Global, Regional, and National Burden of Calcific Aortic Valve and Degenerative Mitral Valve Diseases, 1990-2017.

BACKGROUND: Nonrheumatic valvular diseases are common; however, no studies have estimated their global or national burden. As part of the Global Burden of Disease Study 2017, mortality, prevalence, and disability-adjusted life-years (DALYs) for calcific aortic valve disease (CAVD), degenerative mitral valve disease, and other nonrheumatic valvular diseases were estimated for 195 countries and territories from 1990 to 2017. METHODS: Vital registration data, epidemiologic survey data, and administrative hospital data were used to estimate disease burden using the Global Burden of Disease Study modeling framework, which ensures comparability across locations. Geospatial statistical methods were used to estimate disease for all countries, because data on nonrheumatic valvular diseases are extremely limited for some regions of the world, such as Sub-Saharan Africa and South Asia. Results accounted for estimated level of disease severity as well as the estimated availability of valve repair or replacement procedures. DALYs and other measures of health-related burden were generated for both sexes and each 5-year age group, location, and year from 1990 to 2017. RESULTS: Globally, CAVD and degenerative mitral valve disease caused 102 700 (95% uncertainty interval [UI], 82 700-107 900) and 35 700 (95% UI, 30 500-42 500) deaths, and 12.6 million (95% UI, 11.4 million-13.8 million) and 18.1 million (95% UI, 17.6 million-18.6 million) prevalent cases existed in 2017, respectively. A total of 2.5 million (95% UI, 2.3 million-2.8 million) DALYs were estimated as caused by nonrheumatic valvular diseases globally, representing 0.10% (95% UI, 0.09%-0.11%) of total lost health from all diseases in 2017. The number of DALYs increased for CAVD and degenerative mitral valve disease between 1990 and 2017 by 101% (95% UI, 79%-117%) and 35% (95% UI, 23%-47%), respectively. There is significant geographic variation in the prevalence, mortality rate, and overall burden of these diseases, with highest age-standardized DALY rates of CAVD estimated for high-income countries. CONCLUSIONS: These global and national estimates demonstrate that CAVD and degenerative mitral valve disease are important causes of disease burden among older adults. Efforts to clarify modifiable risk factors and improve access to valve interventions are necessary if progress is to be made toward reducing, and eventually eliminating, the burden of these highly treatable diseases.

Global trends of hand and wrist trauma: a systematic analysis of fracture and digit amputation using the Global Burden of Disease 2017 Study.

BACKGROUND: As global rates of mortality decrease, rates of non-fatal injury have increased, particularly in low Socio-demographic Index (SDI) nations. We hypothesised this global pattern of non-fatal injury would be demonstrated in regard to bony hand and wrist trauma over the 27-year study period. METHODS: The Global Burden of Diseases, Injuries, and Risk Factors Study 2017 was used to estimate prevalence, age-standardised incidence and years lived with disability for hand trauma in 195 countries from 1990 to 2017. Individual injuries included hand and wrist fractures, thumb amputations and non-thumb digit amputations. RESULTS: The global incidence of hand trauma has only modestly decreased since 1990. In 2017, the age-standardised incidence of hand and wrist fractures was 179 per 100 000 (95% uncertainty interval (UI) 146 to 217), whereas the less common injuries of thumb and non-thumb digit amputation were 24 (95% UI 17 to 34) and 56 (95% UI 43 to 74) per 100 000, respectively. Rates of injury vary greatly by region, and improvements have not been equally distributed. The highest burden of hand trauma is currently reported in high SDI countries. However, low-middle and middle SDI countries have increasing rates of hand trauma by as much at 25%. CONCLUSIONS: Certain regions are noted to have high rates of hand trauma over the study period. Low-middle and middle SDI countries, however, have demonstrated increasing rates of fracture and amputation over the last 27 years. This trend is concerning as access to quality and subspecialised surgical hand care is often limiting in these resource-limited regions.

Under-reporting of COVID-19 cases in Turkey.

Having an accurate account of the number of national COVID-19 cases is essential for understanding the national and global burden of the disease and managing COVID-19 prevention and control efforts. There is also substantial under-reporting of COVID-19 cases and deaths in many countries. In this article, the COVID-19 under-reporting problem in Turkey is addressed, and examples and reasons for the under-reporting are discussed.

Survival status and associated factors of death among cervical cancer patients attending at Tikur Anbesa Specialized Hospital, Addis Ababa, Ethiopia: a retrospective cohort study.

BACKGROUND: Cervical cancer is a cancer of uterine cervix caused mostly by sexually-acquired infection called Human papillomavirus (HPV. In developing region of the globe, fewer than 50% of women with cervical malignancy survive more than 5 years. Therefore, the objective of this study was to assess survival status and associated factors of death among cervical cancer patients attending at Tikur Anbesa Specialized Hospital (TASH), Ethiopia. METHODS: Facility based retrospective cohort study was conducted from March to April 2019 at Tikur Anbesa Specialized Hospital oncology center. Data was collected from patient's chart using pre-tested and structured checklist prepared in English and analyzed using STATA14.2. Cox regression model was used to identify Variables that affected survival. RESULT: The overall survival rate was 38.62% at 5 years. There were a significance differences in survival experience between categories of stage of cervical cancer, age of patients, comorbidity, substance use, base line anemia and treatment modalities. Being stage IV [AHR = 11.76; 95% CI (4.02-34.4)],being advanced age [AHR = 5.99; 95% CI (2.1-17.08)], being comorbid [AHR = 1.58; 95%CI(1.14-2.19)], using substance [AHR = 1.56;95% CI(1.09-2.22)] and being anemic [AHR = 1.6;95% CI(1.11-2.36)] increased the risk of death. CONCLUSION: The overall survival rate was lower than high- and middle-income countries and Significant factors of death after diagnosis of cervical cancer were; advanced FIGO stage, base line anemia, comorbidity, substance use, advanced age and treatment modality. Authors recommend that it is better to expand cervical cancer early screening programs and treatment facilities, strengthen awareness in collaboration with public medias about cervical cancer prevention, screening and treatment options.

Perceptions and predictors of dating violence among nursing and midwifery students.

AIMS: To determine the prevalence and predictors of victimization and perpetration of dating violence among nursing and midwifery students. DESIGN: A cross-sectional study design. METHODS: The sample consisted of nursing and midwifery students (N = 603) at the largest state university in southeastern Turkey. Data were collected with a validated, investigator-designed survey instrument between September 2015 and January 2016. FINDINGS: Most participants had been exposed to dating violence. Jealousy, controlling behaviour, and restrictions on another's social life were not perceived as violent behaviour in dating relationships. There was no significant relationship of dating violence with gender, smoking, place of residence, or marijuana use. Exposure to parental violence and alcohol use were found to be the strongest predictors of being a perpetrator of violence in the dating violence perpetration model. CONCLUSION: The findings highlight the lack of recognition of dating violence among nursing and midwifery students. The perceptions of students should be enriched by adding content on violent behaviours in the curriculum of nursing and midwifery programmes. IMPACT: Efforts to reduce and stop dating violence have a crucial role in preventing future violence in established relationships. We acknowledge that the prevalence of dating violence among nursing and midwifery students is high. Psychological and verbal violence are extremely common and most are not recognized as violent behaviours by the students. This study contributes to the understanding of violent behaviours related to dating violence among nursing and midwifery students for establishing healthy relationship.

The Level of Hopelessness and Psychological Distress among Abused Women in A Women's Shelter in Turkey.

Hopelessness prevents abused women from participating in social life and increases the risk of suicide. The aim of this study was to determine the level of hopelessness and psychological distress among abused women admitted to shelter in a conservative country. The sample included 40 abused women. A questionnaire, Beck Hopelessness Scale and the General Health Questionnaire were used to collect data. Chi-square, the Pearson correlation analysis test, and variance analysis were performed. Half of the women experienced moderate and severe hopelessness. Higher levels of hopelessness were found to be associated with higher psychological distress. Women had problems with decision-making, concentrating on a job, felt unhappiness, and depression. The results of the study would be useful in designing training programs for nurses, social workers and counselors as well as policy makers who assist women facing domestic violence to provide better physiological and psychological care for sheltered women in conservative countries.

Traditional practices for maternal and newborn care among Turkish postpartum women.

AIM: Researchers used descriptive study design to examine the traditional practices of women in relation to maternal and newborn care in the postpartum period. METHODS: 523 postpartum women included who were between 15 and 49years of age, had at least one child, and had no medical complications that affect the mother-infant health. A questionnaire was used to collect data. Comparisons were made between the responses about the women's knowledge of traditional practices and other variables. RESULTS: We found that women widely used traditional practices such as putting Koran (Holy book for Muslims) and packing needle under the mother's pillow to prevent mother from "al basmasi", pouring lead in a cup over the head of the newborn to repel evil spirits, and covering the baby's face with a piece of yellow cloth to prevent neonatal jaundice. The rate of using postpartum traditional practices increased with age and number of pregnancies and decreased with education (p<0.05). CONCLUSION: Educational activities are recommended to increase awareness of harmful traditional practices in the field of reproductive health for nurses and midwives. Health professionals should pay special attention to less educated, older and primiparous women from rural areas enable them to reinforce positive cultural practices, and discourage them from using harmful ones by providing non-critical scientific explanations.

Predictors of marital adjustment among child brides.

The researchers aim was to examine the predictors of marital adjustment among child brides in Turkey. The sample included 246 women who were between 18 and 49 years of age, got married while under the age of 18, not divorced, who spoke Turkish or Kurdish, by using convenience sampling method. We used a marital adjustment scale and a survey form to collect data. Our findings indicated that marital adjustment was low among child brides. The factors affecting women's marital adjustment were duration and types of the marriage, number of pregnancies and physical violence. The incidence of physical violence was inversely correlated with the scores of marital adjustment of women, while the women's age, education, income level, number of living children, age, and the education level of their partner was not correlated. The results of this study would be useful for nurses, midwives, social workers, and counselors who assist women who are facing domestic violence.

What Do Married Couples Think About Induced Abortion?

This study examined the opinions of married couples concerning induced abortion in a sample of 674 married couples obtaining services at a large obstetrical/gynecological outpatient service. Although approximately half of the sample were not using birth control, a similar percentage felt that curettage (selective abortion) should never be performed. A larger percentage felt that selective abortion is a sin and should be banned. Sex differences in attitudes were minimal. Couples may benefit from a birth control education program in a hospital that is designed to cover abortion in order to provide accurate information in a more professional environment.

Predictors and measurement of satisfaction with postpartum care in a government hospital.

In this study, the predictors of satisfaction with postpartum care at a government hospital were evaluated. The descriptive research sample included 300 mothers in their postpartum period. Data were collected using a questionnaire and the Postpartum Nursing Care Evaluation Scale. The regression analysis undertaken showed that mothers who received prenatal care had a significantly higher evaluation score (compared to those who had not received prenatal care), as had mothers who had a caesarean delivery (compared to vaginal birth), as well as those who had received support from friends and relatives during their postpartum period (compared to those who did not receive such support). Our recommendation is that postpartum nursing care be improved for mothers who deliver vaginally, have not received prenatal care, were unintentionally pregnant, and have problems with breastfeeding. The results will help nurses who work with an international population of postpartum women to give professional, systematic, and patient-centered care to postpartum mothers in order to increase patient satisfaction.

Opinions of women towards cesarean delivery and priority issues of care in the postpartum period.

This study was conducted, in order to determine the opinions of women who had a cesarean delivery and the problems that they faced in the postpartum period. This descriptive study was conducted with 337 women who delivered babies by cesarean section. The data were collected using a semi-structured questionnaire. The results of the study showed that 53.4% of women underwent cesarean delivery for the first time, and 83.1% said that it was the obstetrician's decision to have a cesarean delivery. More than half of the women (61.1%) had a negative experience with cesarean delivery due to postpartum pain (44.7%) and inability to care for their infant (35.9%). The most common problems associated with cesarean delivery were postpartum pain (96.1%), back pain (68.2%), problems passing gas (62.0%), bleeding (56.1%), breastfeeding problems (49.6%) and limitation of movement (43.6%) respectively. Understanding the the opinions and problems of women towards cesarean delivery assists healthcare professionals in identifying better ways to provide appropriate care and support.

Quality of sexual life and its effect on marital adjustment of Turkish women in pregnancy.

Pregnancy is an important period of a woman's life that can affect marital relationships because of decrease in the sexual function. This study aimed to examine the effect of sexual life on the marital adjustment of 607 healthy, pregnant women using the self-administered Sexual Quality of Life Questionnaire-Female and the Marital Adjustment Scale. Results showed that 30% of the pregnant women experienced problems during sexual intercourse and 50% had painful intercourse. The median total score of the Sexual Quality of Life Questionnaire-Female for pregnant women was 35.5, and the median total score of the Marital Adjustment Scale was 41.0. The authors found a positive moderate level correlation between the sexual quality of life for women and their marital adjustment for being pregnant (r = 0.468, p =.001). The results imply that the variance in the sexual activity during the childbearing period does occur and pregnant women need to be assessed regularly with regards to their sexuality by health care providers in a professional atmosphere.

Determination of the use of traditional practices to ease labour among Turkish women.

The purpose of this study was to determine the use of traditional practices to ease labour among Turkish women. Face-to-face interviews were conducted with 809 women by using an investigator-designed questionnaire. The mean age of the women was 28.9 ± 8.33 years (min = 15, max = 74), 49.4% were between 20-29 years of age and more than half (56.2%) of the women had had one to two pregnancies. The results showed that traditional practices were known and applied mostly by the women who were at an advanced age, less educated and who lived in rural areas. In addition, the knowledge and application status of traditional practices related to religious beliefs were found to be very high compared with superstitious practices. It was suggested that nurses provide culturally competent care that requires a commitment by the individual nurse to develop, refine and use specific skills in the care of women.

Domestic Violence Against Women in North African and Middle Eastern Countries: A Scoping Review.

This scoping review aimed to identify the scope of the current literature on the prevalence, consequences, and risk factors of domestic violence (DV) against women by their husbands or male partners in North African and Middle Eastern countries. The methodology for this scoping review was based on the framework outlined by Arksey and O'Malley. Studies published on DV against women over the age of 15 by partner or husband and published in peer-reviewed scientific journals between January 1970 and April 2018 were included in the review. The databases MEDLINE, PsychINFO, CINAHL, HealthSTAR, EMBASE, Scopus, African Journals Online, Turkish Journal Database, and gray literature sources were searched. On completion of the review process, 151 full-text articles were identified for charting. This review demonstrated that women's age, women's education level, duration of marriage, history of childhood abuse/witnessing family violence, living in the rural region, and family income level were negatively associated with DV, indicating that younger women, women with lower education, a longer marriage duration, and a lower income level had a higher risk of exposure to DV in this region. Anxiety, depression/insomnia, and physical injury were the most common health problems reported by victims in the region. The highest proportion of women with no response to violence was reported in Jordan, Saudi Arabia, and Turkey. The findings of this scoping review represent the first attempt to summarize the literature from North African and Middle Eastern countries and demonstrate the similarity in DV-related behaviors among women despite the cultural and regional diversity of the studies.

Physical Restraint Use in Nursing Homes-Regional Variances and Ethical Considerations: A Scoping Review of Empirical Studies.

BACKGROUND: Physical restraints are known to violate human rights, yet their use persists in long-term care facilities. This study aimed to explore the prevalence, methods, and interventions related to physical restraint use among the elderly in nursing homes. METHODS: The method described by Joanna Briggs was followed to conduct a scoping review without a quality assessment of the selected studies. An electronic search was conducted to find eligible empirical articles using MEDLINE, PsycINFO, EMBASE, Web of Science, Scopus, Google Scholar, CINAHL, and grey literature. The database search was performed using EndNote software (version X9, Clarivate Analytics), and the data were imported into Excel for analysis. RESULTS: The prevalence of physical restraint use was found to be highest in Spain (84.9%) and lowest in the USA (1.9%). The most common device reported was bed rails, with the highest prevalence in Singapore (98%) and the lowest (4.7%) in Germany, followed by chair restraint (57%). The largest number of studies reported the prevention and/or risk of falls to be the main reason for using physical restraints, followed by behavioral problems such as wandering, verbal or physical agitation, and cognitive impairment. Most studies reported guideline- and/or theory-based multicomponent interventions consisting of the training and education of nursing home staff. CONCLUSIONS: This review provides valuable insights into the use of physical restraints among elderly residents in nursing homes. Despite efforts to minimize their use, physical restraints continue to be employed, particularly with elderly individuals who have cognitive impairments. Patient-related factors such as wandering, agitation, and cognitive impairment were identified as the second most common reasons for using physical restraints in this population. To address this issue, it is crucial to enhance the skills of nursing home staff, especially nurses, in providing safe and ethical care for elderly residents with cognitive and functional impairments, aggressive behaviors, and fall risks.

Cultural Sensitivity in Interventions Aiming to Reduce or Prevent Intimate Partner Violence During Pregnancy: A Scoping Review.

Intimate partner violence (IPV) around the time of pregnancy is a recognized global health problem. Ethnic minorities and immigrant pregnant women experiencing IPV require culturally responsive health services. The aim of this scoping review was to identify aspects of cultural sensitivity in interventions to prevent or reduce IPV among ethnic minorities and immigrant pregnant women in high-income countries. Eight databases were searched in November 2019. Any type of scientific research, quantitative, qualitative, or mixed methods studies regarding interventions against IPV among pregnant women were considered for inclusion. Resnicow et al.'s definition of cultural sensitivity was used to identify aspects of cultural sensitivity. Ten papers relating to nine interventions/studies met our inclusion criteria. These studies, which included randomized controlled trials, a mixed methods study, a program evaluation, and a longitudinal study, were conducted in Australia, Belgium, Norway, and the United States. Aspects of surface cultural sensitivity, including the translation of intervention content into the language of the target group(s) and the involvement of bilingual staff to recruit participants, were identified in eight studies. Deep structure aspects of cultural sensitivity were identified in one study, where the intervention content was pretested among the target group(s). Results that could be related to the culture-sensitive adaptions included successful recruitment of the target population. Three studies were planning to investigate women's experiences of interventions, but no publications were yet available. This scoping review provides evidence that culturally sensitive interventions to reduce or prevent IPV among immigrant pregnant women are limited in number and detail.

Welfare technology interventions among older people living at home-A systematic review of RCT studies.

The main goal of health services is for the elderly to maintain their mental and physical health and live at home independently for as long as possible. Various technical welfare solutions have been introduced and tested to support an independent life. The aim of this systematic review was to examine different types of interventions and assess the effectiveness of welfare technology (WT) interventions for older people living at home. This study was prospectively registered in PROSPERO (CRD42020190316) and followed the PRISMA statement. Primary randomized control trial (RCT) studies published between 2015 and 2020 were identified through the following databases: Academic, AMED, Cochrane Reviews, EBSCOhost, EMBASE, Google Scholar, Ovid MEDLINE via PubMed, Scopus, and Web of Science. Twelve out of 687 papers met the criteria for eligibility. We used risk-of-bias assessment (RoB 2) for the included studies. Based on the RoB 2 outcomes that showed a high risk of bias (>50%) and high heterogeneity of quantitative data, we decided to narratively summarize the study characteristics, outcome measures, and implications for practice. The included studies were conducted in six countries, namely the USA, Sweden, Korea, Italy, Singapore, and the UK. One was conducted in three European countries (the Netherlands, Sweden, and Switzerland). A total of 8437 participants were sampled, and individual study sample sizes ranged from 12 to 6742. Most of the studies were two-armed RCTs, except for two that were three-armed. The duration of the welfare technology tested in the studies ranged from four weeks to six months. The employed technologies were commercial solutions, including telephones, smartphones, computers, telemonitors, and robots. The type of interventions were balance training, physical exercise and function, cognitive training, monitoring of symptoms, activation of emergency medical systems, self-care, reduction of death risk, and medical alert protection systems. The latter studies were the first of their kind and suggested that physician-led telemonitoring could reduce length of hospital stay. In summary, welfare technology seems to offer solutions to supporting elderly people at home. The results showed a wide range of uses for technologies for improving mental and physical health. All studies showed encouraging results for improving the participants' health status.

Examining barriers to emergency contraception use.

Using a cross-sectional survey research design, this study examined barriers to emergency contraception (EC) use among a sample of 318 Turkish women. Only 34% of the respondents reported being aware of EC methods, and about 20% had actually used EC. More than 90% of the participant women considered use of EC methods as a sin. The results of the study showed that the major barriers to EC use are lack of awareness and common misconceptions about EC methods. This study highlights the need of education for Turkish women regarding EC to increase awareness and dispel misconceptions related to EC.

Examination of midlife women's attitudes toward menopause in Turkey.

This study used a cross-sectional descriptive design to examine the attitudes of 154 Turkish women aged ≥ 40 years towards menopause. A questionnaire and the Menopause Attitudes scale were used. The mean score of the attitudes was determined as 34.70 ± 8.56. Most women in the study had negative attitudes towards menopause. The majority of women with positive attitudes were older, well educated and had used hormone replacement therapy (P < 0.05). Using multiple linear regression analysis, age and education level were found to be statistically significant (P < 0.001). A statistically significant difference was found between the women in the premenopausal and menopausal years in terms of sexuality after menopause (P < 0.05). This study suggests that Turkish women 40 years and older have negative attitudes towards menopause and their primary concern in the premenopausal period is sexuality after menopause. Counseling of women on menopause-related issues in gynecology clinics is recommended.

Changes in life expectancy and disease burden in Norway, 1990-2019: an analysis of the Global Burden of Disease Study 2019.

BACKGROUND: Geographical differences in health outcomes are reported in many countries. Norway has led an active policy aiming for regional balance since the 1970s. Using data from the Global Burden of Disease Study (GBD) 2019, we examined regional differences in development and current state of health across Norwegian counties. METHODS: Data for life expectancy, healthy life expectancy (HALE), years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life-years (DALYs) in Norway and its 11 counties from 1990 to 2019 were extracted from GBD 2019. County-specific contributors to changes in life expectancy were compared. Inequality in disease burden was examined by use of the Gini coefficient. FINDINGS: Life expectancy and HALE improved in all Norwegian counties from 1990 to 2019. Improvements in life expectancy and HALE were greatest in the two counties with the lowest values in 1990: Oslo, in which life expectancy and HALE increased from 71·9 years (95% uncertainty interval 71·4-72·4) and 63·0 years (60·5-65·4) in 1990 to 81·3 years (80·0-82·7) and 70·6 years (67·4-73·6) in 2019, respectively; and Troms og Finnmark, in which life expectancy and HALE increased from 71·9 years (71·5-72·4) and 63·5 years (60·9-65·6) in 1990 to 80·3 years (79·4-81·2) and 70·0 years (66·8-72·2) in 2019, respectively. Increased life expectancy was mainly due to reductions in cardiovascular disease, neoplasms, and respiratory infections. No significant differences between the national YLD or DALY rates and the corresponding age-standardised rates were reported in any of the counties in 2019; however, Troms og Finnmark had a higher age-standardised YLL rate than the national rate (8394 per 100 000 [95% UI 7801-8944] vs 7536 per 100 000 [7391-7691]). Low inequality between counties was shown for life expectancy, HALE, all level-1 causes of DALYs, and exposure to level-1 risk factors. INTERPRETATION: Over the past 30 years, Norway has reduced inequality in disease burden between counties. However, inequalities still exist at a within-county level and along other sociodemographic gradients. Because of insufficient Norwegian primary data, there remains substantial uncertainty associated with regional estimates for non-fatal disease burden and exposure to risk factors. FUNDING: Bill & Melinda Gates Foundation, Research Council of Norway, and Norwegian Institute of Public Health.