A systematic review of sarcopenia prevalence and associated factors in people living with human immunodeficiency virus.

People living with human immunodeficiency virus (HIV) (PLWH) appear to be at an increased risk of sarcopenia, which can have a devastating effect on their life due to consequences such as physical disability, poor quality of life, and finally death. This systematic review examined sarcopenia prevalence and its associated factors in PLWH. A systematic search was conducted using the keywords in the online databases including Scopus, PubMed, Web of Science, Embase and Cochrane databases from the dates of inception up to May 2022. The retrieved articles underwent a two-step title/abstract and full-text review process, and the eligible papers were selected and included in the qualitative synthesis. Data relating to the study population, purpose of study, gender, age, race, body mass index, medical history, paraclinical results and antiretroviral therapy as associated factors of sarcopenia were extracted. In addition, the prevalence of sarcopenia in PLWH and its promoting and reducing factors were also extracted. We reviewed the 14 related studies for identifying of sarcopenia prevalence and its associated factors in PLWH. The total number of PLWH in all the reviewed studies was 2592. There was no criterion for the minimum number of people with HIV and the lowest number of PLWH was 27, and the highest number was 860. Some studies reported a significantly higher prevalence of sarcopenia in HIV-infected individuals compared with HIV-negative controls as follows: 24.2-6.7%, 15-4% and 10-6%, respectively. We showed that, age (30-50 years), being female, >5 years post-HIV diagnosis, multiple vertebral fractures, cocaine/heroin use and lower gamma-glutamyl transferase level were the main promoting factors of sarcopenia. Higher educational level, employment, physical exercise, calf circumference >31 cm, and gait speed >0.8 m/s were also factors to reduce sarcopenia. Sarcopenia prevalence in PLWH is higher than HIV-negative population. Given the importance and prevalence of sarcopenia among PLWH and its associated consequences (i.e., mortality and disability), determining its risk factors is of great importance.

Comparison of the Effect of Foot and Palm Reflexology Massage on Respiratory Distress Syndrome in Premature Infants under Noninvasive Ventilation.

INTRODUCTION: Respiratory distress is one of the life-threatening conditions in preterm infants. Sensory deprivation in preterm infants hospitalized in the intensive care units affects their physiological and psychological development. Therefore, this study is an attempt to compare the effects of foot and palm reflexology on respiratory distress in infants subjected to noninvasive ventilation. METHODS: In this clinical study, 150 infants hospitalized at Fatemieh Hospital in Hamadan were randomly assigned to 3 groups. In the intervention groups, the reflexology massage to foot and palm was performed for 10 min within 3 days in 6 rounds. In the control group, leg warming was performed. In each group, the personal information checklist, the respiratory distress score, oxygen saturation percentage, and respiratory rate before and after the daily intervention were examined. Data analysis was performed using the standard statistical tests in SPSS. RESULTS: The results mirrored the statistically significant difference between the intervention and control groups 3 days into the intervention with regard to the average oxygen saturation percentage, respiratory rate, and the respiratory distress score (p < 0.05). When eliminating the effect of confounding variables, therapeutic intervention applied to palm compared to foot had a greater effect on reducing respiratory distress score in the studied infants. CONCLUSION: The reflexology massage method, especially palm reflexology massage, contributes to the mitigation of respiratory distress in preterm infants subjected to noninvasive ventilation. Hence, this low-cost and efficient intervention program can be recommended as a complementary method for preterm infants with respiratory distress.

Legal complaints about midwives and the impact on the profession.

INTRODUCTION:: Midwives play an important role in maintaining and increasing women's health and well-being. Training professional midwives is one of the main policies of any healthcare system. Since the number of complaints against midwives has increased recently, this study was conducted to explore the perspectives of midwives regarding patients' complaint to authorities and their impacts on the profession of midwifery. METHODS:: Being conducted in 2013, this qualitative study was the first of its type in Iran. Data were collected through in-depth semi-structured interviews with 14 midwives working in different cities across the country. The participants were selected using a purposive sampling method. Interviews were transcribed verbatim and analyzed following a qualitative content analysis approach. Written text was then coded, and themes were extracted from the data. Ethical considerations: The study was conducted with midwives' free informed consent and was approved by Ethics Committee of Tehran University of Medical Sciences. FINDINGS:: By analyzing the data, four main themes regarding the impact of complaint on midwifery profession were developed. These included the following: "dissatisfied of midwifery, professional deviation, obsession with work, and weakening of the professional status." CONCLUSION:: The experience of patients' complaint to legal authorities against midwives was described, by participants, as a painful experience. Lack of midwives' knowledge about professional rules and litigation process created many problems for them and could negatively affect their practice and the society's attitude toward midwifery. Thus, we suggest that in order to prevent such problems, midwives and midwifery students should be educated regarding factors that have the potential to create such problems and also prevention strategies.

The Experience of Litigation From the Perspective of Midwives in Iran.

INTRODUCTION: Errors and notices to appear in court are a reality of life for many midwives and exert significant effects on both their professional and personal lives. Given the increasing population policies in place, this study was conducted to examine midwives' experiences of litigation in Iran. METHODS: A qualitative study was conducted in 2014 using an interpretive phenomenological approach. The interviews were recorded and transcribed and were then analyzed using the Diekelmann method. FINDINGS: Midwives who participated had professional experience ranging from 3 to 22 years at the time of the complaints. Five participants had received more than one complaint, and 10 participants were judged as guilty creating/leaving significant effects on various dimensions of their lives. CONCLUSION: The present research disclosed four main themes from the interviews including feeling ruined by the complaints, being conflicted between denial and belief, having shattered hopes of release, and experiencing the slowed-down rhythm of midwifery. From these, a basic pattern of "living in despair" was extracted. Litigation is a painful experience for midwives. Anxiety regarding compensation for the patients' losses, public judgment, prolonged litigations, and undermined professional dignity create physical and psychological ramifications for these midwives. Negative feelings about litigation, compounded by the lack of legal support from the authorities, cause a sense of hopelessness regarding the future of the midwifery profession.