January 1958

My dear Brother: It does not require a great stretch of the imagination for me to hear you mutter: Didn\u27t I get one of these yellow sheets only a month ago? Why doesn\u27t he get back to work instead of cluttering up my mail? Well, thereby hangs a tale. A few weeks ago I spent an illuminating, and somewhat dismaying, evening with brother Theophilus in the Middle West. He has a good congregation of about five hundred members. It is an average parish, with the usual complement of saints and sinners, with the lines between them shifting back and forth. Theophilus has worked hard and the Lord of the Church has blessed his hands and his voice

Effect of maternal cortisol levels on fetal heart rate patterns in primiparous pregnant women in the third trimester

OBJECTIVE: This study aimed to determine whether maternal cortisol levels affect fetal heart rate patterns in primiparous pregnant women in the third trimester. METHODS: This cross-sectional descriptive study included 400 primiparous pregnant women with uncomplicated pregnancies between November and December 2022. The study included primiparous pregnant women over 18 years old in the third trimester who had not exercised for at least 2 h before the fetal heart rate monitoring and had a healthy pregnancy without consuming any food or drink. Fetuses with decelerating heartbeats and pregnant women who showed uterine contraction and cervical dilation during the fetal heart rate monitoring were excluded from the study. Research data were collected with the data collection form. The fetal heart rate data were collected using a cardiotocograph. At least two accelerations during the 20-min nonstress test period were the basis for diagnosing a reactive nonstress test. About 5 mL of maternal saliva for cortisol measurements was collected before fetal heart rate monitoring. Research data were analyzed with IBM SPSS Statistics for Macintosh, Version 28.0. A p-value of 0.05). The number of at least two accelerations required for the diagnosis of reactive NST was also higher in Group 1 (maternal salivary cortisol level ≤24.20). A moderately positive relationship between fetal heart rate and maternal salivary cortisol was observed (r=0.448, p=0.000). In total, 11.9% of the total change in fetal heart rate level is explained by maternal cortisol (R2=0.119). Maternal cortisol increases fetal heart rate level (ß=0.349). CONCLUSION: These findings suggest that stress in primiparous pregnant women with high cortisol levels may influence fetal heart rate patterns. It was revealed that the increase in cortisol level, considered a stress hormone, may be a harbinger of fetal tachycardia

Postępowanie z zaparciami u pacjentów neurochirurgicznych

Constipation is a common complication in patients treated in neurosurgery clinics and it is an important problem. Neurosurgery nurse has an important role in assessment and prevention, of the disease. Constipation can be prevented in neurosurgery patients, with effective constipation diagnosis and side effects resulting from unnecessary use of drugs can be minimized. Within this framework, the nurse diagnoses the excretion habits, listens to the abdominal sounds of the patient, palpates the abdomen for distention and uses reliable and safe diagnosis tools. With the most important nursing interventions to prevent constipation, one can include the increase the intake of liquids in patients, making them do exercise and increasing their mobility as well as their intake of fibers and applying necessary pharmacological methods compliant with the recommendations from the physician. In patients with neurosurgery, constipation is a problem which can be prevented by using extensive nursing assessment and effective nursing interventions. This compilation aims at highlighting the fact that constipation is a serious symptom especially in neurosurgery patients and also at revealing the importance of nursing assessment. (JNNN 2014;3(2):81–87)Zaparcie to jedno z częstszych powikłań i jednocześnie poważny problem obserwowany u pacjentów leczonych w klinikach neurochirurgii. Pielęgniarka neurochirurgiczna odgrywa bardzo istotną rolę w diagnostyce i przeciwdziałaniu zaparciom. U pacjentów neurochirurgii możliwe jest przeciwdziałanie zaparciom za pomocą właściwej diagnozy, dzięki której unika się zażywania niepotrzebnych leków oraz zmniejsza skutki uboczne ich stosowania. Pielęgniarka w tym zakresie rozpoznaje nawyki opróżniania jelit, osłuchuje ruchy jelit, wykonuje badanie palpacyjne brzucha w kierunku rozdęcia, stosuje właściwe i miarodajne narzędzia diagnostyczne. Najważniejszymi działaniami podejmowanymi przez pielęgniarkę w celu przeciwdziałania zaparciom są: zwiększanie ilości przyjmowanych przez pacjenta płynów, zwiększanie częstotliwości jego ruchów, mobilizowanie pacjenta do ćwiczeń, zwiększanie ilości przyjmowanego błonnika oraz stosowanie zaleceń farmakologicznych lekarza. Zaparcie u pacjentów neurochirurgii jest powikłaniem, któremu można przeciwdziałać dzięki kompleksowej diagnostyce oraz skutecznym działaniom pielęgniarskim. Celem tego opracowania jest w szczególności podkreślenie, jak ważnym symptomem u pacjentów neurochirurgii jest zaparcie oraz jak ważna jest diagnostyka pielęgniarska. (PNN 2014;3(2):81–87

Określenie ryzyka zaparcia u chorych z dolegliwościami neurochirurgicznymi

Background. Preventing constipation is very important for patients in neurosurgery clinics and especially for those who had cerebral hemorrhage and brain tumor surgery as it might lead to elevated intracranial pressure. Therefore, it is necessary to diagnose constipation especially in individuals in neurosurgery clinics.Aim. This study has been designed as a descriptive and a cross-sectional study intending to identify constipation risk and the factors affecting it in neurosurgery patients.Material and methods. The population of the study consists of patients who stayed at a university hospital in Turkey between April 2011 and April 2012, and the sample population consists of 231 people selected by random sampling method. Data were collected using a Patient Information Form, Constipation Severity Instrument (CSI) and Constipation Risk Assessment Scale (CRAS). Data were analyzed using the SPSS version 11.5 for Windows.Results. 55,4% of the patients in the study were women and the average age was 43,80±13,65. CSI Total score average of the patients at admission was low (14,27±11,28). According to CRAS, 14,3% of the patients at admission, 40,7% of the patients on the 3rd day of surgery, and 32,5% of the patients at discharge were in medium and high risk group in terms of constipation. It has been determined that women, old people, people who use analgesics, and people who stay long at a hospital are at higher constipation risk.Conclusions. As result of the data gathered in the study, it has been concluded that nurses working in neurosurgery clinics should not ignore preoperative and postoperative constipation risk in order to be able to give integrated care. (PNN 2013;2(3):96-103)Wprowadzenie.W przypadku pacjentów klinik neurochirurgicznych, a szczególnie po wylewie krwi do mózgu oraz po operacji nowotworu mózgu, zapobieganie zaparciom jest bardzo istotne z uwagi na powodowany przez nie wzrost ciśnienia wewnątrzczaszkowego. Z tego względu koniecznym jest diagnozowanie zaparć szczególnie w przypadku osób przebywających w klinikach neurochirurgicznych.Cel. Niniejsze badanie zostało zaplanowane z zamiarem identyfikacji ryzyka zaparcia i czynników na nie wpływających w sposób diagnostyczny i przekrojowy.Materiał i metody. Populację badania stanowią pacjenci klinicznych szpitali uniwersyteckich w Turcji w okresie od kwietnia 2011 do kwietnia 2012, spośród których losowo wybrano próbę składającą się z 231 osób. Dane zebrane były przy użyciu Formularzy Informacyjnych Pacjenta, Instrumentu Twardości Zaparcia (CSI) oraz Skali Określania Ryzyka Zaparcia (CRAS). Dane były analizowane przy użyciu wersji 11.5 SPSS dla oprogramowania Windows.Wyniki. 55,4% pacjentów poddanych badaniom stanowiły kobiety w wieku średnio 43,80±13,65 lat. Średni wynik CSI dla pacjentów przyjmowanych był niski (14,27±11,28). Natomiast wg CRAS, 14,3% pacjentów przyjmowanych, 40,7% pacjentów na 3 dni po operacji i 32,5% pacjentów wypisywanych, znajdowało się w średniej i wysokiej grupie ryzyka wystąpienia zaparcia.Wnioski. Na podstawie danych zgromadzonych podczas badania wywnioskowano, że pielęgniarki pracujące na oddziałach neurochirurgicznych w celu zapewnienia kompleksowej opieki nie powinny ignorować ryzyka zaparć przedoperacyjnych i pooperacyjnych. (PNN 2013;2(3):96-103

Stan odżywienia pacjentów Neurochirurgicznego Oddziału Intensywnej Opieki Medycznej

Neurosurgical patients present important metabolic alterations that trigger increased energy and protein expenditure. The clinical condition in neuro patients associated with the use of sedatives, steroids, barbiturates and muscle-relaxing drugs postpones the use of nutrients in these patients and, thus, complications, including infection and longer hospitalization, may occur. Weight loss, negative nitrogen balance and immune dysfunction constitute a characteristic response in neurosurgical patients. There is a strong relationship between adequate nutritional status and recovery from critical illness. Improved nutritional status is associated with positive clinical outcomes. The health care team, nurses in particular, play a major role in the management and maintenance of an optimal nutritional status in patients who are in the neurosurgical clinic. This compilation aims at highlighting the fact that inadequate nutrition is a serious problem which increases incidence of morbidity and mortality especially in neurosurgical patients. The article also emphasises the importance of nursing assessment. (JNNN 2017;6(1):33–38)U pacjentów Neurochirurgicznego Oddziału Intensywnej Opieki Medycznej występują istotne zmiany metaboliczne, które powodują zwiększone wydatkowanie energii i białka. Neurochirurgiczny stan kliniczny w wyniku stosowania środków uspokajających, steroidów, barbituranów i leków zwiotczających mięśnie opóźnia wykorzystanie składników pokarmowych w tej grupie pacjentów, a zatem mogą wystąpić powikłania, w tym infekcje i dłuższa hospitalizacja. Utrata masy ciała, ujemny bilans azotu i dysfunkcja układu odpornościowego stanowią charakterystyczną odpowiedź u pacjentów neurochirurgicznych. Istnieje silny związek pomiędzy odpowiednim stanem odżywienia i regeneracją po chorobie krytycznej. Dobry stan odżywienia jest związany z pozytywnymi wynikami klinicznymi. Zespół opieki zdrowotnej, w szczególności pielęgniarki, odgrywają ważną rolę w utrzymaniu optymalnego stanu odżywienia u pacjentów neurochirurgicznych. Przegląd ten ma na celu podkreślenie, że przeciętny stan odżywienia jest poważnym problemem w kontekście zwiększonej zachorowalności i śmiertelności, zwłaszcza u pacjentów neurochirurgicznych. Artykuł zwraca również uwagę na duże znaczenie oceny pielęgniarskiej. (PNN 2017;6(1):33–38

Opieka pielęgniarska nad pacjentami neurochirurgicznymi z długotrwałą gorączką

Fever negatively affects the recovery of the brain following neurosurgical operation and prolongs the length of stay in the neurosurgery intensive care unit. Accordingly, it is necessary to deliver nursing care as indicated by the evidence regarding the management of fever in neurosurgical patients. The management of body temperature requires teamwork. Each healthcare professional in the team should select appropriate cooling methods, provide an acceptable cooling rate, manage shivering, and monitor the patient closely, with a multidisciplinary perspective. In this context, the present article discusses the causes of fever, its incidence, treatment and care practices for neurosurgical patients and proposes evidence-based recommendations for practice upon the review of the international guidelines. (JNNN 2020;9(2):80–85)Gorączka negatywnie wpływa na regenerację mózgu po operacji neurochirurgicznej i przedłuża pobyt pacjenta na oddziale intensywnej terapii neurochirurgicznej. Z tego powodu konieczne jest zapewnienie opieki pielęgniarskiej zgodnej z zasadami postępowania w przypadku pacjentów neurochirurgicznych z długotrwałą gorączką. Kontrola temperatury ciała pacjenta to praca zespołowa. Każdy pracownik służby zdrowia w tym zespole powinien dobrać odpowiednie dla pacjenta metody chłodzenia ciała, zapewnić odpowiednią szybkość chłodzenia, kontrolować drżenia ciała i uważnie monitorować pacjenta z wielodyscyplinarnej perspektywy. W tym kontekście w artykule omówiono przyczyny gorączki, jej objawy oraz praktyki leczenia i opieki nad pacjentami neurochirurgicznymi, w oparciu o międzynarodowe wytyczne i zalecenia dotyczące praktyki pielęgniarskiej. (PNN 2020;9(2):80–85

AIDS Related Stigma in Social Relations: A Qualitative Study in Turkey

The actual number of HIV/AIDS cases in Turkey is higher than the number of cases reported, and People Living with HIV (PLWHIV) may refrain from acknowledging their sickness or seeking help because of the stigma associated with HIV and fear of discrimination from their close friends, workmates, and even their families. In this paper we aim to explore HIV-positive people\u27s relationships with significant others such as family members, friends, sexual partners, employers and health professionals in order to present the patients\u27 perceptions about stigma and attitudes that lead to pro-social or anti-social behavior towards them. We carried out a qualitative study based on in-depth interviews with 16 PLWHIV in order to understand the conditions of people living with HIV/AIDS in Turkey. Our results revealed that except for family relations, the fear of contagion is the main obstacle for HIV-positive people\u27s relations with others. HIV-positive people are severely afflicted with discrimination due to the overlapping instrumental and symbolic stigmas that directly affect their relations. The attribute of responsibility is related to gender and socio-economic status of PLWHIV living in Turkey

Odnos krimsko-kongoanske hemoragijske groznice i klime: utječe li klima na broj ovih bolesnika?

Crimean-Congo hemorrhagic fever (CCHF) is a tick-borne viral zoonosis. The incidence of zoonotic diseases has been shown to be affected by climatic factors. In this study, we evaluated patients endemic to the CCHF region and examined the relationship between the number of patients and climatic properties of the region where they lived. The study included 548 CCHF patients. Along with the patient demographic and clinical characteristics, we recorded temperature, humidity and precipitation in the places where they lived at the time of their admission to the hospital. In addition to temperature, humidity and precipitation at the time of patient admission, these values were assessed at one month and three months prior to admission. The relationship between the number of patients and the above-mentioned values was examined. Humidity at the time of and one month prior to hospital admission, and precipitation three months prior to hospital admission were found to affect the number of patients admitted to the hospital for CCHF. In conclusion, climate appeared to affect the number of CCHF patients. We believe that the number of patients presenting to the hospital with CCHF could be predicted by taking into account climatic properties of the places where CCHF has been recorded, along with under-taking necessary measures.Krimsko-kongoanska hemoragijska groznica (KKHG) je virusna zoonoza koju prenose krpelji. Dokazano je da klimatski čimbenici utječu na incidenciju zoonotskih bolesti. U ovom smo istraživanju ispitivali bolesnike endemske za područje KKHG te odnos broja bolesnika i klimatskih svojstava područja u kojem oni žive. U istraživanje je bilo uključeno 548 bolesnika s KKHG. Uz demografske i kliničke značajke bolesnika bilježili smo temperaturu, vlagu i količinu padalina u mjestu gdje su bolesnici živjeli u vrijeme prijma u bolnicu. Uz vrijednosti temperature, vlage i količine padalina u vrijeme prijma bolesnika u bolnicu, vrijednosti ovih parametara procijenjene su za jedan mjesec i tri mjeseca prije prijma u bolnicu. Tada smo ispitali odnos broja bolesnika i gore spomenutih vrijednosti. Pokazalo se da razina vlage u vrijeme prijma i jedan mjesec prije prijma u bolnicu, kao i količina padalina tri mjeseca prije prijma u bolnicu utječu na broj bolesnika primljenih u bolnicu zbog KKHG. U zaključku, čini se da klima utječe na broj bolesnika s KKHG. Vjerujemo da bi se broj bolesnika koji dolaze u bolnicu zbog KKHG mogao predvidjeti uzimajući u obzir klimatska svojstva u mjestima gdje je zabilježena KKHG, a time bi se isto tako mogle poduzeti odgovarajuće mjere

Türkiye’de erkek hemşire imgesi

Aim: This study has been conducted to determine men nurse image of the society. Methods: The study that was conducted in cross-sectional design was realized on 1482 persons. Questionnaire that is prepared by researchers were filled by discussing with cases face-to-face. Average, percentage methods were used in evaluation of data.Results: Age year average of cases within the scope of the research is 31.74 (SD=10.37, Minimum=18, Maximum=65) type and 56% woman and 43.5% is graduated from high school. 71.4% cases stated that they knew that men were able to work as nurse in Turkey; 62.6% stated that nursing was a profession to be performed both by women and men; 18.2% stated that only women had to take place in nursing profession; 71.7% stated that success of nurses in practice was more important than gender; 52.5% stated that men nurses would not lead any change in the profession; 31.4% stated that men nurses would not contribute in development of social status of nursing; 45.6% stated that men nurses had to work in every field in hospital environment, 39.7% stated that they had to work in fields such as intensive care, operating theatre and emergency department. 16.6% cases stated that they would be ashamed of care by men nurse, 15.9% cases stated that they would hesitate and 15.4% cases stated that they would be surprised. Conclusions: Men nurse image in Turkey is generally positive. However, a positive point of view against men nurses by all the society should be ensured. For this purpose, the society should be informed that profession and gender are not factors that affect quality of nursing care.Amaç: Bu çalışma, toplumun erkek hemşire imgesini belirlemek amacı ile yapıldı. Yöntem: Kesitsel türde yapılan bu çalışma, 1482 kişi üzerinde gerçekleştirildi. Araştırmacılar tarafından hazırlanan soru formu, bireyler ile yüz yüze görüşülerek dolduruldu. Verilerin değerlendirilmesinde ortalama, yüzdelik yöntemleri kullanıldı.Bulgular: Bireylerin yaş yılı ortalamasının 31.74 (SS=10.37, Minimum=18, Maksimum=65), %56’sının kadın, %43.5’inin lise mezunu olduğu saptandı. Bireylerin %71.4’ü Türkiye’de erkeklerin de hemşirelik yapabileceğini bildiğini; %62.6’sı hemşireliğin hem kadınların hem de erkeklerin yapabileceği bir meslek olduğunu; %18.2’si hemşirelik mesleğinde sadece kadınların olması gerektiğini; %71.7’si hemşirelerin uygulamalardaki başarısının cinsiyetten daha önemli olduğunu; %52.5’i erkek hemşirelerin, meslekte herhangi bir değişime yol açmayacağını; %31.4’ü erkek hemşirelerin, hemşireliğin toplumsal statüsünün gelişmesine katkı sağlamayacağını; %45.6’sı erkek hemşirelerin, hastane ortamında her alanda, %39.7’si yoğun bakım, ameliyathane ve acil gibi alanlarda çalışması gerektiğini ifade etti. Ayrıca araştırma kapsamına alınan bireylerin %16.6’sı erkek hemşirenin bakım vermesinden utanacağını, %15.9’u çekineceğini, %15.4’ü şaşıracağını söyledi. Sonuç ve Öneri: Türkiye’de erkek hemşire imgesi genelde olumlu yöndedir. Fakat tüm toplumun erkek hemşireye bakış açısının olumlu olması sağlanmalıdır. Bu amaçla, toplum, cinsiyetin hemşirelik bakımının kalitesini etkileyen bir faktör olmadığı konusunda bilgilendirilmelidir

Landslide control in Rize Taşlıdere basin:Case studies from Kireçhane and Kırklartepe areas

Rize ilindeki orman tahribatı ve arazinin koruma-kullanma tekniği dikkate alınmadan kullanılması il genelindeki heyelan riskini artırmaktadır. Bu çalışmanın amacı Rize Taşlıdere Havzası, Kireçhane ve Kırklartepe yöreleri heyelan kontrolü amaçlı örnek olay incelemesidir. Bu amaçla araştırma alanı yükselti kademelerine ayrılmış, her bir katmanda toprak penetrasyon direnci ve nem içeri ile 2. yükselti katmanında birikimli infiltrasyon ölçümleri yapılmıştır. Ayrıca katmanlarda 0-10 ve 10-30 cm derinliklerinden toprak örnekleri alınarak laboratuvara gönderilmiştir. Laboratuvarda tekstür ve suya dayanıklı (SDA) analizleri yapılmıştır. Ortalama değerlere göre araştırma sahasındaki zemin biriminin %60’ı yüksek plastisiteli kil, %40’ı ise düşük plastisiteli kil türündedir. Ortalama değerlere göre en yüksek su doygunluk değerine en yüksek kilin (%44,44), olduğu IV. yükselti kademesinde rastlanmıştır. Araştırma alanı III. yükselti kademesinde ölçülen birikimli infiltrasyon kapasitesindeki değişimin zamana göre R2 = 0,988 ile y= -0,0098x2+2,5x+18,03 şeklinde ilişkiye sahip olduğu tespit edilmiştir. Yükselti kademelerine göre en düşük penetrasyon direncine (0.03 mPa) I. yükselti kademesinde ve 8 cm toprak derinliğinde, en yüksek penetrasyon direncine (0.112 mPa) IV. yükselti kademesinde ve 30 cm toprak derinliğinde rastlanmıştır. Suya dayanıklı agregat (SDA) değerlerine bakıldığında en yüksek değere I. yükselti kademesinin alt topraklarında, en düşük değere ise II. yükselti kademesinin üst topraklarında rastlanılmıştır. Koruma-kullanma dengesine uygun toprak yönetim modelinin oluşturulması araştırma alanı topraklarının heyelan oluşturma riskini azaltabilir.The deforestation in Rize province and the use of the land without considering the protection-use technique increase the risk of landslides throughout the province. The aim of this study is a case study for landslide control in Rize Taşlıdere Basin, Kireçhane and Kırklartepe regions. For this purpose, the research area was divided into elevation levels, soil penetration resistance and moisture content in each elevation steps, while cumulative infiltration measurements were made in the 2 nd elevation. In addition, soil samples were taken at 0-10 cm and 10-30 cm depths. Texture and water resistance (SDA) analyzes were performed in the laboratory. According to the average values, 60% of the soil in the study area is clay with high plasticity and 40% is clay with low plasticity. The highest water saturation value was found at the IV altitude steps where the clay content was the highest (%44,44). The cumulative infiltration capacity measured at the altitude III has a relationship with R 2=0.988 and y=-0.0098x2+2.5x+18.03 according to time. According to the elevation, the lowest penetration resistance (SPR) (0.03 mPa) was found at elevation-I and at 8 cm soil depth, while the highest penetration resistance (0.112 mPa) at the elevation- IV and at 30 cm soil depth. The highest water-resistant aggregate (WSA) content was measured at 10-30 cm soil depth in the elevation-I, while the lowest WSA measured at 0-10 cm soil depth in the elevation-II. Establishing a soil management model suitable for the protection-use balance can reduce the risk of landslide formation in the research area