The Edinburgh feeding evaluation in dementia (EdFED) scale: A Turkish validity and reliability study

AIM

The present study aimed to adapt the Edinburgh Feeding Evaluation in Dementia (EdFED) Scale to Turkish.

METHOD

This methodological study was reported using STARD (The STAndards for Reporting of Diagnostic Accuracy). The sample included 200 people with dementia. The data were obtained using the Personal Information Form, the Edinburgh Feeding Evaluation in Dementia Scale, and the Mini Nutritional Assessment Test. For the Turkish adaptation of the scale, construct validity (confirmatory factor analysis), criterion validity (concurrent scale validity) and reliability analysis (Cronbach's α coefficient, item-total score correlation) were performed, respectively.

RESULTS

The three-factor model in the original scale was verified. The content validity index was 0.95. The Cronbach's α coefficient factors were as follows: 'Indicators of Patient Difficulty' α = 0.81, 'Patient's Need for Assistance' α = 0.79 and 'Indicators of Feeding Difficulty' α = 0.64, respectively. When the CFA fit indexes were examined, the model fit values were good. The three-factor structure was verified, compared with the original model and was compatible. No modification was needed in the model.

CONCLUSIONS

The Edinburgh Feeding Evaluation in Dementia Scale Turkish version provides reliable and valid measures of feeding difficulties in people with dementia. It has satisfactory psychometric properties and is suitable to use in clinical practice.

IMPLICATIONS FOR PRACTICE

Feeding is one of the most neglected subjects in caring for people with dementia. Screening is recommended to evaluate feeding and malnutrition, but, to our knowledge, there is no tool/scale to evaluate the feeding of the dementia patient in Turkish. The EdFED scale can serve healthcare professionals and caregivers as a practical tool for feeding difficulties in people with dementia.

Allergenic components, biocides, and analysis techniques of some essential oils used in food products

Nowadays, almost 300 essential oils (EOs) are commonly traded in the world market, with a prediction to be worth over $14 billion in 2024. EOs are natural preservatives for food products in order to reduce the activity of pathogenic microorganisms, therefore their use as an antioxidant or a preservative in foods has been encouraged. They are not only considered as antimicrobial or flavoring agents, but are also incorporated into food packaging materials. There are several types of EOs which have been approved as food additives by the Food and Drug Administration. Hence, it is important to use safe EO products to minimize possible adverse effect risks such as nausea, vomiting, necrosis, nephropathy, mucous membrane, and skin irritation. This review article gives information about some EOs that are used in the food industries and the types of some allergenic compounds and biocides which could make the EOs hazardous or may cause allergenic reactions in the human body. Besides, some analysis techniques of possible allergenic compounds or biocides in EOs were introduced and supported with the most relevant studies. The overall conclusion from the study is that pregnant women, patients taking drugs (e.g., diabetics) or the having a history of allergy are the most prone to be affected from EO allergenic components. As regards to biocides, organochlorine and organophosphorus types of pesticides that are carried over from the plant may be found mostly in EOs. The most common allergic reaction is skin sensitization and irritation if the EO components are oxidized during storage or transportation. Moreover, drug interactions are one of the other possible adverse effect. Hence, determination of biocides and possible allergenic component concentrations is an essential factor when they are used as a preservative or flavoring agent. The most prominent analysis techniques are gas and liquid chromatography because most of the allergens and biocides are mainly composed of volatile components. PRACTICAL APPLICATION: Determining of the essential oil's content will be crucial if oils are used for food preservation or flavoring because they may have some hazardous effects, such as nausea, vomiting, necrosis and nephropathy. Therefore, after applying them to the food products, consumers (especially pregnant women) should be informed about their concentration levels and their possible adverse effects are taken into account when they are consumed over toxic limit. For this reason, we reviewed in our study that some allergenic components, biocides and toxic limits of EOs to be used in food products. In addition to this, recent analytical techniques have been explained and discussed which methods are suitable for analysis.

Reliability and validity of the Turkish version of the Individual-Level Abortion Stigma Scale: a methodological study

OBJECTIVES

The aim of this study was to assess the reliability and validity of the Turkish version of the Individual-Level Abortion Stigma Scale.

SETTING

Three hospitals affiliated to Public Hospitals Union General Secretariat in Manisa, a city located in Western Turkey.

DESIGN

This was a methodological study.

PARTICIPANTS

A total of 230 women aged 22-49 years who previously underwent abortion and volunteered to participate in the study.

PRIMARY AND SECONDARY OUTCOME MEASURES

Data analysis was performed using the SPSS and LISREL software. The Content Validity Index was calculated based on the values obtained from expert opinions. In the reliability analysis, Cronbach's alpha values were calculated for the overall scale and its subscales. To test the stability of the scale over time, the scale was readministered to 30 women in the study 15 days later and the test-retest values (Pearson's correlation coefficients) were determined. In the validity analysis, the exploratory and confirmatory factor analyses were performed. In the exploratory factor analysis, the principal component analysis was performed using the varimax rotation and the factor loading of the scale was examined. Confirmatory factor analysis was performed to investigate the item-factor construct of the scale.

RESULTS

The Content Validity Index was calculated as 0.86. The Cronbach's alpha values ranged between 0.83 and 0.94. The item-total correlation coefficients ranged between 0.36 and 0.72, and the test-retest reliability was 0.96 for the overall scale and its subscales (p<0.05). The total variance revealed by five factors was 75%. Confirmatory factor analysis of the scale revealed an acceptable compliance level (root mean square error of approximation=0.092, χ²/df=2.91, Goodness of Fit Index=0.831, Comparative Fit Index=0.928, p<0.001).

CONCLUSIONS

The results suggest that this scale has the potential for use in research and clinical settings to measure abortion stigma among women.

The knowledge and attitudes of breast self-examination and mammography in a group of women in a rural area in western Turkey

Background

Breast cancer appears to be a disease of both the developing and developed worlds. Among Turkish women, breast cancer is the second leading cause of cancer-related deaths. The aims of this cross-sectional study were to determine levels of knowledge about breast cancer and to evaluate health beliefs concerning the model that promotes breast self- examination (BSE) and mammography in a group of women aged 20–64 in a rural area of western Turkey.

Methods

244 women were recruited by means of cluster sampling in this study. The questionnaire consisted of sociodemographic variables, a risk factors and signs of breast cancer form and the adapted version of Champion's Health Belief Model Scale (CHBMS). Bivariate correlation analysis, Chi square test, Mann-Whitney U test and logistic regression analysis were performed throughout the data analysis.

Results

The mean age of the women was 37.7 ± 13.7. 49.2% of women were primary school graduates, 67.6% were married. Although 76.6% of the women in this study reported that they had heard or read about breast cancer, our study revealed that only 56.1% of them had sufficient knowledge of breast cancer, half of whom had acquired the information from health professionals.

Level of breast cancer knowledge was the only variable significantly associated with the BSE and mammography practice (p = 0.011, p = 0.007). BSE performers among the study group were more likely to be women who exhibited higher confidence and perceived greater benefits from BSE practice, and those who perceived fewer barriers to BSE performance and possessed knowledge of breast cancer.

Conclusion

By using the CHBMS constructs for assessment, primary health care providers can more easily understand the beliefs that influence women's BSE and mammography practice.

Comparative Assessment of the Diagnostic Value of Neopterin and Acute Phase Proteins in Angiographically Assessed Stahle Coronary Artery Disease

Assessment of markers of systemic inflammation, such as acute-phase reactants C-reactive protein (CRP), fibrinogen and ceruloplasmin, sialic acid, a major component of these proteins and neopterin, a specific marker of cellular immune activation, in clinically stable coronary artery disease, may contribute to Staging and risk stratification. These markers were measured in 225 consecutive stable coronary artery disease patients before undergoing coronary angiography. According to their angiographic scores 32 patients were designated as having minor, 34 moderate and 96 severe coronary artery disease. 63 patients with negative angiograms were taken as the angiographic controls. High sensitive-CRP (hs-CRP) and fibrinogen were found to be higher in patients with angiographically established coronary artery disease, than in angiographic controls (p<0.05) and correlated with the severity and extent of disease. Ceruloplasmin and sialic acid concentrations did not differ between patients with and without angiographically cstablished coronary artery disease. Serum neopterin levels were sigificantly higher in patients undergoing coronary angiography than in healthy controls. Neopterin levels were similar between the different subgroups of coronary artery disease, suggesting that neopterin determinations do not contribute to the assessment of the presence and severity of disease in clinically stable patients. In stable angina, serum hs-CRP and plasma fibrinogen levels proved to be more effective than ceruloplasmin, sialic acid and neopterin in discriminating between patients with positive and negative angiograms and various degrees of coronary artery disease, thus in pointing out to increased risk. Our results, do not support the inclusion of neopterin in risk assessment of stable coronary artery disease.