Life Satisfaction and Psychological Status of Mothers with Disabled Children: A Descriptive Study.

The purpose of this study is to determine the life satisfaction, general health conditions, and depression levels of mothers with disabled children and the problems they experienced. This descriptive study was conducted between 1 and 30 December 2014 in a rehabilitation center that renders services for totally 254 physically and mentally-disabled children in Turkey. 184 mothers participated in the study. The data were collected by using an information form, the life satisfaction scale, the general health questionnaire, and the Beck depression inventory. General Health Questionnaire scores of the mothers who had another disabled child and Beck Depression Inventory scores of the working mothers were significantly high. In addition, a significant difference was found between the scores of Life Satisfaction Scale, General Health Questionnaire, and Beck Depression Inventory by mothers who had difficulties regarding care of their children, were worried for their children, and experienced uncertainty with regard to the future.

HEALTH TECHNOLOGY ASSESSMENT IN TURKEY.

OBJECTIVES: The healthcare transformation program in Turkey has shown its success with improvements in important health indicators, increased access to healthcare services and expansion of coverage to all citizens. Turkey has been relatively able to bear the burdens associated with this due to rapid economic growth. The need for health technology assessment (HTA) was believed as a result of the expansion of coverage, pressure of new technologies, and increased expenditures. This study outlines the background and current formalization of HTA and shares the current use of HTA in decision making, while summarizing the transformation of the Turkish healthcare system for developing a high-quality, equal, and accessible care system. METHODS: We reviewed and analyzed policy changes in the Turkish healthcare system, universal health coverage, healthcare expenditures, and pricing and reimbursement policies to identify the changes leading to HTA. We reviewed existing HTA functions in Turkey and outlined their activities. Finally, we outlined a set of major challenges for HTA in Turkey over the next decade. RESULTS: HTA was formalized in Turkey in 2012-2013 with three national HTA structures and one hospital-based HTA unit. These functions currently run independent from each other. There are three major challenges in this country for HTA in the next decade: clarification of the assessment scope and methods, building a strong supporting system for HTA, and defining the role of HTA in the future vision of Turkish healthcare policy. CONCLUSION: HTA, despite challenges, has a good opportunity to develop further with clear action plans and strong political will.

Ontology-based automatic identification of public health-related Turkish tweets.

Social media analysis, such as the analysis of tweets, is a promising research topic for tracking public health concerns including epidemics. In this paper, we present an ontology-based approach to automatically identify public health-related Turkish tweets. The system is based on a public health ontology that we have constructed through a semi-automated procedure. The ontology concepts are expanded through a linguistically motivated relaxation scheme as the last stage of ontology development, before being integrated into our system to increase its coverage. The ultimate lexical resource which includes the terms corresponding to the ontology concepts is used to filter the Twitter stream so that a plausible tweet subset, including mostly public-health related tweets, can be obtained. Experiments are carried out on two million genuine tweets and promising precision rates are obtained. Also implemented within the course of the current study is a Web-based interface, to track the results of this identification system, to be used by the related public health staff. Hence, the current social media analysis study has both technical and practical contributions to the significant domain of public health.

Health-related behaviors and nutritional status of adolescents who study asboarders and day-students.

BACKGROUND/AIM: Boarders and day-students study together in regional boarding schools. This study was carried out to compare the health and nutritional status of boarders and day-students who study at regional boarding schools in Turkey. MATERIALS AND METHODS: A total 634 boarders and 492 day-students in the 4th-8th years of nine boarding schools in Giresun Province of Turkey were included. A questionnaire including 49 questions about sociodemographic characteristics and health and nutritional status was completed by the students. Height and weight measurements of the students were also taken. The chi-square test was used for statistical analyses. RESULTS: The boarders evaluated their health status as worse than the day-students. The proportion of the students having three meals a day was higher among the boarders than the day-students. According to BMI values, 11% of the boarders were evaluated as underweight, 77% as normal, 9.5% as overweight, and 2.5% as obese. These proportions were respectively 15.5%, 67.3%, 12.8%. and 4.5% for the day-students. CONCLUSION: The boarders have more regular diets and the proportion of normal-weighed boarders was higher than that of the day-students. However, they perceived their health as worse than the day-tudents.

Impact of Laboratory Test Use Strategies in a Turkish Hospital.

OBJECTIVES: Eliminating unnecessary laboratory tests is a good way to reduce costs while maintain patient safety. The aim of this study was to define and process strategies to rationalize laboratory use in Ankara Numune Training and Research Hospital (ANH) and calculate potential savings in costs. METHODS: A collaborative plan was defined by hospital managers; joint meetings with ANHTA and laboratory professors were set; the joint committee invited relevant staff for input, and a laboratory efficiency committee was created. Literature was reviewed systematically to identify strategies used to improve laboratory efficiency. Strategies that would be applicable in local settings were identified for implementation, processed, and the impact on clinical use and costs assessed for 12 months. RESULTS: Laboratory use in ANH differed enormously among clinics. Major use was identified in internal medicine. The mean number of tests per patient was 15.8. Unnecessary testing for chloride, folic acid, free prostate specific antigen, hepatitis and HIV testing were observed. Test panel use was pinpointed as the main cause of overuse of the laboratory and the Hospital Information System test ordering page was reorganized. A significant decrease (between 12.6-85.0%) was observed for the tests that were taken to an alternative page on the computer screen. The one year study saving was equivalent to 371,183 US dollars. CONCLUSION: Hospital-based committees including laboratory professionals and clinicians can define hospital based problems and led to a standardized approach to test use that can help clinicians reduce laboratory costs through appropriate use of laboratory tests.

Health perception and healthy lifestyle behaviors of female factory workers.

This study aims at the assessment of heath perception and healthy lifestyle behaviors of female workers at a food industry factory. Sociodemographic characteristics, a questionnaire form encompassing health-related characteristics, and Healthy Lifestyle Behaviors (HLSB) Scale II are utilized for data collection. The percentage of smokers is determined to be 20.9% among the workers and about 35.6% of them are considered as slightly overweight or overweight, based on their body mass index values. About 81.7% of the workers perceive their health as good. The average of the HLSB scores of the workers is found to be at the medium level (122 ± 21.4). The HLSB scores of the nonsmokers are significantly higher (p <.05). Among the subgroups of the scale, the highest score is obtained for spiritual development (24.3 ± 5.1) and the lowest is obtained for physical activity (15.4 ± 4.3).

Myometrial elasticity determined by elastosonography to predict preterm labor.

AIM: To determine the utility of elastosonography (ES) combined to cervical length measurement to predict preterm labor. METHODS: One hundred twenty-seven women with pregnancies between 21 to 36 weeks of gestation without any risk factor for preterm labor were included in the study. All subjects underwent sonographic evaluation including fetal biometry, cervical length measurement and ES of uterine myometrium. Subcutaneous tissue was the reference point for ES evaluation. Tissue strain ratio values were obtained from all patients. RESULTS: Cervical length was a significant predictor for preterm delivery (AUC = 0.958, p < 0.001). Optimal cut-off value was obtained at 30 mm with 92% sensitivity and 81% specificity. Elastosonographic strain ratio was also a significant predictor for preterm delivery (AUC = 0.827, p < 0.001). Optimal cut-off value was obtained at 4.7 with 79% sensitivity and 91% specificity. In linear regression analysis, strain ratio (R(2 )= 0.61, beta = 0.171, p = 0.03) and cervical length (R(2 )= 0.61, beta = -0.516, p < 0.001) were significantly associated with preterm delivery. Cervical length < 30 mm [39.1 (95 CI, 6.6-231.5, p < 0.001)] and strain ratio > 4.7 [24.5 (95 CI, 4.1-146.5, p < 0.001)] were the risk factors for preterm delivery. CONCLUSION: Elastosonographic evaluation of uterine myometrium was found to be significantly correlated with cervical length but cervical length measurement is a better predictor for preterm labor than ES.

Health-promoting lifestyle behaviours in pregnant women in Turkey.

This study aims to describe the health-promoting lifestyle behaviours of pregnant women. The study was carried out with pregnant women who applied to the polyclinics in different maternity and children hospitals located in Adana, Turkey, between 1 March and 30 May 2009. The data collection tools used in the study were (i) a questionnaire that was used to collect sociodemographic data from the participants and (ii) the Health Promoting Lifestyle Profile II (HPLP II). The results obtained from the study showed that total HPLP II scores were moderate; the highest scores were obtained on the spiritual growth dimension and the lowest scores on the physical activity dimension. Pregnant women with older age, those with a higher educational level, those with a better socioeconomic status and those living in a nuclear family were found to be more likely to have health-promoting lifestyles. Health promotion and healthy lifestyle need to be an integral part of health services provided for pregnant women. Midwives and nurses have prominent roles in encouraging pregnant women to engage in health-promoting behaviours.

Unfavorable lipid profile and higher frequency of hot flashes during perimenopausal years after fallopian tube ligation.

AIM: We sought to study the effect of tubal ligation on lipid profile, ovarian reserve and hot flashes during perimenopausal years. METHODS: A total of 210 perimenopausal women complaining of abnormal vaginal bleeding were enrolled for the study. Subjects' menstrual, reproductive and medical histories were recorded. Serum FSH, LH and estradiol levels were screened in all women to determine menopausal status. In order to rule out any gynecologic pathology, all subjects underwent transvaginal sonography. Women were divided into two groups according to presence (study group, n = 68) or absence (control group, n = 142) of tubal ligation history. Lipid profiles and ovarian reserve tests were compared between groups. RESULTS: Mean age, parity, serum hemoglobin (Hb), high density lipoprotein (HDL-C), triglyceride, estradiol levels, endometrial thickness and frequency of hot flashes were significantly different between groups (p < 0.05). Mean age was 42.8 ± 1.9 years in women with tubal ligation and 45.9 ± 3.5 years in control group. Mean serum estradiol level was lower in group with tubal ligation (41.4 versus 92.5 pg/ml). Mean endometrial thickness was higher in control group (10.2 versus 7.5 mm). Age-adjusted serum Hb, HDL-C, triglyceride, estradiol, FSH level, endometrial thickness and frequency of hot flashes remained significantly different between groups (p < 0.05). CONCLUSION: Tubal ligation is associated with unfavorable lipid profile and higher frequency of hot flashes during perimenopausal years.