Tampa Scale of Kinesiophobia for Heart Turkish Version Study: cross-cultural adaptation, exploratory factor analysis, and reliability

PURPOSE: Individuals with cardiac problems avoid physical activity and exercise because they expect to feel shortness of breath, dizziness, or chest pain. Assessing kinesiophobia related to heart problems is important in terms of cardiac rehabilitation. The Tampa Scale of Kinesiophobia Swedish Version for the Heart (TSK-SV Heart) is reliable and has been validated for cardiac diseases in the Swedish population. The aim of this study was to investigate the reliability, parallel-form validity, and exploratory factor analysis of the TSK for the Heart Turkish Version (TSK Heart Turkish Version) for evaluating kinesiophobia in patients with heart failure and pulmonary arterial hypertension. METHODS: This cross-sectional study involved translation, back translation, and cross-cultural adaptation (localization). Forty-three pulmonary arterial hypertension and 32 heart failure patients were evaluated using the TSK Heart Turkish Version. The 17-item scale, originally composed for the Swedish population, has four factors: perceived danger for heart problem, avoidance of exercise, fear of injury, and dysfunctional self. Cronbach’s alpha (internal consistency) and exploratory factor analysis were used to assess the questionnaire’s reliability. Results of the patients in the 6-minute walk test, International Physical Activity Questionnaire, and Nottingham Health Profile were analyzed by Pearson’s correlation analysis with the TSK Heart Turkish Version to indicate the convergent validity. RESULTS: Cronbach’s alpha for the TSK Heart Turkish Version was 0.75, indicating acceptable internal consistency. Although exploratory factor analysis showed a different subgroup distribution than the original questionnaire, the model was acceptable for the four-factor model hypothesis. Therefore, the questionnaire was rated as reliable. CONCLUSION: These results supported the reliability of the TSK Heart Turkish Version. Since the acceptable four-factor model fits the subgroups and measures of reliability are sufficiently high, the questionnaire seems reliable for pulmonary arterial hypertension and heart failure patients

Prognostic importance of central thrombus in hemodynamically stable patients with pulmonary embolism

Background: The association between mortality and localization of central thrombus in hemodynamically stable patients with pulmonary embolism (PE) is unclear. Sufficient data are not available to help clinicians to select between low molecular weight heparin (LMWH), unfractionated heparin (UFH) and thrombolytics for the management of central thrombus. The present study aims to investigate whether central thrombus in the pulmonary artery affects 30-day mortality rate, and to compare the outcomes of different treatment approaches in patients with central thrombus. Methods: This multi-central, prospective, observational study included 874 hemodynamically stable patients with PE confirmed by multidetector computed tomography scan. The localization of the emboli was evaluated and categorized as central (saddle or at least one main pulmonary artery), lobar or distal. The primary study outcome was 30-day all-cause mortality. Results: Localization of the emboli was central in 319 (36.5%) patients, lobar in 264 (30.2%) and distal in 291 (33.2%) patients. Seventy-four (8.5%) patients died during the 30-day follow-up period. All-cause mortality rate was 11.9%, 6.8% and 6.2% in patients with central, lobar, and distal emboli, respectively (p < 0.001). Multivariate analysis did not show that hemodynamically stable central thrombus was an independent predictor of mortality. Additionally, mortality rate was not significantly different between UFH, LMWH and thrombolytic therapy groups. Conclusions: The present study showed that central thrombus was not an independent predictor of mortality in hemodynamically stable PE patients. LMWH and UFH were similarly effective in the treatment of this patient group.

Hypothyroidism Induced Severe Rhabdomyolysis in a Hemodialysis Patient

Hypothyroidism occurs relatively common and is a significant cause of morbidity and mortality during the course of chronic kidney disease. Rhabdomyolysis is a potentially life-threatening condition characterised by necrosis of muscular tissue and rarely associates with hypothyroidism. Here we describe a case of rhabdomyolysis due to severe hypothyroidism in a 56-year-old female hemodialysis patient

Internet Addiction and Depression Levels in Erciyes University Students

Objective: The study was carried out to determine Internet addiction and depression levels among university students, the effects of some socio-demographic factors on these levels, and association between Internet addiction and depressive symptom levels

Determining the Profession's Ethical Requirements in School Psychological Counseling Services

The purpose of this research is to determine school psychological counselors' perspectives on professional ethics knowledge and skills, the requirements, and their opinions related to ethical problems encountered in the profession and ways of solving them. The research has been formed using the phenomenological design, a qualitative research design, and uses a semi-structured open-ended interview form. Categorical analysis, a type of content analysis, has been used in analyzing the data. Interviews have been conducted with 40 school counselors working in different educational institutions. The results reveal school psychologists' ethical knowledge and skills to be important in terms of the effective functioning of psychological counseling services. Helping the psychological counseling and guidance (PCG) specialist to be able to apply ethical principles and being competent in providing ethical service in the PCG specialist's field have been determined as requirements for the training managers. The most frequently experienced ethical problem appears as confidentiality: In other words, this has been experienced on the topic of ensuring client's privacy and in showing unconditional acceptance towards different cultures. The main ethical principle that should be applied has emerged as the need to provide confidentiality. Collegial assistance has been sought after in dealing with ethical problems. According to the results, the requirement of receiving education on how to regulate the ethical principles that need to be followed in school PCG services as well as how to deal with the ethical principles and problems of educational administrators' psychological counseling services by using school PCG specialists is recommended

Investigating the scientific process skills of medical students in relation to medical decision making: Research on basic medical science competence

Background: Medical students are expected to convey scientific literacy and possess certain scientific skills prior to being admitted to medical schools. Laboratory practices being provided during their education play a crucial role in their professional development and the usefulness of these practices is possible and can be enriched if the students possess prior scientific skills. The purpose of this study is to determine the scientific process skills of second year medical students in Suleyman Demirel University, Faculty of Medicine, Turkey. Methods: The study was conducted in April 2006 by using the Scientific Process Skills Questionnaire (SPSQ) for laboratory practices. Randomly selected (n = 76) second year medical students participated in the study. Results: Nine basic scientific process skills were investigated. All of the students responded correctly to the question that measured their ability to interpret data. Students abilities to set up hypothesis and make estimations were found quite high. (94.7 %, 92.1 % respectively) The two skills that were challenging to students were the ability to make an observation and their proficiency in scales. The percentage of correct responses to those questions were 50 % and 50.5 % respectively. Conclusions: The study suggests that students in the study group possess the necessary scientific process skills at some degree (86 %). However, this ratio, thus the productivity of laboratory practices can be enhanced by building up on skills such as making observations and interpreting scales. Quality in medical education cannot be achieved if we do not provide our students with basic scientific process skills early in their education

THE INFLUENCE OF DIALYSATE CALCIUM ON PROGRESSION OF ARTERIAL STIFFNESS IN PERITONEAL DIALYSIS PATIENTS

12th Congress of the International-Society-for-Peritoneal-Dialysis -- JUN 20-24, 2008 -- Istanbul, TURKEYWOS: 000263937100002PubMed ID: 19270206Background: One of the origins of cardiovascular disease in dialysis patients is arterial stiffness. The aim of our study was to assess the relationship between the calcium content of peritoneal dialysis (PD) solution and arterial stiffness. Patients and Methods: We enrolled into the study 49 PD patients who had been treated with the same PD solution for the preceding 6 months. The calcium content of the PD solution was 1.25 mmol/L in 34 patients (low-Ca group) and 1.75 mmol/L in 15 patients (high-Ca group). Study patients were followed for 6 months on the same PD prescription. Arterial stiffness was assessed by measurement of augmentation index (AI) and brachial pulse wave velocity (PWV) at baseline and at month 6 (SphygmoCor: Atcor Medical, West Ryde, NSW, Australia). Demographic data were recorded from patient charts. Results: Mean age of the whole group was 51 +/- 11 years, prevalence of diabetes was 14%, duration of PD was 43 +/- 30 months, percentage of women was 45%, and percentage of patients using a cycler was 33%. We observed no differences between groups with regard to those variables or creatinine clearance, residual renal function, Ca, phosphorus, parathormone, C-reactive protein, lipid parameters, and use of phosphate binder with or without Ca content. Mean arterial pressure was higher in the high-Ca group, but the difference was not statistically significant (100 +/- 22 mmHg vs 88 +/- 18 mmHg, p = 0.06). At baseline, AI was significantly higher in the high-Ca group than in the low-Ca group (27% +/- 10% vs 21% +/- 9%, p < 0.05). Measurements of PWV were not different between the groups (8.4 +/- 1.1 m/s vs 8.5 +/- 1.7 m/s). Measurement of arterial stiffness parameters at month 6 revealed that PWV had increased in the high- Ca group (to 9.6 +/- 2.3 m/s from 8.4 +/- 1.1 m/s, p < 0.05), but had not changed in the low-Ca group (to 8.2 +/- 1.9 m/s from 8.5 +/- 1.7 m/s). The AI did not change in either group. Conclusions: These data suggest that Ca exposure through PD solution plays a role in the progression of arterial stiffness, which may be related to increased vascular calcification.Int Soc Peritoneal Dialysi

The Impact of Strict Volume Control Strategy on Patient Survival and Technique Failure in Peritoneal Dialysis Patients

WOS: 000291539400005PubMed ID: 21293119Strict volume control strategy provides better cardiac functions and control of hypertension in dialysis patients. We investigated the effect of this strategy on mortality and technique failure in peritoneal dialysis patients over a 10-year period. 243 patients were enrolled. Strict volume control by dietary salt restriction and ultrafiltration was applied. Mean systolic and diastolic blood pressures decreased from 138.4 +/- 29.9 and 86.3 +/- 16.8 to 114.9 +/- 32.3 and 74.7 +/- 18.3 mm Hg, respectively. Overall and cardiovascular mortality rates were 48.4 and 29.6 per 1,000 patient-years, respectively. In multivariate analysis, age, diabetes and baseline serum albumin level were independent predictors of overall mortality, and age, diabetes and baseline serum calcium of cardiovascular mortality. Residual diuresis and peritoneal equilibration test values were not related to mortality. Strict volume control leads to lower mortality than comparable series in the literature. Technique survival is better during the first 3 years, but not after 5 years. Copyright (C) 2011 S. Karger AG, Base