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This study aimed to assess body image, self-esteem, and dyadic adjustment in surgically menopausal, naturally menopausal, and perimenopausal women. This descriptive and comparative study was conducted in the clinics and polyclinic of a university hospital with a total of 274 women: 91 in the surgical menopause, 91 in the natural menopause, and 92 in the perimenopause groups. An Individual Introduction Form, the Body Cathexis Scale (BCS), Rosenberg Self-Esteem Scale (RSES), and Dyadic Adjustment Scale (DAS) were used for data collection. The women in the surgical menopause group had significantly higher mean scores for RSES and BCS and lower mean scores for DAS than the women in the natural menopause and perimenopause groups, with the higher BCS and RSES scores indicating lower self-esteem and body satisfaction. A weak negative correlation was found among dyadic adjustment, self-esteem, and body image of women in the surgical menopause group. Results showed that body image, self-esteem, and dyadic adjustment in menopausal women were impaired. This impairment was greater in the surgical menopause group than in the natural menopause group. Additionally, the presence of comorbid chronic diseases, less education, and being overweight negatively affected dyadic adjustment in women. Clinicians’ awareness of the importance of the psychological aspects of menopause and the difference in the effects of menopause transition on mental well-being (body image, self-esteem, and marital harmony) according to the occurrence of menopause will enable them to help patients cope more easily with this process.

The study was to evaluate the anxiety, depressive symptoms, hopelessness, and perceived social support of women who became pregnant using assisted reproductive techniques and who were both diagnosed or not diagnosed with threatened miscarriage (TM). Design and Methods: This comparative and descriptive study was carried out with 194 pregnant women with-TM (96) and non-TM (98). The study data were collected using the Pregnant-Women-Information-Form, Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Beck Hopelessness Scale (BHS) and Multidimensional Scale of Perceived Social Support (MSPSS). Findings: Women in the TM group were found to have higher mean scores from the BDI, BAI, and BHS, and a lower mean score from the MSPSS compared to the non-TM group (The group with TM had higher levels of anxiety, depression, and hopelessness than the group without TM, and the level of perceived social support by this group was lower). It was found that there was a strongly significant positive correlation in both groups between the BDI and BAI, and between the BDI and BHS. A strongly significant negative correlation was found between the BDI, BAI, BHS, and MSPSS in the TM group, whereas there was a moderately significant negative correlation in the non-TM group. It was found that there was a statistically significant difference between the mean BDI, BAI, BHS, and MSPSS scores according to age group, educational status, number of interventional in vitro fertilization attempts, and history of depression. In addition, there was a statistically significant difference between the mean BDI, BAI, and BHS scores according to previous abortion and family history of depression in the TM group. Practice Implications: Monitoring symptoms of depression, anxiety, and hopelessness in women diagnosed with TM who have become pregnant after infertility treatment, intervening due to the risk factors involved, may prevent possible mental problems and have a positive impact on the healthy continuation of the pregnancy.

The presence of distant metastases at initial evaluation influences treatment selection, since no effective systemic treatment for disseminated head and neck squamous cell carcinoma (HNSCC) is currently available. The reported sensitivity for the detection of distant metastases by contrast-enhanced (ce)CT and FDG-PET(/CT) differs substantially between studies. We hypothesized that these sensitivity values are highly dependent on the reference standard use, e.g., follow-up term. Therefore, we analyze our results of FDG-PET/CT (including chest ceCT) with long-term follow-up and compare these findings with data from the literature, with particular interest in the different reference standards. Forty-six HNSCC patients with high-risk factors underwent pretreatment screening for distant metastases by FDG-PET/CT (including chest ceCT). In 16 (35%) patients, distant metastases were detected during screening (6 patients) or during a mean follow-up of 39.4 months after screening (10 patients). The sensitivity and negative predictive value were 83.3 and 97.2% when 6 months, 60.0 and 89.9% when 12 months, and 37.5 and 72.2% when 30 months follow-up were used as reference standard, respectively. This is comparable with reported studies with similar reference standards. This critical appraisal on the reference standards used in our and reported studies shows room for improvement for the detection of distant metastases to refrain more patients from unnecessary extensive locoregional treatment for occult metastatic HNSCC.

With this study, it is aimed to review the innovative approaches in nursing education and practices. The articles on innovation in nursing, which are included in various databases, have been exploited by relevant key words and studies that are appropriate for oversight. Nursing services in order to provide planning, strategies and Innovation, the use of the service quality is among important factors that affect directly. Because nurses are responsible for knowing what they are doing and why they are doing while offering complex and important services such as patient care in the existing health care system. At the same time, nurses take responsibility for being a more efficient, higher-quality and cost-effective, when their services are given how and in which ways. Changing and evolving health care system, people basic health needs of people, and therefore also affect the nursing education. Nurses are required to keep pace with development and change in order to achieve effective and desired results when delivering services and to combine innovative approaches with their services. For this reason, the concepts of simulation, technology and knowledge should be integrated into the content of vocational training. Nurse managers should facilitate the creative efforts of teaching staff in their teaching and clinical practice and innovative programs.Keywords: nursing education, nursing management, innovative approaches, nursing practices, innovation JEL Codes: J10, J12, J15 _____________________________________________________________________ HEMŞİRELİK MESLEĞİNDE YENİLİKÇİ YAKLAŞIMLARIN ÖNEMİ ÖZETBu çalışma ile hemşirelik eğitimi ve uygulamalarında gerçekleştirilen yenilikçi yaklaşımların gözden geçirilmesi amaçlanmaktadır. Çeşitli veri tabanlarında yer alan, hemşirelikte inovasyon ile ilgili makaleler, ilgili anahtar kelimeler ile taranmış ve gözden geçirme için uygun olan çalışmalardan yararlanılmıştır. Hemşirelik eğitimlerini ve hasta bakım hizmetlerini planlamak, sunmak ve değerlendirmek için yenilikçi stratejilerin kullanılması, sağlık profesyonelleri olan hemşirelerin vereceği bakımın kalitesini direkt etkileyen önemli faktörlerdendir. Çünkü hemşireler, mevcut sağlık sistemi bünyesinde hasta bakımı gibi ehemmiyetli ve aynı zamanda karmaşık bir hizmet sunarken neyi neden yaptıklarını ve yapılan uygulamaların bilimsel dayanağını bilmeli, sorgulamalı, verilen hizmetin ne şekilde ve nasıl uygulandığında daha etkin, kaliteli ve ekonomik olacağını da araştırmanın sorumluluğunu taşımaktadırlar. Sürekli değişen ve aynı zamanda gelişim gösteren sağlık sistemi, hem insanların temel sağlık ihtiyaçlarını hem de hemşirelik eğitimini dolaylı olarak etkileyebilmektedir. Hemşireler hizmet sunumu yaparken etkili ve istenen sonuçları elde edebilmek için sürekli olan gelişime ve değişime ayak uydurmak ve yenilikçi yaklaşımları hizmetleri ile birleştirmek zorundadırlar, bu nedenle simülasyon, teknoloji ve bilişim kavramları meslekler arası eğitim içeriğine entegre edilmeli, hemşire yöneticiler, öğretim üyelerinin eğitim ve ...

Introduction: diagnostic imaging, fetal monitoring are used in the care of pregnancy. Ultrasound use doubled, even 4/5 per pregnancy. Electronic fetal monitoring, during delivery has increased. 2/3 of perinatal deaths are, ante partum stillbirths. Lack of antenatal care is a major problem in developing countries. Antenatal screening have changed over the years. Clinicians advocate routine ultrasound screening, not known whether detection of these conditions through screening leads to improved perinatal outcome. Objective: To analyze stillbirths in our part of India, during 1998-2007 using RECODE analysis & study the Impact of failed antenatal care, presenting as unbooked delivery. Material and Methods: Outcome of deliveries in two centers in south India was retrospectively evaluated. Both centres are equipped with in-house obstetric and paediatric units. All cases are evaluated using a structured proforma, maternal age, birth order, birth weight, and consanguinity were documented. Maternal illness during pregnancy, intra partum complications, and ultrasound findings were noted congenital anomaly if detected, the type of follow-up given to the pregnant women, was noted. Postmortem analysis, the gold standard for diagnosis of internal anomalies was offered to the couple however no one consented. Observations: Results were grouped as booked births (B), unbooked births (UB). In B, stillbirths are 8/1000, in UB,100.7/1000. Women below 20 years/above 35 yrs were at higher risk in both groups. Recode analysis showed uterine maternal causes in UB, unclassified in Bgr. Conclusion: Stillbirth rate in India 26/1000. Reproductive health improved over the millennium, has reduced UB deliveries.

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Purpose: Pregnancy period is important for all women. The aim of this study was to evaluate mental status, antenatal depression, attachment, and anxiety in pregnant women with fetal complications.Design and Methods: Mothers who had been diagnosed with fetal complications during pregnancy were interviewed after the delivery of their babies. Findings:The results showed that anxiety and depression scores were significantly higher in the mothers who had received psychiatric support treatment. Maternal attachment scores were found low, depression scores were found high in mothers of children with congenital anomalies. Conclusion:According to the results of the study, a maternal attachment was low and depression was high in mothers with congenital anomalies.Practice Implications: Possible psychological problems after birth can be prevented by psychotherapeutic nursing interventions during pregnancy to pregnant women who have babies with fetal anomalies.