Context: Transesophageal echocardiography (TEE) is an invasive method that causes anxiety. Studies have shown that education is effective in reducing anxiety. Aims: This study aimed to compare the effect of two educational methods of multimedia and peer training on the anxiety of patients who are candidates for TEE. Setting and Design: This study was a randomized controlled clinical trial conducted in 2018 Mazandaran Heart Center, Sari. Materials and Methods: 46 Patient seeking TEE (16 in the multimedia group(ME), 16 in the peer group(PE) and 14 in the control group) and randomly divided into three groups. The data collection tool was personal information form and the Spielberger State Anxiety Inventory. All groups received routine training. In addition,one intervention group, received PE and another intervention group received ME. Statistical Analysis Used: Data were analyzed using SPSS 25. The significance level was considered below 0.05. Results: There was no significant difference between groups in terms of personal and medical characteristics. The mean of anxiety scores before training was 44.6± 2.2, 46.18± 2.7, 46.5± 2 in the peer group, multimedia and control group (P = 0.826). The mean of anxiety scores in the peer group, multimedia and control group after intervention was 42.2 ± 3.3, 41.6 ± 2.6, and 47 ± 7 (P = 0.354). This difference was not statistically significant. Conclusions: Both PE and ME groups decreased anxiety in patients with TEE. But it was not statistically and the use of these techniques required more studies.

Context: Several researchers emphasized to develop cost-effective and easy interventions in this field as communicating about the relationship is the first step of healing. Aims: This study was aimed to evaluate the effectiveness of cognitive behavioral counseling based on film therapy on the communication skills of females with low sexual function. Setting and Design: In this clinical trial study, fifty subjects selected among females referred to health centers of Gonbad-e Kavus City-Iran. Materials and Methods: Samples randomized through permuted block randomization into two intervention (N=25) and control (N=25) groups. The intervention group participated in eight sessions of cognitive behavioral counseling (CBC)-based film therapy while the control group did not receive any intervention. All participants assessed by demographic, Arizona Sexual Experience Scale and Jerabeck Communication Skills Scales in pre and post intervention stages. Statistical Analysis Used: Data is analyzed using descriptive& independent t-test. Results: Findings showed that the two groups did not differ significantly in terms of age, education, and duration of marriage. The control (65.65 ± 6.75) and intervention groups (66.18 ± 7.32) were not significantly different in terms of communication skills before the intervention. However, in the postintervention phase, there was a significant difference between the control (66.04 ± 7.29) and intervention (74.95 ± 6.12) groups in term of communication skills (P < 0.05). Conclusion: Based on the findings of this study, CBT based on film therapy can improve communication skills among females with low sexual function in all aspects. Therefore, it is recommended to use this therapeutic approach to improve couples' relationships with low sexual performance.

Context: The most common opportunistic infection among Human Immunodeficiency Virus (HIV) reactive patients is tuberculosis (TB). TB has an impact on the prognosis of the disease. However, developing countries have not paid much attention to the problem. Aims: The study was conducted with the aim of determining the level of TB/HIV co-infection and associated factors. Setting and Design: A cross sectional study design was used in Wolaita Sodo Teaching and Referral Hospital from March 15 to May 15, 2017. Materials and Methods: Three hundred and seventy three patients were selected using simple random sampling. Statistical Analysis Used: Frequencies and proportions were computed. Logistic regressions were carried out and associations were considered statistically significant at P < 0.05. Results: The study revealed that 17.4% of the patients were co-infected with HIV and TB. Educational status (adjusted odds ratio [AOR] =0.472 and 95% confidence interval [CI] =0.253, 0.883), drug dependency (AOR = 2.366 and 95% CI = 1.129, 4.957), World Health Organization stage (AOR = 3.031 and 95% CI = 1.326, 6.930), and baseline CD4 (AOR = 0.351 and 95% CI = 0.153, 0.803) were predictors of the TB/HIV co-infection. Conclusion: Educational status, drug dependency, WHO clinical stage, and baseline CD4 count were found as significant predictors of co-infection. Therefore, health education about the lifestyle modification, counseling, and close monitoring of pharmacological therapy adherence is recommended.

Context: Leukemia is the most common pediatric cancer. Diagnosis and treatment of childhood cancer may have adverse psychological effects on children and their families. Aim: We examined the effectiveness of positive thinking education on anxiety, depression, and quality of life of mothers of children with leukemia. Settings and Design: This randomized control trial has been conducted during August-September 2017, on 30 mothers of children with leukemia who randomly allocated into two groups using 30 random numbers produced by computer software and assigned to intervention (n = 15) and control (n = 15) groups. Materials and Methods: Data collection tools included depression, anxiety, stress scale-21, and MOS 36-Item Short-Form Health Survey quality of life questionnaire. Statistical Analysis Used: The normality of data distribution examined using the Kolmogorov–Smirnov test. Then, data were analyzed using descriptive methods (mean, frequency, and percentage), Chi-square, and independent t-test. Results: There were no statistically significant differences between the study groups in depression, anxiety, and quality of life variable at baseline (P > 0.05). However after the intervention, results showed significant differences between the study groups in all the three variables in posttest compared to the pretest. The mean scores of depression and anxiety respected, in the intervention group were significantly lower than the control group (P < 0.001) and (P < 0.004). Furthermore, significant differences were found between the study groups in quality of life score (P < 0.05). Conclusion: Positive thinking training reduced anxiety and depression and increased the quality of life of mothers of children with leukemia.

Context: Mood disorders such as postpartum blue are very prevalent in the postnatal period, while the underlying mechanism of postpartum blue is not well known. Aim: This research aimed to investigates the role of brain-behavioral systems activation in postpartum blue according to revised reinforcement sensitivity theory in mothers referring to Mashhad health-care centers. Settings and Design: This correlational study has been conducted during February–March 2018, on 172 cases who diagnosed with postpartum blue were chosen through the purposive sampling method. Materials and Methods: Participants completed demographic questionnaire, Jackson five-factor questionnaire, and the Edinburgh depression scale. Statistical Analysis Used: The normality of data distribution examined using the Kolmogorov–Smirnov test. After, data were analyzed using descriptive methods (mean and standard deviation), Pearson confiscation, and stepwise regression method. Results: The results showed that brain-behavioral systems, including behavioral inhibition system (BIS) (P < 0.001; R = 0.31) and behavioral activation system (BAS), had a significant correlation with postpartum blue (P < 0.05; R = 0.39), while there was no significant relationship between fight-flight systems with postpartum blue. BAS (R² = 0.15,P < 0.05) and BIS (,R² = 0.08,P < 0.001), the predictive potential of BIS and BAS was equal to 21% of variance of postpartum blue. Conclusion: The findings suggest that behavioral-brain systems play a role in mothers' “postpartum psychological disorders such as postpartum blue and in the conception of mothers” distress after maternal delivery, the effects of these systems can be used in short-term interventions.

Context: Lifestyle recognition is important because of its ability to prevent diseases and promote the health of the body and mind. Aims: The aim of this study was to determine the lifestyle and its related factors in elderly in Babol health centers. Settings and Design: This study was a descriptive-analytic study that was carried out on the elderly population of Babol health centers in 2018. Materials and Methods: The sample size was 500 elderly people over 60 years of age who were selected by systematic random cluster sampling method and entered the study. The research tools were the demographic questionnaire, the Iranian elderly lifestyle questionnaire. Statistical Analysis Used: Data were Analyzed by SPSS 21 software using descriptive statistics, Pearson's correlation coefficient test, one-way ANOVA, and independent t-test. Results: The findings of this study showed that the mean ± standard deviation score of healthy lifestyle in the elderly was 155.73 ± 16.28. Of included population, 243 (48.6%) indicated moderate lifestyle and 257 persons (51.4%) had a desirable lifestyle. The Chi-squared test showed that men had better lifestyle than women (P < 0.001), also elderly lifestyle was significantly associated with gender,education, income level, marital status, living arrangement, housing status, and age (P < 0.001). Conclusion: Regarding the study results, some demographic factors must be addressed in intervention program, aimed at life style promotion in elderly people.

Context: Lack of satisfaction of sexual instinct is one of the main factors of couples' divorce in many countries. One of the formal methods of sexual education in Iran is premarital counseling education. Therefore, premarital counseling should meet the needs and wishes of couples. Aim: This study aimed to investigate sexual and reproductive health (SRH) needs and its associated factors in couples participating in premarital counseling. Setting and Design: This descriptive study was conducted with 240 women and 233 men referred to a premarital counseling center in Sari, North of Iran. Materials and Methods: After consideration of the ethical aspects of data collection, the questionnaire developed by Pourmarzi et al. was used for data collection. This questionnaire measures sexuality and reproductive health needs. Statistical Analysis Used: Descriptive and inferential statistics were used for data analysis through the SPSS software (version 21). Results: The mean of SRH education needs in both genders was 24 ± 10, which was not statistically significant (P = 0.19). In men, the major need was related to “genetic counseling and importance of performing it before pregnancy.” On the other hand, in women, the main training need was related to: “Pregnancy prevention methods.” Conclusion: The results of this study showed that the couples before marriage felt more need to education about SRH. Since that the most common method of education on sexual health in Iran is premarital counseling, it should be devised based on the provision of the main reproductive and sexual needs of couples such as genetic counseling and family planning.

Context: Tobacco products' consumption among students seems to have increased, which threatens their health as a cultural and social harm. Aims: The present study aimed to determine the knowledge, attitude, and practice of students in Qom University of Medical Sciences about tobacco. Setting and Design: A cross-sectional study was performed in Qom University of Medical Sciences, Iran, from December 2017 to January 2018. Material and Methods: Subjects accommodates 499 individuals who were selected through the simple random sampling. Data were collected using demographic and Global Youth Tobacco Survey (knowledge, attitude, and practice on tobacco) questionnaire. Statistical Analysis Used: Descriptive statistics, mean, and standard deviation were used to describe the status of the individuals. Pearson correlation coefficient and independent t-test, Chi-square, and ANOVA were used to analyze the relationships in SPSS-20 software. Results: The mean age of the samples was 21.32 ± 3.89 years. Men were 272 (54.4%), 438 (87.6) were single, and the rest were married. Average student knowledge was 6.65 (2.22), and their positive attitude was 40.16 (11.02). About practice, 76.9%, 93.5%, and 76% of people never used smoke, pipe, and hookah, respectively. T-test showed that there is a significant relationship between positive attitude and gender (P < 0.001); however, there is no significant relationship between knowledge scores and gender (P = 0.068). Chi-square test indicates that the difference between the two groups of girls and boys is not significant compared to the age of start of smoking (P = 0.86). Conclusion: Female students' knowledge was slightly higher than male; however, the positive attitude of male students was more than the female students about tobacco. It is necessary that the authorities and counseling centers of the university found underlying causes and work hard to solve the students' problems.