Pembe Keskinoglu

Reliability and validity of revised Turkish version of Mini Mental State Examination (rMMSE-T) in community-dwelling educated and uneducated elderly

To evaluate the reliability and validity of the revised Turkish version of Mini Mental State Examination (rMMSE‐T) in educated and uneducated community‐dwelling elderly, to re‐organize the present Turkish version of MMSE and to determine cut‐off point of the revised test.

Prevalence and risk factors of depression among community dwelling elderly

Depression in the elderly is associated with increased morbidity and mortality. The purpose of this study was to determine the prevalence and risk factors of depression among community-dwelling older population in an urban setting in Turkey. This cross-sectional study was conducted among 482 elderly individuals 65 years and over in an urban area. Cluster sampling method was used for sample size. Depression in the elderly had been diagnosed by a clinical interview and Geriatric Depression Scale. Data were collected by door-to-door survey. Chi square test was used for statistical analysis. P value, which was calculated by the results of chi square test and coefficient of phi (φ), below 0.05 was included in the analysis of logistic regression. Depression was significantly associated with female gender, being single or divorced, lower educational status, low income, unemployment, and lack of health insurance. However, logistic regression analysis revealed higher depression rates in the elderly with chronic obstructive pulmonary disease, psychiatric disease, cerebrovascular disease, low income and being dependent. Depression is common among community-dwelling older people in an urban area of Izmir, Turkey. Older adults living in community should be cautiously screened to prevent or manage depression.

Older people's use of pre-hospital emergency medical services in Izmir, Turkey

The aim of this study is to determine the use of pre-hospital emergency medical services (EMS) in elderly people aged 65 years and over in Izmir, Turkey. In this descriptive study, older patients admitted to pre-hospital EMS of Izmir Province Health Directorate between 2004 and 2005 years was evaluated through the review of Emergency Call Registry Forms. The study data included socioeconomic characteristics, reasons of calling, distribution of calling times in the day, distribution of ambulance callers and preclinical diagnosis. A total of 34% of the subjects admitted to pre-hospital EMS were 65 years old and over. The rate of the use of ambulance services was 68.9/1000 population/year. The rate of pre-hospital EMS use for older persons living in urban areas was significantly higher than that of those living in rural areas. The most frequent pre-hospital EMS caller were persons in family (70.7%), and utilization of ambulance services was the highest in winter. Medically related incidents accounted for 89.1% of all emergency ambulance calls and cardiovascular diseases accounted for most common cause (32.6%) of calls. The utilization rate of pre-hospital EMS among older persons was approximately four times higher than that of the younger age groups.

Elder abuse and neglect in two different socioeconomic districts in Izmir, Turkey

OBJECTIVE To determine and compare the prevalence and risk factors of elder abuse in elderly population in two different districts in Izmir, Turkey. METHODS This cross-sectional study involved 497 subjects selected by cluster sampling. RESULTS The prevalence of physical and financial abuse among the elderly in the district of low socioeconomic status was 1.5% and 2.5%, respectively, while among the elderly in the district of high socioeconomic status, it was 2% and 0.3%, respectively. However, the prevalence of elder neglect in the two districts was 27.4% and 11.2%, respectively. Prevalence of neglect was associated with infrequent contact with relatives, little or no income, and fewer years of education among the elderly in the low socioeconomic district. In the high socioeconomic district, neglect was associated with fewer years in education, poor health status and having chronic status. CONCLUSION The prevalence of abuse among the elderly living in the two different districts was low. However, nearly one-fifth of elderly people were exposed to neglect.

Which cut-off level of urine cotinine:creatinine ratio (CCR) should be used to determine passive smoking prevalence in children in community based studies?

Environmental tobacco smoke (ETS) in the home is a major preventable health problem for children around the world. In children, ETS exposure (passive smoking) has been shown to be particularly associated with respiratory infection, especially lower respiratory tract infection (LRTI).1–3 Exposure intensity of ETS among children shows a strong correlation with indoor parental and, especially, maternal smoking, the number of cigarettes smoked, the number and volume capacity of the rooms where cigarettes are smoked and individual metabolic diversities.4 The use of cotinine, a major metabolite of nicotine, as a biological marker of smoke absorption has been suggested as an approach to strengthen the evidence of the relation between passive …

Home Accidents in the Community-Dwelling Elderly in Izmir, Turkey How Do Prevalence and Risk Factors Differ Between High and Low Socioeconomic Districts?

Objective: To determine and compare the prevalence of and risk factors for home accidents in the elderly in two different districts. Method: This cross-sectional study involves 497 older participants ages 65 and older. Sociodemographic characteristics of the elderly and characteristics of the houses in two different regions are evaluated. Data are analyzed by chisquare and t test. Results : The prevalence of home accidents was 39.3% in the low socioeconomic region and 13.1% in the high socioeconomic region within the past 6 months (p = .000). The most common type of home accident was fall (61.8%), followed by cut or piercing (22.0%). Home accidents are associated with being female and increasing age in the higher socioeconomic region, whereas being female, being unmarried, and living in a squatter house are associated with home accidents in the low socioeconomic region. Discussion: The prevalence of home accidents in the elderly population who live in low socioeconomic region was higher.

Termination of pregnancy for fetal abnormalities: main arguments and a decision-tree model.

By looking through our ethical committee cases, we demonstrate the main arguments we use for making a judgment in face of fetal abnormalities. Our decision making model is a simplified algorithm of the arguments and concepts we use in scientific‐ethic discussion.

Computed Tomographic Analysis: The Effects of Frontal Recess Morphology and the Presence of Anatomical Variations on Frontal Sinus Pneumatization

Abstract The aim of this study is to describe the morphology of frontal recess area with its anatomical variations and to reveal if frontal recess morphology and the anatomical variations related to that region have effects on the pneumatization of the frontal sinuses. The frontal sinus and recess morphometry of 136 sides of 68 dry skulls were evaluated on multislice high-resolution computed tomography. The relationships between frontal sinus and frontal recess measurements were analyzed by correlation and linear regression analysis. The variables between the groups of anatomical variations were analyzed by Mann–Whitney U test and &khgr;2 test or Fisher exact test. A positive relationship between the sagittal length of spina nasalis interna and morphometric measurements of frontal sinus was revealed (P <0.05). Agger nasi cells were present in 64.2% of sides, supraorbital ethmoid cells (SOECs) in 19.6%, type 3 frontal cells (FCs) in 18.9%, suprabullar cells in 24.3%, and frontal bulla was noted in 5.4%. Intersinus septal cells were observed in 16.2% of the skulls. There were statistically different increases in the measurements of frontal sinus morphometry in the presences of SOECs and type 3 FCs (P <0.05). The diameter of frontal sinus ostium was decreased in the presences of AN, SOEC, type 3 FC, and supraorbital ethmoid cell statistically (P = 0.049, P = 0.029, P = 0.043, P <0.001 respectively). In conclusion, frontal sinus pneumatization was affected by the spina nasalis interna and the presence of anatomical variations related to frontal recess or ostium region instead of the morphology of that area.

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.

Follow-up Analysis of Serum TNF-Related Apoptosis-Inducing Ligand Protein and mRNA Expression in Peripheral Blood Mononuclear Cells from Patients with Ischemic Stroke

Tumor necrosis factor (TNF)-related apoptosis-inducing ligand (TRAIL), which is TNF receptor superfamily member, contributes to several diseases pathogenesis. The aim of this research was to investigate the relevance of serum TRAIL protein levels and mRNA expression in peripheral blood mononuclear cells (PBMC) of patients with stroke through 6 months follow-up. We enrolled patients with first-ever acute ischemic stroke (n = 95) and healthy controls (n = 95) in this study. Follow-up blood samples were collected from patients at day 7, 28, and 180 after the onset. The stroke severity was evaluated by National Institutes of Health Stroke Scale score. TRAIL protein levels were quantified by using ELISA kits and TRAIL mRNA expression by quantitative real-time PCR. Our study showed that stroke patients have statistically significant lower levels of serum TRAIL protein (p < 0.0001) and elevated TRAIL mRNA expression (p < 0.0001) in PBMC at the disease onset. Our follow-up study revealed that TRAIL protein levels were increased while mRNA expression levels were downregulated in later periods. Overall, our findings suggest that serum TRAIL levels and mRNA expression in PBMC could reliably serve as a predictor of stroke outcome. Additionally, our study supports that TRAIL plays a role in pathogenesis and progression of ischemic stroke.