Primary care physicians' approach to diagnosis and treatment of hepatitis B and hepatitis C patients

BACKGROUND: Infections caused by hepatitis B virus (HBV) and hepatitis C virus (HCV) are considered to be important health problems worldwide. The purpose of this study was to measure the general practitioners (GPs)' basic knowledge on HBV and HCV risk factors in determining their practice about this subject. METHODS: A cross-sectional type questionnaire survey was carried out at all of 32 primary healthcare centers (PHCCs) in Samsun, Turkey, between March 1 and April 31, 2002. The questionnaires were sent to 160 GPs and 129 (80.6%) of them answered the questionnaires. Knowledge, role responsibility, self-efficacy and attitudes and beliefs regarding to viral hepatitis B and hepatitis C were asked. RESULTS: Most of the GPs had adequate knowledge about transmission of HBV and HCV and also about risk factors for transmission of viruses. Most of the GPs (83.7%) were aware of recommendations for approach to a baby, born from HBsAg positive mother. They have limited facilities in diagnosis of viral hepatitis. Of the participants, 108 (83.7%) expressed that they could not diagnose HBV infections and 126 (97.7%) of them stated that they could not make the diagnoses of HCV infection in their local healthcare centers. The knowledge about treatment of chronic viral hepatitis B (21.8%) and C patients (17.8%) with elevated ALT is not sufficient. CONCLUSION: GPs' knowledge about risks of viral hepatitis was adequate in this study. They were not able to diagnose and follow up of these infections at PHCCs because of limited knowledge about chronic viral hepatitis and diagnostic facilities. GPs should be informed about current advice in diagnosis and treatment of chronic of HBV and HCV infections

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Correction to: Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

The original version of this article unfortunately contained a mistake

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

İstanbul Büyükşehir Belediyesi Spor A.Ş.’ de çalışanların örgütsel sosyalleşme düzeylerinin incelenmesi

06.03.2018 tarihli ve 30352 sayılı Resmi Gazetede yayımlanan “Yükseköğretim Kanunu İle Bazı Kanun Ve Kanun Hükmünde Kararnamelerde Değişiklik Yapılması Hakkında Kanun” ile 18.06.2018 tarihli “Lisansüstü Tezlerin Elektronik Ortamda Toplanması, Düzenlenmesi ve Erişime Açılmasına İlişkin Yönerge” gereğince tam metin erişime açılmıştır.Toplumsal deiim; bilim ve teknolojinin egemen olduu, yaadıımız bu çada, geliim gösteren her ülkenin, sahip olduu en önemli ve en kapsamlı unsurdur. Türkiye? de bu süreçte, içinde bulunduumuz çaa uygun olarak bilim, teknik ve teknolojik boyutlarla ilgili hizmet alanları, illerdeki belediyelere balı olarak güçlenmekte, çoalmakta ve büyümektedir. Yerel yönetimler; sınırları içerisinde bulunan halka çeitli hizmetleri götürmek için birtakım teebbüslerde bulunmaktadır. Çevre, kültür ve sanat alanında olduu gibi sportif anlamda da çeitli yapılanmalar mevcuttur. Türkiye?de bu alandaki en büyük yapının stanbul Büyükehir Belediyesi (BB) Spor A.. olduu tespit edilmitir. Bu tespitlere gerekçe olarak Spor A..?nin personel sayısı, bütçesi, her yıl yaptıı ulusal ve uluslararası spor organizasyonlar, ilettii spor tesisleri ve bu tesislerde spor yapan insanların sayı bakımından azımsanmayacak kadar çok olmasıdır. Bu çalımadaki amaç, Spor A.. Genel Müdürlüünde çalıan personelin, görev aldıı kurumda; motivasyon gücü, örgütsel balılıı, i doyumu ve kabullenme boyutlarında, kurumu; örgütsel sosyalleme anlamında nasıl algıladıklarını saptamak ve incelemektir. Bu çalımanın modeli, taramadır. Çalımanın evreni, Spor A.. Genel Müdürlüü?nde görev yapan 200 personelden olumaktadır. Veri toplama aracı gönüllü olarak katılan 112 kiiden olumaktadır. Cinsiyete ilikin veriler, ilikisiz t-Testi ile kıdem, görev ve örenim durumuna ilikin veriler ise tek yönlü varyans analizi ile test edilmitir. v Aratırmaya katılan personelin görevlerine ve cinsiyetlerine göre, balılık, motivasyon ve kabullenme boyutlarında örgütsel sosyalleme düzeyleri arasında anlamlı bir fark bulunmamıtır. Personelin eitim ve kıdem düzeylerine göre kabullenme, motivasyon ve balılık boyutlarında örgütsel algıları farklı bulunmazken, i doyumu boyutunda anlamlı bir fark bulunmutur. Öneri olarak anlamlı farklılık bulunan hipotezlerle ilgili daha kapsamlı bir çalıma yapılabilir. Farklılıkların hangi konulardan kaynaklandıı ve sebepleri üzerinde durulabilir. Bir baka öneri ise benzer kurumlarla karılatırma yapılıp sonuçlarının nedenleri ortaya konabilir. Anahtar Kelimeler: Örgütsel Sosyalleme, doyumu, Motivasyon, Kabullenme, BalılıkThe social change; is the most important and extensive element, which science and technology are dominant at every developing country holds. In Turkey this process, in accordance with the current age of science, technical and technological dimensions for service areas are getting stronger and growing with municipalities in the provinces. Local administrations are located several attempts to bring various services within the boundaries of the public. Environment, culture and art as well as, there are several structures in the sporting sense. The largest structure in this area in Turkey is Istanbul Metropolitan Municipality (IMM) Sports Inc was determined. As a reason for these findings are,the number of Sports Inc.'s personnel, budget, the national and international sports organizations every year, sports facilities and these facilities are operated in terms of the number of people involved in sports so much that can not be underestimated. The aim of this study is to analyze Directorate General Spor Inc. personnel in the staff of the with respect to motivational power, organizational commitment, job satisfaction, acceptance and stress in the institutions, and examine to determine how they perceive the sense of organizational socialization. Model of this study is scanning. Although target population of the study is 200 people who work for Spor A. Directorate General, 112 people of them contributed the study voluntarily. The data related to gender has been tested with unrelated t-test; seniority, while data on the status of tasks and learning has been tested with a one-way analysis of variance. Any significant difference was not found between the levels of organizational socialization concerning motivation, acceptance and commitment between the staff surveyed in terms of vii sex and duty. Acceptance by level of education and seniority of staff, their perceptions of organizational dependence on motivation and commitment are not different, significant difference is found in terms of job satisfaction. As proposal, related to the hyposteses that find significant variation can be done a comprehensive study. It can be emphasized reasons of variations. The another proposal, after consequences compare with similar instutions, it can analyze. Keywords: Organizational Socialization, Job Satisfaction, Motivation, Acceptance, Commitmen

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Bu dönem projesi çalışması Ionic Stone Maden Tasarım Ar-Ge merkezi tarafından ION011 nolu proje ile desteklenmiştir

Morphological, Agronomical, Phenological and Stand Persistence Traits of Some Wild Narrowleaf Birdsfoot Trefoil (Lotus tenuis Waldst. & Kit.) Populations

WOS: 000377710300003Existing information on the ecology, distribution and plant traits of Lotus taxa is scant for the natural flora of Turkey, which is one of the most important countries in the Mediterranean zone for genetic resources and genetic diversity of these species. Therefore, the aim of this study was to determine (i) morphologic, agronomic, phenologic, stand persistence traits and growth habits of some wild narrowleaf birdsfoot trefoil (NBT; Lotus tenuis Waldst. & Kit.), and (ii) the relationships between these traits and altitude, latitude or longitude of the natural habitats, the samples of which were obtained from diverse natural areas of Black Sea Region, Turkey. The altitudes of sampling sites ranged from 1 to 1510 m. A total of 86 wild NBT were sampled in the study. NBT was present in all ranges of altitude, although its frequency was the highest in altitudes between 1-300 m. On the other hand, considerable variations were determined for the investigated traits, except for growth habit in which all populations had decumbent growth habit. The results of the present study indicate that NBT better adapted to lowlands and studied region offers important genetic resources for further researches and also may serve as a valuable breeding material for new grazing-type and disease resistant NBT varieties.TUBITAKTurkiye Bilimsel ve Teknolojik Arastirma Kurumu (TUBITAK) [108O658]This research was supported by TUBITAK (Project No. 108O658). The authors sincerely thank Dr. Ahmet Balkaya and Dr. Nuh Ocak for critical review of the paper

Two Cases of Autoimmune Hemolytic Anemia Secondary to Brucellosis: A Review of Hemolytic Disorders in Patients with Brucellosis

Brucellosis is a worldwide zoonotic disease associated with hemolytic complications, including thrombotic microangiopathy (TMA) and hemolytic anemia. Autoimmune hemolytic anemia (AIHA) is a rare clinical presentation of this disease. In this report, we describe the cases of two patients with brucellosis who presented with Coombs-positive AIHA. We also include a review of the literature on the hemolytic complications of brucellosis. Both patients were successfully treated with a combination of doxycycline and rifampicin in addition to steroids. In the medical literature, there are several cases of TMA associated with brucellosis, although only a few cases of Coombs test-positive AIHA have been reported. Antibiotic therapy is the mainstay of treatment, and the selection of antibiotics and duration of treatment do not differ between brucellosis patients with and without hemolysis. Although rare, the potential for brucellosis should always be kept in mind in patients who present with hemolysis, especially those living in areas where brucellosis is endemic