"Growth under pressure": The Experience of COVID-19 ICU Nurses - A Qualitative Study.

Background: As an epidemic, COVID-19 has brought a new shock to the world's healthcare system. The crisis caused by this disease and the prolonged involvement of communities and healthcare systems have intensified the duties and psychological burden of nurses. The current study aimed to explain the experience of ICU nurses during the COVID-19 crisis. Materials and Methods: The present study was conducted using conventional content analysis in 2021. Twenty nurses of the COVID-19 ICU of Ahvaz hospitals were selected by purposive sampling. The main method of data collection was semistructured interview. The process of data analysis was done based on Granheim and Lundman's approach using MAXQDA-2020. For the scientific rigor of the findings, Guba and Lincoln's four criteria were abided by. The COREQ (Consolidated Criteria for Reporting Qualitative Research) checklist was used to ensure the study met the recommended standards of qualitative data reporting. Results: After data analysis, 22 subcategories, eight categories, and one theme (growth under pressure) were extracted. The eight main categories included (psychological crisis, physical exhaustion, family conflicts, complex care, professional development, expertise, life enrichment, and full support). Conclusions: Despite the pressures that ICU nurses faced during the COVID-19 pandemic, they were able to grow by benefiting from positive experiences. These findings can lead to the development and implementation of effective interventions to improve adaptation strategies of nurses, especially those working in the intensive care unit, during the COVID-19 and other future crises.

Comparison of the efficacy of venlafaxine and bupropion in the treatment of depressive episode in patients with bipolar II disorder.

Objective: Depressive disorders are common among those with bipolar disorder II (BD II) and may necessitate the use of antidepressants. Because of the lack of quality evidence, there is controversy about the use of antidepressants in BD II. The aim was to compare the efficacy of venlafaxine and bupropion in the treatment of depressive episode in BD II. Materials and Methods: This randomized triple-blind clinical trial study was conducted on patient with depressive episode of BD II (based on diagnostic and statistical manual of disorders [DSM-V] criteria) referred to the specialized clinic of Golestan Hospital. A total of 40 patients were randomly divided into two groups of receiving venlafaxine (75 mg/day) or bupropion (100 mg/day) for 4 weeks. At the end of the intervention, the effectiveness of treatment was assessed using the Hamilton Depression Rating Scale (HDRS). Results: The results of this study showed that the HDRS score before treatment (P = 0.43) and after treatment (P = 0.15) was not significantly different between the two groups. HDRS score in both groups significantly decreased after 4 weeks (P < 0.0001). Although the rate of decrease in depression score was more in venlafaxine than in bupropion, these differences were not significant (% 36.7 ± 21.8 vs. % 45.3 ± 17.9, P value = 0.17). Conclusion: Our study showed that short-term (4-weeks) treatments of venlafaxine and bupropion were equally effective and could be a safe and effective antidepressant monotherapy for BD II major depression. It is suggested that more studies be conducted with larger sample size and over longer periods of time in a multicenter manner.

Do Sleeping Disorders Impair Sexual Function in Married Iranian Women of Reproductive Age? Results from a Cross-Sectional Study.

PURPOSE: This study aimed to evaluate the relationship between sleep quality and sexual function among Iranian women. METHODS: This study was conducted on 277 married women of reproductive age. The inclusion criteria were as follows: married women aged 18-45 years, with at least basic literacy, and women married monogamously for at least one year. The following tools were used for gathering data: a demographic questionnaire; Pittsburgh Sleep Quality Index (PSQI); Insomnia Severity Index (ISI); Epworth Sleepiness Scale (ESS); and Female Sexual Function Index (FSFI). Pearson correlation coefficients, independent t-tests, chi-square tests, and linear regression analyses were used to analyze the data. RESULTS: There was a significant inverse relation between poor sleep quality (r = -0.13, P = 0.02), daytime sleepiness (r = -0.39, P < 0.001), insomnia (r = -0.35, P < 0.001), and sexual function. Sexual desire was significantly related to sleep quality and insomnia (P < 0.001). Sexual arousal (r = -0.18, r = -0.29, P < 0.001), lubrication (r = -0.21, r = -0.3, -0.12, P < 0.001), orgasms (r = 0.17, r = -0.15, P < 0.001), and sexual satisfaction (r = -0.02, -r = 0.3, r = -0.15, P < 0.001) were significantly related to all types of sleep disorders (poor sleep quality, insomnia, and sleepiness). Pain during intercourse was significantly associated with poor sleep quality and insomnia. With each unit decrease in sleep quality, sexual function decreased by 0.49 (P < 0.001), and with each unit increase in the delay of sleep onset, sexual function decreased by 1.58 (P = 0.04). CONCLUSION: Results of this study showed that there was a significant relationship between sleep quality and sexual function in Iranian women of reproductive age. The quality of sleep among reproductive-aged women merits the attention of health care providers and policy makers.

Disruptive behavior scale for adolescents (DISBA): development and psychometric properties.

BACKGROUND: Growing evidence indicates that if disruptive behavior is left unidentified and untreated, a significant proportion of these problems will persist and may develop into problems linked with delinquency, substance abuse, and violence. Research is needed to develop valid and reliable measures of disruptive behavior to assist recognition and impact of treatments on disruptive behavior. The aim of this study was to develop and evaluate the psychometric properties of a scale for disruptive behavior in adolescents. METHODS: Six hundred high school students (50% girls), ages ranged 15-18 years old, selected through multi stage random sampling. Psychometrics of the disruptive behavior scale for adolescents (DISBA) (Persian version) was assessed through content validity, explanatory factor analysis (EFA) using Varimax rotation and confirmatory factor analysis (CFA). The reliability of this scale was assessed via internal consistency and test-retest reliability. RESULTS: EFA revealed four factors accounting for 59% of observed variance. The final 29-item scale contained four factors: (1) aggressive school behavior, (2) classroom defiant behavior, (3) unimportance of school, and (4) defiance to school authorities. Furthermore, CFA produced a sufficient Goodness of Fit Index > 0.90. Test-retest and internal consistency reliabilities were acceptable at 0.85 and 0.89, respectively. CONCLUSIONS: The findings from this study suggest that the Iranian version of DISBA questionnaire has content validity. Further studies are needed to evaluate stronger psychometric properties for DISBA.

The Relationship Between Vitamin D and Postpartum Depression in Reproductive-Aged Iranian Women.

Background: The aim of this study was to evaluate the relationship between vitamin D and postpartum depression in reproductive-aged Iranian women. Methods and Results: This study was conducted on 120 women (60 with postpartum depression and 60 without) in Izeh, Iran. A socio-demographic questionnaire and Beck Depression Scale were used for data collection. The ELISA method was used for measuring 25-OH vitamin D (ng). The participants were classified according to their vitamin D level as follows: 25-OH-D < 10ng/ml considered as severe deficiency, 10-20n g/ml as moderate insufficiency, 20-30 ng/ml as mild insufficiency and >30ng/ml as normal. Data were analyzed using the independent t-test or Mann-Whitney test, chi-square and logistic regression test. The mean level of vitamin D of women with postpartum depression was lower than that in normal women (16.89±7.05 vs. 21.28±7.13, p=0.001). More than 53% of women with postpartum depression had vitamin D <20 ng/ml compared to 31.7% of women with no depression (p=0.005). Moreover, 16.7% of women with postpartum depression had vitamin D < 10ng/ml compared to only 6.7% in the normal group (p = 0.005). Women with vitamin D less than 20ng/ml compared to vitamin D > 20ng/ml were 3.30 times more likely to have postpartum depression (OR: 3.3, CI: 1.32-8.24, p= 0.01). Discussion: There is a significant relationship between a low level of vitamin D and postpartum depression among reproductive-aged Iranian women. Health policy makers should pay attention to the measuring vitamin D level as one of the primary tests of pregnant women.

How does health-promoting lifestyle relate to sexual function among women of reproductive age in Iran?

This study aimed to evaluate the relation between health-promoting lifestyle and sexual function among women of reproductive age. In this cross-sectional study, 1200 women were recruited randomly from 10 public health centers in Ahvaz, Iran. A demographic questionnaire, Health Promoting Lifestyle Profile 2 (HPLP2), and Female Sexual Function Index (FSFI) were used for data collection. The inclusion criteria were as follows: women aged 15-45 years, married, monogamous, and having basic literacy. Data were analyzed using Kruskal-Wallis test, chi-square test, Spearman correlation coefficient, and logistic regression. All aspects of sexual function showed a significant relationship with different dimensions of HPLP2, except for pain and physical activity ( p < 0.001). Women who had better self-actualization were more likely to have better sexual function than other women (OR = 1.10, 95% CI: 1.06-1.14, p < 0.001). Other variables like responsibility, interpersonal relations and stress management also showed a significant correlation with sexual function. Results of this study showed that health-promoting lifestyle dimensions are significantly related to all aspects of sexual function in women of reproductive age. Health policy makers should take lifestyle-related factors of reproductive-aged women into account when seeking to improve the sexual wellbeing of this population. Further attention should also be given to assessing the direction of causality.

Memantine Enhances the Effect of Olanzapine in Patients With Schizophrenia: A Randomized, Placebo-Controlled Study.

Glutamate dysregulation may be involved in the neuropathology of schizophrenia. Memantine, a drug approved by the FDA for the treatment of moderate to severe Alzheimer's disease, acts as a partial uncompetitive NMDA receptor antagonist. The aim of this study was to examine the efficacy of memantine as an adjunctive treatment to olanzapine in patients with schizophrenia. In this double-blind, placebo-controlled studies, patients with schizophrenia according to DSM-IV clinical criteria were selected. Patients were randomly assigned to receive either memantine (week 1:10 mg/day; weeks 2-6:20 mg/day) plus olanzapine (15-20 mg/day) or olanzapine plus placebo. At baseline, no statistically significant difference regarding the mean total PANSS scores between treatment groups was found. Results showed that memantine significantly improved the positive and negative PANSS score in patients maintained on olanzapine after six weeks compared to olanzapine alone (P<0.001). Furthermore, female patients showed significantly better response than males, especially in positive PANSS score. No significant changes in extrapyramidal symptoms were observed.These findings indicate that olanzapine efficacy might be augmented with memantine. Furthermore, this effect is more remarkable in female patients with schizophrenia.

Self-reported risk behaviors among offender motorcyclists in Ahvaz City.

INTRODUCTION: Road traffic accidents are among the most critical public health issues. Many people die on the roads each day and tens of millions sustain nonfatal injuries. The aim of this study is to describe the high-risk behaviors of motorcyclists in which police had to confiscate their motorcycles. METHODS: This cross-sectional study was carried out on 240 motorcyclists in Iran from December 2010 to February 2011. A researcher-created questionnaire was used to collect data on self-reported high-risk behaviors, including passing the crossroads without considering the traffic light, refusing to wear a helmet, performing stunts in the street, and driving in the opposite direction. The collected data was descriptively analyzed. RESULTS: The mean age of motorcyclists was 29.3 years (SD=8.26). Twenty-six percent (n=62) of the participants did not have a motorcycle driver's license. The analysis of risk behaviors showed that 60.8% (n=146) of the motorcycle drivers usually passed crossroads without considering the traffic light and 20.8% (n=50) performed stunts in the street. CONCLUSIONS: This study indicates that the prevalence of high-risk behaviors among motorcyclists is significant. Health education interventions may inhibit these behaviors, thus reducing the risk of injuries.

The Female Sexual Function Index: translation and validation of an Iranian version.

INTRODUCTION: Female sexual dysfunction (FSD) is a prevalent problem in the female population in Iran. A subjective assessment instrument that allows cross-cultural comparison of FSD is urgently needed. AIM: The aims of the study were to translate, validate, and enhance cross-cultural comparability of an Iranian version (IV) of the Female Sexual Function Index (FSFI)-the IV-FSFI. METHODS: A total of 448 women (19-54 years, mean 29.7, standard deviation 7.3) from five different Iranian outpatient obstetrics and gynecology clinics were eligible for this study. The IV-FSFI was developed through forward and backward translation, revision by a research team, and a subsequent pilot study. After an interview for clinical diagnosis of FSD based on the Diagnostic and Statistical Manual of Mental Disorders, all participants completed the IV-FSFI for the validation study. Three hundred sixty-two women completed the IV-FSFI again, 4 weeks after the first visit. MAIN OUTCOME MEASURES: Test-retest reliability was determined by Pearson's product-moment correlations. Reliability was tested using Cronbach's alpha coefficient. Construct validity was evaluated by principal component analysis using varimax rotation and by subsequent confirmatory factor analysis (CFA). Discriminant validity was assessed with between-groups analysis of variance. RESULTS: The overall test-retest reliability coefficients were high for each domain of the IV-FSFI (r ranging from 0.73 to 0.86) and the internal consistencies within the acceptable range (α from 0.72 to 0.90). Principal component analysis with varimax rotation revealed a best fitting five-factor structure similar to the original FSFI (χ(2) = 2.1, degree of freedom = 17, P < 0.001). CFA confirmed the underlying domain structure, supporting the factorial validity of the IV-FSFI. CONCLUSIONS: In conclusion, the newly developed IV-FSFI has demonstrated to be a reliable and valid instrument with good psychometric properties that allows a quick and accurate preliminary screening of women with unknown sexual health status in clinics and other medical settings.