The mediating role of depressive symptoms among Turkish population related to gender and low back pain: evidence from a national health survey.

BACKGROUND: Low back pain (LBP), though non-life-threatening, burdens healthcare with treatment expenses and work hours lost. Globally, 70-84% experience it, with risk factors tied to societal structure, income, and living conditions, making it a leading cause of disability. METHODS: This study utilized data from the 2019 Türkiye Health Survey, which consisted of 17,084 individuals aged 15 and above. Our study focused on investigating the factors related to low back pain through a cross-sectional analysis. To analyze these factors, we employed binary multivariate logistic regression. Additionally, we conducted post-hoc analyses to assess the potential mediating effect of depressive symptoms on the relationship between low back pain and gender. RESULTS: We found that 31.9% of the population experienced low back pain, with women being 58% more likely [aOR = 1.58; 95% CI (1.45-1.73)] than men to report symptoms. Individuals aged 55 + years old had a 90% [aOR = 1.90; 95% CI (1.61-2.23)] chance of experiencing low back pain, indicating an age-related increase. In the general population, having depressive symptoms was 2.49 [95% CI (2.23-2.78)] times more likely associated with low back pain. Our mediation analysis showed that gender (i.e., women vs. men), indicated by direct effects with ß-estimates e = 0.78, predicted the likelihood of low back pain. Additionally, the relationship between gender and low back pain, mediated through a history of depressive symptoms, had a significant total indirect effect (i.e., ß-estimate given as e = 0.49). Specifically, a history of depressive symptoms accounted for 17.86% [95% CI (9.67-20.10)] of the association between women having a higher likelihood of low back pain compared to men. CONCLUSION: We observed that a higher likelihood of low back pain associated with gender and aging. Additionally, BMI served as a significant predictor, particularly in adults. Depression mediated the association between gender and low back pain. Acknowledging these associations may help identify and address contributing factors to LBP, potentially increasing awareness and alleviating the burden. Policymakers and healthcare professionals may consider these findings when developing prevention and treatment programs for low back pain.

Understanding adverse childhood experiences and the call for trauma-informed healthcare system in Turkey: a review.

Over the past four decades, research has underscored the significance of approaching and preventing trauma from a systemic standpoint. Trauma-informed care (TIC) methodologies offer a structure for healthcare practices, striving to convert organizations into trauma-informed systems that employ trauma-specific interventions. This review employs epidemiological and household data from Turkey to underscore the importance of integrating trauma-informed care as a means of prevention and intervention. Through a desk review, the study examines the role of adverse childhood experiences (ACEs), delving into their origin from family dynamics, migration, violence, exposure to violence, juvenile delinquency, and child maltreatment. The research highlights innovative healthcare approaches that leverage data to address complex patient health issues while considering mental health needs. In contemporary times, healthcare organizations acknowledge the value of a data-driven approach to make informed clinical decisions, enhance treatment procedures, and improve overall healthcare outcomes. The reviewed research and empirical data furnish proof of the importance of effective and efficient treatment methods that prioritize trauma prevention and treatment, integrating the role of ACEs. This paper seeks to contribute to discussions on transforming the healthcare system to meet the healthcare needs of Turkish households, all the while taking into account the evolving sociopolitical factors that shape Turkey's population characteristics.

Comparative analysis of videofluoroscopy and pulse oximetry for aspiration identification in patients with dysphagia after stroke and non-dysphagics.

PURPOSE: Dysphagia is a prevalent symptom observed in acute stroke. Several bedside screening tests are employed for the early detection of dysphagia. Pulse oximetry emerges as a practical and supportive method to augment the existing techniques utilized during bedside swallowing assessments. Desaturation levels, as measured by pulse oximetry, are acknowledged as indicative of aspiration by certain screening tests. However, the predictive capability of pulse oximetry in determining aspiration remains a subject of controversy. The objective of this study was to compare aspiration and oxygen desaturation levels by time and aspiration severity in dysphagic patients compared to healthy controls. It also aimed to evaluate the accuracy of pulse oximetry by comparing it with VFSS findings in detecting aspiration in both liquid (IDDSI-0) and semi-solid (IDDSI-4) consistencies. MATERIALS AND METHODS: Eighty subjects (40 healthy and 40 acute stroke patients) participated. Patients suspected of dysphagia underwent videofluoroscopy as part of the stroke unit's routine procedure. Baseline SpO2 was measured before VFSS, and stabilized values were recorded. Sequential IDDSI-0 and IDDSI-4 barium tests were conducted with 5 ml boluses. Stabilized SPO2 values were recorded during swallowing and 3-min post-feeding. Patients with non-dysphagia received equal bolus monitoring. Changes in SPO2 during, before, and after swallowing were analyzed for each consistency in both groups. RESULTS: The study revealed a statistically significant difference in SPO2 between patients with dysphagia and controls for IDDSI-4 and IDSSI-0. In IDDSI-4, 20% of patients experienced SpO2 decrease compared to 2.5% in control group (p = 0.013). For IDDSI-0, 35% of patients showed SpO2 decrease, while none in the control group did (p = 0.0001). Aspiration rates were 2.5% in IDDSI-4 and 57.5% in IDDSI-0. In IDDSI-0, SpO2 decrease significantly correlated with aspiration (p = 0.0001). In IDDSI-4, 20.5% had SpO2 decrease without aspiration, and showing no significant difference (p = 0.613). Penetration-Aspiration Scale scores had no significant association with SpO2 decrease (p = 0.602). Pulse oximetry in IDDSI-4 had limited sensitivity (0%) and positive predictive value, (0%) while in IDDSI-0, it demonstrated acceptable sensitivity (60.9%) and specificity (100%) with good discrimination capability (AUC = 0.83). CONCLUSIONS: A decrease in SPO2 may indicate potential aspiration but is insufficient alone for detection. This study proposes pulse oximetry as a valuable complementary tool in assessing dysphagia but emphasizes that aspiration cannot be reliably predicted based solely on SpO2 decrease.

The Effect of Home-Based Telehealth and Postpartum Care Given According to Watson's Theory of Human Caring on the Improvement in the Emotional State of the Mother During the Pandemic Process: A Case Report.

Objective: The purpose of this case report was to evaluate the effect of telehealth and postpartum care provided to a mother with maternal depression according to Watson's Theory of Human Caring during the pandemic on the improvement in the mother's emotional state and to evaluate the applicability of the model. Methods: Edinburgh Postnatal Depression Scale was administered to eight women who responded to the announcement made on social media, and verbal and written permission was obtained from the mother with the highest scale score. A total of six video calls were made with the mother via WhatsApp, twice a week in the first week after postnatal discharge and once a week in the next 4 weeks, in accordance with the form drawn up according to Watson's Theory of Human Caring. Results: In this study, it was observed that home-based telehealth and postpartum care provided using Watson's Theory of Human Caring, which includes a holistic approach, was very useful, and the care provided according to the model provided a positive improvement in the emotional state of the mother with depression. Conclusions: It was concluded that telehealth and postpartum care is useful in home-based care in extraordinary situations/quarantine conditions such as pandemic; care can also be provided in the form of telehealth service according to Watson's Theory of Human Caring to mothers with depression; and care provides positive improvement in the emotional state of mothers.

A Rare Cause of Coagulopathy in the Emergency Department: Cefoperazone Use.

Cefoperazone (CPZ) is an antibiotic widely used for moderate to severe infections, especially in countries where resources are difficult to access. This case report aimed to draw attention to coagulopathy, a potential side effect of CPZ. This side effect can cause high mortality and morbidity in patients. In the mechanism of CPZ causing coagulopathy, it is reported that effects such as binding to vitamin K, disrupting vitamin K metabolism, and preventing platelet aggregation are responsible. In this presentation, a case who came to the emergency department with the complaint of hematuria caused by coagulopathy after the use of CPZ-containing antibiotics (CPZ + sulbactam) is presented.

Investigation of grief and posttraumatic growth related to patient loss in pediatric intensive care nurses: a cross-sectional study.

BACKGROUND AND AIM: Pediatric Intensive Care Units (PICUs) are clinical settings where patient loss is frequently experienced. A sense of professional grief and posttraumatic growth in nurses who have experienced patient loss has a significant impact on psychological and physical health, work satisfaction, turnover rates, as well as on personal and professional relations, and employee loyalty. The aim of this study was to investigate grief and posttraumatic growth in PICU nurses and to examine related factors. METHODS: The study is of cross-sectional design and was conducted with 200 nurses who were working in 87 PICU's around Turkey during the period March 30 - June 30, 2021. Data were collected with a Descriptive Information Form, the Texas Revised Inventory of Grief (TRIG), the Posttraumatic Growth Inventory (PTGI), and an open-ended question asking for suggestions as to how nurses can cope with loss. Online questionnaires were used in the data collection. Descriptive statistics, the student t-test, one-way analysis of variance, and post-hoc tests were employed in the analysis of the data. RESULTS: The nurses' mean scores were 49.425 ± 10.868 on TRIG and 61.450 ± 24.934 on PTGI. A negative weak correlation was found between the intensity of the nurses' grief and their posttraumatic growth (r = 0.144, p = 0.041). Receiving training on dealing with a patient's terminal stage (t=-2.688, p = 0.001), feeling comfortable about providing the patient's care (t = 2.624, p = 0.009) and providing the family with emotional support during patient care (t = 1.979, p = 0.049), and the presence of supporting health professionals reduced levels of grief (t = 2.797, p = 0.000). Being a woman (t = 3.299, p = 0.001), willingness to work in the unit (t=-3.219, p = 0.002), and being given enough time to accept the loss (t = 3.986, p = 0.000) were correlated with higher levels of posttraumatic growth. The nurses most commonly wanted more time allotted to recuperate after a loss (n = 35) and professional support (n = 22). CONCLUSIONS: Nurses experience a moderate sense of grief after a patient's loss. As levels of grief decrease, posttraumatic growth increases. Healthcare administrators and future researchers can benefit from these findings when planning supportive interventions to help nurses cope with their feelings of grief and achieve posttraumatic growth. STRENGTHS AND LIMITATIONS: A limitation of the study is that it was conducted only with nurses who were Association members.

Cyanopropyl functionalized benzimidazolium salts and their silver N-heterocyclic carbene complexes: Synthesis, antimicrobial activity, and theoretical analysis.

The reaction of N-substituted benzimidazole with 4-bromobutyronitrile gives the corresponding benzimidazolium salts as N-heterocyclic carbene (NHC) precursors. Silver(I) carbene complexes are synthesized by the reaction of the corresponding benzimidazolium salts with Ag2 O in dichloromethane. These new NHC precursors and Ag-NHC complexes were characterized by spectroscopy techniques and also screened for their antibacterial activities against the standard bacterial strains Escherichia coli, Pseudomonas aeruginosa, Acinetobacter baumannii, Klebsiella pneumoniae, Staphylococcus aureus, methicillin-resistant Staphylococcus aureus, and Enterococcus faecalis, and the standard fungal strains Candida albicans and Candida glabrata, and promising results were achieved. The compounds were also analyzed by density functional theory (DFT)/time-dependent DFT and docking methods.

Changes in higher-order aberrations after vitrectomy for vitreomacular interface diseases.

BACKGROUND AND OBJECTIVE: To evaluate ocular wavefront aberrations after vitrectomy in patients with vitreomacular interface diseases. METHODS: Thirty eyes of 30 patients with vitreomacular interface diseases were included in this prospective study. A Sirius topographer (SCHWIND eye-tech-solutions, Germany) was used to measure corneal aberrations and a Hartmann Shack aberrometer (IRX-3; Imagine Eyes, Orsay, France) to measure ocular aberrations. Data were recorded at baseline and 3 months after vitrectomy. RESULTS: Eight patients were excluded due to the formation of cataract during the post-operation follow-up period. Data of 22 eyes (13 eyes with epiretinal membrane, two eyes with epiretinal membrane with vitreomacular traction, one eye with vitreomacular traction, and six eyes with macular hole) were analyzed for the study. The corneal aberrations such as coma, trefoil, spherical aberration, and root mean square of total higher-order aberrations did not significantly change after vitrectomy. The preoperative ocular aberrations such as coma 0.33 (0.14-0.47) µm, trefoil 0.28 (0.15-0.44) µm, root mean square of higher-order aberrations 0.51 (0.45-0.68) µm, root mean square of total aberrations 1.38 (1.16-2.60) µm were significantly reduced to 0.21 (0.14-0.29) µm, 0.20 (0.14-0.30) µm, 0.36 (0.21-0.52) µm, 0.15 (1.13-1.41) µm, respectively, after vitrectomy. CONCLUSION: The ocular higher-order aberrations were significantly reduced after vitreomacular surgery for vitreomacular interface diseases.

Retinal and choroidal vascularity changes in healthcare professionals wearing FFP3 respirators.

PURPOSE: To evaluate short-term retinal and choroidal vascularity changes in the healthcare professionals after four hours of use filtering facepiece respirators (FFR). MATERIALS AND METHODS: This prospective study included 20 healthcare professionals. Oxygen saturation, pulse rate, systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), mean ocular perfusion pressure (MOPP), and spectral domain optical coherence tomography (OCT) imaging were evaluated at baseline and after four hours wearing of FFP3 FFRs without an exhalation valve. Superior temporal artery (STA), inferior temporal artery (ITA), superior temporal vein (STV), and inferior temporal vein (ITV) diameter were measured from OCT images. The total subfoveal choroidal area (TCA), luminal area (LA), stromal area (SA) choroidal vascularity index [(CVI), the ratio of LA to TCA] were determined after binarization of enhanced depth imaging OCT (EDI-OCT) images of the choroid. RESULTS: The mean age of the participants was 27.35 ± 2.80 years (range, 25-34). Eight of them were female and 12 were male. After wearing the FFR for four hours, a significant decrease was observed in the mean DBP (p = 0.018), MAP (p = 0.016), and MOPP (p = 0.007) when compared to base-line values. STV diameter (p = 0.019) and ITV diameter (p = 0.046) measurements were found significantly higher than baseline measurements. A significant increase in the choroidal vascularity was observed in the LA (p = 0.004) and TCA values (p = 0.043) after wearing the FFR for four hours. CONCLUSION: The current study shows that after four hours usage of FFR, in addition to systemic changes, retinal and choroidal vascularity might be affected significantly. With further studies, long-term effects and clinical significance of these short-term changes should be investigated on healthcare professionals.

Premature ejaculation in couples using contraceptive withdrawal and associations with characteristics of its use: A cross-sectional study.

This study aimed to investigate the Premature Ejaculation Profile (PEP) and its related factors in couples using contraceptive withdrawal (WD). The study sample was composed of 108 participants including 54 males and 54 females (their partners) who used WD. The data were collected via a questionnaire and the male and female forms of the PEP. The mean total PEP index score of the couples (female (F); 1.69 ± 0.55 and male (M); 1.65 ± 0.36) was below the average possible score. Although both males and their partners generally rated control over ejaculation (F; 57.4%, M; 61.1%) and satisfaction with sexual intercourse (F; 63%, M; 79.7%) as good/very good, they rate personal distress related to ejaculation (F; 64.8%, M; 83.4%) and interpersonal difficulty related to ejaculation (F; 81.5%, M; 92.6%) as 'extremely/quite a lot'. As the time of using WD increased, male control over ejaculation increased (p = .019); as the marriage duration (p = .045) and ages (F; p = .012, M; p = .045) of the couples increased, their problems related to ejaculation increased. According to the results, couples who use WD experience PE-related problems, and the problems they experience vary depending on the period of WD use, marriage duration and age.

The effect of a grief support program on Turkish parents whose babies have died.

The purpose of this study was to determine the effect of the Grief Support Program on the bereavement of parents whose babies had died. The sample consisted of 77 couples. The data was collected by the Texas Revised Inventory of Grief and the Coping Strategies Inventory. The intervention group was offered before, immediately after, and a month after death of their baby in accordance with the Grief Support Program guideline. The Grief Support Program did not affect grief intensity in the short term but had a positive effect 1 year later.

Surgical outcomes of patients with iridocorneal endothelial syndrome: a case series.

The purpose of this study is to report the intermediate-term surgical outcomes of patients with iridocorneal endothelial syndrome-related glaucoma. The medical records of four patients (five eyes) surgery (Ahmed glaucoma valve implantation surgery and EX-PRESS mini shunt) were retrospectively reviewed. Median follow-up after glaucoma surgery was 24 (15-36) months. The preoperative intraocular pressure was significantly reduced from a median of 33 (22.5-36) mmHg on a median of 4 (4-5) glaucoma medications to a median of 12 (10.5-14.5) mmHg on a median of 2 (0-2) medications at last follow-up after surgery (p = 0.043 for IOP and p = 0.042 for glaucoma medications). Median preoperative visual acuity [0.016 (0.008-0.1)] did not change significantly when compared to median visual acuity at last follow-up [0.016 (0.004-0.5)] (p = 0.59). Intraocular pressure control in patients with iridocorneal endothelial syndrome is challenging and may require multiple operations and revisions. Some modifications during glaucoma drainage implant surgery and use of EX-PRESS mini shunt in certain cases could offer an advantage in these patients.

The relation between prepregnancy sexuality and sexual function during pregnancy and the postpartum period: a prospective study.

This study examined the relation between sexual functions of women in prepregnancy (before conception) and during pregnancy and the postpartum period. This study was conducted on 59 healthy pregnant women. Participants were followed from the eighth week of gestation to 6 months after delivery. Sexual function during pregnancy and the postpartum period was shown to have a significant linear correlation with prepregnancy sexuality. There was no relation between pregnancy and postpartum sexuality. All of the participants who had prepregnancy sexual dysfunction continued to experience it during pregnancy, and the majority of them had a significant level of sexual dysfunction in the postpartum period. Our results showed that prepregnancy sexuality plays an important role in maintaining sexuality during pregnancy and the postpartum period.

New Approach in Fibromyalgia Exercise Program: A Preliminary Study Regarding the Effectiveness of Balance Training.

OBJECTIVES: To determine the effectiveness of balance exercises on the functional level and quality of life (QOL) of patients with fibromyalgia syndrome (FMS) and to investigate the circumstances associated with balance disorders in FMS. DESIGN: Randomized controlled trial. SETTING: Physical medicine and rehabilitation clinic. PARTICIPANTS: Patients (N=57) (age range, 18-65y) with FMS were randomly assigned into 2 groups. INTERVENTIONS: Group 1 was given flexibility and balance exercises for 6 weeks, whereas group 2 received only a flexibility program as the control group. MAIN OUTCOME MEASURES: Functional balance was measured by the Berg Balance Scale (BBS), and dynamic and static balance were evaluated by a kinesthetic ability trainer (KAT) device. Fall risk was assessed with the Hendrich II fall risk model. The Nottingham Health Profile, Fibromyalgia Impact Questionnaire (FIQ), and Beck Depression Inventory (BDI) were used to determine QOL and functional and depression levels, respectively. Assessments were performed at baseline and after the 6-week program. RESULTS: In group 1, statistically significant improvements were observed in all parameters (P<.05), but no improvement was seen in group 2 (P>.05). When comparing the 2 groups, there were significant differences in group 1 concerning the KAT static balance test (P=.017) and FIQ measurements (P=.005). In the correlation analysis, the BDI was correlated with the BBS (r=-.434) and Hendrich II results (r=.357), whereas body mass index (BMI) was correlated with the KAT static balance measurements (r=.433), BBS (r=-.285), and fall frequency (r=.328). CONCLUSIONS: A 6-week balance training program had a beneficial effect on the static balance and functional levels of patients with FMS. We also observed that depression deterioration was related to balance deficit and fall risk. Higher BMI was associated with balance deficit and fall frequency.

Domestic sexual violence and sexual problems among gynecology outpatients: an example from Turkey.

Domestic violence is a universal problem, and sexual violence in marriage, in particular, is a hidden form of it. This descriptive, cross-sectional study was conducted to determine to the prevalence of domestic sexual violence by husbands, the prevalence of sexual problems, and the relation of these among married women attending a gynecology outpatient clinic. This study was performed in a university hospital in Turkey and data were collected February-April 2009. The study sample consisted of 200 married women, 53% of whom reported having been exposed to at least one type of domestic sexual violence behaviors by their husbands. Among those behaviors, the rate of marital rape was 33%. The frequency of experiencing any sexual problem was 82%. Women expressed that they mostly had orgasmic problems, and their husbands had premature ejaculation problems. The majority of women who reported sexual violence reported experiencing sexual problems; the frequency of sexual problems was higher in the participants who did (94.3%) than in those who did not report (68.1%) sexual violence (p < .001). Bad sexual harmony (Odds ratio [OR] = 13.50, 95% confidence interval [CI] = 3.87-47.01) and experiencing sexual problems (OR = 12.67, 95% CI = 3.78-42.35) were strongly related to sexual violence in marriage. The results also revealed that the prevalence of sexual violence and sexual problems among those married women who attended gynecology clinics was considerable, even though they did not report this to the health care provider as a problem.

Factors Related to Prevalence of Depression in Türkiye: A Population-Based Study. / Türkiye'de Depresyonun Yayginligi ile Iliskili Faktörler: Nüfusa Dayali Bir Çalisma.

OBJECTIVE: This study aims to determine the prevalence of depressive symptoms in the adult population in Türkiye and to examine the relationship of depression with socio-demographic and behavioral variables and chronic diseases. METHOD: This sturdy utilized data from the 2019 Turkey Health Survey. The Patient Health Questionnaire Depression Module (PHQ- 8) was employed to assess depressive symptoms in the survey. Based on the analysis using the diagnostic algorithm of the PHQ-8, from a total of 17084 people aged 15+ years old who were, we selected 6.4% individuals with depressive symptoms. Then, we randomly selected 1101 individuals without depressive symptoms, comprising of a total of 2202 individuals as the study sample. We assessed the factors associated with depressive symptoms using multivariate logistic regression analyses. RESULTS: The risk of developing depressive symptoms increased with age. Women were more likely to report depressive symptoms. Education, physical activity, and marital status were negatively correlated with reporting depressive symptoms. Further, social support was a protective factor to report depressive symptoms. The presence of chronic diseases was positively associated with depressive symptoms. CONCLUSION: The results showed that point and annual prevalence of depressive symptoms were high. The findings provide a basis for further studies to explore the factors associated with a higher prevalence of depressive symptoms in Türkiye. Our findings could serve as a reference to monitor depression in the country, as well as help in the planning of health resource and identify high risk segments of the population.

Prevalence of Depressive Symptoms and Related Factors in Türkiye: Results of the 2016 and 2019 Turkish Health Survey. / Türkiye'de Depresif Belirtilerin Yayginligi ve Iliskili Etmenler: 2016 ve 2019 Türkiye Saglik Arastirmasi Sonuçlari.

OBJECTIVE: We investigated the prevalence and distribution of depressive symptoms in individuals aged 15 and older, as well as the relationship between depressive symptoms and sociodemographic characteristics, chronic diseases, health status and health behaviors. METHOD: The analysis of data collected from the Türkiye Health Surveys conducted by Turkish Statistical Institute (TURKSAT) in 2016 and 2019 involved using the Chi-Square independence test. Effect sizes were evaluated using Phi or Cramer's V coefficients. Patient Health Questionnaire-8 (PHQ-8) module was used to scan the depressive symptoms. RESULTS: The adult population's point of prevalence of depressive symptoms was 4.7%±0.24 in males and 8%±0.19 in females, with a population total of 6.3%±0.21. The yearly prevalence of depressive symptoms was 6.1%±0.45 in males, 13.2%±0.53 in females and a population total of 10%±0.49. Age, gender, income, education, social support, health status, disability, and chronic illnesses were found to be significant predictors of the incidence of depressive symptoms (p<0,05). The results indicated that the rate of people with depression getting help from psychologists, psychotherapists,and psychiatrists was low. CONCLUSION: Age, gender, income, education, marital status, self-rated health status, social support, number of chronic illnesses, and disability were the most important risk factors for depressive episodes. In addition to such self-reported research completed before the pandemic and Kahramanmaras earthquakes in Türkiye, further studies based on structured diagnostic interviews are required.

Factors associated with HIV-positive status awareness among adults with long term HIV infection in four countries in the East and Southern Africa region: A multilevel approach.

Antiretroviral treatment (ART) appropriately and regularly used decreases the human immunodeficiency virus (HIV) viral load in the bloodstream, preventing HIV-infected people from spreading the infection to others. Disparities in ART adoption persists in East and Southern Africa, with low HIV-positive status knowledge being the primary factor. We investigated individual and household characteristics of HIV-positive status awareness among adults with long-term HIV infection in four East and Southern African countries: Eswatini, Malawi, Tanzania, and Zimbabwe. The study analyzed data from surveys conducted in Eswatini, Malawi, Tanzania, and Zimbabwe in 2015-2016. Only individuals who tested positive for HIV through rapid tests were included in the analysis. Those who already knew they were HIV-positive were categorized as aware, while those who reported being negative, never tested, or didn't know their status were categorized as unaware. Statistical models were used to examine various factors related to HIV awareness. Pooled and country-specific odds ratios were computed. The percentage of people who knew they had HIV ranged from 58% (Tanzania and Malawi) to 87% (Eswatini). After adjusting for other variables, young persons in all countries were less likely to be aware of their HIV-positive status. Gender, marital status, education, working status, household wealth, and urbanization level of households were also associated with HIV-positive status awareness but inconsistent across countries. HIV-positive status awareness in these four East and Southern African nations remained unsatisfactory as compared to the United Nations' 95% guideline, indicating that testing and knowledge of HIV testing in this region still has a lot of potential for improvement. The observed variations among nations may be attributable to differences in HIV pandemic culture and policies. The findings of this study will assist governments determining which subpopulations to target to boost adoption of HIV testing services, as well as in designing and development of policies.

Symptoms experienced by women who enter into natural and surgical menopause and their relation to sexual functions.

We carried out this study to determine which symptoms women experienced according to menopause type and the relation of these symptoms to sexual functions. The patricipants of the study were 250 women who underwent natural menopause and 200 women who underwent surgical menopause. A questionnaire, the Menopause Rating Scale (MRS), and the Golombok Rust Inventory of Sexual Satisfaction (GRISS) provided data. According to the MRS, hot flushes and sweating problems were the most common experiences, and, according to the GRISS, sexual infrequency problems rated highest in both groups. There was a positive relationship between multiple sexual functioning problems and the perceived level of menopausal symptom intensity, especially in surgical menopause women.

The level of grief in women with pregnancy loss: a prospective evaluation of the first three months of perinatal loss.

OBJECTIVE: To prospectively investigate perinatal grief in women with pregnancy loss. METHODS: A total of 215 women (mean (SD) age: 30.7 (5.9) years) who experienced pregnancy loss were included. Data on sociodemographic, marital and obstetric characteristics and Perinatal Grief Scale (PGS) (first 48 h, 1 week, 1 month and 3 months after the loss) were recorded. RESULTS: Active grief scores were lower (p ranged < .05 to <.01), while difficulty coping (p < .05 for each) and despair (p < .05 for each) scores were higher in the 3rd month as compared with prior assessments. All PGS scores at the 48 h and 3rd month assessments were significantly higher in assisted and planned pregnancies (p < .01 for each). Maternal age was positively correlated with 48 h active grief (r = 0.19, p < .001), despair (r = 0.13, p < .05) and total PGS (r = 0.13, p < .05) scores. Parity and the number of children were negatively correlated (r ranged from -0.35 to -0.20, p < .01 for each) with all PGS scores. CONCLUSION: Our findings revealed decrease in active grief levels, whereas gradual increase in difficulty coping and despair in women with pregnancy loss within the first 3 months of losing a child. Our finding indicate association of older maternal age, primiparity, assisted and planned pregnancies with regular antenatal follow up with higher total PGS scores as well as active grief, difficulty coping and despair scores in women regardless of the time of assessment within 3 months after the pregnancy loss.