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1.
RSC Adv ; 14(36): 26043-26049, 2024 Aug 16.
Artículo en Inglés | MEDLINE | ID: mdl-39161445

RESUMEN

Both BaF2 and MgF2 compounds and Ba x Mg1-x F2 alloy thin films were deposited on glass and silicon (Si) substrates in nanometric sizes (100 ± 10 nm) in a high vacuum environment by radio frequency (rf) magnetron sputtering. Using BaF2 (99% purity) and MgF2 (99% purity) target materials and adjusting the power levels applied to these targets, Ba x Mg1-x F2 alloy coatings at different atomic concentrations were formed under the same vacuum conditions. The microstructure and surface characteristics of the samples were analysed with the help of spectroscopic and microscopic methods. For the surface characterization, with scanning acoustic microscopy (SAM), 2-dimensional surface acoustic images of the samples were mapped, the surface acoustic impedance values were determined, and information about the micro hardness of the materials was obtained. Surface roughness values and grain sizes were obtained by taking 3-dimensional surface images of investigated materials using atomic force microscopy (AFM). Average nanometric particle sizes were determined for each sample with scanning electron microscopy (SEM), therefore, information about surface homogeneity was obtained. For the microstructural characterization, quantitative elemental analysis was performed using scanning electron microscopy/energy dispersive X-ray spectroscopy (SEM-EDS), and stoichiometric ratios of atomic compositions were identified. By evaluating the data obtained from the microscopic and spectroscopic measurements, the effect of the atomic concentration parameter on the morphological properties of the material was determined. The usability of the produced binary fluoride alloy thin film coatings is promising for emerging optoelectronic, ceramic industry, biomedical and surface acoustic wave applications.

2.
BMC Pregnancy Childbirth ; 23(1): 245, 2023 Apr 12.
Artículo en Inglés | MEDLINE | ID: mdl-37046237

RESUMEN

BACKGROUND: Perinatal mental health is a major public health concern. In Turkey, public hospitals operate pregnancy schools which provides an opportunity to integrate an evidence-based Thinking Healthy Programme (THP) for perinatal depression. The aim of this study is to adapt the THP for universal use in the group setting and to understand its acceptability and feasibility for integration into the existing antenatal care programme for both face-to-face and online delivery. METHODS: Following an expert-led adaptation process using the Bernal Framework, field testing was conducted on a group of women and facilitators followed by in-depth interviews (n:8) and group discussions (n = 13). Data were analysed using Thematic Framework Analysis. RESULTS: Minor but significant adaptations were made to the individually delivered THP for use in the universal group pregnancy schools. Initial findings indicate that the THP-group version was acceptable to its target population and could be integrated into the antenatal care plan for delivery during face-to-face and online group classes. CONCLUSION: THP is transferable to the Turkish cultural and healthcare context. The THP-group version has the potential to add value to Turkey's existing perinatal healthcare programme.


Asunto(s)
Atención a la Salud , Atención Prenatal , Femenino , Embarazo , Humanos , Turquía , Promoción de la Salud , Salud Mental
3.
BMC Psychiatry ; 23(1): 14, 2023 01 06.
Artículo en Inglés | MEDLINE | ID: mdl-36604685

RESUMEN

BACKGROUND: Women with perinatal depression and their children are at increased risk of poor health outcomes. There is a need to implement non-stigmatizing interventions into existing health systems which reduce psychosocial distress during pregnancy and prevent perinatal depression. We adapted the WHO-endorsed Thinking Healthy Programme (THP) to be delivered universally to all women attending routine online pregnancy schools in Istanbul, Turkey. This study aimed to evaluate the feasibility and acceptability of this intervention. METHODS: This mixed-methods study incorporated a two-arm pilot randomized controlled trial and qualitative evaluation of the feasibility and acceptability of the adapted THP - Brief Group version (THP-BGV) to a range of stakeholders. We recruited pregnant women at 12-30 weeks' gestation through pregnancy schools within the University Hospital's catchment area. Women in the intervention arm received five online sessions of the THP-BGV delivered by antenatal nurses. The intervention employed principles of cognitive behaviour therapy to provide psychoeducation, behaviour activation, problem-solving strategies and group support to participants. In the control arm, women received usual care consisting of routine online educational pregnancy classes aided by the antenatal nurses. The women were assessed for depressive symptoms with the Edinburgh Postnatal Depression Scale at baseline and 4-6 weeks post-intervention and also evaluated for anxiety, perceived social support, partner relationship, level of disability and sleep quality. In-depth interviews were conducted with women and other key stakeholders. RESULTS: Of the 99 consecutive women referred to the pregnancy schools, 91 (91.9%) were eligible and 88 (88.8%) consented to participate in the study and were randomized. Eighty-two (83%) completed the final assessments. Our main findings were that this preventive group intervention was feasible to be integrated into routine antenatal educational classes and it was valued by the women and delivery-agents. While the study was not powered to detect differences between intervention and control conditions, we found small trends towards reduction in anxiety and depressive symptoms favoring the intervention arm. No serious adverse events were reported. CONCLUSIONS: Given the paucity of preventive interventions for perinatal depression in low and middle-income countries, a fully powered definitive randomized controlled trial of this feasible and acceptable intervention should be conducted. TRIAL REGISTRATION: The study was registered at Clinical Trails.gov ( NCT04819711 ) (Registration Date: 29/03/2021).


Asunto(s)
Trastorno Depresivo , Atención Prenatal , Niño , Femenino , Humanos , Embarazo , Atención Prenatal/métodos , Depresión/prevención & control , Proyectos Piloto , Escalas de Valoración Psiquiátrica
4.
Pediatr Rheumatol Online J ; 17(1): 7, 2019 Feb 14.
Artículo en Inglés | MEDLINE | ID: mdl-30764840

RESUMEN

BACKGROUND: Hemophagocytic lymphohistiocytosis (HLH) and macrophage activation syndrome (MAS) were historically thought to be distinct entities, often managed in isolation. In fact, these conditions are closely related. A collaborative approach, which incorporates expertise from subspecialties that previously treated HLH/MAS independently, is needed. We leveraged quality improvement (QI) techniques in the form of an Evidence-Based Guideline (EBG) to build consensus across disciplines on the diagnosis and treatment of HLH/MAS. METHODS: A multidisciplinary work group was convened that met monthly to develop the HLH/MAS EBG. Literature review and expert opinion were used to develop a management strategy for HLH/MAS. The EBG was implemented, and quality metrics were selected to monitor outcomes. RESULTS: An HLH/MAS clinical team was formed with representatives from subspecialties involved in the care of patients with HLH/MAS. Broad entry criteria for the HLH/MAS EBG were established and included fever and ferritin ≥500 ng/mL. The rheumatology team was identified as the "gate-keeper," charged with overseeing the diagnostic evaluation recommended in the EBG. First-line medications were recommended based on the acuity of illness and risk of concurrent infection. Quality metrics to be tracked prospectively based on time to initiation of treatment and clinical response were selected. CONCLUSION: HLH/MAS are increasingly considered to be a spectrum of related conditions, and joint management across subspecialties could improve patient outcomes. Our experience in creating a multidisciplinary approach to HLH/MAS management can serve as a model for care at other institutions.


Asunto(s)
Linfohistiocitosis Hemofagocítica/diagnóstico , Síndrome de Activación Macrofágica/diagnóstico , Algoritmos , Consenso , Citocinas/sangre , Diagnóstico Diferencial , Medicina Basada en la Evidencia/métodos , Humanos , Linfohistiocitosis Hemofagocítica/terapia , Síndrome de Activación Macrofágica/terapia , Guías de Práctica Clínica como Asunto , Mejoramiento de la Calidad
5.
Pediatr Rheumatol Online J ; 16(1): 19, 2018 Mar 21.
Artículo en Inglés | MEDLINE | ID: mdl-29562920

RESUMEN

BACKGROUND: Withholding live-attenuated vaccines in patients using interleukin (IL)-1 or IL-6 blocking agents is recommended by guidelines for both pediatric and adult rheumatic diseases, since there is a risk of infection in an immune suppressed host. However, this has never been studied. This retrospective, multicenter survey aimed to evaluate the safety of live-attenuated vaccines in patients using IL-1 or IL-6 blockade. METHODS: We contacted physicians involved in the treatment of autoinflammatory diseases to investigate potential cases. Patients were included if a live-attenuated vaccine had been administered while they were on IL-1 or IL-6 blockade. RESULTS: Seventeen patients were included in this survey (7 systemic juvenile idiopathic arthritis (sJIA), 5 cryopyrin associated periodic syndrome (CAPS), 4 mevalonate kinase deficiency (MKD) and 1 familial Mediterranean fever (FMF). Three patients experienced an adverse event, of which two were serious adverse events (a varicella zoster infection after varicella zoster booster vaccination, and a pneumonia after MMR booster). One additional patient had diarrhea after oral polio vaccine. Further, seven patients experienced a flare of their disease, which were generally mild. Eight patients did not experience an adverse event or a flare. CONCLUSION: We have described a case series of seventeen patients who received a live-attenuated vaccine while using IL-1 or IL-6 blocking medication. The findings of this survey are not a reason to adapt the existing guidelines. Prospective trials are needed in order to acquire more evidence about the safety and efficacy before considering adaptation of guidelines.


Asunto(s)
Enfermedades Autoinflamatorias Hereditarias/inmunología , Inmunosupresores/efectos adversos , Interleucina-1/antagonistas & inhibidores , Interleucina-6/antagonistas & inhibidores , Vacunas Atenuadas/efectos adversos , Adolescente , Adulto , Niño , Preescolar , Femenino , Enfermedades Autoinflamatorias Hereditarias/tratamiento farmacológico , Humanos , Inmunosupresores/uso terapéutico , Lactante , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Encuestas y Cuestionarios , Vacunas Atenuadas/administración & dosificación , Adulto Joven
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