Vocational School of Health Services
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Öğe Group problem management plus (PM+) to decrease psychological distress among Syrian refugees in Turkey: a pilot randomised controlled trial(BioMed Central Ltd, 2022-12) Uygun, ErsinAbstract: Background: Syrian refugees resettled in Turkey show a high prevalence of symptoms of mental disorders. Problem Management Plus (PM+) is an efective psychological intervention delivered by non-specialist health care providers which has shown to decrease psychological distress among people exposed to adversity. In this single-blind pilot randomised controlled trial, we examined the methodological trial procedures of Group PM+ (gPM+) among Syrian refugees with psychological distress in Istanbul, Turkey, and assessed feasibility, acceptability, perceived impact and the potential cost-efectiveness of the intervention. Methods: Refugees with psychological distress (Kessler Psychological Distress Scale, K10>15) and impaired psycho? social functioning (World Health Organization Disability Assessment Schedule, WHODAS 2.0>16) were recruited from the community and randomised to either gPM+ and enhanced care as usual (E-CAU) (n=24) or E-CAU only (n=22). gPM+ comprised of fve weekly group sessions with eight to ten participants per group. Acceptability and feasibility of the intervention were assessed through semi-structured interviews. The primary outcome at 3-month follow-up was symptoms of depression and anxiety (Hopkins Symptoms Checklist-25). Psychosocial functioning (WHODAS 2.0), symptoms of posttraumatic stress disorder and self-identifed problems (Psychological Outcomes Profles, PSY? CHLOPS) were included as secondary outcomes. A modifed version of the Client Service Receipt Inventory was used to document changes in the costs of health service utilisation as well as productivity losses. Results: There were no barriers experienced in recruiting study participants and in randomising them into the respective study arms. Retention in gPM+ was high (75%). Qualitative analyses of the interviews with the participants showed that Syrian refugees had a positive view on the content, implementation and format of gPM+. No adverse events were reported during the implementation. The study was not powered to detect an efect. No signifcant diference between gPM+ and E-CAU group on primary and secondary outcome measures, or in economic impacts were found. Conclusions: gPM+ delivered by non-specialist peer providers seemed to be an acceptable, feasible and safe inter? vention for Syrian refugees in Turkey with elevated levels of psychological distress. This pilot RCT sets the stage for a fully powered RCTÖğe Symptoms and care satisfaction in patients who underwent coronary artery bypass graft surgery(Clinical and Experimental Health Sciences, 2021) Bozkurt, TuğçeABSTRACT: Objective: This study was conducted to investigate of symptoms and care satisfaction in patients who had a coronary artery bypass graft (CABG) surgery. Methods: The study population consisted of patients who had a coronary artery bypass graft surgery in a public and a foundation hospital in Istanbul between December 2018 and May 2019 and the study sample 176 patients who met the inclusion criteria and agreed to take part in the study. The study data were collected using the self-report method with the help of a Patient Description Form, the Heart Surgery Symptom Inventory (HSSI) and the Newcastle Satisfaction with Nursing Care Scale (NSNS). The data were analysed on the SPSS version 22.0 software. The data were analysed using numbers, percentages, minimum and maximum values, means and standard deviations, t-test, variance analysis and Pearson correlation analysis. Results: The patients were found after their CABG surgery to experience pain, shortness of breath, fatigue, lack of appetite, nausea and woundrelated symptoms. The most common complaint of the patients after the surgery was sleep problems and the least common wound-related symptoms. The mean HSSI score of the participating patients was 71.22±31.39 and the mean NSNS score 52.87±22.54, which meant that the severity of their post-surgery symptoms and their satisfaction with care were at a moderate level. Post-surgery pain, lack of appetite, nausea and wound-related symptoms were found to have a statistically significant moderate negative correlation with care satisfaction (p<0.05) and shortness of breath, fatigue and insomnia to have a statistically significant strong negative correlation with care satisfaction (p<0.05). Conclusion: The results of this study revealed that patients who experienced less symptoms of pain, shortness of breath, fatigue, sleep disorders, lack of appetite, nausea, vomiting, and wound infection after a CABG surgery were more satisfied with the nursing care.Öğe Five-year analysis of air pollution in Istanbul including also the impact of the COVID-19 pandemic(İzmir Göğüs Hastanesi Dergisi, 2021-09-24) Bostan, PınarABSTRACT: Objective: Particulate matter, sulfur dioxide, ozone, and nitrogen oxide compounds are the main air pollutants. The purpose of this research is to analyze the five-year air quality of Istanbul and examine the effect of movement restrictions due to the COVID-19 pandemic on pollutants. Method: The public data of the National Air Quality Observation Network has been utilized. The research has been conducted based on the five-year daily averages of PM10, NO2 , and NOx pollutants for Istanbul between 2016-2020. The data of stations which measured for 75% and more throughout the year has been used. The effect of lockdowns enforced due to COVID-19 was revealed by comparing data of pollutants from April and May of 2020 to the same period in 2019. Results: There were 12 stations between 2016-2018, and 39 stations in 2019 and 2020 which measured particulate matter and nitrogen oxide compounds. Only 9 stations reached the standard of measuring pollution for 75% and more throughout the year. The PM10, NO2 , and NOx levels measured by all the 9 stations between 2016-2020 are above the limit values set by the World Health Organization (WHO). The lockdowns in 2020 have not been helping improvements in air pollution issue. However, there have been regressions of 33.4%, 59.6%, and 52.6% in the overall average particulate matter, nitrogen oxide, and nitrogen dioxide concentrations during the lockdowns between 23-26 of April, 1-3 of May, and 23-26 of May, respectively. Conclusion: The air pollution issue in Istanbul has not improved in a meaningful and significant manner for the last five years. There is a significant deficiency in measuring traffic pollution. It has been found that two days long lockdowns and physical movement restrictions due to COVID-19 have significantly contributed to a significant regression in the overall concentration of air pollutants.Öğe Aile Bağımlılık Profil indeksinin Geliştirilmesi, Geçerlik Ve Güvenilirliği(Klinik Psikiyatri Dergisi, 2017) Ögel, Kültegin; Çelikay, Hande; Başbaşak, AslıÖzet: Amaç: Ba??ml?l?k aileyi de etkileyen ve tedavide ailenin kat?l?m?n? da gerektiren bir hastal?kt?r. Bu nedenle aile özelliklerinin saptanmas?, tedavinin düzenlenmesine katk?da bulunacakt?r. Yöntem: Aile Ba??ml?l?k Profil ?ndeksi (BAP?-A) ölçe?i ailenin kural koyma, sorumluluk verme, çat??ma çözme becerilerini, aile içi ba?lar? ve ailenin ba??ml?ya kar?? tutumunu de?erlendirme amac?yla 10 sorudan olu?an bir ölçek olarak geli?tirilmi?tir. Ba??ml?l?k klini?ine ba?vuran ba??ml?lar?n; ebeveyn, e? ve di?er yak?nlar?na geli?tirilen bu ölçek ve Aile De?erlendirme Ölçe?i uygulanm??t?r. Uygulama 15 gün sonra tekrarlanm??t?r. Bulgular:Ölçe?in Cronbach alfa katsay?s? 0.82 bulunmu?tur. Aç?klay?c? faktör analizinde toplam varyans?n %30,81'ini aç?klayan 4 faktör elde edilmi?tir. Bunlar "ili?kisel beceriler", "aile içi ba?lar" ve "ba??ml?ya kar?? tutum " olarak adland?r?lm??t?r. Aile de?erlendirme ölçe?i ortalama toplam puan? ile BAP?-A ölçe?inin ortalama toplam puan? 0,52 (p<0.01) düzeyinde ba?lant?l? bulunmu?tur. BAP?-A'n?n ilk ve son test uygulamalar? aras?nda korelasyon 0,67 (p<0.01) olarak saptanm??t?r. Ba??ml? üyesi olan ve olmayan ailelerin ölçek puan? kar??la?t?r?ld???nda toplam puan ortalamalar? aras?ndaki fark istatistiksel olarak anlaml? bulunmu?tur. Ba??ml?n?n ebeveyn, e? ve di?er yak?nlar? de?erlendirmeye ayr?ca al?nd???nda benzer bulgular elde edilmi?tir. Sonuç: Aile Ba??ml?l?k Profil ?ndeksinin (BAP?A), kural koyma, sorumluluk verme ve çat??ma çözme gibi aile içi ili?kisel becerileri, aile ba?lar?n? ve yak?nlar?n ba??ml?ya tutumunu ölçen, geçerli ve güvenilir bir ölçek oldu?u söylenebilir.Öğe Plasma presepsin in determining gastric leaks following bariatric surgery(Türk Biyokimya Dergisi, 2019) Saraç, Elif YaprakABSTRACT: Background: To be able to prevent morbid obesity in the long-term, laparoscopic sleeve gastrectomy (LSG) is one of the most effective surgical interventions. However, leakage and bleeding from the stapler line are significant complications. The aim of this study was to determine the role of the levels of plasma presepsin in the detection of stapler leakage. Materials and methods: The study included 300 patients with LSG due to morbid obesity and 40 control subjects. Before any medical treatment was applied, blood samples were taken from patients at 12 h preoperatively and on days 1, 3, and 5 postoperatively. Evaluation was made of plasma presepsin levels, white blood count (WBC), C-reactive protein (CRP) and neutrophil-lymphocyte ratio (NLR), in all patients with sleeve gastrectomy line leakage. Results: The WBC, CRP, NLR and presepsin values measured on days 1, 3 and 5 postoperatively were determined to be higher in patients with leakage compared to those without. The predictive value of presepsin (p?=?0.001), CRP (p?=?0.001) and NLR (p?=?0.001) was determined to be statistically significantly higher than that of WBC (p?=?0.01). Conclusion: The results of the study suggest that presepsin levels could have a role in the detection and follow-up of stapler line leaks after LSG. Elevated presepsin levels, on postoperative day 1 in particular, could have a key role in the early detection of possible complications which are not seen clinically.Öğe Effects of platelet rich plasma on the gastric serosal surface neomucosa formation: an experimental rodent model(Türk Biyokimya Dergisi, 2019) Saraç, Elif YaprakABSTRACT: Background: Autologous platelet rich plasma (PRP) is the platelet concentration obtained from thrombocytes in the plasma. During the healing process, the platelets are activated and then release the granules which stimulate the inflammatory cascade and healing process. Platelet derived growth factor, vascular endothelial growth factor (VEGF), transforming growth factor ? (TGF?), epidermal growth factor (EGF) and fibroblast growth factor (FGF) are valuable markers used for cell regeneration. The aim of this study was to investigate the potential effects of PRP treatment on the neomucosa formation, a potential technique for increasing the intestinal surface area in patients with short bowel syndrome (SBS). Materials and methods: Thirty-two male Wistar-Hannover rats were divided into: sham, control, PRP-treated and last group for PRP preparation (n?=?8). Plasma levels of VEGF, TGF?, EGF and FGF were quantified by ELISA. En-bloc resection of anastomotic part was performed and stained with hematoxylin-eosin. Results: VEGF, FGF, TGF? and EGF levels were found significantly increased in PRP-treated group compared to others (p?Öğe Sodium arsenic alters the gene expression of some steroidogenic genes in TM3 leydig cell(Celal Bayar Üniversitesi Fen Bilimleri Dergisi, 2019) Taşçı, TunahanABSTRACT: Arsenic is a broad-spectrum environmental contaminant with mutagenic, teratogenic and carcinogenic effects. Due to its widespread distribution in nature, drinking water is the most common source of arsenic exposure for the general population. In this study, we aimed to determine the effect of sodium arsenite on the viability and expression profile of steroidogenic genes in TM3 Leydig cells, responsible for testicular steroidogenesis. The TM3 Leydig cells were treated with sodium arsenic (384,8 µM or 7,6 mM) for 24 hours with LH (Luteinizing hormone) stimulation. The MTT assay was used for measuring cell viability, the expression level of key genes of the steroidogenesis was evaluated using RT-qPCR.The MTT assay showed that cell viability was decreased dose-dependently. RT-qPCR demonstrated that the expression level of CYP11A1, CYP17A1 were decreased as compared to the untreated control while StAR gene expression was found to be surprisingly high in the cell exposed to high-dose arsenic (p<0.05). The expression profile of two dehydrogenase; 17?-HSD and 3?-HSD was significantly reduced in high dose arsenic treated-group (p<0.05); but however, no statistical significance was found in low-dose. The RTqPCR also showed that the expression SF-1 (Steroidogenic factor-1), a key regulator of adrenal and reproductive development, was significantly decreased in both low-dose and high-dose (p<0.05). Arsenic toxicity in Leydig cell leads to cell viability loss and cause a perturbation in key steroidogenic genes, reflecting the possible role of arsenic in infertility and male reproductive system disorders.Öğe Comparison of Radial Extracorporeal Shock Wave Therapy and Traditional Physiotherapy in Rotator Cuff Calcific Tendinitis Treatment(TURKISH LEAGUE AGAINST RHEUMATISM, 2019-09) Duymaz, Tomris; Sindel, DilşadObjectives: This study aims to investigate the efficacy of radial extracorporeal shock wave therapy (rESWT) in relieving pain and improving range of motion (ROM) and functionality besides conventional physiotherapy methods in the treatment of chronic rotator cuff calcific tendinitis (RCCT). Patients and methods: We studied 80 patients (35 males, 45 females; mean age 53.3 +/- 9.6 years; range, 40 to 70 years) with chronic RCCT. Patients were randomly divided into two groups: rESWT group (n=40) treated with conventional physiotherapy and rESWT, and control group (n=40) treated only with a conventional physiotherapy program. The traditional physiotherapy program included ultrasound, transcutaneous electrical nerve stimulation, shoulder joint ROM and stretching exercises, and ice applications. All patients received a total of 20 treatments, five days a week for four weeks. rESWT was applied once a week for four weeks in total. Before and after treatment, all patients were evaluated for age, height, weight, body mass index (BMI), pain intensity with a visual analog scale, shoulder ROM, and functional disability status with the shortened version of the Disabilities of the Arm, Shoulder and Hand questionnaire (QuickDASH). Results: Mean BMI value of the participants was 26.1 +/- 3.0 kg/m(2). Although all parameters of the patients in both groups improved significantly, patients in the rESWT group had a statistically significant improvement in pain, ROM and QuickDash scores (p<0.001, p<0.001, and p<0.001, respectively). Conclusion: We assume that rESWT is an effective and noninvasive method of reducing pain and increasing ROM and functional status without the need for surgery.Öğe Prediction of LIVER Toxicity with Stereotactic Body Radiotherapy: A Dosimetric Analysis(Elsevier, 2019-09-01) Çakır, Aydın[Abstract Not Available]Öğe LOX-catalyzed collagen stabilization is a proximal cause for intrinsic resistance to chemotherapy(NATURE PUBLISHING GROUP, 2018-09-06) Irmak, SterThe potential of altering the tumor ECM to improve drug response remains fairly unexplored. To identify targets for modification of the ECM aiming to improve drug response and overcome resistance, we analyzed expression data sets from pre-treatment patient cohorts. Cross-evaluation identified a subset of chemoresistant tumors characterized by increased expression of collagens and collagen-stabilizing enzymes. We demonstrate that strong collagen expression and stabilization sets off a vicious circle of self-propagating hypoxia, malignant signaling, and aberrant angiogenesis that can be broken by an appropriate auxiliary intervention: Interfering with collagen stabilization by inhibition of lysyl oxidases significantly enhanced response to chemotherapy in various tumor models, even in metastatic disease. Inhibition of collagen stabilization by itself can reduce or enhance tumor growth depending on the tumor type. The mechanistical basis for this behavior is the dependence of the individual tumor on nutritional supply on one hand and on high tissue stiffness for FAK signaling on the other.Öğe EFFECTIVENESS OF KINESIOLOGIC TAPE APPLICATION IN ROTATOR CUFF INJURIES(IJPHY PUBLISHERS, 2018-10) Reyhan, Aycan ÇakmakBackground: In our study, it was aimed to research the effect of kinesiological tape on pain, shoulder movement angles, and daily life activities. Methods: The control group (n:15) was applied with classical physiotherapy program including ultrasound, tens and exercise. The experiment group (n:15) was applied kinesiological-tape for seven days in addition to classical physiotherapy and rehabilitation program. Pretreatment and post-treatment pains of the patients were measured by using Visual Analog Scale (VAS), the goniometer was used to measure the shoulder ranges, Constant-Murley measured daily life activity levels, and DASH-T measured shoulder disability level. Results: As the VAS scores of the control group inactivity reduced by 11,21 points, the scores of the experiment group decreased by 24,53 points. The difference in scores between the two groups is significant statistically (p<0,05). As the extension and abduction scores increased significantly more in the experiment group, flexion increase is more at the control group. However, the difference between the two groups in shoulder movement angles was not found significant statistically (p>0,05). For shoulder movement opening, all records of the experiment group are significantly better than that of the control group, except the flexion increase. Conclusion: Kinesiological tape application ensuring a reduction in pain for rotator cuff injury in a shorter period is a treatment also providing significantly better results in shoulder movement recovery, increase in functionality, and a decrease in disability.Öğe Determinants of the addiction treatment drop-out rates in an addiction counseling centre: a cross-sectional study(Taylor & Francis Ltd., 2019-10-02) Kültegin, ÖgelOBJECTIVE: In the addiction treatment, treatment drop-out rates are very high. Drop-out is a crucial problem in the addiction treatment; therefore, understanding the reasons underlying this problem will help clinicians in developing new treatment strategies for treatment maintainance. In this present study, we aimed to examine the reasons for drop-out behaviour in the outpatients who presented to an addiction counseling centre in Turkey. METHODS: This study was conducted in 554 outpatients with alcohol and/ or substance use disorder who presented to the Turkish Green Crescent Counseling Center (YEDAM) between January 2016 and July 2017. The patients were evaluated retrospectively. The sociodemographic characteristics, substance use-related and psychological characteristics were extracted by using the Addiction Profile Index (BAPI) and Addiction Profile Clinical Form (BAPI-K) included in the YEDAMSOFT software system. The patients who came to the second, fifth, and tenth sessions and the patients who dropped-out of the treatment were analyzed in order to determine the sociodemographic, substance use-related, and psychological characteristics that might caused patients to drop-out from the treatment. RESULTS: The drop-out rates was found higher in male patients compared to the females. Among the factors that caused drop-out behaviour were low education status, negative relationship with father, adverse effects of the substance use, severe desire for the substance use, low motivation level, being under probation, and higher numbers of psychiatric treatments in the past. We found that the factors predicted the drop-out may vary depending on the treatment session when drop-out from the treatment was actualized. The factors that predicted drop-out in the second sessions were severe desire for the substance use, being under probation order, history of psychiatric treaments in the past, and higher excitement seeking behaviour. The factors that predicted the drop-out after the fifth session were educational and marital statuses, adverse effects of the substance use, being under probation, and history of psychiatric treatments in the past. Age, educational status, and being under the probation were found as predictive factors for drop-out behaviour in the tenth session. The duration of the treatments were evaluated by Kaplan-Meier Survival Analysis. It was observed that the patients dropped-out after the 2.78th session from the first to the tenth session (CI = 2.58-2.98). It was found that the patients dropped-out after the 4.24th session from the second to the tenth session (CI = 3.98-4.51). In Cox Regression Analysis; psychiatric treatment history in the past and excitement seeking behaviour were the predictive factors for treatment drop-out with 95% confidence interval (p<0.05). CONCLUSIONS: It was found that the factors that caused drop out from the treatment varied on session duration as it was hypothesized. Evaluating the factors that causes drop-out from the treatment will support clinicians to improve the addiction treatment services and develop more specific, patient-tailored treatment strategies.Öğe Comparison of physical activity level with sleep quality in premenopausal and postmenopausal women Physical activity and sleep quality in menopause(Bayrakol Medical Publisher, 2019-11) Duymaz, TomrisAim: The aim of this study was to examine the individual and combined associations of physical activity and sleep in premenopausal and postmenopausal women. Material and Method: Two hundred and fifty premenopausal (mean age: 45.50 +/- 2.10) and 250 postmenopausal (mean age: 60.27 +/- 3.03) women were evaluated. We compared age, body mass index (BMI), education, marital status, menopause age, jobs, medical conditions, smoking, physical activity and sleep quality using the Women's Health Initiative Insomnia Rating Scale between groups. The SPSS 22.0 program was used for thre statistical analysis of the research data. Frequency and percentage (average, standard deviation) were used as descriptive statistics of the study. Non-parametric tests (Mann-Whitney U, Kruskal-Wallis, Spearman correlation test) were performed for comparison of the variables, which did not comply with the normal distribution. Significance was accepted as p<0.05. Results: Sleep quality scores were better in premenopausal women when compared with postmenopausal women (p<0.000). No significant differences were found in BMI (p=0.691). The mean menopause age was 47.56 +/- 4.91 in postmenopausal women. Postmenopausal women's physical activity and sleep quality was worse than in premenopausal women. Thirty-four premenopausal (14 of them walking, 8 of them swimming, 12 of them fitness) and 12 postmenopausal (8 of them walking, 4 of them swimming) women had physical activity. In all women, exercise training participants had better sleep quality. Those who exercised had better sleep quality in both groups (p<0.000). No significant differences were found in sleep quality between those premenopausal and postmenopausal women who exercised. Discussion: Objective sleep measures differed significantly between the pre- and postmenopausal groups. These findings provide strong evidence that sleep qualities are more favorable in highly active women relative to less active women.Öğe Effect of physiotherapy on respiratory functions in patients with chronic neck pain Physiotherapy on respiratory functions of neck pain(Bayrakol Medical Publisher, 2019-11) Duymaz, TomrisAim: The aim of this study was to investigate the effects of physiotherapy methods applied for chronic neck pain treatment on pulmonary function, functional capacity, pain, and disability. Material and Method: This is a randomized controlled prospective study conducted in 84 patients with chronic neck pain. Patients were divided into 2 groups and physiotherapy was performed in 42 patients (10 minutes with ultrasound 1.0W/cm2 intensity, 20 minutes with conventional Transcutaneous Electrical Nerve Stimulation, 20 minutes with hot pack), home exercise program, respiratory exercises; and 42 patients in the control group had only home exercise and breathing exercises. Age, body mass index (BMI), duration of pain, severity and frequency of pain were recorded in all patients before treatment. Then, at the beginning and at the end of the treatment, pain intensity was assessed by visual analog scale (activity, rest, night), functional capacities with 6-minute walking test (6MWT), respiratory function tests with a spirometer, and disability with neck disability index (NDI) were assessed. Statistical analysis was performed with SPSS 22.0 program and p<0.05 was considered significant. Results: The mean age of the patients was 42.40 +/- 7.26 years and mean pain duration was 18.47 +/- 13.49 months. VAS,6MWT,NDI and VC, ERV(expiratory reserve volume), TV(tidal volume), FEV1(forced expiratory volume in 1 second), FEV1 / FVC, FEF25-75(forced expiratory flow at 25-75%) were found to have a significant improvement in the treatment group in intra- and intergroup comparisons (p<0.001, p<0.001, p<0.001, p<0.001, p<0.001, 0.024, 0.057, p<0.001, 0.009, p<0.001, 0.006). In the control group, the only significant improvement was observed in intra-group VAS values, p=0.015, 0.020, 0.034). Discussion: Physiotherapy program applied to patients with chronic neck pain has been found to increase respiratory functions and functional capacity with decreasing pain and disability level.
