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PURPOSE: To describe the experiences of the family caregivers of patients with malignant musculoskeletal tumors. DESIGN AND METHODS: Descriptive qualitative approach using a semi-structured interview guide. SETTING: Orthopaedics Department of the Gulhane Military Medical Academy in Ankara, Turkey. A total of 11 family caregivers aged 25-62 years were recruited. RESULTS: The analysis revealed 5 themes: religious attributions in terms of the cause and treatment of the tumor, the effect of malignant tumor on daily life, the tendency to think positively and constructively and find meaning through caregiving, the anxiety about the prognosis of the malignant tumor, and the support received from significant others. CONCLUSION: It is important to develop effective nursing care to family caregivers of patients with malignant musculoskeletal tumor to understand the physical, emotional, and spiritual experiences in their lives. [ABSTRACT FROM AUTHOR]

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Aim. To determine the effect of preoperative skin preparation procedures performed by nurses on postoperative surgical site infection in abdominal surgery. Background. Despite all interventions, postoperative SSIs still greatly affect mortality and morbidity. Design. This is an experimental study. Methods. Procedures developed for nurse application of preoperative skin preparations were tested on a control group (n = 39) and study group (n = 43). Results. Only clinical routines for preoperative skin preparation were performed on the control group patients. Control group members' skins were mostly prepared by shaving with a razor blade (41%). For the study group members, the researchers used the preoperative skin preparation procedure. Clippers were used to prepare 55Æ8% of study group members while 44.2% of them were not treated with the clipper because their wounds were clean. As a requirement of the procedure, all members of the study group had a chlorhexidine bath at least twice after being hospitalised and at least once a night before the operation under controlled conditions. In the group where chlorhexidine bath was not applied, the infection risk was found to be 4.76 times (95%CI = 1.20--18.83) greater even after corrections for age and gender had been made. The difference between control group and study group with respect to surgical site infections was also statistically significant (p < 0.05). Conclusion. Preoperative skin preparation using clipper on the nights before an operation and a 50 ml chlorhexidine bath excluding head area taken twice in the pre-operative period are useful to reduce SSI during postoperative period. Relevance to clinical practice. We find that preoperative skin preparation using the procedures developed as a result of findings of this study is useful in reducing surgical site infection during the postoperative period. [ABSTRACT FROM AUTHOR]

The aim of this study was to determine nurses' perceptions of the barriers to and facilitators of research utilization in Turkey. Barriers Scale was utilized in the research, and the population was 631 nurses. According to the research results, the first three important barriers were inadequate authority (63.6%), lack of time (54.0%), and insufficient facilities (52.8%). Nurses have perceived the organizational management support as the most important easing factor in their applications (n = 156). It is highly recommended that nurses be trained in research methods and evidence-based practice, that research articles be written more clearly, and that Research and Development centers where nurses could get consultation services be established. Copyright © 2009 by Elsevier Inc. [ABSTRACT FROM AUTHOR]

Aims and objectives. The aim of the study was to examine the effectiveness of a psychoeducation intervention based on Peplau's approach, including problem-solving compared with intervention with medication on post-traumatic stress disorder (PTSD) symptoms and coping of earthquake survivors. Background. Post-traumatic reactions and recovery are the result of complex interactions among biological, personal, cultural and environmental factors. Both psychosocial and psychopharmacological methods have been advised to treat PTSD. The general goal of treatment is to decrease the anxiety and to support these patients in regaining normal daily functions. Design. The study used a pretest to posttest quasi-experimental design with three comparison groups. Methods. The sample of the study included 51 survivors of the Marmara Earthquake who met diagnostic criteria for PTSD. Comparison groups were made up as psychoeducation only, medication only and psychoeducation with medication (PEM). Six semi-structured psychoeducation sessions were conducted individually. Patients in the 'medication only' group did not participate in these sessions. The Clinician Administered PTSD Scale, Hamilton Depression Scale and Coping Strategies Scale were used for the measurements. Results. There was a significant difference between the 'PEM' group and the 'medication only' group with the first group showing greater relief of symptoms. Generally, there were no differences between the 'medication only' and 'psychoeducation only' groups. Avoidance as a coping strategy had significant positive correlations with PTSD and depression outcomes. Conclusions. Patients with PTSD seem to take more advantage from the combined treatment model. Nurses can help the patients with PTSD by teaching them to cope with the symptoms. Relevance to clinical practice. The number and variety of catastrophic events in the world are increasing. Psychiatric nurses should therefore take responsibility regarding the effects of trauma and investigate the ways of working with people who experienced trauma in more detail and develop interventions based on scientific evidence. [ABSTRACT FROM AUTHOR]

Introduction: Atrial conduction time has important hemodynamic effects on ventricular filling and is accepted as a predictor of atrial fibrillation. In this study we assessed atrial conduction time in patients with non ischemic dilated cardiomyopathy (NIDCMP) and functional mitral regurgitation (MR) and aimed to determine factors predicting atrial conduction time prolongation. Methods: Sixty five patients with non ischemic dilated cardiomyopathy who have moderate to severe MR and 60 control subjects were included in the study. In addition to conventional echocardiographic measures used to asses left ventricle and MR, atrial electromechanical coupling (time interval from the onset of P wave on surface electrocardiogram [ECG] to the beginning of A wave interval with tissue Doppler echocardiography [PA]), intra- and interatrial electromechanical delay (intra and inter AEMD) were measured. Results: The correlations between inter AEMD and left atrial (LA) size, MR volume, isovolumetric relaxation time (IVRT), deceleration time (DT), systolic pulmonary artery pressure (PAPs), E/A ratio and E/e’ were very poor. Similarly, intra AEMD was not correlated to LA size , MR volume, IVRT, DT, PAPs, E/A ratio and E/e’. However, both inter AEMD and intra AEMD had good correlation with left ventricular mass index, tenting area (TA), tenting distance (TD), coaptation septal distance (CSD), sphericity index (SI). Conclusion: Prolongation of inter and intra AEMDs were found to be well correlated with parameters reflecting left ventricular and mitral annular remodeling.

Inspiration has an important role in design education. Searching existing design examples is a widely-used practice for inspiration. There are two different approaches regarding exposure of examples in design process. Some researchers claim that examples can inspire designers and increase the originality of outcomes, while other researchers highlight that examples cause fixedness to their features as a negative effect for creativity. The aim of the study is to analyse different modalities of examples, such as text, photograph, diagram, object as stimulation and to examine the impact of quantity, abstraction, proximity and method on each modality in design education. The paper reviews empirical studies of idea exposure from the existing literature and summarizes results relevant to understanding the effects of the design examples. Overall, to avoid the potential negative effect of using examples in different modalities, designers could pay attention quantity, abstraction, and proximity of examples for each modality.

Abstract Introduction Rectus sheath hematoma is an uncommon cause of acute abdominal pain. It is an accumulation of blood in the sheath of the rectus abdominis, secondary to rupture of an epigastric vessel or muscle tear. It could occur spontaneously or after trauma. They are usually located infraumblically and often misdiagnosed as acute abdomen, inflammatory diseases or tumours of the abdomen. Case presentation We reported three cases of rectus sheath hematoma presenting with a mass in the abdomen and diagnosed by computerized tomography. The patients recovered uneventfully after bed rest, intravenous fluid replacement, blood transfusion and analgesic treatment. Conclusion Rectus sheath hematoma is a rarely seen pathology often misdiagnosed as acute abdomen that may lead to unnecessary laparotomies. Computerized tomography must be chosen for definitive diagnosis since ultrasonography is subject to error due to misinterpretation of the images. Main therapy is conservative management.

Background: Myocardial fibrosis (MF) forms part of the arrhythmic substrate for ventricular arrhythmias (VAs)., Objectives: This study sought to determine whether total myocardial fibrosis (TF) and gray zone fibrosis (GZF), assessed using cardiovascular magnetic resonance, are better than left ventricular ejection fraction (LVEF) in predicting ventricular arrhythmias in patients with nonischemic cardiomyopathy (NICM)., Methods: Patients with NICM in a derivation cohort (n = 866) and a validation cohort (n = 848) underwent quantification of TF and GZF. The primary composite endpoint was sudden cardiac death or VAs (ventricular fibrillation or ventricular tachycardia)., Results: The primary endpoint was met by 52 of 866 (6.0%) patients in the derivation cohort (median follow-up: 7.5 years; Q1-Q3: 5.2-9.3 years). In competing-risks analyses, MF on visual assessment (MF VA ) predicted the primary endpoint (HR: 5.83; 95% CI: 3.15-10.8). Quantified MF measures permitted categorization into 3 risk groups: a TF of >0 g and ≤10 g was associated with an intermediate risk (HR: 4.03; 95% CI: 1.99-8.16), and a TF of >10 g was associated with the highest risk (HR: 9.17; 95% CI: 4.64-18.1) compared to patients with no MF VA (lowest risk). Similar trends were observed in the validation cohort. Categorization into these 3 risk groups was achievable using TF or GZF in combination or in isolation. In contrast, LVEF of <35% was a poor predictor of the primary endpoint (validation cohort HR: 1.99; 95% CI: 0.99-4.01)., Conclusions: MF VA is a strong predictor of sudden cardiac death and VAs in NICM. TF and GZF mass added incremental value to MF VA . In contrast, LVEF was a poor discriminator of arrhythmic risk., Competing Interests: Funding Support and Author Disclosures This work was supported by a National Heart and Lung Institute Foundation grant awarded to Drs Prasad, Hammersley, Jones, Tayal, and Halliday as well as a British Society for Heart Failure Research Fellowship and a British Heart Foundation Clinical Research Training Fellowship (FS/CRTF/23/24444) awarded to Dr Mach. Additionally, the study was supported by Rosetrees Trust, the Alexander Jansons Myocarditis UK Foundation, a BHF Intermediate Clinical Research Fellowship awarded to Dr Halliday (FS/ICRF/21/26019), and an MRC Fellowship awarded to Dr Tayal (MRC MR/W023830/1). This work was additionally supported by The British Heart Foundation (RE/18/4/34215; SP/17/11/32885), Royston Centre for Cardiomyopathy Research, Sir Jules Thorn Charitable Trust (21JTA), Medical Research Council (UK), National Institute for Health Research, Royal Brompton Cardiovascular Biomedical Research Unit, and National Institute for Health Research Imperial College Biomedical Research Centre. Medtronic Plc provided funding for the salary as a research fellow for Dr Zegard. Boston Scientific provided funding for Dr Qiu (statistician). These companies had no participation whatsoever in the study. The views expressed in this work are those of the authors and not necessarily those of the funders. Dr Hammersley has received research funding from Siemens. Dr Baruah is an employee of AstraZeneca. Dr Guha has received honoraria from Bayer, Pfizer, Novartis, AstraZeneca, and Servier Laboratories; has received an unrestricted educational grant from Biotronik; and has received travel assistance from Abbott Laboratories, Medtronic, Biotronik, and Boston Scientific. Dr Ware has acted as a consultant for MyoKardia, Foresite Labs, Pfizer, and Health Lumen. Dr Halliday has received honoraria from AstraZeneca. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose., (Crown Copyright © 2024. Published by Elsevier Inc. All rights reserved.)