Evaluation of the functional status of patients with chronic obstructive pulmonary disease via the modeling approach

Background: Chronic obstructive pulmonary disease (COPD) is common worldwide. COPD has negative effects on the quality of life of the patient due to restrictions on daily activities. It can cause a major healthcare burden according to the stage and grade of disease.Objective: The purpose of this study was to determine the physical and psychological functional capacity factors affecting patients’ functional performance and to develop a COPD-specific functional status model using these factors.Methods: A group of randomly selected patients (n=183) diagnosed with COPD at a university hospital in Turkey comprised the study sample. Physical examinations were carried out on all patients and they completed questionnaires that included socio demographic and disease characteristics, the Hospital Anxiety and Depression Scale, Functional Performance Inventory and Short Form-36 Survey. The proposed theoretical model was analyzed in the LISREL program using the structural equation modeling approach.Results: We found that the independent latent variable of the physiological functional capacity yielded a significant positive effect on the dependent latent variable of functional performance, while the psychological functional capacity produced no significant effect.Conclusions: The COPD-specific functional status model should prove to be an effective and beneficial tool for issues such as treatment maintenance and for the preservation or improvement of patients’ quality of life. [Ethiop.J. Health Dev. 2019; 33(2):81-87]Keywords: Chronic obstructive pulmonary disease, functional status, functional performance, functional capacity, structural equation modelin

Effect of foot anthropometric measurements on postural stability

Aim: To examine the effect of foot anthropometric measurements and body sizes of young male adults with normal posture on balance. Methods: In this study, the effect of body size and foot anthropometric measurements of 112 young male adults with normal posture on balance was investigated. The foot and body parameters of the cases were measured. The static and the dynamic balance tests were evaluated according to the dominant foot in each case. The parameters that affected balance were determined and the variables were taken to the model. In addition, the significance levels that defined the effects of the properties examined in relation with the balance were also calculated. Results: When the findings were evaluated, it was determined that the effect of the foot parameters other than the foot length, and the effect of 15 body parameters other than the biiliac diameter, trochanteric height, and right upper extremity length on balance performance was significant. The balance test performance was predicted with success ranging from 7.8% to 43% with the parameters included in the model. Conclusion: In this study, the fact that the relation between the foot anthropometric and body dimensions and functional balance performances of young male adults was found to be significant shows that this relation must be considered in the creation of a normative database on balance, and in clinical studies that will be conducted on the subject

Development and Assessment of a Coping Scale for Infertile Women in Turkey

Infertile women feel more psychological stress and pressure than their husbands, and the prevalence of anxiety and depression among them are higher. This study aimed to develop a culture-specific measurement tool to identify the strategies of infertile women in dealing with infertility-related problems. This was a scale development study. This study was carried out in three different fertility centers in the three largest cities in Turkey. The data were collected using personal information form and through the application of a Coping Scale for Infertile Women (CSIW) protocol. Ways of Coping with Stress Inventory. Cronbach‘s alpha, Intraclass Correlation Coefficient and Spearman‘s Rank correlation analyses were used to determine the reliability of the scale. The results of explanatory factor analysis and a factor structure of the Coping Scale for Infertile Women, comprising 50 items, were examined, and the data were determined to be suitable to perform factor analysis. The internal consistency of the scale was found to be 0.880. The number of factors in the scale was 10, and the internal consistency of the factors was 0.720. The results showed that the CSIW had good reliability and validity.Keywords: Infertility, Women, Coping, Scale developmen

Volunteer Surgical Camp at Gombe Hospital in Uganda

Background: The Islamic University Habib Medical School in Uganda (IUIU), in collaboration with Doctors Worldwide (DWW) from Turkey, organized a surgical camp in April 2014. In this camp, different types of hernia repair, among other general surgical procedures were conducted. The target population was the population within the Gombe hospital serving districts.Methods: The defined area for the surgical camp was Butambala and neighboring districts including Mpigi; Gomba, Mityana, and parts of Wakiso district. The IUIU team and Gombe hospital team were respectful to the sensitivities of the community, district and government officials. The surgical team composed of 4 surgeons (three from DWW-Turkey and one from Uganda), 3 Anesthesiologists, (two from DWW-Turkey and one from Uganda), 2 nurses and 2 intern doctor, (one from DWW-Turkey and one from Uganda).Results: The total number of patients operated was 115; however the total number of operations performed was 130. One hundred and fourteen operations were different types of hernia repair. The ages of hernia patients ranged between 1 and 80 years (mean±SD is 27.46±24.55). Hemoglobin values ranged between 9.2 and 17 (mean±SD is 12.5±1.48). Only two (1.8%) of 114 hernia patients had positive results on HIV serology. Sixteen patients underwent circumcision. Of those, only two (12.5%) patients had positive results on HIV serology.Conclusion: Hernia is a common surgical problem in all age groups. It is more common in men. In addition to the operations conducted, the need for surgery for 187 patients was detected. This condition shows that the hernia operation is commonly accepted as a negligible condition.Keywords: Global surgery; Provincial; Hernia; World Wide Doctors; Ugand

Sixth Class Students' Performance and Confidence Levels Before and After Training in Clinical Skills Laboratories

Background: Acquisition of basic clinical skills by undergraduate medical students is becoming of greater concern. Clinical skills laboratories may provide a comfortable environment for training and may allow students to gain adequate performance level. The aim of this study is to evaluate students' performance and confidence levels before and after training of selected procedural skills; also to explore students' expectation towards skills laboratory training. Methods: Two questionnaires were conducted before and after training sessions in the clinical skills laboratory, school of medicine, University of Jordan, Amman, Jordan. The skills selected for this study: suture practice, venous access, arterial access, intradermal and intramuscular injection, central venous cannulation, male and female urinary catheterization, nasogastric tube placement and rectal examination. Although fifty-seven 6th year medical students filled the first questionnaire at the beginning before training, only 29 students could attend all training sessions, and fill the second questionnaire. Results: For all trained clinical skills, the mean students' performance scores and confidence levels were significantly increased after training (P <0.001). Expectations of students for skills laboratory were high. Conclusions: The students' performance and confidence levels were significantly improved after training in the clinical skills laboratory

Detecting imipenem resistance in Acinetobacter baumannii by automated systems (BD Phoenix, Microscan WalkAway, Vitek 2); high error rates with Microscan WalkAway

<p>Abstract</p> <p>Background</p> <p>Increasing reports of carbapenem resistant <it>Acinetobacter baumannii </it>infections are of serious concern. Reliable susceptibility testing results remains a critical issue for the clinical outcome. Automated systems are increasingly used for species identification and susceptibility testing. This study was organized to evaluate the accuracies of three widely used automated susceptibility testing methods for testing the imipenem susceptibilities of <it>A. baumannii </it>isolates, by comparing to the validated test methods.</p> <p>Methods</p> <p>Selected 112 clinical isolates of <it>A. baumanii </it>collected between January 2003 and May 2006 were tested to confirm imipenem susceptibility results. Strains were tested against imipenem by the reference broth microdilution (BMD), disk diffusion (DD), Etest, BD Phoenix, MicroScan WalkAway and Vitek 2 automated systems. Data were analysed by comparing the results from each test method to those produced by the reference BMD test.</p> <p>Results</p> <p>MicroScan performed true identification of all <it>A. baumannii </it>strains while Vitek 2 unidentified one strain, Phoenix unidentified two strains and misidentified two strains. Eighty seven of the strains (78%) were resistant to imipenem by BMD. Etest, Vitek 2 and BD Phoenix produced acceptable error rates when tested against imipenem. Etest showed the best performance with only two minor errors (1.8%). Vitek 2 produced eight minor errors(7.2%). BD Phoenix produced three major errors (2.8%). DD produced two very major errors (1.8%) (slightly higher (0.3%) than the acceptable limit) and three major errors (2.7%). MicroScan showed the worst performance in susceptibility testing with unacceptable error rates; 28 very major (25%) and 50 minor errors (44.6%).</p> <p>Conclusion</p> <p>Reporting errors for <it>A. baumannii </it>against imipenem do exist in susceptibility testing systems. We suggest clinical laboratories using MicroScan system for routine use should consider using a second, independent antimicrobial susceptibility testing method to validate imipenem susceptibility. Etest, whereever available, may be used as an easy method to confirm imipenem susceptibility.</p

Adjusting the Effect of Baseline Differences Between Groups in Trials with Which Have Two or More Groups

WOS: 000264851900013Objective: In many clinical and experimental trials, researchers assess the effect of treatment by measuring the value of a continuous variable before and after the treatment. If there is an imbalance in baseline values between groups, some statistical comparisons may result with mistakes in estimation of the treatment effect. The aim of this study was to explain which statistical methods were more suitable in the estimation of the treatment effect when there was an imbalance for the baseline values between groups. Material and Methods: Different statistical methods, which are used in estimation of treatment effects, were briefly explained and were applied to a hypothetical data set, which had significant differences between groups according to baseline values of the related variable. In addition, a limited simulation study for several conditions was carried out to determine suitable statistical methods. Results: Baseline values were different between two groups and correlation was low between baseline and follow up values of related variable in each group for hypothetical data set. In this condition, comparison of simple differences between baseline and follow up values was the best method for the estimation of treatment effect. In the simulation study, the power of the test for simple differences was higher (85%) than the value in the analysis of covariance (40%) when correlations were low and sample sizes were small in each group. Moreover, the powers of these two tests were high and similar to each other, when sample sizes were moderate. When the correlation was high, the powers of both tests were high in both small and moderate sample sizes. Conclusion: The presence of a significant difference should be sought between groups according to baseline values of the related variable even though groups are randomly assigned. In addition, the degree of the correlation between baseline and follow up values should be taken into consideration. When significant differences exist between baseline values and the correlation is low, we suggest that the classical methods should be used to determine the significance of the effect; however, when the correlation is high, covariance analysis is a suitable method

Which Measure Should be Used for Testing in a Paired Design: Simple Difference, Percent Change, or Symmetrized Percent Change?

WOS: 000261655200013We aimed to determine the most proper change measure among simple difference, percent, or symmetrized percent changes in simple paired designs. For this purpose, we devised a computer simulation program. Since distributions of percent and symmetrized percent change values are skewed and bimodal, paired t-test did not give good results according to Type I error and the test power. To be to able use percent change or symmetrized percent change as change measure, either the distribution of test statistics should be transformed to a known theoretical distribution by transformation methods or a new test statistic for these values should be developed

Statistical Properties of Sampling Distributions of Different Test Statistics for Different Measures of Change and a New Test: Simulation Study

The aim of this study is to analyse the distribution characteristics of four different test statistics, namely the Mean/Standard Error of Mean (Mean/SEmean), Median/Interquartile Range (Median/IQR), Trimmed Mean/Standard Error of Mean (TrMean/SEmean), and Trimmed Mean/Interquartile Range (TrMean/IQR), which can be used to test two measures of change, namely percent change (PC) and modified symmetrised percent change (MSPC). To ensure the selection of suitable test statistics using the two measures of change, the observed type-I errors and powers of the test statistics have been computed. Results demonstrate that the sampling distributions of the four different test statistics by using PC values exhibit skewness. The Mean/SEmean statistic for the MSPC measure exhibits a two-peak value and platykurtic distribution, while the TrMean/SEmean statistic shows a leptokurtic distribution. The Median/IQR test yields robust and powerful results, especially for large sample sizes. This new statistical measure is referred to as the HS test.WOS:00059204480000