Background: Breast cancer appears to be a disease of both the developing and developed worlds. Among Turkish women, breast cancer is the second leading cause of cancer-related deaths. The aims of this cross-sectional study were to determine levels of knowledge about breast cancer and to evaluate health beliefs concerning the model that promotes breast self-examination (BSE) and mammography in a group of women aged 20-64 in a rural area of western Turkey.
Maternal cbl status is an important determinant of infantile cbl status. Both maternal holoTC and tHcy may assist in predicting infantile cbl status. The finding of high prevalence of maternal and infantile cbl deficiency in this study points towards the need for effective strategies to prevent cbl deficiency in women prior to getting pregnant.
The effects of Ringer lactate, 6% hydroxyethyl starch (130/0.4) or 4% succinylated gelatin solutions on perioperative coagulability were measured by thromboelastography (TEG). Seventy-five patients (ASA I-III) who were to undergo major orthopedic procedures performed under epidural anesthesia were included in the study. Patients were randomly divided into three groups of 25 each for the administration of maintenance fluids: group RL (Ringer lactate), group HES (6% hydroxyethyl starch 130/0.4), and group JEL (4% gelofusine solution). Blood samples were obtained during the perioperative period before epidural anesthesia (t1, baseline), at the end of the surgery (t2), and 24 h after the operation (t3). TEG data, reaction time (R), coagulation time (K), angle value (α), and maximum amplitude (MA) were recorded. TEG parameters changed from normal values in all patients. In group RL, R and K times decreased compared to perioperative values while the α angle and MA increased (P < 0.05). In group HES, R and K times increased, however, the α angle and MA decreased (P < 0.05). In group JEL, R time increased (P < 0.05), but K time, α angle and MA did not change significantly. In the present study, RL, 6% HES (130/0.4) and 4% JEL solutions caused changes in the coagulation system of all patients as measured by TEG, but these changes remained within normal limits.
Healthcare workers’ cognitive performances and alertness are highly vulnerable to sleep loss and circadian rhythms. The purpose of this study was to investigate the changes in sleep characteristics of intensive care unit (ICU) and non-ICU physicians. Actigraphic sleep parameters, Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale and Hamilton Depression Rating Scale were evaluated for ICU and non-ICU physicians on the day before shift-work and on three consecutive days after shift-work. Total sleep time, sleep latency, wakefulness after sleep onset, total activity score, movement fragmentation index, sleep efficiency, daytime naps and total nap duration were also calculated by actigraph. In the ICU physicians, the mean Pittsburgh Sleep Quality Index score was significantly higher than the non-ICU physicians (P=0.001), however mean Epworth Sleepiness Scale scores were not found significantly different between the two groups. None of the scores for objective sleep parameters were statistically different between the groups when evaluated before and after shift-work (P >0.05). However in both ICU and non-ICU physicians, sleep latency was observed to be decreased within the three consecutive-day period after shift-work with respect to basal values (P <0.001). Total sleep time, total activity score and sleep efficiency scores prior to shift-work were significantly different from shift-work and the three consecutive-days after shift-work, in both groups. Working in the ICU does not have an impact on objective sleep characteristics of physicians in this study. Large cohort studies are required to determine long-term health concerns of shift-working physicians.
Bu çalışmanın amacı, yoğun bakım hemşirelerinin uyku kalitesinin araştırılmasıdır. Gereç ve Yöntem: Çalışmamıza Celal Bayar Üniversitesi Tıp Fakültesi Hastanesi'nde poliklinik, servis ve yoğun bakımda çalışan toplam 60 gönüllü hemşire, 20'şer kişilik eşit üç grup oluşturacak şekilde dahil edildi. Tüm hemşireler öncelikle Pittsburgh Uyku Kalite İndeksi ve Epworth uykululuk skalası ile subjektif değerlendirildi. Ayrıca aktigraf cihazı takılan tüm hemşirelerde uyku kalitesi objektif olarak da araştırıldı. Sonuçlar gruplar arasında karşılaştırıldı. Bulgular: Subjektif testlerden Pittsburgh uyku kalite indeksi, yoğun bakım grubunda istatistiksel olarak anlamlı derecede yüksek bulundu. 'Actual wake time', 'Actual wake %', 'Total aktivasyon skoru' ve 'Fragmentasyon indeks'i içeren aktigrafik uyku parametreleri, yoğun bakım grubunda poliklinik ve servis grubuna kıyasla istatistiksel olarak anlamlı yüksekti. Aktigrafik uyku parametrelerinden 'Actual sleep time', 'Actual sleep %' ve 'Sleep efficiency' yoğun bakım grubunda, servis ve poliklinik grubuna kıyasla istatistiksel olarak anlamlı derecede daha düşük olarak bulundu. Sonuç: Çalışmamızın sonuçları yoğun bakım şartlarında hizmet vermenin hemşirelerde uyku kalitesini olumsuz etkilediğini ve uyku bozukluklarına neden olduğunu göstermektedir. (Türk Yo €un Ba-k›m Der ne €i Der gi si 2011; 9: 59-63) Anah tar Ke li me ler: Yoğun bakım hemşireleri, uyku bozuklukları ÖZET SUMMARY Objective: The aim of this study was to investigate the sleep quality of intensive care nurses. Material and Method: Sixty volunteer intensive care, policlinic and general wards nurses working in Celal Bayar University Hospital were included as three equal groups. The sleep characteristics of all nurses were evaluated initially by subjective tests: Pittsburgh Sleep quality index and Epworth sleepiness scale, furthermore actigraph was used to investigate sleep quality objectively in all groups. Results were compared between the groups. Results: Pittsburgh index, which is a subjective sleep test, was found to be significantly higher in intensive care nurses. In intensive care nurses, the values of Actigraphic sleep parameters such as 'Actual wake time', 'Actual wake %', 'Total Activation Score', 'Fragmentation index' were significantly higher and 'Actual sleep time', 'Sleep efficiency' and 'Actual sleep %' were significantly lower, when compared with the policlinic nurses and the general wards nurses. Conclusion: The results of the present study indicate that, nursing of the critically ill patients continuously should give rise to sleep disorders in intensive care nurses.
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