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Item Functional Status in Turkish Women with Gynecological Cancer(2014) Akkuzu, Gulcihan; Talas, Melek Serpil; Ortac, FiratBackground: Functional status is the ability to perform daily activities. Little is known about quality of life and health status of gynaecological cancer patients. The present study therefore aimed to evaluate the functional status of women receiving treatment for gynecological oncological disease while not hospitalised. Materials and Methods: This descriptive study covered 42 patients monitored by the Gynecological Oncology Unit in 2011. Data were collected using the Functional Living Index-Cancer and analysed with the chi square test, independent samples t-test, Mann-Whitney U test, one-way ANOVA test and the Kruskal-Wallis H test. Results: Of the 42 cases, 66.7% had been diagnosed within the previous year and 90.5% were undergoing chemotherapy. The most severe symptoms experienced were pain (35.7%), fatigue-weakness (40.5%) and nausea and vomiting (56.5%). Daily activities where the most difficulty was experienced were housework (28.6%), average pace walking (31.0%), carrying more than 5 kg (28.6%). The mean Functional Living Index score was quite high (103.5 +/- 24.1). FLIC-C scale scores did not vary with the educational status, diagnosis duration, and family history of cancer (p>0.05). Conclusions: Evaluation of the functional status of gynecological cancer patients and how they cope with problems should indicate to healthcare professionals what help can be given to maintain quality of life.Item Turkish foreign policy after the 'Arab Spring': from agenda-setter state to agenda-entrepreneur state(2014) Ozpek, Burak Bilgehan; Demirag, YeldaThis article explores Turkey's changing foreign policy approach towards the Middle East after the spread of the Arab upheavals to Syria. Instead of preserving the status quo, Ankara has turned to a revisionist state that has begun to threaten Middle Eastern governments. While Turkey was reluctant to join the foreign military interventions against Middle Eastern regimes, (e. g. Libya) it has been instrumental in immersing NATO in the Syrian civil war. Such transformation ultimately undermines analyses that define Turkey as the kingmaker of the Middle East.Item A View from Young Oncologists on Clinical Trials in Turkey: Obstacles and Solution Proposals(2014) Akman, Tulay; Tanriverdi, Ozgur; Ozturk, Mehmet A.; Petekkaya, Ibrahim; Bakkal, Hakan; Sonmez, Ozlem U.; Avci, Nilufer; Zengin, Seyda; Aksu, Gorkem; Ozyigit, Gokhan; Akbali, HuseyinThere is a new improvement in oncology nearly in every day as a result of preclinical or clinical. As the number of publication per capita, Turkey is far behind the other developed European countries. For example, the number of publications in oncology field is 2.134.964 in the world, it is 15.576 in our country. The most important obstacles for clinical trials in Turkey may be listed as financial problems, difficulties of working conditions, time limitation due to work intensity, inadequate experienced/trained man-power, absence of assistance team at all steps of a scientific trial, difficulties faced during project planning and ethics committee submissions, and lack of motivation. In this article, we, as young oncologists, aimed to discuss the place of Turkey in areas of scientific and clinical trials in the world; underlying causes for inadequate number, type and quality of national studies and possible solution proposals in our country.Item The unmet need for safe abortion in Turkey: a role for medical abortion and training of medical students(2015) Mihciokur, Sare; Akin, Ayse; Dogan, Bahar Guciz; Ozvaris, Sevkat Bahar; 25702066Abortion has been legal and safe in Turkey since 1983, but the unmet need for safe abortion services remains high. Many medical practitioners believe that the introduction of medical abortion would address this. However, since 2012 there has been political opposition to the provision of abortion services. The government has been threatening to restrict the law, and following an administrative change in booking of appointments, some hospital clinics that provided family planning and abortion services had to stop providing abortions. Thus, the availability of safe abortion depends not only on permissive legislation but also political support and the ability of health professionals to provide it. We conducted a study among university medical school students in three provinces on their knowledge of abortion and abortion methods, to try to understand their future practice intentions. Pre-tested, structured, self-administered questionnaires were answered by 209 final-year medical students. The students' level of knowledge of abortion and abortion methods was very low. More than three-quarters had heard of surgical abortion, but only 56% mentioned medical abortion. Although nearly 90% supported making abortion services available in Turkey, their willingness to provide surgical abortion (16%) or medical abortion (15%) was low, due to lack of knowledge. Abortion care, including medical abortion, needs to be included in the medical school curriculum in order to safeguard this women's health service. (C) 2015 Reproductive Health MattersItem Counterfeit Supply Chains(2015) Eser, Zeliha; Kurtulmusoglu, Bahar; Bicaksiz, Adnan; Sumer, Selay IlgazThis paper studies supply chains of counterfeits in Turkey based on insider information from actors in such chains as well as from knowledgeable witnesses. The study depends on semi-structured interviews with actors in or witnesses to such chains. Findings suggest that (i) various forms of counterfeit supply chains exist, (ii) profit margins of counterfeiters seem to be higher than legitimate businesses, (iii) counterfeiters are discouraged if they experience actual or threatened litigation, (iv) law enforcement places higher priority on fighting counterfeits that threaten public health and safety, and (v) counterfeits appear to drive down the prices of legitimate products. Overall, poor action by legitimate businesses against counterfeiters, weak institutional efforts on the part of law enforcement and low consumer awareness appear to foster counterfeit supply chains, or at least contribute to their persistence. (C) 2015 The Authors. Published by Elsevier B.V.Item Problematic Areas Related to Sexual Life of Individuals with Gynecological Cancer: A qualitative Study in Turkey(2015) Pinar, Gul; Pinar, Tevfik; Akalin, Ayse; Saydam, Tulay; Ayhan, AliThis study was conducted to examine problematic areas related to sexual life of individuals with gynecological cancer. Qualitative phenomenological research design was used in the study. The data were collected through "Semistructured In-depth Interview Form" and "Individual Information Form" with 30 women diagnosed with gynecological cancer. In-depth interview technique was used for obtaining data related to sexual problem areas of women. The data obtained were evaluated by content analysis. Average age of women who participated in the study was 46.70 +/- 10.66 (min=30, max=67), and women who were followed for the diagnosis of endometrium cancer (53.3%), ovarian cancer (36.7%), cervical cancer (10%). It was determined that there were significant changes in sexual lives of the individuals following the illness, and that body image, role of sexuality, sexual functions and reproduction ability, which are the four important components of sexual health, were affected unfavorably to a great extent. It was determined in this study that individuals with gynecological cancer face multidimensional problems regarding sexual life. Adoption of holistic approach by health professionals in the evaluation of sexual problems of women and attempting to solve the problem are of significance.Item Design and rationale of dabigatran's stroke prevention in real life in Turkey (D-SPIRIT)(2016) Turk, Ugur Onsel; Alioglu, Emin; Tuncer, Esref; Ozpelit, Mehmet Emre; Pekel, Nihat; Tengiz, Istemihan; Cetin, Nurullah; Dalgic, Onur; Topaloglu, Caner; Bilgin, Nazile; Altin, Cihan; Ozdemirkiran, Tolga; Tuluce, Kamil; Turkoglu, Ebru Ipek; Ozpelit, Ebru; 27138311Objective: The D-SPIRIT registry is designed to investigate the safety and efficacy of dabigatran etexilate in patients with nonvalvular atrial fibrillation (NVAF) and to collect data on outcomes in clinical practice. Methods: The D-SPIRIT is a national, prospective, observational, post-marketing registry involving patients with NVAF who have been taking dabigatran etexilate therapy for stroke prevention for a minimum of 6 months prior to enrollment. The registry will collect and analyze data from routine care, enrolling up to 600 patients in 9 centers. Patients will be followed up for 2 years to evaluate effectiveness and safety. A sample size of 600 subjects is proposed based on the following assumptions; Two-sided significance level of 0.05 (1-sided significance level of 0.025), ischemic stroke incidence rate of 0.768%-1.111%, hemorrhagic stroke incidence rate of 0.109%-0.130%, transient ischemic attack incidence rate of 0.722%-0.623%, therapy discontinuation incidence rate of 40% at day 730, and duration of enrollment period of 12 months with non-uniformed enrollment rate. Ethics approval was given by Dokuz Eyll University Ethics Committee of Clinical Research (2014/54) and approved by the Turkish Ministry of Health. Conclusion: Potential results of D-SPIRIT registry will add data from clinical practice to those from the RE-LY trial to expand knowledge of dabigatran etexilate treatment in patients with NVAF.Item A content analysis of food advertising on Turkish television(2016) Ok, Mehtap Akcil; Ercan, Aydan; Kaya, Fatih Suleyman; 26135584; AAZ-8170-2020The aim of this study was to conduct a comprehensive content analysis of Television (TV) food advertising and compare various food advertisements on free-to-air Turkish national TV channels by broadcast time (duration) and frequency over the period of aweek (19-25 April 2012). TV food advertisements were the unit of content analysis in this study. Each advertisement identified as promoting a food product was analysed for content; non-food advertisements were not analysed, although they were counted as a proportion of the advertisements aired. We recorded all programmes for 4 h each per day (7 p.m.-11 p.m.), totalling 84 h. Five types of food-related advertisements were identified (basic foods, junk foods, meat products, beverages and fast food), and six types of non-food advertisements. The Student t-test and ANOVA were used to compare the mean broadcast time of all prime time advertising for the two groups. The mean broadcast times for prime time, non-food advertisements showed a statistically significant difference (p < 0.05). This difference is related to the prime time period 7 p.m.-8p.m. being considered dinner time for most Turkish families. Additionally, the number and broadcast times of beverage advertisements increased during this time period, while the broadcast time per beverage advertisement decreased (ratio = 20.8 s per ads). As a result, TV food advertising increased not only during dinner time but also in overall broadcast time (per advertisement). These findings may be useful for explaining how advertising can negatively influence food choices, thereby increasing public awareness of the need for health messages targeting obesity.Item Analysis of the treatment costs of HIV/AIDS in Turkey(2016) Malhan, Simtem; Zengin, Tuba Elbir; Yenilmez, Fatma Betul; Dalgic, Canan; Cerci, Pamir; Oksuz, Ergun; Unal, Serhat; 0000-0002-5723-5965; K-8238-2012OBJECTIVE: Infection with the human immunodeficiency virus (HIV), the causative agent of acquired immune deficiency syndrome (AIDS), is a major global health problem. Patients with HIV can live normal lives with today's new treatment options. As the treatment is generally successful, the life expectancy of patients infected with HIV is rising. As a result, the economic burden of HIV treatment on health systems is set to increase. According to the Ministry of Health, there were more than 6000 HIV-positive patients in Turkey in 2013. The aim of this study was to determine the direct costs of HIV treatment in Turkey. METHOD: A retrospective data analysis was performed from the reimbursement agency perspective. Data for 252 patients at a university hospital in Ankara from 2001 to 2012 were used for the analysis. The average costs of treatment per HIV patient and the average costs per HIV patient, depending on the state of the patient's health, were calculated. The latter was determined according to the number of CD4 cells/ml, as defined by the CDC's classification system for HIV infection. The cost of treatment was calculated based on published reimbursement prices in 2013, per patient per year. RESULTS: The CD4 values of 25.3%, 29%, and 45.7% of the 252 patients were < 100 cells/mm(3), 100-300 cells/mm(3), and > 300 cells/mm(3), respectively. The treatment costs per patient per year for 2013 for those with CD4 values of < 100 cells/ mm(3), 100-300 cells/mm(3), and > 300+ cells/mm(3) were $ 5,637.04, $ 2,211.54, and $ 2,182.35, respectively. The weighted average of the treatment cost per patient was $ 3,344.64 for 2013. CONCLUSION: This analysis is unique to Turkey and calculates the cost only of HIV treatment in Turkey. Lower CD4 values are associated with higher treatment costs. Appropriate HIV treatment is crucial for controlling CD4 values and lowering the treatment costs of HIV patients. These findings need to be considered by policy makers who may need to focus on HIV.