Experiences of patients with implantable cardioverter defibrillator in Turkey: A qualitative study

Background. There has been an increase in the number of patients with implantable cardioverter defibrillator (ICD). It isimportant to understand ICD patients’ experiences with it.Aim. The aim of this study was to describe experiences of patients with implantable cardioverter defibrillator (ICD).Methodology. A qualitative approach was used. Focus group interviews were used to obtain data from 19 patients whowere implanted cardioverter defibrillator at two centers in Izmir, Turkey. The patients were assigned into four groups. Thedata was analyzed using qualitative content analysis.Results. The analysis revealed six main themes: activities of daily living, social life, familial relationships, emotionalchanges, implantable cardioverter defibrillator shocks and experiences with receiving information and counselling fromhealth care providers.Conclusions. It can be concluded that patients with ICD experience physical and psychological problems and are not offeredthe education they need. To reduce the fears of the patients and their families and to prepare them for possible life stylechanges, comprehensive training programs that start in the pre-implantation period and continue into the post-implantationperiod should be organized

VIEWS OF HIGHER EDUCATION ADMINISTRATORS AND STUDENTS ON THE EXAMINATION OF CRISIS AND CHAOS SITUATIONS MANAGEMENT

Abstract. The purpose of this study is to determine the opinions and expectations of higher education administrators and students about the crisis and chaos situations management. Research was conducted in 2016-2017 academic year. The study group consisted of 41 people including 10 participants from Gazi, Başkent and Selçuk Universities each and 11 from Ankara University. This study was conducted by semi-structured interview method based on qualitative research approach. In the research, a nine-question form was used by the researcher. Content analysis method was used in data analysis. As a result of the study, it has been revealed that higher education administrators are not effective in crisis management and often intervened after the crisis has emerged and there is no preliminary preparation.Keywords: higher education, administrator, crisis, chaos

Effects of Medication Perceptions of Patient Who Take The Disease Modifying Anti- Rheumatic Drugs in Rheumatic Disease on Adherence

Giriş: Romatizmal hastalıkların tedavisinde hastalık modifiye edici antiromatizmal ilaç (disease-modifying anti-rheumatic drug [DMARD])tedavisi önemli rol oynamakta, ilaçlar uzun dönemde düzenli kullanıldığında etkili olmaktadır. Bu nedenle hastaların ilaç tedavisine uyumuönem taşımaktadır. İlaç tedavisine uyumun önemli bir belirleyicisi de tedaviye ilişkin algılardır.Amaç: Araştırma DMARD tedavisi alan bireylerin tedaviye ilişkin algılarının uyuma etkisini incelemek amacıyla tanımlayıcı olarakyapılmıştır.Yöntem: Araştırmaya bir üniversite hastanesinin Romatoloji polikliniğinde izlenen, en az üç aydır romatizmal hastalığı nedeniyle DMARDtedavisi alan, 18 yaş ve üzerinde 300 hasta alınmıştır. Veri toplama aracı olarak araştırmacı tarafından düzenlenmiş anket formukullanılmıştır. Formda bireye, hastalığa, tedaviye ilişkin özellikler, ilaç tedavisine uyum ve tedaviye ilişkin algılar ile ilgili sorular yeralmaktadır. Verilerin analizinde iki ortalama arasındaki farkın önemlilik testi (t testi) kullanılmıştır.Bulgular: Olguların uyum puan ortalamaları 7.85±2.28 olarak bulunmuştur. Olguların uyum puanlarının, ortalamanın üzerinde olduğusöylenebilir. Sürekli ilaç kullanmanın günlük yaşamı etkilediği, ilaçların yan etkileri olacağı ve sürekli kullanıldığında ilaca bağımlı olmaalgısının uyumu etkilemediği belirlenmiştir. İlaç kullanmanın gerekli olduğunu, ilaçların yan etkileriyle baş edebildiğini, kullanılan ilaçlarınyakınmaları azalttığını, kullanılan ilaçların yararlı olduğunu ve düzenli ilaç kullanımı ile hastalığın ilerlemeyeceğini düşünen bireylerin uyumpuan ortalamaları, düşünmeyen bireylere göre istatistiksel olarak anlamlı derecede yüksek bulunmuştur.Sonuç: Elde edilen bulgulara göre; ilaç tedavisine uyumda, bireylerin ilaçlarla ilgili algılarının etkili olabileceği belirlenmiştir. Bu nedenle,DMARD kullanan bireylerin ilaç kullanma konusundaki algılarının tartışılması ve gereksinimlerine yönelik eğitim verilmesi önerilmektedir. Background: Disease-modifying anti-rheumatic drugs (DMARDs) plays an important role to treatment of rheumatic disease, drugs arethought to be effective only if the patients adheres to long term treatment. Therefore patients adherence to treatment is important. Treatmentperception is an important determinant of medication adherence.Objectives: This descriptive study was performed to identify effects of subjects', who undertake DMARDs, treatment perceptions onadherence.Methods: The study sample included 300 patients, aged 18 years or over and receiving DMARDs for at least three months. Data werecollected with a questionnaire developed by the researcher. The questionnaire was composed of questions about general and diseasecharacteristics, treatment given, adherence to treatment and perceptions regarding the treatment. Data were analyzed with t- test.Results: The mean score for adherence to treatment was 7.85±2.28. The case's adherence score is higher than the mean score of adherenceto treatment. According to the results of the study, perception of effecting the daily life because of using the medicine all the time,perceptions of adverse effect, perceptions of being addict didn't effect the adherence rate to medication. In addition, adherence to treatmentwas influenced by the following perceptions: "It is necessary to receive disease modifying antirheumatic drugs, "the drugs used decreasecomplaints and are useful, regular drug use prevents disease progression and perception of overcoming with adverse effect.Conclusion: In conclusion that, patients perceptions of treatment effects on adherence to treatment. Therefore, it is suggested that thepeople's who taking DMARD therapy, medication perception should be discussed and the people educated according to their needs

İmplante edilebilen kardiyoverter defibrilatörü olan hastanın eğitiminde teknoloji kullanımı

İmplante edilebilen kardiyoverter defibrilatör (ICD) cihazları ile tedavi günümüzde ölümcül aritmilerin ve ileri düzey kalp yetersizliklerinin tedavisinde sıklıkla kullanılan bir yöntemdir. ICD kullanımı klinik olarak etkili olmasına karşın, hasta ve ailesi için bir dizi psikososyal zorluğu da beraberinde getirmektedir. Bu hastaların ve ailelerinin kaliteli bir yaşam sürdürmesi için psikolojik destek ve eğitimlerine özel bir önem verilmelidir. ICD hastalarının eğitimi için birçok teknolojik yöntem kullanılmıştır. Yapılan girişimlerin amacı hastaların yaşadıkları psikososyal sorunları gidererek yaşam kalitelerini yükseltmektir. Teknoloji alanında yaşanan büyük değişiklikler ve bireylerin bu yönde olan ilgisi, sağlık çalışanlarının da bu konuya olan ilgisinin artmasına neden olmuştur. Hasta ve sağlam bireyler için teknoloji temelli eğitim programları geliştirilmeye başlanmıştır. Bu makalenin amacı ICD hastalarına teknoloji kullanılarak yapılan sağlık eğitimi araştırmalarının sonuçlarını sunmak ve başta hemşirelik mesleği olmak üzere tüm sağlık profesyonellerine bu konu hakkında bakış açısı kazandırmaktır

A Learning Experience: Reflection

Öğrenme yaşantısından anlam çıkarmaya yardım edici yöntemlerden biri reflekşındır (reflection). Reflekşın, kişinin tüm düşüncelerini birproblem üzerinde yoğunlaştırması, bir konuyu ayrıntıyla düşünmesi ve irdelemesidir. Reflekşın yöntemi, öğrencilerin karşılaştıklarıdurumlarla ilgili eylemleri ya da eylemsizliklerinde kendilerini tanımalarına, eleştirel düşünmelerine, problem çözmelerine, sorumlulukalmalarına yardım etmektedir. Dokuz Eylül Üniversitesi (DEÜ) Hemşirelik Yüksekokulu'nda hemşirelik öğrencilerinin kişisel veprofesyonel gelişimini kolaylaştırmak amacıyla reflekşın yöntemi uygulanmaya başlanmıştır. Bu makalede reflekşın ile ilgili bilgiler vedeneyimlerin paylaşılması amaçlanmıştır. One of the methods which help us to infer from learning is reflection. Reflection is a way through which a person concentrates all hisattention on a certain problem, thinks about a topic in detail and examines it thoroughly. The reflection method helps students recognizethemselves, scrutinize, solve problems and take responsibility for being active or inactive in situations they encounter. In Dokuz EylülUniversity School of Nursing, in order to help nursing students improve their personal and professional development, the reflection methodhas been introduced. This article aims at sharing information and experiences related to reflection

Determination of aluminum rolling oil and machinery oil residues on finished aluminum sheet and foil using elemental analysis and fourier transform infrared spectroscopy coupled with multivariate calibration

Light Metals 2014 - TMS 2014 Annual Meeting and Exhibition; San Diego, CA; United States; 16 February 2014 through 20 February 2014The surface characteristics of rolled aluminum products such as sheets and foils are strongly affected by the particular rolling process and the type of aluminum rolling oil compositions. After the rolling process, coiled aluminum sheets and foils undergoes annealing to form desired crystal structure and remove the rolling oil residues. Depending on the time and the temperature that rolled aluminum exposed for annealing, rolling oil residues are mostly removed from the coiled aluminum products but if there is any contamination in rolling oil due to hydraulic and gearing parts of the rolling systems these heavier oils are not easily evaporates from the aluminum surfaces especially inner parts of the coiled aluminum sheets and foils. These rolling oil contaminants create serious problems for the some specific applications of these aluminum products in certain industries such as automotive and coating as remaining thin oil layer prevents proper painting and coating. Therefore, it is very crucial for the rolling industry to be able to monitor the heavy oil contamination on the rolled products and determine the source of these contaminants .In this study, it was aimed to develop a nondestructive infrared spectroscopic method combined with chemometric multivariate calibration techniques for the quantitative determination of rolling oil residues and contaminants on the rolled aluminum products. To be able to generate multivariate calibration methods, an industrial elemental analysis system was adopted for the quantitative determination of heavy oil contaminants on the rolled aluminum products and these were used as reference values for infrared analysis of the same samples. In addition, apart from conventional use of elemental analysis systems for the total organic analysis, the raw data (raw chromatogram) obtained from elemental analysis was used to directly generate multivariate calibration models for each contaminant by using synthetically contaminated surfaces as the calibration samples. The results promised that elemental analysis can be used not just for the total organic content but also specifically to determine amount of each contaminant on the aluminum surfaces, it is also, expected that infrared spectroscopy with grazing angle spectra collection accessories can be used for nondestructive analysis of these contaminants.s

Age-Related Effects of COVID-19 Pandemic on Mechanical Reperfusion and 30-Day Mortality for STEMI : Results of the ISACS-STEMI COVID-19 Registry

Background: The constraints in the management of patients with ST-segment elevation myocardial infarction (STEMI) during the COVID-19 pandemic have been suggested to have severely impacted mortality levels. The aim of the current analysis is to evaluate the age-related effects of the COVID-19 pandemic on mechanical reperfusion and 30-day mortality for STEMI within the registry ISACS-STEMI COVID-19. Methods: This retrospective multicenter registry was performed in high-volume PPCI centers on four continents and included STEMI patients undergoing PPCI in March–June 2019 and 2020. Patients were divided according to age (< or ≥75 years). The main outcomes were the incidence and timing of PPCI, (ischemia time longer than 12 h and door-to-balloon longer than 30 min), and in-hospital or 30-day mortality. Results: We included 16,683 patients undergoing PPCI in 109 centers. In 2020, during the pandemic, there was a significant reduction in PPCI as compared to 2019 (IRR 0.843 (95%-CI: 0.825–0.861, p < 0.0001). We found a significant agerelated reduction (7%, p = 0.015), with a larger effect on elderly than on younger patients. Furthermore, we observed significantly higher 30-day mortality during the pandemic period, especially among the elderly (13.6% vs. 17.9%, adjusted HR (95% CI) = 1.55 [1.24–1.93], p < 0.001) as compared to younger patients (4.8% vs. 5.7%; adjusted HR (95% CI) = 1.25 [1.05–1.49], p = 0.013), as a potential consequence of the significantly longer ischemia time observed during the pandemic. Conclusions: The COVID-19 pandemic had a significant impact on the treatment of patients with STEMI, with a 16% reduction in PPCI procedures, with a larger reduction and a longer delay to treatment among elderly patients, which may have contributed to increase in-hospital and 30-day mortality during the pandemic

Gender Difference in the Effects of COVID-19 Pandemic on Mechanical Reperfusion and 30-Day Mortality for STEMI: Results of the ISACS-STEMI COVID-19 Registry

Background. Several reports have demonstrated the impact of the COVID-19 pandemic on the management and outcome of patients with ST-segment elevation myocardial infarction (STEMI). The aim of the current analysis is to investigate the potential gender difference in the effects of the COVID-19 pandemic on mechanical reperfusion and 30-day mortality for STEMI patients within the ISACS-STEMI COVID-19 Registry. Methods. This retrospective multicenter registry was performed in high-volume primary percutaneous coronary intervention (PPCI) centers on four continents and included STEMI patients undergoing PPCIs in March–June 2019 and 2020. Patients were divided according to gender. The main outcomes were the incidence and timing of the PPCI, (ischemia time ≥ 12 h and door-to-balloon ≥ 30 min) and in-hospital or 30-day mortality. Results. We included 16683 STEMI patients undergoing PPCIs in 109 centers. In 2020 during the pandemic, there was a significant reduction in PPCIs compared to 2019 (IRR 0.843 (95% CI: 0.825–0.861, p < 0.0001). We did not find a significant gender difference in the effects of the COVID-19 pandemic on the numbers of STEMI patients, which were similarly reduced from 2019 to 2020 in both groups, or in the mortality rates. Compared to prepandemia, 30-day mortality was significantly higher during the pandemic period among female (12.1% vs. 8.7%; adjusted HR [95% CI] = 1.66 [1.31–2.11], p < 0.001) but not male patients (5.8% vs. 6.7%; adjusted HR [95% CI] = 1.14 [0.96–1.34], p = 0.12). Conclusions. The COVID-19 pandemic had a significant impact on the treatment of patients with STEMI, with a 16% reduction in PPCI procedures similarly observed in both genders. Furthermore, we observed significantly increased in-hospital and 30-day mortality rates during the pandemic only among females. Trial registration number: NCT 04412655

Impact of chronic obstructive pulmonary disease on short-term outcome in patients with ST-elevation myocardial infarction during COVID-19 pandemic: insights from the international multicenter ISACS-STEMI registry

Background Chronic obstructive pulmonary disease (COPD) is projected to become the third cause of mortality worldwide. COPD shares several pathophysiological mechanisms with cardiovascular disease, especially atherosclerosis. However, no definite answers are available on the prognostic role of COPD in the setting of ST elevation myocardial infarction (STEMI), especially during COVID-19 pandemic, among patients undergoing primary angioplasty, that is therefore the aim of the current study. Methods In the ISACS-STEMI COVID-19 registry we included retrospectively patients with STEMI treated with primary percutaneous coronary intervention (PCI) between March and June of 2019 and 2020 from 109 high-volume primary PCI centers in 4 continents. Results A total of 15,686 patients were included in this analysis. Of them, 810 (5.2%) subjects had a COPD diagnosis. They were more often elderly and with a more pronounced cardiovascular risk profile. No preminent procedural dissimilarities were noticed except for a lower proportion of dual antiplatelet therapy at discharge among COPD patients (98.9% vs. 98.1%, P = 0.038). With regards to short-term fatal outcomes, both in-hospital and 30-days mortality occurred more frequently among COPD patients, similarly in pre-COVID-19 and COVID-19 era. However, after adjustment for main baseline differences, COPD did not result as independent predictor for in-hospital death (adjusted OR [95% CI] = 0.913[0.658-1.266], P = 0.585) nor for 30-days mortality (adjusted OR [95% CI] = 0.850 [0.620-1.164], P = 0.310). No significant differences were detected in terms of SARS-CoV-2 positivity between the two groups. Conclusion This is one of the largest studies investigating characteristics and outcome of COPD patients with STEMI undergoing primary angioplasty, especially during COVID pandemic. COPD was associated with significantly higher rates of in-hospital and 30-days mortality. However, this association disappeared after adjustment for baseline characteristics. Furthermore, COPD did not significantly affect SARS-CoV-2 positivity. Trial registration number: NCT 04412655 (2nd June 2020)

Age-Related Effects of COVID-19 Pandemic on Mechanical Reperfusion and 30-Day Mortality for STEMI: Results of the ISACS-STEMI COVID-19 Registry

Background: The constraints in the management of patients with ST-segment elevation myocardial infarction (STEMI) during the COVID-19 pandemic have been suggested to have severely impacted mortality levels. The aim of the current analysis is to evaluate the age-related effects of the COVID-19 pandemic on mechanical reperfusion and 30-day mortality for STEMI within the registry ISACS-STEMI COVID-19. Methods: This retrospective multicenter registry was performed in high-volume PPCI centers on four continents and included STEMI patients undergoing PPCI in March-June 2019 and 2020. Patients were divided according to age (= 75 years). The main outcomes were the incidence and timing of PPCI, (ischemia time longer than 12 h and door-to-balloon longer than 30 min), and in-hospital or 30-day mortality. Results: We included 16,683 patients undergoing PPCI in 109 centers. In 2020, during the pandemic, there was a significant reduction in PPCI as compared to 2019 (IRR 0.843 (95%-CI: 0.825-0.861, p < 0.0001). We found a significant age-related reduction (7%, p = 0.015), with a larger effect on elderly than on younger patients. Furthermore, we observed significantly higher 30-day mortality during the pandemic period, especially among the elderly (13.6% vs. 17.9%, adjusted HR (95% CI) = 1.55 [1.24-1.93], p < 0.001) as compared to younger patients (4.8% vs. 5.7%; adjusted HR (95% CI) = 1.25 [1.05-1.49], p = 0.013), as a potential consequence of the significantly longer ischemia time observed during the pandemic. Conclusions: The COVID-19 pandemic had a significant impact on the treatment of patients with STEMI, with a 16% reduction in PPCI procedures, with a larger reduction and a longer delay to treatment among elderly patients, which may have contributed to increase in-hospital and 30-day mortality during the pandemic