Challenges of divorced women: a qualitative study

The health of women, as half of the world's population and the foundation of families and societies, has played a significant role in securing and stabilizing of the health of fami- lies and societies. The increasing rate of divorce in Iran caused us to perform this study aimed to explore the challenges of divorced women. This was a qualitative study which was carried out through in-depth semi- structured interviews with 12 divorced women whose divorce decree was issued in the Family Court of Shahrood, Iran, at least one year ago. Participants were selected purposefully and the data was analyzed using qualitative content analysis. The results of the study revealed the 4 following themes of health meaning from divorced women's experiences, causes of divorce, divorced women's problems, and divorced women's expec- tations from the society and authorities. Adverse consequences of divorce on women's health including physical, mental and venereal diseases, and other serious social problems should be considered as the main and most important priority of the country by the authorities. Paying attention to the major and underlying grounds of divorce, also the most important problems of youth of the country, including addiction, superficiality, negligence of basic criteria in marriage, and infidelity, can be helpful in solving the problem of divorce

Psychological predictors of intention to deliver vaginally through the extended parallel process model: a mixed-method approach in pregnant iranian women

Despite the fact that cesarean delivery does not offer significant health benefits for either mother or newborn, there has been a noticeable upward trend in elective cesarean births in Iran, over the last two decades. This study aims to examine whether knowledge, perception of health threats, efficacy, and personal beliefs act as psychological predictors towards the intention of women to have a normal vaginal delivery. The mixed-method approach was used as quantitative and qualitative design. Simultaneously, 290 pregnant women who visited prenatal clinics participated in the study. Quantitative and qualitative data were collected using a structured questionnaire based on Witte's Extended Parallel Process Model, and four focus groups, respectively. Women perceived lower personal risk but higher levels of efficacy. Perceived self-efficacy, severity, and response efficacy emerged as significant predictors of intention to experience vaginal birth. The participants' insufficient knowledge and misconceptions about birth methods were prevalent. Major themes were identified and divided into negative and positive beliefs about vaginal birth. This educational model is useful for understanding women's intention to undergo a vaginal birth, especially when it is combined with a qualitative approach. Maternal care providers should acknowledge their clients' beliefs and intended childbirth methods prior to offering medical intervention.

Neonatal seizures in a rural Iranian district hospital: etiologies, incidence and predicting factors

Current study determined the overall incidence, common causes as well as main predictors of this final diagnosis among neonates admitted to a rural district hospital in Iran. This study was conducted on 699 neonates who were candidate for admission to the NICU. Study population was categorized in the case group, including patients exposed to final diagnosis of neonatal seizures and the control group without this diagnosis. Neonatal seizure was reported as final diagnosis in 25 [3.6%] of neonates. The most frequent discharge diagnosis in the seizure group was neonatal sepsis and in the non-seizure group was respiratory problems. No significant difference was found in early fatality rate between neonates with and without seizures [8.0% vs. 10.1%]. Only gestational age <38 week had a relationship with the appearance of neonatal seizure. Low gestational age has a crucial role for predicting appearance of seizure in Iranian neonates

Important risk factors of mortality among children aged 1-59 months in rural areas of Shahroud, Iran: a community-based nested case-control study

The aim of the study was to evaluate potential risk factors of children mortality between 1-59 months of age. This nested case-control study was conducted among children born from June 1999 to March 2009 in rural areas of Shahroud, located in the central region of Iran using health care visit reports and follow-up data available in household health records. Mortality was significantly associated with breastfeeding duration [OR: 0.87, 95% CI: 0.81-0.93], total health care visits [OR: 0.90, 95% CI: 0.83-0.98] and low birth weight [LBW] [OR: 7.38, 95% CI: 1.37-39.67]. In our study, a longer breastfeeding period and more frequent health care visits were two important protective factors, while LBW was an important risk factor for 1-59 month child mortality. It seems, that complex and multiple factors may be involved in mortality of under 5-year-old children, so combined efforts would be necessary to improve child health indicators

prevalence and determinants of pterygium and pinguecula in an urban population in Shahroud, Iran

While pterygium is considered a common eye disorder, the etiology and pathogenesis is still not known. The aim of this study was to describe the prevalence of pterygium and pinguecula in the over 40 population of Shahroud and assess associated factors. The present study is part of the phase one of the Shahroud Eye Cohort Study conducted in 2009, in which the target population was people between 40 and 64 years of age. Ophthalmic examinations were performed by two ophthalmologists who made the diagnosis of pterygium and pinguecula. We used Chi-square tests, analysis of variance, and multiple logistic regression tests to examine associations. Of the 6311 invitees, 5190 people participated in the study [response rate: 82.2%]. The prevalence of pterygium in at least one eye was 9.4% [95% CI, 8.6-10.3], while 2.9% [95%CI, 2.4-3.3] had bilateral pterygium. The prevalence was significantly higher in men [11.4% vs. 8.0%], and remained relatively constant with age, while the prevalence in women significantly increased with age. The prevalence of pinguecula was 61.0% [95%CI, 59.1-62.9] in at least one eye, and 49.0% [95%CI, 47.1-50.9] in both eyes. The age difference between those with and without pinguecula was significant and the prevalence was significantly higher among men than women [70.6% vs. 53.8%]. The prevalence of pterygium in our study was lower than reported rates in the world but higher than Tehran and was significantly associated with age, gender, working outdoors, and the level of education. The prevalence of unilateral and bilateral pinguecula falls in the mid range and was significantly associated with age, male gender, smoking, working outdoors, and level of education

Attitude of pregnant women, midwives, obstetricians and anesthesiologists toward mode of delivery: a qualitative study

To investigate the attitudes toward mode of delivery of pregnant women, midwives, obstetricians and anesthesiologists who participate in childbirth in Shahrood, Iran. This was a qualitative research with tri-angulations data collection strategy. The study sample was consisted of primiparous and multiparous women, midwives, obstetricians and anesthesiologists. A total of 18 women who seek prenatal care from Fatemiyeh obstetrics clinics during pregnancy, were asked to participate in 3 focus group discussions. 8 midwives in labour ward and clinic were interviewed individually. All of physicians were participate in study by Delphi method for data collection purpose. All interviews and discussions were tape recorded. The main themes were categorized into two main categories: [causes of intention to cesarean] and [causes of intention to vaginal delivery]. The main reason for intention to use cesarean was fear of pain due to vaginal delivery and the main reason for intention to use vaginal birth was fear of post cesarean pain and its morbidity. Other reasons that raise the cesarean section rate in Shahrood included, fear of legal complaints after vaginal birth complications fear of sexual disorders after vaginal birth, existing conflicts between midwives duties and obstetricians and negative attitudes. The results clearly show that although most of women and health providers do not consider cesarean section as the first option for delivery, but some essential obstacles remain as major reasons for increasing cesarean rate

[Investigating employees' satisfaction with E-learning courses in Tehran university of medical sciences]

Introduction: The aim of staff-in service training is to improve employees' performance [functionality] in organizations. On the other hand, effective learning hinges in staff's satisfaction with educational courses. This study was designed and performed to assess employees' satisfaction with staff-in-service electronic training

Methods: This cross-sectional study was performed in year 2008 for population of those employees of Tehran University of Medical Sciences who attended staff-in-service electronic training [electronic satisfaction assessment]. Using simple sampling method, 651 employees completed the questionnaire on 3 areas of satisfaction with content, instruction method, and electronic training program. During the conduction of primary study, questionnaire's content validity was measured using Cronbach's alpha coefficient. Data was analyzed by SPSS software version 16 using statistic tests of Pearson correlation, student's T test, and one way ANOVA according to the variables

Results: Employees' highest satisfaction related to the area of satisfaction with program [3.96 +/- 0.9 out of maximum score of 5] and the lowest satisfaction was about educational program's content [3.84+/-0.8]. Thematic variables such as years in workforce, employment type, and educational level left no effect on employees' satisfaction with participation in electronic training courses

Conclusion: Employees enrolled in this study were significantly satisfied with the e-learning courses. Regarding the fact that the satisfaction was relatively low, content quality improvement seems necessary

Tissue expansion for reconstruction of an unusual form of complex syndactyly

Tissue expanders can be used over the dorsum of hand and fingers to increase available tissue for flap coverage after release of syndactyly. Herein, we presented an 18-year-old man who had an unusual complex syndactyly in the middle and ring fingers of his right hand. He had also complete fusion of the proximal phalanges. In this report, we described the application of tissue expander to cover separated exposed bones