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The discriminant ability of the Eating Assessment Tool-10 to detect dysphagia and aspiration according to the stage of Alzheimer's disease
No full textBackground Alzheimer's disease (AD) is a progressive neurodegenerative disorder frequently associated with dysphagia, leading to malnutrition, dehydration, and aspiration pneumonia. The Eating Assessment Tool-10 (EAT-10) is widely used for dysphagia screening; however, its reliability in advanced AD, where cognitive impairments hinder self-reporting, remains uncertain. Objective This study aimed to evaluate the diagnostic accuracy of EAT-10 in detecting dysphagia and aspiration across different AD stages. Methods The study included 30 AD patients classified into mild, moderate, and advanced stages based on Clinical Dementia Rating (CDR) scores. Dysphagia was assessed using EAT-10 and validated through Videofluoroscopic Swallowing Study (VFSS) and the Penetration-Aspiration Scale (PAS). Statistical analyses included the Mann-Whitney U test, Spearman correlation, and receiver operating characteristic (ROC) curve analysis (p < 0.05). Results EAT-10 scores significantly differed across AD stages (p = 0.001), with mean scores of 3.11 +/- 1.17 (mild), 11.70 +/- 4.64 (moderate), and 18.00 +/- 6.90 (advanced). Unsafe swallowing and aspiration were observed in 43.3% and 23.3% of patients, respectively, with higher prevalence in advanced AD. ROC analysis determined an EAT-10 cut-off score of 15 for unsafe swallowing (AUC: 0.96, sensitivity: 88%, specificity: 77%) and 18 for aspiration (AUC: 0.81, sensitivity: 81.2%, specificity: 75%). Strong correlations were found between EAT-10 and PAS scores (r = 0.812, p < 0.001). Conclusions EAT-10 is an effective screening tool for dysphagia and aspiration risk in early and moderate AD stages. However, in advanced AD, objective assessments like VFSS remain essential to complement EAT-10 results. Integrating EAT-10 into routine evaluations may enhance early detection, enabling timely interventions and improved clinical outcomes
Total diz protezi uygulanacak hastalarda ameliyat öncesi korkunun konfor düzeyine etkisi
Full text linkBu araştırma, total diz protezi cerrahisi uygulanacak hastalarda cerrahi öncesi korkunun cerrahi sonrası konfor düzeyine etkisini belirlemek amacıyla tanımlayıcı olarak gerçekleştirildi. İstanbul'da bir kamu hastanesinde Mayıs 2024-Mayıs 2025 tarihleri arasında total diz protezi ameliyatı olan, dahil edilme kriterlerine uyan 280 hasta ile yapıldı. Araştırmaya katılmaya gönüllü olan hastalara "Bilgilendirilmiş Onam Formu" doldurularak sözlü ve yazılı izinleri alındı. Ameliyattan önceki gün tanıtıcı özellikler formu, cerrahi korku ölçeği, genel konfor ölçeği dolduruldu. Ameliyattan sonra postoperatif 1. Gün genel konfor ölçeği yüz yüze görüşme yöntemi kullanılarak araştırmacı tarafından uygulandı. Çalışmadan elde edilen bulgular değerlendirilirken, IBM SPSS Statistics 25.0 (IBM SPSS Statistics for Windows, Version 25.0.Armonk, NY: IBM Corp.) paket programı kullanıldı. Niteliksel veriler için sayı ve yüzde, niceliksel veriler için minimum, maksimum, ortalama, standart sapma ve medyan analizleri yapıldı. İkili değişkenlerin ölçek ve alt boyutlarının karşılaştırılması Mann-Whitney U testi ile, ikiden fazla değişkeni olan grupların ölçek ve alt boyutlarıyla karşılaştırılması Kruskall-Wallis testi ile analiz edildi. Hastaların yaş ortalamasının 67±6,1 olduğu %81,4'nün kadın olduğu, %81,8'nin daha önce ameliyat geçirdiği belirlendi. Hastaların cerrahi korku ölçeği kısa dönem puanının ortalaması 12,13±8,6, cerrahi korku ölçeği uzun dönem puan ortalaması 8,13±6,5 ve cerrahi korku ölçeği toplam puan ortalaması 20,25±10,84, genel konfor ölçeği toplam puan ortalaması 147,24±16,17 olarak belirlendi. Hastaların cerrahi korku ölçeği ve genel konfor ölçeği ve alt boyutlarının ilişkisel analizinde tüm ölçek ve alt boyutlar arasında orta düzeyde, negatif yönde ve istatistiksel olarak anlamlı ilişki olduğu görüldü. Araştırmada hastaların cerrahi korku ölçeği toplam puanları ile genel konfor ölçeği toplam puanları arasında istatiksel olarak negatif yönde bir ilişki olduğu, hastaların cerrahi korku düzeyi arttıkça cerrahi sonrası konfor düzeylerinin azaldığı sonucuna ulaşıldı.This study was conducted as a descriptive study to determine the effect of preoperative fear on postoperative comfort level in patients undergoing total knee replacement surgery. It was conducted with 280 patients who met the inclusion criteria and underwent total knee replacement surgery between May 2024 and May 2025 at the İstinye State Hospital Orthopedic Service. Patients who volunteered to participate in the study filled out the "Informed Consent Form" and their verbal and written permissions were obtained. The descriptive characteristics form, surgical fear scale, and general comfort scale were filled in the day before the surgery. The general comfort scale was filled in by the researcher on the first postoperative day using the face-to-face interview method. The findings obtained from the study were evaluated using the IBM SPSS Statistics 25.0 (IBM SPSS Statistics for Windows, Version 25.0. Armonk, NY: IBM Corp.) package program. Number and percentage analyses were performed for qualitative data, and minimum, maximum, mean, standard deviation, and median analyses were performed for quantitative data. Comparisons of scales and subdimensions of binary variables were analyzed using the Mann-Whitney U test, and comparisons of groups with more than two variables using the scales and subdimensions were analyzed using the Kruskall-Wallis test. The results of this study showed that the mean age of the patients was 67±6.1, 81.4% were female, and 81.8% had previously undergone surgery. The mean short-term surgical fear scale score of the patients was 12.13±8.6, the long-term surgical fear scale score was 8.13±6.5, the total surgical fear scale score was 20.25±10.84, and the total general comfort scale score was 147.24±16.17. In the relational analysis of the patients' surgical fear scale and general comfort scale and its sub-dimensions, it was seen that there was a moderate, negative and statistically significant relationship between all scales and sub-dimensions.In the study, it was concluded that there was a statistically negative correlation between the total scores of the patients' surgical fear scale and the total scores of the general comfort scale, and that as the patients' surgical fear level increased, their post-surgical comfort level decreased
Managing Candida auris fungemias: the results of a prospective and international study
Full text linkCandida auris causes hospital outbreaks and life-threatening infections, is recognized as a global health threat, and was designated a priority pathogen by the World Health Organization (WHO). Since the data on C. auris fungemias are quite scarce and limited to small retrospective case series, this international study aimed to prospectively assess patient characteristics, outcomes, and therapeutic approaches. The study, conducted through the Infectious Diseases-International Research Initiative (ID-IRI) platform, involved 34 referral centers. Patients with C. auris candidemia were prospectively enrolled between 15 April 2024 and 15 October 2024. Data on demographics, clinical and laboratory findings, treatment details, and 30-day mortality outcomes were collected. Mortality risk factors were analyzed using univariate tests and stepwise multiple binary logistic regression. The study enrolled 162 patients with a mean Charlson Comorbidity Index of 4.1 +/- 2.2. Overall, 91 patients (56.2%) died. Antifungal susceptibility profiles were fluconazole (13/135, 9.6%), caspofungin (121/133, 91%), micafungin (125/126, 99.2%), anidulafungin (74/76, 97.4%), and amphotericin-B (50/134, 37.3%). Inadequate access to appropriate antifungals (odds ratio [OR] = 11.258; 90% confidence interval [CI]: 1.302-97.310; P = 0.065), the presence of central venous catheters (OR = 3.581; 90% CI: 1.037-12.368; P = 0.090), intensive care unit (ICU) stay (OR = 6.148; 90% CI: 1.977-19.123; P = 0.008), abdominal surgery (OR = 5.077; 90% CI: 1.651-15.610; P = 0.017), deep-seated candidal complications (OR = 4.546; 90% CI: 1.103-18.741; P = 0.079), and decreased platelet counts (OR = 1.004; 90% CI: 1.002-1.006; P = 0.006) were associated with increased mortality. Optimizing therapy for C. auris fungemia involves early strain identification, prompt echinocandin use, surveillance, proper catheter management, effective source control particularly in abdominal surgery, monitoring deep-seated candidal complications, and recognizing thrombocytopenia as a critical warning sign
An investigation of healthy aging among older adults in nursing homes: A cross-sectional study
No full textAim This cross-sectional study examined healthy ageing and associated factors among 249 older adults aged 65 years and above residing in nursing homes in Istanbul, T & uuml;rkiye. Methods Data were collected using the "Personal Information Form," "Standardized Mini-Mental State Examination," "Katz Daily Life Activity Index," "Mini Nutritional Assessment Short Form," "Satisfaction with Life Scale," and "Physical Activity Scale for the Elderly." Analyses included chi-square tests, independent t-tests, and logistic regression. Results Results showed a healthy ageing rate of 38.5 %. Significant predictors included cardiovascular diseases, fear of falling, number of medications, and life satisfaction. Cardiovascular diseases decreased healthy ageing odds by 3.015 times, while fear of falling reduced them by 0.516 times. Conversely, higher life satisfaction increased healthy ageing by 0.886 times. Conclusions.Only 4 out of 10 elderly met the criteria for healthy ageing. Interventions should focus on promoting physical activity, psychological and social support, chronic disease management, and personalized care to enhance healthy ageing among older adults in T & uuml;rkiye. (c) 2025 Elsevier Inc. All rights are reserved, including those for text and data mining, AI training, and similartechnologi
Supervisor experience and cybersecurity response in aviation organizations using a two-wave exploratory design
Full text linkAs cybersecurity threats continue to intensify across safety-critical industries, the aviation sector faces unique challenges due to its high digital dependency and human-centered operational environments. This study investigates how aviation supervisors in T & uuml;rkiye perceive and respond to cybersecurity incidents involving employees, focusing on the psychological dimensions of leadership under pressure. Using a two-wave mixed-method design, data were collected from 300 supervisors through structured surveys and open-ended reflections on recent cybersecurity-related incidents. Thematic analysis identified common incident types such as phishing, password negligence, and unauthorized device use, along with eight distinct supervisory response strategies. Supervisors rated their actions on stressfulness and effectiveness, and K-means cluster analysis revealed three psychological response profiles. Multinomial logistic regression showed that psychological distress and time pressure were significant predictors of unfavorable experiences, while organizational cybersecurity support reduced the likelihood of high stress and low perceived effectiveness. These findings contribute to psychosocial risk and critical incident theory by highlighting cybersecurity incidents as emotionally significant events and underscore the need for supervisor training that integrates emotional resilience and cyber preparedness
Gebelikte aile sağlığı merkezinden alınan doğum öncesi bakım hizmetinin içeriği ve hizmet hakkındaki görüşlerinin değerlendirilmesi / Evaluation of the content of prenatal care services received from family health center during pregnancy and their opinions about the service
No full textBu araştırma, gebelerin Aile Sağlığı Merkezlerinde (ASM) sunulan doğum öncesi bakım (DÖB)
hizmetlerine yönelik beklenti ve memnuniyet düzeylerini değerlendirmek amacıyla tanımlayıcı
tipte bir araştırma olarak gerçekleştirilmiştir. Araştırmanın evrenini, İstanbul ili Sultanbeyli İlçe
Sağlık Müdürlüğü’ne bağlı 24 Aile Sağlığı Merkezi’ne kayıtlı 0-3 ay bebeği olan anneler
oluşturmuştur. Araştırmanın örneklemini, ASM’lerin hizmet verdiği nüfussayısına göre dağılım
yapılan toplam 288 anne oluşturmuştur. Araştırmada veriler, ‘Tanıtıcı Bilgiler Formu’,
‘Obstetrik Özellikler ve ASM Kullanım Bilgi Formu’, ‘Doğum Öncesi Bakım Değişkenleri
Bilgi Formu’ ve ‘Doğum Öncesi Bakım Memnuniyeti ve Hasta Beklentiler Ölçeği’ kullanılarak
elde edilmiştir. Kadınların büyük çoğunluğu (%62,1) 25–34 yaş grubunda,
%96,5’i resmi nikahlı, %47,5’i lisans mezunu, %60,8’i bir işte çalışıyor ve %69,8’i gelir
durumunun orta düzeyde olduğu belirlenmiştir. Kadınların %43,4’ü primipar, %67,6’sı en az 4
kez antenatal kontrole gitmiş ve %80,9’u ilk kontrolünü 1–14. haftalar arasında yaptırmıştır.
DÖB hizmetlerinden en sık kan basıncı ölçümü (%70,8), kilo takibi (%73,2), fetal kalp sesi
dinleme (%70,8), demir (%72,9) ve D vitamini (%71,6) desteği alma yer almaktadır. Buna
karşın ödem (%42,7) ve varis kontrolü (%34,4), özel danışmanlık (%40,9), gebe eğitimi
(%41,7) hizmetleri daha düşük oranda sunulmuştur. Özellikle anamnez alma (%47,6), fizik
muayene (%41) ve Leopold muayenesi (%45,1) gibi temel izlem uygulamaları bazı katılımcılar
tarafından yetersiz bulunmuştur. Kadınların %91,7’si gebelikte tetanos aşısı, %50’si Hepatit B
ve sadece %30,9’u grip aşısı yaptırdığı saptanmıştır. “Doğum öncesi bakım memnuniyet ve
hasta beklentileri ölçeği” memnuniyet puan ortalaması, 60,56 ± 25,82 ve beklentiler puan
ortalaması 24,25 ± 7,97 olarak saptanmıştır. En yüksek memnuniyet “sağlık personeli bakımı”
ve “sistem özellikleri” alt boyutlarında; en yüksek beklenti ise antenatal hizmetlerde “sağlık
personelin sürekliliği” ve “kişiselleştirilmiş bakım” alanlarında olmuştur. Ev hanımı, eş eğitimi
lisans düzeyinde ve planlı gebeliği olan, öyküsünde düşük/kürtaj ve riskli gebelik durumu
olmayan, ASM’den alınan DÖB hizmetini yeterli bulan, hizmet beklentileri tamamen karşılandığını ifade eden kadınlarda, ölçeğin memnuniyet boyut düzeyleri, anlamlı derecelerde
(p<0,05) daha yüksek bulunmuştur.
Eş yaşı 40-45 grubunda ve eş eğitimi lisans düzeyinde olan, son gebeliğinin planlı olduğunu ve
ASM lerden DÖB hizmetini en az 4 kez aldığını ifade eden, düşük/kürtaj yapma öyküsü
olmayan ve yine aile sağlığı merkezlerinde verilen DÖB hizmetlerinden beklentilerinin az da
olsa karşılandığını belirten kadınların beklenti düzey puan ortalamalarının diğer gruplara
kıyasla anlamlı düzeyde (p<0,05) daha yüksek olduğu saptanmıştı
Age-related differences on low back pain and lower extremity isokinetic muscle strength and balance
No full textBackground: Given the growing population of the elderly, understanding how aging impacts pain, muscle strength, and balance, especially in individuals with chronic low back pain, is imperative.Objective: This study aims to investigate age-related differences in lower extremity muscle strength and balance in patients with chronic low back pain.Methods: In this cross-sectional study, 110 people with chronic low back pain were divided into two age groups (Group 1, age: 29.89 +/- 6.82, Group 2, age: 51.42 +/- 6.33). Both groups used Oswestry for low back pain and disability assessment, isokinetic device for muscle strength, and Biodex Balance System for balance assessment.Results: There were no significant differences between groups in terms of pain (p = 0.426) or disability (p = 0.056). In contrast, significant differences were observed in isokinetic muscle strength: peak torque for the dominant side at 60 degrees/s for quadriceps (p = 0.003) and hamstring (p = 0.007), and at 180 degrees/s for hamstring (p = 0.012) and quadriceps (p = 0.011). The balance assessment revealed significant differences in fall risk (p = 0.004) and postural stability (p = 0.006) variables. The most significant regression association was found between dominant side 60 degrees/s quadriceps and fall risk variables across age groups.Conclusion: Understanding age-related differences in muscle strength and balance among patients with chronic low back pain is critical. Customizing rehabilitation interventions improves efficacy and quality of life. Further research is necessary to optimize clinical approaches and elucidate underlying mechanisms
Resolvin E1 and maresin 1 restore senescence-induced disruption of human periodontal ligament fibroblast function
No full textBackgroundAging impairs the mechanisms that regulate inflammation, resulting in low-level chronic inflammation even in the absence of infection and increasing the risk of developing age-related illnesses. Periodontal ligament fibroblasts (PDLF) are responsible for wound healing and periodontal tissue regeneration. Periodontal inflammation disrupts PDLF function, which may be exacerbated by aging. We tested the hypothesis that senescence-induced changes in PDLF will be reversed by specialized mediators of resolution of inflammation-resolvin E1 (RvE1) and maresin 1 (MaR1). MethodsPrimary human PDLFs were cultured with D-galactose to induce senescence. The senescence was confirmed with a senescence-associated beta-galactosidase assay. The impact of senescence on cell viability, proliferation, wound healing, cell cycle, type I collagen expression, oxidative stress, inflammatory profiles, and growth factor production was evaluated. We measured the specialized pro-resolving mediators (SPM)-mediated effects on senescent PDL fibroblasts by treating them with 100 nM RvE1 or 100 nM MaR1 or the vehicle. ResultsD-galactose treatment significantly increased senescence, oxidative stress, and inflammation while it delayed wound closure and reduced cell viability and proliferation on PDLFs (p < 0.05). RvE1 or MaR1 treatment significantly decreased beta-galactosidase expression and inflammation, restored cell viability, increased cell proliferation, and accelerated wound closure (p < 0.05). MaR1 demonstrated a more potent impact on reversing the senescence and regenerative effect than RvE1. ConclusionRvE1 and MaR1 reversed the senescence-induced changes in primary PDLFs, restoring wound healing capacity and function.Plain Language SummaryAging may induce periodontal inflammation, which interferes with the activity of the periodontal ligament fibroblasts (PDLFs). We measured the effect of specific mediators of resolution of inflammation, resolvin E1 (RvE1) and maresin 1 (MaR1), on aging in PDLFs. Treatment with RvE1 or MaR1 significantly reduced inflammation and senescence and restored cell proliferation, wound closure, and cell viability
The relationship between COVID-19 fear, health perceptions, routine health checks, and safety behaviors in participants with chronic illnesses
No full textThe COVID-19 pandemic has significantly impacted individuals with chronic illnesses, leading to increased fear of contracting the virus, delays in routine health follow-ups, and notable behavioral changes. This study aimed to determine the relationship between fear of COVID-19 and health perceptions, routine health checks, and safety behaviors among participants with chronic illnesses during the pandemic. An online survey was conducted between February and July 2021 to collect data from 288 patients in Istanbul who had been diagnosed with chronic illnesses persisting for six months or longer. Data were collected using the Fear of COVID-19 Scale (FCV-19S), the Perception of Health Scale (PHS), and a descriptive information form. Of the participants, 38.2% had diabetes mellitus, with an average diagnosis duration of 44.5 +/- 15.64 months. Due to the fear of contracting the virus, 30.2% reported avoiding regular health follow-ups during the pandemic. The participants were found to have a high level of adherence to safety behaviors. Fear of COVID-19 negatively predicted the certainty subdimension of health perception, while the fear of COVID-19 positively predicted the importance of health subdimension. Fear of COVID-19 was linked to increased safety behaviors but had a negative impact on routine health follow-ups and health perceptions in participants with chronic illnesses. Thus, during pandemics, it is essential to plan interventions that improve awareness and promote self-management in individuals with chronic illnesses