Evaluating the Health Belief Model Constructs in Adopting the HPV Preventive Behavior.

Objective: Genital warts are a highly contagious sexually transmitted disease. It is caused by the human papillomavirus (HPV), which is transmitted through sexual contact. HPV is the most important cause of cervical cancer. This study aimed to evaluate the health belief model (HBM) constructs in adopting HPV preventive behavior in women referred to comprehensive health centers in Southwestern Iran. Materials and methods: This descriptive-analytical study was performed on 1000 women referring to health centers in Ahvaz during 2019-2020 who were selected via a two-stage stratified random sampling technique. Data were collected using a valid and reliable researcher-made questionnaire based on the HBM. The data were analyzed using descriptive statistics, t-test, ANOVA, Pearson correlation coefficient, and regression analysis in SPSS v.18, at a significance level lower than 0.05. Results: Total scale reliability of the tool was very good (α=0.828), as the Intra-cluster correlation coefficient (ICC) was to be 0.86. The mean of preventive behavior using an ANOVA test was significantly different at different levels of education (P <0.05). The mean and standard deviation of knowledge about HPV and preventive behavior was moderate (11.45±3.4). Pearson correlation coefficient showed a significant direct relationship between preventive behavior with awareness, perceived sensitivity, and self-efficacy and inversely related to perceived barriers. Perceived sensitivity (0.01) and self-efficacy (<0.001) were identified as the final predictors of behavior in regression analysis. Conclusion: As the results showed, designing programs to prevent HPV, considering the perceived role of perceived sensitivity and self-efficacy, increases the likelihood of effective interventions.

The effects of normal vaginal birth simulation training on the clinical skills of midwifery students: a quasi-experiment study.

BACKGROUND: Vaginal birth management is vital to midwifery education and practice in which midwives are most likely to be directly involved. This situation requires strong cognitive, technical, communicational, and teamwork skills. Therefore, the present study was conducted to evaluate the effect of normal vaginal birth simulation training before formal clinical education on the clinical skills of midwifery students compared with routine clinical education. METHODS: This quasi-experimental study was conducted at the Shoushtar Faculty of Medical Sciences from September 2018 to August 2021. Sixty-one midwifery students participated in the intervention group (n = 31) and in the control group (n = 30). The intervention group participated in the simulation-based training before entering the formal clinical education courses. The control group received no simulation-based training before their formal clinical education. The clinical skills of these students for performing normal vaginal birth in the real field were evaluated by observational examination in the three years (fourth, fifth, and sixth semesters). Data were analyzed by descriptive (mean, SD, and percentage) and inferential statistics (independent t-test and chi-square). A P-value less than 0.05 was considered significant. RESULTS: The mean score of midwives' skills in the control group was (28.10 ± 3.42) and in the intervention group, it was (31.15 ± 4.30). The difference in the skill score between the groups was statistically significant (3.40 ± 0.68). The results showed that in the intervention group, 29 students (93.93%) were evaluated from a good to an excellent level, while only ten students (32.71%) in the control group achieved a good level, and others (n = 30) were evaluated at a low level (p < .001). CONCLUSION: The results of the present study indicated that the simulation situation for critical skills, such as vaginal birth skills, was significantly more effective than workplace-based learning situations.

The Effectiveness of Prenatal Care Programs on Reducing Preterm Birth in Socioeconomically Disadvantaged Women: A Systematic Review and Meta-Analysis.

Background: Preterm Birth (PTB) is one of the leading causes of infant morbidity and mortality. Prenatal care is an effective way to improve pregnancy outcomes but there is limited evidence of effective interventions to improve perinatal outcomes in disadvantaged pregnant women. This review was conducted with the aim to assess the effectiveness of prenatal care programs in reducing PTB in socioeconomically disadvantaged women. Materials and Methods: We searched the Scopus, PubMed, Web of Science, and Cochrane Library databases from January 1, 1990 to August 31, 2021. The inclusion criteria included clinical trials and cohort studies focusing on prenatal care in deprived women with the primary outcome of PTB (< 37 weeks). Risk of bias was assessed using the Cochrane Collaboration's tool for assessing risk of bias and the Newcastle-Ottawa Scale. Heterogeneity was evaluated using the Q test and I2 statistics. The pooled odds ratio was calculated using random-effects models. Results: In total, 14 articles covering 22,526 women were included in the meta-analysis. Interventions/exposures included group prenatal care, home visits, psychosomatic programs, integrated intervention on socio-behavioral risk factors, and behavioral intervention through education, social support, joint management, and multidisciplinary care. The pooled results showed that all types of interventions/exposure were associated with a reduction in the risk of PTB [OR = 0.86; 95% confidence interval: (0.64, 1.16); I2 = 79.42%]. Conclusions: Alternative models of prenatal care reduce PTB in socioeconomically disadvantaged women compared with standard care. The limited number of studies may affect the power of this study.

Care Providers' Perspectives on Quality Prenatal Care in High-risk Pregnancies: A Qualitative Study.

Background: A high-risk pregnancy (HRP) is adversely affects the health of the mother, baby, or both. Most prenatal care research, rather than quality concepts, focuses on the adequacy of prenatal care and describes the emotional-psychological experiences of women with HRP. The main purpose of this study was to explore the perspectives of healthcare professionals regarding the quality of prenatal care for women with HRP. Methods: This qualitative study was conducted in three university hospitals and 12 comprehensive health centers in Ahvaz (Iran) from December 2020 to May 2021. In the present study, 10 midwives, 2 executive directors, and 7 specialists were purposefully selected with maximum diversity. In-depth semi-structured individual interviews were used to collect the data. Data were analyzed concurrently using Elo and Kinga's content analysis. The MAXQDA software version 10 was used for data analysis. Results: During data analysis, the 6 main categories "infrastructure for care provision", "optimal clinical care", "organizing referrals", "preconception care", "risk assessment", and "family-centered care" and 14 subcategories were identified. Conclusion: Our findings showed that professional groups focused on the technical aspects of caring. The findings from this study highlight several conditions that can affect the quality of prenatal care for women with HRP. Healthcare providers can use these factors to effectively manage HRPs, thereby improving pregnancy outcomes among women with HRPs.

Quality of perinatal care for women with high-risk pregnancies during the COVID-19 pandemic in Iran.

BACKGROUND: COVID-19 has had a catastrophic effect on the healthcare system. Healthcare quality assessment measures the difference between expected and actual performances to identify gaps in the healthcare system. This study aimed to evaluate the quality of perinatal care for women with high-risk pregnancies (HPR) during the COVID-19 pandemic. MATERIALS AND METHODS: This cross-sectional study enrolled 450 women with HPR from health centers in Ahvaz, Iran, from December 2020 to May 2021, using a multi-stage sampling method. Quality of care was assessed using an observational checklist adapted from Ministry of Health guidelines. Data were analyzed using descriptive and statistical methods. RESULTS: The quality of the assessed aspect in comprehensive health centers and in peripartum, perinatal, and postpartum wards was moderate. The overall score for peripartum care was significantly positively correlated with the length of the retraining period, and the quality of perinatal care was significantly related to the proportion of elective cesarean sections and preterm delivery. CONCLUSION: The development of care practices in health centers in Iran should focus on education and counseling. Practices in peripartum wards should emphasize the use of partographs, physical/mental support, and privacy for mothers, while perinatal wards should focus on timely counseling.

Comparing the Effectiveness of Arnebia euchroma with ClotrimazoleVaginal Cream for the Treatment of Vulvovaginal Candidiasis: A Randomized Controlled Triple-Blind Trial.

Background: Vulvovaginal candidiasis is the second most common cause of vulvovaginal infections. Due to the increasing resistance to synthetic antifungal drugs, the use of drugs with a natural origin is a priority. The aim of the present study was to compare the effectiveness of Arnebia euchroma with vaginal cream clotrimazole 1% United States Pharmacopeia (USP) for the treatment of vulvovaginal candidiasis. Materials and Methods: This triple-blind trial study was performed on 112 women with diagnosed Candida vaginitis clinically and by a laboratory test, patients were randomly divided into two groups receiving Arnebia euchroma and vaginal clotrimazole (56 people per group) in clinics and medical centers Ahvaz (Iran) from April 2018 to April 2019. Clinical and laboratory symptoms were recorded at the beginning of the study and 1 week after the end of treatment by a researcher-made questionnaire. Data analysis were performed using SPSS software v-23. p < 0.05 was considered significant. Results: After the intervention, vaginal culture was negative in terms of Candida in 17 (36.17%) patients of the Amoeba euchroma group and 37 (69.81%) patients of the clotrimazole group. The Chi-square showed that there was a significant difference between the culture results in both groups (χ 2 = 10.10, df = 1, p = 0.001). No differences were observed between the two groups in terms of vaginal symptoms based on adjustment for age and using a logistic regression model. Conclusions: A vaginal cream containing Arnebia euchroma could reduce the complaints of vulvovaginal candidiasis. But, future studies with larger sample sizes and different dosages are recommended.

Explaining the Psychological Distress of Women with High-Risk Pregnancies in Iran: A Qualitative Study.

Background: Psychological Distress (PD) is one of the most common mental disorders during pregnancy and involves stress, anxiety, and depression. According to the literature, High-Risk Pregnancy' (HRP) is a major physiological risk factor associated with PD during pregnancy. The main purpose of this study was to explore the perception and experience of women with HRP who, based on standard questionnaires, had moderate-to-severe stress and anxiety scores. Materials and Methods: This qualitative study was conducted using conventional content analysis from December 2020 to June 2021. To this aim, 16 women with HRP were purposefully selected from Imam Khomeini Hospital in Ahvaz, Iran, with maximum diversity. In-depth, semi-structured, individual interviews were conducted to collect the data. The MAXQDA software was used for data analysis. Results: Data analysis led to the extraction of two main categories and nine subcategories. "Disrupted peace" and "inefficient adaptation to the situation" were the two extracted categories. The former included the five subcategories of concerns about pregnancy complications, concerns about the parenting process, concerns about the couple's relationship, fear of Covid-19, and occupation-related stress. The latter included the three subcategories of unpleasant feelings, current pregnancy experiences, and previous pregnancy experiences. Conclusions: This study highlighted a wide range of psychosocial factors involved in the PD of women with HRP. These findings can be used to design appropriate prevention strategies to manage the mental health problems of these women in order to turn their pregnancy into a pleasurable experience.

Affecting Factors of Parturient Women's Privacy Preservation in The Maternity Ward: A Qualitative Study.

Objective: Different factors have an important role in the positive and negative childbirth experiences of the mothers. The parturient mother's privacy preservation is one of the factors for increasing the mothers' satisfaction consistent with natural childbirth. Hence, this study aimed to investigate the factors affecting the parturient mother's privacy preservation. Materials and methods: Content analysis was used in this qualitative study that is based on the semi structured individual interviews with women who had experienced natural vaginal delivery, midwives, and the specialist in a maternity ward from 2018 to 2021 in Shahroud, Iran. The collected data were analyzed simultaneously with the sampling procedure using a five-step qualitative content analysis method. To ensure the robustness of the data, Lincoln and Guba's four criteria (credibility, dependability, confirmability, and transferability) were used. Results: The findings of the study with 40 participants resulted in the extraction of 28 codes, 9 subcategories, and 2 main categories entitled extra-and intra personal factors affecting the mother's privacy. Conclusion: To foster the mother's awareness of her rights and privacy during pregnancy and delivery, continuous education, monitoring, and evaluating both the students and the staff to respect preserving the mother's privacy is necessary to develop an instrument to measure the preservation of the mother's privacy in the maternity ward.

Astaxanthin protects mesenchymal stem cells from oxidative stress by direct scavenging of free radicals and modulation of cell signaling.

Recent evidence has shown that mesenchymal stem cells (MSCs) play vital roles in cell therapy of ischemia/hypoxia damaged tissues. However, after the transplantation, they might undergo apoptosis due to oxidative stress. Thus, some strategies have been developed to support stem cells in harsh conditions, including pre-treatment of the cells with antioxidants. Of various antioxidants, in this study, astaxanthin (ATX) was used to protect adipose-derived MSCs against oxidative stress. The MSCs were exposed to different doses of hydrogen peroxide, and then the expression of key genes involved in the redox signaling pathway was studied, including nuclear factor erythroid 2-related factor 2 (Nrf2), heme oxygenase-1 (HO-1), and NADPH quinine oxidoreductase 1 (NQO1). The balance of intracellular reactive oxygen species was detected with the H2DCFDA molecular probe. Additionally, for the detection of apoptosis and protective effect of ATX, the DAPI/Phallacidin and annexin V cell staining were performed. The results of cellular studies revealed that ATX reduced the H2O2-induced cell apoptosis and oxidative stress. Furthermore, after the induction of oxidative stress, the cells' native antioxidants (HO-1 and NQO1) were overexpressed but they were modulated with ATX treatments (p < 0.023). Based on our findings, ATX could increase the expression of Nrf2 as a key transcription factor of antioxidant enzymes (p < 0.05). These findings support the notion that ATX can act as an effective antioxidant in the pre-treatment of MSCs before cell therapy. Thus, to enhance the viability of stem cells during the transplantation in harsh conditions, the concurrent use of ATX in cell therapy modalities is proposed.

New insights into the core Hippo signaling and biological macromolecules interactions in the biology of solid tumors.

As an evolutionarily conserved pathway, Hippo signaling pathway impacts different pathology and physiology processes such as wound healing, tissue repair/size and regeneration. When some components of Hippo signaling dysregulated, it affects cancer cells proliferation. Moreover, the relation Hippo pathway with other signaling including Wnt, TGFß, Notch, and EGFR signaling leaves effect on the proliferation of cancer cells. Utilizing a number of therapeutic approaches, such as siRNAs and long noncoding RNA (lncRNA) to prevent cancer cells through the targeting of Hippo pathways, can provide new insights into cancer target therapy. The purpose of present review, first of all, is to demonstrate the importance of Hippo signaling and its relation with other signaling pathways in cancer. It also tries to demonstrate targeting Hippo signaling progress in cancer therapy.

The effect of Calendula officinalis versus metronidazole on bacterial vaginosis in women: A double-blind randomized controlled trial.

Bacterial vaginosis (BV) is a common disorder among women of reproductive age. This study aimed to compare the effect of a Calendula officinalis extract-based cream and metronidazole on BV among women of reproductive age. In this study, 80 women of reproductive age with BV were randomly assigned to the C. officinalis (n = 40) or metronidazole (n = 40). Diagnosis of BV was confirmed when at least 3 of the 4 Amsel criteria were met (pH >4.5, whitish grey or thin homogeneous discharge, release of a fishy odor on adding 10% KOH, and detection of clue cells on microscopic examination). For each group, either a methanol extract of C. officinalis or metronidazole vaginal cream (5 g) was used for 1 week intravaginally, and all signs and symptoms were assessed 1 week after treatment completion. Before the intervention, the two groups did not differ significantly with regard to vaginal burning, odor, dysuria, and dyspareunia, but itching was significantly more common in the C. officinalis group than in the metronidazole group (22.5% vs. 2.5%, P = 0.01). One week after the intervention, all women in both groups were free of symptoms, including vaginal itching and burning sensation, odor, dysuria, and dyspareunia. None of the women in either group suffered any side effects from C. officinalis or metronidazole. C. officinalis was effective for the treatment of BV in women of reproductive age, without any side effects. This herb could be recommended for women of reproductive age who uncomfortable with the potential side effects of synthetic drugs.

Higher Frequency of Nocturnal Blood Pressure Dipping but Not Heart Rate Dipping in Inflammatory Bowel Disease.

BACKGROUND: Masked hypertension (MHTN) and lack of nocturnal dipping in blood pressure (BP) have been linked to the state of inflammation. AIMS: We aimed to assess the frequency of nocturnal patterns of BP and heart rate (HR) in patients with IBD. METHODS: Sixty-three normotensive patients with confirmed IBD during remission and 63 healthy subjects were enrolled in a case-control study. All subjects were monitored for BP and HR over a period of 24 h under ambulatory setting. Means for BP and HR were calculated for nighttime and daytime periods. Daytime BP ≥ 135/85 mmHg, nighttime BP ≥ 120/70 mmHg, and 24-h average BP ≥ 130/80 mmHg were defined as MHTN. The main end points of this study were lack of >10% nocturnal decrease in the systolic BP (NDP-BP) and in HR (NDP-HR). RESULTS: After exclusion of 8 patients with IBD from analysis, 55 patients and 63 control subjects (49% men) with a mean age of 37.5 ± 11.0 years were enrolled. NDP-BP was more common in the IBD group compared to controls (55 vs. 33%; P = 0.026). MHTN was detected in 24% of IBD patients compared to 8% among controls (P = 0.017). Meanwhile, NDP-HR was observed in 22% of the IBD patients and 30% of the control group (P = 0.402). IBD remained a significant predictor of NDP-BP (odds ratio 2.60, 95% confidence interval 1.19-5.51) following an adjustment for age and gender. CONCLUSIONS: IBD is associated with higher frequency of NDP-BP and MHTN; however, nocturnal changes in HR were similar in both groups.