banks and information of Oversight Committee on Stem Cell Research. Recommendations to handle ethical issues for conducting stem cell research are well-designed studies, compliance codes of ethics in biomedical research (specifically codes of ethics on stem cell research, codes of ethics on clinical trials studies and codes of ethics on animals studies), appropriate collaboration with ethics committees and respecting of rights of participants (including both of human and animal rights) in research. In addition, there is a necessity for extending global networks of bioethics for strengthening communications within organizations at both the regional and international level, strengthening legislation systems, designing and establishing convenient collaborative educational courses at different levels.

Lack of Association between Cu T-380A Intrauterine Device and Secondary Infertility in Iran.

BACKGROUND: The appropriate choice of a contraceptive method has been a major issue in reproductive health research. Cu T intrauterine device (Cu T IUD) has been introduced as one of the most effective contraceptive methods in the world, however, the relationship between prior use of Cu T IUD and secondary infertility has not been evaluated in Iran. To examine the association of Cu T-380A IUD and secondary infertility in Iran. MATERIALS AND METHODS: A retrospective cohort study was conducted from December 2010 to September 2011 in the Research and Clinical Center for Infertility, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. A total of 750 married women (15-49 years old) with at least one parity, whom were referred to four educational healthcare centers of Shahid Sadoughi University of Medical Sciences, were selected as participants. They were divided into two groups (case and control) based on previous history of using Cu T-380A IUD. Data were gathered using a standard reliable questionnaire along with a face-to-face interview and were analyzed with descriptive and analytical (χ²) tests. RESULTS: Mean period of Cu T-380A IUD usage in the case group was 57.46 ± 47.74 months and mean time length from Cu T-380A IUD removal to pregnancy was 14.87 ± 5.18 months in this group. We observed no relationship between the use of Cu T-380A IUD and frequency of secondary infertility (3.5% in the case group versus 2.7% in the control group, P=0.52). CONCLUSION: Given the relatively large sample size studied here, it is unlikely that Cu T-380A IUD results in secondary infertility and may be used by Iranian women as a safe contraceptive method.

Oral fennel (Foeniculum vulgare) drop effect on primary dysmenorrhea: Effectiveness of herbal drug.

BACKGROUND: Primary dysmenorrhea refers to the occurrence of painful menstrual cramps of uterus and is considered as a gynecological complaint. The common treatment for this problem is medical therapy such as mefenamic acid [non-steroidal anti-inflammatory drugs (NSAIDs)] and oral contraceptive pills, both of which work by reducing myometrial activity. Fennel contains an antispasmodic and anethol agents and may be helpful for management of primary dysmenorrhea. MATERIAL AND METHODS: The aim of this study was to evaluate the effects of oral fennel drop for treating primary dysmenorrhea. Sixty college students suffering from primary dysmenorrhea were randomly assigned to two groups and followed up for two cycles. Statistical analysis was performed using SPSS version 16. P < 0.05 was considered to be statistically significant. Parametric and non-parametric tests were adopted. RESULTS: Comparison of pain intensity in the two groups showed that there was no significant difference in pain relief between the two groups. Comparison of bleeding severity in the study group before and after intervention was demonstrated from the first day to the fifth day (PV on first day, second day, third day, fourth day, and fifth day 0.948, 0.330, 0.508, 0.583, 0.890, respectively). CONCLUSION: It seems that fennel can be effective in reducing the severity of dysmenorrhea, but it has an unpleasant taste in view of most of the volunteers.