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1.
Niger J Clin Pract ; 22(12): 1629-1634, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31793467

RESUMO

Defects in the face area caused by trauma, accident, tumor or congenital defects are treated with special facial prostheses. Besides esthetics, the most common problem with these prostheses is the retention of prostheses. In the present article review, the methods used for the retention of prostheses from past to present were researched, and the advantages of adhesives and implants, which are the most commonly used current methods, were evaluated. Current techniques, new materials, treatment options, and implementation procedures are described. The success of maxillofacial prostheses in meeting the expectations of patients and dentist doctors is increasing day by day with the development of adhesive material science, the emergence of technical knowledge, and the development of implant technology. Increasing the retention provides both ease of use and acceptance by the patient. Therefore, the chosen method for retention has great importance in the long-term prognosis of the prosthesis.


Assuntos
Adesivos , Face/cirurgia , Prótese Maxilofacial , Próteses e Implantes , Desenho de Prótese , Implantação de Prótese/métodos , Retenção da Prótese/instrumentação , Estética , Humanos
2.
Colorectal Dis ; 2019 Oct 25.
Artigo em Inglês | MEDLINE | ID: mdl-31652398

RESUMO

AIM: This study was designed to evaluate a new technique for a completely diverting tube ileostomy achieved through temporary occlusion of the distal ileum using a flexible rubber strip. METHODS: This prospective interventional study was conducted in one centre. Patients who underwent colorectal resections with a primary anastomosis and who were deemed as requiring a defunctioning stoma were included in the study. After completion of resection and anastomosis, the tube ileostomy was fashioned by inserting a reinforced (spiral) endotracheal tube with an inner diameter of 7.5 mm into the ileum. To provide complete faecal diversion, temporary occlusion of the distal ileum was performed using a flexible rubber strip. The primary outcome of this study was the incidence of complete diversion achieved using this method. RESULTS: Fifty consecutive patients underwent a diverted tube ileostomy using the technique described above. Defaecation before removal of the strip did not occur in any of the patients inferring that complete diversion was observed in all patients (100%). The tube was removed at postoperative week 3. After tube removal, the resulting enterocutaneous fistulas closed spontaneously in a median of 6 (2-30) days. CONCLUSION: The diverting tube ileostomy technique using an easily removable rubber strip to defunction the colorectal anastomosis is a safe and effective method that precludes the need to fashion a stoma.

3.
Niger J Clin Pract ; 22(7): 906-912, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31293253

RESUMO

Objective: The aim of this study was to investigate how Queen bee syndrome, which is known as the mobbing behaviors of female employees from other female employees or managers, as perceived by nurses who are predominantly female workers. Materials and Methods: The universe of the qualitative type patterned research was formed by 12 nurses between the ages of 20 and 40 who worked for at least one year in different parts of a private hospital on the Anatolian side of Istanbul province. Maximum diversity sampling method for purposes was used for sample selection. The research data were collected in the form of written recording and voice recording with an unstructured interview form, which includes the structure, gender, competence, support, conflict, and competition themes created by the researchers to evaluate the characteristics of Queen bee syndrome. Focus group interviews were held on 30 April 2018. The results were evaluated using descriptive analysis and indicator methods. Results: In the study, the nurses' responses to interview questions were examined and women managers felt more emotional than men managers, and therefore they were less successful in problem-solving than men managers, but they were more successful in communication among women. The majority of nurses stated that women managers are more suitable for management in healthcare, that they are open to change, but they are not enough for men to solve the problem due to the fact that they are more concerned with the details. In addition, a significant part of the nurses, more than one female managers can cause competition and conflict in the workplace, especially women managers with similar status, said that this situation is seen more. Conclusions: The results of this study indicate that the woman is adapting to the Queen bee syndrome because of her ambition, competition, and emotional approaches, but that she has not been able to produce enough of it due to the environment.


Assuntos
Atitude do Pessoal de Saúde , Recursos Humanos de Enfermagem no Hospital/psicologia , Local de Trabalho/psicologia , Adolescente , Adulto , Animais , Feminino , Grupos Focais , Hospitais Privados , Humanos , Relações Interprofissionais , Entrevistas como Assunto , Masculino , Pessoa de Meia-Idade , Enfermeiras Administradoras/organização & administração , Enfermeiras Administradoras/psicologia , Recursos Humanos de Enfermagem no Hospital/organização & administração , Percepção , Pesquisa Qualitativa , Adulto Jovem
4.
Niger J Clin Pract ; 22(5): 598-602, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31089012

RESUMO

Objective: The aim of this study was to determine the effectiveness of hematological parameters measured at the moment of admission to the emergency room in predicting in-hospital mortality and to determine cut-off values of strongly predictive values. Subjects and Methods: The study began with approval of the ethics committee. In total, 1,929 patients over 18 years of age, whose date could be obtained, were included in the study. From the hemogram parameters, white blood cells (WBC), red cell distribution width, mean platelet volume, and ratio of neutrophils to lymphocytes (NLR) values were determined and recorded. CK-MB and high-sensitive Troponin T values were recorded as cardiac markers. For statistical analysis, "SPSS for Windows Version 21" package program was used. Findings: About 71.7% (n = 1384) of the patients were male and 28.3% (n = 545) of the patients were female. About 92.5% of the patients (n = 1785) were discharged from the hospital, whereas the remaining 144 patients (7.5%) were exitus in the hospital. When the efficacy of hematological parameters and cardiac markers in predicting mortality was examined by receiver operating charecteristics analysis, NLR was found to be the strongest predictor (area under the curve [AUC], 0.772, standard deviation [SD] = 0.022, 95% confidence interval [CI]). It was found that the WBC value came in second place after NLR as a strong predictor of mortality (AUC, 0.749, SD = 0.024, % 95 CI). Conclusion: The use of predictors for the prediction of mortality for ST elevation myocardial infarction patients is of great importance for faster implementation of treatment modalities. We found that WBC and especially NLR values obtained with a simple method can be used as powerful predictors.


Assuntos
Mortalidade Hospitalar , Linfócitos , Neutrófilos , Infarto do Miocárdio com Supradesnível do Segmento ST/sangue , Infarto do Miocárdio com Supradesnível do Segmento ST/mortalidade , Idoso , Área Sob a Curva , Creatina Quinase Forma MB/sangue , Índices de Eritrócitos , Feminino , Humanos , Contagem de Linfócitos , Masculino , Volume Plaquetário Médio , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Curva ROC , Troponina T/sangue
6.
Eye (Lond) ; 30(7): 925-8, 2016 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-27055680

RESUMO

PurposeTo investigate the effects of tropicamide and cyclopentolate, which are two anti-muscarinic agents commonly used in the ophthalmologic practice, on subfoveal choroidal choroidal thickness (ChT) in healthy adults.MethodsA total of 74 healthy adult subjects were enrolled in the study. Subjects were randomly divided into two groups: (1) cyclopentolate group (n=37) in which the right eye (study eye) of each subject received topical cyclopentolate 1%, and the fellow eye (control eye) received artificial tears and (2) tropicamide group (n=37) in which the right eye (study eye) of each subject received topical tropicamide 1% and the fellow eye (control eye) received artificial tears. Each topical medication was applied three times with 10-min intervals. ChT measurements were performed at baseline and 40 min after the last drops of the topical medications by enhanced depth imaging (EDI) optical coherence tomography (OCT).ResultsIn the cyclopentolate group, subfoveal ChT significantly increased in the study eyes (P=0.013), whereas it did not significantly change in the control eyes (P=0.417). On the other hand, in the tropicamide group, no significant subfoveal ChT changes were observed in either the study eyes (P=0.715) or the control eyes (P=0.344).ConclusionsThe current study demonstrated that cyclopentolate caused significant choroidal thickening, whereas tropicamide had no significant effect on ChT in healthy adults. As a result, mydriasis by cyclopentolate may complicate ChT measurements by EDI OCT. Use of tropicamide may provide more reliable results for evaluation of ChT in ocular pathologies.


Assuntos
Corioide/efeitos dos fármacos , Corioide/patologia , Ciclopentolato/farmacologia , Antagonistas Muscarínicos/farmacologia , Tropicamida/farmacologia , Administração Tópica , Adolescente , Adulto , Idoso , Ciclopentolato/administração & dosagem , Feminino , Fóvea Central , Voluntários Saudáveis , Humanos , Masculino , Pessoa de Meia-Idade , Antagonistas Muscarínicos/administração & dosagem , Soluções Oftálmicas , Tomografia de Coerência Óptica , Tropicamida/administração & dosagem
7.
Sci Rep ; 6: 22121, 2016 Feb 26.
Artigo em Inglês | MEDLINE | ID: mdl-26916556

RESUMO

Foot-and-mouth disease (FMD) in Turkey is controlled using biannual mass vaccination of cattle. However, vaccine protection is undermined by population turnover and declining immunity. A dynamic model of the Turkish cattle population was created. Assuming biannual mass vaccination with a single-dose primary course, vaccine history was calculated for the simulated population (number of doses and time since last vaccination). This was used to estimate population immunity. Six months after the last round of vaccination almost half the cattle aged < 24 months remain unvaccinated. Only 50% of all cattle would have received > 1 vaccine dose in their life with the last dose given ≤ 6 months ago. Five months after the last round of vaccination two-thirds of cattle would have low antibody titres (< 70% protection threshold). Giving a two-dose primary vaccination course reduces the proportion of 6-12 month old cattle with low titres by 20-30%. Biannual mass vaccination of cattle leaves significant immunity gaps and over-reliance on vaccine protection should be avoided. Using more effective vaccines and vaccination strategies will increase population immunity, however, the extent to which FMD can be controlled by vaccination alone without effective biosecurity remains uncertain.


Assuntos
Doenças dos Bovinos/prevenção & controle , Febre Aftosa/imunologia , Febre Aftosa/prevenção & controle , Vacinação em Massa/métodos , Vacinas Virais/imunologia , Animais , Anticorpos Antivirais/sangue , Anticorpos Antivirais/imunologia , Bovinos , Doenças dos Bovinos/epidemiologia , Doenças dos Bovinos/virologia , Febre Aftosa/epidemiologia , Febre Aftosa/virologia , Vírus da Febre Aftosa/imunologia , Modelos Teóricos , Turquia/epidemiologia , Vacinas Virais/administração & dosagem
8.
Dalton Trans ; 44(28): 12526-9, 2015 Jul 28.
Artigo em Inglês | MEDLINE | ID: mdl-26103060

RESUMO

Engineering a copper coordination sphere with organoimine ligands and tuning the organophosphonate protonation states produced [{Cu(2,2'-bpy)}2(HO3P(CH2)8PO3H2)4] (1) and [{Cu(terpy)}2(2,7-FDA-H2)2]·(2,7-FDA-H4)(2H2O) (2) (2,7-FDA-H4 = 2,7-fluorenonediphosphonic acid) macrocyclic copper-organophosphonate building blocks. 1 exhibits high temperature magnetic ordering, while 2 is paramagnetic. The structures were characterized by single crystal X-ray diffraction.


Assuntos
Complexos de Coordenação/química , Cobre/química , Organofosfonatos/química , Fenômenos Magnéticos , Temperatura Ambiente , Termogravimetria , Difração de Raios X
10.
Vaccine ; 33(6): 805-11, 2015 Feb 04.
Artigo em Inglês | MEDLINE | ID: mdl-25528523

RESUMO

Despite years of biannual mass vaccination of cattle, foot-and-mouth disease (FMD) remains uncontrolled in Anatolian Turkey. To evaluate protection after mass vaccination we measured post-vaccination antibodies in a cohort of cattle (serotypes O, A and Asia-1). To obtain results reflecting typical field protection, participants were randomly sampled from across Central and Western Turkey after routine vaccination. Giving two-doses one month apart is recommended when cattle are first vaccinated against FMD. However, due to cost and logistics, this is not routinely performed in Turkey, and elsewhere. Nested within the cohort, we conducted a randomised trial comparing post-vaccination antibodies after a single-dose versus a two-dose primary vaccination course. Four to five months after vaccination, only a third of single-vaccinated cattle had antibody levels above a threshold associated with protection. A third never reached this threshold, even at peak response one month after vaccination. It was not until animals had received three vaccine doses in their lifetime, vaccinating every six months, that most (64% to 86% depending on serotype) maintained antibody levels above this threshold. By this time cattle would be >20 months old with almost half the population below this age. Consequently, many vaccinated animals will be unprotected for much of the year. Compared to a single-dose, a primary vaccination course of two-doses greatly improved the level and duration of immunity. We concluded that the FMD vaccination programme in Anatolian Turkey did not produce the high levels of immunity required. Higher potency vaccines are now used throughout Turkey, with a two-dose primary course in certain areas. Monitoring post-vaccination serology is an important component of evaluation for FMD vaccination programmes. However, consideration must be given to which antigens are present in the test, the vaccine and the field virus. Differences between these antigens affect the relationship between antibody titre and protection.


Assuntos
Anticorpos Antivirais/sangue , Doenças dos Bovinos/prevenção & controle , Febre Aftosa/prevenção & controle , Vacinação/métodos , Vacinas Virais/imunologia , Animais , Estudos de Casos e Controles , Bovinos , Doenças dos Bovinos/imunologia , Doenças dos Bovinos/virologia , Esquema de Medicação , Feminino , Febre Aftosa/imunologia , Febre Aftosa/virologia , Vírus da Febre Aftosa/imunologia , Masculino , Fatores de Tempo , Falha de Tratamento , Turquia , Vacinas Virais/administração & dosagem
11.
Vaccine ; 32(16): 1848-55, 2014 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-24530150

RESUMO

Foot-and-mouth disease (FMD) is present in much of Turkey and its control is largely based on vaccination. The arrival of the FMD Asia-1 serotype in Turkey in 2011 caused particular concern, spreading rapidly westwards across the country towards the FMD free European Union. With no prior natural immunity, control of spread would rely heavily on vaccination. Unlike human vaccines, field protection is rarely evaluated directly for FMD vaccines. Between September 2011 and July 2012 we performed four retrospective outbreak investigations to assess the vaccine effectiveness (VE) of FMD Asia-1 vaccines in Turkey. Vaccine effectiveness is defined as the reduction in risk in vaccinated compared to unvaccinated individuals with similar virus exposure in the field. The four investigations included 12 villages and 1230 cattle >4 months of age. One investigation assessed the FMD Asia-1 Shamir vaccine, the other three evaluated the recently introduced FMD Asia-1 TUR 11 vaccine made using a field isolate of the FMD Asia-1 Sindh-08 lineage that had recently entered Turkey. After adjustment for confounding, the TUR 11 vaccine provided moderate protection against both clinical disease VE=69% [95% CI: 50%-81%] and infection VE=63% [95% CI: 29%-81%]. However, protection was variable with some herds with high vaccine coverage still experiencing high disease incidence. Some of this variability will be the result of the variation in virus challenge and immunity that occurs under field conditions. In the outbreak investigated there was no evidence that the Asia-1 Shamir vaccine provided adequate protection against clinical FMD with an incidence of 89% in single vaccinated cattle and 69% in those vaccinated two to five times. Based on these effectiveness estimates, vaccination alone is unlikely to produce the high levels of herd immunity needed to control FMD without additional control measures.


Assuntos
Doenças dos Bovinos/epidemiologia , Surtos de Doenças/prevenção & controle , Febre Aftosa/epidemiologia , Vacinação/veterinária , Vacinas Virais/uso terapêutico , Animais , Bovinos , Doenças dos Bovinos/prevenção & controle , Doenças dos Bovinos/virologia , Surtos de Doenças/veterinária , Feminino , Febre Aftosa/prevenção & controle , Masculino , Análise de Regressão , Estudos Retrospectivos , Turquia/epidemiologia , Vacinação/estatística & dados numéricos
12.
Transplant Proc ; 46(1): 33-9, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-24507022

RESUMO

BACKGROUND: To determine effects on calcium and sodium channels of Ca(2+) and Na(+) channel blockers in the present study, expression levels of TRPM1, TRPM2, TRPM3, TRPM4, TRPM5, TRPM6, TRPM7, TRPM8, and NaV1.9 genes were evaluated in kidney tissues after induced ischemia-reperfusion. MATERIAL AND METHODS: Forty albino Wistar male rats were equally divided into 4 groups as follows: group I: control group (n = 10), group II: ischemia group (60 minutes of ischemia + 48 hours of reperfusion; n = 10), group III: ischemia (60 minutes of ischemia + 48 hours of reperfusion) + calcium channel blocker (n = 8), group IV: ischemia (60 minutes of ischemia + 48 hours of reperfusion) + sodium channel blocker (n = 8). RESULTS: When compared to ischemia group expression levels of TRPM2, TRPM4, TRPM6, and NaV1.9 in Ca(2+) and Na(+) channel blocker groups were increased, whereas that of TRPM7 was decreased. However, expression levels of TRPM1, TRPM3, TRPM5, and TRPM8 were not determined in kidney tissue. Histologically, the Ca(2+) channel blocker verapamil and the Na(+) channel blocker lidocaine inhibited the cell death in kidney tissue compared to control. CONCLUSION: Our study suggested that verapamil and lidocaine significantly reduce the degree of ischemia-reperfusion injury due to effects to TRPM and Nav1.9 genes.


Assuntos
Bloqueadores dos Canais de Cálcio/administração & dosagem , Regulação da Expressão Gênica , Nefropatias/tratamento farmacológico , Nefropatias/patologia , Rim/patologia , Lidocaína/administração & dosagem , Canal de Sódio Disparado por Voltagem NAV1.9/metabolismo , Traumatismo por Reperfusão/tratamento farmacológico , Canais de Cátion TRPM/metabolismo , Verapamil/administração & dosagem , Bloqueadores do Canal de Sódio Disparado por Voltagem/administração & dosagem , Animais , Canais de Cálcio/metabolismo , Modelos Animais de Doenças , Masculino , Ratos , Ratos Wistar
13.
Contraception ; 63(6): 309-14, 2001 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-11672552

RESUMO

Women seeking legal first trimester abortion were counseled concerning contraception methods available for use immediately postabortion. Fifty women each accepted hormonal methods that were available only in the clinic and were novel to the country, the levonorgestrel IUD and Norplant implants, whereas another 50 chose either coitus interruptus or abstinence. All were experienced contraceptors, but larger percentages of women selecting the levonorgestrel IUD or implants had used the pill or IUDs previously, were under age 30, and weighed less than 60 kg compared to the other study participants. In the initial 2-6 weeks postabortion, women using the long-acting hormonal methods resumed sexual activity earlier and experienced more bleeding and spotting days than did other study participants, but their hematocrits were not adversely affected. No clinically significant side effects were noted in any group in the 6 weeks following the abortion. At the end of 1 year of follow-up, women using the hormonal methods had experienced no pregnancies and had high rates of continuation. IUD and implant participants had greater weight gain than did the other participants, but their mean weight remained below that of participants using traditional methods. No significant between-group differences in levels or changes in levels from admission were noted in hematocrit and blood pressure. The women found the levonorgestrel implants and IUDs easy and safe to use and highly effective. Bleeding disturbances, including amenorrhea, were the principal features the women disliked.


Assuntos
Aborto Induzido/efeitos adversos , Assistência ao Convalescente , Coito Interrompido/psicologia , Comportamento Contraceptivo/psicologia , Implantes de Medicamento/efeitos adversos , Implantes de Medicamento/uso terapêutico , Dispositivos Intrauterinos Medicados/efeitos adversos , Dispositivos Intrauterinos/efeitos adversos , Levanogestrel/efeitos adversos , Levanogestrel/uso terapêutico , Adulto , Estudos de Coortes , Feminino , Humanos , Satisfação do Paciente , Gravidez , Abstinência Sexual , Fatores de Tempo , Turquia
14.
Int J Gynaecol Obstet ; 74(3): 281-5, 2001 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-11543753

RESUMO

OBJECTIVE: To demonstrate the impact of preabortion counseling followed by immediate postabortal provision of the chosen method on postabortion contraceptive use. METHODS: Three hundred and forty-two women undergoing voluntary termination of pregnancy at less than 10 weeks gestation were enrolled at the Woman and Child Health Training and Research Clinic, Medical School of Istanbul. Clinic visits and telephone surveys were performed to measure contraceptive use at 6 months following abortion. RESULT: Two hundred and thirty-six women either visited the clinic or responded to the telephone survey. Eighty percent of the respondents reported use of a modern contraceptive as compared to less than 40% prevalence found in the national survey. CONCLUSION: Preabortion counseling combined with immediate postabortal provision of contraceptives may significantly increase contraceptive use at 6 months postprocedure.


Assuntos
Aborto Induzido , Comportamento Contraceptivo , Aconselhamento , Adolescente , Adulto , Feminino , Humanos , Pessoa de Meia-Idade , Gravidez , Turquia
15.
J Virol Methods ; 97(1-2): 33-48, 2001 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-11483215

RESUMO

A solid-phase competition ELISA has been developed to measure antibodies to foot-and-mouth disease (FMD) virus and has been validated using an extensive range of sera from cattle. The assay uses polyclonal antisera and inactivated purified 146S antigens of FMD virus and was compared with the liquid-phase blocking ELISA and the virus neutralisation test on a range of serum sets. When examining test sera at a 1:5 dilution with a cut-off point of 30% inhibition of reaction, the solid-phase competition ELISA was as sensitive as the liquid-phase blocking ELISA for sera from infected or vaccinated animals. The limit of detection of the solid-phase ELISA was similar to that of the liquid-phase assay and both tests had lower limit of detection (i.e. were able to detect lower amounts of antibody) than the virus neutralisation test. The specificity of the solid-phase ELISA was considerably higher than that of the liquid-phase blocking ELISA and almost equivalent to that of the virus neutralisation test. The assay thus retains the sensitivity of the liquid-phase blocking ELISA whilst being easier to use, more robust and specific, and therefore offers an improvement for FMD virus antibody detection.


Assuntos
Doenças dos Bovinos/diagnóstico , Doenças dos Bovinos/imunologia , Ensaio de Imunoadsorção Enzimática/métodos , Vírus da Febre Aftosa/imunologia , Febre Aftosa/diagnóstico , Febre Aftosa/imunologia , Animais , Anticorpos Antivirais/imunologia , Antígenos Virais/imunologia , Bovinos , Doenças dos Bovinos/virologia , Febre Aftosa/virologia , Vírus da Febre Aftosa/classificação , Soros Imunes/imunologia , Sensibilidade e Especificidade , Vacinação
16.
Contraception ; 63(5): 267-75, 2001 May.
Artigo em Inglês | MEDLINE | ID: mdl-11448468

RESUMO

The diaphragm is not available in many countries, despite the recommendations of numerous authors that it has important advantages as a woman-controlled method that offers some protection against sexually transmitted diseases, and one that is safe and free of side effects. An interagency team collaborated to introduce the diaphragm in Colombia, the Philippines, and Turkey, using the same protocol to assess the acceptability, service delivery requirements and use-effectiveness of the method. Eighteen public and private sector service delivery sites were involved and a total of 550 women were enrolled in the study. Provider training aimed to improve the quality of care with which all methods were delivered and included counseling about sexuality and reproductive health risks. The cumulative 12-month pregnancy rate of 10.1 (SE 1.7) per 100 woman-years is on the low end of previous studies of the diaphragm, and the 12-month continuation rate (57.2 [SE 2.4] per 100) compares favorably with that for oral contraceptives and the intrauterine device. Focus group discussions conducted with clients and providers indicated that the method was an important alternative for some women, particularly those who had experienced health problems with other methods or were unable to negotiate condom use with their partners. Provider biases diminished as they observed the strategic niche that the diaphragm filled for their clients. While providing the diaphragm requires training and good client-provider interaction, the requirements are consistent with those called for in the Programme of Action of the International Conference on Population and Development (ICPD, 1994). With proper attention to quality of care, the diaphragm can be successfully offered in resource-poor settings.


Assuntos
Dispositivos Anticoncepcionais Femininos/normas , Assistência à Saúde , Aceitação pelo Paciente de Cuidados de Saúde , Adolescente , Adulto , Colômbia , Dispositivos Anticoncepcionais Femininos/economia , Escolaridade , Emprego , Feminino , Humanos , Masculino , Filipinas , Turquia
18.
Reprod Health Matters ; 9(18): 114-25, 2001 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-11765387

RESUMO

In this article we present the results of three studies investigating methods for including men in antenatal education in Istanbul, Turkey. Participants were first-time expectant parents living in low and middle-income areas. After a formative study on the roles of various family members in health during the period surrounding a first birth, an antenatal-clinic-based education programme for women and for couples was carried out as a randomised, controlled study. Based on the results, separate community-based antenatal education programmes for expectant mothers and expectant fathers were tested. There was demand among many pregnant women and some of their husbands for including expectant fathers in antenatal education. In the short term, these programmes seemed to have positive effects on women and men's reproductive health knowledge, attitudes and behaviours. In the clinic-based programme the positive effects of including men were mainly in the area of post-partum family planning, while in the community-based programme positive effects among men were also seen in the areas of infant health, infant feeding and spousal communication and support. Free antenatal education should be made available to all expectant mothers and when possible, men should be included, either together with their wives or in a culture such as that of Turkey, in separate groups.


Assuntos
Pai/educação , Educação em Saúde/organização & administração , Cuidado Pré-Natal/organização & administração , Serviços de Planejamento Familiar , Pai/psicologia , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Cuidado do Lactente , Recém-Nascido , Masculino , Mães/educação , Mães/psicologia , Gravidez , Desenvolvimento de Programas , Avaliação de Programas e Projetos de Saúde , Turquia
19.
Eur J Contracept Reprod Health Care ; 5(2): 119-23, 2000 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-10943574

RESUMO

OBJECTIVE: To make an assessment of the acceptability and cost of subdermal implants, a new method in Turkey, in a free-choice environment. METHODS: The records of women attending a university well-woman clinic in Istanbul, Turkey, were analyzed retrospectively. Among other contraceptives registered in the country, the women were offered subdermal contraceptive implants (Norplant) during counselling sessions. The women who chose implants were invited to attend for follow-up three times during the first 12 months and were advised to return annually thereafter. An estimation of cost was performed for Norplant, using the government price of the implant and the wage rates of public-sector staff. An estimation of cost was also performed for oral contraceptives. RESULTS: Among the 5650 women who applied to the Clinic for contraception between 1 January 1995 and 31 December 1998, 274 women decided to use implants, giving an initial acceptance rate of 5.1%. Continuation rates were 91.8%, 71.6% and 42.5% at 12 months, 24 months and 36 months, respectively. There were no pregnancies within the study period. The only demographic characteristic that was positively related to the acceptability of Norplant was younger age. The cost of contraception with Norplant was found to be lower than that for oral contraceptives. CONCLUSION: The high initial acceptance and continuation rates, combined with its high efficacy, make Norplant a valuable tool for Turkey's National Family Planning Program. Contraception with Norplant is also a cost-effective method, at least for the public sector.


Assuntos
Anticoncepcionais Orais Sintéticos , Levanogestrel , Aceitação pelo Paciente de Cuidados de Saúde , Adulto , Anticoncepcionais Orais Sintéticos/economia , Análise Custo-Benefício , Implantes de Medicamento , Feminino , Humanos , Levanogestrel/economia , Tábuas de Vida , Modelos Logísticos , Cooperação do Paciente , Estudos Retrospectivos , Turquia
20.
FEMS Immunol Med Microbiol ; 24(4): 461-7, 1999 Jul 15.
Artigo em Inglês | MEDLINE | ID: mdl-10435766

RESUMO

Suggested measures to prevent transmission and sequelae of sexually transmitted diseases are almost universally agreed. But the important question to be answered is whether the interventions are worth the resources spent. To facilitate the decision making on resource allocation, the best possible information should be available concerning the relationships between health intervention programs and changes in the health status. Cost benefit analysis is the main approach used to assess the efficiency of any intervention. If the economic benefits of the program are greater than the costs, the program should be seriously considered. Although information about the costs of management of STDs is scarce in developing countries because of the complicated behavioral, social and economic issues involved, it is widely held that making treatment available for curable sexually transmitted diseases represents one of the most cost-effective ways to improve the health in the world.


Assuntos
Doenças Sexualmente Transmissíveis/economia , Análise Custo-Benefício , Humanos
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