The impact of health literacy on COVID-19 immunization.

The COVID-19 pandemic can be controlled by vaccination in addition to public health measures. This study investigate the impact of Health Literacy (HL) on vaccination and COVID-19. 334 patients and patient's relatives aged 18 to 65 years who were followed up at the Infectious Diseases Clinic between March and July 2022 for reasons other than COVID-19 disease were included in the study. The COVID-19 vaccination status of each participant was queried and the preferred vaccination was recorded on the case form. The mean age was 40.9 years, and 52.4% (n:175) of participants were women. It was found that 82.3% (n:275) of participants had received at least one dose of the vaccine COVID-19. It was found that 17.6% of participants had not been COVID-19 vaccinated. It was found that 60.7% (n:203) of participants received ≥ 2 doses of the mRNA-based viral vaccine. Vaccination rates were found to be significantly lower in patients with 'inadequate' HL (p = .047). In addition, the vaccination rate was lower in people aged 39 years and younger and in the presence of one or more chronic diseases. When chronic diseases are present, COVID-19 becomes more severe. On the other hand, the disease shows a moderate clinical picture and plays a significant role in transmission to risk groups in the young population, where vaccination rates are low. This situation in the context of COVID-19 demonstrates once again the importance of informing at-risk groups and the healthy young population about vaccine-preventable diseases.

The Impact of Vaccination Among Hospitalized Patients with the Diagnosis of COVID-19.

Objective: We aimed to investigate the vaccination status and the risk factors for the intensive care unit (ICU) support need of the laboratory-confirmed breakthrough COVID-19 infection inpatients. Materials and Methods: This multi-center point-prevalence study was conducted on inpatients, divided into two groups as 'fully' and 'partially' vaccinated according to COVID-19 vaccination status. Results: Totally 516 patients were included in the study. The median age was 65 (55-77), and 53.5% (n=276) of the patients were male. Hypertension (41.9%, n=216), diabetes mellitus (DM) (31.8%, n=164), and coronary artery disease (CAD) (16.3%, n=84) were the predominant comorbidities. Patients were divided into two groups ICU (n=196) and non-ICU (n=301). Hypertension (p=0.026), DM (p=0.048), and congestive heart failure (CHF) (p=0.005) were significantly higher in ICU patients and the median age was younger among non-ICU patients (p=0.033). Of patients, 16.9% (n=87) were fully vaccinated, and this group's need for ICU support was statistically significantly lower (p=0.021). Conclusion: We conclude that older age, hypertension, DM, CHF, and being partially vaccinated were associated with the need for ICU support. Therefore, all countries should continuously monitor post-vaccination breakthrough COVID-19 infections to determine the national booster vaccine administration approach that will provide vulnerable individuals the highest protection.

Teaching sustainability: does style matter?

Purpose: This paper aims to analyze how a tangram activity improved students' abilities to explain sustainability, articulate a positive perception of sustainable design and relate sustainability with innovation in engineering design. Design/methodology/approach: The concept of paradigm shift was introduced in the classroom by using a tangram activity to help students understand that sustainable design requires out-of-the-box thinking. Instructors from three institutions teaching various levels of sustainability courses to engineering majors used the activity to introduce sustainable design, then measured the understanding and appreciation of the concepts introduced through the tangram activity with pre- and post-activity surveys. Findings: Findings from the study indicate that students' perceptions of sustainability significantly improved due to the activity, without regard to the institution. The activity also significantly improved students understanding of the connection between sustainability and innovation, across all three institutions, across all majors and across all years of study except second-year students. Improving engineering students' views on sustainability may lead, over time, to changes in the industry, in which environmental performance is incorporated into the engineering design process. Originality/value: Active learning approaches are needed for affective-domain learning objectives in the sustainability field for students to learn the necessary attitudes, values and motivations to implement sustainability in engineering design. Simple, easily implemented active learning techniques, such as the tangram activity presented here, can be implemented across the curriculum or to the public to introduce the paradigm shift necessary with sustainable design.

Tetanus immunization among healthcare professionals: cross-sectional study in Turkey.

INTRODUCTION: Vaccine-preventable diseases can be effectively managed through timely vaccine booster doses. In this study, the tetanus vaccination status of healthcare professionals and their level of knowledge about tetanus vaccination were investigated. METHODOLOGY: The data were obtained through a survey questionnaire from 336 healthcare professionals. The survey participants were recruited on a voluntary basis among the personnel working in a tertiary hospital between 1 July 2021 and 30 September 2021. The participants were asked about their tetanus vaccination status and general awareness about the tetanus vaccine. RESULTS: The survey participants included nurses (41.4%, n = 139), doctors (39.9%, n = 134) and support unit personnel (18.8%, n = 63). The support unit personnel had insufficient knowledge about military service period, pregnancy period, vaccination of women aged 15-49 years, and the necessity of booster tetanus vaccine every 10 years. Interestingly, the nurses had significantly inadequate knowledge of geriatric tetanus vaccination. CONCLUSIONS: Although the tetanus immunization program is widely implemented throughout the country, our study concluded that it is necessary to educate healthcare professionals on the importance of the tetanus vaccine.

Joint line reestablishment in revision total knee arthroplasty.

BACKGROUND: In this study, the traditional "Anatomical Landmark-Distance Method (AL-DM)" in the formation of joint line (JL) was compared with "Adductor Tubercle-Ratios method" (AT-RM), and the effect of reestablishment of JL on clinical and functional outcomes were evaluated. MATERIALS AND METHODS: 16 revision total knee arthroplasties (rTKAs) were performed by using "AT-RM" (group 1) and 16 rTKA by using "AL-DM" (group 2) in our clinic between 2015 and 2018. The data were prospectively collected and a total of 32 knees of 31 patients were analyzed. At the final follow-up, knee functions were evaluated by using Knee Society Score (KSS) knee and function, Western Ontario and McMaster Universities Arthritis Index (WOMAC) scores, Short Form-36 (SF-36) questionnaires and physical examinations. RESULTS: Postoperative flexion arc was higher in Group 1. KSS knee and function scores were better in group 1. In group1, JL was reestablished successfully in all revision rTKAs in terms of ATJL and the tibial tubercle TT-JL ratios. The improvement in KSS knee and function scores and WOMAC scores were also better in group 1. Measurements showed that the improvement in KSS scores increased as AT-JL and TT-JL distances approached the calculated values. CONCLUSION: "AT-RM" was shown to be superior to the traditional distance method in terms of JL reestablishment. Functional results and patient satisfaction increased when JL was reestablished.

A comparison of the effects of platelet-rich plasma and demineralized bone matrix on critical bone defects: An experimental study on rats.

BACKGROUND: Delayed union of fractured bone is one of the main problems of orthopedics and traumatology practice. It was hypothesized that the beneficial effects of allogeneic platelet-rich plasma (PRP) would be valuable in the treatment of segmental bone defects. This study is a comparison of the effects of demineralized bone matrix (DBM) and PRP in a segmental bone defect model. METHODS: Total of 48 Wistar albino rats were separated into 4 groups. Segmental bone defect was created at right radius diaphysis in all specimens using dorsal approach. Four additional rats were used as PRP source. Intracardiac blood was withdrawn before the operation for preparation of allogeneic PRP. Group 1 (n=12) served as control group and defects were left untreated. Group 2 (n=12), was PRP group, and received grafting with PRP. Group 3 (n=12) was PRP+DBM combination group, and was treated with grafting and mixture of DBM and PRP. In Group 4 (n=12), defect area was grafted with DBM only. At the end of 10th week, rats were sacrificed, forearms were dissected, and defect areas were examined with radiological and histopathological parameters. RESULTS: Radiological evaluation revealed that ossification was best in PRP group, followed by DBM group. According to results of histopathological studies, union quality was better than control group in all treatment groups (Groups 2, 3, and 4), and was best in PRP group (p<0.05). Results were also better in PRP group when examined in terms of cortex development and remodeling (p<0.05). When examined in terms of new osteogenesis, results were comparable in Groups 2, 3, and 4, but all were better than control group. CONCLUSION: It was concluded that PRP and DBM have comparable effect on recovery of defective bones, but there is no synergistic effect when used together. We believe that PRP can be a cost-effective, readily available alternative to DBM with minimal morbidity.

Simultaneous posterior dislocation of primary total knee arthroplasty with ipsilateral tibial shaft fracture: A case report and review of literature.

Dislocation following total knee arthroplasty (TKA) is a rare but serious complication. Here, a 74-year-old woman with posterior dislocation of her right cruciate-retaining TKA and ipsilateral tibia diaphysis fracture was presented. She only slipped down on the ground with a quick twist of her right leg. She underwent revision semiconstrained TKA and osteosynthesis of tibial fracture with plate and screw. Her partially avulsed patellar tendon was repaired as well. She was ambulatory with a cane and satisfied with revision operation at last control. Extensor mechanism and functional posterior cruciate ligament is especially important in patients receiving cruciate-retaining TKA. As far as we know, simultaneous dislocation of TKA with fracture of tibia diaphysis has never been reported before.

Impact of Surgery Type on Quality of Life in Breast Cancer Patients.

OBJECTIVE: Breast cancer can lead to alterations in quality of life of the patients. The aim of this study is to evaluate the changes in quality of life of the female patients who had undergone surgical treatment for breast cancer. MATERIALS AND METHODS: A total of 250 female patients (breast-preserving surgery (BPS), n=27, 11%; modified radical mastectomy (MRM), n=194, 77%, and simple mastectomy (SM), n=29; 11%) aged between 28-55 years (47.4±6.4 yrs) were included in the study. Patient information, demographic characteristics, income, and treatment modalities applied were recorded. Validated Turkish versions of EORTC QLQ-C30, and EORTC-BR23 questionnaires were used for all patients. RESULTS: Breast-preserving surgery has a more favorable impact on general well-being, physical role, cognitive, psychological, and social functions, and symptom scale scores. When the identical parameters were taken into consideration, relatively favorable outcomes of BPS on the patients were observed relative to mastectomized patients. Besides, though not statistically significant, BPS has more patient-friendly effects on sexual function and sexual satisfaction in comparison with mastectomy. Patients with advanced stage disease and elder patients had more unfavorable health related quality of life (HRQoL) scores than younger patients, and those in their early stages of breast cancer. CONCLUSION: Quality of life of BPS patients is less adversely affected relative to mastectomized patients. In the decision-making process, quality of life should be taken into consideration.

Crataegus orientalis associated multiorgan hypersensitivity reaction and acute renal failure.

Patients, especially those with chronic disease and disorders are increasingly relying on complementary and alternative medical therapies (CAMT). Because the use of CAMT is escalating worldwide, it is essential to be aware of the clinical and adverse effects, doses and potential drug-herb interactions. Crataegus orientalis or hawthorn is a small tree with red fruits. A number of studies appear to demonstrate that Crataegus spp. have a clinically detectable positive cardiac inotropic action. The ingredients, characteristics of metabolism and elimination, and adverse effects of hawthorn remain largely unknown. We report a case of multisystem hypersensitivity reaction and progressive acute renal failure associated with the consumption of Crataegus orientalis.