Pelvic floor muscle training patient reported Outcome Measures (PROM) (PFMT-P): Turkish adaptation and its validity and relibiality.

OBJECTIVE: Although there are several patient reported outcome measures (PROM) regarding knowledge, source of knowledge and practice about pelvic floor muscle training (PFMT), there is a lack of a valid and reliable PROM that includes the practice component of PFMT along with knowledge and source of knowledge. There is no valid and reliable measurement tool in Turkish used for this purpose. In this context, the aim of our study is to evaluate the psychometric properties of Pelvic Floor Muscle Training Patient Reported Outcome Measures (PROM) (PFMT-P) and to test whether it is a valid and reliable measurement tool for Turkish women. STUDY DESIGN: This study has been carried out psychometric testing (validity and reliability) of a new assessment tool concerning PFMT-P. A total of 170 female healthcare professionals (midwives, nurses, doctors, physiotherapists) who were between the ages of 23 and 49 and who volunteered to participate were included in the study. SPSS 25.0 and LISREL 8.80 statistical programs were used for the analysis of data. Descriptive statistics were evaluated with numbers, percentages and means. Content validity index and confirmatory factor analysis were used for validity. Cronbach Alpha value and test-retest were used for reliability. Level of significance was p < 0.05. RESULTS: Content validity index (CVI) was found to be 0.96 for the overall scale. Model fit indices were found as perfect and good matched. Cronbach's alpha coefficient was found as 0.813 for the overall scale. Test-retest correlation was found as 0.658, it was 0.998 for practice component and 0.997 for source of knowledge component and a positive, significant and high correlation was found. CONCLUSIONS: It has been determined that PFMT-P is a valid and reliable measurement tool suitable for Turkish culture. With this, it is a short, comprehensive and useful tool that can be used in both pregnancy and the postpartum period for women of reproductive age or menopause.

What Should a Breastfeeding Place in Public Spaces Be Like? A Qualitative Study on Women's Experiences.

BACKGROUND: Mothers need a place in public spaces where they can comfortably breastfeed and care for their babies. The availability and design features of these places are critical for meeting mothers' safety and comfort needs while they are breastfeeding. AIM: This study was conducted to examine mothers' experiences with breastfeeding places in public spaces. METHODS: This study, which was planned as a phenomenological research, one of qualitative research designs, was conducted with mothers (n = 18) with breastfeeding experience in public places. Data were collected through in-depth interviews using a semi-structured questionnaire developed by the researchers. The thematic analysis method was employed to evaluate the data. RESULTS: Study findings were examined under two main themes and 12 subthemes. Getting to the breastfeeding place was actually enough for many of the participants. Women who could not breastfeed for any reason in breastfeeding places stated that they came up with some solutions, such as breastfeeding in the car, feeding with formula, and not taking the baby with them. Participants' basic expectations about the breastfeeding place were that it met cleanliness, hygiene, privacy, and ventilation conditions. CONCLUSIONS: It was found that women who tended to spend more time in public spaces recently encountered similar problems during the breastfeeding process. Breastfeeding environments should meet minimum standards such as cleanliness and privacy as well as having the necessary comfort, aesthetics, and decoration features.

Effect of Stress Ball Application On Anxiety Levels of Pregnant Women During Non-Stress Test: Randomized Controlled Experimental Study.

Background: This randomized controlled trial was designed to assess the efficacy of stress ball application on stress levels of pregnant women during non-stress tests. Methods: The study included 80 primiparous pregnant women (n = 40 in the experimental group and n = 40 in the control group) and was carried out in a state hospital's non-stress test room. Data for the study were gathered using Individual Description Form, and the State Anxiety Inventory (STAI). Results: Both groups are independent and homogeneous in terms of the sociodemographic and obstetric characteristics of pregnant women (P > .05). While there was no statistically significant difference between the STAI-1 score averages of the experimental and control groups in the pre-test of the research (P > .05), in the post-test of the research, it was determined that the STAI-2 average score of the women in the experimental group was significantly lower than the women in the control group (P < .001). In the intra-group comparison, while there was a statistically significant difference between the STAI-1 and STAI-2 score averages in the experimental group (P < .001), no statistically significant difference was detected between the STAI-1 and STAI-2 score averages in the control group (P = .696). Conclusion: In this study, the use of a stress ball during the non-stress test is effective in reducing anxiety levels in pregnant women.

Midwives' views about the effects of climate change on maternal and child health: A qualitative study.

BACKGROUND: Midwives have important responsibilities to protect the health of mothers and children from the negative effects of climate change. AIM: This research was conducted to determine how midwives perceived climate change, the effects of climate change on maternal and child health, and what midwives could do to combat these effects. METHODS: The research was designed as a case study, one of the qualitative research designs. The research sample consisted of 11 midwives selected by snowball sampling, which is one of the non-random sampling methods. FINDINGS: The data obtained were collected under five main themes. The themes were determined as "(I) the causes of climate change, (II) concerns about the consequences of climate change, (III) the effects of climate change on mother-child health, (IV) measures to mitigate the effects of climate change, and (V) midwives' role in protecting mother-child health against the effects of climate change." CONCLUSION: Midwives are knowledgeable about climate change. They are aware of the effects of climate change on maternal and child health and they are doing some practices in this regard (breastfeeding, promoting the regulation of fertility and adequate/balanced nutrition, etc.). Midwives are aware of the importance of the midwifery profession in raising awareness of the individual and society, in addressing the effects of climate change on human health and in reducing the negative effects of climate change on health, and they want to take action at the national level (with the support of the midwifery organization and the state) for the sustainability of health.

The effect of mandala coloring on pregnancy-related anxiety.

PURPOSE: In the literature, the efficacy of mandala coloring on pregnancy-related anxiety has been investigated, and no study has been found on its effect on anxiety. This randomized controlled trial was designed to assess the efficacy of mandala coloring application on pregnancy-related anxiety. METHODS: The study included 77 primiparous pregnant women: 39 in the control group and 38 in the experimental group, and was carried out in an education-research hospital's obstetric clinic. Data for the study were gathered using Information Form, the Pregnancy-related Anxiety Scale, and the State Anxiety Inventory. While the experimental group did mandala coloring during a month twice in a week, and the control group was not do anything. The "Pregnancy-related Anxiety Scale" and "The State Anxiety Inventor" were used to assess anxiety in all groups before and after application. In the statistical analysis of the data, the SPSS 23.0 package program was used. In all tests, p < 0.005 was considered statistically significant. RESULTS: Immediately post-intervention, the women in the experimental group had a significantly higher reduce pregnancy-related anxiety (p < 0.05). Especially in the mandala group within according to control group were found to have significantly reduced anxiety the application (PrAS-1 82,50 ± 2,47 vs. 84,41 ± 4,12; PrAS-2 77,92 ± 2,16 vs. 83,89 ± 3,80; PrAS-3 72,05 ± 3,97 vs. 84,10 ± 4,35; PrAS-Total 77,49 ± 5,21 vs. 84,13 ± 4,07; STAI-1 52,39 ± 2,50 vs. 51,17 ± 1,16; STAI-2 49,73 ± 0,75 vs. 49,05 ± 1,27; STAI-3 48,84 ± 3,17 vs. 49,02 ± 1,22; STAI-Total 50,32 ± 2,8 vs. 49,75 ± 1,58). CONCLUSIONS: Mandala coloring is effective in reducing pregnancy-related anxiety. CLINICAL TRIAL NUMBER: (NCT05534867).

The effect of online hypno-breastfeeding and solution-focused psychoeducation on mothers' breastfeeding motivation and perception of insufficient milk: Randomize controlled study.

This study was conducted to evaluate the effects of hypno-breastfeeding (HB) and solution-focused psychoeducation (SFP) on breastfeeding motivation and insufficient milk perception in mothers. It is a randomized controlled experimental study. The sample of the study consisted of 90 women who met the inclusion criteria. Women in the intervention groups had increased motivation to breastfeed and decreased perception of insufficient milk. Those in the SFP group had significantly lower midwife support scores than the HB group. HB and SFP are safe and effective methods to increase mothers' motivation to breastfeed and reduce the perception of insufficient milk.

Determination of pre-pregnancy fear of childbirth levels in Turkish and Syrian refugee individuals with no children: A comparative study.

Objective: This study was conducted to determine pre-pregnancy fear of childbirth levels and related factors in Turkish and Syrian refugee individuals with no children. Study design: A cross-sectional-descriptive design was used. The study was carried out between September 29 and November 15, 2022 with Turkish and Syrian refugee women with no children who presented to the Obstetrics and Gynecology Polyclinic of a state hospital and their spouses. A total of 545 people, including the spouses of the women who wanted to participate, were included in the study. The data were collected by the researcher in the waiting room of the outpatient clinic by using the face-to-face interview method. A Personal Information Form and the Childbirth Fear-Prior to Pregnancy Scale were used to collect the research data. Results: There was no statistically significant relationship between participants' culture and their age, education level, employment status, family type, income level, and birth preferences (p > 0.05), and the groups were independent and homogeneous in terms of the specified characteristics. It was determined that Syrian refugee women had a significantly higher total score on the Childbirth Fear-Prior to Pregnancy Scale than Turkish women. Also, the score of Syrian refugee men on the same scale was significantly higher than that of Turkish men. A statistically significant difference was found between the total scores of the Turkish and Syrian participants according to age, education level, and preferred mode of birth. Conclusions: In the current study, it was determined that both genders and cultures had a fear of childbirth, although it was more common in women and Syrian refugees. According to the findings of the study, culture, gender, age, education level, and preferred mode of birth were factors related to childbirth fear prior to pregnancy.

Sexual attitudes and sexual functions during pregnancy: A comparative study.

Background: Sexuality is a multidimensional, not shallow, concept that involves the biological make-up and desires of women and men. It is a complex process that is shaped by the culture to which the individual belongs and the social conditions in which he/she lives. Aims: This descriptive and cross-sectional study aims to determine the sexual function status and sexual attitudes of Turkish and Syrian pregnant women who admitted to birth clinics in Turkey to investigate the relationship between pregnancy processes and some variables. Methods: This descriptive and cross-sectional study population (n:200) consisted of Turkish and Syrian pregnant women who met the research inclusion criteria, agreed to participate in the research and admitted to the Y City Education and Research Hospital in Turkey. Findings: In the study, the mean "Female Sexual Function Index (FSFI)" score of Turkish pregnant women was found to be (20.83 ± 9.28), whereas the FSFI score of Syrian pregnant women was (16.28 ± 11.45), Considering the Attitude Scale Towards Sexuality (ASTS), Turkish women score was found to be (123.77 ± 45.35), in contrast the ASTS score of Syrian pregnant women was (94.74 ± 43.69). Clinical implications: Since sexual myths can have a negative impact on pregnant women's sexual functions, clinicians should be knowledgeable about sexuality and sexual myths. Strengths & limitations: Regarding the limitations, first, the sample size was small. Second study results can only be generalized to this group. Last limitation, spouses of the women who participated in the study did not participate in the study. Conclusion: The study found that there is a difference in the sexual dysfunction and sexual attitudes of the women, depending on to be the refugee and socio-cultural structure.

Turkish validity and reliability study of the "respectful maternity care" knowledge and practice scale of midwives.

Objective: Increasing cesarean rates in Turkey show that respectful maternity care services should be given priority and importance. It is difficult to achieve sustainable development goals without adopting a respectful maternity care approach, and there is no Turkish measurement tool to evaluate the knowledge and practices of midwives on "respectful maternity care". The aim of this study is to evaluate whether the "respectful maternity care knowledge and practice scale of midwives" is an appropriate measurement tool for Turkish women by conducting a Turkish validity and reliability study. Study design: The methodological study was carried out by midwives working in three Public Hospitals. Data were collected face-to-face using the "introductory information form" and "the respectful maternity care knowledge and practice scale of midwives". Results: The scale consists of two sections knowledge and practice. Both sections have three sub-dimensions: "providing emotional support", "providing safe care", and "preventing abuse". The cronbach alpha internal consistency coefficient value ranged between 0.76 and 0.95 for both sections.This study has determined that this scale, which was adapted, consists of three sub-dimensions and 46 items (23 items each) in both knowledge and application sections, is a highly valid and reliable scale compatible with Turkish culture, as a result of the validity and reliability findings.

Challenges and perspectives of tobacco cessation in special groups of patients and populations.

During the first 2 years of the coronavirus disease 2019 pandemic, health systems worldwide were put under extreme pressure, and healthcare professionals had to manage unprecedented health crises as well as provide healthcare services to an increased number of patients. Therefore, public health policies with respect to smoking and education of the general population regarding the harmful effects of active and second-hand smoking may not have received adequate attention during this period. More specifically, certain subpopulations suffering from chronic diseases may not have received adequate information about the effects of smoking on the course and outcome of their disease; high-level, evidence-based pharmaceutical therapies; and the potential for follow-up. However, adequate education and awareness regarding short- and long-term health benefits from smoking cessation for the general population as well as special subgroups remains of utmost importance. Healthcare professionals should understand that it is only through high-quality evidence and results from independent studies that they will be able to provide their expertise and scientific knowledge concerning newer tobacco products and their effects on human health.

The effect of tele-education delivered to mothers during the COVID-19 pandemic on breastfeeding success and perceived breastfeeding self-efficacy: Randomized controlled longitudinal trial.

This study was conducted to determine the effect of tele-education offered to mothers during the COVID-19 pandemic on breastfeeding success and perceived breastfeeding self-efficacy. The mothers were divided into experimental (n = 28) and control groups (n = 28). They were followed-up postnatal 1st week, 4th week, 3rd month, and 6th month in both groups. The researchers provided a 4-week long education and counseling service to mothers in the experimental group via direct phone calls and text messages. It was determined that the tele-education given to mothers about breastfeeding during the COVID-19 pandemic increased breastfeeding success and perceived breastfeeding self-efficacy.

Will plain packaging of cigarettes achieve the expected? Perceptions among medical students.

INTRODUCTION: Plain packaging is one of the critical strategies in eliminating the promotion of tobacco products. Evidence indicates that plain packaging decreases the attractiveness of tobacco products and enhances the effectiveness of health warnings. This study aimed to explore the perceptions of undergraduate medical students of plain packaging and new pictorial warnings before they came into use in Turkey. METHODS: This qualitative study was carried out among undergraduate students in a Medical School in Istanbul in 2019. Participants were recruited through purposive sampling, and data were collected through focus group discussions. The participants were asked to discuss their perceptions regarding one original branded pack and ten plain package models. All discussions were audiotaped and thematic content analysis was conducted. RESULTS: A total of 72 students participated in the study. None of the students had seen plain packaging before. Most of the students perceived plain packaging as more favorable compared to the branded packs. The terms used to describe plain package were: 'appealing/desirable', 'attractive', 'beautiful', 'cool/eye-catching', 'charming', 'elegant', and 'special'. Some students indicated that they would have preferred plain packs over the branded ones if both types of products had been in the market and provided they were of the same brand. Pictorials had different impacts based on their content. At the same time, outer body deformities were perceived as 'real' and provoked unfavorable feelings; inner organ images were defined as 'imaginary' and had little to no impact. CONCLUSIONS: Plain packaging was perceived as a more attractive alternative to the conventional branded packs among most participants. We must be aware of the unforeseen effects of plain packaging among different subgroups in the new generations. We suggest using outer body deformities in the pictorials more frequently due to their higher impact.

Turkish Thoracic Society's Statement Report on Electronic Cigarettes and Heated Tobacco Products.

Tobacco addiction, which causes the death of more than 8.5 million people in the world every year, is a preventable global public health problem. There are 1.1 billion adult smokers worldwide and 60% of them desire or intend to quit but unfortunately, the tobacco industry continues to profit at the expense of people's lives by marketing electronic cigarettes and heated tobacco products as a smoking cessation method and they continue to poison young people with new threat tobacco products, promising a "smoke-free future" Turkish Thoracic Society is actively involved in the implementation of the National Tobacco Control Program to protect public health and has warned and raised awareness of new threats to the youth, such as electronic cigarettes and heated tobacco products. The purpose of this report is to provide information about electronic cigarettes and heated tobacco products and to present TTJ's position on the subject.

Protective effect of creatine on amikacin-induced ototoxicity.

INTRODUCTION: Aminoglycosides are widely known for their ototoxic side effects. Nevertheless, they are potent antibiotics used in the treatment of life-threatening conditions because of the current concern for antibiotic resistance. We hypothesized that creatine supplements which are believed to improve mitochondrial antioxidant defense system and maintain optimal energy homeostasis may improve the ototoxic side effects. OBJECTIVE: This study aimed to investigate the protective effects of creatine monohydrate against ototoxicity induced by amikacin in rats in an experimental animal model, using distortion product otoacoustic emissions and auditory brainstem response. METHODS: Twenty healthy rats were assigned to four groups (5 rats in each): the control group, the creatine monohydrate group, the amikacin group and the amikacin+creatine monohydrate group. The creatine monohydrate group received creatine at a dose of 2g/kg once daily via gastric gavage for 21 days. The amikacin group received amikacin at a dose of 600mg/kg by intramuscular injections once daily for 21 days. The amikacin+creatine monohydrate group received intramuscular injections of amikacin (600mg/kg) once daily for 21 days and creatine monohydrate (2g/kg) once daily via gastric gavage for 21 days. The control group received nothing. The distortion product otoacoustic emissions and auditory brainstem response measurements were performed on all rats on days 0, 7, 21. RESULTS: Regarding auditory brainstem response values, a significant increase in the auditory threshold was observed in the amikacin group on day 21 (p< 0.001). The amikacin+creatine monohydrate group showed significantly lower levels of auditory brainstem response auditory thresholds on day 21 in comparison to the amikacin group (p< 0.001). Additionally, the control group and the amikacin+creatine monohydrate group did not differ significantly with respect to auditory brainstem response thresholds on treatment day 21 (p> 0.05). When we compare distortion product otoacoustic emissions values, there was no significant difference between the amikacin and amikacin+creatine monohydrate groups on day 7 (p> 0.05), However significantly greater distortion product otoacoustic emissions values were observed in the amikacin+creatine monohydrate group on day 21 compared to the amikacin group (p< 0.001). CONCLUSION: Our findings demonstrate that creatine treatment protects against amikacin ototoxicity when given at a sufficient dose and for an adequate time period.

The effect of oxytocin massage and music on breast milk production and anxiety level of the mothers of premature infants who are in the neonatal intensive care unit: A self-controlled trial.

This study was conducted to evaluate the effect of music and oxytocin massage on production and anxiety in mothers of premature infants. The study was designed in the self-controlled trial type and conducted with 73 mothers. The anxiety scores of mothers decreased in the oxytocin massage and the music interventions, and the amount of their breast milk secretion increased (p < 0.05). Music and oxytocin massage has a positive effect on increasing breast milk and decreasing the anxiety of mothers.

Tobacco use among working adolescents and high school students in Turkey: evaluating the effect of the national tobacco control policy.

BACKGROUND: In our previous published study conducted in 2006 before the national tobacco control program (NTCP), we found that working adolescents (WA) more frequently consumed cigarettes than high school students (HSS). The objective of the present study was to compare the smoking status of WA and HSS before and after the NTCP. METHODS: A questionnaire including questions about the participant`s socio-economic level and smoking status was administered. RESULTS: There were 668 subjects in the 2006 study and 869 subjects in the 2015 study. When we compared the 2015 results with the 2006 study, while there was a significant decline in the ever smokers (p < 0.001), there was no difference in current smokers in both the female and male WA groups. In the HSS group, there was a significant decline in ever smokers (p < 0.01), for both females and males. While there was a significant decline in current female smokers (p=0,002), no significant decrease was found in current male smokers (p > 0.05) in the HSS group. CONCLUSIONS: After the initiation of the NTCP, we have not seen a reduction in the smoking rates of both female and male WA and male HSS. The NTCP should particularly focus on the adolescent group in Turkey.

Excess Mortality During COVID-19 Pandemic in Istanbul.

OBJECTIVE: Epidemiological studies have shown that mortality owing to the coronavirus disease 2019 (COVID-19) could be under-reported under different conditions. Excess mortality analysis is suggested as a useful tool in estimating the impact of the disease. MATERIAL AND METHODS: Mortality data between January 01 and May 18, 2020, were analyzed to evaluate the excess mortality owing to COVID-19 in Istanbul, the city most affected by the pandemic in Turkey. The average weekly percentage changes in the number of deaths in 4 previous years were compared with those in the year 2020 using excess mortality analysis. RESULTS: The number of deaths in Istanbul was significantly higher in 2020 (p=0.001), with a 10% weekly increase between the 10th and 15th weeks, which started to decrease until the 20th week. The excess mortality found during the study period was 4,084 deaths, higher than the officially reported COVID-19 mortality. CONCLUSION: Our findings demonstrated that mortality owing to COVID-19 could be higher than the official figures reported by health authorities.