Women with chronic medical conditions require careful contraceptive management. The aim of this cross-sectional study in Tehran was to determine the pattern of contraception use by women with diabetes, hypertension or obesity. A sample of 264 women aged 18-53 years old was recruited; 81 (30.7%) had diabetes type 2, 100 (37.9%) were obese/overweight (BMI > 25 kg/m 2 ) and 83 (31.5%) had hypertension. Across all 3 groups, the rate of use of contraceptive methods was significantly different before and after diagnosis. Before diagnosis of disease the most common method was hormonal contraception in all women (55.0%, 71.6% and 78.3% of diabetic, overweight and hypertensive women respectively), whereas after diagnosis coital withdrawal was the most common method in diabetic and obese/overweight women (41.2% and 28.0% respectively) and almost the most common method for hypertensive women (35.4%). Use of safe and modern methods of contraception in women with certain chronic medical conditions was low and needs more attention. Utilisation de la contraception chez des femmes iraniennes hypertendues, diabétiques ou obèsesRÉSUMÉ Les femmes atteintes d'affections médicales chroniques ont besoin d'une prise en charge prudente de leur contraception. L'objectif de la présente étude transversale menée à Téhéran était de déterminer les tendances dans l'utilisation de la contraception chez des femmes diabétiques, hypertendues ou obèses. Un échantillon de 264 femmes âgées de 18 à 53 ans a été recruté ; 81 femmes (30,7 %) étaient atteintes d'un diabète de type 2 tandis que 100 femmes (37,9 %) étaient obèses/en surpoids (IMC > 25 kg/m 2 ) et 83 (31,5 %) souffraient d'hypertension. Dans l'ensemble des trois groupes, le pourcentage de recours à des méthodes contraceptives après la pose du diagnostic a considérablement changé par rapport au pourcentage relevé avant. Avant le diagnostic de l'affection, la méthode la plus fréquente était hormonale chez l'ensemble des femmes interrogées (55,0 %, 71,6 % et 78,3 % des femmes diabétiques, en surpoids et hypertendues, respectivement), alors qu'après la pose du diagnostic, le retrait coïtal était la méthode la plus fréquente chez les femmes atteintes diabétiques et obèses/en surpoids (41,2 % et 28,0 % respectivement) et presque la méthode la plus fréquente chez les femmes hypertendues (35,4 %). L'utilisation de méthodes de contraception sûres et modernes chez les femmes atteintes de certaines affections chroniques était faible. Le sujet mérite que l'on y accorde davantage d'attention.املتوسط لرشق الصحية املجلة عرش التاسع املجلد السابع العدد 639
Objective: There are disparities in mental health services (MHS) utilization within and between populations and several factors are studied as its potential correlates. Identifying those correlates would help health policy makers to adjust service provision with characteristics of their community. To evaluate demographic, socioeconomic and system correlates of MHS utilization among married women from Tehran, Iran.Methods: A household survey of 615 married women residents of 22 municipal districts of Tehran selected via a cluster sampling method. All subjects were asked about health services utilization during last one and 12 months as well as need and access for MHS, demographic and socioeconomic factors. Independent correlates of MHS use were determined with logistic regression analysis.Results: Total 615 women, mean±SE age and duration of marital life of 42.6±0.9 and 22±0.8 years, respectively were selected, rate of MHS utilization during last one and 12 months were 5.2% and 10.1% respectively. 23.6% of women reported having mental illness and 19.3% and 17.9% had need for MHS and access to outpatient health services, respectively. Logistic regression models showed that need for MHS (OR:5.25, 95%CI:2.7-10.1), access to outpatient services (OR:2.17, 95%CI:1.04-4.52), smoking (OR:3.4, 95%CI:1.16-10.2) and crowding index (OR:0.69, 95%CI:0.48-0.99).Conclusions: Rate of MHS utilization in women are low considering the near to estimated rate of perceived illness. Bridging the gap between perceived illness and need for services, then providing better access to services in areas with higher crowding index and higher rates of smoking in residents should considered in any mental health promotion programs.
BackgroundWith modern medical management, thalassemia major is now extending into adulthood and it is expected to have a negative impact on the quality of life (QOL) of the patients. The aim of this study was to evaluate quality of life in patients with thalassemia major. Materials and MethodsThis is an analytic case control study. Two hundred and fifty patients and 51 participants as controls were assessed using WHOQOL-BREF (Farsi version) questionnaire. All questions were answered based on the self-evaluated status in the past 2 weeks before enrollment and were rated on a five-point Likert scale. Therefore, the raw item score ranged from 1 to 5 and scaled in a positive direction and 6 dimensions including overall QOL, overall health, physical, psychological, social, and environmental relationship were assessed.
Complaints of sleep disturbance increase with age and many studies have been reported on the relation of sleep problems with greater use of health services, physical and mental morbidity, functional decline and all cause mortality. This study aimed to examine the sleep patterns and sleep disturbances in Iranian older people and to see how their sleep quality relates to their health status. 400 men and women, 60 years or older, interviewed by trained psychiatrist regarding their physical and mental health status, then the Pittsburg Sleep Quality Index, the Epworth Sleepiness Scale, and General Health Questionnaire implemented on them. The gathered data analyzed by chi-square test, t-test, one-way analysis of variance and logistic regression. The results showed that the majority of participants (82.6%) suffered from poor sleep quality and approximately one third had sleepiness (29.2%) during daytime. Difficulty falling (p≤0.001) and maintaining (p≤0.01) sleep and feeling too hot at night sleep (p≤0.005) were significantly more prevalent in women, but men suffered more from leg twitching (p≤0.01). Being female (OR=2.52), and having GHQ scores more than 11 (OR=4.14) increased the risk of poor sleep quality considerably. Promoting sleep hygiene education and screening of mental health problems in primary health care services for older people are recommended.
IntroductionPhysical domestic violence (DV) against women is associated with adverse health effects and great burden on victims, families and communities. The phenomenon, though prevalent in EMR countries, is not well defined regarding the determining factors.Objectives & aimsThis systematic review is to sum up evidences from the EMR countries, on factors associated with physical DV.Methods:Data sourcesPubmed, EMBASE, ISI, PsycInfo, IMEMR, Ovid, Global health, Cochrane Library, IranMedex, SID, IranDoc, Science direct, Elsevier, Proquest and Magiran were searched with no language limits up to December 30, 2011. The hand searching included papers’ lists of references and evidence list of “The National agenda for preventing domestic violence”.Study selectionQuantitative studies on ever partnered, not-pregnant women in the EMR countries, which referred to either predisposing or protective factors of physical DV, in each of victims, perpetrators and community domains, were selected. A criterion based critical appraisal was performed by two reviewers.Synthesis methodsThe Odds Ratios of all reported factors - regardless of statistical significance- were either directly extracted from the papers or indirectly calculated from provided contingency tables, and used to make summary tables.ResultsAccording to 16 finally selected articles, either partners’ lower levels of education, their witnessing /exposure to DV in childhood, personal/ family unfavorable socioeconomic status, rural residency and husbands’ alcohol / drug abuse were predisposing; while consanguinity, women’s age and employment were protective factors.ConclusionFindings are consistent with most international evidences. A meta-analysis will provide a more comprehensive understanding and evidence.
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