Association between health literacy and medication adherence in the elderly population with chronic disease

Background: Medication adherence is a key factor in the therapy of chronic diseases in older people. It is important to investigate the effect of health literacy on medication adherence in this patient population. Health literacy can be summarized as an individual’s ability to understand and interpret the provided medical information and to behave appropriately based on this information. Aim: The purpose of this study was to investigate the association between health literacy and medication adherence in older people with chronic disease. Methods: A total of 175 patients admitted to the family health center clinic in Bursa, Turkey, who were older than 65 years old, were enrolled in this cross-sectional study using the convenience sampling method. A priori power analysis was conducted to determine the required sample size to reach 90% power. The Turkish version of the 8-item Morisky Medication Adherence Scale (MMAS-8) was used to assess medication adherence. The European Health Literacy Survey Questionnaire (HLS-EU-Q47) was used to evaluate health literacy. Disability associated with dyspnea was assessed using the Medical Research Council (MRC) dyspnea scale. Results: The data showed that, according to dyspnea status and diagnosis, medication adherence varied. In this sample, medication adherence in elderly patients was not associated with health literacy. Instead, medication adherence was associated with the patient’s disability and the course of the disease. Discussion and conclusions: Improving health literacy may enhance the medication adherence of older people with chronic disease. The development, practice and evaluation of health literacy interventions for older people with chronic conditions are important to increase medication adherence and potentially improve patient outcomes. [Ethiop. J. Health Dev. 2020; 34(2):90-96] Key words: Health literacy, medication adherence, older patients, chronic disease, dyspne

EFFECT OF EXERCISE ON APPETITE-REGULATING HORMONES IN OVERWEIGHT WOMEN

Over the past decade, our knowledge of how homeostatic systems regulate food intake and body weight has increased with the discovery of circulating peptides such as leptin, acyl ghrelin, des-acyl ghrelin and obestatin. These hormones regulate the appetite and food intake by sending signals to the brain regarding the body’s nutritional status. The purpose of this study was to investigate the response of appetite-regulating hormones to exercise. Nine overweight women undertook two 2 h trials in a randomized crossover design. In the exercise trial, subjects ran for 60 min at 50% of maximal oxygen uptake followed by a 60 min rest period. In the control trial, subjects rested for 2 h. Obestatin, acyl ghrelin, des-acyl ghrelin and leptin concentrations were measured at baseline and at 20, 40, 60, 90 and 120 min after baseline. A two-way ANOVA revealed a significant (P<0.05) interaction effect for leptin and acyl ghrelin. However, changes in obestatin and des-acyl ghrelin concentration were statistically insignificant (P>0.05). The data indicated that although acute treadmill exercise resulted in a significant change in acyl ghrelin and leptin levels, it had no effect on plasma obestatin and des-acyl ghrelin levels

Impact of antimicrobial drug restrictions on doctors' behaviors

Background/aim: Broad-spectrum antibiotics have become available for use only with the approval of infectious disease specialists (IDSs) since 2003 in Turkey. This study aimed to analyze the tendencies of doctors who are not disease specialists (non-IDSs) towards the restriction of antibiotics.Materials and methods: A questionnaire form was prepared, which included a total of 22 questions about the impact of antibiotic restriction (AR) policy, the role of IDSs in the restriction, and the perception of this change in antibiotic consumption. The questionnaire was completed by each participating physician.Results: A total of 1906 specialists from 20 cities in Turkey participated in the study. Of those who participated, 1271 (67.5%) had 5 years of occupational experience in their branch expressed that they followed the antibiotic guidelines more strictly than the JSs (P < 0.05) and 755 of physicians (88%) and 720 of surgeons (84.6%) thought that the AR policy was necessary and useful (P < 0.05).Conclusion: This study indicated that the AR policy was supported by most of the specialists. Physicians supported this restriction policy more so than surgeons did

Profilin-1 as a New Potential Biomarker on Diagnosis of Early Atherosclerosis in Hemodialysis Patients

13th International Congress of Update in Cardiology and Cardiovascular Surgery (UCCVS) -- MAR 23-26, 2017 -- Cesme, TURKEYWOS: 000407309200091

Dual frequency reflectarray cell using split-ring elements with RF MEMS switches

In this study, a dual frequency circularly polarized reconfigurable reflectarray (RA) cell with RF-MEMS switches is designed. RA combines the advantages of reflector-based and phased array antennas, providing a low-cost and high performance antenna array solution. In their reconfigurable implementations, RAs are capable of electronic beam scanning/forming with potential multiband operation, as discussed here. In this work, reconfigurability is achieved by series RF-MEMS switches that are placed on the ring strips. Switches are used to change the orientation of the gaps to realize the rotation of the element. The RA antenna composed of these elements will be capable of beamsteering independently for the two operating frequencies. In the following section the RA unit cell geometry is presented, some simulation results are given, and the phase design curve is discussed

Proof of concept of a dual-band circularly-polarized RF MEMS beam-switching reflectarray

In this communication we propose the concept of a circularly polarized reflectarray (RA) antenna capable of independent beam-switching in both K and Ka bands. The RA unit cell comprises one microstrip ring per each operation frequency. Each ring is integrated with six equally spaced series RF micro electro-mechanical systems (RF MEMS) switches, which allows implementing the sequential rotation principle formerly used in circularly-polarized RA for single-frequency operation. A detailed design is proposed, considering the best relative arrangement of the rings corresponding to each frequency, the accurate modeling of the RF MEMS switches, and the full-wave simulation of the full array. The designed RA is implemented on a 4-inch quartz wafer and comprises 109 K-band and 124 Ka-band split-rings. Two prototypes representing two frozen states of the reconfigurable antenna are fabricated and measured. The designed RA can +/- 120 degrees provide progressive phase difference in both operation bands exhibiting beam switching to +/- 35 degrees and +/- 24 degrees off the broad-side in K and Ka bands respectively. The performance of the designed antenna is verified by the agreement of the measured and simulated radiation patterns

Catheter-Related Bacteremia in a Hemodialysis Unit: Cronobacter Sakazakii

WOS: 000433118700001In this study, a case of catheter-related bacteremia caused by Cronobacter sakazakii, which was successfully treated with antibiotic therapy, was presented. Since 1989, cases of contamination of powder infant formula caused by C. sakazakii have been reported. However, adult infections related to C. sakazakii are exceedingly rare. A 61-year-old male patient was in dialysis treatment with chronic renal failure and blood cultures were taken from peripheral veins and catheter because of fever. At the same time, moxifloxacin (400 mg/day iv) and ampicillin-sulbactam (1 g/day iv) were started as empirical therapy. One bacterium was detected on blood cultures obtained from peripheral veins and catheters and this bacterium was identified as C. sakazakii by the VITEK 2 Compact automated system. The species identification of the isolated strain was confirmed by 16S rRNA sequence analysis. The treatment of the patient, who was thought to represent a case of catheter-related bacteremia, was continued and the catheter was not removed since subsequent cultures did not reveal any bacterial growth. To our knowledge, the presented case is the first bacteremia related to C. sakazakii from Turkey. As a result, C. sakazakii is an infection agent that we have recently encountered and may pose a threat to public health

Ana bileşenler analizi ile panik bozukluğu alt tiplerinin değerlendirilmesi

Amaç: Panik bozukluğunun (PB) değişik alt tiplerinin olduğu ve farklı alt tiplerin belirlenmesinin tanı, tedavi ve sonlanım açısından önemli olduğu ileri sürülmektedir. PB'nin psikopatolojisinin kantitatif değerlendirilmesi konusundaki çalışmalar azdır. Çalışmamızda, panik atak belirtilerinin faktör analizine dayanan alt tiplerinin belirlenmesi amaçlanmıştır.Yöntem: Çalışmamız, Bakırköy Prof. Dr. Mazhar Osman Ruh Sağlığı ve Sinir Hastalıkları Eğitim ve Araştırma Hastanesi ikinci basamak polikliniklerine başvuran ve çalışmaya dahil edilme ölçütlerini karşılayan 159 hasta üzerinde gerçekleştirildi. Çalışmada, araştırıcılar tarafından hazırlanan sosyodemografik bilgi formu, DSM-IV Eksen I Bozukluklar İçin Yapılandırılmış Klinik Görüşme Formu (SCID-I), Panik Agorafobi Ölçeği (PAÖ), Hamilton Depresyon Derecelendirme Ölçeği (HAM-D), Beck Anksiyete Ölçeği (BAÖ) kullanıldı. DSM IV-TR panik atak tanı ölçütlerinde bulunan 13 maddeye, "felç olma korkusu" ile "kaçma isteği, yerinde duramama hali"nin eklenmesiyle toplam 15 maddeden oluşan değişkenlere, katılımcıların son panik ataklarında yaşadıklarını bildirdikleri belirtilere göre Ana Bileşenler Analizi uygulandı.Bulgular: Ana Bileşenler Analizinde toplam varyansın %56'sını açıklayan 6 ayrık faktör kümesi elde edildi. Birinci küme otonomik aktivasyon kümesi, ikinci küme vestibüler belirtiler, üçüncü küme kardiovasküler belirtiler, dördüncü küme psödonörolojik belirtiler, beşinci küme solunum sistemi belirtileri ve altıncı küme ölüm korkusu kümesi olarak adlandırıldı.Sonuç: Çalışmamızda elde edilen belirti profilleri DSM-IV-TR tanı ölçütlerini desteklemektedir. Ana Bileşenler Analizinde, varyansın önemli bir kısmını açıklayan anlamlı alt tipler oluşmuşturObjective: Panic disorder is put forward to have a heterogeneous structure and multiple subtypes. Evaluating the different subtypes is important for diagnosis, treatment and prognosis. Studies about the quantitative psychopathology assessment are so rare. We aim to determine the subtypes with principal component analysis of panic attack symptoms.Method: 159 outpatients with panic disorder who had referred to the anxiety disorder outpatient unit in Bakirkoy Research and Training Hospital for Psychiatry, Neurology and Neurosurgery were included in the study. A sociodemographic questionnaire that was prepared by the investigators, The Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I), Panic and Agoraphobia Scale (PAS), Hamilton Depression Rating Scale (HAM-D), Beck Anxiety Inventory (BAI) were used in the study. Variables with 15 items were created adding ‘Fear of stroke’ and ‘desire to escape, restlessness’. Principal Component Analysis was applied according to the panic symptoms that the patiens declared.Results: Six loading factors were obtained explaning 56% of total variance in Principal Component Analysis. The first set was named autonomic activation, the second was vestibular symptoms, the third was cardiovascular symptoms, the fourth was pseudoneurologic symptoms, the fifth was respiratory system symptoms and the sixth was fear of death.Conclusion: Symptom profiles in our study were compatible with DSM-IV-TR diagnostic criteria. Significant panic disorder subtypes were found in principal component analysi

Evaluating the subtypes of panic disorder by using principal component analysis

Objective: Panic disorder is put forward to have a heterogeneous structure and multiple subtypes. Evaluating the different subtypes is important for diagnosis, treatment and prognosis. Studies about the quantitative psychopathology assessment are so rare. We aim to determine the subtypes with principal component analysis of panic attack symptoms. Method: 159 outpatients with panic disorder who had referred to the anxiety disorder outpatient unit in Bakirkoy Research and Training Hospital for Psychiatry, Neurology and Neurosurgery were included in the study. A sociodemographic questionnaire that was prepared by the investigators, The Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I), Panic and Agoraphobia Scale (PAS), Hamilton Depression Rating Scale (HAM-D), Beck Anxiety Inventory (BAI) were used in the study. Variables with 15 items were created adding 'Fear of stroke' and 'desire to escape, restlessness'. Principal Component Analysis was applied according to the panic symptoms that the patiens declared. Results: Six loading factors were obtained explaning 56% of total variance in Principal Component Analysis. The first set was named autonomic activation, the second was vestibular symptoms, the third was cardiovascular symptoms, the fourth was pseudoneurologic symptoms, the fifth was respiratory system symptoms and the sixth was fear of death. Conclusion: Symptom profiles in our study were compatible with DSM-IV-TR diagnostic criteria. Significant panic disorder subtypes were found in principal component analysis