Impact of early admission in labor on maternal and neonatal outcomes in Hajar health-care center of Shahr-e-Kord, Iran.

Background and Aim: Time of hospitalization of women for delivery can have an important impact on the outcome of labor and attention to it could prevent many complications affecting mother and fetus. The aim of this study was to detect the impact of early admission of women in labor and maternal and neonatal outcomes. Materials and Methods: In this descriptive and analytical study , 463 women with low risk Pregnancy ; single fetus and vertex presentation, that had been admitted in their latent phase (group 1) and 287 women who had similar characteristics and had been admitted in their active phase (group 2) were assessed in Hajar hospital from February to November 2004. Information recording forms and check lists were used for data collection. SPSS software, t-test, chi -square and logistic regression tests were used to analize the obtained data. P<0.05 was considered as the significant level. Results: 463 (61.7%) of women admitted were in their latent phase and 287 (38.3%) cases were in their active phase of labor. Mean age of mother, gestational age based on left mentoposterior (LMP) and sonography, mean birth weight and Apgar score of neonates were not significant in the two groups. Although the number of women who were augmentated with oxytocin due to dystocia were similar in the two groups (79.9% ,76.5%), the incidence of cesarean section in women who received oxytocin was more in group 1 than in group 2 (57.2% versus 25.8% , P<0.001). Total rate of cesarean section was more in group 1 than in group 2 (363 versus 118, P<0.001).The main Cause of cesarean section in group 1 was dystocia and in group 2 it was fetal distress. There was no difference in the rates of forceps delivery, vacuum extraction, neonatal intubation and postpartum hemorrhage in two groups. Conclusion: It is suggested that pregnant women should be sufficiently instructed about prenatal care regarding the signs of the beginning of active labor and they had better refer to the hospital when in the active phase of labor in order to prevent complications which could be resulted from early admission

The effect of occupational therapy on positive and negative symptoms in schizophrenic patients

Background and aim: Poor social, self-care, and vocational functioning are criteria for a diagnosis of schizophrenia in most diagnostic systems. Consequently, improving the social behaviors of persons with schizophrenia has been a key target of psychiatric rehabilitation. The occupational therapy is a non organic therapeutic that causes elevated self stem, foppishness and strengthening of occupational behaviour. The aim of this survey is the effect of occupational therapy on the positive and negative symptom’s of schizophrenic patients with bear out their symptoms. Methods: This survey is an experimental study that, positive and negative symptom’s of schizophrenic patients assessed with scale for the assessment of positive and negative symptoms. Then the samples consisted of schizophrenic patients divided randomly into case (30) and control (30) groups. Occupational therapy was performed in case group within a period 20 hours in week for 6 months, then patiants assessed repeatly with SAPS.SANS. Quantative analysis of data was undertaken by using paired and dependent t students tesats and Willcoxon test . Results: Results demonestrated the mean of the total score of negative symptom 72.5±19.5 and posetive symptom 112±32.57. Also occupational therapy effected on the posetive and negative symptom’s of schizophrenic patiants. In posetive symptom occupational therapy effected on the hallusination and bizzare behaviour (P<0.001), for all noeffected on dellusions and thought. In negative symptom occupational therapy effected on the apathy and involition, attention disorders, anhedonia and thought disorders (P<0.001), for all noeffected on inappropiate affect. Conclusion: The occupational therapy is a non organic therapuitic that causes elevated self steem, foppishness and strengthening of occupational behaviou

The social consequences of infertility among Iranian women: A qualitative study

Background: Infertility may prevent couples to achieve the desired social roles and lead to some social and psychological problems. This study aimed to explain the social consequences of infertility in Iranian women seeking treatment. Materials and Methods: A qualitative content analysis was conducted based on 32 semi-structured interviews with 25 women affected by primary and secondary infertility with no surviving children. The participants were purposefully selected with maximum variability from a fertility health research center in Tehran, Iran, from January to October 2012. Data were collected using semi-structured interviews and analyzed using the conventional content analysis method. Results: Our findings indicate that the consequences of infertility are divided into five main categories: 1. violence including psychological violence and domestic physical violence, 2. marital instability or uncertainty, 3. social isolation including avoiding certain people or certain social events and self-imposed isolation from family and friends, 4. social exclusion and partial deprivation including being disregarded by family members and relatives and reducing social interactions with the infertile woman and 5. social alienation. Conclusion: This study reveals that Iranian women with fertility issues seeking treatment face several social problems that could have devastating effects on the quality of their lives. It is, therefore, recommended that, in Iran, infertility is only considered as a biomedical issue of a couple and pay further attention to its sociocultural dimensions and consequences. © 2015, Royan Institute (ACECR). All rights reserved

Relationship between cancer characteristics and quality of life in the cancer patients under chemotherapy referred to selected clinic of Tehran university of medical sciences

زمینه و هدف: بیماران مبتلاء به سرطان دچار مشکلات جسمی، روحی و اجتماعی زیادی می شوند که این مشکلات باعث اختلال در روند طبیعی زندگی و کیفیت آن می گردد. لذا با توجه به اینکه در جامعه ما به مفهوم کیفیت زندگی و عوامل مرتبط با آن از جمله درد، خستگی وغیره در بیماران سرطانی کمتر پرداخته شده است شناخت این عوامل به پرستاران کمک می کند تا فعالیت های خود را در جهت ارتقاء سطح سلامت و بهبود کیفیت زندگی بیماران سازماندهی نمایند. پژوهش حاضر یک مطالعه توصیفی از نوع ارتباطی است که به منظور بررسی ارتباط بین ویژگی های سرطان و کیفیت زندگی در بیماران سرطانی تحت شیمی درمانی مراجعه کننده به درمانگاه منتخب انکولوژی دانشگاه علوم پزشکی تهران صورت گرفته است. روش مطالعه: در این تحقیق 200 نفر از بیماران مبتلا به انواع سرطان (تومورهای توپر)که به منظور شیمی درمانی به درمانگاه منتخب انکولوژی دانشگاه علوم پزشکی تهران مراجعه نموده بودند بصورت نمونه گیری در دسترس انتخاب شدند. گردآوری داده ها از طریق مصاحبه، گزارش خود بیمار و مراجعه به پرونده بیمار انجام شد. ابزار گردآوری اطلاعات بر اساس پرسشنامه Qol-BC ( (Quality of Breast Cancerبود که توسط پژوهشگر تعدیل شده است. جهت دستیابی به اهداف از آمار توصیفی و استنباطی استفاده شده و جهت تعیین ارتباط آماری از آزمون کای دو استفاده شده است. نتایج: یافته ها نشان داد اکثریت واحدهای مورد پژوهش 35 مبتلاء به سرطان گوارش، 5/35 بیماران در مرحله 3 بیماری، در 5/61 طول مدت بیماری از زمان تشخیص کمتر از یکسال، 41 دارای شدت درد خفیف بودند، 91 بیماری خود را قبول داشتند، 5/84 کاهش یا از دست دادن عملکرد اعضاء بدن از زمان بیماری داشتند و 5/69 شدت خستگی متوسط داشته اند. نتیجه گیری: نتایج پژوهش بیانگرآن بود که کیفیت زندگی اکثریت واحدهای مورد پژوهش (66) متوسط بوده است در رابطه با ارتباط ویژگی های سرطان با کیفیت زندگی نتایج نشان داد که بین نوع سرطان (05/0

Predictors of mothers� postpartum body dissatisfaction based on demographic and fertility factors

Background: There are fundamental and rapid changes in body shape during pregnancy, some of which persist for an extended time after delivery and may cause dissatisfaction with body shape. Therefore, we conducted this study to determine predictors of body dissatisfaction at six months postpartum based on demographic and fertility factors. Methods: This cross-sectional study was conducted on 300 women who referred to seven health centers affiliated with Iran University of Medical Sciences, Tehran, Iran. The sampling was multistage and we collected data from a demographic and fertility questionnaire and Cooper�s Body Shape Questionnaire (BSQ-34). The independent t-test, Mann-Whitney U test, chi-square test, one-way ANOVA, Kruskal-Wallis, Pearson correlation coefficient, and multiple linear regression were used for data analysis. The level of significance was set at P < 0.05. Results: The mean age of participating women was 29.77 (standard deviation: 5.9) years. Body dissatisfaction had a statistically significant association with variables such as body mass index (BMI) at six months postpartum, gestational age, the receipt of information about body shape, spouse�s views on the shape of a woman�s body, and mode of delivery. These variables predicted 34 of body dissatisfaction based on multiple linear regression. Conclusion: Postpartum body dissatisfaction is related to a several variables. Paying attention to these variables will help to plan and improve postpartum counseling and educational programs. © 2021, The Author(s)

Sources of get information and related factors during pregnancy among Afghan migrant women in Iran

Aim: The present study aims to investigate the sources of information and its related factors among pregnant Afghan migrant women who reside in southeast Tehran Province, Iran. Design: Cross-sectional study. Methods: A total of 280 pregnant Afghan women who received care at the prenatal clinics of selected healthcare centres in southeast Tehran Province (Iran) in 2018 enrolled in this study. Data were collected by continuous sampling by a questionnaire that asked about demographic, obstetric and sources of information used during pregnancy. Results: The most important sources of information accessed by pregnant Afghan women were healthcare providers (65.1), family and friends (47.55), the Internet (32.1) and media (18.9). There was statistically a significant relationship between sources of information and education level, number of children, length of residence in Iran, place of birth and insurance status. © 2020 The Authors. School of Nursing and midwifery, Iran University of Medical Sciences. Nursing Open published by John Wiley & Sons Ltd

Mapping 123 million neonatal, infant and child deaths between 2000 and 2017

Since 2000, many countries have achieved considerable success in improving child survival, but localized progress remains unclear. To inform efforts towards United Nations Sustainable Development Goal 3.2—to end preventable child deaths by 2030—we need consistently estimated data at the subnational level regarding child mortality rates and trends. Here we quantified, for the period 2000–2017, the subnational variation in mortality rates and number of deaths of neonates, infants and children under 5 years of age within 99 low- and middle-income countries using a geostatistical survival model. We estimated that 32% of children under 5 in these countries lived in districts that had attained rates of 25 or fewer child deaths per 1,000 live births by 2017, and that 58% of child deaths between 2000 and 2017 in these countries could have been averted in the absence of geographical inequality. This study enables the identification of high-mortality clusters, patterns of progress and geographical inequalities to inform appropriate investments and implementations that will help to improve the health of all populations

Past, present, and future of global health financing: a review of development assistance, government, out-of-pocket, and other private spending on health for 195 countries, 1995–2050

© 2019 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license Background: Comprehensive and comparable estimates of health spending in each country are a key input for health policy and planning, and are necessary to support the achievement of national and international health goals. Previous studies have tracked past and projected future health spending until 2040 and shown that, with economic development, countries tend to spend more on health per capita, with a decreasing share of spending from development assistance and out-of-pocket sources. We aimed to characterise the past, present, and predicted future of global health spending, with an emphasis on equity in spending across countries. Methods: We estimated domestic health spending for 195 countries and territories from 1995 to 2016, split into three categories—government, out-of-pocket, and prepaid private health spending—and estimated development assistance for health (DAH) from 1990 to 2018. We estimated future scenarios of health spending using an ensemble of linear mixed-effects models with time series specifications to project domestic health spending from 2017 through 2050 and DAH from 2019 through 2050. Data were extracted from a broad set of sources tracking health spending and revenue, and were standardised and converted to inflation-adjusted 2018 US dollars. Incomplete or low-quality data were modelled and uncertainty was estimated, leading to a complete data series of total, government, prepaid private, and out-of-pocket health spending, and DAH. Estimates are reported in 2018 US dollars, 2018 purchasing-power parity-adjusted dollars, and as a percentage of gross domestic product. We used demographic decomposition methods to assess a set of factors associated with changes in government health spending between 1995 and 2016 and to examine evidence to support the theory of the health financing transition. We projected two alternative future scenarios based on higher government health spending to assess the potential ability of governments to generate more resources for health. Findings: Between 1995 and 2016, health spending grew at a rate of 4·00% (95% uncertainty interval 3·89–4·12) annually, although it grew slower in per capita terms (2·72% [2·61–2·84]) and increased by less than $1 per capita over this period in 22 of 195 countries. The highest annual growth rates in per capita health spending were observed in upper-middle-income countries (5·55$8·0 trillion (7·8–8·1) in 2016 (comprising 8·6% [8·4–8·7] of the global economy and $10·3 trillion [10·1–10·6] in purchasing-power parity-adjusted dollars), with a per capita spending of US$5252 (5184–5319) in high-income countries, $491 (461–524) in upper-middle-income countries,$81 (74–89) in lower-middle-income countries, and $40 (38–43) in low-income countries. In 2016, 0·4$9·5 billion, 24·3% of total DAH), although spending on other infectious diseases (excluding tuberculosis and malaria) grew fastest from 2010 to 2018 (6·27% per year). The leading sources of DAH were the USA and private philanthropy (excluding corporate donations and the Bill & Melinda Gates Foundation). For the first time, we included estimates of China's contribution to DAH ($644·7 million in 2018). Globally, health spending is projected to increase to$15·0 trillion (14·0–16·0) by 2050 (reaching 9·4% [7·6–11·3] of the global economy and $21·3 trillion [19·8–23·1] in purchasing-power parity-adjusted dollars), but at a lower growth rate of 1·84% (1·68–2·02) annually, and with continuing disparities in spending between countries. In 2050, we estimate that 0·6% (0·6–0·7) of health spending will occur in currently low-income countries, despite these countries comprising an estimated 15·7% of the global population by 2050. The ratio between per capita health spending in high-income and low-income countries was 130·2 (122·9–136·9) in 2016 and is projected to remain at similar levels in 2050 (125·9 [113·7–138·1]). The decomposition analysis identified governments’ increased prioritisation of the health sector and economic development as the strongest factors associated with increases in government health spending globally. Future government health spending scenarios suggest that, with greater prioritisation of the health sector and increased government spending, health spending per capita could more than double, with greater impacts in countries that currently have the lowest levels of government health spending. Interpretation: Financing for global health has increased steadily over the past two decades and is projected to continue increasing in the future, although at a slower pace of growth and with persistent disparities in per-capita health spending between countries. Out-of-pocket spending is projected to remain substantial outside of high-income countries. Many low-income countries are expected to remain dependent on development assistance, although with greater government spending, larger investments in health are feasible. In the absence of sustained new investments in health, increasing efficiency in health spending is essential to meet global health targets. Funding: Bill & Melinda Gates Foundation

Health sector spending and spending on HIV/AIDS, tuberculosis, and malaria, and development assistance for health: progress towards Sustainable Development Goal 3

Sustainable Development Goal (SDG) 3 aims to “ensure healthy lives and promote well-being for all at all ages”. While a substantial effort has been made to quantify progress towards SDG3, less research has focused on tracking spending towards this goal. We used spending estimates to measure progress in financing the priority areas of SDG3, examine the association between outcomes and financing, and identify where resource gains are most needed to achieve the SDG3 indicators for which data are available