Heterologous Production of Antimicrobial Peptides: Notes to Consider.

Heavy and irresponsible use of antibiotics in the last century has put selection pressure on the microbes to evolve even faster and develop more resilient strains. In the confrontation with such sometimes called "superbugs", the search for new sources of biochemical antibiotics seems to have reached the limit. In the last two decades, bioactive antimicrobial peptides (AMPs), which are polypeptide chains with less than 100 amino acids, have attracted the attention of many in the control of microbial pathogens, more than the other types of antibiotics. AMPs are groups of components involved in the immune response of many living organisms, and have come to light as new frontiers in fighting with microbes. AMPs are generally produced in minute amounts within organisms; therefore, to address the market, they have to be either produced on a large scale through recombinant DNA technology or to be synthesized via chemical methods. Here, heterologous expression of AMPs within bacterial, fungal, yeast, plants, and insect cells, and points that need to be considered towards their industrialization will be reviewed.

Effect of infrared belt and hot water bag on labor pain intensity among primiparous: a randomized controlled trial.

BACKGROUND: Labor pain is complex, paradoxical and varied in every parturient woman. Management of labor pain has been a crucial component in maternity care. Heat therapy is one of the proposed method for labor pain relief. Infrared is one of the methods of heat therapy but there is any study in this regard. This study aimed to compare the effect of the infrared belt and hot water bag on the severity of pain in the first stage of labor among primiparous women. METHODS: In this clinical trial in the first stage of labor, 20-min cycles of heat therapy were conducted at the dilations of 4-5 and 6-7 cm in the intervention group 1 by an infrared belt and in the intervention group 2 by hot water bag, respectively. The control group received routine care. The severity of the pain was measured by the short-form McGill Pain Questionnaire. RESULTS: In total, 136 women consented to participate in this clinical trial study. The mean score of pain intensity was significantly lower in the two intervention groups compared to the control group (P < 0.001). The mean pain intensity was significantly lower in the infrared belt group than in the hot water bag group (P < 0.001). CONCLUSIONS: Based on these findings, heat therapy with an infrared belt reduced the severity of pain in the first stage of labor. The infrared belt could be used and recommended as a safe and effective pain relief in childbirth and maternity care. TRIAL REGISTRATION: This study was registered in the Iran Clinical Trial Center with the code of IRCT20190805044446N1 .

The effect of couple supportive counseling on self-efficacy in women with insulin-treated gestational diabetes: A randomized clinical trial.

BACKGROUND: Gestational diabetes is the most common medical complication and a common metabolic disorder during pregnancy. Increasing people's self-efficacy is one of the best ways to control this disease. As there is a lag of intervention in this regard, the purpose of this study was to determine the effect of couple supportive counseling on self-efficacy in women with insulin-treated gestational diabetes. MATERIALS AND METHODS: In this randomized clinical trial, 64 women with gestational diabetes who referred to diabetes clinic of Mashhad Ommolbanin Hospital were divided into intervention and control groups through block randomization during 2019. Their gestational age was in 26-30 weeks. For the couples in the intervention group, three couple supportive counseling session was held. Each session lasted 1 h and was held one time per week. The instruments were diabetes self-efficacy questionnaire, fasting and 2-h postprandial checklist and Cassidy social support, which were assessed before and 4 weeks after intervention in both groups. Data was analyzed by SPSS software version 25 through Mann-Whitney and Wilcoxon test. P values of < 0.05 were reported to be significant. RESULTS: In the preintervention, the diabetes self-efficacy score had no significant difference in the intervention (30/6 ± 38/50) and control groups (09/8 ± 56/51) (P = 515/0). However, in the postintervention, the diabetes self-efficacy score was significantly higher in the intervention group (58/6 ± 41/71) compared to the control group (15/7 ± 31/51) (P < 001/0). Also, before the intervention, there was no significant difference between the intervention (30/2 ± 72/10) and control group (87/1 ± 63/11) (P = 137/0) regarding social support. However, after the intervention, there was a significant difference between the intervention and control groups (879/0 ± 53/13, 03/2 ± 41/11, P < 0/001 respectively). Also, data analysis showed a significant correlation between self-efficacy and social support (r = 0.451, P < 0.001), self-efficacy and fasting blood sugar (P < 0.001, r = -0.577), and 2 h post prandial (r = -0.778, P < 0.001). CONCLUSION: Couple supportive counseling leads to increased self-efficacy and social support in pregnant women with gestational diabetes. Therefore, it is recommended to use this counseling as an effective method in the management of diabetic pregnant women during their prenatal care to have a healthier pregnancy.

Antimicrobial peptides with anticancer activity: Today status, trends and their computational design.

Some antimicrobial peptides have been shown to be able to inhibit the proliferation of cancer cell lines. Various strategies for treating cancers with active peptides have been pursued. According to the reports, anticancer peptides are important therapeutic peptides, which can act through two distinct pathways: they either just create pores in the cell membrane, or they have a vital intracellular target. In this review, publications up to Sep. 2021 had extracted form Scopus and PubMed using "antimicrobial peptide" and "anticancer peptide" as keywords. In second step, "computational design" related publications extracted. Among publications, those have similar scopes were classified and selected based on mechanisms of action and application. In this review, the most recent advances in the field of antimicrobial peptides with anti-cancer activities have been summarized. Freely available webservers such as AntiCP, ACPP, iACP, iACP-GAEnsC, ACPred are discussed here. In conclusion, despite some limitations of ACPs such as production cost and challenges, short half-life and toxicity on normal cells, the beneficial properties of AMPs make some of them good therapeutic agents for cancer therapy. Towards designing novel ACPs, the computational methods have substantial position and have been used progressively, today.

Applications of Essential Oils and Plant Extracts in Different Industries.

Essential oils (EOs) and plant extracts are sources of beneficial chemical compounds that have potential applications in medicine, food, cosmetics, and the agriculture industry. Plant medicines were the only option for preventing and treating mankind's diseases for centuries. Therefore, plant products are fundamental sources for producing natural drugs. The extraction of the EOs is the first important step in preparing these compounds. Modern extraction methods are effective in the efficient development of these compounds. Moreover, the compounds extracted from plants have natural antimicrobial activity against many spoilage and disease-causing bacteria. Also, the use of plant compounds in cosmetics and hygiene products, in addition to their high marketability, has been helpful for many beauty problems. On the other hand, the agricultural industry has recently shifted more from conventional production systems to authenticated organic production systems, as consumers prefer products without any pesticide and herbicide residues, and certified organic products command higher prices. EOs and plant extracts can be utilized as ingredients in plant antipathogens, biopesticides, and bioherbicides for the agricultural sector. Considering the need and the importance of using EOs and plant extracts in pharmaceutical and other industries, this review paper outlines the different aspects of the applications of these compounds in various sectors.

Algae-Based Biorefinery as a Sustainable Renewable Resource.

Algae are a large and diverse group of autotrophic organisms that are multicellular and single-celled and found in a variety of environments. Biofuel production and value-added chemicals produced through a sustainable process are represented by the biorefinery of algae. Algae are important because of the production of polysaccharides, lipids, pigments, proteins, and other compounds for pharmaceutical and nutritional applications. They can also be used as raw materials for biofuel production. Moreover, they are useful for wastewater treatment. All these factors have absorbed the attentions of researchers around the world. This review focuses specifically on the potentials, properties, and applications of algae as a sustainable renewable resource, which can be a good alternative to other sources due to their high biomass production, less land required for cultivation, and the production of valuable metabolites.

The Validity and Reliability of the Wijma Delivery Expectancy/Experience Questionnaire (Version A) in Primiparous Women in Mashhad, Iran.

BACKGROUND: Although pregnancy and childbirth are physiological processes, fear of childbirth is a common problem that is often associated with requests for cesarean delivery. This study was undertaken to determine the validity and reliability of the Wijma Delivery Expectancy/Experience Questionnaire A (W-DEQ [A]) primiparous women in Mashhad, Iran. METHODS: This study was conducted on 220 primiparous women with a gestational age of 28-30 weeks referred to health centers in Mashhad. Using demographic questionnaire, Beck's Anxiety Inventory, Beck's Depression Inventory, and the W-DEQ (A), for determining the validity and reliability of the W-DEQ (A), first two linguists translated the questionnaire into Persian; then, two other linguists translated the Persian version back into English. The content validity of this version was then assessed by expert faculty members. The final version was sent to the questionnaire's original developers (Klass Wijma and Barbro Wijma) and then used after their approval. Factor analysis was used to analyze the data. RESULTS: The result of actor analysis revealed six factors, forming 58.8% of the total variance. The reliability of this questionnaire was confirmed with a Cronbach's alpha coefficient of 0.84, and the fear of childbirth was found to be correlated with Beck's anxiety (r=0.414) and depression (r=0.287) scores. CONCLUSION: The W-DEQ (A) is a valid and reliable tool for measuring the fear of childbirth and is recommended to be used for measuring the fear of childbirth among Iranian women.

Effect of maternal role training program based on Mercer theory on maternal self-confidence of primiparous women with unplanned pregnancy.

INTRODUCTION: Maternal confidence is an extremely important factor in playing the mother's role and her identity formation. Loss of self-confidence occurs in primiparous women due to the lack of maternal skills. Obtaining the behaviors of maternal role and self-confidence, the mother provides better care for her child. Hence, the aim of this study was to examine the effect of maternal role training program based on Mercer theory on maternal self-confidence of primiparous women with unplanned pregnancy. METHODOLOGY OF THE RESEARCH: This clinical trial was performed on 67 primiparous women referring to Mashhad health centers. Individuals were randomly divided into intervention and control groups. A maternal role training program based on Mercer theory was carried out for intervention group (three sessions of group training in the 34th, 35th, and 36th weeks of pregnancy and one individual training session before discharge from the hospital and then, weekly follow-up over the phone for 4 weeks). The control group received the normal pregnancy care. The research tools were questionnaires of demographic characteristics, London, DASS 21, Edinburgh Postnatal Depression Scale, Parenting Sense of Competence, General Impressions on Infant Temperament Questionnaire, and Six Simple Questions. Maternal self-confidence was measured before training, 4 weeks after delivery, and 4 months after delivery. Data analysis was carried out using independent t-test, Chi-square test, paired t- test, Mann-Whitney test, one-way ANOVA, and Wilcoxon test. P < 0.05 was considered statistically significant. RESULTS: There was a significant difference between mean maternal self-confidence changes (before training and 4 weeks after delivery (P = 0.003) and before training and 4 months after delivery (P = 0.001) in both groups. After eliminating the effect of interventional variables, the mean scores of maternal self-confidence after training in the intervention group had a statistically significant difference with that in the control group (P = 0.001). CONCLUSIONS: Maternal role training program based on Mercer theory increases maternal self-confidence in primiparous women with unplanned pregnancy. Teaching maternal role is recommended to all health-care providers.

Effect of a maternal role training program on maternal identity in primiparous women with unplanned pregnancies.

AIM: Primiparous women with unplanned pregnancies experience greater levels of anxiety that reduce their ability to perform their maternal role. METHODS: This clinical trial was conducted in 2014 on 67 primiparous women with unplanned pregnancies visiting the health centers of Mashhad, Iran, who were randomly divided into an intervention and a control group. The intervention group received maternal role training based on Mercer's Maternal Role Attainment Theory, and the control group received the routine pregnancy care. Maternal identity was measured before training and 4 weeks and 4 months after delivery. RESULTS: Four months after delivery, 28 women (80%) in the intervention group and 18 women (56%) in the control group successfully formed a maternal identity (P = 0.036). CONCLUSION: A maternal role training program given based on Mercer's theory facilitates the formation of maternal identity in primiparous women with unplanned pregnancies.

Comparing the effects of simulation-based training, blended, and lecture on the simulated performance of midwives in preeclampsia and eclampsia.

INTRODUCTION: Preeclampsia is the most common medical complication in pregnancy; along with bleeding and infection, it is one of the three causes of death in pregnant women. Most of these deaths were due to delays in the diagnosis and improper midwifery management and care. On the other hand, the quality of midwifery education has a profound effect on the proper provision of services. Therefore, the present study has been done to compare the effect of simulation-, blended-, and lecture-based education on simulated midwife performance in the management of preeclampsia and eclampsia. MATERIALS AND METHODS: This three-group clinical trial study was performed on 90 midwives of selected hospitals in Mashhad in 2016. Midwives were divided into three groups of simulation-, blended-, and lecture-based education using the random number table. The simulation group was trained for 6 h at the Center for Clinical Skills, the blended group was trained for 4 h by lecture, and 6 weeks through the educational website, and the lecture group was trained for 6 h through lecture. An objective structured clinical test was performed before and 2 weeks after the intervention. Data were analyzed using SPSS Version 16 software and descriptive statistics, paired t-test, one-way ANOVA, and Wilcoxon and Kruskal-Wallis tests. Significance level was considered to be P < 0.05 in all cases. RESULTS: The mean score of midwives' performance was not statistically significant before education in all three groups (P < 0.05). The mean score of midwives' performance was significantly increased in all three groups 2 weeks after education (P < 0.001), and the results of intergroup comparison showed that the mean score of performance in the simulation group was significantly higher than the blended group and the lecture group (P < 0.001), and it was higher in the blended group compared to the lecture group (P < 0.001). CONCLUSION: Education increased the midwives' simulated performance in preeclampsia and eclampsia. The performance of the management of preeclampsia and eclampsia in the simulation educational group is more than that of the blended and lecture groups, so we can use the simulation education which is a self-centered method.

A comparison of face to face and group education on informed choice and decisional conflict of pregnant women about screening tests of fetal abnormalities.

BACKGROUND AND GOAL: Screening of fetal anomalies is assumed as a necessary measurement in antenatal cares. The screening plans aim at empowerment of individuals to make the informed choice. This study was conducted in order to compare the effect of group and face-to-face education and decisional conflicts among the pregnant females regarding screening of fetal abnormalities. METHODS: This study of the clinical trial was carried out on 240 pregnant women at <10-week pregnancy age in health care medical centers in Mashhad city in 2014. The form of individual-midwifery information and informed choice questionnaire and decisional conflict scale were used as tools for data collection. The face-to-face and group education course were held in two weekly sessions for intervention groups during two consecutive weeks, and the usual care was conducted for the control group. The rate of informed choice and decisional conflict was measured in pregnant women before education and also at weeks 20-22 of pregnancy in three groups. The data analysis was executed using SPSS statistical software (version 16), and statistical tests were implemented including Chi-square test, Kruskal-Wallis test, Wilcoxon test, Mann-Whitney U-test, one-way analysis of variance test, and Tukey's range test. The P < 0.05 was considered as a significant. RESULTS: The results showed that there was statically significant difference between three groups in terms of frequency of informed choice in screening of fetal abnormalities (P = 0.001) in such a way that at next step of intervention, 62 participants (77.5%) in face-to-face education group, 64 members (80%) in group education class, and 20 persons (25%) in control group had the informed choice regarding screening tests, but there was no statistically significant difference between two individual and group education classes. Similarly, during the postintervention phase, there was a statistically significant difference in mean score of decisional conflict scale among pregnant women regarding screening tests in three groups (P = 0.001). DISCUSSION AND CONCLUSION: With respect to effectiveness of group and face-to-face education methods in increasing the informed choice and reduced decisional conflict in pregnant women regarding screening tests, each of these education methods may be employed according to the clinical environment conditions and requirement to encourage the women for conducting the screening tests.

Comparison of The Effects of A Positive Reappraisal Coping Intervention and Problem-Solving Skills Training on Depression during The Waiting Period of The Result of Intrauterine Insemination Treatment: A Randomized Control Trial.

BACKGROUND: The outcomes of fertility treatments are unpredictable, and levels of depressive symptoms increase in patients during the waiting period of the result of intrauterine insemination (IUI) treatment. The aim of this study was to compare the effects of a positive reappraisal coping intervention (PRCI) and problem-solving skills training (PSS) on depression during the waiting period of the result of IUI Treatment. MATERIALS AND METHODS: This randomized control clinical trial was done among 108 women undergoing IUI treatment. In the control group, the women received routine care. In the PRCI group, women attended two training sessions and were asked to complete coping thoughts cards and fill out daily monitoring forms during the waiting period. In the PSS group, PSS were taught over three sessions. The depression was measured by the beck depression inventory. RESULTS: On the 10thth day of the IUI waiting period, there were significant differences between the control group (21.42 ± 11.42) and the PSS group (12.52 ± 8.05) and PRCI groups (13.14 ± 9.7) (P<0.001), but no significant difference between the PRCI group and the PSS group. CONCLUSION: According to the results of this randomized control trial there is no difference between a PRCI and PSS on depression during the waiting period of the result of IUI treatment. This suggests that both interventions can be used to help infertile women combat depression during the waiting period of the result of fertility treatments (Registration number: IRCT2016020926490N1).

Relationship between length and width of the purple line and foetal head descent in active phase of labour.

Purple line is one of the non-invasive methods to assess the progress of labour. This longitudinal observational study was performed on 350 women during the active phase of labour. We assessed the relationship between length and width of the purple line and foetal head descent. Women were examined in the lateral position and researcher recorded the presence or absence of the line before each vaginal examination. Where present length and width of the line was measured using a disposable tape measure. The purple line appeared in 75.3% of 350 women during the active phase of labour. There was a positive correlation between length of the purple line and station of the foetal head (r = +0.29, p = .001). There was also a medium positive correlation between width of the purple line and the station of the foetal head (r = +0.71, p < -.001). There is a positive correlation between purple line and station of the foetal head. Where the purple line is present, measurement of it may reduce the number of vaginal examinations, especially when the single aim is to measure station of the foetal head. Further research is needed to confirm the current finding in other races. IMPACT STATEMENT Current knowledge on the subject: In the literature, purple line is one of the non-invasive methods to assess the progress of cervical dilatation and foetal head descent in labour. Failure of the foetal head is the second most common indication for performing surgical deliveries. Progression of labour has been evaluated by vaginal examination for the assessment of cervical dilatation and foetal head station. Vaginal examinations can be unpleasant, intrusive, embarrassing and so painful for women. Researchers suggested to explore whether the line is also present in women across other ethnic and racial groups and they also suggested further researches to examine the width of purple line. The contribution made by the results of this study: The results of this study add to the growing body of research on progression of labour that the purple line appeared in most of Iranian women during the active phase of labour. There was a positive correlation between length and width of the purple line and station of the foetal head. The implications are of these findings for clinical practice and further research: The results of this study can be used reduce the number of vaginal examinations, especially when the single aim is to measure station of the foetal head. Further research is needed to confirm the current finding in other races.

Effect of Dates in Late Pregnancy on the Duration of Labor in Nulliparous Women.

BACKGROUND: Long-term delivery is an important significant issue which is associated with mortality and fetal and maternal disorders. Based on the previous studies, consumption of dates affects uterine contractions and duration of delivery processes. This study aimed to study the effect of date consumption in late pregnancy on the duration of delivery processes in nulliparous women in 2013. MATERIALS AND METHODS: This randomized clinical trial was conducted among 182 nulliparous women 18-35 years who presented to OmAlBanin Hospital in Mashhad in 2013. The comparison has been made between 91 pregnant women who consumed 70-76 g dates daily from the 37th week of pregnancy and 91 pregnant women who did not consume dates. Data collection tool was a questionnaire and a checklist of daily dates' intake. Data were analyzed using the Statistical Package for the Social Sciences software and statistical tests - chi-square and Mann-Whitney test, and P value <0.05 was considered significant. RESULTS: The average length of active phase (P = 0.0001), length of second phase (P = 0.0001), and third phase (P = 0.004) in two groups had statistically significant difference. The average length of the second phase (P = 0.03) and the third phase (P = 0.02) in case of spontaneous start of delivery in the intervention group was significantly lower than the control group. Use of oxytocin to accelerate delivery had a significant difference between the two groups (P < 0.001). CONCLUSION: According to the results of this study, consuming dates in late pregnancy was effective in decreasing length of labor processes and reduced the need of oxytocin for labor acceleration. Thus, it is recommended to consume dates in women without contraindications.

The effect of maternal role training program on role attainment and maternal role satisfaction in nulliparous women with unplanned pregnancy.

INTRODUCTION: The maternal role is one of the most basic and important roles played by women during their lifetime. The process of the maternal role starts during pregnancy and to continue and develop after postpartum with the growth of suckling. However, unplanned pregnancy may jeopardize achieving the maternal role and reduce maternal role satisfaction. Therefore, the researcher conducted the present study to determine the impact of maternal role training program on attainment of role and role satisfaction in nulliparous women with unplanned pregnancy. METHODOLOGY OF THE RESEARCH: In this clinical trial, the researcher divided 67 nulliparous women with unplanned pregnancies into two groups at random by drawing lots. For the intervention group, in addition to the usual pregnancy care, the researcher conducted 3 group training sessions at weeks 34, 35, and 36 of pregnancy and an individual training session in the 1st day after delivery before release; then, during the next 4 weeks, the researcher made follow-up phone calls each week. The control group received the usual pregnancy care. The research tools included London questionnaire to measure unplanned pregnancy, Myself-As-Mother Scale (SD-Self), My-Baby Scale (SD-Baby), Perceived Competence Scale to measure maternal role attainment, and Parenting Sense of Competence Scale to measure maternal role satisfaction. The researcher measured the maternal role attainment and maternal role satisfaction before training and 4 weeks after delivery. The researcher analyzed the data using SPSS software version 21 and statistical tests such as independent t-test, Chi-square, paired sample t-test, Mann-Whitney, one-way analysis of variance, and Wilcoxon. The amount of P was supposed to be <0.05. RESULTS: The mean age of research units was 24.10 ± 4.3. Twenty-one persons (60%) in the intervention group and ten persons (31.3%) in the control group attained the maternal role (P = 0.019) and changes to achieve the maternal role in intervention group were significantly more than the control group (P = 0.002). Changes in the mean scores of maternal role satisfaction in the intervention group were significantly more than the control group (P = 0.023). CONCLUSION: Maternal role training for nulliparous women with unplanned pregnancy during pregnancy and postpartum period can help them in maternal role attainment and maternal role satisfaction.

Does maternal and fetal health locus of control predict self-care behaviors among women with gestational diabetes?

INTRODUCTION: Gestational diabetes is the most common metabolic disorder in pregnancy, and lack of self-care is the most important reason for mortality in diabetic patients. Since the glycemic control is associated with physiological and psychological mechanisms, variables such as health locus of control can play a role in health behaviors of diabetic patients. Therefore, this study was aimed to predict self-care behaviors among women with gestational diabetes based on maternal health locus of control (MHLC) and fetal health locus of control (FHLC). METHODS: This study is a descriptive, predictive correlational study that it is conducted on over 400 women with gestational diabetes attending the health centers and clinic of hospitals affiliated to Mashhad University of Medical Sciences in 2015. Data were collected using individual questionnaire, self-care derived from the summary of diabetes self-care activities, MHLC, and FHLC scale. The data were analyzed using Spearman's correlation coefficient test, linear regressions model, and multiple regression in SPSS software version 16. P < 0.05 was considered statistically significant. RESULTS: Results of Spearman's correlation coefficient test showed a significant direct linear relationship between self-care and internal MHLC (P = 0.027) and internal dimensions (P < 0.0001) and powerful others (P = 0.012) of FHLC. According to linear regressions model, internal MHLC (P = 0.027), internal dimensions (P < 0.0001), and powerful others (P = 0.012) of FHLC are considered as predictor variables of self-care. CONCLUSION: Midwives should perform interventions to increase internal locus of control and encourage more responsibility among women with gestational diabetes to achieve better self-care.

The comparison the effect of training by means of simulation and oral method on midwives' skill in management of shoulder dystocia.

INTRODUCTION: Shoulder dystocia is one of the obstetric emergencies that are accompanied to serious risks for mother and fetus. It necessitates making the method of training of shoulder dystocia management more efficient, i.e., better management and giving services with higher quality. Thus, this study was carried out to compare the impact of training by simulation and oral technique on the skill of the employed midwives in obstetric clinics at Mashhad city (Iran) in shoulder dystocia management during 2012. METHODS: The current research is a double-group clinical trial that was conducted on 51 members of the employed midwives in the obstetric clinic at Mashhad city in 2012. The questionnaire of personal specification and awareness about shoulder dystocia and practical examination (objective-structured clinical examination) were employed as tools for data collection. The learners were divided into two groups by randomized allocation. Training was done by the presentation of lecture in the oral content group and a short movie was displayed at the end of it. The shoulder dystocia management technique was simulated in another group and through role-playing of instructor application of moulage (station) training was conducted. The period of the training course (4 h) and content of the educational workshop was identical for both groups. The practical examination was held for the learners before and immediately after training course. The given data were analyzed by means of statistical descriptive tests including Mann-Whitney U-test and Wilcoxon test via SPSS software (version 16). The significance level was considered as (P < 0.05) in all cases. RESULTS: The total mean score was significantly increased for the variable of shoulder dystocia management skill after intervention in both groups (P < 0.0001). Similarly, the results of Mann-Whitney U-test statistical tests indicated that total mean score for the variable of shoulder dystocia management skill after the intervention was significantly greater in simulation group than in an oral group (P = 0.040). CONCLUSION: Training in simulated delivery room by means of role-playing is an efficient method for training shoulder dystocia management skill, so it is recommended to use this program in the training of this skill.

The effect of a positive reappraisal coping intervention and problem-solving skills training on coping strategies during waiting period of IUI treatment: An RCT.

BACKGROUND: Waiting period of fertility treatment is stressful, therefore it is necessary to use effective coping strategies to cope with waiting period of intrauterine insemination (IUI) treatment. OBJECTIVE: The aim of this study was comparing the effect of the positive reappraisal coping intervention (PRCI) with the problem-solving skills training (PSS) on the coping strategies of IUI waiting period, in infertile women referred to Milad Infertility Center in Mashhad. MATERIALS AND METHODS: In this randomized clinical trial, 108 women were evaluated into three groups. The control group received the routine care, but in PRCI group, two training sessions were held and they were asked to review the coping thoughts cards and fill out the daily monitoring forms during the waiting period, and in PSS group problem-solving skill were taught during 3 sessions. The coping strategies were compared between three groups on the 10th day of IUI waiting period. RESULTS: Results showed that the mean score for problem-focused were significantly different between the control (28.54±9.70), PSS (33.71±9.31), and PRCI (30.74±10.96) (p=0.025) groups. There were significant differences between the PSS group and others groups, and mean emotion-focused were significantly different between the control (32.09±11.65), PSS (29.20±9.88), and PRCI (28.74±7.96) (p=0.036) groups. There were significant differences between the PRCI and the control group (p=0.047). CONCLUSION: PSS was more effective to increase problem-focused coping strategies than PRCI, therefore it is recommended that this intervention should be used in infertility treatment centers.

The effect of individual counseling program by a midwife on fear of childbirth in primiparous women.

INTRODUCTION: Fear of childbirth is a common problem in pregnant women, which in many cases leads to maternal requested cesarean. A midwife, as a responsible person, plays an important role in providing advice and giving care to mothers during pregnancy, delivery, and the postpartum period. The present study was conducted with the aim of determining the effect of individual counseling program by a midwife on fear of childbirth in primiparous women. MATERIALS AND METHODS: This clinical trial was conducted in 2015-16, on ninety primiparous women with gestational ages of 28-30 weeks, who presented themselves at health-care centers in Mashhad. The individuals were randomly divided into two groups: intervention and control. The intervention group received the counseling program individually during three sessions, and the routine care was given to the control group. Data collection tools the Wijma Delivery Expectancy/Experience Questionnaire. The data were collected at recruitment during 34-36 weeks of pregnancy and were analyzed using SPSS 16 software and the statistical tests: Chi-square and t-test, and P < 0.05 was considered to be significant. RESULTS: During weeks 34-36 of pregnancy, the mean scores for fear of childbirth in the intervention group and control group were 39.733 ± 17.085 and 65.666 ± 15.019, respectively, and there was a significant difference between the two groups (P < 0.001). CONCLUSION: The individual counseling program provided by the midwife to the primiparous women during pregnancy resulted in reduced fear of childbirth.

Quality of Life Evaluation in Iranian Postpartum Women With and Without Striae Gravidarum.

BACKGROUND: Striae are a common change during pregnancy, leaving striae in various body parts after delivery, which most women find unpleasant. They create a big aesthetic concern for most women. Although striae do not endanger the mother and the fetus, they may cause a desire to scratch the region leading to small wounds, induce stress over beauty, decrease self-confidence, and create psychological disorders. They may try various treatments and often refer to dermatology clinics and receive long-term treatments; these time-consuming and costly behaviors and may affect their quality of life. OBJECTIVES: The aim of this study was to evaluate the quality of life in Iranian postpartum women with and without striae gravidarum. MATERIALS AND METHODS: This cross-sectional study was conducted on 145 women who had referred to health centers of Mashhad to receive post-delivery health care six weeks after delivery during year 2013. Multi-stage sampling was applied to select the participants. The tools used were demographic, SF-36 quality of life, Skindex29, Atwal and Fitzpatrick classification questionnaires. Data were analyzed using the SPSS V.11.5 software. RESULTS: The subjects' mean age was 26.3 ± 5.7. Mann-Whitney test showed there was a significant difference between mean of Skindex29 and its dimensions (P < 0.001), general life quality (P < 0.001) in women with and without striae. Mann-Whitney test showed no significant difference between mean general quality of life dimension, except physical function in women with and without striae (P > 0.05). CONCLUSIONS: The results showed that striae lead to reduced quality of general life and reduced skin quality index in women postpartum.