Postcoital contraception in Turkey

WOS: 000180984300009PubMed ID: 12566189Objectives: The purpose of this article is to determine the knowledge status of women concerning postcoital contraception when they turn to curettage in order to terminate an undesired pregnancy. Methods: This defining study has been carried out at a maternity hospital in Izmir on pregnant women admitted for curettage. We interviewed 150 pregnant cases using an improbability sampling method. Results: We discovered that 48.7% of women had avoided pregnancy before curettage by withdrawal before ejaculation. When we investigated the method used after uncontrolled coitus, 27.3% of cases reported vaginal douche while 12.7% indicated curettage. After having an unprotected coitus or failure in contraceptive methods 99.3% of the women indicated they would report to health institutes to utilize postcoital methods if they were familiar with them. Conclusions: Postcoital contraception may be a solution for undesired pregnancies. (C) 2002 International Federation of Gynecology and Obstetrics. Published by Elsevier Science Ireland Ltd. All rights reserved

Level of Knowledge of Midwives on Prenatal Diagnostic Methods and Antepartum Fetal Well-being who Work in the Community Polyclinics in Kocaeli [Kocaeli İli Merkez Saglik Ocaklari'nda Çalişan Ebelerin Prenatal Tani ve Antepartum Fetal Degerlendirme Yöntemleri Konusunda Bilgi Düzeylerinin Araştirilmasi]

OBJECTIVE: To determine the level of knowledge of midwives on methods of prenatal diagnosis and fetal well-being. STUDY DESIGN: One hundred midwives who work in central community polyclinics of City Health Administrative of Kocaeli has been enrolled. In order to find out the level of knowledge of midwives on methods of prenatal diagnosis and fetal well-being, a survey composed of appropriate questionnaire techniques and related literature has been applied. The data have been analyzed by the statistical computer software, SPSS. RESULT(s): The rate of midwives, who believe to have a counseling role in fetal well-being assessment was 79%. The rate of midwives who obtained correct information on methods used in fetal well-being assessment was as follows: 57% for ultrasonography (USG), 64% for non-stress test (NST), 90% for amniocentesis, 51% for maternal serum alpha-fetoprotein (AFP 54% for chorionic villus sampling (CVS), 30% for fetoscopy, 87% for cordocentesis. In addition, there was a significant correlation between the educational levels of midwives and their role on prenatal counseling (chi-square test, X2=23.7, P<0. 05). CONCLUSION(s): Although most of the midwives believe that they have a counseling role in prenatal care services, it seems that they don't have enough knowledge in terms of prenatal diagnostic methods and fetal well-being despite that they are supposed to have a very important role and great responsibility on primary health care maternity services. It is necessary that the midwives should be trained intensively regarding the prenatal diagnosis and fetal well-being trough oncop traning

Prevention and health education: How recent advances in the science and art of health education have been applied in practical ways within medical and other settings for prevention and public health

PubMed ID: 12718705The terms health education, patient education, self-care education, school health education, and health promotion are distinguished from each other as follows. Health education is a subset or strategy within each of these but is the primary and dominant strategy in health promotion. Health education occurs through the health care providers in various settings: worksites, medical, community agencies and schools. Nurses and midwives are the most important health care providers to train people for health promotion and cancer prevention. We appreciate the importance of the "Fight against Cancer" movement in the primary health care centre and its health care providers who inform people about cancer and its symptoms, how to find lesions and early stages, and how to avoid hazardous factors. This is as process of continuous information transfer by in-service education. Primary prevention should encompass all actions aimed to reducing the occurrence of cancer. In reviewing recent advances in science and how the art of health education has been applied in practical ways within medical and other settings for prevention and public health, we can point ot the necessity for facilities like an APOCP Training Centre as a venue for scientific courses

Cervical cancer prevention and early detection - The role of nurses and midwives

PubMed ID: 12718696Worldwide 31% of cancers in women are in the breast or uterine cervix. Cancer of the uterine cervix is one of the leading causes of cancer death among women. The estimated new cancer cervix cases per year is 500.000 of which 79% occur in the developing countries, where it is consistently the leading cancer and there are in excess of 233.000 deaths from the disease. The major risk factors for cervical cancer include early age at first intercourse, multiple sexual partners, low socioeconomic status, HSV, HPV infection, cigarette smoking and extended use of oral contraceptives. Well organized and applied public education and mass screening programmes can substantially reduce the mortality from cervical cancer and the incidence of invasive disease in the population. Women who are health conscious are more likely to have used screening services (mammogram, pap-smear test) and performed breast-self examination and genital hygiene. There are both opportunities and burdens for nurses and midwives working in primary health care settings. This is a prime example of a role of public education in cancer prevention with reference to population-based cancer screening programs

Influence of prenatal risks of pregnant women on mental symptoms [Gebelerin prenatal risklerinin ruhsal belirtilere etkisi]

Objective: In this study, it was aimed to investigate the influence of prenatal risk indicator scores of pregnant women on mental symptoms. Methods: This cross-sectional study was carried out with 142 pregnant women who were admitted to obstetrics clinic of a state hospital in İzmir province and who stated that they were not diag-nosed with any psychiatric diseases. A form questioning socio-demographic and obstetric characteristics of preg-nant women, Prenatal Risk Indicator aiming at determining risk of pregnant women and Brief Symptom Inventory (BSI) aiming at screening mental symptoms were used for data collection. Results: The most common risk fac-tors according to risk indicator were detected as experiencing urinary tract infection during the current pregnancy, being nulliparous, receiving late or insufficient prenatal care and inadequate weight gain and almost half of the pregnant women were found to be high risk. In addition, it was found that BSI scores were low, paranoid thought scores were high in high risk women and there was a positive correlation and phobic anxiety scores of all preg-nant women were equal. Conclusion: High risk pregnant women were detected to have paranoid thoughts and all pregnant women found to experience phobic anxiety equally

Does eosinophilic COPD exacerbation have a better patient outcome than non-eosinophilic in the intensive care unit?

Cüneyt Saltürk, Zuhal Karakurt, Nalan Adiguzel, Feyza Kargin, Rabia Sari, M Emin Celik, Huriye Berk Takir, Eylem Tuncay, Ozlem Sogukpinar, Nezihe Ciftaslan, Ozlem Mocin, Gokay Gungor, Selahattin OztasRespiratory Intensive Care Unit, Sureyyapasa Chest Diseases and Thoracic Surgery Teaching Hospital, Istanbul, TurkeyBackground: COPD exacerbations requiring intensive care unit (ICU) admission have a major impact on morbidity and mortality. Only 10%–25% of COPD exacerbations are eosinophilic.Aim: To assess whether eosinophilic COPD exacerbations have better outcomes than non-eosinophilic COPD exacerbations in the ICU.Methods: This retrospective observational cohort study was conducted in a thoracic, surgery-level III respiratory ICU of a tertiary teaching hospital for chest diseases from 2013 to 2014. Subjects previously diagnosed with COPD and who were admitted to the ICU with acute respiratory failure were included. Data were collected electronically from the hospital database. Subjects’ characteristics, complete blood count parameters, neutrophil to lymphocyte ratio (NLR), delta NLR (admission minus discharge), C-reactive protein (CRP) on admission to and discharge from ICU, length of ICU stay, and mortality were recorded. COPD subjects were grouped according to eosinophil levels (>2% or ≤2%) (group 1, eosinophilic; group 2, non-eosinophilic). These groups were compared with the recorded data.Results: Over the study period, 647 eligible COPD subjects were enrolled (62 [40.3% female] in group 1 and 585 [33.5% female] in group 2). Group 2 had significantly higher C-reactive protein, neutrophils, NLR, delta NLR, and hemoglobin, but a lower lymphocyte, monocyte, and platelet count than group 1, on admission to and discharge from the ICU. Median (interquartile range) length of ICU stay and mortality in the ICU in groups 1 and 2 were 4 days (2–7 days) vs 6 days (3–9 days) (P<0.002), and 12.9% vs 24.9% (P<0.034), respectively.Conclusion: COPD exacerbations with acute respiratory failure requiring ICU admission had a better outcome with a peripheral eosinophil level >2%. NLR and peripheral eosinophilia may be helpful indicators for steroid and antibiotic management.Keywords: chronic obstructive pulmonary disease, exacerbation, respiratory failure, intensive care unit, peripheral eosinophili