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Copyright of Brazilian Journal of Occupational Therapy / Cadernos Brasileiros de Terapia Ocupacional is the property of Cadernos de Terapia Ocupacional da UFSCar and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: The simultaneous occurrence of diabetes and cancer may complicate the management of both conditions resulting in poor prognosis and more deterioration of patient‐related outcomes. Objective: To assess the effective provision of clinical pharmacy services and pharmacist‐led counselling program on improving patient‐related outcomes among patients with diabetes and newly diagnosed with cancer during chemotherapy administration. Methods: A single‐centre, prospective, randomised, controlled study was carried out on patients with diabetes newly diagnosed with cancer during chemotherapy administration at the outpatient oncology setting. Patients were assigned as a normal care group receiving only normal care by the oncology care providers and an intervention group receiving both normal and clinical pharmacy care through an extensive oral and written patient education, pharmacotherapy optimisation and regular recommendations for diabetic self‐care activities with three‐month follow‐up. Results: Patients within the intervention group showed a better glycaemic control (p =.049), a significant increase in medication adherence (p =.0049), a significant increase in diabetes self‐care activities, including diet (p =.037), self‐monitoring of blood glucose (p =.027) and foot care (p =.0085) and reported a lower deterioration in quality of life. Conclusion: Patients with diabetes and cancer receiving chemotherapy experienced improved patient‐related outcomes after clinical pharmacy intervention and counselling program compared to the normal care group. [ABSTRACT FROM AUTHOR]

Objective: Testicular cancers (Tca) are most common in men aged 20-34. Despite the increase in its incidence, the mortality rate from Tca decreases. In our study, it was aimed to evaluate the general characteristics, the treatments and survival of the patients who were followed up and treated with the diagnosis of Tca. Materials and Methods: In this study, patients who were admitted to Okmeydanı Training and Research Hospital and Abant İzzet Baysal University, Medical Faculty, Medical Oncology Outpatient Clinic between January 2004 and December 2014 with the diagnosis of Tca, were evaluated retrospectively. Results: In 324 (96.7%) of 332 patients included in the study with the diagnosis of Tca, testicular germ cell tumor (TGCT) was present. Of the patients, 150 (46.3%) had seminoma and 174 (53.7%) had non-seminoma tumors. The median age of patients with TGCT was 32 (minimum 18-maximum 81) years. Non-seminoma group was diagnosed at a younger age (p<0.05). The most common histology in the non-seminoma group was mixed germ cell tumor which was found in 135 patients (77.6%). The stage in which the patients were most diagnosed was stage I (seminoma 73.3% and non-seminoma tumor 44.3%, p<0.001). Distant metastasis was present in 3.5% of patients with seminoma and 32.7% of patients with non-seminoma tumor (p<0.001). It was observed that 98% of the patients in the seminoma group and 85.6% of the patients in the non-seminoma group were in the good prognostic group (p<0.001). Radiotherapy, which was applied in 90 (81.8%) patients, was the most applied treatment in the group with stage I seminoma. In stage I non-seminomatous group, the most common treatment was cisplatin-based combination treatments, which was given to 58 (75.3%) patients. The median follow-up period of patients with stage I seminoma was 60 (minimum 3-maximum 134) months, and the median follow-up period of patients with non-seminoma tumor was 69 (minimum 8-maximum 178) months. Three hundred twelve (96.3%) patients with TGCT survived and 145 (96.7%) in the seminoma group and 167 (96%) patients in the non-seminoma group survived (p>0.05). Conclusion: The majority of our patients were diagnosed at an early stage and were in the good prognostic group. Most of our patients survived during our followup period. [ABSTRACT FROM AUTHOR]

This study aims to elucidate child welfare workers' resilience and coping styles. Data were collected via questionnaire, specifically the Resilience Scale (RS) and Coping Style Scales-Brief Form (CSS-BF). RS-based results indicated intermediate professional resilience (n = 108) wherein professionals protect their resilience with training and peer support or coaching. Emotion-focused coping methods were also found to be effective. Using different methods than those used in this study, future research on professional resilience in other social work areas is recommended. [ABSTRACT FROM AUTHOR]

Purpose: This study, conducted at a public university in Turkey, sought to determine the effects of yoga‐based physical activity on perceived stress, anxiety, and quality of life in young adults. Design and Methods: This study was planned as a semiexperimental nonrandomized study with a control group. Findings: Yoga‐based physical activity decreased the perceived stress and state anxiety levels, but had no effect on trait anxiety levels and quality of life. Practical Implications: It is recommended that yoga‐based treatment can be included in nursing interventions for reducing stress and anxiety levels in young adults. [ABSTRACT FROM AUTHOR]

Background: Lymphedema is an important morbidity due to its physical and psychological restrictions and financial burden in women having breast cancer surgery. The study was performed to examine effects of Health Belief Model (HBM) based nursing interventions given at home visits on prevention of lymphedema in women having breast surgery. Design: The study had an experimental design. Methods: The study included 72 women receiving radiotherapy after breast surgery, of whom 37 formed the intervention group and 35 formed the control group. The sample was based on Consolidated Standard of Reporting Trials (CONSORT). Data were collected with a personal information questionnaire, Quick‐Disabilities of the Arm, Shoulder and Hand Score (Q‐DASH), European Organization for Research and Treatment of Cancer Quality of Life for Breast Cancer 23 (EORTC QLQ‐BR23), Strategies Used by Patients to Promote Health (SUPPH), Arm Circumference Form at three home visits at 3‐month intervals. Results: HBM based nursing interventions regularly offered at home visits were found to create positive changes in behaviour of lymphedema prevention and improve upper extremity functions, reduce side‐effects, relieve arm and breast symptoms, enhance the quality of life, increase self‐efficacy and lower the frequency of lymphedema and costs. Conclusion: The HBM based nursing interventions regularly offered at home visits can create positive changes in behaviour of lymphedema prevention and prevent lymphedema in women receiving radiotherapy after breast surgery. Considering costs of treatment for lymphedema, these interventions can be considered as cost‐effective. Relevance to clinical practice: Nursing interventions directed towards behaviour of preventing lymphedema and follow‐ups in the long‐term should be supported by home visits and reminders through phone calls. Nurses should perform HBM based interventions regularly at home visits to prevent lymphedema. These interventions were found to reduce financial burden and were cost‐effective. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to investigate the effect of reflexology on lactation and postpartum comfort in primiparas giving births through caesarean section. Methods: This randomized controlled trial was conducted in 100 women with first birth through caesarean section between May 2016 and May 2017. Expectant mothers were randomly included into an intervention and a control group. The intervention group consisted of mothers in whom reflexology was performed three times per day at every eight hours for 30 min for 3 days. Results: The mean scores of the breastfeeding chart system and breastfeeding satisfaction scores of the mothers in the intervention group were significantly higher than those of the controls, and the first lactation period of the mothers in the intervention group was shorter than that of the controls. Mean breast‐tension, breast‐heat, and breast‐pain scores were similar in both groups on day 1; however, a significant increase was seen the intervention group on days 2 and 3, compared to those in the controls. The mean scores of the Postpartum Comfort Questionnaire in the intervention group were significantly better than those of the controls. Conclusions: Reflexology starts lactation earlier in mothers giving birth via caesarean section, supports the breastfeeding period, and increases mothers' postpartum comfort. SUMMARY STATEMENT: What is already known about this topic? Immediately after caesarean birth, many women suffer from breastfeeding problems due to pain, fatigue, activity intolerance, anaesthesia, and delayed onset of lactation.As a result of these avoidable problems, the baby cannot get enough breast milk, and mothers' postpartum comfort decreases. What this paper adds? Evidence in the study indicates that nurses can support effective breastfeeding, especially for caesarean‐delivery primiparous mothers, by delivering reflexology, which may start lactation sooner and improve postpartum comfort. The implications of this paper: This randomized controlled trial study provides evidence to support effective breastfeeding, especially for the caesarean‐delivery primiparous mothers, by delivering reflexology, which may start lactation sooner and improve postpartum comfort.This controlled trial study contributes to the knowledge base of healthcare professionals who provide care during childbirth by promoting the ability to offer appropriate interventions according to individual needs. [ABSTRACT FROM AUTHOR]

Objective: The study was conducted to examine the efficacy of a web‐based program, informed by Pender's Health Promotion Model, given to primiparous women on the growth and development of infant, infants' health, and women's self‐efficacy level. Methods: This randomized controlled study with a posttest design was conducted in three primary care clinics. The study group comprised 71 primiparous women and their infants (intervention group: N = 35; control group: N = 36). The women who are at the 33–37th gestational week in the intervention group participated in the web‐based program. They completed four education modules. Women in the control group received routine care in clinics. Data forms were completed in the first week and first, second, and third months postpartum. Breastfeeding status, weight, head circumference, development of infants and women's self‐efficacy were evaluated in the postnatal period up to 3 months. Results: In the intervention group, the ratio of infants who were exclusively breastfed was higher compared to the control group. The mean scores for the LATCH instrument which measures breastfeeding status and Parental Self‐Efficacy Scale, were significantly higher in the intervention compared to the control group (p <.05). Conclusion: The women who participated in the web‐based program demonstrated better self‐efficacy and their infants demonstrated better scores on measures of growth, development, and health than those in the control group. [ABSTRACT FROM AUTHOR]

Objectives: To assess validity and reliability of Turkish oral hygiene‐related self‐efficacy (OHSE) scale, and the scores of general self‐efficacy (GSE) and OHSE in the patients with gingivitis and chronic periodontitis (CP). Additionally, the effect of motivation and oral hygiene instructions on the OHSE scores and plaque index (PI) was also aimed. Materials and methods: GSE and OHSE scores were obtained from 210 patients with gingivitis and CP (Group A). After determination of "cut‐off" values on OHSE scores, patients with OHSE scores <30 (OHSE‐low) and ≥50 (OHSE‐high) were included in Group B (gingivitis, N = 25; CP, N = 27). PI values were determined, and motivation and oral hygiene instructions were performed in Group B at baseline. PI measurements and OHSE questionnaire were repeated at 1 and 3 months. Results: The intraclass reliability coefficient and Cronbach's alpha for Turkish translation of OHSE scale were 0.920 and 0.911. OHSE scores significantly correlated with GSE scores and smokers had lower OHSE scores than those of non‐smokers in patients (n = 210). In both gingivitis and CP groups, OHSE scores increased and PI values decreased at 3 months. PI values were lower in gingivitis and CP groups with OHSE‐high scores compared to patients with OHSE‐low scores at 3 months. Conclusions: Within the limitations of this study, it seems that Turkish version of OHSE questionnaire is reliable and valid. Patients with OHSE‐low scores in both gingivitis and CP groups were less successful in performing daily plaque control, compared to patients with OHSE‐high scores. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the effects of caesarian section (CS) versus vaginal birth (VB) delivery techniques on results from neonatal hearing screening tests (NHSTs). Design: Retrospective analysis. Study sample: A total of 10,767 neonates divided into two groups according to delivery technique underwent NHSTs. Those who failed TEOAE or AABR were sent for diagnostic ABR examination. Results: A total of 5620 of 6044 (92.9%) of the neonates in the CS group passed the TEOAE test bilaterally and 424 (7.1%) failed either unilaterally or bilaterally. In the VB group, 4496 of 4723 (95.1%) neonates passed the TEOAE test bilaterally, while the remaining 227 (4.9%) failed the test either unilaterally or bilaterally. Bilateral passing rate of TEOAE test results was significantly higher in the VB group than the CS group (p < 0.05). The AABR failure rate (unilaterally or bilaterally) was 1% in the CS group, which was significantly higher than that in the VB group (0.6%). Diagnostic ABR bilateral pass rate was not statistically different between the groups. Conclusions: Delivery method was shown to affect the results of NHSTs. We found that the rates of failing the TEOAE and screening AABR examinations were higher among neonates born by CS compared to VB. [ABSTRACT FROM AUTHOR]

Objective: This is a descriptive study that was conducted with the purpose of determining the nonpharmacological practices that are used by cancer patients for controlling the pain that develops in relation to chemotherapy. Method: This study was carried out between May 2015 and December 2015 at a state hospital in Kastamonu, Turkey. It was conducted with 50 patients who were receiving chemotherapy treatment at the state hospital. A personal information form and the McGill Melzack Pain Questionnaire Form were used to collect the data. Descriptive statistics, Mann-Whitney U test and Kruskal-Wallis test were used for the statistical analyses. Findings: It was determined that 54% of the patients felt pain on their torso, 28% had fatiguing pain and 54% stated that they felt pain inside (deep in the body). 64% described their pain as a disturbing sense, while 48% said their pain was intermittent. There was no significant relationship between the pain characteristics of the patients before or after administering chemotherapy drugs and all dimensions of pain, pain index or pain levels (p>0.05). Conclusion: It was found that most patients felt a disturbing form of pain, and the practice they used the most frequently was "restricting movement and self-persuasion." There was no significant relationship between the pain characteristics before or after administering chemotherapy drugs and all dimensions of pain, pain index or pain levels. [ABSTRACT FROM AUTHOR]

Objective: It is unclear whether admissions to the emergency department and administration of medical interventions at this clinic increase in different seasons and working shifts. Aim: The goal of this retrospective and cross-sectional research was to determine the frequency of attending the emergency department according to seasons and working hours, and also to determine the frequency of non-real emergency visits and the frequency of medical procedures performed on patients in a touristic town in Turkey. Methods: The ED visits of 116306 adult and paediatric patients between 1 January and 31 December 2013 were examined retrospectively. The data was obtained from hospital admissions records. Results: Non-emergency visits accounted of 19010 of all ED (p= 0.000). Visits to the emergency department increased in the summer season and in the evening between 16:00 and 24:00 p.m. Non-real emergency visits increased in the summer season and in the 24:00-08:00 p.m. shift (p= 0.000). Final remarks: Hospital management should make personnel planning according to the seasons and shifts in which emergency services are intense for patient and staff safety. [ABSTRACT FROM AUTHOR]

Purpose: To determine the effects of a child and parent program on developing social skills for preventing violent behaviors in children aged 60~72 months through a specially developed pre and posttest, control group, quasi-experimental study. Methods: A social skills development program based on Gardner's Multiple Intelligence Theory was used. The data were collected using the Social Skills Assessment Scale (SSAS), a Chart to Monitor Verbal and Behavioral Violence in Children, the Parental Attitude Scale and the Parent Interview Form. This quasi-experimental study that included a pretest, posttest, and control group had a sample comprising 67 children and parents, with 36 in the experimental group, and 31 in the control group. Results: Over a six-month period, while the social skill scores of the children in the experimental and control groups increased, their violent behaviors decreased (p<.050). Increase in social skill scores and decrease in violent behaviors were higher in the experimental than in the control group children (p<.050). The parents in the experimental group stated that they had started to empathize with their children, using "I" language, and applied rules more consistently after the program. Conclusion: This program was successful in preventing violent behaviors in children through the development of social skills. Hence, it can be effectively implemented through a teacher/nurse collaboration. [ABSTRACT FROM AUTHOR]

Background: Epilepsy is an important disorder that is sometimes accompanied by inattention problems. This study explored the features of seizures in children with epilepsy, with or without attention‐deficit/hyperactivity disorder (ADHD). Methods: Between January 2017 and January 2018, data records of children with epilepsy aged 5–18 years admitted to hospital were retrospectively collected. SPSS 17.0 was used for analyses and P < 0.05 was accepted as significant. Results: Of 301 patients with epilepsy, 32 of them had ADHD. Median age at diagnosis of epilepsy in the epilepsy + ADHD group was lower than in the epilepsy alone group (6 vs 8 years; z = −2.989, P = 0.003). The two groups were similar in terms of duration of epilepsy, seizure types and features of complicated versus non‐complicated epilepsy, number of anti‐epileptic drugs (AED) used (for all, P > 0.05). The epilepsy + ADHD group had a significantly higher prevalence of intellectual disability (31.3% vs 12.6%; χ2(1) = 7.9, P = 0.014) and specific learning disorder (12.5% vs 1.9%; χ2(1) = 11.1, P = 0.009) than the epilepsy alone group (χ2(1) = 11.1, P = 0.009). ADHD medication use was identified in 68.8% of children in the epilepsy + ADHD group. Conclusion: Attention‐deficit–hyperactivity disorder was identified in 11.8% of 5–18‐year‐old children (32/301) with epilepsy in a 1 year period. ADHD is more frequent in children with epilepsy in childhood (5–11 years of age). Epilepsy diagnosis is more frequent in younger children with ADHD. Children with epilepsy and ADHD, also have a significantly higher prevalence of intellectual disability and specific learning disorder. Younger children diagnosed with epilepsy should be carefully monitored for ADHD. [ABSTRACT FROM AUTHOR]

Background: The study investigated the association between varicocele, lower extremity venous insufficiency and hemorrhoidal disease. Methods: The study included 62 patients with varicocele and 60 voluntary subjects with no varicocele. Patients who were diagnosed as having varicocele on physical examination and Doppler ultrasonography were included in the study group. Examination of lower extremity venous insufficiency was performed by physical examination and Doppler ultrasonography. Examination of hemorrhoidal disease was performed by a general surgery specialist. Results: The patients with varicocele had a statistically significant (p < 0.05) higher rates of venous insufficiency of the lower extremities and had a borderline significant difference of higher hemorrhoidal disease rates (p = 0.05). Therewithal incidences of hemorrhoidal disease and lower extremity venous insufficiency were significantly higher in body mass index > 25 and age > 30 years of varicocele patients. Conclusion: There is a statistically significant relation between varicocele, lower extremity venous insufficiency, and hemorrhoidal disease. In particular, varicocele patients who are aged over 30 years and overweight are at higher risk. [ABSTRACT FROM AUTHOR]

This study was carried out to determine the changes in sexual functioning of patients with cancer. We identified the frequency and causes of changes in sexual functioning among patients with cancer, and determined whether this change differed according to age, type of cancer, type of treatment, side effects of drugs, anxiety, depression, and perceived social support. The study was conducted with 192 patients with cancer. Data were collected using the data collection form which included questions about socio-demographic, disease-related characteristics as well as those related to changes in sexual functioning. In addition, the Hospital Anxiety and Depression Scale and the Multidimensional Scale of Perceived Social Support Scale were used. Data were analyzed using the SPSS 15.0 software. For analyzing the data, means, frequencies, percentages, t test and Pearson's Chi square test were used. Of the patients with cancer, 69.3% were experiencing changes in sexual functioning, where 75.9% of those began to have changes in sexual functioning only after the cancer. Experiencing changes in sexual functioning after cancer did not differ according to the type of cancer (when genitourinary cancers and breast cancer were compared to the other cancer types) (p > 0.05). Experiencing changes in sexual functioning after cancer significantly differed according to age, the presence of fatigue, and depression scores (p < 0.05). The mean age of those who experienced changes in sexual functioning after the cancer was lower than those who did not, their fatigue rate and depression scores were higher. It is suggested that healthcare professionals should view sexual functions as vital functions such as movement, eating, and respiration and evaluate patients with regard to those functions. [ABSTRACT FROM AUTHOR]

This descriptive, cross-sectional study investigated problems experienced by patients after undergoing a thyroidectomy. The study included 60 firsttime, post-thyroidectomy patients diagnosed with benign thyroid disease from a university hospital's general surgery clinic in Ankara, Turkey. The data were collected in two stages: interviews with patients on the first day following surgery and postoperative follow-up telephone interviews in each of the first 4 weeks following surgery. The follow-ups revealed that patients principally experienced varying degrees of pain and difficulties in connection with work and recreation, communication, body image, and movement, for up to 4 weeks after surgery. These results showed that patients were particularly prone to problems on the first day and during the first week of the postoperative period; therefore, patients should be provided with follow-up telephone interviews to facilitate easier recovery and to help them overcome any problems experienced during the postoperative period. [ABSTRACT FROM AUTHOR]

Background: Patient falls are the most common adverse safety event in hospitals. Thus, both health institutions and healthcare professionals working in these institutions need to understand the characteristics of patient falls and factors associated with them. However limited studies have been conducted specifically on this topic for hospitalized patients in Turkey. Aims: The aim of this study was to define the frequency of inpatient falls, the characteristics of patients who fall, conditions leading to falls and fall-related characteristics. Methodology: A retrospective study design was used. The study is based on the results of follow-up observations of fall cases in hospitalized patients between January 1, 2012, and December 31, 2017. Data were encoded and analyzed with descriptive statistics, the chi-square test, and and Fisher's exact tests using IBM SPSS Statistics version 22.0. Results: The fall rate was 0.89 per 1000 patient bed days. Our findings showed that falls in the hospital setting were more common in 0-6 and 65 years and over age groups. According to our findings a significant relationship was found between age and factors such as the location of fall, the cause of fall, conditions leading to a fall and the presence and absence of a companion. Conclusions: The results obtained from the study show that each hospitalized patient should be assessed for fall risks by considering their individual characteristics, fall scales should be used and risk reduction strategies should be implemented for high-risk patients and their caregivers. [ABSTRACT FROM AUTHOR]

Aims and objectives: To determine the effect of position change that is applied after percutaneous coronary intervention on vital signs, back pain and vascular complications. Background: In order to minimise the postprocedural complications, patients are restricted to prolonged bed rest that is always accompanied by back pain and haemodynamic instability. Design: Randomised‐controlled quasi‐experimental study. Methods: The study sample chosen for this study included 200 patients who visited a hospital in Turkey between July 2014–November 2014. Patients were divided into two groups by randomisation. Patients in the control group (CG, n = 100) were put in a supine position, in which the head of the bed (HOB) was elevated to 15°, the patient's leg on the side of the intervention was kept straight and immobile; positional change was applied to patients in the experimental group (EG, n = 100). Results: After the procedure in the EG, the systolic blood pressure (T4–T6), the rate of postprocedural vascular complications (1%) and the back pain scores were significantly lower (between T5–T6) than the CG, also, the back pain was the lowest level in the standard fowler's position in the 6th hr wherein the HOB was elevated by 45–60°. Conclusions: It was found that systolic blood pressure and back pain were at the lowest levels in the standard fowler's position in the 6th hr after the procedure when the HOB was elevated 45–60° and the result was clinically significant and the position change decreased back pain without causing any vascular complications. Relevance to clinical practice: Low fowler's position was applied in which HOB was elevated 15–30° and standard fowler's position was applied in which the HOB was elevated 45–60° could be safe and applicable in patients by nurses after the procedure. [ABSTRACT FROM AUTHOR]

Background: The identification of skin toxicities due to radiotherapy in cancer patients is important in planning strategies to eliminate or reduce the severity of potential skin reactions. Objective: The aim of this study was to determine the frequency of skin toxicity in patients receiving radiotherapy and to determine the evidence-based practices of patients in dealing with skin toxicity. Methods: The study sample consisted of 84 patients treated between December 2016 and May 2017 in the Department of Radiation Oncology at a university hospital. Skin toxicity was categorized using the Classification of Skin Reactions Associated with Radiation Therapy Form, which was developed by the Radiation Therapy Oncology Group (RTOG). Data were analyzed using the SPSS 25.0 program. One-way analysis of variance was used to compare quantitative variables; chi-square test was used for categorical variables. A p<0.05 was considered statistically significant. Results: Of the patients who had received radiotherapy, 70.2% (n = 59) had an acute skin reaction, RTOG Grade-1 skin reactions being the most frequent(44%, n = 37). The degree of RTOG skin toxicity was found to increase as the RT dose increased. Evidence-based applications such as aloe vera (8.3%, n = 7), using high-factor sunscreen for sun exposure (16.7%, n = 14), and moisturizing the skin (32.1%, n = 27) were not frequent. The evidence-based practice score of the Grade-1 group (17.00 ± 2.53) was higher than that of the Grade-0 group (12.6 ± 5.44) or Grade 2 and above (14.32 ± 4.25). Conclusion: The findings of this study showed that skin toxicity is quite prevalent among RT patients. Randomized clinical trials are required to propose solutions to this problem. Additionally, these findings support the importance of the patient training for the prevention of skin toxicities and the necessity of taking precautions after the RT treatment. [ABSTRACT FROM AUTHOR]

Aims and objectives: To investigate hospital nurses' involvement in the identification and reporting of medication errors in Turkey. Background: Medication safety is an international priority, and medication error identification and reporting are essential for patient safety. Design: A descriptive survey design consistent with the STROBE guidelines was used. Methods: The participants were 135 nurses employed in a university hospital in Turkey. The survey instrument included 18 sample cases and respondents identified whether errors had been made and how they should be reported. Descriptive statistics were analysed using the chi‐square and Fisher's exact tests. Results: The sample case of "Patient given 10 mg morphine sulphate instead of 1.0 mg of morphine sulphate" was defined as a medication error by 97% of respondents, whereas the sample case of "Omitting oral/IV antibiotics because of the need to take the patient out for X‐rays for 3 hr" was defined as a medication error by only 32.1%. It was found that eight sample cases (omitting antibiotics, diluting norodol drops with saline, giving aspirin preprandially, injecting clexane before colonoscopy, giving an analgesic at the nurse's discretion, dispensing undiluted morphine, preparing dobutamine instead of dopamine and administering enteral nutrition intravenously) were assessed as errors and reported, although there were significant statistical differences between the identification and reporting of these errors. Conclusion: Nurses are able to identify medication errors, but are reluctant to report them. Fear of the consequences was the main reason given for not reporting medication errors. When errors are reported, it is likely to be to physicians. Relevance to clinical practice: The development of a commonly agreed definition of a medication error, along with clear and robust reporting mechanisms, would be a positive step towards increasing patient safety. Staff reporting medication errors should be supported, not punished, and the information provided used to improve the system. [ABSTRACT FROM AUTHOR]

Sleep problems may have negative effects on work–life balance, overall health, and safety. We aimed to investigate the association between sleep disorders and absenteeism and delay to work (being late or tardy) among the working adult population. The study was conducted by using data from a large survey of working adults who participated in the Turkish Adult Population Epidemiology of Sleep Study (TAPES) managed by Turkish Sleep Medicine Society (TSMS). Secondary analyses was employed to examine absenteeism and delay to work and their associations with sleep problems, including sleepiness by Epworth Sleepiness Scale (ESS), parasomnias, sleep apnea (by Berlin Questionnaire), sleep quality (by Pittsburgh Sleep Quality Index), and restless leg. History of any absenteeism and delay to work was observed in 276 (18%) and 443 (29%) out of 1,533 working adults, respectively. In the multivariate analyses, absenteeism was associated with younger age, female gender and poor sleep quality, while delay to work was associated with younger age, poor sleep quality, parasomnia, and sleepiness. In the presence of absenteeism and delay to work, sleep disorders including sleepiness, poor sleep quality, and parasomnia should be considered. Such evaluation may improve worker well-being and provide some additional benefits in terms of increasing productivity and lowering work-related costs. [ABSTRACT FROM AUTHOR]

Copyright of Physiotherapy Canada is the property of University of Toronto Press and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Aim: Anxiety and depression can affect patients with asthma. It has been shown that asthma-related quality of life has previously been associated with asthma control. The aims of the present study were to investigate the frequency of anxiety and depression symptoms among Turkish patients with asthma, and to evaluate the relation of anxiety and depression symptoms with asthma control and quality of life in these patients. Materials and Methods: A total number of 174 patients regularly followed-up by the asthma clinics were included to the study.Since27 patients had bronchiectasis and were receiving concomitant antidepressant therapy, 147 patients were requested to complete the ACT (Asthma Control Test), HAD (Hospital Anxiety Depression) questionnaire and asthma-specific quality of life questionnaire (AQLQ). Results: Of all patients with asthma,30.6% had anxiety symptoms and 45.6% had depression symptoms, while asthma was adequately controlled (ACT≥20) in 49%. Patients with asthma and depression symptoms had significantly lower scores in total AQLQ and in all subgroups (p<0.05). Patients with adequately controlled asthma had higher quality of life and lower HAD anxiety and depression scores. A significant negative correlation was found between HAD anxiety and depression scores, and AQLQ and ACT scores (p<0.001). Conclusion: The prevalence of anxiety and depression symptoms is elevated among Turkish patients with asthma. These patients have poorly controlled asthma and lower quality of life. The presence of anxiety and depression symptoms is negatively associated with asthma control and quality of life. [ABSTRACT FROM AUTHOR]

Backround: Esophagogastroduodenoscopy (EGD) permits endoscopic investigation of the esophagus, stomach and duodenum via the oral route. However, it can give rise to procedure-related anxiety, sensitivity, embarrassment and discomfort, and this can have an adverse impact on the patient's compliance with the procedure Objective: Conscious sedation should be applied in endoscopic procedures only in case of serious and significant anxiety. The purpose of this study was to determine the relationship between patients' anxiety levels before endoscopy and the application of conscious sedation. Methodology: Two hundred forty study patients scheduled for EGD in two public hospitals in Istanbul. Data collected using a data collection form and the Spielberger State and Trait Inventory were expressed as mean, standard deviation, and percentage. Statistical analysis was performed using analysis of variance, Pearson's correlation test, Fisher's exact chi-square test. Results: Patients' mean state anxiety score was 43.7+10.15 and the mean trait anxiety score was 39.05+7.37. State anxiety was high in women (p<0.001), and in patients with no previous experience of endoscopy (p<0.001). State anxiety in patients requesting sedation and analgesia was severe and statistically significant (p<0.001). Conscious sedation was applied to 79.13% of patients whose state anxiety was at a severe level and clinically significant (n=230), but was not applied to 20.87%, the difference between the two being clinically, but not statistically significant. Conclusion: The study shows that the decision to apply conscious sedation was not made in consideration of preoperative anxiety levels. [ABSTRACT FROM AUTHOR]

Objective: This descriptive cross-sectional study was conducted to determine the factors affecting gas pains in infants aged 0-4 months and applications of mothers in this area. Methods: The data of the study were collected by the questionnaire (37 questions) generated by the researchers as a result of the literature review. Data were evaluated and tabulated using average, standard deviation, percent, Fisher's exact test, and the chi-squared test in the SPSS (22.0) package program. Statistical significance was accepted to be p<0.05. Results: The results of this study indicate that in order to alleviate or halt the colic in their babies, mothers often used behavioral therapy (massage, patting on the back, cradling or swinging baby by arms, etc.) followed by drug therapy and natural therapy, respectively. Some sociodemographic characteristics (educational status, age, place of residence, stressful personality) affected the applications for colic. Conclusion: Mothers of babies can be informed and stress can be reduced in parents in hospitals or at home visits regarding the physiology of infantile colic, its effects on infants and the methods used in relieving gas pains by nurses and midwives. [ABSTRACT FROM AUTHOR]

Abstract: Purpose: The aim of this randomized controlled study was to determine the effect of semielevated side‐lying (ESL) and semielevated supine (ESU) positions, which are used to bottle‐feed preterm infants, on their physiological characteristics and feeding performance. Design and Methods: The sample consisted of preterm infants who were born in the 31st gestational week and below, and met the inclusion criteria. A randomization was provided in the sample group with a total of 80 infants including 38 infants in the ESL (experimental) group and 42 infants in the ESU (control) group. Both groups were compared in terms of their SpO2 values, heart rates, and feeding performances before, during, and after the feeding. The data were obtained by using a form for infant descriptive characteristics, feeding follow‐up form, a Masimo Radical‐7 pulse oximeter device, and a video camera. Results: It was determined that the infants in the ESL group had statistically significantly higher SpO2 values (ESL: 96.77 ± 2.51; ESU: 93.48 ± 5.63) and lower heart rates (ESL: 155.87 ± 11.18; ESU: 164.35 ± 6.00) during the feeding compared to the infants in the ESU group (p < .05). Besides, oxygen saturation levels of the infants in the ESU group decreased more (p < .01) and their heart rates increased more (p < .05) during the feeding than those obtained before the feeding compared to the infants in the ESL group. Practice Implications: The ESL position has a more positive effect on oxygen saturation and heart rate of infants and it is more effective in providing a physiological stabilization during the feeding, compared to the ESU position. According to these results, the ESL position can be recommended for preterm feeding. [ABSTRACT FROM AUTHOR]

In Turkey, the high incidences of stomach and oesophageal cancers in East and high incidence of stomach cancer in Northeast regions are remarkable. This study was conducted to identify homecare needs of patients with stomach cancer and their caregivers and the effect of family supportive nursing care on the quality of life of patients and families. The patient and his/her caregiver were assessed with respect to their daily life activities and NANDA was used for the identified nursing diagnoses, NIC for the appropriate interventions and NOC for assessment of the results. This study was conducted in a pre‐test, post‐test, controlled trial model to identify. The sample of the investigation consisted of 72 patients and 72 caregivers. As a data‐collecting instrument, the Quality of Life Scale and Caregiver Quality of Life Index‐Cancer were used. The overall quality of life, global health status and emotional and cognitive functions of the patients in the experimental group improved after the interventions. The overall quality of life and global health status was found to be poorer in the control group patients at post‐test as compared to pre‐test and their physical, role and social functions deteriorated. The caregivers’ quality of life in the control group was affected more negatively with respect to the “Disruption in Daily Life” subscale as compared to pre‐test values. [ABSTRACT FROM AUTHOR]

Aims and objectives: The aim of the study was to investigate the effect of educating nurses on preventing catheter‐associated urinary tract infections in patients who undergo hip fracture surgery. Background: Urinary tract infections after hip fracture surgery are observed at a rate of 12% to 61%, and the most important risk factor associated with urinary tract infection is considered to be the presence of urinary catheters. Nurse education about the use and management of urinary catheters is important to decrease the risk of urinary tract infections. Design: The study was semi‐experimental. Methods: The study was conducted in an orthopedics and traumatology clinic of a training hospital between January 2014–December 2015. After a power analysis was performed, a total of 60 patients fulfilled the criteria to be included in the study, with n = 30 in the pre‐education group and n = 30 in the posteducation group. Nurses who worked in the orthopedics and traumatology clinic of the military hospital were the target population, and 18 nurses who consented to join the study constituted the sample. The “Patient Monitoring Form,” “Nurse Information Form” and “Daily Urinary Catheter Assessment Tool” were used as data collection tools. Results: The mean pre‐education knowledge score of the nurses was found to be 68.05 ± 10.69, while the mean posteducation score was 95.13 ± 6.27. The mean catheter duration decreased from 11.06 ± 6.34 days–3.83 ± 0.95 days after the education. The catheter‐associated urinary tract infection rate decreased by 9.37 per thousand. Conclusion: Educating nurses on preventing catheter‐associated urinary tract infections in patients who underwent hip fracture surgery significantly decreased the rate of catheter‐associated urinary tract infections and the duration of catheterisation. Relevance to clinical practice: The systematic and comprehensive education of all healthcare professionals and the development and practice of catheter removal protocols could contribute to the prevention of catheter‐associated urinary tract infections. [ABSTRACT FROM AUTHOR]

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ABSTRACT Background The process of admission to an ICU may have a negative impact on a patient's physiological parameters and comfort. Aim To determine the effect of providing a patient admission protocol on patients' comfort and physiological parameters prior to admission to the intensive care unit ( ICU). Design A randomized, controlled experimental study. Methods This study included 100 (50 control, 50 experimental) patients who experienced planned admissions to the ICU of a University Hospital. Standard forms were used to record patient information, evaluations and comfort. Data were collected from patients prior to, during and 24 h after admission to the ICU and 24 h after being transferred. The experimental group was admitted to the ICU using the patient admission protocol and the control group underwent routine admittance. Findings There was no significant difference between the groups regarding the individual characteristics, physiology and comfort prior to, during or 24 h after admission to the ICU ( p > 0·05). However, 24 h after being transferred, the experimental group's comfort was significantly higher than that of the control group ( p < 0·01). Conclusions The use of the patient admission protocol does not affect the physiological parameters of patients; however, it does raise the comfort level of patients. Relevance to clinical practice The patient admission protocol specific to the institution (in this context, a unit introductory booklet) should be developed in ICUs. We suggest that admission to the ICU should be carried out in accordance with this protocol. [ABSTRACT FROM AUTHOR]

Aim: The study aims to determine the effect of pre-intervention training provided through therapeutic play on reducing the anxiety of pediatric oncology patients during peripheral catheterization. Materials and Method: This experimental study was conducted between September 2012 and March 2013. The study included 40 children (20 in the control group and 20 in the experimental group) who were receiving treatment for hematological-oncological diseases in the Pediatric Hematology and Oncology Units of Istanbul University, Istanbul Faculty of Medicine and Cerrahpasa Faculty of Medicine, and in the Department of Pediatrics of the American Hospital. The children were randomly allocated into the experiment and control groups. The children were asked to complete an Information Form before the peripheral catheterization. The intervention was explained to the experimental group through therapeutic play. The data obtained through the State-Trait Anxiety Inventory for Children (STAIC) after the peripheral catheterization were analyzed using the Statistical Package for Social Science (SPSS) 21 package for Windows. Findings: It was found that the mean trait anxiety scores were similar and remained moderate in the experimental and control groups; that there wasn’t any statistically difference between the groups (p<0.05); and that the mean state anxiety score of the experimental group was lower than that of the control group (Control: 43.40 ± 5.42, Experimental: 31.50 ± 4.73) and this difference was statistically significant (p<0.001). The state anxiety level was found to be reduced in all children – regardless of the variables – with the training provided through therapeutic play. Conclusion: Children provided training with therapeutic play before the intervention can reduce their anxiety during procedures, such as peripheral catheterization. The use of therapeutic play made widespread in health institutions will decrease both pain and suffering in children. [ABSTRACT FROM AUTHOR]

Purpose This study was conducted to determine the pediatric usage of complementary/alternative medicine (CAM) by parents in Turkey, the incidence of using these methods, and the factors affecting their use. Design and Methods The sectional and relational design of the study included a sample of 497 parents who took children for treatment at the Maternity and Children's Hospital in Giresun, Turkey. Data for the study were collected via the Personal Information Form and the Evaluation Form for Complementary/Alternative Treatment Use. The data collection tools were filled out by the researchers during the face-to-face interviews. Data obtained from the study were analyzed by Pearson chi-square, Fisher-Freeman-Halton and Fisher's exact (posthoc Bonferroni) tests and Z-test. Results It was determined that 97.7% of the parents had used at least one CAM method. Moreover, the parents had used CAM methods mostly for respiratory complaints. The CAM methods were most commonly used for the symptoms of fever, diarrhea, and cough. It was observed that the most commonly used alternative methods in the past were vitamin/mineral remedies, cold treatments, and hodja (Islamic teacher) consultations, while the most common alternative methods currently used are massage, music, and cold treatment. In addition, the differences found between CAM users in terms of sociodemographic characteristics were not statistically significant. Practice Implications : It is crucial for nurses to learn the characteristics of the health/disease treatments used by those with whom they work in order to increase the efficiency of the service they provide. Thus, it was recommended that nurses should be knowledgeable and aware of the benefits/side effects, treatment methods, and contraindications of CAM. [ABSTRACT FROM AUTHOR]

Objective: Although hyperbaric oxygen therapy (HBOT) has long been used for diabetic foot ulcers (DFUs), its effectiveness is still controversial. The aim of this study was to investigate the efficacy of HBOT in the management of DFUs and identify amputation predictors. Method: Patients with chronic DFUs (Wanger grade 2-5) were included in the study, which took place between January 2010 and December 2012. HBOT, 100% oxygen, 2.4 atmosphere absolute (ATA) for 120 minutes, was administered to all patients in addition to standard treatment. DFUs were monitored for at least 3 years, or until healing or amputation occurred. Results: Patients with a total of 146 chronic DFUs were recruited. Complete healing (69.6%) and significant improvement (17.9%) was observed in 87.5 % of the patients. The cases with no improvement resulted in amputation (minor amputation: 15.0%; major amputation: 8.2%). The duration of diabetes (p=0.037), new wound formation (p=0.045), C-reactive protein (p=0.001) and Wagner grade (p=0.0001) were correlated with amputation in multiple regression analysis. Mortality was higher in the amputation group than in the non-amputation group (47.1 % versus 21.4 %, p=0.007). Conclusion: The inclusion of HBOT with standard treatment and a multidisciplinary approach may be useful in the treatment of DFUs. We found the most important predictors of amputation to be Wagner grade and wound infection. Multicentre, prospective, randomised studies are needed to provide more evidence. Declaration of interest: The authors have no conflict of interest. [ABSTRACT FROM AUTHOR]

This research, which is a cross sectional-descriptive study, aims to evaluate the self-esteem and sexual satisfaction of patients aged between 18 and 70 who had bowel stoma and applied to a Stoma Therapy Polyclinic of a university hospital. The study was conducted between 15 October 2015 and 15 January 2016, with 59 patients who applied to the Stoma Therapy Polyclinic and met the research criteria. The data were collected through the Patient Information Form, Rosenberg Self-esteem Scale, and Golombok Rust Inventory of Sexual Satisfaction (GRISS) Female-Male forms. Analysis of the data was performed using Pearson Chi Square test, Fisher Exact, Mann-Whitney U test and Kruskal-Wallis test. Mean score for the patients' total self-esteem was found to be 3.27 ± 2.02, and total GRISS mean score was 58.80 ± 16.44. There was a positive, significant relationship between women's self-esteem and frequency, communication and satisfaction sub-dimensions of GRISS ( p = 0 < 0.05). No significant difference was detected between women's avoidance, touch, vaginismus and anorgasmia scores and their self-esteem ( p > 0.05). As for the male patients, there was a positive, significant relationship between their self-esteem and frequency, communication, satisfaction, avoidance, impotence, and premature ejaculation sub-dimensions of GRISS ( p = 0 < 0.05). Results of the present study show that patients with stoma had moderate levels of self-esteem, they experienced above-moderate levels of sexual problems and there were no significant differences between male and female patients in terms of self-esteem mean scores and sexual functions (except for frequency scores). [ABSTRACT FROM AUTHOR]

Social network sites (SNSs) are relatively new phenomena, and the relationship between SNSs and psychopathology remains unclear. The purpose of this study was to evaluate the type of SNSs depressed adolescents use and the incidence of depressive disclosure on SNSs among them. The study was designed to be cross-sectional. The sample consisted of 53 adolescents diagnosed with depressive disorder, as confirmed by K-SADS-PL, and 55 non-depressed adolescents. The Children’s Depression Inventory, Social Anxiety Scale and Social Network Use Questionnaire were administered. The primary finding was that the amount of time spent on the Internet and on SNSs was significantly higher among depressed adolescents than non-depressed adolescents. Additionally, depressed adolescents reported significantly higher disclosure of anhedonia, worthlessness, guilt, loss of concentration, irritability and thoughts of suicide on SNSs. The intensity of the depression sharing was significantly higher in the depressed group. Depressed young people use social networks to express their symptoms. Adolescents’ disclosure on social networks may be able to guide relatives, friends and mental health professionals. [ABSTRACT FROM PUBLISHER]

By using two-dimensional speckle tracking echocardiography, we aimed to investigate the structural and functional changes on myocardium in chronic asymptomatic alcoholics without any cardiovascular disease. Forty-one consecutive asymptomatic male alcoholics who were admitted to the outpatient alcoholism unit and 30 age matched healthy male volunteers selected as the control group were enrolled in the study. The study group were investigated by using standard two-dimensional echocardiography and speckle tracking echocardiography. The left ventricular (LV) global longitudinal strain and LV global circumferential strain were significantly lower in alcoholics when compared with control subjects. There was no difference in global radial strain between the two groups. To demonstrate the effect of total life time dose of ethanol (TLDE) on echocardiographic abnormalities, we assessed the correlation analysis. There was a nonsignificant weak correlation between global LV circumferential strain and TLDE (r=0.27, p=0.083). Speckle tracking echocardiography derived left ventricular systolic function was impaired in chronic alcoholic patients when compared with healthy controls. [ABSTRACT FROM AUTHOR]

Aim Behçet's disease (BD) is a rare and multisystemic vasculitis disease. In this study, we investigated whether BD had any effect on the biochemical components of first and second trimester aneuploidy screening tests. Methods A case-control retrospective study was conducted with 32 pregnant women with BD and 60 healthy pregnant women as controls. All pregnant womens' first trimester maternal serum pregnancy-associated plasma protein-A, free β-human chorionic gonadotropin and second trimester serum alpha-fetoprotein, unconjugated estriol and total human chorionic gonadotropin levels were examined from medical records. First and second serum screening markers were compared between pregnancies with BD and without. Results There was no difference in age, body mass index and obstetric history between the groups. No significant difference was observed between the groups in terms of first and second trimester serum screening test results in the absence of aneuploidy or neural tube defect. Gestational age at birth, birth weight and neonatal intensive care admission rate were also similar between the groups. Conclusion Both first and second serum screening tests for Down syndrome may be recommended to pregnant women with BD without the need to readjust these markers. Pregnancy with BD was not associated with adverse perinatal outcome with respect to gestational age at birth or birth weight. [ABSTRACT FROM AUTHOR]

Objective: To compare updated weight and height percentiles of 6-17-year-old children from all socio-economic levels in Kayseri with previous local references and other national/international data. Methods: The second study "Determination of Anthropometric Measurements of Turkish Children and Adolescents study (DAMTCA II)" was conducted in Kayseri, between October 2007 and April 2008. Weight and height measurements from 4321 (1926 boys, 2395 girls) school children aged between 6 to 17 years were included in this cross-sectional study. Using these data, weight and height percentile curves were produced with generalized additive models for location, scale and shape (GAMLSS) and compared with the most recent references. Results: Smoothed percentile curves including the 3rd, 5th, 10th, 15th, 25th, 50th, 75th, 85th, 90th, 95th, and 97th percentiles were obtained for boys and girls. These results were compared with DAMTCA I study and with two national (İstanbul and Ankara) and international data from Asia and from Europe. Conclusion: This study provides updated weight and height references for Turkish school children aged between 6 and 17 years residing in Kayseri. [ABSTRACT FROM AUTHOR]

Mobbing is a type of violence which occurs in workplaces and is classified under the community violence subgroup of interpersonal violence. The aim of this study is to examine health care workers who work in primary health care in the city of Mugla and to determine whether there is a relationship between sociodemographic characteristics, work conditions, and their level of mobbing. A cross-sectional analysis has been conducted in which 130 primary health care workers were selected. Of the 130, 119 health workers participated, yielding a response rate of 91.5%; 83.2% of health workers are female, 42.9% are midwives, 27.7% are nurses, and 14.3% are doctors. In all, 31.1% of health workers have faced with “mobbing” in the last 1 year, and the frequency of experiencing “mobbing” of those 48.6% of them is 1 to 3 times per year. A total of 70.3% of those who apply “mobbing” are senior health workers, and 91.9% are female. The frequency of encountering with “mobbing” was found significantly in married health workers, in those 16 years and above according to examined total working time, in those who have psychosocial reactions, and in those who have counterproductive behaviors. It has been discovered that primary health care workers have high prevalence of “mobbing” exposure. To avoid “mobbing” at workplace, authorities and responsibilities of all employees have to be clearly determined. [ABSTRACT FROM AUTHOR]

We aimed to assess the relationship between myeloperoxidase ( MPO) and internal derangement ( ID) of temporomandibular joint ( TMJ) and effects of arthrocentesis procedure, either alone or in combination with hyaluronic acid ( HA) injection on the prognosis of ID of TMJ. A prospective randomised controlled trial has been conducted through patients, who underwent arthrocentesis for the treatment of ID of TMJ, were randomly divided into two groups. Group SS ( n = 10) and Group HA ( n = 14) patients were assigned 0·9% NaCl solution and sodium hyaluronate intra-articularly, respectively. Synovial fluid samples were assayed for MPO at the time of arthrocentesis and pain visual analogue scale ( VAS) and maximum mouth opening ( MMO) scores were recorded at pre- and post-operative periods as well as first-week, first-month and third-month intervals. There was a statistically significant decrease in MPO levels between the first to second arthrocenteses only in Group 2 ( P = 0·001). Both VAS scores and MMO measurements decreased in the course of time following arthrocentesis and do not differ between the patients administered HA or SS. Similarly MPO levels do not change significantly between the two groups at either first or second arthrocenteses. In HA group, MPO levels significantly decreased from first to second sessions. In HA group, MPO levels decreased significantly only in patients with clinical success. Arthrocentesis procedure improves both pain VAS and MMO scores in the course of time, but these parameters do not differ between patients receiving either HA or SS. HA significantly reduces levels of MPO in synovial fluid, but SS does not. HA appears to alleviate inflammation inside the TMJ in patients with TMJ- ID. [ABSTRACT FROM AUTHOR]

Background: One of the most common behavioral problems in patients with dementia is eating problems, which are known to increase the risk of malnutrition. However, few studies have been conducted in this patient group regarding the relationship between eating difficulties and nutritional status. Purpose: This study was designed to determine the eating difficulties faced by patients with dementia and to evaluate the relationship in this population between eating difficulties and malnutrition. Methods: This study was carried out in a dementia outpatient clinic of a university hospital in Istanbul, Turkey. This cross-sectional, case-control study included 50 patients and 50 healthy controls as participants. Participants were assessed for eating difficulties and for nutritional, cognitive, and functional statuses. Results: The patients with dementia had more difficulties in terms of self-feeding skills. Although problems related to manipulating food on the plate and the use of utensils were not seen in the control group, these problems were found in 30% of the participants in the dementia group (p <.001). Moreover, 30% of the patients in the dementia group were unable to eat without assistance (p <.001). Associations were found between eating difficulties and age, duration of illness, and cognitive and functional (basic and instrumental activities of daily living) statuses. In addition, self-feeding skills were found to be associated with nutritional status. Rate of malnutrition or risk of malnutrition was higher in patients with dementia than in those in the control group. Conclusions: In this study, compared with the control group, patients with dementia had more problems in self-feeding skills such as manipulation of food on a plate, use of utensils, need for assistive tools, ability to eat without assistance, and negative eating behaviors (refusal to eat). An association was found between eating difficulties and nutritional status. Evaluating eating difficulties is recommended in patients with dementia to prevent nutritional deterioration. [ABSTRACT FROM AUTHOR]

Objectives. In this study, we aimed to demonstrate the perinatal and neonatal outcomes of patients who were diagnosed with neural tube defect (NTD) in the midtrimester fetal ultrasound scan and refused the request for termination of pregnancy. Material and Methods. The records of 69 patients, for whom NTD was detected in the midtrimester fetal ultrasound scan and who preferred the continuation of the pregnancy after comprehensive counselling about the possible prognosis and treatment options during the period between January 2011 and February 2016, were reviewed retrospectively. Results. Of these patients, 66.7% were 25–35 years old; 95.7% were multiparous; and 1.4% had a history of a fetus having NTD in previous pregnancies. There were 7 (10.1%) neonatal deaths in these patients. Meningomyelocele closure procedure was the most performed surgery in the postnatal period (92%). Of these patients, 30.7% had paraplegia; 51.6% had neurogenic bladder; and 6.4% had infections due to surgery. Conclusion. The results of this study demonstrated perinatal and neonatal outcomes of fetuses with NTD who were not terminated by the preference of the family in midtrimester. The experience of our centre would be beneficial as a tool for nondirective counselling of these patients when considering the antenatal/postnatal care options and postnatal prognosis. [ABSTRACT FROM AUTHOR]

Coronary artery ectasia (CAE) is associated with coronary artery disease (CAD). The underlying pathophysiology of CAE is not fully understood. α1-antitrypsin (A1AT) plays a role in the tissue protease system, and AAT-1 deficiency (A1ATD) has been shown to be related to CAD. We compared A1AT serum levels in patients with and without CAE to determine the association between A1AT levels and the extent of ectasia using the Markis score. We included 50 patients (38 males) with isolated CAE and 46 patients (28 males) with normal coronary arteries after coronary angiography. The levels of A1AT were measured by nephelometry. The median A1AT levels were lower in patients with isolated CAE than in the control group (1.27 ng/mL [range: 1.07-1.37 ng/mL] vs 1.43 ng/mL [range: 1.27-1.59 ng/mL]; P < .001). According to the Markis classification, the extent of CAE was not correlated with A1AT levels (P = .41). Our results demonstrate an inverse relationship between serum A1AT levels and CAE. α1-antitrypsin is fundamental for the stability and integrity of the arterial wall. Lack of elastase inhibition in cases of A1ATD may contribute to ectasia formation by facilitating proteolysis and weakening the arterial wall. [ABSTRACT FROM AUTHOR]

Bilirubin may have important antiatherosclerotic effects. Prediabetes (PD), the intermediate stage before diabetes mellitus, is associated with increased cardiovascular morbidity and mortality. We evaluated the relationship between serum bilirubin levels and carotid intima–media thickness (cIMT), as a surrogate marker of subclinical atherosclerosis, in patients with PD. We enrolled 170 consecutive patients with PD. The patients underwent ultrasonography to evaluate cIMT. The patients were divided into groups according to cIMT values (<0.9 vs ≥0.9 mm). The patients with cIMT ≥ 0.9 mm had significantly higher diastolic blood pressure, neutrophil–lymphocyte ratio (NLR), and glycated hemoglobin values compared with patients having cIMT < 0.9 mm, whereas total and direct bilirubin values were significantly lower in this group. Multivariate regression analyses revealed NLR and total bilirubin as the independent predictors of subclinical atherosclerosis. The present study demonstrated that NLR and lower total bilirubin levels were independent predictors of subclinical atherosclerosis in patients with PD. Simple measures such as NRL and total bilirubin may provide predictive information regarding the risk of cardiovascular disease in patients with PD. [ABSTRACT FROM AUTHOR]

Background Despite concerns about complications with the implantable cardioverter defibrillator (ICD), it is effective for the prevention of sudden cardiac death (SCD). We aimed to analyze our midterm experience with ICD in children and young adults. Methods This retrospective study included patients who were implanted with an ICD between 2001 and 2014. Demographic characteristics, clinical information, shock features, and complications for all patients with ICD were analyzed. The study population was divided into two groups: early-era patients implanted before 2008, and late-era patients implanted after 2008. Results Sixty-nine patients (median age: 12 years, median follow-up: 52 months) were implanted with an ICD. Diagnostic categories were channelopathy (56.6%), cardiomyopathy (36.2%), congenital heart disease (5.8%), and other (1.4%). We performed implantation for primary prevention in 66.6% (39.3% in early-era patients and 85.4% in late-era patients). Thirty-one (44.9%) received 139 appropriate shocks (66% of total shocks) while 14 (20.2%) received 71 inappropriate shocks. However, there was no statistically significant difference in the use of appropriate shocks in the primary (66.7%) versus the secondary (72.2%) prevention groups. The incidence of appropriate and inappropriate shock was 66.7% and 33.3% in the primary prevention group, and 72.2% and 27.8% in the secondary prevention group, respectively. Two patients died, although only one death was the result of a lead problem. Conclusions Although lead integrity problems, inappropriate shocks, and infections are significant issues, ICD therapy appears to be a safe, effective, and necessary option for the prevention of SCD in both children and young adults. [ABSTRACT FROM AUTHOR]

Background The purpose of this study is to assess the electrocardiographic and electrophysiological parameters of conduction abnormalities in patients undergoing transcatheter aortic valve implantation (TAVI) due to severe aortic valve stenosis. Methods The study included 55 patients who underwent TAVI using either the Boston Scientific Lotus (n:25) (Boston Scientific, Natick, MA, USA) or Edwards Sapien XT (n:30) (Edwards Lifesciences, Irvine, CA, USA) prostheses. An electrophysiological study (EPS) was performed in the catheterization room immediately before the initial balloon valvuloplasty and immediately after prosthesis implantation. Results QRS duration and His-bundle to His-ventricle (HV) intervals, which were similar between the two groups before the procedure, were found to be significantly higher in the Lotus valve group postprocedure. Permanent pacemakers (PPMs) were required more frequently in the Lotus group than in the Sapien XT group at discharge (24.0% vs 6.7%, P = 0.07). With the exception of a higher prevalence of paravalvular leakage (P < 0.001) in patients undergoing Sapien XT implantation, other clinical outcomes were similar between the two groups. Multiple regression analysis revealed that baseline atrioventricular (AV) conduction disorders and HV intervals after the procedure were independently associated with PPM implantation after TAVI. Conclusion In this first study comparing the findings of EPS and electrocardiography, the impact of the Lotus valve on AV conduction systems was greater than that of the Sapien XT. However, the need for PPM was higher in the Lotus valve than in the Sapien XT. PPM requirement is related to valve design; it may decrease with reduced frame height and metal burden in novel valve systems. [ABSTRACT FROM AUTHOR]

Objective: It is suggested that vitamin D is one of the factors that can regulate the function of Treg cells. In this study, the relationships between Treg cells and vitamin D levels was investigated in pediatric chronic autoimmune thyroiditis (CAT) patients. Methods: Thirty-two children with CAT and 24 healthy subjects were studied. FOXP3 expressing CD4+CD25+high Foxp3+T cells were identified as Treg cells. At diagnosis, 25-hydroxycholecalciferol (25OHD3) levels were determined in all patients. FOXP3 expression was measured before and after vitamin D replacement therapy in patients having low levels of 25OHD3. Results: In the CAT patients, Treg cell levels did not differ from the control group, while the frequency of vitamin D deficiency was higher and FOXP3 molecule expression was lower. FOXP3 molecule expression significantly increased in CAT patients having vitamin D deficiency who were given vitamin D replacement. Conclusion: FOXP3 expression is decreased in pediatric CAT patients. This reduction seems to be associated with vitamin D levels. Vitamin D can play a role in enhancing natural Treg cell functions. [ABSTRACT FROM AUTHOR]

What is known and objective Antibiotic therapy aimed at eradicating Pseudomonas aeruginosa ( Pa), and improved regimens to treat chronic Pa infection have played a major role in increasing the median survival of patients with cystic fibrosis ( CF). However, different clinical centres use varying eradication regimens. The aim of this study was to evaluate the efficacy of multiple eradication treatments against initial Pa infection and to determine the factors affecting the treatment success. Methods This study was conducted at the Hacettepe University Department of Pediatric Pulmonology. We examined the demographic, clinical and microbiological data of 146 CF patients with first Pa isolation in sputum culture from all 630 patients with CF studied. We aimed to identify the factors that affected the eradication of Pa infection and assessed the success rates of the different eradication protocols used. Results and discussion The mean age of the patients was 71·5 months (2 months-29 years) when Pa was first isolated; the mean duration from CF diagnosis to first Pa isolation was 40 months. The most common treatment choices consisted of 2 weeks of intravenous ceftazidim-amikacin for severe exacerbation or 3 months of inhaled gentamycin combined with 3 weeks of oral ciprofloxacin for mild exacerbation in asymptomatic patients. With these treatment regimens, eradication was observed in 47 patients (32%), intermittent colonization in 42 patients (28%) and chronic colonization in 57 patients (40%). Forced expiratory volume in 1 s decline was statistically significant in patients with chronic colonization ( P = 0·006). Being older than 2 years of age or having symptoms at the first Pa isolation was negatively associated with the treatment success. What is new and conclusion Early antibiotic treatment for Pa can eradicate the bacteria, prevent or delay the development of chronic colonization and improve the general health status. The acquisition of Pa at an older age and having symptoms at first isolation negatively affected the success of eradication. The use of intravenous antibiotics may increase the efficacy of therapy. Inhaled tobramycin for Pa eradication was approved for reimbursement in Turkey from August 2014. The relatively low eradication rate may be explained by a lack of reimbursement for inhaled tobramycin and colistin in our country during the study period. [ABSTRACT FROM AUTHOR]

We investigated whether serum bilirubin level (a marker of heme oxygenase activity) is a predictor of thrombus burden in patients with acute myocardial infarction. Patients (n = 229; male 72.9%; mean age 63 ± 13.4 years) who were admitted with ST-segment elevation myocardial infarction (STEMI) were enrolled. Patients were divided into 2 groups. Group 1 was defined as low thrombus burden and group 2 was defined as high thrombus burden. Patients with high thrombus burden had higher total bilirubin levels (14.4 [4.3-22.9] vs 7.7 [2.4-20.3] µmol/L, P ≤ .001), (0.84 [0.25-1.34] vs 0.45 [0.14-1.19] mg/dL P ≤ .001) and direct bilirubin levels (3.1 [2.1-8.4] vs 1.7 [0.5-6.5] µmol/L, P ≤ .001), (0.18 [0.03-0.49] vs 0.10 [0.03-0.38] mg/dL, P ≤ .001). At multivariate analysis, total bilirubin (odds ratio: 1.05, 95% confidence interval: 1.03-1.08, P ≤ .001) was the independent predictor of high thrombus burden. In conclusion, total bilirubin level is independently associated with high thrombus burden in patients with STEMI. [ABSTRACT FROM AUTHOR]