Opinions of the midwives about enabling factors of skin-to-skin contact immediately after birth: a descriptive study

Despite the benefits of mother-newborn skin-to-skin contact [SSC] immediately after birth, the process has not been universally implemented as routine care for healthy term neonates. The purpose of this study was to determine opinions of the midwives about enabling factors of SSC immediately after birth in Tehran hospitals in 2012- 2013. This study has been conducted in a descriptive method based on PRCEDE-PROCEED model. The samples were 292 midwives from 18 hospitals. We used stratified and then simple random sampling. In this study midwives were working at delivery room; deliveries were conducted by midwives or they were in charge of the newborn immediately after birth. Data collection instrument was a self developed questionnaire concerning the enabling factors in the SSC. We applied face and content validity ratio [CVR], content validity index [CVI] and item impact method for the instrument's validity and Cronbach's Alpha for reliability. Finally, data were analyzed and interpreted using spss-18 through descriptive statistics. The results show that 90.4% of the midwives believed in necessity of a plan, 96.2% believed that good services should be provided to mothers, and 97.9%, 85.3% and 93.8% of them believed there is a need for private space, essential facilities and essential equipment for skin contact process; with Cronbach's Alpha of 0.731, 0.551, 0.501, and 0.600 respectively. Most of the midwives believed that enabling factors concerning the successful SSC are effective. We suggest further studies on other enabling factors effective in SSC from the view point of midwives, gynaecologists and caregivers

Investigation of Relationship between Husband's Occupation and Preeclampsia in Pregnant Women Admitted to Selected Hospitals in Tehran, 2011

Background and Purpose: Preeclampsia is a significant threat to public health and the leading cause of maternal and fetal death and disability worldwide. Its incidence is between 5 to 12 percent in Iran, which has many causes.Husband's occupation is one of these factors that has not been considered till now. This study was performed to determine the effect of husband's occupation on preeclampsia in pregnant women in Tehran

Materials and Methods: This is a retrospective study with a total case of 195 pregnant women [65 women with preeclampsia and 130 controls] admitted to selected hospitals in Tehran, 2011. Among the hospitals with higher number of deliveriesin the north, south, east, west and central of Tehran, 4 reference hospitals wereselected based onobjectiveand non-randomized methodand given referrals for prenatal care and delivery; every hospital was given a quota. Data collecting tools were questionnaire and checklist that were filled by interview with qualified women and their cases. Women were divided into worker, employee, unemployed and self employed groups. Confounding factors were controlledthrough randomizing. We used independent t test for quantitative variables and chi-square test for relationships between categorical variables. Odds ratio was used to show the statistics relationship between some variables and preeclampsia.All data analysiswas performed bySPSSversion 18

Results: The results of this study showed that there is a statistically significant association between husband's occupationand preeclampsia [P=0.01]. In preeclamptic group, the worker husbands and in healthy group the self employed husbands were the most

Conclusion: It seems that husband's occupation is related to preeclampsia and the incidence of preeclampsia in worker's family is more than families that are employee and selfemployed

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

[Assessment of quality of prenatal care in Shahid Beheshti University of Medical Sciences health centers]

Objective: To evaluate the prenatal care status to improve quality of prenatal care services in Shahid Beheshti university hospital and health canters

Method: This was a cross sectional descriptive study to evaluate status of provided prenatal care services in three domain of structure of the services, procedures of care and outcomes. Using nonrandomized Quota sampling, 600 subjects of care were assessed in 12 prenatal clinics of hospital and health centers of the university. Tools of the study were included: a questionnaire and a checklist to observe facilities and equipment, a check list to observe the care procedure and a questionnaire to assess clients' satisfaction. The tools were used to assess the percentages of conformity with desired situation. These tools were mainly provided by an instruction of ministry of health. Content and face validity of these tools were assessed by a team of reproductive health experts and concurrent inter-rater reliability of the checklists were demonstrated by correlation coefficient of 0.84. Reliability of the satisfaction questionnaire was also shown by correlation coefficient of 0.9 and 0.95 using half splitting and test-retest methods. Data was analyzed by SPSS version 16 and using descriptive statistics and student t test and using 95% confidence interval

Results: 600 subjects with average pregnancy duration of 29.32+/-9.42 weeks were assessed in the study. Assessment of different care procedures demonstrated the percentages of conformity with desired situation as follow: counseling procedures 55.49+/-21.24 percent, history-taking procedure 48.71+/-11.36 percent, vital signs assessment 53.41+/-10.55 percent, general examination for first time attended clients 30.22+/-13.23 percent, obstetrical examination 91.77+/-27.01 percent, blood tests 93.83+/-21.89 percent, urinary tests 86.85+/-26.29 percent and sonograhic assessment of 95.7+/-4.3 percent. The conformity with desired situation of education about individual health and perinatal-risk assessment were 6.54+/-17.10 and 39.67+/-27.09 percent respectively. The results demonstrated 73.76+/-15.04 percent of clients' satisfaction with the structure of prenatal care services and 70.54+/-13.13 percent of satisfaction with the care procedures

Conclusion: For the first time, this study assessed the prenatal care services in three dimensions of the services structure, care procedures and outcome of these services in the PNC clinics of Shahid Beheshti Medical Science University. The study aimed to provide a tool to assess quality of PNC area of reproductive health. Despite almost high quality obstetrical care and paraclinic tests, the quality of care in other care areas and the quality of clients' education and counseling was moderate or low. Counseling and education are among the most important objectives of prenatal visits that needs precise planning and implementation. Screening of clients with psychosocial risks also requires special attention in prenatal care assessments. Preparing comprehensive forms for history taking, general and obstetrics assessments and would help to improve quality of prenatal care

Effects of licorice on relief and recurrence of menopausal hot flashes

Vasomotor hot flash is the most common and distressful complication of menopausal women. Its treatment is the most frequent clinical challenge. As a result, an effective and harmless therapy is needed. This double-blind controlled clinical trial was conducted to determine the effects of licorice roots on the relief and recurrence of hot flash in menopausal women referring to the healthcare centers affiliated to Shahid Beheshti Medical University in 2010. Ninety menopausal women complaining of hot flash were selected by reviewing their records in healthcare centers and randomly divided into 2 licorices [3 capsules daily containing 330 mg licorice abstract] and placebo [3 capsules daily containing 330 mg starch] groups over the 8 weeks of intervention and 4 weeks of follow-up. Two weeks prior to the intervention, the severity as well as frequency of hot flashes and the foods taken were asked and documented with questionnaires and data sheets. Data within and between the groups were analyzed by ANOVA with repeated measurements and t-test respectively. Means of age and body mass index [BMI] of the subjects in licorice and placebo groups were 53 +/- 3.2, 52.69 +/- 2.8, 24.71 +/- 3.2 and 23.61 +/- 3.3, respectively. The groups were similar in terms of intervening variables. The frequency of hot flash decreased significantly in the experimental [than the placebo group] and this lasted for 2 weeks after the administration of the capsules. The severity of hot flash decreased in the licorice group as well. This decrease was also seen in the placebo group in the first week of the intervention. Decreased hot flash in the placebo group was only significant after the 1[st] week of intervention compared to the previous period. Recurrence of frequency and severity of hot flashes occurred 2 weeks after the termination of therapy. The significant decrease in the placebo group after the 1st week of the intervention may be attributed to the psychological effects of placebo. Licorice roots decreased the frequency and severity of hot flashes. The administration of this harmless, inexpensive herb well accepted by the menopausal women together with the appropriate and continuous physical activities and consumption of dairy products are recommended for relieving this complication

[ effect of Licorice root extract on hot flashes in menopause]

Regarding the high prevalence of hot flashes in menopausal women and its effect on the quality of life, and due to its controversial treatment, this study was run to assess the effect of Licorice root extract on hot flashes in menopausal women in families under the cover of health and medical centers affiliated with Shahid Beheshti University of Medical Sciences and Health Services in 2008. This double blind placebo-controlled clinical trial was conducted on 68 menopausal women who had experienced different degrees of hot flashes. Patients were chosen through the existing records in health and medical centres and then randomly divided into two thirty-four-member groups of Licorice [three capsules of 330 mg Licorice root extract each day], and placebo group [three capsules of 330 mg starch each day] for a treatment period of 4 weeks. Two weeks before taking the medicine, the intensity and number of hot flashes and type of food they had eaten were recorded using a questionnaire. To assess validity and reliability, content validity and repeated test with correlation index of 96% were used. Data were assessed by variance analysis test with repeated measurements and by t-test. Menopausal women in Licorice and placebo group were 53.3 +/- 3 and 53 +/- 2.6 years old, 73.6% and 61.8% had 1.5 years or less from their last menstruation, and 41.2% and 38.2% had hot flashes during night, respectively. In Licorice group, the average number and intensity of hot flashes were 7.6 +/- 0.5 and 10 +/- 1.8 before the treatment and 5.1 +/- 0.6 and 5.1 +/- 1.6 after it. However, the average number and intensity of hot flashes in placebo group did not change. Licorice was effective in reducing the number and intensity of hot flashes in menopausal women. It is essential that studies be conducted with a longer length of treatment and investigation of the time of recurrence of hot flashes after discontinuance of medicine

Relationship between delivery type and menstrual disorders: a case-control study

High incidence of menstrual disorders at late ages of fertility accounts for 20% of clinical visits and 25% of gynecological surgeries. This study was conducted to identify the relationship between delivery type and menstrual disorders in women referring to hospitals affiliated to Medical Universities in Tehran in 2008. In this case-control study, which was conducted from April to August, 2008 in Tehran, 160 women aged 36 to 44 years, 80 women with and 80 without menstrual disorder as case and control groups were enrolled respectively. Data collection tool was a questionnaire [included questions regarding demographic and obstetrical characteristics]. Higham pictorial chart [scores more than 80 denoted menorrhagia], a verbal multidimensional scoring scale [from 0 for painless to 3 for severe pain], and Holmes-Rahe scale for assessing stress were used. About 93.1% of the cases and 65% of the controls had experienced dysmenorrhea at the begging of the study [P=0.009]. In other words, 65% of women with dysmenorrhea had a history of C-section. Women with menstrual disorders had more caesarian sections [53.7%] than those without the disorders [27.5%] [P<0.001] with an odds ratio estimate of 3.06 [95% CI: 1.58, 5.91]. There were significant differences in the number of pads/tampons used [P=0.009] and amount of uterine bleeding based on Higham chart [P=0.009] among case and control group. Caesarian may be considered as a risk factor for menstrual disorders particularly at late ages of fertility. Therefore, pregnant women should be consulted by health providers regarding advantages versus disadvantages of caesarian before selective C-section