Study protocol for promoting physical activity among women based on the MAPP process

Background: The participation of all stakeholders is necessary when a community-based intervention is designed. For running a practical intervention, it is necessary to have a framework to design the programme while considering all stages of planning, implementation and evaluation.

Aims: To describe a study protocol based on the MAPP process [Mobilizing for Action through Planning and Partnerships] for promoting physical activity [PA].

Methods: This protocol is implemented in 6 distinct phases. The goal of the first and second phase is to organize the programme and increase participation, and to determine the vision of the programme, respectively. The third phase provides a comprehensive picture of a community. The fourth and fifth phases identify strategies for the programme. The sixth phase is about the action cycle.

Conclusion: The framework considers all factors on PA improvement and, consequently, results in a culture-based programme for women

[Self-efficacy of midwives in order to provide reproductive health services in disasters, Tehran, 2014]

In addition to the knowledge and skills, midwives should have adequate self-efficacy in order to provide effective reproductive health services in disasters; because self-efficacy is one of the factors influencing proper performance in emergency and stressful situations. Sudden onset disasters indicate the need to evaluate the midwives self-efficacy more, as a predictor of the performance in providing reproductive health services. In this cross-sectional survey, 361 midwives who work in three areas of Tehran public hospitals, north, south and center after completing informed consent form, were participated by cluster random sampling. Data was collected by using a self-administered questionnaire and statistically analyzed by SPSS. The results are as follows: a total of 55, the self-efficiency score of midwives was moderate [38.3 +/- 8] and only 19% of the midwives had a good level of self-efficacy; The highest score of self-efficacy belonged to "collaborate with other team members in disaster" and the lowest score related to "adaptation to psychological stress with distress". There were significant correlation between self-efficacy with clinical experience [P=0.036], age [P=0.04], previous exposure to disasters [P=0.01] and completing the previous training course [P=0.04]. With Consideration to average midwives self-efficacy scores and its relationship with training courses, preparing midwives by education seems necessary

[Maternal-fetal attachment and its associated factors]

Maternal-fetal attachment plays an important role in maternal identity forming. The attachment behavior is different between mothers; and most of the reported studies are from Western countries. The aim of this study was to assess maternal-fetal attachment behavior and some related factors among Iranian mothers. This cross-sectional study was carried out in 12 health and medical centers, affiliated to Tehran University of Medical Sciences. Four hundred pregnant women were selected for the study. Data were gathered using two questionnaires. The first one was a self-structured questionnaire and the second one was the maternal-fetal attachment scale. Data were analyzed using the Pearson, Anova and t-test statistical tests. The P<0.05 denoted statistical significance. Findings showed that the mothers had good attachment toward their fetuses [M=84.72]. The race, higher maternal age, higher education, gestational age, planned pregnancy, sex of fetus, and assessing health of fetus had positive effects on prenatal attachment [P<0.05]. Tobacco use, multiparity, and high risk pregnancy had negative effects on attachment. There were no relationships between attachment and previous marriage, infertility, abortion, number/type of ultrasound, participation in prenatal classes and healthy baby [P>0.05]. Understanding maternal-fetal attachment behavior could play an important role in quality of prenatal care. Midwives can assess and promote attachment behavior as well as recognize factors influencing maternal-fetal attachment

predictive model for the diagnosis of preeclampsia

Preeclampsia is one of the three main causes of death in pregnant women. The medical condition is identified by hypertension and proteinuria with serious effects on the health of mother and the fetus. There seems to be no precise methods to diagnose preeclampsia at its onset. This study was done to evaluate the simultaneous measurement of some variables thought to be responsible in the pathogenesis of preeclampsia for predicting or screening those at risk. In this study, 466 primiparas were selected randomly among the bulk of pregnant women who attended Maryam Hospital for prenatal care in Tehran, Iran during 2007-2008. The subjects had no history of chronic health conditions and regularly took Iron supplements. The predictive variables included age, job, education, income, number of pervious marriages, BMI during the first trimester of pregnancy, age at the time of recruitment for the study, changes in hematocrit concentration at the beginning and the 24[th] to 28[th] weeks of pregnancy, blood pressure and roll-over test during 28[th] to 32[nd] week of gestation but the onset of preeclampsia was considered as a dependent variable. For analyzing the overall effects of the mentioned variables on prediction of the disease, multivariate logistic regression analysis was employed and ROC curves were used for determining a suitable cut-off point for determining the sensitivity and specificity of the model. The prevalence of preeclampsia was 6.4% [95% CI: 4.2-8.6]. Variables such as as positive roll-over test, fulfillment of university education, marriage more than once, high blood pressure during the 24[th]-28[th] weeks of gestation, being a housekeeper, satisfaction with income, positive roll over test at a late stage of gestation and increase in BMI raised the risk of preeclampsia 8.61, 7.98, 2.65, 1.84, 1.56, 1.28, 1.21 and 1.11 times respectively. The proposed logistic regression model had a sensitivity of 83% and a specificity of 76% regarding the inclusion of all the mentioned variables. Regarding the serious complications and negative effects of preeclampsia on both the mother and the fetus and the high sensitivity of this logistic regression model and imposition of no costs on the person for the measurement of the variables this model seems to be suitable for the screening of preeclampsia