Mohammad Abbasi

‘Super-mothers’: the meaning of mothering after assisted reproductive technology

Objective: The objective was to explore mothers’ experiences after assisted reproductive technology (ART). Background: The experience of mothering in women after assisstive reproductions has not been fully understood. Study design: An interpretive phenomenology approach was used to conduct the study. Participants: A purposive sample of nine mothers who had babies through ART participated in the study. Data were collected using semi-structured in-depth interviews. Findings: ‘Super-mothering’ was the main theme emerging from the data, describing mothers who wanted to be exceptional by performing all of their mothering responsibilities without fatigue or exhaustion and who were ready to do everything in their power to support the child. This theme incorporates four sub-themes: (1) over-care; (2) over-protection; (3) over-emotional investment; and (4) over-expectation of themselves and others. Conclusion: The challenge to be a mother through ART is a stressful phenomenon, particularly so for the majority who are also first-time mothers. Healthcare professionals need to consider the concept of super-mothering in trying to understand and care effectively for this group.

Factors associated with HIV risk perception among people who inject drugs: Findings from a cross-sectional behavioral survey in Kermanshah, Iran

ABSTRACT Background: In Iran there are limited data regarding HIV risk perceptions among people who inject drugs (PWID). The objective of this study was to explore HIV risk perception and to examine factors associated with the perception of HIV risk among PWID in Iran. Methods: We surveyed 433 PWID in Kermanshah concerning demographic characteristics, sexual risk behaviors, HIV risk perception, and drug-related risk behaviors in the month prior to the study. Two classes of HIV risk perception (high vs. low) were identified. We used logistic regression to identify factors associated with high HIV risk perception. Result: Of 433 PWID who participated in this study, 36% (95% confidence interval; CI95%: 25.3%, 42.2%) of participants reported high HIV risk perception. Methamphetamine use (adjusted odds ration; AOR = 3.7, p < 0.05), or use of multiple drugs at the same time (AOR = 1.7, p < 0.05) was associated with higher HIV risk perception. Moreover, PWID who were NSP users had 2.8 times the odds of high risk perception compared with non-Needle and Syringe Program (NSP) users (AOR = 2.8) . Conclusion: This study implies that initiating drug use at a younger age, using methamphetamine, polydrug use, and needle- and syringe-exchange program utilization were predictors of higher HIV risk perception among PWID in Iran.

Effect of recorded male lullaby on physiologic response of neonates in NICU

PURPOSE Most infants in the NICU are exposed to sensory overloads and deprivations as part of their care. This study conducted to assess the effect of lullaby on physiologic response of neonates admitted to NICU. METHOD This is a randomized double-blind intervention trial which was performed on 52 neonates in Jahrom (Iran) 2013-2014. The samples were randomly assigned into lullaby group and a control group (sampling was sequential and randomization was by lottery). Neonates in lullaby group (n=26) listened to male lullaby via headphones during 3days and daily for 20min. Headphones without sound were placed for the control group (n=26) during this period. Immediately before the intervention, 10min later, 20min after the start and 20min after the completion of it, changes in heart rate and oxygen saturation were recorded by heart monitor, then data were analyzed by software SPSS:V 21, Greenhouse-Geisser test, repeated measures and t-test. RESULTS The mean of Heart rate in secondday at 20th and 40th minutes in lullaby group were less than control and this differences were significant (respectively p=0.013, 0.026). Also the blood oxygen saturation levels on the first day at 20th minutes, secondday at 10th minutes-20th and 40th minutes and the third on 40min were significantly different among groups. CONCLUSION Lullaby (male voice and without music) could significantly reduce heart rate and increase blood oxygen saturation of neonates. Future studies are required to make music as a part of evidence-based strategies to promote outcome of neonates in NICUs.

The Challenges of Living With an Implantable Cardioverter Defibrillator: A Qualitative Study

Background Dysrhythmia is one of the most common causes of sudden cardiac death worldwide. An implantable cardioverter defibrillator is the most effective method of treatment for dysrhythmias causing cardiac arrest. However, living with an implantable cardioverter defibrillator is associated with challenges such as fear, anxiety, and depression. Objectives The purpose of this study was to identify the challenges of living with an implantable cardioverter defibrillator. Patients and Methods In this qualitative study, an interpretive phenomenological approach was used, with thirteen participants (seven men and six women) between the ages of 21 and 70 years old (mean = 58.15, SD = 14.4). The duration of having an implantable cardioverter defibrillator was 1 - 120 months (mean = 23.15, SD = 33.31). Maximum variation sampling was used to purposefully select the participants from the governmental Imam Khomeini hospital in Tehran, Iran, between May and October of 2013. Semi-structured interviews were conducted for 30 to 45 minutes, and Van Manen’s six-step method was used in this study. Results The challenges of living with an implantable cardioverter defibrillator include: living with fear, concerns about the future, concerns about device malfunction, fearing death during the shock, pain due to the shock, loss of control, the cost of the device, and the lifestyle limitations. Conclusions Patients who live with implantable cardioverter defibrillators face many concerns and challenges. Therefore, the role of nurses in teaching patients before and after implementation is very important.

Comparing Therapeutic Efficacy and Safety of Epoetin Beta and Epoetin Alfa in the Treatment of Anemia in End-Stage Renal Disease Hemodialysis Patients

Background: Anemia is one of the most prevalent complications in patients with chronic kidney disease, which is believed to be caused by the insufficient synthesis of erythropoietin by the kidney. This phase III study aimed to compare the efficacy and safety of CinnaPoietin® (epoetin beta, CinnaGen) with Eprex® (epoetin alfa, Janssen Cilag) in the treatment of anemia in ESRD hemodialysis patients. Methods: In this randomized, active-controlled, double-blind, parallel, and non-inferiority trial, patients were randomized to receive either CinnaPoietin® or Eprex® for a 26-week period. The primary endpoints of this study were to assess the mean hemoglobin (Hb) change during the last 4 weeks of treatment from baseline along with the evaluation of the mean weekly epoetin dosage per kilogram of body weight that was necessary to maintain the Hb level within 10–12 g/dL during the last 4 weeks of treatment. As the secondary objective, safety was assessed along with other efficacy endpoints. Results: A total of 156 patients were included in this clinical trial. There was no statistically significant difference between treatment groups regarding the mean Hb change (p = 0.21). In addition, the mean weekly epoetin dosage per kg of body weight for maintaining the Hb level within 10–12 g/dL showed no statistically significant difference between treatment arms (p = 0.63). Moreover, both products had comparable safety profiles. However, the incidence of Hb levels above 13 g/dL was significantly lower in the CinnaPoietin® group. Conclusion: CinnaPoietin® was proved to be non-inferior to Eprex® in the treatment of anemia in ESRD hemodialysis patients. The trial was registered in Clinicaltrials.gov (NCT03408639).

Are Faculty Members of Paramedics Able to Designed Accurate Multiple Choice Questions

BACKGROUND & OBJECTIVES Multiple choice questions (MCQ) are one of the assessment instruments in medical sciences. The overall aim of this study was to perform qualitative and quantitative analysis of the multiple choice question MCQ provided by the professors of Kermanshah University of Medical Sciences-Faculty of Medicine in the academic year 2011-2012. MATERIALS & METHODS In this descriptive-analytic study, 37 tests of the Faculty of Medicine were analyzed. Quantitative data included difficulty coefficient, discrimination coefficient, whole credibility test, standard deviation of the questions, and the qualitative data consisted of taxonomic percent I, II and III, percentage of questions with no structural problems. The data were analyzed using SPSS software version 20.00 while T-test and chi-square test were applied. RESULTS The average validity coefficient of the total tests (KR-20) was measured as 0.63, the average difficulty coefficient as 0.58, the average discrimination coefficient as 0.19. The average percentage of the questions without structural problems as 37.1%; all of which were in the acceptable range. The mean Taxonomy I percentage of the questions was38.36% (±11.31), Taxonomy II percentage of the questions was 42.46% (±15.51) with no significant difference in the entire tests. Average percentage of questions with taxonomy III was 20.73% (±12.83) for which independent t-test showed significant difference in the total tests (P=0.00). Average percentage of questions without structural problems was measured as 55.23% (±13.23) for which there was a significant difference in the total tests when independent t-test was used (P=0.041). CONCLUSION Considering the average validity of the whole test, the mean difficulty coefficient and Taxonomy indexes I, II and III, the tests designed by the professors of the Faculty of Allied Science are within an a acceptable standard range.