Effects of Cognitive Behavioral Therapy, Existential Psychotherapy and Supportive Counselling on Facial Emotion Recognition Among Patients with Mild or Moderate Depression

OBJECTIVE: This study compared the effects of cognitive behavioral therapy (CBT), existential psychotherapy (ExP) and supportive counseling (SUP) on facial emotion recognition among mildly and moderately depressed patients. METHODS: 21 patients for CBT, and 20 each for ExP and SUP groups with 60 healthy controls were investigated. Eight consecutive weekly sessions and following two monthly boosters were performed. Prior to the sessions, all subjects received Sociodemographic Data Form, the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-1), and Facial Emotion Recognition Test (FERT). Patients received Hamilton Depression Rating Scale (HDRS) and FERT at the onset and after weekly and booster sessions. RESULTS: Patients' ability to recognize surprised and neutral emotions were lower than controls. ExP group improved recognition of almost all emotions, CBT group improved only happy emotions and SUP group did not improve any emotions. HDRS scores declined in all patient groups, ExP and CBT groups had lower scores than SUP. CONCLUSION: MDD patients recognized surprised and neutral emotions lower than controls. ExP improved ability to recognize almost all emotions, CBT improved only happy emotions, SUP did not improve at all. ExP, CBT and SUP all led to a reduction in MDD. ExP and CBT had comparable effects and both were more helpful than SUP.

Coronary ectasia is associated with impaired left ventricular myocardial performance in patients without significant coronary artery Stenosis

To determine both ventricular functions and tissue Doppler echocardiography [TDE]-derived myocardial performance index [MPI] in patients with coronary artery ectasia [CAE]. Twenty-five patients with CAE [13 men; mean age 57 +/- 9 years] and 25 age- and sex-matched controls without CAE [8 men; mean age 54 +/- 10 years] were enrolled in the study. Left and right ventricular functions were detected using conventional echocardiography and TDE. Left ventricle-lateral wall [0.61 +/- 0.17; 0.50 +/- 0.10, p = 0.02], interventricular septum [0.66 +/- 0.17; 0.52 +/- 0.10, p = 0.007] and mean MPI [0.63 +/- 0.15; 0.51 +/- 0.09, p = 0.004] were increased in the CAE group compared to the control group. Right ventricular MPI was similar in both the CAE and control groups [0.58 +/- 0.18; 0.52 +/- 0.19, p > 0.05]. The findings show that left ventricular MPI is different in CAE patients without obstructive coronary artery disease compared to the normal control group. Also in these patients, right ventricular MPI was similar to the control group

Importance of structured training programs and good role models in hand hygiene in developing countries

The aim of this study is to identify the beliefs and perceptions associated with hand hygiene performance in two different institutions with limited resources and recently established infection control programme later than developed institutions. The study was conducted in two different hospitals [University Hospital-U-hospital and Community Hospital-C-hospital] in the same city by a selfadministered questionnaire. Most questions were drawn from questionnaires used previously in other studies from "industrialized" countries based on "The Theory of Planned Behavior". All nurses, nurse students [last class], physicians and intern medical students in the U-hospital, and all nurses in the C-hospital were included into the study. Of 1764 questionnaires, 941 [41%] were returned. The return rate was highest for nurses in C-hospital [63.8% [303 of 475]] and lowest for senior physicians in U-hospital [7.5% [16 of 212]]. Out of the respondent a total of 16 [1.7%] were senior physicians, 110 [11.6%] were physician assistants, 400 [42.6%] were nurses in the U-hospital, 303 [32%] were nurses in the C-hospital, 66 [7%] were medical students and 46 [4.9%] were nurse students. Seven hundred and ninety five [85.9%] of 926 respondents were female. Respondents provided demographic information and data about various behavioral, normative, and control beliefs that determined their intentions with respect to performing hand hygiene. Among individuals from the other professional categories, a greater percentage of U-hospital nurses [57.6% vs. 53.9%, respectively] believed that healthcare-associated infections to be greater than 20%, and mortality rate among infected patients to be greater than 5%. C-hospital nurses generally believed the frequency, severity, and impact of healthcare-associated infections to be lower than U-hospital nurses and other individuals. However, all professional categories believed that good hand hygiene effectively prevents infections [98%]. In univariate analysis, receipt of structured training in hand hygiene, perceived colleagues adherence's as good, adherence models good practices for others, having been observed for their adherence [normative beliefs], the perception that hand hygiene is relatively easy to perform and high workload [control beliefs] was associated with good hand hygiene. However, in multivariate analysis, high self reported adherence to hand hygiene was independently associated with receipt of structured training in hand hygiene, perceived good adherence by colleagues, the perception that hand hygiene is relatively easy to perform and having been observed for their adherence. In a country with limited resources, intention to comply was associated with training and strong normative and control beliefs. Also, in two different kinds of institution with the similar hand hygiene promotion campaign in the same city, the believes of nurses were different. In developing countries, more resources have to be allocated for training of HCWs and easy access for hand hygiene products

Should the Nottingham Health Profile or the Short Form-36 be given preference in stroke?

To compare the usefulness of the Nottingham Health Profile [NHP] and the Short Form 36 [SF-36] as general outcome measures for chronic stroke patients with respect to the response rate, internal consistency reliability, validity analyses, and agreement in similar domains of the 2 instruments. In this prospective study, 90 consecutive stroke patients attending the Neurology outpatient clinic at Erciyes University, Kayseri, Turkey from March 2004 to March 2005 were evaluated for the study. Seventy outpatients who had a stroke 6 months previously were included in the study. As a datacollecting device, SF-36 and NHP scales were used. The prevalence of patients with highest quality of life score [ceiling effect] was higher for the NHP scale [10-35.7%] than for the SF-36 scale [1.4-37.1%]. The prevalence of patients with lowest quality of life score [floor effect] was also higher for the NHP scale [1.4-45.7%] than for the domains of SF-36 [1.4-30%]. The internal consistencies of the subscales of both the SF-36 and the NHP showed satisfactory values. Regarding convergent validity, correlations were found between comparable subscales of the 2 instruments. Limits of agreement in similar domains of the 2 instruments were very large. In all 5 demonstrated Bland-Altman plots, there was agreement of the scales in the measurement of the similar fields of quality of life. Both the SF-36 and the NHP have acceptable degrees of reliability, convergent validity, and response rate. Limits of agreement in similar domains of the 2 instruments were very large

Activity of propolis in an experimental model of pneumocystosis

To investigate the anti Pneumocystis effects of propolis on Pneumocystis carinii P. carinii in rat model. Rats were obtained, and the study was taken in to place in Erciyes University Clinical and Experimental Research Center, Kayseri, Turkey, in June 2007. In order to obtain spontaneous pneumonia, rats were remained on immunosuppression therapy with dexamethasone throughout the study. Propolis administered orally at doses of 30, 50, and 100 mg/kg/day. Trimethoprim-sulfamethoxazole [TMP-SMX, 50/250 mg/kg/day] was used as positive control and untreated animals as negative control in the study. There were 6 animals in each group. Untreated animals showed P. carinii infection level with a mean +/= standard deviation log number of cysts per gram of lung tissue of 4.6 +/= 1.6 at the end of the experiment. Trimethoprim-sulfamethoxazole 50/250 mg/kg/day has significantly reduced the log number of cysts per gram to 1.8 +/= 1.6 [p<0.001]. There was no reduction found in the number of cysts in infected animals treated with 30, 50, and 100 mg of propolis/kg/day, and so the results were not statistically significant [p>0.05] compared with the control group. In our rat model of pneumocystosis the efficacy of propolis, this was used in folk medicine since ancient times, found completely ineffective

Poststroke depressive symptoms and their relationship with quality of life, functional status, and severity of stroke

The present study aimed to investigate the relationship between depressive symptoms in 6 months after stroke and the quality of life [QOL], clinical and socio-demographical characteristics, functional status, and severity of stroke. Ninety consecutive stroke patients who attended the neurology outpatient clinic at Erciyes University, Kayseri, Turkey from March 2004 to March 2005 were evaluated for the study. Seventy outpatients who had a stroke 6 months previously were included in the study. As a data-collecting device, Short Form 36, Functional Independence Measure [FIM], Canadian Neurological Scale, and Beck Depression Inventory [BDI] were used. In addition, a questionnaire was administered to obtain clinical and socio-demographic data. Seventy patients were included in the study. Depression measured using BDI was identified in 47.1% of the patients. Total FIM scores, especially motor subscale scores, were decreased in the depressive patients. No difference was found in the stroke severity scores of the depressed and non-depressed patients. The QOL subscale scores, such as physical functioning, bodily pain, general health perception, vitality, social functioning, and mental health, were lower in the patient group with high BDI scores. There was a positive correlation between age and BDI scores of the patients. Negative correlations were found between the scores of QOL and FIM in both total and motor subscale scores. Poststroke depression seems to be associated with age, education level, QOL, and functional status