Investigating the relationship between breast and gynecological cancers and infertility and its treatments: a case-control study.

OBJECTIVE: Due to the high prevalence of breast and gynecological cancers among women, it is crucial to identify the risk factors of these cancers. Thus, the present study aimed to evaluate the relationship between breast and gynecological cancers and infertility and its treatments in women suffering from these cancers. METHODS: This case-control study was conducted with the participation of 400 people (200 women with breast and gynecological cancers and 200 healthy women without a history of cancer) in hospitals and health centers in Tabriz, Iran, in 2022. Data were collected using a four-part researcher-made questionnaire including sociodemographic characteristics, obstetric characteristics, information related to cancer, and information related to infertility and its treatments. RESULT: s Based on the multivariable logistic regression model and by controlling sociodemographic and obstetric characteristics as possible confounding variables, women with cancer had an infertility history almost four times more than women who did not have a history of cancer (OR = 3.56; 95% CI: 1.36-9.33; P = 0.010). Women with breast cancer had an infertility history five times more than women without a history of breast cancer (OR = 5.11; 95% CI: 1.68-15.50; P = 0.004). The infertility history of women with gynecological cancer was more than three times that of the control group. However, there was no statistically significant difference between the two groups (OR = 3.36; 95% CI: 0.99-11.47; P = 0.053). CONCLUSION: Infertility and its treatments may be involved in increasing the risk of breast and gynecological cancers.

Prevention of osteoporosis in menopausal women: A systematic review of nonpharmacological clinical trials.

Osteoporosis is a systemic skeletal disease that is associated with negative physical and psychosocial consequences, so understanding the effective strategies that can be used in the prevention of osteoporosis is especially important. The aim of this study was to integrative review the published interventional of nonpharmacological studies regarding the prevention and treatment of osteoporosis among menopausal women. In this systematic review, databases such as PubMed, PsycInfo, Web of Science (ISI), Scopus, ScienceDirect, EmBase, Cochrane library, Google scholar, and Iranian databases, such as Scientific Information Database and Magiran, were searched. The latest search was performed between "November 2020 and December 2020" separately by two researchers and then double-checked by them. The quality of the included studies was assessed using the Jadad score calculation tool. Twenty eight randomized controlled trials and quasi-experimental studies were included in this current study. The quality assessment indicated that 19 studies had acceptable (good) methodological quality and also 9 studies had weak methodological quality. The main results of this study were classified in three main categories such as exercise or physical activity training (n = 15), educational sessions (n = 11), and other interventions (n = 2). The results of most included studies showed that nonpharmacological strategies such as physical activity and educational interventions are considered as the appropriate actions to prevention of osteoporosis among menopausal women so implementing these strategies can be a good alternative for women with contraindication of hormone therapy or therapeutic treatment.

Translation and validation of Persian version of sexual function: vaginal changes questionnaire (SVQ) for women with gynecologic cancers.

BACKGROUND: Changing in the sexual function is an important condition in women with gynecological cancers. A valid and reliable questionnaire is required to assess this condition. The aim of this study was to translate and validate the Persian version of the Sexual-Vaginal Function Changes Questionnaire (SVQ) in women with gynecologic cancers. METHODS: This methodological study with a psychometric design was conducted on 250 women with gynecologic cancers, who visited public and private medical centers in Tehran to receive follow-up services. Convenience sampling was conducted from April 2019 to May 2020. First, the Persian version of the Sexual Function-Vaginal Changes Questionnaire was developed and then, psychometric properties such as content validity, face validity, construct validity and criterion validity were assessed. Reliability of the instrument was assessed by Cronbach's alpha coefficient. RESULTS: Mean age of participants was 53.3 ± 11.8 and mean score of SVQ was 63.0 ± 9.1 in the possible range of 26-104. Content validity was tested through qualitative method and six items were revised as suggested by the expert panel. Cronbach's alpha coefficient was 0.71 for the whole questionnaire and it was 0.93, 0.92, 0.89, 0.78, 0.88 and 0.78 for the 6 subscales, respectively, which shows the optimal internal consistency. Results of exploratory factor analysis revealed six factors as (1) intemacy and sexual interst, (2) arousal, (3) changes in intemacy and sexual interst after cancer, (4) vaginal changes after cancer, (5) vaginal bleeding during coitus, (6) and sexual worry and dissatisfaction after cancer. explained 70.09% of the variance observed. Criterion validity test of the questionnaire showed a significant correlation between the total SVQ scores and the total Female Sexual Function Index (FSFI) scores as well as between SVQ dimensions and dimensions of FSFI (P < 0.001). CONCLUSIONS: The findings from this study indicated that the Persian version of the SVQ is a valid and reliable instrument to assess sexual function-vaginal changes in women with gynecologic cancers.

Knowledge and attitudes of adolescent girls and their mothers about early pregnancy: a cross-sectional study.

BACKGROUND: Adolescent pregnancy is an important public health problem and a socio-economic challenge in diverse societies. As a tremendously important problem, this issue has caused major concerns, as it exposes adolescent girls to social isolation and physical and psychological harm. So, this study aimed to determine the knowledge and attitude of adolescent girls and their mothers about early pregnancy, its causes, consequences, and predictors in Tabriz-Iran in 2020-21. METHODS: This cross-sectional study was done with 540 people (270 adolescent girls and 270 mothers) in the health centers of Tabriz. Data were collected using the questionnaires of sociodemographic information, knowledge, and adolescent girls' attitudes and their mothers about early pregnancy, its causes, and consequences. Multivariate logistic regression was used to determine the predictors of adolescent girls and their mothers' attitudes toward early pregnancy. RESULTS: The mean (SD: Standard Deviation) of knowledge of adolescent girls and their mothers about early pregnancy was 5.17 (3.11) and 5.57 (3.01), respectively (score range: 0 to 9). Most girls (94.1%) and mothers (87.1%) opposed pregnancy before 18. There was a statistically significant relationship between the knowledge and attitudes of girls (p < 0.001) and mothers (p < 0.001) about pregnancy at a young age. Adolescent girls and their mothers mentioned the lack of sufficient knowledge about sexual relations (57.4% of girls and 66.3% mothers agree) and the lack of knowledge about contraceptive methods (51.9% girl and 59.2% mother agree) important reasons for early pregnancy. Based on the multivariate logistic regression model and controlling for potentially confounding variables, girls whose parents were married under the age of 18 were about three times more likely to agree to early pregnancy than girls whose parents married over the age of 18 (OR = 3.10; 95% Cl: 0.90 to 10.69; p = 0.037). Also, mothers whose other children were married before 18 were almost five times more likely to agree to early pregnancy than women whose other children were not married before 18 (OR = 4.91; 95% Cl: 1.60 to 15.10; p = 0.045). CONCLUSIONS: The current study results indicate that despite the negative attitude of adolescent girls and their mothers towards early pregnancy, they had a low level of knowledge about early pregnancy. Consequently, increasing the level of knowledge of girls and their families about the consequences of marriage and pregnancy at an early age and creating a culture to correct cultural and social misconceptions to prevent marriage and pregnancy of children can reduce the severity of this damage.

Development of strategies to promote healthy sexuality based on Iranian girls perspective about the role of virginity in the construction of their sexuality: an explanatory sequential mixed method study protocol.

BACKGROUND: The modern Iran is a blend of tradition and modernity, but its dominant culture is still traditional and takes pride in female virginity. On the other hand, the influential factors such as modernity, education, social networks, global communication, influence from advanced Western societies, have obviously led to the emergence of a freer sexual attitude associated with less significance of virginity. Since the traditional, cultural and religious significance of virginity among Iranian girls can shape their sexual behaviors, therefore, the aim of the present study is development of strategies to promote healthy sexuality based on Iranian girls perspective about the role of virginity in the construction of their sexuality. METHODS/DESIGN: This is a two-stage study; an explanatory sequential mixed-methods follow-up design will be employed in the first stage, which consists of two quantitative and qualitative phases. The first phase is the cross-sectional survey that will be conducted on 700 single girls born in the 1970s, 1980s and 1990s. The sample will be selected using the cluster sampling method in the health centers of Tabriz-Iran. The determined sample size will be divided among the selected health centers based on the quota criterion, and eligible households will be selected randomly from the said centers using the SIB website (sib.tbzmed.ac.ir). To collect the required data in the quantitative phase, we will use a researcher-made questionnaire to evaluate the girls' views about virginity and its influential factors, designed based on the theory of "social construction of sexuality". After quantitative data collection and analysis, the findings inform qualitative data collection and analysis. The qualitative phase of the study will be conducted on girls living in Tabriz using in-depth and semi-structured individual interviews and purposive sampling method to collect the required qualitative data. The collected data will be analyzed using the conventional content analysis approach. The findings of two phase will be integrated for further explanation and interpretation to be used in the second stage. In the second phase of this study, a nominal group meeting will be held with the participation of reproductive and sexual health experts. The strategies extracted from the results of the first phase and review the texts in this meeting will be provided to experts and after receiving the opinions and ideas of the relevant group of experts and prioritizing them, appropriate strategies to improve and promote the healthy sexuality of Iranian girls will be presented. DISCUSSION: This study is one of the few studies conducted in the field of sexual health and culture in Iran, that using a "mixed-methods" approach to determine and explain the role of virginity in the construction of the sexuality from the Iranian girls perspective. We hope that this study can present evidence-based documents from the latest physical, psychological and social developments in young Iranian girls' sexuality and that the presented healthy sexuality promotion strategies, which will be based on Iranian socio-cultural developments, can provide the basic information required for policy-making and planning for young girls' sexual health. It is also hoped that the findings of this study will be useful in culture-based sexuality education and support for reproductive and sexual health care for the young Iranian generation.

Knowledge and viewpoint of adolescent girls regarding child marriage, its causes and consequences.

BACKGROUND: Child marriage is a violation of children's rights and it exposes them to social isolation and psychological damages. These negative effects are not limited to them and expands to the family and society as well. The present research aimed at determining the knowledge and viewpoint of adolescent girls regarding child marriage, its causes and consequences in the city of Tabriz-Iran, in 2020-2021. METHODS: This cross-sectional study was carried out on 300 adolescent girls who had records in the health centers in the city of Tabriz. The data were collected using the sociodemographic characteristics questionnaire, questionnaire of knowledge, and view of adolescent girls regarding child marriage, and its causes and consequences. The multivariate logistic regression model with adjusting the sociodemographic characteristics was used to determine the relationship between the viewpoint of adolescent girls about child marriage and their knowledge in this regard. RESULTS: The mean (SD) knowledge about child marriage was 6.70 (3.09) (score range: 0-11). The majority of the girls (85.4%) were against marriage before the age of 18 and only 16 girls (5.1%) of them agreed with marriage before the age of 18. Investigating the viewpoint of adolescent girls regarding the causes of child marriage revealed that the important issue leading to reduction of child marriage can be "intellectual, emotional, social, and economic maturity of girls plus their physical puberty (92.4% agree), increase in the girls' education (79% agree) and increasing girls' awareness regarding the consequences of early marriage in schools and media (69.6% agree). Illiteracy or lack of education of parents (64% agree), meeting the emotional needs (59.3% agree), family problems and conflicts (59.6% agree), and lack of exhilaration in daily life, especially in the rural regions and suburbs (58.3% agree) were among the reasons of increase of child marriage. The most important consequence of child marriage from the viewpoint of the girls is deprivation from the chance of education. The results of multivariate logistic regression model by adjusting the possible confounding variables, showed that girls who believed the appropriate age for marriage is under 20 were almost 13 times more likely to agree with child marriage than girls who believed the appropriate age for marriage is over 20 years (aOR = 13.82; 95% Cl 2.61-71.16 p = 0.002) and girls who opposed their parents' decision to marry under the age of 18 were less likely to agree with the child marriage than girls who did not oppose their decision (aOR = 0.09; 95% Cl 0.01-0.63 p = 0.016). CONCLUSIONS: The results revealed a good level of knowledge and negative attitude to child marriage among the girls. The girls who disagreed with child marriage were more knowledgeable than the girls who agreed with child marriage. Thus, the increase of the level of knowledge of girls and their families regarding the consequences of early marriage and developing the culture for correcting the cultural beliefs and wrong social beliefs to prevent child marriage can decrease this damage to a great extent.

Relationship of fear of COVID-19 and pregnancy-related quality of life during the COVID-19 pandemic.

AIM: The aim of this study was to determine the relationship between fear of COVID-19 and quality of life in Iranian pregnant women during the COVID-19 pandemic. METHODS: This cross-sectional study was carried out on 250 Iranian pregnant women. Data was collected through questionnaires including demographic and obstetric characteristics, fear of COVID-19 and quality of life. An adjusted general linear model was used to determine the relationship between variables. RESULTS: There was a negatively significant relationship between fear of COVID-19 and quality of life (P < 0.001). Based on the adjusted general linear model, it was expected that if COVID-19 fear score increased, the quality of life score would decrease significantly (B = -0.21, 95%CI: -0.34 to -0.09, P = 0.001). CONCLUSION: This study indicated a reverse correlation between fears of COVID-19 and quality of life. Therefore, developing appropriate interventions in order to overcome the fear caused by COVID-19 are recommended to improve pregnant women's quality of life.

Domestic violence and its relationship with quality of life in pregnant women during the outbreak of COVID-19 disease.

BACKGROUND: During the COVID-19 pandemic, pregnant women bear considerable physical and psychological stress because of their special conditions, which combined with other stress factors such as violence, makes their situation even more critical. This study aimed to investigate the prevalence of domestic violence and its relationship with quality of life in pregnant women during the COVID-19 pandemic. METHODS: This cross-sectional study was performed with the participation of 250 pregnant women in the obstetrics clinic of 29-Bahman Hospital, Tabriz city. Using a three-part questionnaire consisting of the socio-demographic and obstetrics information, the domestic violence questionnaire developed by WHO, and the SF-12 quality of life questionnaire, the required information was collected. A general linear model was then used to determine the relationship between domestic violence and quality of life, while adjusting the socio-demographic and obstetrics information. RESULTS: According to the data, more than one-third of pregnant women (35.2 %) had experienced domestic violence. The most common type of violence experienced was emotional violence (32.8 %), followed by sexual violence (12.4 %), and physical violence (4.8 %). The mean score of the physical health department of quality of life in the group of women exposed to violence (50.21) was lower compared to the unexposed group (53.45), though there was no significant difference between them (P = 0.25). However, the mean score of the mental health department of quality of life in women exposed to violence (46.27) was significantly lower compared to unexposed women (61.17) (P < 0.001). Based on the general linear model, the mean score for quality of life in the mental health dimension was significantly higher among unexposed women compared to those exposed to violence (ß = 9.3, 95 %CI: 3.5 to 15.0, P = 0.002). CONCLUSIONS: The findings of this study indicate a high prevalence of domestic violence and its relationship with a low quality of life during the COVID-19 pandemic. Therefore, the findings signify the importance of screening pregnant women in terms of domestic violence in respective centers as well as the necessity of conducting proper interventions to address domestic violence to improve the quality of life in women.