Medicine and Health Sciences

Purpose/Background: Dopamine receptor blocking agents (DRBAs), also known as antipsychotics, are medications widely used to treat a growing number of mental health diagnoses. However, their utility is limited by the potential to cause serious adverse movement reactions. Akathisia, dystonia, parkinsonism, and tardive dyskinesia (collectively known as extrapyramidal symptoms or EPSs) are associated with reduced social and occupational functioning, negative patient attitudes toward treatment, and nonadherence to pharmacotherapy. Neuroleptic malignant syndrome is a life-threatening reaction that can result from DRBA use and cause musculoskeletal dysfunction. The aim of this study is to profile patients who have developed DRBA-related movement adverse effects and identify risk factors significantly associated with each subtype of EPSs or other movement disorders (OMDs) such as neuroleptic malignant syndrome. Methods/Procedures: A report of all potential DRBA-related EPSs or OMDs occurrences within a large community hospital network was generated using International Classification of Diseases, Ninth Revision (ICD-9) and 10th Revision (ICD-10) billing codes. Each patient encounter was manually reviewed to confirm that a documented case of DRBA-related EPSs or OMDs had indeed occurred and subsequently determine the likely causative agent(s). Findings/Results: The resultant cohort of 148 patients experiencing unique DRBA-related EPS or OMD events was analyzed. The average patient was female, middle-aged, and overweight. The most common DRBAs precipitating EPSs or OMDs were haloperidol and quetiapine. In the population studied, age was significantly associated with the subtype of EPSs experienced such that those patients with akathisia and dystonia tended to be younger, whereas those with tardive dyskinesia tended to be older. Body mass index (BMI) category was also negatively correlated with the incidence of dystonia. In addition, it was observed that exposure to specific DRBAs, classes, and routes of administration significantly affected the risk of developing different subtypes of EPSs or OMDs in the study population. Implications/Conclusions: To our knowledge, this is the first study to describe an association between age and BMI with the risk of akathisia and dystonia, respectively, in patients taking DRBAs. Other trends observed with age and BMI in patients developing DRBA-related EPSs support previously reported findings. Expanding the knowledge base of individual characteristics associated with the risk of developing different subtypes of EPSs or OMDs can help providers and patients anticipate and attempt to mitigate these reactions, and may ultimately improve adherence to DRBA therapy.

[email protected] www.bau-sbdergisi.com ÖZ Anne ölümlerinin başlıca nedenlerinden biri doğum sonu kanamadır. Doğum sonu kanamanın erken tespiti ve doğum sonu kanamaya zamanında ve uygun müdahale edilmesi ebelerin sorumlulukları arasındadır. Uluslararası Ebelik Konfederasyonu (ICM) ve Uluslararası Kadın Hastalıkları ve Doğum Birliği (FIGO), maternal ölüm ve sakatlığın azaltılmasının yanı sıra anne ölümlerinin başlıca nedenlerinden biri olan doğum sonu kanamanın önlenmesi için ortak bir çaba içerisindedirler. Ebeler, doğum sonu meydana gelen kanamalarda, annede oluşabilecek bilinç kaybı ve genel durum bozukluğu için gerekli yaşamsal destek tekniklerini bilmek zorundadır. Ebeler, acil bir durumda tek başına müdahale edemeyeceğinin farkında olmalı ve yardım çağırdıktan sonra acil müdahaleye başlamalıdır. Ayrıca ebelerin gerekli durumlarda tıbbi bir işlemin ne zaman yapılacağını, hangi ilacın kullanılacağını, ilaçların veriliş yolunu ve dozunu bilmesi gerekir. Doğum sonu kanamanın tespit edilemez ve durdurulamaz ise, vücudun kanamaya toleransı hızla azalacak, şok hatta anne ölümüne bile neden olacaktır. Doğum Sonu Kanama, önlenebilir bir sorundur. Kanıt temelli ebelik bakımında, ebelerin doğum sonu kanamayı önleme konusunda oldukça önemli görevleri bulunmaktadır. Ebeler bu nedenle, doğum sonu kanamanın tespiti, önlenmesi ve yönetimi konusunda bilgi ve beceri sahibi olmalıdır. Bu makale, doğum sonu kanama kanamanın yönetimi ve önlenmesinde ebelerin sorumluluklarının önemini vurgulamak amacıyla literatür bilgileri paylaşılarak hazırlanmıştır. ANAHTAR KELİMELER: Doğum sonu, ebelik, kanama. ABSTRACT One of the main reasons of maternal death is postpartum hemorrhage. Early detection of postpartum hemorrhage and timely intervention are among the responsibilities of midwives. In addition to decreasing maternal death and disability in the world, The International Confederation of Midwives and International Federation of Gynecology and Obstetrics (FIGO) are in a struggle for prevention of postpartum hemorrhage which is one of the main reasons of maternal death. The midwives have to know the life-sustaining techniques necessary for the blackouts and disorders which can emerge in postpartum hemorrhages. They should be aware of the fact that they cannot intervene alone in an emergency and should begin immediate treatment after calling for help. They also should know when a medical treatment will be performed, which medicine will be used and the way of medication and potion when necessary. If the postpartum hemorrhage is undetectable and unstoppable, the tolerance of body towards hemorrhage will decrease quickly and the shock will even cause to maternal death. Postpartum hemorrhage is a preventable problem. Mıdwives have highly important duties about preventing postpartum hemorrhage in evidence-based midwifery care. Therefore, they must have knowledge and skill about detection, prevention and management of postpartum hemorrhage. This article was prepared with the purpose of emphasizing the importance of responsibilities which midwives have in the management and prevention of postpartum hemorrhage by sharing the literature data.

Tujuan penelitian ini adalah untuk mengetahui faktor persalinan. Jenis penelitian ini adalah survei analitik dengan rancangan adalah ibu yang melahirkan selama sampling dengan jumlah sampel kasus 71 dan sedangkan analisis multivariat menggunakan regresi logistik ganda. yang berhubungan dengan kejadian perdarahan postpartum adalah partus lama (OR=9,598), paritas (OR=4,264), usia (OR=3,589), jarak per anemia (OR=17,654). Sedangkan variabel riwayat seksio ses Selanjutnya dilakukan analisis mutivariat didapatkan ibu hamil dengan anemia memiliki peluang sebesar 16,972 kali lebih besar untuk mengalami perdarahan postpartum dibandingkan dengan ibu yang tidak anemia. Saran dalam penelitian ini adalah memberikan pen kehamilan minimal 4 kali selama hamil, memberikan motivasi kepada ibu bersalin untuk mengi keluarga berencana, melakukan penanganan anemia dengan baik sesuai standar pengelolaan anemia ser menerapkan penatalaksanaan manajemen aktif kala tiga untuk mengurangi perdarahan Kata Kunci: Perdarahan pasca persalinan FACTORS THAT INFLUENCE Type of study is analytical survey with case control approach. a period during 2014 as many as 1.511 number of sample 71 cases and 71 control. Bivariate analysis using chi square while multivariate analysis using multiple logistic regression. The results showed the variables related with the incidence of postpartum is prolonged labor (OR=9,598) 3.972), a history of postpartum haemorrage (OR = 6.569), anemia (OR = 17.654). While variable a history of section cesarean was not related with p = 0.121 and macrosomia with p = 0.185. Furthermore, multivariate analysis found pregnant women with anemia have the opportunity of hemorrhage postpartum compared to women who are not anemia.Suggestions in this research is to provide health education to pregnant women about antenatal care (ANC) at provide motivation to maternal for follow the birth control program, handling anemia with standardized management of anemia and applying the active management of third stage to accelerating the the release of the placenta, and reduce hemorrhage postpartum ABSTRAK Tujuan penelitian ini adalah untuk mengetahui faktor-faktor yang mempengaruhi kejadian perdarahan. Jenis penelitian ini adalah survei analitik dengan rancangan case control. Populasi tahun 2014 yaitu 1.511. Sampel penelitian diambil secara purposive umlah sampel kasus 71 dan sampel kontrol 71. Analisis bivariat menggunakan chi square sedangkan analisis multivariat menggunakan regresi logistik ganda. Hasil penelitian menunjukkan variabel yang berhubungan dengan kejadian perdarahan postpartum adalah partus lama (OR=9,598), paritas (OR=3,589), jarak persalinan (OR=3,972), riwayat perdarahan postpartum (OR=6,569), Sedangkan variabel riwayat seksio sesaria dan makrosomia ternyata tidak berhubungan. Selanjutnya dilakukan analisis mutivariat didapatkan ibu hamil dengan anemia memiliki peluang sebesar 16,972 kali lebih besar untuk mengalami perdarahan postpartum dibandingkan dengan ibu yang tidak anemia. Saran dalam penelitian ini adalah memberikan pendidikan kesehatan kepada ibu hamil mengenai pemeriksaan kehamilan minimal 4 kali selama hamil, memberikan motivasi kepada ibu bersalin untuk mengi melakukan penanganan anemia dengan baik sesuai standar pengelolaan anemia ser menerapkan penatalaksanaan manajemen aktif kala tiga untuk mengurangi perdarahan pasca persalinan pasca persalinan, Kehamilan, Perempuan ABSTRACT Type of study is analytical survey with case control approach. The population is the mothers who birthing within as many as 1.511. In the taking the number of samples is using purposive sampling. the ntrol. Bivariate analysis using chi square while multivariate analysis using The results showed the variables related with the incidence of (OR=9,598), parity (OR=4,264, age (OR = 3.589), distance of childbirth (OR = 3.972), a history of postpartum haemorrage (OR = 6.569), anemia (OR = 17.654). While variable a history of section cesarean was not related with p = 0.121 and macrosomia with p = 0.185. Furthermore, multivariate und pregnant women with anemia have the opportunity of 16,972 times greater to experience compared to women who are not anemia.Suggestions in this research is to provide health education to pregnant women about antenatal care (ANC) at least four times during pregnancy, to provide motivation to maternal for follow the birth control program, handling anemia with standardized management of anemia and applying the active management of third stage to accelerating the the release of the hemorrhage postpartum. , Pregnancy, Women (2017). Faktor-Faktor Yang Mempengaruhi Terjadinya Perdarahan Aisyah: Jurnal Ilmu Kesehatan. 2 (1), 51 – 60. 60 TERJADINYA faktor yang mempengaruhi kejadian perdarahan pasca. Populasi penelitian secara purposive 71. Analisis bivariat menggunakan chi square Hasil penelitian menunjukkan variabel yang berhubungan dengan kejadian perdarahan postpartum adalah partus lama (OR=9,598), paritas arahan postpartum (OR=6,569), aria dan makrosomia ternyata tidak berhubungan. Selanjutnya dilakukan analisis mutivariat didapatkan ibu hamil dengan anemia memiliki peluang sebesar 16,972 kali lebih besar untuk mengalami perdarahan postpartum dibandingkan dengan ibu yang tidak anemia. didikan kesehatan kepada ibu hamil mengenai pemeriksaan kehamilan minimal 4 kali selama hamil, memberikan motivasi kepada ibu bersalin untuk mengikuti program melakukan penanganan anemia dengan baik sesuai standar pengelolaan anemia serta pasca persalinan. EVENTS The population is the mothers who birthing within. In the taking the number of samples is using purposive sampling. the ntrol. Bivariate analysis using chi square while multivariate analysis using The results showed the variables related with the incidence of hemorrhage), distance of childbirth (OR = 3.972), a history of postpartum haemorrage (OR = 6.569), anemia (OR = 17.654). While variable a history of section cesarean was not related with p = 0.121 and macrosomia with p = 0.185. Furthermore, multivariate times greater to experience compared to women who are not anemia.Suggestions in this research is to provide least four times during pregnancy, to provide motivation to maternal for follow the birth control program, handling anemia with standardized management of anemia and applying the active management of third stage to accelerating the the release of the Perdarahan Pasca

Published in the underground in 1972, Justin Green's Binky Brown Meets the Holy Virgin Mary is an autobiographical graphic memoir concerned with Binky Brown's (Green's comic alter ego) Catholic guilt, sexual awakening, and struggles with OCD. Although Binky Brown is often read as a meditation on sexuality and as the first extended confessional autobiographical comics, no study thus far has investigated Green's refigured and repeated use of tarot cards. In fact, the author himself attests to the influence of tarot cards in the afterword to McSweeney's absolute edition (2009) and in various interviews.

Increasing reliance on statistics for treatment and clinical risk assessment not only leads to the reductive interpretation of disease but also obscures ambiguities, distrust, and profound emotions that are important parts of a patient's lived experience of illness and that should be regarded as clinically and ethically relevant. Enabling critique of the limitations of statistics and illustrating their hegemonic impact on the patient's experience of illness, graphic medicine emerges as a democratic platform where marginalized perspectives on illness experiences are vindicated. Through a close reading of two carer narratives, Mom's Cancer (2006) and Janet & Me: An Illustrated Story of Love and Loss (2004), we illustrate how graphic pathographies represent experiential features of illness that are obscured by overreliance on statistical data. Statistics in Clinics and Comics " Your survival rate is 10%! " the oncologist pronounced after a quick glance at the pathology report of our friend. Although the physician was objectively stating our friend's chances of survival, it had a paralyzing impact on us. Five years has passed since his diagnosis of lung cancer; today, our friend is a successful entrepreneur and a motivational speaker inspiring thousands of cancer patients with his survival saga. In retrospect, the physician's statistical assertion inspired dread in him and all those who were close to him each day. Today, we are relieved that reality was far different from those figures. It was during this span of 5 years of uncertainty that we came across a website called graphicmedicine.org as well as numerous other online sources about illness and survival. The website featured several comics that boldly explored those aspects of illness and health care that physicians and the medical system at large don't convey to patients. The increasing reliance on and ritualistic use of medical statistics for treatment, risk assessment, and other related purposes not only leads to the reductive interpretation of disease but also obscures the ambiguities, distrust, fear, and profound emotions that are important aspects of a patient's lived experience of illness. In Illness as Narrative, Ann Jurecic characterizes such a chasm as " a fundamental incompatibility " 1 between personal experience of illness and statistically mediated measurement. Through critiquing and

With changing literary and socio-cultural conventions, theories on metaphor have undergone revision in their conceptualisation and use since Aristotle's Poetics. Although Aristotle premised his theoretical framework of metaphor on analogy, most contemporary research on metaphor is grounded on its role as a linguistic device and of poetic imagination until the radical exploratory studies made by George Lakoff and Mark Johnson, who redefined metaphor as a characteristic of thought and action. However, a systematic reflection on metaphor as a phenomenon of lived experience and conditions for its expression is lacking in different metaphor theories. Therefore, this essay aims to provide an overview of the major theoretical postulates on metaphor, with an emphasis on Lakoff and Johnson's cognitive metaphor theory (CMT) and its correspondence to expressions of illness experience. Further, the wider implications of using metaphors, especially visual metaphors in graphic pathographies, will be analysed in the essay.

The present article reports a systematic review of reviews and meta-analysis whose main objective was to systematize current evidence of technologies for ageing in place designed to support the daily living of community-dwelling older adults. The broad analysis of the study reported in the present article is useful to inform older adults, practitioners and researchers about the state of the art of technologies for ageing in place. A total of 24 reviews and meta-analysis were retrieved. These studies analyse the impact of different technologies in community-dwelling older adults, considering several outcomes, namely physical activity, nutrition, health education, or loneliness and social isolation.