Prevalence of food insecurity and malnutrition, factors related to malnutrition in the elderly: A community-based, cross-sectional study from Turkey

Background and aim: Malnutrition is an important cause of mortality and morbidity in the elderly. The objectives of this study were to determine the malnutrition and food insecurity prevalence in the elderly in the Balcova District of Izmir and to evaluate the risk factors leading to malnutrition

Intraoperative Temperature Monitoring with Zero Heat Flux Technology (3M SpotOn Sensor) in Comparison with Tympanic and Oesophageal Temperature and Hypotermia Risk Factors: An Observational Study

Objective: Inadvertent hypothermia (body temperature below 35 degrees C) is a common and avoidable challenge during surgery under anaesthesia. It is related to coagulation (clotting) disorders, an increase in blood loss, and a higher rate of wound infection. One of the methods for non-invasive monitoring of the core body temperature is the 3M SpotOn zero heat flux method. In this approach, sensors placed at the frontal region of the patient measure the skin temperature by creating an isothermic channel. The study aimed to determine the risk factors for hypothermia and compare the 3M SpotOn zero heat flux method with the tympanic membrane (eardrum) and oesophageal (food pipe) temperature measurement methods. Design: Observational. Data sources: The patients' data were collected, including age, gender, weight, BMI, other illnesses, smoking history, type of anaesthesia, duration of surgery, operating room temperature, pulse rate, blood pressure, blood loss, and transfusions. Body temperature was measured by the tympanic membrane method before and after surgery, oesophageal method during surgery, and SpotOn measurements throughout all three periods were recorded. Eligibility criteria: Inclusion criteria was: adult patients, both genders, who had undergone major abdominal cancer surgery at the trialists' institution, in whom the SpotOn zero heat flux, tympanic membrane, and oesophageal temperature measurement methods had all been used. Participant exclusion criteria was the absence of recorded data. Results: In this study, inadvertent intraoperative hypothermia incidence was 38.1% in the recovery room. Although gender, presence of comorbidities, history of smoking, administration of epidural anaesthesia, and requirement of blood transfusion [red blood cells (RBCs) and fresh frozen plasma (FFP)] did not affect hypothermia significantly during admission to the recovery room, prewarming the patient throughout the operation prevented the occurrence of hypothermia significantly (p=0.004). Additionally, as the American Society of Anaesthesiologists (ASA) physical status score worsened, the rate of hypothermia increased significantly (Frequency: 1st degree, 29.4%; 2nd degree, 47.5%; 3rd degree, 66.7%; X-Slope-(2) p=0.047). Conclusion: The most significant risk factor was found to be not prewarming the patient as a strict procedure, and as the ASA physical status score worsened, the rate of hypothermia increased significantly. Besides, the SpotOn method provided temperature measurements as good as the oesophageal temperature measurements

Intraoperative Temperature Monitoring with Zero Heat Flux Technology (3M SpotOn Sensor) in Comparison with Tympanic and Oesophageal Temperature and Hypotermia Risk Factors: An Observational Study

Objective: Inadvertent hypothermia (body temperature below 35 degrees C) is a common and avoidable challenge during surgery under anaesthesia. It is related to coagulation (clotting) disorders, an increase in blood loss, and a higher rate of wound infection. One of the methods for non-invasive monitoring of the core body temperature is the 3M SpotOn zero heat flux method. In this approach, sensors placed at the frontal region of the patient measure the skin temperature by creating an isothermic channel. The study aimed to determine the risk factors for hypothermia and compare the 3M SpotOn zero heat flux method with the tympanic membrane (eardrum) and oesophageal (food pipe) temperature measurement methods. Design: Observational. Data sources: The patients' data were collected, including age, gender, weight, BMI, other illnesses, smoking history, type of anaesthesia, duration of surgery, operating room temperature, pulse rate, blood pressure, blood loss, and transfusions. Body temperature was measured by the tympanic membrane method before and after surgery, oesophageal method during surgery, and SpotOn measurements throughout all three periods were recorded. Eligibility criteria: Inclusion criteria was: adult patients, both genders, who had undergone major abdominal cancer surgery at the trialists' institution, in whom the SpotOn zero heat flux, tympanic membrane, and oesophageal temperature measurement methods had all been used. Participant exclusion criteria was the absence of recorded data. Results: In this study, inadvertent intraoperative hypothermia incidence was 38.1% in the recovery room. Although gender, presence of comorbidities, history of smoking, administration of epidural anaesthesia, and requirement of blood transfusion [red blood cells (RBCs) and fresh frozen plasma (FFP)] did not affect hypothermia significantly during admission to the recovery room, prewarming the patient throughout the operation prevented the occurrence of hypothermia significantly (p=0.004). Additionally, as the American Society of Anaesthesiologists (ASA) physical status score worsened, the rate of hypothermia increased significantly (Frequency: 1st degree, 29.4%; 2nd degree, 47.5%; 3rd degree, 66.7%; X-Slope-(2) p=0.047). Conclusion: The most significant risk factor was found to be not prewarming the patient as a strict procedure, and as the ASA physical status score worsened, the rate of hypothermia increased significantly. Besides, the SpotOn method provided temperature measurements as good as the oesophageal temperature measurements

Türkiye'ye ilişkin yaşlı sağlığı örgütlenmesi model önerisi

Dünyada ve Türkiye'de ölüm ve doğum hızlan azalmasıyla birlikte yaşlı sayısı ve oranı gittikçe artmaktadır. Bu artış ile birlikte sağlık sorunları yanında sosyal ve ekonomik sorunlar da ortaya çıkmaktadır. Ülkelerin birçoğunun sağlık örgütlenmesinde ve sağlık çalışanlarının lisans ve hizmet içi eğitimlerinin yapılandırılmasında bu değişim göz ardı edilmektedir. Türkiye'de de sağlık örgütlenmesi içinde yaşlı sağlığı hizmetleri salt gelene hizmet biçiminde ve hastalık temelli olarak yapılmaktadır. Bu nedenle Halk Sağlığı doktora Öğrencileri ve bir öğretim üyesi tarafından, 2005-2006 güz döneminde "Yaşlı Sağlığı" dersi kapsamında Türkiye'de yaşlı sağlığına ilişkin örgütlenme modeli önerisi oluşturulmuştur. Model oluşturulurken verilecek hizmetin amacının, temel özelliklerinin, kapsamının ne olacağı, nerede ve kimler tarafından verileceği ve finansmanın nasıl sağlanacağı sorularına yanıt aranmıştır.Decrease in mortality and fertility rate result an increase in elderly population in Turkey and in the world. Not only health problems but social and economical problems occur within this age group. In most of the countries this demographic transformation is neglected in medical education. In Turkey, elderly care is mainly focused on treatment of the diseases and based on "to whom who can apply" approach. Therefore the PhD students of Public Health and their supervisor create a model for elderly health care which describes the objectives of elderly health care, the main characteristics of the system, content, where the service should be given, by whom and finance of the system

Evaluation of education, attitude, and practice of the Turkish anesthesiologists in regional block techniques

Background: The demand for regional blocks from both patients and surgeons has significantly increased in anesthesia practice during the last 30 years. Although the studies show that the complications are rare, regional blocks still have serious difficulties which can be prevented by training programs. Objectives: The purpose of this study was to determine the factors affecting the educational methods, attitude and practice of the Turkish anesthesiologists in regional blocks during and following residency programs. Patients and Methods: Anesthesiologists were asked to answer a questionnaire. Educational proficiency was determined by at least 50 spinal, 50 epidural and 50 peripheral block applications during residency. Specialists were asked for the numbers of spinal, epidural and peripheral blocks (PBs) they applied in 2009. The mean and median values were calculated. Results: One hundred and eighty-eight anesthesiologists (84.3 %) agreed to participate in the study. While all participants had made their first attempts in neuraxial blocks (NBs) when they were residents, this ratio was detected as 96.8% for PBs. All participants learned neuraxial and PBs on patients in the operating theater. Education proficiency ratios for spinal, epidural and PBs were 98.1 %, 92.5 % and 62.3 %, respectively. Age, perception of adequate training, nerve block rotation, adequate application in education, following innovations were the factors which significantly affected the number of PBs in practice according to univariate analysis. The participants who consider their applications on NBs were adequate (P = 0.029) and the ones working in state or private hospitals (P = 0.017), applied NBs significantly above the median number. Conclusions: Anesthesiologists had adequate education and practice of NB applications but a significant proportion of participants (51.8%) lacked both in PBs applications. We believe that NBs are more easily learned than PBs during residency training program. © 2013 Iranian Society of Regional Anesthesia and Pain Medicine (ISRAPM); Published by Kowsar Corp