Sexual function and help seeking for urinary incontinence in postmenopausal women

ABSTRACT

Urinary incontinence (UI) is a common condition, especially in middle-aged and older women. UI is known to affect sexual function. Many women with UI do not consult a doctor about their condition. The aim of this study was to determine the relationship of sexual function and help seeking in postmenopausal women with urinary incontinence. This cross-sectional correlation study took place from March to May 2012. The subjects were selected by a clustered sampling method from various zones of Rasht (North of Iran). The data were collected using personal data forms, Questionnaire for Urinary Incontinence Diagnosis, Incontinence Severity Index, and Incontinence Quality of Life questionnaire. Data were analyzed by SPSS17 at the significant level of P < .05 and then were compared by parametric and nonparametric tests. A total of 313 menopausal women aged 45 to 60 years (mean 52.9) were recruited for the study. The mean sexual function score was 31.07 ± 7.52. Only 27.3% of subjects seek care for urinary incontinence. There was a significant correlation between sexual function and help seeking. The results of this study indicate that there is a significant correlation between sexual function and help seeking in postmenopausal women who participated in the present study. Health-care professionals should pay more attention to sexual symptoms of UI and make patients aware of available treatments.     

Validation Study: The Iranian Version of Caregiver Abuse Screen (CASE) among Family Caregivers of Elderly with Dementia

Since abuse screening is difficult among the elderly with dementia, detection of elder abuse is a serious issue; meanwhile, the number of available tools to assess elder abuse by caregivers is limited. The aim was to evaluate validity and reliability of the Iranian version Caregiver Abuse Screen (CASE) tool. After the translating process of the tool to the Farsi language for 236 dementia participants ≥60 years old and their informal caregivers’ from outpatient’ clinics, in a cross-sectional method then the validity, reliability and factorial structure of the CASE was evaluated. The translated Iranian version CASE reveals a good psychometric property (α = 0.868) with strong internal consistency and reliability. Some variables (depression, burden, dementia intensity, and ADLs) were associated with abuse in dementia elderly. The two-factor structure was obtained in exploratory factor analysis labeled interpersonal abuse and neglect. Generally, the Iranian version of CASE approved with sufficient validity and reliability as a suitable instrument to find the risk of elder abuse among dementia caregivers.     

GEE-based zero-inflated generalized Poisson model for clustered over or under-dispersed count data

The zero-inflated regression models such as zero-inflated Poisson (ZIP), zero-inflated negative binomial (ZINB) or zero-inflated generalized Poisson (ZIGP) regression models can model the count data with excess zeros. The ZINB model can handle over-dispersed and the ZIGP model can handle the over or under-dispersed count data with excess zeros as well. Moreover, the count data may be correlated because of data collection procedure or special study design. The clustered sampling approach is one of the examples in which the correlation among subjects could be defined. In such situations, a marginal model using generalized estimating equation (GEE) approach can incorporate these correlations and lead up to the relationships at the population level. In this study, the GEE-based zero-inflated generalized Poisson regression model was proposed to fit over and under-dispersed clustered count data with excess zeros.     

How Rumination Affects Marital Conflict in Iranian Women: A Qualitative Study

Rumination can cause numerous problems for an individual. Previous studies have indicated that the tendency of women toward rumination is greater than that of men. Therefore, the aim of this study was to investigate how rumination might affect marital conflict in Iranian women. This qualitative study has a thematic analysis design. Using purposeful sampling, women were recruited to be interviewed using a semistructured manual, and the sampling continued until it reached saturation (N = 63). Analysis of the data showed that findings could be grouped into 5 themes: insecure attachment style, deteriorating behaviors, deactivation, uncertainty about the relationship, and negative emotions. The finding of this research is that when marital conflicts are not solved, insecure attachment styles are activated, possibly resulting in rumination. As a result, rumination will exacerbate the negative emotions and marital relationship quality.     

How can community-based health organisations play a role in biohazards? A thematic analysis

ABSTRACT

Health professionals respond to biohazards according to international guidelines. However, concerns over the applicability of guidelines do exist since local conditions, as well as cultural traits of communities, tend to differ. Community-Based Health Organisations (CBHOs) are gatekeepers of communities whose roles and responsibilities have been assessed in this study to learn how they can assist health systems in times of biohazards. We conducted a content analysis among directors of CBHOs and disaster authorities. The participants read a hypothetical scenario, followed by a semi-structured interview. The results showed that more investments should be made to improve the functional roles of CBHOs during biological hazards by filling capacity gaps and take advantage of existing capabilities. Therefore, communities need to direct their efforts in the context of social capitals and leading strategies. As long as the state’ policies and strategies limit the power of communities, the CBHOs will experience social exclusion and equality.     

B Butterfly Campaign: A social marketing campaign to promote normal childbirth among first-time pregnant women

Problem

The steep increase and inappropriateness of caesarean birth represent a healthcare problem in Iran.

Difficult Conversations in a School of Social Work: Exploring Student and Faculty Perceptions

Difficult conversations about isms, power, privilege, and oppression are an essential part of social work education, and they present unique challenges for students and faculty. The current study examined students’ and faculty’s perceptions of the safety of the classroom and the competence of the faculty in facilitating difficult conversations at a graduate school of social work in New York City. Student and faculty versions of a survey were distributed to both groups. Results indicated students rated the experience of having difficult conversations at the school significantly more negatively than the faculty did. The majority of respondents expressed the need for courses and training to be more fluent in having difficult conversations. Future directions are discussed based on the findings.     

Analysis of over-dispersed count data with extra zeros using the Poisson log-skew-normal distribution

ABSTRACT

Mixed Poisson distributions are widely used in various applications of count data mainly when extra variation is present. This paper introduces an extension in terms of a mixed strategy to jointly deal with extra-Poisson variation and zero-inflated counts. In particular, we propose the Poisson log-skew-normal distribution which utilizes the log-skew-normal as a mixing prior and present its main properties. This is directly done through additional hierarchy level to the lognormal prior and includes the Poisson lognormal distribution as its special case. Two numerical methods are developed for the evaluation of associated likelihoods based on the Gauss–Hermite quadrature and the Lambert's W function. By conducting simulation studies, we show that the proposed distribution performs better than several commonly used distributions that allow for over-dispersion or zero inflation. The usefulness of the proposed distribution in empirical work is highlighted by the analysis of a real data set taken from health economics contexts.