Women's Empowerment Status in Menopausal Transition: A Cross-sectional Study.

Background: Women's empowerment status in menopausal transition is of great importance due to the increasing trend of life expectancy and population aging. This study was conducted to evaluate the empowerment status of women during the menopausal transition in Gonabad, Iran. Methods: This cross-sectional study was conducted in Gonabad city in Northeast of Iran from April 2017 to March 2018. Cluster sampling was used for selecting 680 women who were in the menopausal transition. Demographic questionnaire and Women's Empowerment Status Questionnaire - a researcher-made questionnaire- was used for data collection. Pearson's correlation coefficient, one-way ANOVA, and linear regression were used to analyze the data using SPSS version 16; A p-value less than 0.05 was considered as significant. Results: The majority of the participants (510; 76.10%) had a high empowerment level. A high empowerment status in the family, economic, social, and health domains was observed in 499 (74.50%), 534 (79.70%), 523 (78.05%), and 493 (73.60%) participants, respectively. The majority of the participants had moderate empowerment status in political (427; 70.40%) and religious domains (464; 69.30%). There was a negative correlation between the total empowerment score and the participants' age (P<0.001), husband's age (P<0.001), and the number of children (P<0.001). There was a positive correlation between the total empowerment score and education (P=0.003) as well as age of marriage (P=0.03). Conclusion: Overall empowerment status of women in menopausal transition in Gonabad -Iran was high. However, in political and religious domains, the status was moderate. We suggest that empowered women should be invited to share their experiences with other females. Development of social networks could provide the basis for sharing the experiences of these women and helps policy makers to develop community empowerment programs.

The factors affecting male infertility: A systematic review.

BACKGROUND: In recent years, the incidence of male infertility has increased worldwide. It is necessary to study the factors that influence male infertility in each area/region for better management. OBJECTIVE: To determine the factors affecting male infertility in the Iranian male population. MATERIALS AND METHODS: An online search was conducted in electronic databases including PubMed, Google Scholar, SID, and Scopus to identify articles on the factors associated with male infertility, published in English and Persian. The keywords used to perform the search included "factor", "epidemiology", "causes of infertility", and "male infertility". The search was conducted without a time restriction, up to April 2020. RESULTS: The search resulted in a total number of 691 studies. After an assessment of the articles, finally 14 studies were included in this study with a total number of 26,324 infertile males. The factors associated with male infertility included semen abnormalities, varicocele and testis disorder, smoking, exposure to heat, obesity, anabolic steroids, vascular abnormalities, anti-spermatogenesis factors, antidepressants, taking ranitidine and cimetidine, penile discharge and genital ulcers, painful micturition, occupational factors, alcohol, chronic disease, sexual disorder, Surgical and urological diseases, genetic factors and herpes infection. Among these, the semen and varicocele disorders were common in most studies. CONCLUSION: The present review suggests that the factors affecting male infertility in Iran are similar to those reported from other countries. The results of this study can be used in adopting appropriate strategies for infertility management in Iran.

Facilitators of Sexual Health Education for Male Adolescents in Iran: A Qualitative Study.

BACKGROUND: Adolescence is a period of rapid physical, social, emotional, cognitive, and sexual development. The widening gap between biological maturity and social transition to adulthood highlights the importance of adolescents' need for education, especially in sexual health. The main objective of this study was to explore the facilitators of Sexual Health Education (SHE) for male adolescents in Iran. MATERIALS AND METHODS: In this qualitative content analysis, a total number of 45 participants were investigated from June 2018 to July 2019 through individual, semi-structured, in-depth interviews in the city of Mashhad, Iran, until data saturated. The participants were selected using a purposive sampling method. The data were analyzed using a conventional content analysis method based on the approach developed by Graneheim and Lundman (2004) using MAXQDA software. RESULTS: In data analysis, 2 main categories and 9 subcategories emerged. The main categories included extrapersonal facilitators and intrapersonal facilitators. The category of extrapersonal facilitators included the 7 subcategories of appropriate policy-making, use of religious capacities, consideration of native culture, supportive family environment, school empowerment, inter-sectoral integration and collaboration, and reinforcement of parent-teacher interaction. The category of intrapersonal facilitators comprised of the 2 subcategories of supporting adolescent socialization and using distraction techniques in adolescents. CONCLUSIONS: The study revealed that having an action plan with a scientific, ethical, legal, religious, and cultural background, establishing a suitable home, school, and community environment, strengthening inter-sectoral integration, collaboration, and interpersonal coordination, and utilizing the capabilities and potentials of adolescents can provide an appropriate SHE for adolescent boys.

Sexual health education issues (challenges) for adolescent boys in Iran: A qualitative study.

BACKGROUND: Sexual health education, especially in adolescents, faces excess challenges in many cultures. Iranian adolescents, especially boys, have many educational needs in the field of sexual health that have not been met due to various obstacles. The main purpose of this qualitative study was to explore the challenges of sexual health education for Iranian adolescent boys. MATERIALS AND METHODS: This qualitative content analysis study was conducted through individual semi-structured in-depth interviews from 45 participants (20 adolescents and 25 key adults). Data were analyzed using inductive conventional content analysis based on the Graneheim and Lundman's approach via MAXQDA software (version 2010) by VERBI GmbH Company, Berlin, Germany. RESULTS: In total, 2 categories and 11 subcategories emerged; including, "extrapersonal barriers to sexual health education for adolescent boys" containing seven subcategories of lack of clear policies, family inadequacy, social barriers, cultural heterogeneity, school inadequacy, cyber threats, and educational process inadequacy concerning adolescent sexual health education as well as "intrapersonal barriers to sexual health education for adolescent boys" comprised four subcategories of uncontrolled emotions of adolescence, adolescent rebellion, information and communication weaknesses, and adolescents' concerns about being judged by others. CONCLUSION: The findings clarify some barriers to sexual health education for adolescent boys. Therefore, it was recommended to develop community-based educational programs to change attitudes of families and society toward addressing the challenges of providing sexual health education to adolescent boys. Moreover, it was suggested to utilize an educational program specific to adolescent boys, tailored to the Iranian culture, using the potential of religion.

Exploring the Barriers to Sexual and Reproductive Health Education for Men in Iran: A Qualitative Study.

BACKGROUND: Considering the obvious reasons for the necessity of men's sexual and reproductive health education, the present qualitative study aims to identify and contextualize the barriers to sexual and reproductive health education to men in Iran. MATERIALS AND METHODS: This qualitative research was conducted using conventional procedures of content analysis. A total of 34 participants consisting of authorities in health organizations, healthcare providers, clergies, and adult men in a general population were interviewed in two large cities of Iran including Tehran and Mashhad in 2016. Purposive sampling continued until data saturation was ensured. Data were collected through individual in-depth semi-structured interviews. All interviews were tape-recorded and transcribed in verbatim. Finally, the data were analyzed using conventional qualitative content analysis. RESULTS: Participants' experiences were categorized into three main themes including (1) individual barriers, (2) sociocultural barriers, and (3) structural barriers along with seven subthemes including low perceived threat, unwillingness to learn, sociocultural taboos, family's lack of knowledge and malperformance, policy-making barriers, executive barriers, and health system deficiency barriers. CONCLUSIONS: Considering the results obtained, many barriers to men's sexual and reproductive health education could be eliminated through overcoming the individual and structural barriers and sociocultural taboos, as major obstacles. The findings suggest overcoming these barriers and promoting men's health require raising awareness overcoming sociocultural taboos. In this regard, policy-makers should provide sexual and reproductive health education programs and create opportunities and facilities along with appropriate learning environments for men.

Respect for woman's decision-making in spontaneous birth: A thematic synthesis study.

BACKGROUND: Participation of woman in decision-making processes is one of the key indicators of an appropriate relationship between a woman and the health care professionals. This study aimed to recognize the factors facilitating respect for woman's decision-making in spontaneous birth. MATERIALS AND METHODS: This paper employed a meta-synthesis on articles published in four biomedical databases including MEDLINE, Web of Science, CINAHL, and Cochrane Library. All qualitative studies published after 1990 and directly or indirectly discussing the women's and the health care professional's attitudes toward respect for woman's decision-making in spontaneous birth were searched. Of 5372 citations, 95 full-text papers were considered, of which 14 satisfied the inclusion criteria. RESULTS: In this meta-synthesis, initial codes were obtained through meticulous, line-by-line coding of the findings of the primary studies. Then, thematic synthesis was performed on the codes to search for concepts, and 20 descriptive themes were obtained in the second stage. Finally, through an inductive process, five new interpretations were obtained in the last stage of the thematic synthesis. These interpretations included confidence to health care providers, the central role of midwives in maintenance of women's dignity, childbirth as a natural phenomenon, the impact of contextual conditions, and the political and human factors affecting the delivery management and women seek place of safety for childbirth. CONCLUSIONS: Studies suggested that midwifes have a central role in maintenance of women's dignity and their experience of childbirth.

Meta-analysis of the effect of acupressure on duration of labor and mode of delivery.

BACKGROUND: Acupressure is increasing in popularity as an alternative treatment in obstetrics and gynecology. OBJECTIVES: To summarize and assess evidence regarding the effects of acupressure on duration of labor and mode of delivery. SEARCH STRATEGY: Four major databases and Google Scholar were searched using terms related to labor and acupressure, without language restrictions, up to November 2015. SELECTION CRITERIA: Randomized controlled trials were included if they examined the effect of acupressure at any acupoint during childbirth on duration of labor and/or mode of delivery. DATA COLLECTION AND ANALYSIS: Two reviewers independently extracted data. The outcome measures were duration of labor and mode of delivery. Random-effects models were used to pool results. MAIN RESULTS: Thirteen studies were included in meta-analyses. Acupressure increased the chance of vaginal delivery when compared with placebo/no intervention (odds ratio [OR] 2.329, 95% confidence interval [CI] 1.348-4.024, P=0.002; risk difference [RD] 8.9%, 95% CI 2.7%-15.0%, P=0.005). Acupressure decreased the duration of the active phase by 1.310 hours (95% CI -1.738 to -0.882; P<0.001) and the second stage of labor by 5.808 minutes (95% CI -1.615 to -0.807; P<0.001). CONCLUSIONS: Acupressure could have a role in reducing the rate of cesarean delivery and decreasing the duration of labor in parturient women. However, there is a need for more reliable randomized controlled trials.

Knowledge, attitudes and practice about pap smear test among women living in Bojnourd, North East of Iran: a population-based study.

BACKGROUND: The aim of the study was to assess the extent of knowledge, attitudes and practical behavior of women in Bojnourd conerning the Pap smear test. MATERIALS AND METHODS: This cross-sectional and population-based study was conducted with 1000 Iranian women aged 15-60 years old in Bojnourd city. In order to collect the data, a validated questionnaire was provided in four sections covering demographic information and questions about knowledge, attitude and practice about the Pap smear. Statistical analysis was performed with the Statistical Package for Social Sciences (version 17.0) applying a 0.05 significance level. RESULTS: Evaluation of knowledge showed that 146 women (14.6%) had very weak, and 594 women (59.4%) had weak knowledge. In contrast, most of the women studied, 873 (87.3%), had a positive attitude toward the Pap smear test. According to the findings, 375 women (37.6%) had done this test so far. Findings indicated that the extent of knowledge had a meaningful relationship with the attitude status (p<0.0001). Also, there was a meaningful relationship between knowledge and practice, so that the weakest practice was seen in women who had weak knowledge (61.1%), (p<0.0001). CONCLUSIONS: According to findings of this research, most women do not have an appropriate knowledge about the necessity of having the Pap smear test, so that only a low percentage of women had undergone this test.

Socioeconomic inequality and its determinants regarding infant mortality in iran.

BACKGROUND: Infant mortality rate is a useful indicator of health conditions in the society, the racial and socioeconomic inequality of which is from the most important measures of social inequality. OBJECTIVES: The aim of this study was to determine the socioeconomic inequality and its determinants regarding infant mortality in an Iranian population. PATIENTS AND METHODS: This cross-sectional study was performed on 3794 children born during 2010-2011 in Shahroud, Iran. Based on children's addresses and phone numbers, 3412 were available and finally 3297 participated in the study. A data collection form was filled out through interviewing the mothers as well as using health records. Using principal component analysis, the study population was divided to high and low socioeconomic groups based on the case's home asset, education and job of the household's head, marital status, and composition of the household members. Inequality between the groups with regard to infant mortality was investigated by Blinder-Oaxaca decomposition method. RESULTS: The mortality rate was 15.1 per 1000 live births in the high socioeconomic group and 42.3 per 1000 in the low socioeconomic group. Mother's education, consanguinity of parents, and infant's nutrition type and birth weight constituted 44% of the gap contributing factors. Child's gender, high-risk pregnancy, and living area had no impact on the gap. CONCLUSIONS: There was considerable socioeconomic inequality regarding infant mortality in Shahroud. Mother's education was the most contributing factor in this inequality.