Mehrdad Salehi

Effect of add-on gabapentin on opioid withdrawal symptoms in opium-dependent patients

AIMS Evaluation of the efficacy of gabapentin in patients undergoing out-patient treatment for opiate withdrawal. DESIGN A 3-week double-blind, randomized, placebo-controlled trial of adjunctive gabapentin in methadone-assisted detoxification (MAD). SETTING Specialized Addictive Behaviors Unit, an out-patient unit for the treatment of patients with an addictive disorder serving the city of Isfahan (Iran). PARTICIPANTS Forty out-patients, 37 males and three females, aged 21-61 years, who met DSM-IV criteria for opiate dependence. INTERVENTION Random assignment of subjects to receive adjunctive treatment with either gabapentin (900 mg/day) or placebo under double-blind conditions. MEASUREMENTS Severity of subjective withdrawal symptoms using the Subjective Opiate Withdrawal Scale at six stages. FINDINGS Despite the superiority of gabapentin on controlling some of withdrawal symptoms, no significant differences were reported between two groups. CONCLUSIONS Dosage of 900 mg/day of gabapentin is not significantly superior to placebo in controlling opiate withdrawal symptoms.

The Relationship Between Self-Esteem and Sexual Self-Concept in People With Physical-Motor Disabilities

Background: Self-esteem is the value that the individuals give themselves, and sexual self-concept is also a part of individuality or sexual-self. Impairment or disability exists not only in the physical body of disabled people but also in their attitudes. Negative attitudes affect the mental health of disabled people, causing them to have lower self-esteem. Objectives: This study aimed to examine the relationship between self-esteem and sexual self-concept in people with physical-motor disabilities. Patients and Methods: This cross-sectional study was conducted on 200 random samples with physical-motor disabilities covered by Isfahan Welfare Organization in 2013. Data collection instruments were the Persian Eysenck self-esteem questionnaire, and five domains (sexual anxiety, sexual self-efficacy, sexual self-esteem, sexual fear and sexual depression) of the Persian multidimensional sexual self-concept questionnaire. Because of incomplete filling of the questionnaires, the data of 183 people were analyzed by the SPSS 16.0 software. Data were analyzed using the t-test, Man-Whitney and Kruskal-Wallis tests and Spearman correlation coefficient. Results: The mean age was 36.88 ± 8.94 years for women and 37.80 ± 10.13 for men. The mean scores of self-esteem among women and men were 15.80 ± 3.08 and 16.2 ± 2.90, respectively and there was no statistically significance difference. Comparison of the mean scores of sexual anxiety, sexual self-efficacy, sexual self-esteem, sexual fear and sexual depression among men and women showed that women scored higher than men in all domains. This difference was statistically significant in other domains except the sexual self-esteem (14.92 ± 3.61 vs. 13.56 ± 4.52) (P < 0.05). The Kruskal-Wallis test showed that except for sexual anxiety and sexual self-esteem, there was a statistical difference between other domains of people’s sexual self-concept and degree of disability (P < 0.05). Moreover, Spearman coefficient showed that there was only a correlation between men’s sexual anxiety, sexual self-esteem and sexual self-efficacy with their self-esteem. This correlation was positive in sexual anxiety and negative in two other domains. Conclusions: Lack of difference in self-esteem of disabled people in different degrees of disability and in both men and women suggests that disabled people should not be presumed to have low self-esteem, and their different aspects of life should be attended to, just like others. Furthermore, studies should be designed and implemented based on psychological, social and environmental factors that can help disabled people to promote their positive sexual self-concept through marriage, and reduce their negative self-concept.

A comparison of substance dependence treatment information system in America, England, and Iran

Context: Addiction, as a social problem, is a phenomenon that causes structural changes in cultural, social, political, and economic system in society. Prevention of this problem means decrease of risk factors and increase of protective factors; and recognition of these factors is possible with the help of update, accurate, and complete information in information systems. Aims: The aim of this study was to compare substance dependence treatment information system (SDTIS) in America, England, and Iran. Materials and Methods: This research was an applied and comparison-descriptive study, in which SDTIS was compared in America, England, and Iran. These countries were chosen based on available information on the Internet and also on the development of these countries in the health information management field. Information resources included library resources, electronic resources, and expert people (Health Information Management, Medical Records Education, Psychologist, Psychiatrist, and Medical Informatics). The data collection tool was the data raw form, whose reliability was proved by expert people. Statistical Analysis Used: Findings were analyzed by theory and descriptive method. Results: America and England had the SDTIS. Their systems had special characteristics such as goals, scope, special method for collecting, processing, reporting, quality and validity control, and confidentiality principles. However, there was no such system in Iran and the present situation in Iran has many differences with similar situations in the studied countries. Conclusion: Presence of an information system in the substance dependence treatment field helps to prevent, control, and treat addicted people. Hence, we try to submit a suitable model for implementing this system.

Comprehensive View of the Human Mating Process Among Young Couples in Isfahan-Iran: An Explanatory Mixed-Method Study

Background: Heterosexual relationship is the main component of mate selection. Regardless of the importance of mate favorites, little is known about exact valued criteria in potential mates. Objectives: This study was designed to comprehensively explain the theoretical view of the human mating process. Materials and Methods: This was as an explanatory mixed–method study. The first phase was a cross-sectional quantitative study with two Farsi-modified versions of instruments: preferences concerning potential mates and factors of choosing a mate; content analysis was the second phase. The quantitative phase of this study consisted of 202 dating couples, decided to get married. The qualitative phase consisted of 28 participants who acquired the extreme scores (highest and lowest) in the first phase. Results: Average age of marriage for women and men was 23.04 and 26.41 respectively; the actual age difference was 3.37 years (women younger than men). The results of this study in support of evolution-based theory explained that, age is a preference and choosing an older husband and a younger wife is due to having reproductive capacity. Also, they mentioned that appearance is necessary for men because of sexual attraction, not as a prediction for the next generation appearance. In both phases of this study, both genders had a strong emphasis on “chastity” in a potential mate. Results showed that, men preferred a mate who was a good housewife, capable of cooking, and women preferred a mate with “Good earning capacity”, “Good financial prospect” “university education”, “Favorable social status” and “Industriousness”. Conclusions: The results confirmed that for a comprehensive view in human mating process, we need a combined theoretical approach as well as qualitative and quantitative study to explore the real meaning of each preference in a mate.

Self-esteem, general and sexual self-concepts in blind people

Background: People with visual disability have lower self-esteem and social skills than sighted people. This study was designed to describe self-esteem and general and sexual self-concepts in blind people. Materials and Methods: This was a cross-sectional study, conducted in the Isfahan University of Medical Sciences in 2013-2014. In this study, 138 visually impaired people participated from Isfahan Province Welfare Organization and were interviewed for measuring of self-esteem and self-concept using Eysenck self-esteem and Rogers’ self-concept questionnaires. The correlation between above two variables was measured using Statistical Package for the Social Sciences (SPSS) software by Pearson correlation test. Results: Mean [± standard deviation (SD)] age of patients was 30.9 ± 8 years. The mean (±SD) of general self-concept score was 11 ± 5.83. The mean (±SD) of self-esteem score was 16.62 ± 2.85. Pearson correlation results showed a significant positive correlation between self-esteem and general self-concept (r = 0.19, P = 0.025). The mean of sexual self-concept scores in five subscales (sexual anxiety, sexual self-efficacy, sexual self-esteem, sexual fear, and sexual depression) were correspondingly 11 ± 4.41, 19.53 ± 4.53, 12.96 ± 4.19, 13.48 ± 1.76, and 5.38 ± 2.36. Self-esteem and self-concept had significant positive correlation with sexual anxiety (r = 0.49; P < 0.001) (r = –.23; P < 0.001) and sexual fear (r = 0.25; P = 0.003) (r = 0.18; P = 0.02) and negative correlation with sexual self-efficacy (r = –0.26; P = 0.002) (r = –0.28; P = 0.001) and sexual-esteem (r = –0.34; P < 0.001) (r = –0.34; P < 0.001). Conclusion: Self-esteem and self-concept had significant correlation with sexual anxiety and sexual fear; and negative correlation with sexual self-efficacy and sexual-esteem.

Sexual and Reproductive Health Knowledge Among Men and Women Aged 15 to 49 Years in Metropolitan Tehran

Sexual and reproductive health (SRH) knowledge is an important predictor of an individual’s sexual behavior; however, little is known regarding this issue among Iranians. This study assessed sexual and reproductive health knowledge among men and women aged 15 to 49 years in Tehran. A total of 755 men and women aged 15 to 49 years were recruited using multistage, random cluster sampling in June 2014. An illustrative anonymous questionnaire endorsed by the World Health Organization (WHO) was used to collect the data. Bivariate and multivariate analyses were performed. The results showed that men and women were moderately knowledgeable about sexual and reproductive health (mean score of SRH knowledge = 39, range: 26 to 52); however, myths and misperceptions prevailed in different aspects of SRH. For example, only 45% of women and 38.7% of men accurately knew that a person infected with human immunodeficiency virus (HIV) can look healthy. Friends were identified as the primary or secondary source of knowledge about puberty and sex-related issues. A multivariate analysis showed that being female (coefficient = 0.139, p < 0.001) and being married (coefficient = 0.180, p < 0.001) were significant predictors of better SRH knowledge, while being young (age group 15 to 24) was a significant determinant of poor SRH knowledge (coefficient = −0.161, p < 0.001) when other influencing factors were controlled. Culturally appropriate and age-specific comprehensive education is recommended, particularly for men, the unmarried, and the younger generation in Iran.

A comprehensive sexual health care program for educable intellectually disabled adolescent girls: protocol for a mixed methods study

BackgroundProtection and promotion of sexual health is of great importance for educable intellectually disabled adolescent girls; since they are prone to high risk sexual vulnerabilities and consequences, such as unwanted pregnancy, sexually transmitted infections, and acquired immune deficiency syndrome. Although the rights of intellectually disabled adolescents have been emphasized through the recent years, their sexual health care is still a challenge for parents, teachers, caregivers, and service providers. This study aims to present a comprehensive sexual health care program for educable intellectually disabled adolescent girls.MethodsThis study is carried out by an exploratory sequential mixed qualitative-quantitative methods approach including three sequential phases. The researcher represents sexual health state of educable intellectually disabled adolescent girls using a qualitative approach. In the onset of the second phase, a comprehensive sexual health care program is designed for educable intellectually disabled adolescent girls. In this regard, in addition to qualitative studies, some related papers and texts are used. The suggested program of expert panel is approved based on prioritization guidelines. Then, in the third phase and after different stages of finalization of the program, its affectability is evaluated regarding improvement of sexual health state of educable intellectually disabled adolescent girls.DiscussionIt is expected that from the results of the present mixed methods study, by presenting a comprehensive sexual health program for educable intellectually disabled adolescent girls, lead to improvements in the sexual health of these girls. Moreover, it wants to reduce risky sexual behaviors, sexual abuse and harassment, and their consequences in adolescent girls in order to improve sexual health state of the society. If this program works, it can become one of the leading education and care guidelines for sexual health care of intellectually disabled adolescent girls.Trial registrationIRCT20160224026756N5. Registered 22 June 2018.

How Is Developing the Sense of Belonging in Iranian Adolescent Girls? A Qualitative Study

BACKGROUND: Communicating with adolescents is associated with many challenges for parents and healthcare providers. AIM: This qualitative study was conducted for exploring the sense of belonging in Iranian adolescent girls. METHODS: In this study, deep semi-structured interviews were carried out with 27 adolescent girls, 10 experts, and 10 parents. Purposeful sampling was used and continued until data saturation. The data were coded and categorised through a conventional content analysis method by MAXQDA 10. RESULTS: Three main categories were obtained from the analysis of the participants’ descriptions: “family; a haven of tranquillity”, “dominated by peers”, and “concerns about differences in gender socialization”. According to our results, most of the girls achieved calmness through being emotionally accepted by their families. But this sense of belonging and tranquillity was shaken by their peers’ showing off, in a way that adolescent girls were always struggling to gain acceptance among their peers. Also for fear of being rejected by their peers’ group, they sometimes began to make friends with the opposite sex. Meanwhile, traditional attitudes towards gender roles and adolescent girls’ feelings about their lower social participation as compared to that of boys had also led to their concern about differences in gender socialization and a lower sense of community belonging among some adolescent girls. CONCLUSION: Adequate parental education and the proper management of girls’ interactions with the family and society can play an important role in the development of a sense of belonging among adolescent girls.

Gender identity development in the shadow of socialization: a grounded theory approach

Gender identity is one of the basic forms of identity which has a key role in the mental health during adolescence. The present study was conducted to determine the process of gender identity development among Iranian female adolescents. In this grounded theory study, semi-structured interviews were conducted with 55 purposefully and theoretical selected participants including 30 female adolescents and 25 key informants who lived in urban society of Isfahan, Iran, in 2016–2018. Data were analyzed using Strauss and Corbin’s mode of analysis (2008), through constant comparative method, applying levels of open, axial, and selective coding with MAXQDA software. Development of gender identity in the shadow of socialization was presented as the core category extracted from the data in this study. Female adolescents would use “sexual self-expression during puberty,” “attachment to parents and peers,” “tendency towards the opposite sex,” and “effort for social acceptance” as the main strategies in the development of gender identity until achieving “stabilized gender identity.” “Girls’ communicational skills” and “parents’ empowerment” were the causal conditions in this process. “Gender differences” and “sociocultural texture of the society” were the contextual conditions and the influence of “peers” and “media” was the interventional conditions in the development of gender identity in female adolescents. Improving girls’ communicational skills, empowering parents for managing their interactions with their daughters, adjusting gender roles in the society, and creating appropriate content by the media could have an important role in helping female adolescents achieving stabilized gender identity.

Changing Beliefs and Behaviors Related to Sexually Transmitted Diseases in Vulnerable Women: A Qualitative Study

Background: The first step in health education is awareness of the people and their acceptance to change their behavior. Therefore, the aim of this study was to investigate the effects of empowerment program towards the concept of self-care and prevention of sexually transmitted diseases (STDs) in women at risk of STDs. Materials and Methods: The present study was conducted as a qualitative approach (step of action and observation of an action) by using conventional content analysis method. An empowerment program regarding STDs (Action) was performed among 32 (with convenient sample) drug user women with addicted husbands referring to the counseling center for vulnerable women (drop in enter) in Isfahan in 2015. The knowledge of quiddity, transmission, and prevention of STDs, as well as some items of life skills such as self-awareness, interpersonal communication, and assertive behavior were taught in an educational program. Teaching methods were lectures, group, and individual training and role play. The impact of the program on modified belief and behavior change regarding STDs was evaluated with structured interviews. Results: Analysis of the obtained results yielded three categories. The categories were awareness of STD, believing in being at risk, and decision and change. Conclusions: Promoting self-care and prevention through education programs based on action research can make a significant reduction in the incidence of problems and cause a behavior change in women with the disease or those at risk for STDs.