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Background: Women’s empowerment status in menopausal transition is of great importance due to the increasing trend of life expectancy and population aging. This study was conducted to evaluate the empowerment status of women during the menopausal transition in Gonabad, Iran.Methods: This cross-sectional study was conducted in Gonabad city in Northeast of Iran from April 2017 to March 2018. Cluster sampling was used for selecting 680 women who were in the menopausal transition. Demographic questionnaire and Women’s Empowerment Status Questionnaire - a researcher-made questionnaire- was used for data collection. Pearson’s correlation coefficient, one-way ANOVA, and linear regression were used to analyze the data using SPSS version 16; A p-value less than 0.05 was considered as significant.Results: The majority of the participants (510; 76.10%) had a high empowerment level. A high empowerment status in the family, economic, social, and health domains was observed in 499 (74.50%), 534 (79.70%), 523 (78.05%), and 493 (73.60%) participants, respectively. The majority of the participants had moderate empowerment status in political (427; 70.40%) and religious domains (464; 69.30%). There was a negative correlation between the total empowerment score and the participants’ age (P

Abstract Background This study examined how socio-demographic characteristics constructs derived from the health promotion model (HPM) influence the level of physical activity (PA) women in Bojnourd, North East of Iran. Method This cross-sectional study has been carried out through multi-stage sampling design on 356 women aged 18–60 years living in Iran. Data was collected through reliable and valid questionnaire survey women who were selected from their homes. Results Most of participants (53.40%) had a low level of physical activity behaviors with minimal physical activity (PA) scores. Using regression analysis showed that 23.22% of the total variance in PA behaviors was predicted by socio-demographic variables, whilst 40.81% of the variance in PA behaviors was predicted by constructs from the HPM. The results from Path modeling indicated that prior behavior, interpersonal influences, perceived self-efficacy, perceived barriers and commitment to PA, were significant predictors for PA behaviors with 86.93% of total effects on PA, whereas, activity-related affect and situational influences had no significant effect on the PA behaviors. Conclusions We found that constructs derived from the HPM are determinants of PA among Iranian women and may be important in developing educational intervention programs to facilitate a physically active lifestyle in this population.

Background Coronary heart disease (CHD) is the leading cause of morbidity and mortality globally, and specifically in Iran. Accurate assessments of Coronary heart disease (CHD) incidence is very necessary for public health. In current study we aimed to investigate the incidence of CHD and importance of several classical, modifiable and un-modifiable risk factors for CHD among an urban population in eastern Iran after 6 years of follow-up. Methods The population of MASHAD cohort study were followed up for 6 years, every 3 years in two step by phone and who reported symptoms of CVD were asked to attend for a cardiac examination, to estimate the incidence of CHD with 95% confidence interval (95% CI) as well multiple logistic regression analysis was performed to assess the association of several baseline characteristics with incidence of CHD event. Evaluation of goodness-of-fit was done using ROC analysis. CHD cases divided into four different classes which include: stable angina, unstable angina pectoris, myocardial infarction and sudden cardiac death. Results In the six years' follow-up of Mashhad study, the incidence rate of all CHD event in men and women in 100,000 people-years with 95% confidence intervals were 1920 (810-3030) and 1160 (730-1590), respectively. The areas under ROC curve (AUC), based on multivariate predictors of CHD outcome, was 0.7825. Conclusion Our findings indicated that the incidence rate of coronary heart diseases in MASHAD cohort study increases with age as well as our final model designed, was able to predict approximately 78% of CHD events in Iranian population.

Introduction: Nausea and vomiting are among the most common gastrointestinal complaints of women at beginning of pregnancy that can cause many social and individual problems. Since no study was found on the effect offoot solar plexus reflexology on nausea and vomiting of pregnancy in Iran, this study was performed with aim to evaluate the effect of solar plexus reflexology on severity of nausea and vomiting at first half of pregnancy. Methods: This randomized clinical trial was conducted on 73 pregnant women at 8-20 weeks of pregnancy who referred to one of the health care centers of Najafi, Amiralmomenin and Vahdat, Mashhad in 2018. The subjects were randomly divided into two groups of reflexology (n=36) and control (n=37). This study was conducted for 10 days in three steps; the scores of nausea and vomiting were measured by Rhodes Index. No intervention was done on days 1 to 3. On days 4 to 7, intervention group received one session of foot reflexology daily for 20 minutes with emphasis on solar plexus point, and the control group received only routine care. On days 8 to10, no intervention was performed. Data were analyzed by SPSS software (version 25) and variance analysis, Chi-square and independent t-test. P

Background and Purpose: Serum total cholesterol (TC) concentrations are affected by several factors including ethnicity, diet, geographic, and environmental determinants, and are related to another disease, including hypothyroidism, and renal and liver disease. It is associated with an increased risk of cardiovascular disease, particularly if associated with high levels of serum low-density lipoprotein (LDL). The distribution of TC levels within populations may be useful, and the current study aimed to determine the reference values and specific cut points in a population sample from Mashhad, Iran. Methods: A cross-sectional study was conducted, and data was collected from 6518 individuals (2483 men and 4035 women) aged 25–64 year-old living in Mashhad city using a stratified cluster random sampling design. Reference values for borderline and high TC levels in three age groups were obtained using a percentile regression model. Data were analyzed using Quantreg Software Package and R Ver. 3.1.2 Software. Results: Within the population sample, 38% of the subjects were male and 62% of them were female. The mean and standard deviation for age were found to be 47.07±9 years and 45.28±9 years for men and women, respectively. Percentile regression showed that borderline TC levels for men and women aged 25-64 years were 198-216 mg/dl and 176-243mg/dl, respectively. The values for defining high TC levels were also 226-239 mg/dl in men and 202 - 271 mg/dl in women. Conclusion: Our study estimated reference values and cut points for borderline and high TC separately in both men and women, and age-related sub-groups for a population derived from Mashhad. These findings could be used in local policy plans to allocate health resources.

Background & aim: Despite the global efforts to promote breastfeeding, women report some problems leading to stop breastfeeding in the early postpartum. Nipple soreness is considered as one of the main causes of early breastfeeding discontinuation. Treatment of this problem could keep breastfeeding for a prolonged period of time. Therefore, the present study aimed to investigate the effect of nipple pain treatment with lanolin and purslane cream on frequency and duration of breastfeeding. Methods: This double-blinded, randomized clinical trial was conducted on 86 breastfeeding women with nipple soreness who attended healthcare clinics in Mashhad, Iran, in 2016. The participants were randomly allocated to two equally sized group (43 in each), receiving purslane cream and lanolin for eight days. The correct method of breastfeeding and using the cream were trained to both groups. The nipple pain score was measured before intervention and on the third and eighth days post-intervention using a numeric pain rating scale. The subjects were also trained to record the duration and frequency of breastfeeding during the study period. Data were analyzed by SPSS version 22 using t-test, Fisher's exact test, Chi-square, and Wilcoxon tests. Results: Two study groups were identical in terms of the pain intensity before intervention. There was a significant difference concerning the pain intensity between the two groups on days 3 and 8. The pain intensity in the purslane cream group was significantly lower than the lanolin group (P

Background and Aim: Post-Traumatic Stress Disorder is one of the anxiety disorders which occur in postpartum period. The prevalence of PTSD – induced by preeclampsia has been already reported as 28%, however no study was found to compare PTSD in primiparous and multiparous women. This study was therefore conducted to compare PTSD in primiparous and multiparous women. Methods: This comparative descriptive study was performed on 100 pregnant women with preeclampsia including 56 primiparous and 44 multiparous women who selected conveniently from labor wards of university hospitals in Mashhad, Iran in 2012. PTSD was diagnosed by psychiatrist interview and Perinatal Post-traumatic stress Questionnaire (PPQ) in 6th week postpartum. Social support was measured using Hopkins questionnaire in 2nd and 6th week postpartum. Data analyzed with SPSS Version 16 using Spearman correlation coefficient and Mann-Whitney test. Results: The rate of PTSD was 24% in primiparous and 37.8% in multiparous women. There was no significant difference in relation to mean score of PTSD in primiparous and multiparous women. Mean score of social support in 2nd and 6th week postpartum was significantly higher in primiparous women (P=0.000). 34% of multiparous vs. 5.4% of primiparous women had unwanted pregnancy (P=0.000). There was also a direct relationship between postpartum social support in 2nd (P=0.005) and 6th week postpartum (P=0.002) and the rate of PTSD. Conclusion: The rate and mean score of PTSD in multiparous has been higher than primiparous women. Thus, it seems that multiparous women are at higher risk for PTSD due to lower postpartum social support and higher rate of unwanted pregnancy.

Background and Aim: One of the key aspects of maternal care is observing the progress of labor. Careful assessment of labor progress could provide mothers to be referred on time and could decrease the maternal and neonatal morbidity. This study aimed to compare diagnostic accuracy of purple line with transvers diagonal of Michaelis sacral rhomboid to predict labor progress in nulliparous and multiparous women. Methods: In this double-blind diagnostic accuracy study, 350 nulliparous and multiparous womenwith a single pregnancy in vertex presentation and gestational age of 38-42 week, who admitted in Om-ol-Banin Hospital, Mashhad, Iran, from April to August 2012, were selected using convenience sampling. At first, the transvers diagonal of the Michaelis sacral rhomboid area was measured in cervical dilatation of ≤ 3 centimeters. Then, labor progress and presence or absence of purple lines between the buttocks in the lateral position was hourly controlled in the active phase of labor. Data were analyzed by SPSS Version 16 using Mann-Whitney and Chi-square test. Results: The mean age of the women was 25/22 (±5) years. Out of the 350 women enrolled, 61/2% were primigravidas and 38/8% were multigravidas. The presence of purple line was accompanied with normal labor progress with 68.57% sensitivity, 42.66% specificity, and 80.57% validity. The transverse diagonal of the Michaelis sacral cut-off point was ≥98.5 millimeter with 86.5% sensitivity, 59.45% specificity and 79.65% validity, which was also accompanied with normal progress of labor. Conclusion: Considering the diagnostic accuracy of transverse diagonal of the Michaelis sacral and purple line, thetransvers diagonal of Michaelis Sacral is more accurate predictor of labor progress.

INTRODUCTION: Preeclampsia is the most common medical complication in pregnancy; along with bleeding and infection, it is one of the three causes of death in pregnant women. Most of these deaths were due to delays in the diagnosis and improper midwifery management and care. On the other hand, the quality of midwifery education has a profound effect on the proper provision of services. Therefore, the present study has been done to compare the effect of simulation-, blended-, and lecture-based education on simulated midwife performance in the management of preeclampsia and eclampsia. MATERIALS AND METHODS: This three-group clinical trial study was performed on 90 midwives of selected hospitals in Mashhad in 2016. Midwives were divided into three groups of simulation-, blended-, and lecture-based education using the random number table. The simulation group was trained for 6 h at the Center for Clinical Skills, the blended group was trained for 4 h by lecture, and 6 weeks through the educational website, and the lecture group was trained for 6 h through lecture. An objective structured clinical test was performed before and 2 weeks after the intervention. Data were analyzed using SPSS Version 16 software and descriptive statistics, paired t-test, one-way ANOVA, and Wilcoxon and Kruskal–Wallis tests. Significance level was considered to be P < 0.05 in all cases. RESULTS: The mean score of midwives' performance was not statistically significant before education in all three groups (P < 0.05). The mean score of midwives' performance was significantly increased in all three groups 2 weeks after education (P < 0.001), and the results of intergroup comparison showed that the mean score of performance in the simulation group was significantly higher than the blended group and the lecture group (P < 0.001), and it was higher in the blended group compared to the lecture group (P < 0.001). CONCLUSION: Education increased the midwives' simulated performance in preeclampsia and eclampsia. The performance of the management of preeclampsia and eclampsia in the simulation educational group is more than that of the blended and lecture groups, so we can use the simulation education which is a self-centered method.