Investigation into the Relationship Between COVID-19 Anxiety and Spiritual Orientation in Elderly Individuals in Nursing Homes and Care Centers in Turkey

Spirituality is seen as a coping strategy for reducing stress and anxiety. This research aimed to investigate the relationship between COVID-19 anxiety and the spiritual orientation of individuals aged 65 and over in nursing homes and elderly care centers during the COVID-19 pandemic in Turkey. The findings showed that with increasing age, coronavirus anxiety levels decrease, and spiritual orientation increases. There was a negative relationship between the time of diagnosis of COVID-19 and coronavirus anxiety (r =  - .48; p =  0.01). Those diagnosed with COVID-19 had higher coronavirus anxiety levels (U = 374.5; p < 0.001) and had lower spiritual orientation (U = 593.5; p > 0.05). As spiritual orientation increases in elderly individuals, their level of anxiety decreases.

Epidemiology and impact of frailty in patients with atrial fibrillation in Europe

BACKGROUND

Frailty is a medical syndrome characterised by reduced physiological reserve and increased vulnerability to stressors. Data regarding the relationship between frailty and atrial fibrillation (AF) are still inconsistent.

OBJECTIVES

We aim to perform a comprehensive evaluation of frailty in a large European cohort of AF patients.

METHODS

A 40-item frailty index (FI) was built according to the accumulation of deficits model in the AF patients enrolled in the ESC-EHRA EORP-AF General Long-Term Registry. Association of baseline characteristics, clinical management, quality of life, healthcare resources use and risk of outcomes with frailty was examined.

RESULTS

Among 10,177 patients [mean age (standard deviation) 69.0 (11.4) years, 4,103 (40.3%) females], 6,066 (59.6%) were pre-frail and 2,172 (21.3%) were frail, whereas only 1,939 (19.1%) were considered robust. Baseline thromboembolic and bleeding risks were independently associated with increasing FI. Frail patients with AF were less likely to be treated with oral anticoagulants (OACs) (odds ratio 0.70, 95% confidence interval 0.55-0.89), especially with non-vitamin K antagonist OACs and managed with a rhythm control strategy, compared with robust patients. Increasing frailty was associated with a higher risk for all outcomes examined, with a non-linear exponential relationship. The use of OAC was associated with a lower risk of outcomes, except in patients with very/extremely high frailty.

CONCLUSIONS

In this large cohort of AF patients, there was a high burden of frailty, influencing clinical management and risk of adverse outcomes. The clinical benefit of OAC is maintained in patients with high frailty, but not in very high/extremely frail ones.

Determining care burden and psychiatric symptom level in caregiver of schizophrenia patient

PURPOSE

The present study was conducted to determine the care burden and psychiatric symptom levels of the caregivers of schizophrenic patients.

DESIGN AND METHODS

The caregivers of schizophrenic patients were included in this descriptive study.

FINDINGS

It was determined that there was a statistically significant difference in the care burden scores and the education, family type, and the presence of physical diseases of the caregivers (P < .05). It was determined that there was a statistically significant positive relation between age and care duration (r = .339, P = .001).

PRACTICE IMPLICATIONS

It is recommended that the family members are guided to plan activities that will allow the family members to relax and cover their own needs.

Relationship between educational stress and psychological resilience in nursing students

Aim: The aim of this study was to determine the relationship between educational stress and psychological resilience in nursing students. Method: The descriptive and analytical design of the study consists of 602 students in the nursing department of the Faculty of Health Sciences of Ordu and Tokat Gaziosmanpasa University. Data were collected using Personal Information Form, Nursing Education Stress Scale (NESS), and Resilience Scale for Adults (RSA). Data, frequency distribution, descriptive statistics (mean, standard deviation) Mann Whitney U test, Kruskal Wallis test, and Spearman correlation test were used. Findings: The mean age of the students was 20.37±2.10, 73.8% of them were women, the mean NESS score was 66.76±16.56, and the mean RSA score was 99.99±5.19. There was a high positive correlation between NESS total, academic and application sub-dimensions, RSA structural style and future perception, NESS total and academic sub-dimension was negatively correlated with social resources and NESS academic and family cohesion. Conclusions: Acording to results,  nursing students experience moderate academic and practice stress. Among the factors that affect students' psychological well-being, there is a positive relationship between personal strength and future goals, quests and adaptation to future, and stress (in practice area). In addition, it can be said that the psychological resilience of the students is moderate when the scores of the students are evaluated. ​Extended English summary is in the end of Full Text PDF (TURKISH) file.   Özet Amaç: Bu çalışmanın amacı, hemşirelik öğrencilerinin eğitim stresi ile psikolojik dayanıklılıkları arasındaki ilişkiyi ve etkileyen faktörleri belirlemektir. Metod: Tanımlayıcı ve analitik tipte planlanan araştırmaya, Ordu ve Tokat Gaziosmanpaşa Üniversitesi Sağlık Bilimleri Fakültesi Hemşirelik Bölümünde öğrenim gören 602 öğrenci dahil edilmiştir. Veriler, Kişisel Bilgi Formu, Hemşirelik Eğitimi Stres Ölçeği (HESÖ) ve Yetişkinler için Psikolojik Dayanıklılık Ölçeği (YPDÖ) kullanılarak toplandı. Verilerin analizinde, frekans dağılımı ve tanımlayıcı istatistikler (ortalama, standart sapma), Mann Whitney U, Kruskal Wallis ve Spearman korelasyon testi kullanıldı. Bulgular: Öğrencilerin yaş ortalaması 20.37±2.10, %73.8’i kadın, HESÖ puan ortalaması 66,76±16,56, YPDÖ puan ortalaması ise 99,99±5,19’dur. HESÖ toplam, akademik ve uygulama alt boyutları ile YPDÖ yapısal stil ve gelecek algısı arasında yüksek derecede pozitif yönde, HESÖ toplam ve akademik alt boyutu ile sosyal kaynaklar arasında ve HESÖ akademik ile aile uyumu arasında negatif yönde ilişki olduğu saptandı. Sonuç: Hemşirelik öğrencileri orta düzeyde akademik ve uygulama alanlarında stres deneyimlemektedir. Öğrencilerin psikolojik iyi oluşlarını etkileyen faktörlerden kişisel özellikler ve geleceğe yönelik yeni amaç, arayışlar ve geleceğe uyumları ile stres (uygulama alanında) arasında pozitif ilişki bulunmaktadır.  Ayrıca, öğrencilerin YPDÖ puanlarına bakıldığında, psikolojik dayanıklılıklarının orta derece olduğu söylenebilir.

Turkish Midwifery Students' Fear of Delivery Process

Introduction: Fear affects a person’s decision-making process and causes a midwife to make a wrong decision about normal vaginal delivery and cesarean delivery, so research was carried out in order to determine the fields related to delivering process in which students experience the most fear and feel sufficient.

Methods: A descriptive/cross-sectional study was performed between September and October 2017. The sample consisted of 732 students selected with the convenience maximum variation sampling method from six universities studying in the third and fourth years of a midwifery program. The study measured data collected with a questionnaire entitled “Midwives’ Fear of Delivery Process”. The data were analyzed in with the SPSS for Windows using percentage and mean values and Spearman correlation test.

Results: In general, students are more afraid of practices with which they say they have more experience such as vaginal palpation (3.30 (0.884), rs=0.131, P<0.001), and they are less afraid of practices (interventional) with which they have less experience such as breech delivery (1.70 (0.915), rs=0.048, P=0.197) or no experience at all and of cases in which they can get hurt. The students feel most sufficient when performing prenatal and postnatal practices.

Conclusion: The results of our study parallel the conclusion in the literature that students are afraid of the fields that they have practiced most. Before clinical practice, instructors can determine students’ fears and deficiencies in relation to procedures and areas of practice and can develop approaches for alleviating their fears and weaknesses.

Suicide Risk and Depression in Individuals with Chronic Illness

The study aims to determine the suicide risk and depression in individuals diagnosed with chronic illnesses. The sample of the study comprised of 286 persons. The Information Form developed by the researchers on the basis of the models available in previous research, Suicide Probability Scale (SPS) and Beck Depression Scale (BDS) were used to collect data. Mann Whitney U-test, Kruskal Wallis test and Pearson correlation analysis were used to evaluate the study data. The mean score of the individuals participating in the study with reference to Suicide Probability Scale were found to be 68.80 ± 9.94 and that with reference to Beck Depression Scale 15.68 ± 9.91. Also, a significant positive relationship was found between the mean scores regarding SPS and BDS scales (r: 0.601, p: 0.000 < 0.05). The SPS and BDS mean scores of individuals who said they had poor mental health, low quality of life and low economic status and that of those who had no support from their families were found to be high in respect of statistical significance. In accordance with these findings, chronic illness is a risk factor that might induce depression and suicide ideation and attempt. According to the statistical analysis, the results of this study shown that people with poor mental health, poor quality of life and low economic status and those who had no support from their families especially had more vulnerable to depression and suicidal behaviours compared with other people.

Earthquakes and crush syndrome casualties: lessons learned from the Kashmir disaster

Major earthquakes may provoke a substantial number of crush casualties complicated by acute kidney injury (AKI). After the 1988 Armenian earthquake, the International Society of Nephrology (ISN) established the Renal Disaster Relief Task Force (RDRTF) to organize renal care in large disasters; this approach proved to be useful in several recent disasters. This paper depicts the organizational aspects of the rescue intervention during the Kashmir earthquake, in 2005. Specific problems were fierce geographic circumstances, lack of pre-registered local keymen, transportation problems, and inexperience of local teams to cope with problems related to mass disasters. Once treatment was installed, global outcomes were favorable. It is concluded that well-organized international help in renal disasters can be effective in saving many lives, but still necessitates conceptual adaptations owing to specific local circumstances.

Cooling for the reduction of postoperative pain: prospective randomized study

Hernia surgery has been associated with severe pain within the first 24 h postoperatively. The application of cold or cryotherapy has been in use since at least the time of Hippocrates. The physiological and biological effects from the reduction of temperature in various tissues include local analgesia, inhibited oedema formation and reduced blood circulation. Our hypothesis was that cold therapy, applied by means of ice packs, following inguinal hernia surgery, controlled pain postoperatively. Forty patients scheduled for inguinal hernia repair were enrolled in a double-blind, randomized study. Postoperatively, chipped ice in a plastic bag (cold group), and a plastic bag containing only room temperature water (control) were placed over the incision for 20 min. Postoperative pain data were collected at 2, 6 and 24 h after operation according to the well validated visual analogue scale (VAS). The highest pain levels were recorded 2 h postoperatively for both groups. Pain levels then gradually decreased for both the trial groups during the first 24 h postoperatively. There were significant differences in the VAS scores between the groups at 2, 6 and 24 h. We conclude that local cooling is a safe and effective technique for providing analgesia following inguinal hernia repair.

The effects of oral zinc sulphate during radiotherapy on anti-oxidant enzyme activities in patients with head and neck cancer: a prospective, randomised, placebo-controlled study

The purpose was to determine the effects of oral zinc sulphate along with radiotherapy on anti-oxidant enzyme activities in patients with head and neck cancer. Thirty patients with head and neck cancer were randomly assigned to receive either zinc sulphate capsules (including 50 mg zinc) (n = 15) or placebo (n = 15) three times a day, starting on the day of the first radiotherapy fraction and continuing throughout the scheduled radiotherapy course including weekends and 6 weeks after radiotherapy. The patients were treated with telecobalt radiation at conventional fractionation of 2 Gy/fraction and five fractions/ week in 20-35 fractions for a period of 4-7 weeks. Blood samples for biochemical parameters were collected after an overnight fast (12 h) before radiotherapy, the first day and 6 weeks after radiotherapy. In the placebo group, three patients were excluded. No difference was detected in any final measurement activities of erythrocyte anti-oxidant enzyme such as copper-zinc superoxide dismutase (Cu-Zn SOD), catalase (CAT) and glutathione peroxidase (GSH-Px) in the direct comparison between the zinc sulphate and the placebo group, except erythrocyte SOD activities measured the first day after radiotherapy (p < 0.03). In the respective measurement analysis of the groups in themselves, in the zinc sulphate group, while the statistical analysis for the activities of erythrocyte CAT and GSH-Px were significantly different (chi2 = 12.4, p < 0.05; chi2 = 8.9, p < 0.05, respectively) before radiotherapy, the first day and 6 weeks after radiotherapy, the activities of SOD did not differ (chi2 = 4.2, p > 0.05). In these three measurements, there was no statistical significance in the activities of enzymes in erythrocyte Cu-Zn SOD, CAT and GSH-Px in the placebo group. Before radiotherapy, plasma zinc levels were normal in 16 patients (59.2%) and were lower in 11 patients (40.8%) compared with laboratory levels. It would be worthwhile studying the effect of oral zinc sulphate supplements to improve the anti-oxidant enzyme activity in radiation-treated cancer patients, in the hope of reducing radiation-induced toxicity.

Laparoscopic herniorrhaphy: preference rate among surgeons in Ankara, Turkey

OBJECTIVE

To determine the surgeons' and the surgical residents' choice for inguinal hernia repair.

DESIGN

A questionnaire study.

SUBJECTS

One hundred and forty two respondents who work in surgical clinics as surgeons or residents.

SETTING

University hospitals and non-academic teaching hospitals in Ankara, Turkey.

MAIN OUTCOME MEASURE

The preference rates of open and laparoscopic hernia repairs for respondents' own inguinal hernias: "If you had an inguinal hernia, how would you prefer to have it repaired?"

RESULTS

Only 14.1% of the respondents preferred a laparoscopic hernia repair. Eight of 63 residents (12.7%) and 12 of 79 surgeons (15.2%) chose laparoscopic technique for their own hernia (p=0.67). Personal laparoscopic herniorrhaphy experience significantly affected the choice. Among 118 respondents who had performed no laparoscopic hernia repair, only 12 (10.2%) preferred laparoscopic technique for their own inguinal hernias, whereas the preference rate rose to 33.3% in other 24 participants who had previously done laparoscopic hernia repair (p=0.03). The only independent variable in multivariate analysis was personal experience on laparoscopic herniorrhaphy (SE:0.33, Wald 11.73, Sig:0.0006). The majority of the respondents who preferred open hernia repair stated that it was a better known technique. Other common reasons for open repair were being better repair and the advantage of local anesthesia. Top three reasons for choosing laparoscopic hernia repair were less pain, short hospital stay and early return to normal activity.

CONCLUSION

Majority of surgeons and residents still prefer open hernia repair.

Severe hyperkalemia in two renal transplant recipients treated with standard dose of trimethoprim-sulfamethoxazole

Hyperkalemia is a serious electrolyte disorder and is a frequent finding in renal transplant recipients. Trimethoprim-induced hyperkalemia has been increasingly reported in recent years. We describe two renal transplant recipients who developed end-stage renal disease secondary to familial Mediterranean fever and presented with severe hyperkalemia secondary to the use of standard dose of trimethoprim. One of the patients had potential underlying adrenal insufficiency, which might be a contributing factor for the development of hyperkalemia. We concluded that renal transplant patients receiving even the standard dose of trimethoprim should be monitored closely for the development of hyperkalemia. They should be recognized as a group with increased risk in regard to their concurrent renal insufficiency, concomitant use of cyclosporine, and associated tubulointerstitial disease. Patients with secondary amyloidosis are at even greater risk, and subclinical adrenal insufficiency may be an underlying risk factor for the development of severe, life-threatening hyperkalemia among this group of patients.

Grain protein and grain yield of durum wheats from south-eastern Anatolia, Turkey

High grain protein in durum wheat [Triticum turgidum ssp. turgidum L. conv. Durum (Desf.)] is one of the main goals of breeding programs. Landraces may be very useful germplasm for achieving this goal. To examine their potential as a source of high grain protein content, 11 genotypes, including 7 landraces, were evaluated in 8 environments. Environment, genotype, and the interaction of the two (G E) significantly influenced the variation in grain yield, grain protein content, and grain protein yield. The environmental effect was the strongest, mostly due to differences in water supply. Grain yields of the modern genotypes were higher than those of landraces. Yields of the modern genotypes tended to respond more strongly to the higher yielding environments, but they varied more than the yields of landraces. With the exception of VK.85.18, the grain protein content of the high-yielding genotypes was almost as high as that of the best landraces. Moreover, grain protein content of these bred genotypes tended to respond more strongly to the higher protein environments. Differences in grain protein yield were closely related to the differences in grain yield. The results indicate that it is possible to improve grain protein content without grain yield being adversely affected. The results also indicate that potential gene sources should be compared over a number of environments before they can be used as breeding material or as crop varieties producing high grain protein yields.

IL-8 in pleural effusion

Interleukin-8 (IL-8) is a recently described potent chemotactic factor that may be involved in the pathogenesis of pleural effusions. To understand the actual mechanisms mediating the inflammatory response, changes in cellular components and IL-8 level in pleural fluid of different aetiologies were evaluated. Thirty-four patients (19 male, 15 female) with a mean age of 46 +/- 22 years (range 16-92) were included in the study. Of these, 13 had tuberculous pleural effusion, seven had empyema/parapneumonic pleural effusion, and 14 had malignant pleural effusion (seven adenocarcinoma, three ovarian carcinoma, two lymphoma, one chronic myeloid leukaemia, and one small cell carcinoma) with positive cytology. Differential cell counts in the pleural fluid were obtained using cytocentrifuge preparations. The concentrations of IL-8 in pleural fluid were measured by the ELISA method. Interleukin-8 was detected in all 34 pleural fluid samples. The serum IL-8 level was analysed only in the empyema/parapneumonic pleural effusion group. The mean IL-8 levels of tuberculous, empyema/parapneumonic, and malignant pleural effusions were 1420 +/- 1049 pg ml-1, 4737 +/- 2297 pg ml-1, and 1574 +/- 1079 pg ml-1, respectively. The IL-8 levels in the empyema/parapneumonic group were significantly raised over malignant and tuberculous groups (P < 0.02). The mean pleural fluid neutrophil counts in tuberculous, empyema/parapneumonic and malignant pleural effusions were 315 +/- 575 cells mm-3, 11,136 +/- 12,452 cells mm-3, and 635 +/- 847 cells mm-3, respectively (P < 0.003). There was a significant positive correlation between pleural IL-8 levels and neutrophil counts (r = 0.46, P < 0.006). The levels of IL-8 in paired samples of serum and pleural fluid in the empyema/parapneumonic effusion group were compared, and the concentration of IL-8 was higher in the pleural effusion than serum (means, 4737 +/- 2297 pg ml-1 and 130.0 +/- 62.5 pg ml-1, respectively, P < 0.03). There was a significant negative correlation between IL-8 concentrations in serum and pleural fluid (r = -0.80, P < 0.03). This data suggests that production of IL-8 in pleural effusion may play a key role in initiation and maintenance of inflammatory reactions, especially in empyema/parapneumonic pleural effusions. It may offer the basis for introduction of novel anti-inflammatory agents in treatment.