Comparing the effects of text messaging and mobile social networking on physical activity and anthropometric indices of middle-aged women: a randomized controlled trial

BACKGROUND

Physical inactivity is a global health problem which is more prevalent among women. Among different age groups, middle-aged women are more vulnerable to physical inactivity as one of consequences of menopause. This study aimed to compare the effect of text messaging and that of mobile social networking on the improvement of physical activity and anthropometric indices of middle-aged women in Iran.

METHODS

This was a randomized controlled trial in which 110 overweight or obese women who were physically inactive were recruited and allocated into two groups of text messaging (n = 55) or mobile social networking (n = 55). Women in both groups received information regarding the necessity, benefits, and barriers of physical activity and how to overcome these barriers for 12 weeks. The International Physical Activity Questionnaire (IPAQ), and a demographic questionnaire were used to collect data. Anthropometric indices including weight, height, waist circumference, hip circumference, waist/hip ratio, and body fat percentage were measured at baseline, as well as 4, 8, and 12 weeks after intervention. Data were analyzed using independent t-test, Chi-square, and repeated measure test.

RESULTS

In the mobile social networking group, most women had moderate physical activity after 12 weeks (P < 0.05). The mean physical activity and energy expenditure were significantly higher in the mobile social group than those in the text messaging. In the 12th week of intervention, there was a significant reduction in the weight and BMI of the participants in the mobile social networking group compared to the text messaging group (P < 0.05). The waist and hip circumferences of women in the mobile social networking group reduced significantly after 12 weeks of intervention in comparison to the text messaging group (P = 0.001). The two groups did not show any significant difference regarding waist/hip ratio. While the body fat percentage was reduced in the mobile social networking group in the 4th, 8th, and 12th week of intervention, the differences between the two groups was not significant.

CONCLUSION

Both text messaging and mobile social networking were effective in promoting physical activity and reducing anthropometric indices except for waist/hip ratio and body fat percentages, but the effect of mobile social networking was more pronounced. Thus, mobile social networking is recommended for promoting physical activity among middle-aged women.

Strategies to improve the quality of midwifery care and developing midwife-centered care in Iran: analyzing the attitudes of midwifery experts

Background

In recent years, extensive studies have been designed and performed in the context of providing midwifery care in developed countries, which has been unfortunately neglected in some low resources and upper middle-income countries such as Iran. This study was conducted to identify the best strategies for improving the quality of midwifery care and developing midwife-centered care in Iran.

Methods

This was a qualitative study using focus group discussion and content analysis method. Data were collected from 121 participants including midwifery board members, gynecologists, heads of midwifery departments, midwifery students, in charge midwives in hospitals, and midwives in the private sector. Focused-group discussions were used for data collection, and data were analyzed using content analysis method.

Results

The main themes extracted from the participants’ statements regarding improving the quality of midwifery care were as follows: Promotion and development of education, Manpower management, Rules, and regulations and standards for midwifery services, and Policy making.

Conclusion

This study showed that to improve midwifery care, health policy makers should take into account both the quality and quantity of midwifery education, and promote midwifery human resources through employment. Furthermore, insurance support, encouragement, supporting and motivating midwives, enhancing and improving the facilities, providing hospitals and maternity wards with cutting-edge equipment, promoting and reinforcing the position of midwives in the family doctor program, and using a referral system were the strategies proposed by participants for improving midwifery care. Finally, establishing an efficient and powerful monitoring system to control the practice of gynecologists and midwives, promoting the collaborative practice of midwives and gynecologists, and encouraging team-work with respect to midwifery care were other strategies to improve the midwifery services in Iran. Authorities and policymakers may set the stage for developing high quality and affordable midwifery care by relying on the strategies presented in this study.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12884-022-04379-7.

Comparison of pre- and intra-COVID-19 postpartum depression among reproductive aged women: A comparative cross-sectional study in Ahvaz, Iran

BACKGROUND

The association between PPD and COVID-19 pandemic has been studied in some countries. This study aimed to compare postpartum depression before and during the COVID-19 pandemic among reproductive-aged women in Ahvaz, Iran.

METHODS

This comparative cross-sectional study involved 600 women of reproductive age in Ahvaz, Iran during the COVID-19 pandemic who were compared with 504 of their counterparts before the pandemic. Literate women who had given birth 1-6 months prior to the study, were aged 18-35, and were willing to participate in this study were recruited. A demographic questionnaire and Edinburgh Postnatal Depression Scale were used to collect the data. Independent t-test, Chi-square, and Logistic regression were used to analyze the data.

RESULTS

Before the pandemic, only 123 (24.9%) of the women had PPD, while during the pandemic, this number rose to 409 (68.2%). During the COVID-19 pandemic, the women were 8.727 times more likely to have PPD (95% CI: 5.919-12.868). During the pandemic, women with high school education and those having a high school diploma were 2.454 and 2.054 times more likely to have PPD compared to women with a university degree (95% CI: 1.508-3.996 and 1.302-3.241, respectively).

CONCLUSION

The prevalence of PPD among Iranian reproductive-aged women increased during the COVID-19 pandemic. Policymakers should seek some strategies to support women during pregnancy and postpartum in times of crises such as the COVID-19 pandemic.

The Effect of Mindfulness on Quality of Life among Women with Premature Ovarian Insufficiency: A Randomized Clinical Trial

Background:

Premature ovarian insufficiency may impair the quality of life and expose women to disorders such as cardiovascular disease, osteoporosis, and depression. This study aimed to evaluate the effect of mindfulness on the quality of life in women with premature ovarian insufficiency.

Methods:

This study involved 62 women who were randomly allocated into two groups of mindfulness and control. The mindfulness group received eight sessions of training. A demographic questionnaire, menopause-specific quality of life and a checklist (for assessing hot flashes) were used to collect the data. The quality of life, frequency, and intensity of hot flashes were measured before the intervention, immediately, and 3 months after it. Independent t-test, the Chi-square test, and the repeated measure test were used for data analysis.

Results:

The scores of quality of life dropped from 95.6 ± 9.77 at baseline to 77.32 ± 7.93 after intervention and 48.32 ± 4.96 at 3-months follow-up in the mindfulness group but rose from 99.5 ± 16.1 at baseline to 100.2 ± 15.33 after intervention, and 102.6 ± 14.9 3-months after it in the control group, P < 0.001. The scores of vasomotor, psychological, physical, and sexual domains also improved significantly in the mindfulness group compared to the control group. The mean of hot flashes in the mindfulness group was 1.30 ± 0.69 and decreased to 1.1 ± 0.56 and 0.66 ± 0.58 immediately and in 3 months after intervention, respectively. The frequency of hot flashes was 14.74 ± 10.4 per week before intervention in the mindfulness group which reduced to 12.38 ± 8.66 and 6.74 ± 6.34 per week, immediately and 3 months after the intervention, while in the control group, there was an increase in the frequency of hot flashes (P < 0.0001).

Conclusion:

According to the results of this study, mindfulness could improve quality of life and reduce hot flashes, so mindfulness training for women with premature ovarian insufficiency is strongly recommended.

Reliability of ultrasound versus digital vaginal examination in detecting cervical dilatation during labor: a diagnostic test accuracy systematic review

Background

This systematic review aimed to investigate the reliability of ultrasound method compared with digital vaginal examinations in detecting cervical dilation.

Methods

We searched Cochrane (CENTRAL), MEDLINE, EMBASE, CINAHL, ISI Web of Science Core Collection, Trip Database, PubMed, DARE and NHS EED, HTA, and PROSPERO. Ten observational studies with a total sample size of 856 were included in the meta-analysis.

Results

The intraclass correlation coefficient (ICC) values ranged between 0.21 and 0.69. The fixed-effect models for the ultrasound test showed an average of ICC (r = 0.32 (95% CI 0.26–0.38). Correlation between two methods was poor (r = 0.359, 95% CI 0.26–0.44). In nulliparous and multigravida participants the correlation between ultrasound measurements and digital examinations was (r = 0.349, 95% CI 0.25–0.43) and ICC (r = 0.676, 95% CI 0.419–0.833), respectively.

Conclusion

Trans-perineal ultrasonography seems to be a reliable method for assessing labor progression in multigravida women, but its usage in nulliparous women needs further studies.

Effect of Zinc on Testosterone Levels and Sexual Function of Postmenopausal Women: A Randomized Controlled Trial

This study aimed to investigate the effect of zinc supplementation on testosterone levels and sexual function in postmenopausal women. This randomized clinical trial was performed on 116 postmenopausal women with serum zinc levels below 62, and low sexual function who were randomly divided into two groups: intervention and control. Serum zinc levels, testosterone, hemoglobin and hematocrit, as well as their Female Sexual Function Index (FSFI) were evaluated before and after the intervention. Data analysis was performed using paired and independent t-tests, Fisher's exact test, and Chi Square test. The use of zinc supplementation in the intervention group significantly improved sexual desire, arousal, orgasm, satisfaction, vaginal moisture, and pain during intercourse and also the overall score of sexual function compared to the control group (p < 0.001). Zinc supplementation in the intervention group, resulted in a significant increase in testosterone levels compared to the control group, which improved sexual function in postmenopausal women non-significantly. The results of this study showed that zinc supplementation can improve testosterone levels and sexual function in postmenopausal women. Using this supplement in postmenopausal women having zinc insufficiency is recommended. Also, there is need for more studies to prove the effect of zinc on testosterone and sexual function.

The effectiveness of emotional freedom techniques (EFT) on depression of postmenopausal women: a randomized controlled trial

OBJECTIVES

Postmenopausal women are at greater risk of depression. Depression may negatively affect the quality of life of women. An emotional freedom technique (EFT) is an evidence-based therapy combining cognitive and exposure components with acupressure. This study aimed to evaluate the effect of EFT on depression in postmenopausal women.

METHODS

This was a randomized controlled trial in which 88 women with mild to moderate depression recruited from a menopausal clinic in Ahvaz, Iran, and randomly assigned into two groups of EFT (n=44) and control for sham therapy (n=44). Women in the EFT group received two sessions of training and asked to continue EFT for 8 weeks, one time per day. The Beck Depression Inventory (BDI2) completed by women before and after the intervention. The control group received training on sham acupressure points similar to the intervention group. Data collected using a demographic and BDI2. Women requested to complete the BDI2 before and after the intervention. The independent t-test, chi-square, and ANCOVA were used to analyze data.

RESULTS

The mean depression score in the intervention group reduced from 20.93 ± 4.6 to 10.96 ± 4.38 in comparison to the control group that reduced from 19.18 ± 2.79 to 17.01 ± 6.05 after intervention (p=0.001). After the 8 week intervention, the frequency of moderate depression decreased from 56.8 to 9.35% in the intervention and from 50 to 29.5% in the control group. In total, 63.4 and 34.15% in the intervention and control groups were free of depression respectively after the intervention (p<0.001).

CONCLUSIONS

The results of this study showed that using EFT for 8 weeks could significantly reduce the mean score of depression in postmenopausal women. Using this method in public health centers for postmenopausal women is recommended.

The effect of group cognitive behavioural therapy for insomnia in postmenopausal women

The menopausal period is associated with several complications in women. One of these complications is sleep disorders including insomnia disorder that can affect all aspects of personal life. The present study aimed to evaluate the effectiveness of cognitive behavioural therapy for insomnia (CBT-I) on insomnia severity and sleep quality among postmenopausal women. This was a randomised clinical trial in which 46 women were recruited and randomly allocated into two groups, one receiving CBT-I and a control group. The CBT-I group received six sessions of training, while the control group received only usual care. A demographic questionnaire, Insomnia Severity Index (ISI), and Pittsburgh Sleep Quality Index (PSQI), were used to collect the data. The ISI and PSQI were measured at baseline, 3 and 6 weeks after intervention, and in a 4-week follow-up. The Independent t test, the chi-square test, generalised estimating equation models, and Bonferroni correction were applied to analyse the data. According to our results, in the CBT-I group compared to the control group, the mean ISI, PSQI, sleep onset latency, sleep time, and sleep quality score reduced continuously from baseline to week 3 and from week 3 to week 6, and remained constant from week 6 to week 10. The mean sleep efficiency score improved significantly from baseline to week 3 in the CBT-I group and remained unchanged until the end of the study. CBT-I could significantly improve insomnia severity and sleep quality in postmenopausal women. Therefore, using this method is recommended for menopausal women with insomnia.

Women's perception of continuity of team midwifery care in Iran: a qualitative content analysis

Background

Understanding the pregnant women’s perception of continuity of team midwifery care is necessary for introducing and implementing this model of midwife-led care in the Iranian maternity services. This qualitative study aims to explore women’s perception of continuity of team midwifery care in Iran.

Methods

This research is a qualitative study conducted in Iran to explore women’s perception of continuity of team midwifery care during pregnancy, birth and postpartum from October 2019 to August 2020. Fifteen semi-structured interviews were conducted with women individually in private midwifery clinic through a purposive sampling method. Interviews were digitally recorded and transcribed verbatim in Persian and analyzed using conventional content analysis.

Results

From the data analysis, two themes, four main categories, and nine subcategories emerged. The themes were “Maternal empowerment” and “Mother’s satisfaction during the transition from pregnancy to motherhood”. The first theme included two categories of improving self-efficacy during antenatal education classes and the effective midwife-mother interaction. The second theme composed of two categories of satisfaction with the process of pregnancy, childbirth and postpartum as well as satisfaction with motherhood.

Conclusion

Findings of this qualitative study highlight the effectiveness of continuity of team midwifery model of care for promoting empowerment and satisfaction in women during pregnancy, birth and postpartum. The results of this study could pave the way for developing, introducing and implementing the midwife-led continuity models of care in Iran.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12884-021-03666-z.

Health anxiety and related factors among pregnant women during the COVID-19 pandemic: a cross-sectional study from Iran

BACKGROUND

The COVID-19 pandemic has affected many countries around the world and Iran was no exception. The aim of this study was to evaluate health anxiety of Iranian pregnant women during the COVID-19 pandemic.

METHODS

In this cross-sectional study, 300 pregnant women in different trimesters (n = 100 in each trimester) were recruited. A demographic questionnaire and the Health Anxiety Questionnaire were used to collect data. Scores of < 27, 27-34 and more than 35 were defined as low, moderate and high health anxiety, respectively. Due to nationwide restrictions, data were collected through social media groups. Chi-square tests, ANOVA and multiple linear regression were used to analyze the data.

RESULTS

Mean (SD) total anxiety scores were 22.3 ± 9.5, 24.6 ± 9.3 and 25.4 ± 10.6 in the first, second and third trimesters of pregnancy, respectively. 9, 13 and 21% of women had severe anxiety in the first, second and third trimesters of pregnancy, respectively. Women in the third trimester had significantly higher health anxiety scores than those in the first trimester (p = 0.045).

CONCLUSION

At the time of the COVID-19 pandemic, women in the second and third trimesters of pregnancy were more worried about consequences of disease, but total health anxiety scores were significantly higher among women in the third trimester of pregnancy. Health care providers should pay more attention to the mental health of pregnant women in times of crises such as the COVID-19 pandemic.

Two decades of Iranian midwives' activities as a health care provider under supervision in a multidisciplinary team in reducing maternal mortality

Iran is amongst the countries that have achieved the fifth goal of the United Nations Millennium Development Goal. The maternal mortality ratio (MMR) in Iran has declined from 48 cases per 100,000 in 2000 to 16 cases per 100,000 in 2017, showing an annual decline rate of about 6.3%. In the International Year of the Nurse and the Midwife (year 2020), this commentary highlights two decades of Iranian midwives' activities as a health care provider under supervision in a multidisciplinary team in reducing maternal mortality.

Maternal death of a hemophilic patient due to the inhaling of a mixture of industrial bleach and detergents-A case study

Use of detergents and cleaning products puts women at risk due to hazardous chemical substances. Education of all women, especially pregnant and high-risk women about the proper use of detergents, is a necessity.

Effect of dill (Anethum Graveolens Linn) seed on the duration of labor: A systematic review

BACKGROUND

It is well documented that prolonged labor is associated with complications. This systematic review aimed to study the effect of Anethum Graveolens Linn (Dill) on the duration of labor.

METHODS

We conducted a search on PubMed, Scopus, Cochrane central, Web of Science, and MEDLINE. All randomized controlled trials and observational studies evaluating the effect of Dill seeds on labor were recruited. The mean differences (MD) with 95% CI were calculated.

RESULTS

Two RCTs showed that using Dill seeds could significantly reduce duration of the first stage (MD = -43.66, 95% CI [-52.99, - 34.33]), second stage (MD = -15.76, 95% CI [-20.06, -11.47]) and third stage of labor (MD = -1.79, 95% CI [-2.62, -0.95]). Two retrospective cohort studies showed a significant reduction in the first, and second stages of labor.

CONCLUSION

Using Dill seeds could reduce the duration of labor. Using this herb in low-risk pregnant women is recommended. Systematic review registration number: CRD42020145225.

Is there a relationship between restless legs syndrome and medical problems in pregnant women? A cross-sectional study in Iran

This study aimed to assess the relationship between RLS and medical problems among pregnant women. In this study, 700 pregnant women were recruited. A socio-demographic questionnaire and the International Restless Legs Questionnaire were used to gather information. Data analyzed using an independent t test, Chi-square, and multivariate analysis. The prevalence of RLS was 28.9%. Women with hypertension were 1.90 times more probable to have RLS (adjusted OR 1.90, CI 1.14-3.19). Women with chronic hypertension and superimposed preeclampsia were 2.39 and 2.13 times more probable to experience RLS, respectively. Pre-eclamptic women were 1.87 times more probable to experience RLS. Women with diabetes, gestational diabetes and anemia have also been more likely to have RLS. Results of the present study show that there is a significant relationship between RLS and medical problems such as chronic hypertension, superimposed preeclampsia, gestational diabetes and anemia among pregnant women.

Effect of Dietary Education on Cardiovascular Risk Factors in Rheumatoid Arthritis Patients

AIM

The aim of this study was to investigate the effect of dietary education on cardiovascular risk factors in patients with rheumatoid arthritis.

METHODS

In this randomized clinical trial, 112 patients with rheumatoid arthritis were randomly assigned into two groups, intervention and control. Dietary education was provided for the intervention group in 4 sessions; anthropometric measurements, serum levels of RF, triglycerides, cholesterol, HDL, LDL, and fasting blood sugar were measured before and three months after the intervention. Data were analyzed using SPSS software and appropriate statistical tests.

RESULTS

The mean of total cholesterol (p <0.001), triglycerides (p = 0.004), LDL (p <0.001), systolic blood pressure (p = 0.001), diastolic blood pressure (p = 0.003), FBS and BMI (p <0.001) were decreased significantly in the intervention group after education compared the control group.

CONCLUSION

Traditional care for rheumatoid arthritis patients is not enough. Patients need more education in order to improve their situation.

Vaginal Fluid Urea and Creatinine as Indicators of Premature Rupture of Membranes: a Systematic Review

The purpose of the present study was to determine the diagnostic accuracy of vaginal urea and creatinine levels in the detection of premature rupture of membrane (PROM). The Cochrane (central), EMBASE, PubMed, Scopus, and Web of Science were searched for studies published from the inception of the databases up to January 2020. We included published observational full-text articles. The mean differences (MD) and 95% confidence intervals (95% CI) were calculated. The significance level was set as 0.05. Eleven studies (n = 1324) were considered for meta-analysis. Using the bivariate model, the summary estimate of sensitivity and specificity for urea was 0.96 (95% CI: 0.86, 0.98) and 0.93 (95% CI: 0.83, 0.97), respectively. The summary estimate of sensitivity and specificity for creatinine was 0.98 (95% CI: 0.92, 0.99) and 0.97 (95% CI: 0.89, 0.99), respectively. The overall mean of urea and creatinine in the case group was significantly higher than that in the control group (MD = 12.63, 95%, CI [12.01, 13.25]) and (MD = 0.31, 95%, CI [0.29, 0.32]), respectively. The results of this systematic review showed that the mean of urea and creatinine in the case group was significantly higher than that in the control group and the sensitivity and specificity of creatinine is higher than urea in the diagnosis of PROM.

The effect of Lavender on pain and healing of episiotomy: A systematic review

INTRODUCTION

Some studies have investigated the effect of Lavender on pain and the healing of wounds. The aim of this systematic review was to investigate the effect of Lavender on pain and wound healing of episiotomy.

METHODS

The Cochrane Library, MEDLINE (PubMed), Scopus, and Web of Science (all databases from inception until February 2020) were searched. Data were extracted from eligible studies by two review authors individually. Our inclusion criteria were full-text interventional studies published in English or any other languages. All data were analyzed using Review Manager 5.3. The protocol of this systematic review was registered in PROSPERO with the reference number CRD42020140623.

RESULTS

Our search found six trials involving 415 participants. The use of Lavender could significantly reduce pain in women with episiotomy (95 % CI: -1.06 - -0.32). The use of Lavender has significantly improved the healing of episiotomy compared to the placebo (95 % CI: -2.13 - -1.34). In all studies, pain and healing of episiotomy were evaluated with Visual Analog Scale (VAS) and Redness, Edema, Ecchymosis, Discharge, Approximation (REEDA) scale respectively.

CONCLUSION

This review showed that the use of Lavender (in any form) in postpartum has a significant effect on pain relief and healing of episiotomy wound. All six studies that were included in this systematic review were from developing countries. A high level of heterogeneity was observed in the effect of Lavender on pain but not the healing of the episiotomy. Therefore, the results should be considered with caution. Using Lavender may be considered for wound healing of episiotomy.

The effectiveness of cognitive- behavioral therapy on quality of life in women with hypothyroidism in the reproductive age: a randomized controlled trial

Background

Worldwide, hypothyroidism affects 3.7% of the population, and is associated with impaired quality of life. This study aimed to evaluate the effect of cognitive- behavioral therapy (CBT) on the quality of life in women with hypothyroidism.

Methods

96 women with hypothyroidism randomly allocated into two groups: CBT group (n = 48) and control group (n = 48). Women in the CBT group were classified into four sub-groups of 12, and each sub-group received eight sessions of counseling (each session lasting 90 min). We collected data using a demographic questionnaire and the 36-Item Short Form Health Survey (SF 36) for measuring the quality of life. We used the independent t-test, chi-square test and ANCOVA to analyze the data.

Results

Five women from each group withdrew from the study, leaving 43 women in each group. The scores on physical functioning, physical health problems, social functioning and pain improved in the CBT group after the intervention, but the differences between the two groups were not significant. The scores on emotional health, emotional health problems, energy and emotions, and general health were significantly better in the CBT group than those in the control group (p < 0.05).

Conclusion

Counseling using CBT can improve some aspects of quality of life, including emotional health, emotional health problems, energy and general health in patients with hypothyroidism.

Trial registration number

Iranian Registry for Clinical Trials: 20190323043101 N1. https://www.irct.ir/

The effect of oxytocin vaginal gel on vaginal atrophy in postmenopausal women: a randomized controlled trial

Background

Around 90% of postmenopausal women are suffering from vaginal atrophy. This study aimed to evaluate the effect of oxytocin vaginal gel on vaginal atrophy among postmenopausal women.

Methods

This was a randomized controlled trial that was conducted on 96 postmenopausal women who suffered from vaginal atrophy. The inclusion criteria were: literate women, age 40–60, at least 1 year passed from their last menstrual period or the level of FSH > 40 IU, monogamous women with the sexual relationship. Women in the intervention group, requested to use one applicator of 400 IU oxytocin gel per night and women in the placebo group used placebo each night. The subjective symptoms of vaginal atrophy, vaginal PH, maturation index were measured before and after the intervention.

Results

The number of superficial cells was increased significantly in the oxytocin group compared to placebo (38.7 ± 7.18 vs. 3.69 ± 2.76, p = 0.0001), while the number of parabasal cells was decreased significantly in the oxytocin compared to placebo after the intervention. The improvement of the maturation index was more dominant in the oxytocin group (increased from 7.76 ± 4.68 to 52.48 ± 7.54) in comparison to the placebo group (increased from 8.58 ± 4.35 to 13.25 ± 5.06). The PH of the vagina decreased significantly in the oxytocin group in comparison to the placebo group (p = 0.0001). After 8 weeks, 88.6 and 7.1% of women in the oxytocin and placebo groups did not show the severe symptoms of vaginal atrophy (p = 0.001).

Conclusion

The results of this study showed that eight- week intervention with oxytocin vaginal gel (400 IU) could significantly improve the vaginal maturation index, subjective symptoms of vaginal atrophy and reduce the PH of the vagina. Using this medication in women who have a contraindication for hormone therapy is recommended.

Trial registration

IRCT20160602028220N2.