Ali Taghipour

Skype interviewing: the new generation of online synchronous interview in qualitative research.

The most commonly used method for data collection in qualitative research is interviewing. With technology changes over the last few decades, the online interview has overcome time and financial constraints, geographical dispersion, and physical mobility boundaries, which have adversely affected onsite interviews. Skype as a synchronous online service offers researchers the possibility of conducting individual interviews as well as small focus groups, comparable to onsite types. This commentary presents the characteristics of the Skype interview as an alternative or supplemental choice to investigators who want to change their conventional approach of interviewing.The most commonly used method for data collection in qualitative research is interviewing. With technology changes over the last few decades, the online interview has overcome time and financial constraints, geographical dispersion, and physical mobility boundaries, which have adversely affected onsite interviews. Skype as a synchronous online service offers researchers the possibility of conducting individual interviews as well as small focus groups, comparable to onsite types. This commentary presents the characteristics of the Skype interview as an alternative or supplemental choice to investigators who want to change their conventional approach of interviewing.The most commonly used method for data collection in qualitative research is interviewing. With technology changes over the last few decades, the online interview has overcome time and financial constraints, geographical dispersion, and physical mobility boundaries, which have adversely affected onsite interviews. Skype as a synchronous online service offers researchers the possibility of conducting individual interviews as well as small focus groups, comparable to onsite types. This commentary presents the characteristics of the Skype interview as an alternative or supplemental choice to investigators who want to change their conventional approach of interviewing.

Help seeking behavior of women with self-discovered breast cancer symptoms: a meta-ethnographic synthesis of patient delay.

Background and Objective Patient delay makes a critical contribution to late diagnosis and poor survival in cases of breast cancer. Identifying the factors that influence patient delay could provide information for adopting strategies that shorten this delay. The aim of this meta-ethnography was to synthesize existing qualitative evidence in order to gain a new understanding of help seeking behavior in women with self-discovered breast cancer symptoms and to determine the factors that influence patient delay. Methods The design was a meta-ethnography approach. A systematic search of the articles was performed in different databases including Elsevier, PubMed, ProQuest and SCOPUS. Qualitative studies with a focus on help seeking behaviors in women with self-discovered breast cancer symptoms and patient delay, published in the English language between 1990 and 2013 were included. The quality appraisal of the articles was carried out using the Critical Appraisal Skills Programme qualitative research checklist and 13 articles met the inclusion criteria. The synthesis was conducted according to Noblit and Hare’s meta-ethnographic approach (1988), through reciprocal translational analysis and lines-of-argument. Findings The synthesis led to identification of eight repeated key concepts including: symptom detection, initial symptom interpretation, symptom monitoring, social interaction, emotional reaction, priority of medical help, appraisal of health services and personal-environmental factors. Symptom interpretation is identified as the important step of the help seeking process and which changed across the process through active monitoring of their symptoms, social interactions and emotional reactions. The perceived seriousness of the situation, priority to receive medical attention, perceived inaccessibility and unacceptability of the health care system influenced women’s decision-making about utilizing health services. Conclusion Help seeking processes are influenced by multiple factors. Educational programs aimed at correcting misunderstandings, erroneous social beliefs and improving self-awareness could provide key strategies to improve health policy which would reduce patient delay.

Appraisal of Breast Cancer Symptoms by Iranian Women: Entangled Cognitive, Emotional and Socio-Cultural Responses

BACKGROUND Breast cancer is the most common cancer in Iranian women and usually features delayed presentation and late diagnosis. Interpretation of symptoms, as the most important step, has a significant impact on patient delay in seeking treatment. There is a dearth of studies on symptom appraisal and the process leading to seeking help in breast cancer patients. This study explored the perceptions and experiences of Iranian women with self-detected possible breast cancer symptoms. MATERIALS AND METHODS A qualitative method was conducted involving in-depth semi-structured interviews with 27 Iranian women with self-discovered breast cancer symptoms. Participants were purposefully selected from women who attended Cancer Institute of Tehran University of Medical Sciences during June 2012 to August 2013. The audiotaped interviews were transcribed and analyzed using conventional content analysis with MAXQDA soft ware version 10. The trustworthiness of the study was verified by prolonged engagement, member validation of codes, and thick description. RESULTS The main concepts emerging from data analysis were categorized in four categories: symptom recognition, labeling of symptoms, interactive understanding, and confronting the fear of cancer. Symptom recognition through breast self-examination, symptom monitoring and employing prior knowledge distinguished normal from abnormal symptoms and accompanied with perception of being at risk of breast cancer led to symptom labeling. Social interaction by selective disclosure and receiving reassurance from a consultant led to confirmation or redefinition of the situation. Perceived seriousness of the situation and social meanings of breast cancer as a stigmatized and incurable illness associated with loss of femininity were reasons for patient worries and fear. CONCLUSIONS This study emphasized that entangled cognitive, emotional and socio-cultural responses affecting understanding of symptom seriousness require further investigation. It is suggested that programs aimed at shortening patient delay in breast cancer should be focused on improving womens knowledge and self-awareness of breast cancer, in addition to correcting their social beliefs.

Serum Inflammatory Cytokines and Depression in Coronary Artery Disease

Background: Severe depression may be accompanied by immune dysregulation and is also associated with increased risk of coronary artery disease (CAD). Objectives: We investigated serum levels of 10 cytokines and their relationship with depression in patients with cardiovascular diseases as well as healthy subjects in northeast of Iran. Patients and Methods: The study was carried out on 462 subjects (120 healthy subjects and 342 candidates undergoing angiography). The healthy subjects were referred for routine annual checkups or pre-employment examinations; they did not have clinically evident CAD. A questionnaire was used to obtain demographic data and the Beck depression inventory (BDI) was applied to assess depression. The Evidence Investigator® platform was used for cytokines assays for IL-1α, IL-1β, IL-2, IL-4, IL-6, IL-8, IL-10, TNF-α, MCP-1 and IFN-γ, using sandwich chemiluminescent method. The statistical analysis was performed using SPSS version 11.5. Results: The mean age was 53.3 ± 11.5, 54.8 ± 11.3, and 59.5 ± 11.3 in healthy, angiography (-), and angiography (+) subjects, respectively (P < 0.05). There were significant differences in serum levels of IL-4, IL-6, IL-10, and MCP-1 cytokines, comparing subjects with CAD and healthy persons (P < 0.05). When all subjects were divided to with and without depression regardless of their cardiovascular status, there was a significant difference in serum levels of IL-8 and IL-6 between the groups (P < 0.05). When the subgroup with features of CAD was selected and divided to those with and without depression, there was also a significant difference in serum levels of IL-8 and TNF-α (P < 0.05). Conclusions: The positive interaction between depression and CAD was probably mediated by inflammatory mechanisms.

hs-CRP is strongly associated with coronary heart disease (CHD)

BACKGROUND AND AIMS Coronary heart disease (CHD) is an important public health problem globally. Algorithms incorporating the assessment of clinical biomarkers together with several established traditional risk factors can help clinicians to predict CHD and support clinical decision making with respect to interventions. Decision tree (DT) is a data mining model for extracting hidden knowledge from large databases. We aimed to establish a predictive model for coronary heart disease using a decision tree algorithm. METHODS Here we used a dataset of 2346 individuals including 1159 healthy participants and 1187 participant who had undergone coronary angiography (405 participants with negative angiography and 782 participants with positive angiography). We entered 10 variables of a total 12 variables into the DT algorithm (including age, sex, FBG, TG, hs-CRP, TC, HDL, LDL, SBP and DBP). RESULTS Our model could identify the associated risk factors of CHD with sensitivity, specificity, accuracy of 96%, 87%, 94% and respectively. Serum hs-CRP levels was at top of the tree in our model, following by FBG, gender and age. CONCLUSION Our model appears to be an accurate, specific and sensitive model for identifying the presence of CHD, but will require validation in prospective studies.

NUTRITIONAL AND THERAPEUTIC CHARACTERISTICS OF CAMEL MILK IN CHILDREN: A SYSTEMATIC REVIEW

Introduction Camel milk is the closest to a human mother’s milk. Camel milk is different from other milks, however, having low sugar and cholesterol, high minerals (sodium, potassium, iron, copper, zinc and magnesium, and vitamin C). The milk is considered have medicinal characteristics as well. This systematic review is aimed at determining and reporting nutritional values and medicinal characteristics of camel milk in children. Methods The search strategy of the current review is “(camel AND milk) AND (autism OR food allergy OR milk allergy OR children OR diarrhea.” The search was conducted via PubMed, Scopus, and Google scholar. Also two Persian scientific databases (SID and Iranmedex) and international congresses were investigated. Full-text papers and abstracts on the topic of camel milk, evaluating nutritional value and medicinal properties, were included in this systematic review. Results Out of the 472 records found in the resources, 35 related studies were included in the final analysis. The result showed that camel milk is highly nutritious and is safe for consumption by children. Conclusion It seems that many researchers did not follow a specific guideline for reporting and confirming the therapeutic properties of camel milk in children, but there is evidence denoting the importance, trials, and investigations of its usability and benefits. Camel milk as a supplemental treatment seems less invasive and costly than specialist care, medications, alternative treatments, and behavioral interventions. Based on our findings, camel milk is safer for children, effective in the treatment of autism, improves general well-being, promotes body natural defenses, is a good nutritional source, and can helps the daily nutritional needs of humans.

Challenges of Providing Cervical Cancer Prevention Programs In Iran: A Qualitative Study

BACKGROUND Cervical cancer has become a major public health problem worldwide. Iran, like other developing countries, is facing a number of challenges in managing the disease. This qualitative study documents challenges encountered in cervical cancer preventing programs in Iran. MATERIALS AND METHODS In-depth interviews were conducted with 28 participants including eleven patients with cervical cancer, three gynecologic oncologists, five specialists in Obstetrics and Gynecology, five midwives, three health care managers and one epidemiologist in Mashhad Iran, between May and December of 2012. The sample was selected purposively until data saturation was achieved. Data credibility verified via allocated sufficient time for data collection, using member checking and peer debriefing. Data analysis was carried out using conventional content analysis approach with ATLAS. ti software. RESULTS Findings from data analysis demonstrated 2 major themes and 6 categories about challenges of providing cervical cancer prevention programs including: individual and social challenges (cognitive/behavioral challenges and socio/cultural challenges) and health system challenges (stewardship, financing, competency of health care providers and access to services). Each category included some subcategories. CONCLUSIONS Managing the cervical cancer prevention programs need to include the consideration of individuals, health care providers and health system challenges. Addressing the low level of knowledge, negative attitudes, socio cultural challenges, Poor intersectional collaboration and coordination and intra-sectional management, financing and competency of health care providers are essential steps toward significantly reducing the burdens of cervical cancer.

ANXIETY, DEPRESSION, CORONARY ARTERY DISEASE AND DIABETES MELLITUS, AN ASSOCIATION STUDY IN GHAEM HOSPITAL, IRAN

Background: There is an increasing trend in the prevalence of coronary artery disease (CAD) in Iran. Objectives: The present study aimed to investigate the relationship of anxiety, depression, diabetes and coronary artery disease among patients undergoing angiography in Ghaem Hospital, Mashhad, Iran. Patients and Methods: This case-control study was conducted between September 2011 and August 2012 among 200 patients undergoing coronary angiography for symptoms of coronary disease at Ghaem Hospital, Mashhad, Iran. The control group consisted of 697 healthy adults recruited from the individuals who attended the clinic for routine medical checkups or pre-employment examinations. The Beck anxiety and depression inventory scores and fasting blood glucose results were assessed in all the subjects. Data were analyzed using SPSS version 16. P < 0.05 was regarded as statistically significant. Results: The mean age of patients was 57.52 ± 9.33 years old and for the control group it was 55.35 ± 8.45 years; there was no significant difference between the subjects (P = 0.647) regarding age. There was also no significant difference in gender distribution between the patients and control groups (P = 0.205). There was however a significant difference in anxiety and depression scores between the patients and healthy controls (P < 0.001). There was a significant positive correlation between anxiety score and depression score in both groups when data were analyzed by Pearson test. (P < 0.001, r = 0.604 and r = 0.521). Moreover, there was a significant positive linear correlation between the depression/anxiety scores and fasting blood glucose concentrations in the patients group (r = 0.3, P < 0.001) and a weak negative correlation in the healthy controls (r = -0.096, P < 0.05). Conclusions: Depression and anxiety are potentially important factors among patients with angiographically-defined CAD. There appear to be significant associations between glucose tolerance and anxiety and depression in these patients.

“Caring for my family integrity”: Fertile couples’ first childbearing experience in the urban society of Mashhad, Iran

Abstract Background: This qualitative study was conducted to discover fertile couples’ experiences of having their first child in the urban society of Mashhad, Iran. Methods: In this grounded theory study, 45 participants were selected. In-depth interviews were conducted at health centres, homes and workplaces. Data analyses were carried out adopting Strauss and Corbins mode of analysis through a constant comparative method applying open, axial and selective coding using MAXqda software. Study rigour was verified via prolonged engagement with participants, member check and debriefing with peers. Results: The core category that describes couples’ experience of having their first child was ‘caring for my family integrity’. The process of first-time childbearing included four interrelated stages: (1) gaining confidence about the spouses capability for being a parent, (2) evaluating situational conditions to make a decision whether to try to become pregnant, (3) managing childbearing across the life course and (4) parental role attainment. Conclusion: Couples’ decisions about having their first child are influenced by their mutual relationship and the results of their evaluation of a variety of circumstantial, economic, child-training abilities and health-related conditions. Both planned and unplanned events influence childbearing experiences. It is important to comprehend the four-stage process and apply it in reproductive health care especially in the delivery of family planning services.

Cognitive emotional consequences of male infertility in their female partners: a qualitative content analysis.

Introduction Infertility, as a global phenomenon and one of the most important issues of reproductive health, affects women more often than men, even when the infertility is due to a male factor. The purpose of this study was to explore the cognitive emotional experiences of women faced with male infertility. Methods This qualitative study was conducted in 2014–2015 in Mashhad, Iran. The perceptions and experiences of healthy women whose husbands were diagnosed with primary male factor infertility were investigated using a qualitative content analysis approach. Participants were selected through purposeful sampling, and data collection was conducted using in-depth semistructured interviews. Data were analyzed using conventional content analysis with MAXqda software. Study rigor was verified via criteria proposed by Lincoln and Guba. Results One main theme emerged through analysis entitled “cognitive emotional reactions confronting infertility diagnosis” with sub-themes of cognitive emotional reactions when confronted with male infertility diagnosis with subthemes of disbelief and denial, fear and apprehension, suffering and emotional distress, disappointment, frustration, confusion, and joy. Conclusion The diagnosis of male infertility was associated with important emotional cognitive consequences for their female partners. Emotional support, providing new insights into how to treat the issue, and trying to shorten the process of diagnosis are necessary for these women. This kind of support could reduce the psychological effects of confrontation with the diagnosis of male infertility, including social insecurity for women.