Pregnant individuals' genetic literacy and decisional conflict about prenatal screening tests: A cross-sectional study.

Understanding the prenatal screening and diagnostic tests performed during pregnancy and making a decision in line with the test results can be a complex process for pregnant individuals and their families. Therefore, this study examined pregnant individuals' genetic literacy and decisional conflict regarding prenatal screening tests. The study was conducted with 328 pregnant individuals who applied to a training and research hospital to receive antenatal care between April 05 and September 30, 2021. Research data were collected by using the "Decisional Conflict Scale," "SURE Scale," and "Genetic Literacy and Comprehension Measure." The mean age of the participants was 28.69 ± 5.48, and the mean gestational week was 25.90 ± 10.43. A statistically significant difference was found between the educational levels of the pregnant individuals and the genetic literacy and comprehension scales (p < 0.001). A statistically significant difference was found between getting information about prenatal screening tests, having a screening test and decisional conflict scale, SURE Scale, and genetic literacy and comprehension scales (p < 0.001). A weak, negative, statistically significant correlation was found between the genetic literacy and comprehension familiarity and decision conflict scales (r = -0.177, p = 0.001). It is well known that pregnant individuals have difficulty understanding and interpreting test results due to prenatal screening tests that include genetic information. In our study, approximately half of the pregnant individuals received information about prenatal screening tests. Therefore, prenatal care must include the necessary information about prenatal screening tests. The study found that as the genetic literacy of pregnant individuals increased, the conflict of decisions they experienced decreased. Accordingly, it is suggested that interventions to increase genetic literacy among pregnant individuals may be effective in reducing decisional conflict regarding prenatal screening tests.

Comparison of Fat Transfer Combined with Plasma Energy and Only Fat Transfer Methods for Genital Rejuvenation.

BACKGROUND: To compare the fat transfer combined with plasma energy and only fat transfer methods for genital rejuvenation and to investigate the efficacy enhancing properties of plasma energy. METHODS: Forty-six patients were equally divided into two groups according to the surgical method as the group A (n = 23) and the group B (n = 23). The patients in the group A received only fat transfer, while the patients in the group B received fat transfer combined with plasma energy. Both groups were scheduled for postoperative follow-up at 1, 3, 6, and 12 months. The lifting effect on the labia majora after the procedure was evaluated with photographs and patient satisfaction questionnaires including the female genital self-image scale (FGSIS). RESULTS: The mean age of all participants was 32.8 ± 5.1 years, and the mean body mass index (BMI) was 24.7 ± 3.4 kg/m2. The mean preoperative FGSIS scores were similar between the groups (p = 0.542). The mean total FGSIS score was 18.8 ± 1.4 in the group A and 18.3 ± 1.5 in the group B in the preoperative period. However, the mean FGSIS scores at 1, 3, and 6 months were significantly higher in the group B than the group A (p = 0.032, p = 0.012, and p = 0.009, respectively). At 6 months of follow-up, the mean total FGSIS score was 20.7 ± 1.4 in the group A and 22.3 ± 1.5 in the group B, indicating a statistically significant difference (p = 0.028). CONCLUSION: This novel technique is a more minimally invasive technique compared to other energy modalities with lower lateral and vertical energy dissipation than other conventional methods, and labia majora fat filling augmentation application can be performed with more permanent and longer-lasting outcomes than fat transfer only. LEVEL OF EVIDENCE II: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

Developing the better and effective nursing education for improving transcultural nursing skills cultural competence and cultural sensitivity assessment tool (BENEFITS-CCCSAT).

BACKGROUND: A clear need for the development of new comprehensive, reliable, sensitive and valid measurement tools to adequately asses the cultural competence and cultural sensitivity of nursing students exists. This study aimed to develop a new measurement tool to assess the nursing students' cultural competence and sensitivity. METHODS: This cross-sectional, instrument development study's first phase included postgraduate nursing students (n = 60) for the piloting study, and the second one included undergraduate nursing students (n = 459) for the main survey. This study used two data collection forms: The Student Descriptive Information Form and the Better and Effective Nursing Education for Improving Transcultural Nursing Skills Cultural Competence and Cultural Sensitivity Assessment Tool (BENEFITS-CCCSAT) draft. The content validity index was calculated using the Davis method. Cronbach's α coefficient and the item total correlation were calculated during the reliability analysis. The Kaiser-Meyer-Olkin (KMO) coefficient test, Bartlett significance test, and explanatory factor analysis (EFA) were used to evaluate the validity of the assessment tool. RESULTS: Scale validity and reliability analyses showed that the BENEFITS-CCCSAT included 26 items and five sub-dimensions: respect for cultural diversity; culturally sensitive communication; achieving cultural competence; challenges and barriers in providing culturally competent care; and perceived meaning of cultural care. CONCLUSION: The BENEFITS-CCCSAT appears to be a valid and reliable instrument for measuring the cultural sensitivity and cultural competence of nursing students. This can be of great use, especially before attending clinical areas, and can offer both students and faculty reliable information to promote reflective and critical thinking, especially in areas where improvement is needed.

Knowledge and attitudes of healthcare professionals working in a training and research hospital on early diagnosis of cervical cancer (a Somalia example): cross-sectional study.

BACKGROUND: Despite the early diagnosis and treatment of cervical cancer, it is still a significant public health problem in Somalia. This study was conducted to evaluate the knowledge and attitudes of healthcare professionals towards the early diagnosis of cervical cancer. METHODS: This study was conducted in Mogadishu, the capital of Somalia, between December 2020 and February 2021. The cross-sectional study consisted of a total of 280 healthcare professionals. The study data was collected using a questionnaire consisting of 38 questions evaluating the knowledge and attitudes of all healthcare professionals towards the early diagnosis of cervical cancer, an additional 15 questions for women only, and a total of 43 questions. RESULTS: 22.1% of the participants received cervical cancer training during vocational education and training. Cervical cancer education after graduation is 16.8%, and the rate of providing education to patients is only 29.6%. The rate of female healthcare professionals having a Pap smear test is 2%. The participants' cervical cancer total knowledge score was 16.5 ± 6.69, and the success rate was 63.46. The highest success rate in knowledge subgroup questions was HPV questions with 69.6. A statistically significant difference was found between the participants' profession, training on the subject during their vocational education, and total knowledge scores (p < 0.001). When the knowledge question subscales were compared, a significant difference was found between participants' gender and HPV questions subscale score (p = 0.028). A statistically significant difference was found between the participants' professions, receiving training on the subject during vocational training, and all subscales (p < 0.05). A statistically significant difference was found between the participants' income status and risk factors questions scores (p = 0.026). CONCLUSION: This study shows that the knowledge and training of healthcare professionals working in a training and research hospital in Somalia for early cervical cancer diagnosis are not sufficient. In addition, it reveals that female healthcare professionals have almost no Pap smears. Therefore, studies and training should be planned to train all healthcare professionals, especially female healthcare professionals, and overcome all possible obstacles to the acceptance of the screening tests by women.

Vascular effect of levonorgestrel intrauterine system on heavy menstrual bleeding: is it associated with hemodynamic changes in uterine, radial, and spiral arteries?

The aim of this study was to evaluate the clinical and blood flow changes associated with the use of a levonorgestrel-releasing intrauterine device (LNG-IUD) in patients with idiopathic heavy menstrual bleeding (HMB). LNG-IUD was inserted into a total of 91 patients (39.5 ± 5.4 years) who were diagnosed with HMB. Uterine volume, ovarian volume, uterine, radial and spiral artery blood flow, Pictorial Blood Loss Assessment Chart (PBAC) scores, and other clinical and laboratory parameters were evaluated before and 12 months after insertion of LNG-IUD. Compared to pre-insertion values, LNG-IUD dramatically improved haemoglobin, PBAC scores, and endometrial thickness. Mean resistance indices of radial and spiral arteries significantly increased 12 months after insertion. Our study results suggest that a significant increase in the resistance indices of the intra-myometrial arteries in LNG-IUD users one year after insertion may be due to its local progestational effects, indicating a possible mechanism of LNG-IUD in reducing menstrual blood flow.Impact StatementsWhat is already known on this subject? The mechanisms of action of LNG-IUD on heavy menstrual bleeding include atrophy, decidualization and vascular changes of in the endometrium, resulting endometrial suppression. However, the exact mechanism to stop bleeding is not clear.What do the results of this study add? The present study suggests that one of the effects of the LNG-IUD on heavy menstrual bleeding is its ability to increase the resistance indexes of the intra-myometrial arteries.What are the implications of these findings for clinical practice and/or further research? These results will foster further studies on the effects of LNG-IUD on intra-myometrial arteries and will further assure clinicians on the vascular effect of LNG-IUD during management of heavy menstrual bleeding which includes hysterectomy as a final step.

The impact of pregnant women's health literacy on their health-promoting lifestyle and teratogenic risk perception.

This study was conducted to determine pregnant women's health literacy level and its effect on health-promoting lifestyle and perception of teratogenic risk related to medicine. The sample of the study consisted of 326 pregnant women. Women with high health literacy have more health-promoting lifestyles and lower teratogenic risk perceptions toward using antidepressants and influenza immunization during pregnancy. This study gives baseline data on health literacy and teratogenic risk perception of medicine usage during pregnancy in Turkish women.

Consanguineous marriage and its effect on reproductive behavior and uptake of prenatal screening.

The study aimed to determine the prevalence of consanguinity among pregnant women, its effect on reproductive behavior and the uptake of prenatal screening. The sample consisted of 842 pregnant women recruited to a prospective cohort study conducted in twenty-three cities from different regions in Turkey between June 2017 and March 2018. Of the women, 17.7% (n = 149) were in consanguineous marriages. The consanguineous couples were younger at the time of their marriages than non-consanguineous couples, and 49% of the consanguineous marriages were arranged. The educational levels of both spouses in consanguineous marriages were lower than those in non-consanguineous marriages. There was a statistically significant difference in the prevalence of the pregnant women having a prenatal screening test between women in consanguineous marriages (53%) and those in non-consanguineous marriages (78.2%). There were no statistically significant differences between the two groups in terms of having health problems during pregnancy, the number of pregnancies, abortions and/or stillbirths, the week of delivery and the birthweight of the baby. Healthcare providers play a key role in eliciting whether or not pregnant couples are consanguineous, providing a tailored risk assessment, education, and counseling about screening and diagnostic tests for early diagnosis and management of the fetus, explaining the testing process and possible outcomes, and helping couples make informed decisions regarding their reproductive options or pregnancy management.

Oncologic outcomes in patients undergoing maximal or optimal cytoreductive surgery for Stage 3C serous ovarian, tubal or peritoneal carcinomas.

The aim of this study was to evaluate overall survival (OS) and disease-free survival (DFS) of patients with Stage 3C serous ovarian, tubal and peritoneal carcinomas. A retrospective analysis of 111 patients who underwent maximal or optimal cytoreductive surgery was performed. Patients were divided into three groups as ovarian cancer (n = 47), tubal cancer (n = 24) and peritoneal cancer (n = 40). Median follow-up was 30 months. There was no significant difference in DFS and OS among the groups. Complete cytoreduction was an independent prognostic factor for DFS in all groups (HR 2.3, 95% CI 1.14-4.93; p=.020). Positive peritoneal cytology (HR 2.2, 95% CI 1.02-4.78; p=.044), and retroperitoneal lymph node involvement (HR 2.3, 95% CI1.11-4.89; p=.025) were independent risk factors for decreased OS, and extended cytoreduction (HR 2.7, 95% CI 1.05-6.99; p=.039) were independent risk factors for increased OS. In conclusion, these malignancies should be considered a single entity during treatment.IMPACT STATEMENTWhat is already known on this subject? Epithelial ovarian cancer is the second most common gynaecological cancer in women worldwide. There are different histological types including ovarian, tubal and peritoneal carcinomas in which malignant cells form in the tissue covering the ovary or lining the fallopian tube of peritoneum. Recent data have supported the view that these malignancies should be considered a single entity and should be treated the same way.What the results of this study add? In the present study, we evaluated overall survival and disease-free survival of patients with Stage 3C ovarian, tubal and peritoneal cancer undergoing maximal or optimal cytoreductive surgery. We found similar oncologic outcomes in all patient groups. To the best of our knowledge, this is the first study to compare oncologic outcomes of these similar and often confused malignancies in the literature. We, therefore, believe that the present study provides additional information to the body of knowledge on this topic.What the implications are of these findings for clinical practice and/or further research? This study is important, as it indicates similar oncologic outcomes in patients undergoing maximal or optimal cytoreductive surgery for Stage 3C ovarian, tubal and peritoneal cancer. Based on these findings, clinicians should keep in mind that these malignancies should be considered a single clinical entity and be treated the same way. We believe that our study would pave the way for further studies regarding this subject.

Genetic Literacy of pregnant women and their use of prenatal screening and diagnostic tests in Turkey.

This study evaluated how genetic literacy of pregnant women in Turkey affects their use of prenatal screening and diagnostic tests. As a descriptive cross-sectional study, a Participant Identification Form and the Genetic literacy and Comprehension Measure (GLAC) were used to collect data. The sample of study consisted of 189 pregnant women who made regular antenatal care visits in Giresun, Turkey. The mean age was 29.5 ± 5.9 years and mean gestational week was 34.9 ± 5.09. Of the women, 76.7% had undergone prenatal screening tests, and 85.5% of them had learned about the tests from their doctors. The mean GLAC score of familiarity was 3.67 ± 1.78 (out of seven), and the genetic concepts answered correctly were 5.30 ± 1.79 (out of eight). No statistically significant relationship emerged between the women's genetic literacy and their use of prenatal screening or diagnostic tests. However, relationships were statistically significant between the genetic literacy of the women and the educational levels of the women themselves or their spouses, consanguineous marital status, parity, and use of folic acid supplements. Primiparous women who were highly educated, had a highly educated spouse, were not in consanguineous marriages, and had taken folic acid supplements during pregnancy were more literate in genetics. There is a need for more educational opportunities in order for women to increase their familiarity with genetic terms. Educating women will improve their understanding of genetics-related health services and increase their awareness of genetic diseases, which will allow them to take the appropriate actions for primary prevention.

The effectiveness of the double B-lynch suture as a modification in the treatment of intractable postpartum haemorrhage.

A broader range of more effective compression techniques are needed in the patients who have an intractable postpartum haemorrhage due to uterine atony despite medical treatment and B-Lynch sutures. The aim of this study was to report the outcome of a series of patients with haemorrhage who were managed by double B-Lynch suture. Fourteen patients who were treated in a tertiary hospital between July 2010 and February 2015 were included in the study. The intractable haemorrhage rate was 0.35% over 5 years (14/4000 births). Bleeding was controlled in all the patients with a double B-Lynch suture. The mean age of the patients was 24 ± 3.4 years. The mean estimated blood loss was 1696 ± 272.075 mL, and the mean transfusion rate was 4.2 ± 2.5 units. Pregnancy was observed in five patients at follow up. The double B-Lynch suture seems to be an effective and reliable solution to an intractable postpartum haemorrhage resulting from uterine atony and has no unfavourable impacts on fertility. It should be considered before the use of any aggressive surgical techniques such as a hypogastric artery ligation or a hysterectomy. This the first study to investigate the effectiveness of the double B-Lynch suture, and we showed that the hysterectomy and/or hypogastric artery ligation rate can be decreased by adding a second B-Lynch suture in cases where the medical treatment or a single B-Lynch has failed. Impact statement What is already known on the subject? Uterine atony is the most common cause of a primary postpartum haemorrhage. When a simple massage of the uterus and medication failed to manage this condition, various surgical solutions have been sought, including uterine compression sutures, uterine artery ligation, devascularisation of the uterus, internal iliac artery ligation and, ultimately, a hysterectomy. The B-Lynch suturing technique is particularly useful because of its simplicity of application, life-saving potential, relative safety and capacity for preserving the uterus and subsequent fertility. To-date, this suturing technique, when applied correctly, has been successful with no problems and no apparent complications. However in the cases of when it falls, usually a hysterectomy or a hipogastric artery ligation is preferred. What does this study add? A 'double B-Lynch suture seems to be an effective and reliable method in an intractable postpartum haemorrhage due to a uterine atony and has no unfavourable impact on fertility'. What are the implications of these findings for clinical practice? The double B-Lynch suture seems to be an effective, reliable and technically easy method. With this aspect, it might be considered before any aggressive surgical techniques, such as a hypogastric artery ligation and hysterectomy in selected cases.

Palliative care needs of patients with gynaecologic cancer.

AIMS AND OBJECTIVES: To identify gynaecologic cancer patients' palliative care needs using the three levels of needs questionnaire. BACKGROUND: Measuring both the burden of symptoms and patient-reported palliative care needs is valuable to improve cancer care. Data representing the palliative care needs of cancer patients in Turkey remain limited. DESIGN: A cross-sectional descriptive study. METHODS: A total of 134 cancer patients were included in the study at an oncology hospital in Turkey. A data collection form, a short-form medical outcomes health survey, and the three levels of needs questionnaire were used to collect data. RESULTS: The mean age of participants was 59 ± 8·76, of 69·4% were diagnosed with ovarian cancer and 52·2% had stage-3-4 cancer. Of patients, 69·3% had no desire for sexual intimacy, 33·5% expressed feeling as though they burden their families and 28·4% feel lonely at some level. The most prevalent problems were tiredness, to feel depressed and problems performing physical activities. The most frequent unmet needs were tiredness (60·5%), feel depressed (47·4%) and lack of appetite (38·5%). CONCLUSIONS: Gynaecologic cancer patients have relatively high prevalence of symptoms and unmet palliative care needs. Health professions mostly were unable to recognise and properly manage tiredness, depression as well as lack of appetite as an integral part of quality cancer care. RELEVANCE TO CLINICAL PRACTICE: Nurses trained in palliative care are needed to evaluate and meet cancer patients' needs regularly to improve quality of palliative care. Nurses should examine the underlying reasons for most prevalent problems and give nursing care accordingly.

Evaluation of the quality of life of caregivers in gynecological cancer patients.

The aim of this study was to determine the factors influencing the general quality of life and the quality-of-life subdimensions of family members caring for gynecological cancer patients. This descriptive study was conducted at a training and research hospital in Turkey. A total of 168 caregivers who were family members were included in the study sample. The data collection form and the Caregiver Quality-of-Life Index Cancer Scale were used to collect data. The mean age of family caregivers was 42.6 ± 12.30 and 81% were female. The caregivers had the most problem with coping with the depressive symptoms and the nausea of the patient and with medication use for the patient. Information on care was requested by 35.7%, whereas 70% of this group felt they needed information on every subject regarding disease and its treatment. It is also found that although some factors did not influence the general quality of life of caregivers, they did have a negative effect on various areas such as burden, disruptiveness, positive adaptation, and financial concerns. Health care professions should educate patients and their caregivers who are distant relatives of patient or providing care for older patients especially on medical drug usage after discharge and management of symptoms such as nausea.

The Effect of Prenatal Yoga on Pregnancy-Related Symptoms: A Pilot Quasi-Experimental Study.

INTRODUCTION: In the last decade, yoga has attracted much attention from researchers. Although there are many studies on yoga, research on the effect of prenatal yoga on pregnancy-related symptoms is limited. This study aimed to determine the effect of prenatal yoga on pregnancy-related symptoms. METHODS: The study was conducted at antenatal care services between June 2018 and October 2018 in Turkey. Simple random method was used to assign participants to the study arms. The yoga group attended a prenatal yoga program for 60 min once a week for 4 weeks. The control group received routine care. Data were collected before and after the intervention using the Descriptive Characteristics Form and Pregnancy Symptoms Inventory. Data analysis used descriptive statistics (mean, standard deviation/standard error, and percentages), χ2, Mann-Whitney, and Wilcoxon tests. Significance was set at p < 0.05. RESULTS: The study was completed with 70 participants (the yoga group: 35; the control group: 35). The yoga group had a significantly lower posttest Pregnancy Symptoms Inventory Symptom Frequency Total Score than the pretest score (38.42 ± 18.76 vs. 32.77 ± 16.55, p < 0.05). The total score of the yoga group's gastrointestinal, respiratory, and mental health symptoms was reduced after the intervention (respectively, 6.74 ± 4.32 vs. 5.31 ± 3.38; 1.48 ± 1.26 vs. 1.05 ± 1.13; 7.08 ± 4.59 vs. 5.22 ± 3.48, p < 0.05). The yoga group had significantly lower mental health symptom scores than the control group (5.22 ± 3.48 vs. 7.34 ± 4.02, p < 0.05). There was no significant difference between the control group's pretest and posttest Pregnancy Symptoms Inventory Symptom Frequency Scores. CONCLUSION: Pregnancy-related symptoms were significantly reduced in the yoga group. It is thought that prenatal yoga may be effective on pregnancy-related symptoms. Yoga can be recommended to cope with pregnancy-related symptoms and support activities of daily living.

The effects of irrational romantic relationship beliefs and experiences in close relationships on dating violence of nursing and midwifery students.

PURPOSE: This study aimed to investigate the effects of irrational romantic relationship beliefs and experiences in close relationships on dating violence of nursing and midwifery students. METHODS: This was a descriptive, correlational study. The study was conducted with 261 nursing and midwifery students in a university located in northeastern Turkey. RESULTS: A negative and moderate correlation was found between students' dating violence with the use of social time and different thinking (p < 0.01). Anxious attachment (ß = -3.241), secure attachment (ß = -3.119), use of social time (ß = -0.252), and different thinking (ß = -2.788) were predictors of dating violence (p < 0.01). PRACTICE IMPLICATIONS: Nursing and midwifery students exposed to dating violence should be applied psychosocial interventions including motivational interviewing and cognitive-behavioral therapy.

Genetics and genomic competency of Turkish nurses: A descriptive cross-sectional study.

BACKGROUND: Nurses have essential roles in genetic related healthcare, including risk assessment, referring individuals to genetics services, advocating for and educating individual, families, and communities who might benefit from genetic services. OBJECTIVE: To determine the genetics and genomic competency of Turkish nurses. DESIGN: A descriptive cross sectional research design was used to collect data. SETTING: Totally 385 nurses working in clinical or academic settings in Turkey were recruited between 20 January and 20 April 2020. METHODS: Data were collected using socio-demographic characteristics form and Genetics and Genomics in Nursing Practice Survey on 20 January-20 April 2020. Descriptive statistics, Kruskal Wallis, and Mann-Whitney U tests were used for data analyses. RESULTS: A total of 385 nurses participated in this study. Most, 44.9% had a BSN degree, 42.1% were clinical nurses. Of the nurses, 34.5% reported that they had genetics included in their nursing curriculum, and 74.0% intended to learn more about genetics. The mean knowledge score was 9.36/12. Gender, primary role of nurses, and whether to see patients actively in practice were the factors effecting knowledge score of nurses in genetic and genomics. CONCLUSIONS: Turkish nurses' genomics skills need additional development and integration of genomics to the nursing curriculum can be effective to decrease their knowledge gaps. Clinical nurses' genomic competency should improve to increase the nursing care quality.

Test/Retest Reliability of a Turkish Version of the Genetics and Genomics in Nursing Practice Survey.

Background and Purpose: The Genetics and Genomics in Nursing Practice Survey (GGNPS) was developed to evaluate the use of genetics in clinical practice. This study aimed to translate the GGNPS into Turkish and perform the test/retest reliability. Methods: A descriptive, cross-sectional research design was used to collect data. Data were collected two times with ~3-7 weeks apart by using RedCap software. Results: At Time 1, a total of 385 nurses completed the survey; at Time 2, 88 nurses completed the retest survey. Findings show that one item has a slight agreement, 9 items fair agreements and 18 items moderate agreements, and 19 items substantial agreements between Times 1 and 2. Conclusions: The Turkish version of GGNPS appears to be a reliable instrument.

Analysis of prognostic factors in Grade 3 endometrioid type endometrial carcinoma.

OBJECTIVE: To investigate the prognostic factors of patients with Grade 3 endometrioid endometrial cancer (G3EEC). METHODS: This four-center, retrospective study included a total of 129 women with G3EEC. Demographic, clinicopathologic, and survival data were collected. Kaplan-Meier method was used for survival analysis. Predictors of outcome were analyzed using Cox proportional hazards models. RESULTS: Median age at the time of diagnosis was 63 (range 39-87) years and median follow up was 37 (range 6-126) months. For the entire cohort, the 5-year disease-free survival (DFS) and overall survival (OS) were 54.3% and 63.6%, respectively. The 5-year DFS rates for lymphovascular space invasion (LVSI) -positive and -negative patients were 41.6% and 88.3%, respectively (P < 0.001). The 5-year OS rates for LVSI-positive and -negative patients were 54.7% and 88.3%, respectively (P = 0.001). Positive LVSI status was identified as the independent prognostic factor for decreased DFS and OS (hazard ratio [HR] 5.5, 95% confidence interval [CI] 1.65-18.86; P = 0.006 versus HR 4.4, 95% CI 1.33-14.58; P = 0.013, respectively). CONCLUSION: LVSI seems to be an independent prognostic factor for decreased DFS and OS in G3EEC patients.

Risk factors for cervical stromal involvement in endometrioid-type endometrial cancer.

OBJECTIVE: The aim of this study was to identify predictors of cervical stromal involvement in women with endometrioid-type endometrial cancer (EEC). METHODS: A total of 795 patients with EEC who underwent comprehensive surgical staging including pelvic and para-aortic lymph node dissection between January 2007 and December 2018 were retrospectively analyzed. Data including age, menopausal status, serum CA-125 levels, tumor size, lymphovascular space invasion (LVSI), depth of myometrial invasion, positive peritoneal cytology, cervical stromal involvement, histologic grade, recurrence, and follow-up duration were recorded. RESULTS: Median follow up was 49 months. Cervical stromal invasion was found in 88 patients. Multivariate analysis revealed that presence of LVSI (hazard ratio [HR] 2, 95% confidence interval [CI] 1.02-4.25, P = 0.045), a primary tumor diameter of at least 3 cm (HR 3, 95% CI 1.31-7.25, P = 0.010), and at least 50% deep myometrial invasion (HR 2.7, 95% CI 1.37-5.41, P = 0.004) were independent risk factors for cervical stromal involvement in patients with EEC. CONCLUSION: Our study results suggest that presence of LVSI, a primary tumor diameter of at least 3 cm, and LVSI of at least 50% seem to be independent predictors of cervical involvement in women with EEC.

Depressive symptoms during pregnancy and postpartum: a prospective cohort study.

PURPOSE: The aim was to determine the prevalence and risk factors of postpartum depression, and changes over time from pregnancy to postpartum period. DESIGN AND METHODS: A prospective cohort study was conducted in 23 cities in Turkey, with 497 pregnant women. FINDINGS: Of women, 13.5% had a high level of depressive symptoms during pregnancy and 4.8% during the postpartum period. Significant relationships emerged between total Edinburgh Postnatal Depression Scale score and mean age of participants and their husbands, duration of marriage, parity, and history of receiving professional psychological support. PRACTICE IMPLICATIONS: Family planning education could be an important intervention to prevent depression in young couples.

Attitudes to HPV Vaccination among Parents of Children Aged 10 to 13 Years.

STUDY OBJECTIVE: This study aimed to determine the willingness of parents to allow their sons and/or daughters aged 10-13 years to be vaccinated for human papillomavirus (HPV). DESIGN, SETTING, AND PARTICIPANTS: This was a descriptive study conducted in an elementary school to recruit students' parents into the study. The sample consisted of 368 (69.1%) parents of children aged 10-13 years who were willing to participate in the study as a couple. INTERVENTIONS: Questionnaire-based data were collected from the couples. MAIN OUTCOME MEASURES: Prior information regarding HPV and vaccination and the opinions of parents of children aged 10-13 about HPV vaccination for their daughter or son. RESULTS: Only 26.9% of mothers and 25.0% of fathers claimed to be aware of HPV, and only 24.5% of mothers and 21.2% of fathers claimed to be aware of its vaccine. If the vaccine were available in Turkey, 21.6% of mothers and 22.4% of fathers would be willing to vaccinate their sons; although the vaccine for girls is available in Turkey, only 14.4% of mothers and 15.5% of fathers were willing to vaccinate their daughters. CONCLUSIONS: Few participants reported knowing about the HPV vaccine, while far fewer intended to vaccinate their daughters and sons against the infection. Both males and females should be informed about HPV and its vaccine, and initiatives to increase both awareness and the information of health care professionals should be encouraged.