tayebeh darooneh

Adolescents need services that improve their physiological, cognitive, emotional, and social alteration into adulthood. Since the adolescent health needs have been identified, the focus of service delivery has mainly been on access to sexual health care assistance, including HIV issues. 

This systematic review aims to assess the perceived barriers and facilitators of adolescent friendly health services in the world because teens are a positive and energetic force for the present and future of a community.

All qualitative studies from 2000 to 2019 have been considered in this review. The searched databases include Cochrane Central Register, MEDLINE, Google Scholar, Embase, ProQuest, Scopus, Web of Science, CINAHL, and the Ovid platform. The studies included those conducted on all gender and ethnic groups adolescents between 10 to19 years that received health services, as well as their families and health care providers. Selected studies will be critically appraised by two independent reviewers using the Joanna Briggs Institute (JBI) critical appraisal checklist for qualitative research. Qualitative data will be extracted from papers using the standardized data extraction tool from JBI SUMARI (System for the Unified Management, Assessment, and Review of Information) by two independent reviewers. Qualitative research findings will, where possible, be integrated using JBI SUMARI and the meta-aggregation approach, and the final synthesized findings will be graded according to the ConQual approach for establishing confidence in the output of qualitative research synthesis and illustrated in the summary of results.

This systematic review addresses perceived barriers and facilitators of adolescent friendly health services in the world. Developing and extending young people’s demands is a concern for all societies. So the results of this study can help us to discover barriers and providers of adolescent friendly health services, and by removing barriers and strengthening facilitators, we will promote the possibility of adolescents accessing adolescent friendly health services.

Saffron is a perennial plant native to Iran which has been traditionally prescribed to facilitate labor. We aimed to investigate the effect of Crocus sativus (Saffron) on cervical ripening and progress of labor in a sample of primiparous term Iranian women. This randomized double-blinded study, was conducted on 60 primiparous women whose gestational age was 40 weeks or longer and who had referred to Hazrat Zahra Marzieh hospital in Isfahan, Iran. Inclusion criteria were: singleton pregnancy, cephalic presentation of the fetus, lack of uterine contractions, intact amniotic sac and having a low-risk pregnancy. The intervention (n=30), and control groups (n=30) respectively received one saffron capsule (250 mg, the content of total flavonoid in each saffron capsule was calculated 0.13-0.18 mg), and one placebo capsule for 3 consecutive nights. Bishop scores of the samples were recorded before and after the intervention. The mean Bishop score before inclusion in the study did not show significant difference between two groups (P>0.05). However, on third day of study, this score in saffron group was higher than the placebo (Saffron: 3.93±1.10 vs. placebo: 2.52±1.57) (P=0.001). Further, the mean Bishop score in saffron group was higher on third day of study compared to before their inclusion in the study (before: 2.42±1.19 vs after: 3.93±1.10) (P=0.001). But the placebo group did not show a significant difference before and after inclusion in the study (P=0.16). The average length of first and second stages of labor in saffron group was shorter than in the placebo (P>0.05). It seemsconsumption of oral saffron capsules, affects cervical softening and ripening, and progress of labor.

One of the important factors affecting women’s satisfaction with their marital life and the stability of family foundation is children. Several studies on the impact of the number and gender of children on marital satisfaction have shown conflicting results. This study is intended to explore the role of children on women’s marital satisfaction.

This cross-sectional study was conducted on 264 married women living in Tehran. Data collection tool was a two-part questionnaire containing demographic information and the modified version of Enrich marital satisfaction scale. Data analyzed by SPSS software, version 17. Indeed, Chi-square, Mann-Whitney and Kolmogorov- Smirnov tests and linear regression were employed. Significance level was taken 0.05.

The results suggested that mean ± standard deviation [1] of marital satisfaction score for all research units was 37.28 ± 6.24. Generally, the average score of marital satisfaction for women without any children was higher compared to those with one or two children. Moreover, women whose first child was a girl had a higher average score in marital satisfaction than those whose first child was a boy. According to the results of multiple linear regression model, a significant predictor of women’s marital satisfaction was the gender of the first baby (P = 0.01).

The results demonstrated that generally women with no child had higher marital satisfaction and the gender of the child in our research community played a determinant role in their marital satisfaction. Analytical studies in which the intervening variables are controlled are recommended.

In Iran the growing concern over low reproductive rates has led to alterations in demographic policies over recent years. The literature is indicative of different effects of women’s employment and religiosity on their reproductive performance.

Present study aimed to Comprise religious orientation and reproductive performance of employment and non-employment women.

This cross sectional study was conducted on 360 unemployed and employed women in healthcare centers affiliated to Shahid Beheshti University of Medical Sciences and in schools of selected districts of Ministry of Education in Tehran, 2015. A questionnaire including: demographic characteristics, religious orientation and reproductive performance were utilized for data collection.

The Mean±SD number of children for unemployed women was 1.29±0.75, for women working at schools 1.68±0.71 and those working in healthcare centers was 1.08± 0.84 (p=0.001). The mean ideal number of children for women working at schools was significantly higher than that of unemployed women and employed women in healthcare centers and hospitals(p=0.001). The level of gender preference for a male child in the housewife group 21.7%(39) was higher than that of the employed groups and the majority of employed women in Ministry of Health 61.1%(55) and Ministry of Education 70%(63) had no gender preferences. Intention for childbearing in unemployed women 43.3%(78) was higher than in the employed ones. Religious orientation had significant and positive correlation with the number of children (p=0.01, r =0.13).

Women’s employment is associated with their religious orientation and reproductive performance. This research took steps to identify the factors affecting the success of demographic policies.

Regarding high prevalence of postpartum pain and side-effects of pharmaceutical analgesics on maternal and neonatal health, the present study aimed to explore the effect of Melissa officinalis on after-pain among mothers hospitalized in Asgariyeh Hospital, Isfahan, 2016. In this single-blind clinical trial, 110 women with moderate to severe after-pain were divided into two M.officinalis and mefenamic acid groups by random allocation. Samples in the first group received 250mg of mefenamic acid and the second group received 395mg of M.officinalis oral capsules every 6hours for 24hours following childbirth. The primary outcome (After-pain) was assessed using a numeric 10-point scale before intervention, 1,2 and 3hours after the first intervention and every 6hours to 24hours after delivery for each of second, third and fourth interventions. Data were analyzed, using SPSS by independent t-test, Mann-Whitney and chi-square test. The demographic and obstetric variables and after-pain severity before the intervention in both groups were homogenous (P>0.05). Pain intensity wasn’t significantly different between the two groups during first and second hours after the first intervention, but there was a significant difference in the third hour (P<0.05). The severity of pain was significantly different between the two groups in different assessments including: an hour after the second, third and fourth intervention (P<0.05). A significant difference was found between mefenamic acid and M.officinalis in pain relief (P<0.001). M.officinalis can reduce the severity of after-pain, because it eliminates the need for pharmaceutical analgesics and works much better than mefenamic acid.

Pregnancy affects women’s sexual function. Although previous studies have introduced various factors affecting sexual function, but few studies have examined the prognostic factors on sexual dysfunction during pregnancy. These factors are influenced by cultural issues of each society. This study aimed to determine the prognostic factors of sexual dysfunction in selected pregnant women in Tehran City, Iran. This descriptive analytical study was conducted on 250 pregnant women in Tehran selected using convenience sampling method. The data collection instrument consisted of a questionnaire for individual and midwifery information, female sexual function index, Enrich marital satisfaction questionnaire (short version), female sexual distress scale, and prenatal distress questionnaire. The data were analyzed via SPSS software using Kolmogorov-Smirnov, one-way ANOVA, Pearson correlation, and linear regression (Enter method) statistical tests. The significance level was considered to be less than 0.05. The mean (standard deviation) of sexual function score was 22.27 (9.73), and the majority of pregnant women (72%) had sexual dysfunction. Among the areas of sexual function, women had the highest rates of sexual dysfunction in the area of “pain”. The duration of marriage, prenatal distress, and sexual distress were significantly predictive factors of sexual dysfunction in pregnant women (P < 0.05). The duration of marriage, prenatal distress, and sexual distress significantly predicted sexual dysfunction in pregnant women. Knowing these factors is an important achievement for better prenatal care and designing interventional studies to improve sexual health during pregnancy.

 Thrombophilia is an inherited or acquired predisposition in developing thrombosis. The two common thrombophilia polymorphisms are factor V Leiden (FVL) and factor II/ prothrombin G20210A (PT) gene mutations which can contribute to negative pregnancy outcomes such as miscarriage, in-vitro fertilization (IVF) failure, preeclampsia, intrauterine growth restriction (IUGR), placental abruption, stillbirth, and pregnancy-associated venous thromboembolism. This review study sought to describe the effects of FVL and PT mutations on pregnancy complications. Evidence Acquisition: In this review study, a comprehensive search was performed on Iranian and international databases including MEDLINE, PubMed, Scopus, Web of Sciences, Proquest and Google Scholar for articles published during 1996-2018. Out of 220 reviewed articles, 80 papers were ultimately selected. According to these 80 selected papers, the possible relations of PT and FVL with recurrent pregnancy loss (RPL) have been widely evaluated. Several studies indicated higher risk of recurrent early miscarriages, implantation failure and fetal loss after IVF among women with FVL and PT mutations. Observational studies have suggested the benefits of screening patients for thrombophilic polymorphisms in identification of women with higher risk of developing thromboembolic events and other related pregnancy complications. Based on such screening programs, prophylactic therapy can be limited to a selected group of women who truly need it.

The key role of social determinants of health also applies to sexual function as a part of sexual health. Accordingly, this study aimed to determine the relation between social determinants of health and sexual function among women who were referred to health centers affiliated to Shahid Beheshti University of Medical Sciences. This descriptive analytic study was conducted with participation of 260 women who were referred to health centers affiliated to Shahid Beheshti University of Medical Sciences in 2016. Health centers were selected by random method and convenience sampling was conducted for selecting participants. Data were collected via demographic questionnaire, socio-economic questionnaire, Multidimensional Scale of Perceived Social Support and Female Sexual Function Index. Data were analyzed using SPSS software-version 23, and Kolmogorov-Smirnov, Independent T-Test, Pearson’s correlation and Linear Regression with Enter and Step-Wise method. Significance level was considered 0.05 in all tests. The mean (SD) total score of sexual function was 25.7 (5.8). Increased level of couples' education, finance Index with the mean (SD) of 85.3 (13.3), and social support with the mean (SD) of 60.1 (13.5) were associated with improved sexual function (p<0.05). Couple’s occupation didn’t have significant relationship with sexual function of women (p>0.05). The analysis of stepwise regression showed that social support, husband's education and Finance Index could directly predict the sexual function of women. The study showed that higher levels of social support, husband's education and Finance Index were associated with better female sexual function scores.

  Cervical cancer has a high prevalence and mortality, while early diagnosis greatly reduces its complications. Therefore, it is important to identify the factors affecting the screening of cervical cancer. Studies have shown that health locus of control plays an important role in beliefs about screening. This study aimed to identify the correlation between health locus of control and beliefs about Pap smear among women. This was a descriptive study which was conducted cross-sectionally. It was conducted on 250 married women who had the inclusion criteria and attended health centers selected by Shahid Beheshti University of Medical Sciences in Oct. 2017 to February 2018 (a period of 5 months). Data collection tools included a demographic information questionnaire, multidimensional health locus of control scale, and the Pap Smear Belief Questionnaire (PSBQ). Data analysis was carried out through SPSS (v.17) using statistical tests including correlation and regression. The significance level was considered 0.05. Among the participants, 50.8% never had a history of undergoing a Pap smear test. The mean scores for the internal health locus of control (IHLC), chance health locus of control (CHLC), and powerful others health locus of control (PHLC) were 22.59±5.32, 22.84±4.65 , and 24.54±4.28, respectively. The total score for the Pap smear belief had a significant positive correlation with two dimensions: IHLC (r=0.209, P=0.001) and PHLC (r=0.216, P=0.001). In addition, based on the results of the linear regression analysis, the scores of IHLC (R2=0.03, P=0.004), PHLC (R2=0.036, P=0.003), and CHLC (R2=0.16, P=0.04) were the predictors of the total score for the Pap smear belief. Our results showed that all dimensions of the health locus of control were the predictors of belief in women’s Pap smear screening. It is necessary that health care providers hold programs for health locus control of cervix cancer prevention in Iranian women

Regular screening has an important role in early detection of breast cancer. Due to high prevalence of breast cancer and its late diagnosis in Iran, the aim of this study was to determine the breast cancer screening practice and its relationship with breast cancer screening beliefs. This cross-sectional study was carried out in Tehran, Iran, during the years 2017-2018 with participation of 335 women who met the inclusion criteria, referred to the selected health centers affiliated to Shahid Beheshti University of Medical Sciences; they were selected using convenience sampling method. Study tools included checklist of breast cancer screening information, breast cancer screening beliefs questionnaire, and demographic information checklist. Data were analyzed using descriptive statistics, t test and logistic regression analysis via SPSS software. The significance level was considered as P < 0.05. Findings: The mean age of 335 participants was 34.78 years, and the vast majority of them were married, housewife, and had good income. The mean ± standard deviation of the breast cancer screening beliefs score was 41.03 ± 10.54. The mean score of screening beliefs was 42.71 ± 10.76 and 38.16 ± 9.38 in subjects with and without screening practice, which showed a significant difference in t-test (P = 0.001). Based on logistic regression analysis, independent variables of age, education, marital status, and breast cancer screening belief score were predictive of breast cancer screening practice (P < 0.050 for all). According to the results of this study, breast cancer screening belief (awareness, attitude, and barrier of screening) and socioeconomic factors should be considered in breast cancer screening programs.

Different actions are performed today to reduce labor anxiety, among them medicinal herbs may provide a safer and more effective treatment option. Based on anxiolytic effects of saffron in previous studies, this study was conducted with aim to determine the effect of saffron capsule on labor anxiety in primiparous women.
This clinical double-blind randomized controlled trial with parallel groups was performed in 2016 on 60 primiparous women referred to a selected hospital in Isfahan. The subjects were divided into two groups (n=30) of saffron capsules and placebo. The two groups received saffron or placebo capsule 250mg per night for 3 nights. Anxiety level was measured in two stages (at entering the study before start of taking capsules and at the time of admission in the ward). The study's tools included demographic and midwifery questionnaire and Spielberger Anxiety Inventory. Data were analyzed by SPSS software (version 23) and Independent t-test, paired t-test, Mann-Whitney, Fisher exact and Chi-square test. P Mean of anxiety scores before intervention was 30.2±10.01 in saffron group and 30.1±14.6 in control group, and no significant difference was found between two groups (P>0.05). The mean score of anxiety before start of taking capsule (P=0.99) and at admission (P=0.83) was not significantly different between the two groups. In both groups, there was no significant difference in mean anxiety score between pre-initiation of capsule and admission in maternity ward (P>0.05).
In this study, there was no evidence of reducing effect of saffron capsule on anxiety during labor admission in primiparous women. Perhaps, it can be said that Saffron has anti-anxiety effect close to consumption. Pharmacological studies are suggested in this regard.

Few available studies suggest the possible role of vitamin D deficiency in sexual dysfunction. The relationship between vitamin D deficiency and depression is still considered challenging issue. According to the bilateral relationship between depression and sexual dysfunction, this study aimed to determine the relationship of serum level of vitamin D and depression severity with sexual function in a sample of Iranian women with sexual dysfunction in the year 2017.
This cross-sectional study was conducted on 85 women diagnosed for sexual dysfunction [Female sexual Function Index (FSFI) score of less than 28] and selected via convenience sampling method at selected health centers of Shahid Beheshti University of Medical Sciences, Tehran, Iran, in 2017. Research instruments were demographic questionnaire, Female Sexual Function Index, and Beck's Depression Inventory-II (BDI-II). Serum level of 25-hydroxy vitamin D was measured via electrochemiluminescence (ECL) method. Data were analyzed using Pearson’s correlation and linear regression tests via SPSS software.
Findings: From all sexual response domains, arousal (r = 0.22), lubrication (r = 0.31), and sexual satisfaction (r = 0.27) domain scores and total FSFI score (r = 0.23) were directly correlated with the serum level of vitamin D (P It is appeared that there is a correlation between serum level of vitamin D and depression severity with sexual function. Broader analytical studies to identify possible causal relationship are suggested.