Contributing factors to high-risk sexual behaviors among Iranian adolescent girls: a systematic review

Background: Adolescence is a period of overwhelming changes and challenges, which expose the adolescents to high-risk behaviors. Risky sexual relationship is one of these behaviors that entails physical risks and psychosocial harms. Various factors have been recognized to shape sexual behaviors in adolescents. This paper is an attempt to investigate the factors contributing to high-risk sexual behaviors in Iranian adolescent girls

Methods: A literature review of the research published by Iranian authors, in Farsi or English language in local and foreign journals, was conducted using PubMed, Science Direct, Scopus, Scientific Information Database [SID], IranMedex, IranDoc, and Google Scholar. The search in each database included all the years covered at that time using keywords such as "sexual, adolescents, and Iran", and continued using other keywords such as "sexual behavior, high-risk behavior, sexual risk and reproductive behavior" individually and in combination

Results: Sixteen published articles were identified. Factors contributing to high-risk sexual behaviors in girls can be divided into four general groups including personal, family, peer, school and community

Conclusion: Regarding the identified risk and protective factors, appropriate individual, family and school-based interventions can be designed and implemented to strengthen protective factors. While individual and family factors are considered more in research, factors related to peers, school and community have received less attention. Since social values, beliefs and norms are important factors in formation of sexual behaviors, further research regarding these factors is suggested

Factors influencing first childbearing timing decisions among men: path analysis

Background: Factors that influence men's childbearing intentions have been relatively unexplored in the literature

Objective: This study aimed to determine the influencing factors about the first childbearing timing decisions of men

Materials and Methods: In this cross-sectional study, 300 men who were referred to private and governmental healthcare centers in Shahrood, Iran were randomly recruited from April to September 2014. Data were collected using a demographic questionnaire, the Quality of Life Questionnaire; ENRICH Marital Satisfaction Questionnaire, Synder's Hope Scale, and the Multidimensional Scale of Perceived Social Support

Results: After removing the statistically insignificant paths, men's age at marriage had the highest direct effect [beta=0.86] on their first childbearing decision. Marital satisfaction [beta=-0.09], social support [beta=0.06], economic status [beta=0.06], and quality of life [beta=-0.08] were other effective factors on men's first childbearing decisions. Moreover, marital satisfaction and social support had significant indirect effects on men's childbearing decisions [beta=-0.04 and -0.01, respectively]

Conclusion: Many factors, including personal factors [age at marriage and quality of life], family factors [marital satisfaction], and social factors [social support], can affect men's decision to have a child. Policymakers are hence required to develop strategies to promote the socioeconomic and family conditions of the couples and to encourage them to have as many children as they desire at an appropriate time

Comparison of generalized estimating equations [GEE], mixed effects models [MEM] and repeated measures ANOVA in analysis of menorrhagia data

Menorrhagia is one of the most common gynecological problem and leading causes of poor quality of life and iron deficiency anemia in women of reproductive age. Research in gynecological field relies heavily on repeated measure designs

Repeated measure studies are helpful in understanding how factors of interest change over time

Our goal is to apply statistical methods which are appropriate for analyzing repeated measure data such as gynecological data. Three statistical methods were performed by data collection from 100 patients with menorrhagia

One-hundred patients were randomly assigned to two groups, i.e. intervention group [Urtica Dioica and mefenamic acid] and control group [placebo and mefenamic acid] with an equal size of 50. In this study, generalized estimating equations [GEE] and mixed effects models [MEM] were used for analyzing menorrhagia data to determine the effect of hydroalcoholic extract of Urtica Dioica on Menorrhagia. Finally, these methods are compared to the conventional repeated measures ANOVA [RM-ANOVA]

Based on the results, the three methods are found to be similar in terms of statistical estimation, the amount of bleeding before and after treatment between and within groups was compared. Results showed the average amount of bleeding was reduced significantly [P=0/001]

The average menorrhagia score in the third month [second cycles after intervention] were 91.38 [71.432] and 149.40 [127.823] in Urtica Dioica and control groups, respectively. The difference between the two groups was statistically significant [p =0.036]

Because their advantages, GEE and MEM should be strongly considered for the analysis of repeated measure data. In particular, GEE should be utilized to explore overall average effects

When in addition to overall average effects, subject-specific effects are of primary interest, MEM should be utilized. With respect to these methods, it seems the extract of Urtica Dioica can be effective in reducing the amount of menstrual bleeding in women of reproductive age with Menorrhagia

Using support vector machines in predicting and classifying factors affecting preterm delivery

Various statistical methods have been proposed in terms of predicting the outcomes of facing special factors. In the classical approaches, making the probability distribution or known probability density functions is ordinarily necessary to predict the desired outcome. However, most of the times enough information about the probability distribution of studied variables is not available to the researcher in practice. In such circumstances, we need that the predictors function well without knowing the probability distribution or probability density. It means that with the minimum assumptions, we obtain predictors with high precision. Support vector machine [SVM] is a good statistical method of prediction. The aim of this study is to compare two statistical methods, SVM and logistic regression. To that end, the data on premature infants born at Tehran Milad Hospital is collected and used

Diagnosis of premature rupture of membranes by assessment of urea and creatinine in vaginal washing fluid

Background: rupture of fetal membranes can occur at any gestational age. Premature rupture of membranes [PROM] means rupture of fetal membranes before the onset of labor

Objective: the purpose of this study was to evaluate and compare the reliability of the vaginal washing fluid urea and creatinine for the diagnosis of PROM and to determine cut-off values

Materials and Methods: a total of 179 pregnant women were recruited. All patients underwent different examinations. These included nitrazine paper test, fern test, amniotic fluid pooling, vaginal washing fluid urea and creatinine sampling. The one group consisted of 126 pregnant women between 14 and 41 weeks of gestation with the complaint of vaginal fluid leakage. Patients who had positive pooling, nitrating paper test and fern test were considered as confirmed PROM group [group 1]. On the other side, patients with pooling [-] and/or nitrazine paper test [-] and/or fern test [-] were taken as suspected unconfirmed PROM cases [group 2]. The control group consisted of 53 pregnant women between 14 and 41 weeks of gestation without any complaint or complication. We conducted one-way ANOVA test on the urea and creatinine measures and post-hoc comparison test. Cut-off value was determined by receiver operating characteristic [ROC] curve

Results: vaginal fluid concentrations of urea and creatinine were significantly different between the three groups [p<0.001]. The sensitivity, specificity, positive and negative predictive values and accuracy were all 100% in detecting premature rupture of membranes by evaluation of vaginal fluid creatinine concentration with a cut-off value of 0.45 mg/dl, respectively

Conclusion: this study demonstrates that of two markers investigated creatinine has the higher diagnostic power

Using ROC surface to predict preterm delivery based on hemoglobin level in the first trimester of pregnancy

Receiver Operating Characteristics [ROC] curves have numerous applications for identifying a cut-off point in diagnostic tests. Nonetheless, given that sometimes two cut-off points have to be specified simultaneously, the ROC curve can be used to identify such points. The Volume under the ROC Surface [VUS] serves as a criterion for the accuracy of diagnostic tests. One of the unfortunate outcomes in pregnancy is pre-term delivery; it has been noted that an increase in the level of hemoglobin in the first trimester of pregnancy could result in preterm delivery in weeks 34 to 37 and that an ongoing hemoglobin increase could result in the delivery of a premature fetus before the 34th week of pregnancy. In this regard, in order to separate three groups of on-time delivery, pre-term delivery and immature delivery two cut-off points have to be identified, simultaneously. A suitable measure to identify such points is the ROC surface. In the current study, the hemoglobin information of the first trimester of pregnancy and delivery time of 623 pregnant ladies referring to Milad Hospital in Tehran in 2009-2010 was obtained. ROC surface was adopted to draw two ideal cut-off points for the first trimester of pregnancy. The optimal points for hemoglobin of the first trimester computed with the ROC surface were 12.54 and 13.2. While a hemoglobin rate less than 12.54 indicated an on-time delivery, a rate between the two cut-off points referred to pre-term delivery and hemoglobin more than 13.2 showed a premature fetus. The three-dimensional ROC surface is a useful tool that can visually summarize the ability of a biological marker to classify individuals between more than two groups

study on the effects of pimpinella anisum on relief and recurrence of menopausal hot flashes

With respect to the high incidence of hot flash in postmenopausal women and the controversies regarding its treatment, this double-blind clinical trial was conducted to determine the effects of Pimpinella anisum on hot flashes in these women referring to rural and urban health centers of Qazvin Province in 2009.Seventy-two women with hot flashes were randomly selected according to the predetermined criteria and divided into two experimental and control groups. Their medical records at health centers were used for sampling. Each woman in the experimental group took a capsule containing 330 mg Pimpinella anisum 3 times a day while in the control group, women took 3 capsules, each containing 330 mg potato starch, over 4 weeks and after that, they were following up for 4 weeks. Before taking the capsules, they were assessed for 2 weeks about the frequency and severity of hot flashes. Data were collected through a questionnaire and an information form. Content validity method was used for validity of the tools. ANOVA and Student›s t-test were applied for statistical analysis. In the experimental group, the frequency and severity of hot flashes before the treatment were 4.21% and 56.21% and, after that, were 1.06% and 14.44% at the end of the fourth week respectively. No change was found in the frequency and severity of hot flashes in the control group. The frequency and severity of hot flashes was decreased during 4 weeks of follow up period. P. anisum is effective on the frequency and severity of hot flashes in postmenopausal women

Effect of portfolio assessment on student learning in prenatal training for midwives / 보건의료교육평가

The tendency to use portfolios for evaluation has been developed with the aim of optimizing the culture of assessment. The present study was carried out to determine the effect of using portfolios as an evaluation method on midwifery students' learning and satisfaction in prenatal practical training. In this prospective cohort study, all midwifery students in semester four (n=40), were randomly allocated to portfolio and routine evaluation groups. Based on their educational goals, the portfolio groups prepared packages which consisted of a complete report of the history, physical examinations, and methods of patient management (as evaluated by a checklist) for women who visited a prenatal clinic. During the last day of their course, a posttest, clinical exam, and student satisfaction form were completed. The two groups' mean age, mean pretest scores, and their prerequisite course that they should have taken in the previous semester were similar. The mean difference in the pre and post test scores for the two groups' knowledge and comprehension levels did not differ significantly (P>0.05). The average scores on questions in Bloom's taxonomy 2 and 3 of the portfolio group were significantly greater than those of the routine evaluation group (P=0.002, P=0.03, respectively). The mean of the two groups' clinical exam scores was significantly different. The portfolio group's mean scores on generating diagnostic and therapeutic solutions and the ability to apply theory in practice were higher than those of the routine group. Overall, students' satisfaction scores in the two evaluation methods were relatively similar. Portfolio evaluation provides the opportunity for more learning by increasing the student's participation in the learning process and helping them to apply theory in practice.