Comments on the Influence of the Western Architectural Styles on the Ottoman Water Structures; Case study Sultan Mahmud II Dam

Western architectural styles are introduced to the Ottoman architecture gradually starting with the beginning of the 18th century. These styles were accepted by the Ottoman society rapidly after the second half of the 18th century and the Western patterns were widely used in art and architecture. The most distinctive influence is observed on the water structures such as fountains and water conveyance structures. Ottomans welcomed the relationship of water and Baroque forms in their culture. The Sultan Mahmud II Dam dating to 1839 is one of the three dams that were constructed in the Taksim water conveyance system that supplies water to the region where the non-Muslim Ottoman population and Westerns lived. This dam is the largest dam of the system and bears the most decorative curved Baroque forms. Although this dam was constructed very far away from the city within the Belgrade Forest its design and construction competes with the contemporary buildings in the city. In this paper the function, architecture, architectural decoration of the Sultan Mahmud II Dam will be introduced and the perception of the Baroque style of the Ottoman architects will be emphasized by giving some other examples from the same period

DETERMINANTS OF GROWTH IN FRANCHISING CONTRACTS IN EMERGING MARKETS; EVIDENCES FROM TURKEY

This study aims to examine the franchise sector and determine the significant factors that contribute to an increase in the number of franchiser’s contracts in Turkey. Secondary data is used from the Turkish Franchise Association and multivariate regression models are run for each sector. Our models explain the change in the number of franchise contracts with R2’s varying between .6577 and .7549. We provide evidence that success factors in increasing the number of contracts change depending on the sector firms operating in and contracts may be designed thusly to pursue success

Professional autonomy for midwives in the contemporary UK maternity system: part 2

In this article, professionalisation, the midwifery profession and professional autonomy are explored from a sociological perspective to answer whether it is possible for a midwife to achieve professional autonomy within the contemporary UK system. Within part 1, obstetric influences and frictions, government policy and guidelines, risk, litigation and increasing managerialisation were considered, highlighting the complexities of professional midwifery and the challenges it faces. In part 2, choice, service pressures, evidence-based care, consumerism, leadership and reflexive practice are considered in the context of professional autonomy and the intention of retaining women's choice as the core belief of the profession. A conceptual framework has been devised to enable this, utilising the concept ‘New Professional Midwifery’

The Case for Gold Revisited: A Safe Haven Or A Hedge ?

This paper attempts to analyze the relation among gold prices and other macroeconomic and financial variables and addresses the question whether gold is a safe haven or a hedge for investors. The study investigates the relationship by using an econometric analysis for top gold exporter and importer countries, for a sample period of 11 years from 2000 to 2011. The results are twofold (i) return of silver, USD returns and change in the volatility index influences gold returns positively whereas, Swiss Franc and Canadian Dollar returns influence gold returns negatively regardless of presence of the 2008 crisis. (ii) In times of stress, our findings indicate that Swiss Franc, Norwegian Krone and Canadian Dollar function as haven whereas, on average, Swiss Franc, Canadian Dollar and 10 year US treasuries function as a hedge against gold but the results show no evidence for the US dollar.

Tumor angiogenesis assessed by three-dimensional power Doppler ultrasound in early, advanced and metastatic ovarian cancer: a preliminary study

Objective To evaluate tumor vascularity by threedimensional power Doppler ultrasound (3D-PDU) in early and advanced stage primary ovarian cancers and in metastatic tumors to the ovary. Patients and methods This was a retrospective analysis of clinical and sonographic data from 49 women with primary ovarian cancers or metastatic tumors to the ovary. All women underwent 3D-PDU prior to surgery. Vascularization index (VI), flow index (FI) and vascularization flow index (VFI) from solid portions or papillary projections in the tumors were calculated using the Virtual Organ Computer-aided AnaLysis (VOCALTM) program. Definitive histological diagnosis was obtained in each case. Results Among the 49 women, 10 had stage I primary cancers (five low-malignant potential tumors and five invasive tumors), 26 had advanced stage primary ovarian cancers and 13 had metastatic tumors to the ovary. Mean VI and VFI were significantly higher in advanced stage tumors and metastatic tumors as compared with early stage tumors. No differences in 3D-PDU indices were found between advanced stage and metastatic cancers. Conclusions Vascular indices derived from 3D-PDU tend to be higher in advanced stage and metastatic ovarian cancers as compared with early stage ovarian tumors

Factors that Determine the Self-Efficacy of The Maternal Care in Postpartum Women: Data for Future Memory

The birth of a child demands the provision of care. Mothers have different levels of safety or confidence when it comes to caring, which reveals the perception of self-efficacy. Our aim is to register, for future memory, the factors associated with self-efficacy in maternal care. Quantitative and cross-sectional study. It explores sociodemographic factors, factors related to the pregnancy and labor history, the newborn's characteristics, and related care environment with self-efficacy in maternal care. The study population included postpartum women from two Turkish maternity hospitals, in convenient sampling, with a response rate of 93,4%. Prudent ethical principles. The criterion variable was observed through the Perceived Maternal Parenting Self-Efficacy (PMP S-E). The statistical analysis was carried out on the SPSS software. The participants had an average age of 27.81(DP=5.13), the majority were married (95.9%) and for 40.1% this was their first child. The majority of labors were vaginal (52.4%). When it comes to the criterion variable, about 70% had a high perception regarding self-efficacy in maternal care. The univariate analysis revealed eight variables, included in the logistic regression: maternal age (p=.050), number of children (p<.001), number of prenatal appointments (p=.006), time that elapsed between the birth and the first episode of breastfeeding (p=.047), maternal safety while breastfeeding (p<.001), type of food given to the newborn p=.011), midwife support for exclusive maternal breastfeeding (p<.001) and maternal breastfeeding self-efficacy (p<.001). In the binary logistic regression, the best predictors of self-efficacy in maternal care were: midwife support for exclusive maternal breastfeeding (OR=1.092; B=0,088) and the self-efficacy in the maternal breastfeeding (OR=13.187; B=2.579). When it comes to maternal breastfeeding, both from the perspective of self-efficacy and the support offered by professionals, are the most relevant factors in the perception of maternal skills recognized by mothers. This study fills an information gap about the phenomenon, looking at it in retrospect

Targeted Treatment Protocol in Patellofemoral Pain: Does Treatment Designed According to Subgroups Improve Clinical Outcomes in Patients Unresponsive to Multimodal Treatment?

Background: Targeted intervention for subgroups is a promising approach for the management of patellofemoral pain. Hypothesis: Treatment designed according to subgroups will improve clinical outcomes in patients unresponsive to multimodal treatment. Study Design: Prospective crossover intervention. Level of Evidence: Level 3. Methods: Patients with patellofemoral pain (PFP; n = 61; mean age, 27 ± 9 years) were enrolled. Patients with PFP received standard multimodal treatment 3 times a week for 6 weeks. Patients not responding to multimodal treatment were then classified into 1 of 3 subgroups (strong, weak and tight, and weak and pronated foot) using 6 simple clinical tests. They were subsequently administered 6 further weeks of targeted intervention, designed according to subgroup characteristics. Visual analog scale (VAS), perception of recovery scale (PRS), 5-Level European Quality 5 Dimensions (EQ- 5D-5L), and self-reported version of the Leeds Assessment of Neuropathic Symptoms and Signs scale (S-LANSS) were used to assess pain, knee function, and quality of life before and after the interventions. Results: In total, 34% (n = 21) of patients demonstrated recovery after multimodal treatment. However, over 70% (n = 29/40) of nonresponders demonstrated recovery after targeted treatment. The VAS, PRS, S-LANSS, and EQ-5D-5L scores improved significantly after targeted intervention compared with after multimodal treatment (P < 0.001). The VAS score at rest was significantly lower in the “weak and pronated foot” and the “weak and tight” subgroups (P = 0.011 and P = 0.008, respectively). Posttreatment pain intensity on activity was significantly lower in the “strong” subgroup (P = 0.006). Conclusion: Targeted treatment designed according to subgroup characteristics improves clinical outcomes in patients unresponsive to multimodal treatment. Clinical Relevance: Targeted intervention could be easily implemented after 6 simple clinical assessment tests to subgroup patients into 1 of 3 subgroups (strong, weak and tight, and weak and pronated foot). Targeted interventions applied according to the characteristics of these subgroups have more beneficial treatment effects than a current multimodal treatment progra

Oncofertility program implementation increases access to fertility preservation options and assisted reproductive procedures for breast cancer patients

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/136021/1/jso24418.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/136021/2/jso24418_am.pd

Medical, ethical, and legal considerations in fertility preservation

The past 2 decades have seen a significant rise in cancer survival rates, and an increasing proportion of survivors at reproductive age are interested in childbearing. Although assisted reproduction provides physicians with an array of potential possibilities to help patients whose fertility is compromised by cancer treatment, there is still a dearth of regulation regarding the application of this technology. The present paper reviews the current options for fertility preservation, with a particular focus on the legal and ethical challenges that confront providers of this type of care.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/135176/1/ijgo11.pd

Breast cancer in young women and its impact on reproductive function

BACKGROUND: Breast cancer is the most common cancer in women in developed countries, and 12% of breast cancer occurs in women 20-34 years. Survival from breast cancer has significantly improved, and the potential late effects of treatment and the impact on quality of life have become increasingly important. Young women constitute a minority of breast cancer patients, but commonly have distinct concerns and issues compared with older women, including queries regarding fertility, contraception and pregnancy. Further, they are more likely than older women to have questions regarding potential side effects of therapy and risk of relapse or a new primary. In addition, many will have symptoms associated with treatment and they present a management challenge. Reproductive medicine specialists and gynaecologists commonly see these women either shortly after initial diagnosis or following adjuvant therapy and should be aware of current management of breast cancer, the options for women at increased genetic risk, the prognosis of patients with early stage breast cancer and how adjuvant systemic treatments may impact reproductive function. METHODS: No systematic literature search was done. The review focuses on the current management of breast cancer in young women and the impact of treatment on reproductive function and subsequent management. With reference to key studies and meta-analyses, we highlight controversies and current unanswered questions regarding patient management. RESULTS: Chemotherapy for breast cancer is likely to negatively impact on reproductive function. A number of interventions are available which may increase the likelihood of future successful pregnancy, but the relative safety of these interventions is not well established. For those who do conceive following breast cancer, there is no good evidence that pregnancy is detrimental to survival. We review current treatment; effects on reproductive function; preservation of fertility; contraception; pregnancy; breastfeeding and management of menopausal symptoms following breast cancer. CONCLUSION: This paper provides an update on the management of breast cancer in young women and is targeted at reproductive medicine specialists and gynaecologists