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It may be suggested that taking precautions at units, providing better working conditions, defining the duties of nurses and providing further dialysis education for nurses may decrease burnout rates.

Objective. Vascular cognitive impairment (VCI) is an entity associated with vascular damage of the brain resulting in cognitive dysfunction of a wide spectrum from mild cognitive impairment to vascular dementia. The quality of life (QL) of patients with VCI is poorly understood especially in patients with mild VCI. The aim of the study was to estimate medical factors influencing QL of patients with mild VCI.Methods. We investigated 90 patients with mild VCI (52 men and 38 women, mean age 67.5 ± 10.6 years) that had score 3 on Riesberg Global Deterioration Scale, a MMSE score of more than 24 and focal or diffuse vascular changes on MRI (0.5 T scan). We used the EQ-5D scale for QL assessment and comprehensive neuropsychological battery for evaluation of several domains of cognitive functions: verbal and visual memory, attention, language, abstraction, visuospatial and executive functions, praxis. For assessment of motor dysfunction we used Tinetti balance and mobility scale (TBMS) and scale of pseudobulbar syndrome and for measure of affective disorders-Beck depression inventory (BDI).Results. EQ-5D values correlated to a degree of cognitive dysfunction measured with digit symbol constitution test (r = 0.34, p < 0.05), Rey-Osterrieth complex figure test (r = 0.68, p < 0.01), block design test (r = 0.33, p < 0,05), grammatical and phonetic associations number in verbal fluency tests (p < 0.05) categories achieved and number of perseverative responses on Wisconsin Card Sorting Test (r = 0.30, p < 0.05, r = − 0.39, p < 0.01). There were no correlations between EQ-5D values and total severity of cognitive dysfunction. We also found that EQ-5D values correlated to TBMS score (r = 0.51, p < 0.05), pseudobulbar scale score (r = − 0.4, p < 0.05) and severity of mood disturbances, assessed with BDI (r = − 0.42, p < 0,001).Conclusion. These results suggest that QL of patients with mild VCI correlates with the severity of executive and visuo-spatial cognitive dysfunction, postural instability and gait disorder, pseudobulbar syndrome and mood disturbances.

Aim: The aim of this paper is to share the initial experiences on a European Union (EU) Lifelong Learning Programme Leonardo Da Vinci Transfer of Innovation Project related to the use of simulation-based learning with nursing students from Turkey. The project started at the end of the 2010 involving 7 partners from 3 different countries including Turkey, England, and Italy. Methods:This project is divided into 7 work packages (WP). In this paper, experiences from the first three WPs (WP1: Preparation and dissemination of the project. WP2: Regulation of the project management. WP3: Development of the evaluation tools used to evaluate the impact of the innovative practice within the coordinating partner's institution) are shared. Results:In the WP1 and WP2: the kick-off meeting was organized in Turkey, the coordinating partner's country. During the meeting project-related events were planned and the steering committee of the project was formed. A strong team spirit within the partnership was established. For the dissemination of the project, a poster and flier of the project were prepared and placed on corporate boards visible to students and teaching staff and put on the partners' institutional websites. Regular bulletins of the project were also prepared and posted on the project website. In the WP3, student data sheet, items for students' satisfaction questionnaire and confidence scale were created based on the literature. Trauma patient scenarios (abdominal trauma, thoracic trauma, pelvic fracture and traumatic amputation) were created to test the target group's knowledge. Ethical approval was obtained from the coordinating partner institution. A pilot study to test the cases was conducted. Following the pilot study, the final version of the student data sheet and scenario cases was created. The second meeting was organized in Italy. In this meeting, the results of the pilot study, the scenario cases, and the Patient Intervention Self Confidence /Competence Scale were evaluated. Conclusion:The work on this EU project is still in progress. Considering that learning from experience is an important part of nursing education, sharing experiences on such a project related to using simulation as an innovative teaching strategy in nursing education in Turkey should provide an example to others who want to develop other EU projects in nursing education.

The study emphasized the importance of nursing education and organizational support in order to accomplish the implementation of evidence-based nursing. The findings indicated that integrating all sources of evidence into practice, and appreciating the use of evidence in clinical practice are crucial in surmounting the challenge of achieving evidence-based practice.

The objective of this study was to test the reliability and validity of the Turkish version of the Functional Living Index-Cancer in Turkey. The English version of the Functional Living Index-Cancer was translated into Turkish following the standard translation methodology. The questionnaire was administered to 110 cancer patients who had been receiving chemotherapy. Internal consistency reliability was in the acceptable range for this instrument. Among cancer patients, the Cronbach alpha reliability for the total scale was .88, and subscale alpha coefficients ranged from .60 to .83, which is similar to the alpha of .79 observed in the Functional Living Index-Cancer, English version. The results of the principle components analysis and varimax rotation resulted in 5-factor structure: physical functioning, psychological functioning, current well-being, social functioning, and gastrointestinal symptoms. The results of this study suggest that the Turkish version of the Functional Living Index-Cancer is a reliable and valid supplementary measure of the quality of life in cancer patients in Turkey, and it can be used in clinical trials and studies of outcome research in oncology.

Silent brain infarction (SBI) is defined as asymptomatic infarction areas detected in computerized tomography (CT) scans in patients without a history of stroke. The incidence of SBI is increased in CT or magnetic resonance imaging in patients with carotid stenosis and with atrial fibrillation (AF), but its relation with rheumatic mitral stenosis (MS), another major source of emboli, is uncertain. The aim of this study was to investigate the incidence of SBI in patients with MS. Fifty-three patients with MS (44 females and 9 males; range 25-52 years; mean age 38 +/- 7 years) diagnosed by transthoracic echocardiography (TTE) were enrolled in the study. Mitral valve calcification, left atrium (LA) dimension, and the presence of associating mitral regurgitation on TTE were recorded. Electrocardiographic evaluation was done for rhythm analysis and neurologic examination was performed prior to cerebral CT. Carotid artery Doppler examination was carried out in patients with SBI to exclude carotid artery lesions. Patients with a history of hypertension, diabetes mellitus, anticoagulant drug usage, presence of thrombus in LA, left ventricular segmental or systolic dysfunction, or other valve diseases were excluded from the study. The incidence of SBI was found to be 24.5% in patients with MS (47% cortical, 53% lacunar). SBI was observed to be significantly high in patients with LA dimension > 4 cm or in patients with AF (p < 0.05). The SBI incidence was markedly higher if AF was found with enlarged LA when compared with patients having sinus rhythm and small LA (p < 0.01). When moderate to severe mitral regurgitation was associated with MS, the SBI incidence was found to be lower (p < 0.05). Although SBI was higher in patients with MVA < 1.5 cm2, it was not statistically significant (p > 0.05). No significant correlation was found between calcific and noncalcific valves for SBI (p > 0.05). Our data suggest that SBI may be expected in about 1/4 of patients with MS. The presence of LA enlargement and AF increase the incidence of SBI in patients with MS, whereas the presence of moderate to severe mitral regurgitation decreases the incidence of SBI.

Objectives:The prevalence of sexual dysfunction in Behçet patients, patients' practices toward sexual problems, pre-disease sexual life and distribution of postdisease sexual problems were evaluated. Patients and Methods:Sexually active 96 patients were included to the study. The data were collected with the "Sexual Problems in Behçet Patients Data Collection Form" and "Arizona Sexual Experience Scale (ASES)". The scale's score interval is 5-30; 11-above scores indicate sexual dysfunction. Results:Of the patients, 51 (53.1%) were 40-yearold and above, 49 (51%) were women; the most frequent symptoms were oral aphtosis (58.3%), genital ulcers (31.2%), and erythema nodosum (28.1%). Mean ASES score was 14.2±5.8 66 patients (68.7%) had sexual dysfunction. The most prevalent problems were decreased frequency of intercourse (n=32, 86.5%), painful sexual relation (n=18, 48.6%) and unwillingness (n=9, 24.3%). Most of the patients (n=15, 40.5%) who expressed sexual problems were not using any practice for the solution. None of the patients received any information about sexual problem and the most preferenced source of information would be the doctors (n=83, 86.4%) in case having this opportunity. Female gender and the belief about the impact of Behçet's disease on sexual life determined ASES score (43%). Conclusion:Sexual dysfunction in Behçet's disease was seen in a significant proportion.Key words: Behçet's disease; sexuality; sexual dysfunction;, gender.Amaç: Bu çalışmada Behçet hastalarında cinsel disfonksiyon görülme oranı, cinsel sorunlara yönelik hasta uygulamaları, hastalık öncesi cinsel yaşantı ve hastalık sonrası cinsel sorunların dağılımı değerlendirilmiştir. Hastalar ve Yöntemler:Çalışma kapsamına cinsel açıdan aktif olan 96 hasta alınmıştır. Veriler "Behçet Hastalarında Cinsel Sorunlar Veri Toplama Formu" ve "Arizona Cinsel Yaşantılar Ölçeği" (ACYÖ) ile toplanmıştır. Ölçeğin puan aralığı 5-30 olup, 11 ve üzeri puan cinsel disfonksiyonu gös-termektedir. Bulgular:Hastaların 51'inin (%53.1) 40 yaş ve üzerinde, 49'unun (%51) kadın, sık görülen semptomlarının oral aftlar (%58.3), genital ülserler (%31.2) ve eritema nodozum (%28.1) olduğu bulunmuştur. Arizona Cinsel Yaşantılar Ölçeği puan ortalamalarının 14.2±5.8 olduğu 66 hastada (%68.7) cinsel disfonksiyon bulunduğu saptanmıştır. Hastalarda en çok görülen cinsel sorunların cinsel ilişki sıklığında azalma (n=32, %86.5), ağrılı cinsel ilişki (n=18, %48.6) ve cinsel isteksizlik (n=9, %24.3) olduğu bulunmuştur. Cinsel sorunu olduğunu ifade eden hastaların çoğunluğunun (n=15, %40.5) sorunun çözümü için hiçbir uygulamada bulunmadığı belirlenmiştir. Hastaların hiçbirinin cinsel sorunu ile ilgili sağlık çalışanların-dan bilgi almadığı ve bilgi alma olanağı olması durumda en çok doktorların (n=83, %86.4) tercih edileceği saptanmıştır. Çalışmamızda kadın cinsiyetin ve Behçet hastalığı nedeniyle cinsel yaşamın etkilendiği düşüncesinin, ACYÖ puanını önemli oranda (%43) belirlediği bulunmuştur.Sonuç: Bulgular doğrultusunda Behçet hastalığında cinsel disfonksiyonun önemli ora...