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Farklı türlerdeki osilasyonlu yarı-kapantılı ses egzersizlerinin aerodinamik akustik elektroglottografik ve nazometrik parametrelere etkisi / Effect of different types of oscillatory semi-occluded voice exercises on aerodynamic, acoustic, electroglottographic and nasometric parameters
No full textBu çalışmanın amacı vokal yükleme görevinin ses parametrelerinde oluşturduğu değişimlerle beraber vokal yükleme sonrasında uygulanan 3 farklı terapötik vokal egzersizin ses üzerindeki etkilerini objektif ve subjektif olarak incelenmesidir. Araştırmaya katılan 30 adet normofonik kadın araştırmanın örneklem grubunu oluşturmaktadır. Katılımcılar, belirli dahil etme kriterlerine göre seçilmiş ve çeşitli akustik, elektroglottografik ve algısal ölçümler yapılmıştır. Araştırmada uygulanan prosedürler 30 dakika boyunca uygulanan vokal yükleme görevini sonrasında, 3 santimetre batma derinliğinde suya pipetle ses üfleme (SOVTE) uygulaması (task-1), Acapella Duet (Smith Medical, US) ile gerçekleştirilen VOHFO uygulaması (task-2) ve Konrot ve ark. (2022) tarafından geliştirilen SONTE uygulamalarına (task-3) dayanan 3 farklı terapötik vokal egzersizi kapsamaktadır. Egzersizleri uygulama sırası randomizasyon yoluyla belirlenmiştir. Her bir egzersiz 10 dakika boyunca uygulanmış ve uygulama sırasında akustik ve elektroglottografik ölçümler tekrar edilmiştir. Verilerin istatistiksel analizinde normal dağılım gösteren veriler için ANOVA, normal dağılım göstermeyen veriler için Friedman testi kullanılmıştır. 30 dakikalık bir vokal yükleme görevinin algısal vokal efor, akustik, nazometrik ve elektroglottografik bulgular doğrultusunda indüklenmiş olduğu gözlemlenmiştir. Diğer bir ifadeyle vokal yükleme için 30 dakikalık yüksek ses şiddetine dayalı fonasyona bağlı bir görev, seste algısal ve objektif parametrelerde farklılaşma meydana getirmiştir. Kullanılan restorasyon stratejileri incelendiğinde ise, yalnızca 10 dakikalık SONTE ve VOHFO uygulamalarının, vokal yüklemenin negatif etkilerini stabilize edebileceği düşünülmektedir. Araştırma, özellikle SONTE ve VOHFO gibi egzersizlerin, bu sürelerdeki etkilerini inceleyen ilk çalışmalardan biri olma özelliği taşımaktadır.The aim of this study was to objectively and subjectively examine the changes in vocal parameters caused by the vocal loading task and the effects of 3 different therapeutic vocal exercises on the voice after vocal loading. The sample group of the study consisted of 30 normophonic women. Participants were selected according to specific inclusion criteria and various acoustic, electroglottographic and perceptual measurements were performed. The procedures applied in the study consisted of a 30-minute vocal loading task followed by 3 different therapeutic vocal exercises based on the SOVTE (task-1), VOHFO with Acapella Duet (Smith Medical, US) (task-2), and SONTE (task-3) developed by Konrot et al. (2022). The order of the exercises was determined by randomization. Each exercise was performed for 10 minutes and acoustic and electroglottographic measurements were repeated during the exercise. Statistical analysis of the data was performed using ANOVA for normally distributed data and Friedman test for non-normally distributed data. It was observed that a 30-minute vocal loading task was induced in line with perceptual vocal effort, acoustic, nasometric and electroglottographic findings. In other words, a 30-minute high-volume phonation task for vocal loading caused a difference in the perceptual and objective parameters of the voice. When the restoration strategies used are examined, it is thought that only 10 minutes of SONTE and VOHFO can stabilize the negative effects of vocal loading. This is one of the first studies to examine the effects of exercises such as SONTE and VOHFO at these durations
The Effects of Acupressure on Postoperative Gastrointestinal Function and Pain in Women with Hysterectomy: A Randomized Controlled Study
Get PDFBackground: Hysterectomy is one of the most commonly performed abdominal surgeries. Postoperative pain, nausea, and vomiting are common complications after surgery and anesthesia. Numerous studies have revealed that acupressure can increase postoperative pain, nausea, and vomiting. This randomized controlled trial was conducted to evaluate the effect of acupressure on gastrointestinal function and pain after abdominal hysterectomy. Methods: After undergoing hysterectomy, 39 women were randomized into acupressure (n = 19) and control (n = 20) groups. Women in the acupressure groups received acupressure on the stomach meridian (ST36), heart meridian (HT7), large intestine meridian (LI4), intersection of the spleen, liver with kidney meridians 6 (SP6) and pericardium meridian (PC6) acupoints 30 min after admission to the clinic for a period of 15 min, and acupressure on locations 1-1.5 cm away from these points. The control groups received standard treatment. Patient information, visual analog scale scores, the Rhodes Index of Nausea, vomiting with retching, and daily follow-up data were collected. Results: The nausea and vomiting with retching experience scores in the acupressure-treated group were lower than those in the control group (p < 0.001). After acupressure, the gas output from stool formation of the participants in the acupressure groups was significantly greater than that of the participants in the control group (p < 0.001). The intensity of pain decreased significantly in the acupressure group compared with the control group (p < 0.001). Conclusions: The findings of these trials indicated that acupressure is an effective method for reducing pain, nausea, vomiting, and recovery of vital signs. Clinical Trial Registration: The trial protocol was registered on the website http://clinicaltrials.gov (registration number: NCT06340776)
Physician Preferences in Using Novel Digital Devices for the Management of Atrial Fibrillation-A DAS-CAM III Survey
Get PDFAim: A recent European Heart Rhythm Association (EHRA) practical guide provides guidance on the use of novel digital devices for heart rhythm analysis using either electrocardiogram (ECG) or photoplethysmography (PPG) technology for the diagnosis of atrial fibrillation (AF). This survey assesses physicians' preferences to use digital devices in patients with possible AF and their impact on clinical decision-making. Methods and Results: Participants of the DAS-CAM III initiated and distributed an online survey assessing physician preferences in using digital devices for the management of AF in different clinical scenarios. A total of 505 physicians (median age: 38 [IQR 33-46] years) from 30 countries completed the survey. A third of respondents were electrophysiologists, the others were cardiologists, cardiology residents, or general practitioners. Electrophysiologists were more likely to have experience with both ECG-based (92% vs. 68%, p < 0.001) and PPG-based (60% vs. 34%, p < 0.001) digital devices. The initial diagnostic approach to each scenario (symptomatic low-risk, symptomatic high-risk, or asymptomatic high-risk patient) was heterogeneous. Electrophysiologists preferred intermittent single-lead ECG monitoring to traditional Holter ECGs to screen for AF. Both electrophysiologists and non-electrophysiologists would rarely use PPG-based devices to diagnose and screen for AF (8.2%-9.8%). Electrophysiologists and non-electrophysiologists use ECG-based technology to confirm PPG-documented tracings suggestive of AF. Conclusion: While PPG-based digital devices are rarely used for diagnosis and screening for AF, intermittent ECG-based digital devices are beginning to be implemented in clinical practice. More education on the potential of novel digital devices is required to achieve diagnostic pathways as suggested by the EHRA practical guide
EVALUATING BARRIERS OF CHANGE IN SUSTAINABLE SUPPLY CHAIN PERFORMANCE USING ISM-MICMAC METHODOLOGY
No full textVarious industries around the world have faced many changes, the most important of which are the globalisation of markets, technological changes, shorter life of products, and the diversification of customer demands and needs. Due to the changes, there has recently been a significant focus on the development of supply chains (SCs) within the industries and the improvement of various executive systems in such chains. One of the mentioned systems that has received a lot of attention in recent years is the performance evaluation system.The main objective of this research is to investigate the barriers of change to achieve sustainable performance with the interpretive structural modelling (ISM)/MicMac approach. The current research is applied in terms of the research objective; and descriptive survey research, in terms of the topic and research questions. The data collection tool was an expert questionnaire. The statistical population studied in this research were experts in the field of SC in the food industry. The snowball sampling method was used to select 20 people. Excel and MicMac software were used for data analysis. Based on ISM, the criteria were categorised into 4 levels. The results obtained from the MicMac analysis revealed that legal barriers were the most effective barriers, with a score of 300. Economic barriers ranked second with a score of 220, while human barriers ranked third with a score of 200. Also, environmental barriers were placed in the first priority of effectiveness, with a score of 280. Social barriers ranked second with a score of 240, and economic barriers ranked third with a score of 200. The map of the direct effects of legal barriers was placed as the most important in the independent matrix. Economic, technological and human barriers were placed in the interface matrix. The dependent matrix encompassed social and environmental barriers as well. It was found that these barriers exhibit a robust interdependence and limited guidance. Essentially, these variables wield significant influence but possess limited effectiveness within the system
AC-2306327-0000001 Association Between History of Polymerase Chain Reaction-verified COVID-19 Infection and Outcomes of Subsequent ST-Elevation Myocardial Infarction
No full textWhile the acute phase of coronavirus disease 2019 (COVID-19) is associated with worsening cardiac outcomes, it is unclear whether it affects the outcome of patients with ST-segment elevation myocardial infarction (STEMI) after the acute phase. In addition, while many studies compared the course of STEMI during the COVID-19 pandemic with the years before the outbreak, we evaluated the course of STEMI during the pandemic according to whether or not patients had history of COVID-19. Patients diagnosed with STEMI during the ongoing COVID-19 pandemic were included in the study. The Ministry of Health database was analyzed retrospectively, and patients with (n = 191) and without (n = 127) a history of polymerase chain reaction (PCR) confirmed COVID-19 infection were divided into groups. Clinical and angiographic characteristics were assessed. The rates of in-hospital major adverse cardiac events (MACE) were higher in those who had a history of PCR-verified COVID-19 infection. Angiographic and procedural findings indicating successful reperfusion were better in patients without a history of COVID-19. A history of COVID-19 infection (odds ratio 1.40, 95% confidence interval 1.25-1.60, P < .01) independently predicted MACE. A history of COVID-19 infection is a predictor of worse outcomes following coronary intervention and in-hospital MACE among patients with STEMI
Do pulmonary and extrapulmonary characteristics differ between asthmatic and healthy children?
No full textMeeting - Abstract
Meeting: European-Respiratory-Society Congress (ERS
Exploring Balance Impairment and Determinants in Chronic Obstructive Pulmonary Disease: A Comparative Study with Healthy Subjects
Get PDFBackground: Many pulmonary and extrapulmonary factors may impair balance in patients with chronic obstructive pulmonary disease (COPD), but the determinants of this impairment are still debated. The primary aim was to compare both balance-related and independent variables that may affect balance with healthy subjects. The secondary aim was to investigate the potential determinants of balance in patients with COPD. Methods: This comparative study recruited 23 patients with COPD and 23 age- and comorbidity-matched healthy subjects. Participants were assessed regarding demographic and clinical data, "Postural Stability Test" (PST), "Limits of Stability Test" (LOST), "Clinical Test of Sensory Integration of Balance" (CTSIB), pulmonary function, respiratory and peripheral muscle strength, functional capacity, and cognitive function. Results: There were significant differences in all outcome measures assessing balance, pulmonary function, respiratory muscle strength, peripheral muscle strength, and functional capacity, but not cognitive function, in the COPD group compared to the healthy group (p < 0.05). The PST had a significant and strong correlation with maximal inspiratory pressure (MIP) (r = -0.630, p = 0.001) and a significant and moderate correlation with m. quadriceps strength and 6 min walk test (6MWT) distance (r = -0.472, p = 0.023; r = -0.496, p = 0.016; respectively). MIP, m. quadriceps strength, and 6MWT distance were independent predictors to explain the PST with an R-2 = 0.336 (p = 0.004). Conclusions: The present study revealed that balance is impaired in adults with COPD, even if compared with age- and comorbidity-matched healthy subjects. Assessing and improving balance and its determinants, inspiratory and peripheral muscle strength, and functional capacity may be important for fall prevention and disease management in patients with COPD
Pediatric renal caregiver burden scale: Psychometric properties of the Turkish version
No full textBackground and purpose: As treatment increasingly shifts from hospital settings to home environments, the burden on caregivers of chronic kidney disease patients has the potential to increase further. It is essential to assess the experience and burdens of caregivers of children with chronic kidney disease to identify caregivers' needs and provide targeted interventions when necessary. Hence, this study aimed to assess the psychometric properties of the Turkish version of the Pediatric Renal Caregiver Burden Scale (PR -CBS). Methods: This methodological study involved 215 parents with children aged 5 -18 and was conducted between December 5, 2021, and August 15, 2022. The Content Validity Index, Explanatory and Con firmatory Factor Analyses, Cronbach's alpha, Test -retest reliability, and item -total score correlation were used in the data analysis. The Turkish version of PR -CBS test -retest reliability analysis was performed with 30 parents after four weeks. Results: PR -CBS consists of 20 items and five sub -dimensions (illness worries, impact on self, impact on child, responsibility, institutional burden). The Turkish version of the PR -CBS and its five dimensions demonstrated satisfactory internal consistency and reliability. The construct validity of the Turkish version of the PR -CBS was con firmed by Explanatory Factor Analyses and was validated with Con firmatory Factor Analysis. Conclusions: PR -CBS is a valid and reliable tool to assess the burden of caregivers of children with chronic kidney disease in Turkish society. Implications for practice: By assessing the care burden of families, pediatric nurses can enhance the opportunity to provide quality care and support to caregivers and their patients. (c) 2024 Elsevier Inc. All rights are reserved, including those for text and data mining, AI training, and similar technologies
Targeting Metabolic Diseases: The Role of Nutraceuticals in Modulating Oxidative Stress and Inflammation
Get PDFThe escalating prevalence of metabolic and cardiometabolic disorders, often characterized by oxidative stress and chronic inflammation, poses significant health challenges globally. As the traditional therapeutic approaches may sometimes fall short in managing these health conditions, attention is growing toward nutraceuticals worldwide; with compounds being obtained from natural sources with potential therapeutic beneficial effects being shown to potentially support and, in some cases, replace pharmacological treatments, especially for individuals who do not qualify for conventional pharmacological treatments. This review delves into the burgeoning field of nutraceutical-based pharmacological modulation as a promising strategy for attenuating oxidative stress and inflammation in metabolic and cardiometabolic disorders. Drawing from an extensive body of research, the review showcases various nutraceutical agents, such as polyphenols, omega-3 fatty acids, and antioxidants, which exhibit antioxidative and anti-inflammatory properties. All these can be classified as novel nutraceutical-based drugs that are capable of regulating pathways to mitigate oxidative-stress- and inflammation-associated metabolic diseases. By exploring the mechanisms through which nutraceuticals interact with oxidative stress pathways and immune responses, this review highlights their potential to restore redox balance and temper chronic inflammation. Additionally, the challenges and prospects of nutraceutical-based interventions are discussed, encompassing bioavailability enhancement, personalized treatment approaches, and clinical translation. Through a comprehensive analysis of the latest scientific reports, this article underscores the potential of nutraceutical-based pharmacological treatment modulation as a novel avenue to fight oxidative stress and inflammation in the complex landscape of metabolic disorders, particularly accentuating their impact on cardiovascular health
Polikistik over sendromu olan kadınlarda sağlıklı beslenme tutumunun, fiziksel aktivitenin ve yaşam kalitesinin değerlendirilmesi / Evaluation of healthy nutrition attitudes, physical activity and quality of life in women with polycystic ovary syndrome
No full textTek bir hastalık değil de bir sendrom olan polikistik over sendromu, üreme çağındaki kadınlarda en sık görülen endokrin bozukluktur. Tedavisinde sağlıklı beslenme ve fiziksel aktiviteyi de kapsayan yaşam tarzı müdahaleleri önceliklendirilmektedir. Bu araştırmada polikistik over sendromu olan kadınların sağlıklı beslenme tutumunun, fiziksel aktivitenin ve yaşam kalitesinin değerlendirilmesi amaçlanmıştır. Araştırmaya Atlas Üniversitesi Medicine Hastanesi Kadın Hastalıkları ve Doğum Bölümü'ne başvuran 18-49 yaş aralığındaki polikistik over sendromu tanılı, gönüllü 87 hasta katılmıştır. Katılımcılara anket uygulanarak demografik özellikleri "Genel Bilgiler Formu" ile, sağlıklı beslenme tutumları "Sağlıklı Beslenmeye İlişkin Tutum Ölçeği (SBİTÖ)" ile, fiziksel aktiviteleri "Uluslararası Fiziksel Aktivite Anketi - Kısa Form (IPAQ-SF) ile ve yaşam kaliteleri "Polikistik Over Sendromu Yaşam Kalitesi- 50 Ölçeği (PCOSQ-50)" ile değerlendirilmiştir. Katılımcıların yaş ortalaması 26.85 yıl, vücut ağırlığı ortalaması 68.64 kg, boy ortalaması 163.76 cm'dir. Katılımcıların %60.9'u bekar ve %78.2'sinin doğum sayısı 0'dır. Beden kütle indeksi ortalaması 25.56±5.32 kg/m2 olan katılımcıların beden kütle indekslerine göre gruplandırma yapıldığında neredeyse yarısı fazla kilolu ya da obez bulunmuştur. Katılımcıların semptomları incelendiğinde %78.2 oranı ile adet düzensizliği en başta olmak üzere sırasıyla hormonal dengesizlik, akne- sivilce, hirsutizm, insülin direnci, fazla kilo- obezite, bölgesel saç dökülmesi, depresyon, infertilite, kalp damar hastalıkları görülmektedir. Uluslararası Fiziksel Aktivite Anketi - Kısa Forma (IPAQ-SF) göre sınıflama yapıldığında katılımcıların %43.7'sinin inaktif, %50.6'sının minimal aktif, %5.7'sinin çok aktif olduğu bulunmuştur. Katılımcıların beslenme hakkında bilgi, beslenmeye yönelik duygu, olumlu beslenme, kötü beslenme başlıklarını kapsayan SBİTÖ ortalama puanı 74.69'dur. Bu puan ile katılımcılar yüksek düzeyde sağlıklı beslenmeye ilişkin tutuma sahip olarak ifade edilebilmektedir. PCOSQ-50 ortalama puanı 156.91 olan katılımcılar bu ölçek içerisinde psiko – sosyal duygusal durum, doğurganlık, cinsel fonksiyon, obezite ve menstrual bozukluk, tüylenme ve başa çıkma olmak üzere 6 alt kategoride değerlendirilmiştir. Ortalama puana göre katılımcıların çoğunun yaşam kalitesinin iyi olduğu söylenebilir. Ancak yaşam kalitesi iyi olan katılımcılar ile iyi olmayan katılımcıların sayısının birbirine çok yakın olduğu dikkat çekmektedir.Polycystic ovary syndrome, which is not a single disease but a syndrome, is the most common endocrine disorder in women of reproductive age. Lifestyle interventions, including healthy nutrition and physical activity, are prioritized in its treatment. In this study, the goal was to evaluate the healthy eating attitude, physical activity and quality of life of women with polycystic ovary syndrome. 87 volunteer patients diagnosed with polycystic ovary syndrome between the ages of 18-49 who applied to the Department of Obstetrics and Gynecology of Atlas University Medicine Hospital participated in the research. Demographic characteristics were evaluated with the "General Information Form", healthy eating attitudes were evaluated with the "Healthy Eating Attitude Scale (SBITÖ)", physical activities were evaluated with the "International Physical Activity Questionnaire - Short Form (IPAQ-SF) and quality of life was evaluated with the "Polycystic Ovary Syndrome Quality of Life- 50 Scale (PCOSQ-50)" by giving a questionnaire to the participants. The average age of the participants was 26.85 years old, the average body weight was 68.64 kg, the average height was 163.76 cm. %60.9 of the participants were single and the number of births of %78.2 was 0. When the participants with an average body mass index of 25.56 ± 5.32 kg/m2 were grouped according to their body mass indexes, almost half of them were overweight or obese. When the symptoms of the participants are examined, hormonal imbalance, acne- acne, hirsutism, insulin resistance, overweight- obesity, regional hair loss, depression, infertility, cardiovascular diseases are observed, especially menstrual irregularity with a rate of 78.2%. When the classification was made according to the International Physical Activity Questionnaire - Short Form (IPAQ-SF), it was found that %43.7 of the participants were inactive, %50.6 were minimally active, and %5.7 were very active. The average SBITÖ score of the participants covering the topics of information about nutrition, feelings towards nutrition, positive nutrition, poor nutrition was 74.69. With this score, the participants can be described as having a high level of attitude towards healthy nutrition. Participants with a mean PCOSQ-50 score of 156.91 were evaluated in 6 subcategories within this scale, including psycho-social emotional state, fertility, sexual function, obesity and menstrual disorder, hair growth and coping. According to the average score, it can be said that most of the participants have a good quality of life. However, it is noteworthy that the number of participants whose quality of life is good and the number of participants whose quality of life is not good is very close to each other