Psychometric testing and the predictive validity of the Postpartum Depression Predictors Inventory-Revised (PDPI-R): A longitudinal study with Turkish women.

OBJECTIVE: The aim of this study was to investigate the validity and reliability of the prenatal and postnatal versions of the Postpartum Depression Predictors Inventory-Revised (PDPI-R) and to examine the predictive validity of PDPI-R in Turkish women, considering two gold standards to determine postpartum depression (PPD). METHODS: This prospective longitudinal study was conducted between August 2021 and September 2023. A total of 301 pregnant women participated in the study. Participants completed the PDPI-R during the third trimester of pregnancy (T1) and at 4 weeks postpartum (T2). At T2, participants also completed the Edinburgh Postnatal Depression Scale (EPDS), and women were interviewed using the Structured Clinical Interview for DSM-IV Disorders. RESULTS: The prenatal version of the PDPI-R predicted PPD with 64% (R:0.64) accuracy on the basis of the EPDS and 78% accuracy (R:0.78) according to DSM IV criteria. The postnatal version of the PDPI-R predicted PPD with 71% (R:0.71) accuracy on the basis of the EPDS and 81% accuracy (R:0.781) based on DSM IV criteria. The cut-off points exhibited the highest sensitivity and specificity values at 8.5 for the prenatal version and 10.5 for the postnatal version. CONCLUSIONS: The PDPI-R is a valid and reliable screening tool for identifying Turkish women at high risk of developing PPD and for estimating the psychosocial risk associated with PPD.

YouTube as an information source in paediatric dentistry education: Reliability and quality analysis.

INTRODUCTION: In the era of Covid 19 pandemic, the audio-visual contents of YouTube™ could be an information source for dental students, practitioners, and patients. The aim of this study was to evaluate the quality, content, and demographics of YouTube™ videos about pediatric dentistry for the education of dentistry students. MATERIALS AND METHODS: A search on YouTube™ was performed using the keywords "pediatric dentistry", "pediatric dental treatments", "primary teeth treatments" in Turkish. The first 50 videos selected for each keyword were evaluated. Parameters of the videos such as the number of views, the days since the upload, the duration of the video, and the number of likes and dislikes were recorded. Videos are categorized by upload source and content categories as an academic, dentist, physician, patient, reporter, and other, and average points are obtained for the Journal of American Medical Association (JAMA) benchmark. The normality of the data was evaluated with the Shapiro-Wilk test. The data were not distributed normally, compared with the Kruskal Wallis test between source and content groups. The Dunn's Post Hoc was used to determine to find out which group caused the difference. The Spearman Correlation coefficient was calculated to assess a possible correlation between JAMA, GQS, and VPI scores. All significance levels were set at 0.05. RESULTS: The duplicates and non-related ones were removed from 150 videos and remaining 119 videos were evaluated. Most of the videos were uploaded by the dentists and other categories, and mainly the videos were uploaded for patient education. JAMA score was 1 out of 4 for 55 videos, 2 for 63 videos, and 3 for only 1 video. When the video source groups were compared, the difference was statistically significant (p = 0.01). The difference between academic and patient groups (p = 0.007); the dentist and patient groups were statistically significant (p = 0.02). CONCLUSION: YouTube platform does not contain videos of appropriate quality to support the education of dentistry students in pediatric dentistry in Turkish.

Probiotic Whey-Based Beverages from Cow, Sheep and Goat Milk: Antioxidant Activity, Culture Viability, Amino Acid Contents.

Recently, the demand for goat and sheep cheese has increased mainly because of its nutritional and health benefits. As a result, an enormous amount of whey from various animal species is produced as a waste/by-product. The production of functional probiotic fermented beverages from different types of whey protein concentrates (WPC) could be a good way to valorize whey. Meanwhile, reduced environmental pollution and economic sustainability will be provided. In this study, probiotic beverages enriched with 1% kiwi powder were produced from goat, sheep, and cow WPC (15%). Moreover, Streptococcus salivarius subsp. thermophilus and the probiotic bacteria Lactobacillus acidophilus and Bifidobacterium animalis subsp. lactis were used for fermentation. The results showed that WPC significantly increased the protein content and acidity of beverages (p < 0.05). Production with WPC also improved the viability of probiotic bacteria and S. thermophilus, total phenolic compound (TPC), and antioxidant activity of beverages. The highest viability of probiotic bacteria (9.67 log CFU/mL for Bb-12 and, 9.35 log CFU/mL for L. acidophilus) was found in beverages produced from goat WPC. In addition, WPC increased the free amino acid content of beverages, and the highest essential amino acids and branched-chain amino acids were found in beverages produced from goat WPC as 146.19 mg/100 g and 70.31 mg/100 g, respectively (p < 0.05). Consequently, while production with goat, cow, and sheep WPC improved quality compared to the control, beverages produced from goat WPC excelled. The production of a functional probiotic beverage with goat WPC is promising for dairy technology.

Knowledge and attitude towards human papillomavirus and its vaccination and affecting factors among nursing and medical students: a questionnaire study.

The aim of this study was to investigate the knowledge about the Human Papillomavirus (HPV), HPV testing and HPV vaccinations and affecting factors among nursing and medical students and explore their attitudes regarding HPV vaccination. A cross-sectional study was conducted with 635 undergraduate nursing and medical students from March to June 2020 at a state university in Turkey. The data were collected using the Questionnaire Form and HPV Knowledge Scale (HPV-KS). The HPV-KS mean scores of the students were 17.07 ± 6.95. The students were aged 26 and over, females, had good economic status, registered at the faculty of medicine, at higher year of studies, had sexual experience and recommended HPV vaccination got higher knowledge scores regarding HPV, HPV testing and HPV vaccination (p ˂ .05). Despite low vaccination rate (2.0%), almost all the students recommended the HPV vaccine (95.9%). Sex, place of residence, faculty (departments), and year of study are among the significant predictor of knowledge about HPV, HPV testing and HPV vaccinations level up to 39% (p ˂ .05). This study highlights the need for further education and training are required to increase the knowledge about HPV, HPV testing and HPV vaccination, which may help increase awareness and improve the ratio of vaccination.IMPACT STATEMENTWhat is already known on this subject? Human papillomavirus (HPV) is one of the most common sexually transmitted diseases and most likely to cause cervical cancer. Prophylactic vaccine administrations is critical in primary protection from HPV.What the results of this study add? The study revealed the needs for education among nursing and medical students about HPV, HPV testing and HPV vaccines. Knowledge regarding HPV, HPV testing and HPV vaccines is statistically significantly associated with age, sex, economic status, place of residence, faculty, year of study, sexual experience and recommending HPV vaccines. Sex, place of residence, faculty, and year of study are among the statistically significant positive predictors for HPV knowledge.What the implications are of these findings for clinical practice and/or further research? Educators should increase education and/or training opportunities related to HPV among nursing and medical students who are the future healthcare providers and in the risky group for HPV during undergraduate education.

The effect of a reproductive health course on sexual myths, sexual attitudes and gender perceptions among university students.

OBJECTIVES: This study aimed to investigate the effect of a reproductive health course on sexual myths, sexual attitudes and gender perceptions of university students. METHODS: A quasi-experimental study with a pre-test/post-test design was conducted among 222 undergraduate students. Data were collected using a questionnaire form, the Sexual Myths Scale, the Brief Sexual Attitudes Scale and the Perception of Gender Scale. RESULTS: Comparison of pre-test with post-test results showed that the course achieved an improvement in sexual attitudes (p < 0.001), a positive effect on gender perceptions (p < 0.05) and a decrease in sexual myth beliefs (p < 0.001) among participants. CONCLUSION: The results indicate the importance of educating young people about reproductive health. Courses on reproductive and sexual health should be integrated into the curriculum of first year undergraduate education.

Intimate Partner Violence against Women in Turkey during the COVID-19 Pandemic.

This study aims to determine the prevalence of and risk factors for intimate partner violence (IPV) during the COVID-19 pandemic. The cross-sectional study was conducted with 1,036 women in Turkey who were either married or had an intimate partner. The data were collected between June 20 and July 10, 2020. Experience of any form of IPV (physical (10.1%), sexual (4.0%), psychological (32.2%) or economic (11.5%) was reported by 35.5% of the participants. Regression analyses revealed that exposure to IPV during the pandemic was significantly associated with being married, having children, unemployment, poor marital/relationship satisfaction, an increased workload in the household and the negative effect of quarantine on mood (p < 0.05). Educational programs need to be prepared for the prevention of IPV during the COVID-19 pandemic and for the acquisition of protective behaviors toward women victims of IPV.

Recent advances in dual effect of power ultrasound to microorganisms in dairy industry: activation or inactivation.

There is a growing interest on ultrasonic processing of dairy products, especially fermented dairy products which are a basis to functional foods. The studies have shown that power ultrasound can enhance the fermentation process of lactic acid bacteria by modifying their metabolic activity while reducing fermentation time and improving the quality characteristics of fermented milk products. Fermentation is one of the important stages in the processing of dairy products, but it is also one of the most time and resource consuming stages during production. Thus, the benefits of ultrasound to the fermentation process due to microbial activation become increasingly important. In fact, ultrasound applications have the dual effect on microorganisms. Besides being used for microbial activation in dairy industry, it can also be used for inactivation of microorganisms depending on ultrasound power and frequency, sonication time, microorganism type, pH, and temperature. This review article summarizes the effect of power ultrasound on microbial inactivation and microbial growth based on fermentation profile of dairy products, with a theoretical background on ultrasound, including research findings. Also, the details on the activation and inactivation mechanisms of power ultrasound to microorganisms are presented.

Sexual myths and attitudes regarding sexuality of nursing students: A mixed method study.

PURPOSE: To determine the nursing students' sexual myths and attitudes regarding sexuality, and to explore their views towards sexual care in practice. DESIGN AND METHODS: A mixed-method sequential explanatory design was used. Data were collected using Questionnaire Form, Sexual Myths Scale (SMS), Sexual Attitude and Beliefs Scale (SABS), and Focus-Group Interview Form. FINDINGS: The average scores on the SMS and the SABS were 58.66 ± 18.74 and 37.50 ± 6.97, respectively, indicating students' sexual myths and their attitudes regarding sexuality were moderate. A positive, significant correlation was found between SMS and SABS scores (p < 0.001). In the interviews, the views on the barriers and facilitators in sexual care and the negative effect of sexual myths on sexual care were revealed. PRACTICE IMPLICATIONS: Courses regarding sexuality should include into nursing curriculum from the first years of undergraduate education.

The impact of high-fidelity simulation on knowledge, critical thinking, and clinical decision-making for the management of pre-eclampsia.

OBJECTIVE: To investigate the impact of high-fidelity simulation on nursing students' knowledge, critical thinking, and clinical decision-making in the management of pre-eclampsia, and to explore the students' views and learning experiences. METHODS: A mixed-methods design study was conducted on 107 third-year nursing students. The students were randomly assigned to the control group (n=54) or the experimental group (n=53). The students in the experimental group attended the simulation training using a high-fidelity simulator, while the students in the control group attended only the classical training on "the management of pre-eclampsia." RESULTS: Knowledge (P<0.001), critical thinking (P<0.05), and clinical decision-making (P<0.05) scores of students in the experimental group increased after the simulation. In the focus group interviews, five themes were identified: learning development; closing the gap between theory and practice; confident decision-making and self-confidence; professional preparation; and recommendations. CONCLUSION: High-fidelity simulation is efficacious for improving the management of pre-eclampsia among nursing students.

Obstetric simulation in undergraduate nursing education: An integrative review.

BACKGROUND: Simulation as an innovative teaching method is an effective form of pedagogical approach. A wealth of evidence shows that simulation in nursing education provides an opportunity for undergraduate students to improve learning outcomes. AIM: The aim of this review was to systematically appraise and synthesize evidence that examine the effects of obstetric simulation in an undergraduate nursing program. METHODS: Integrative review method guided this review. Four electronic databases were searched using "CINAHL (EBSCOhost)," "Science Direct," "OVID," and "WILEY" to identify original research published between 2008 and 2018. Search and MeSH terms included: obstetric, maternal, simulation, nursing, and student. RESULTS: Seventeen articles were included in this review. The results of content analysis revealed three essential themes: cognitive and psychomotor (knowledge-skills) skill, affective (self-confidence, anxiety, critical thinking-self-efficacy) skill, and students' views on obstetric simulation. In all of the studies, it was determined that the simulation method was a safe and effective teaching strategy. CONCLUSION: The use of obstetric simulation in an undergraduate nursing program has a positive effect on the level of self-confidence, anxiety, critical thinking-self-efficacy, psychomotor skills, and level of anxiety.

Psychiatric symptom rate of patients with Diabetes Mellitus: A case control study.

AIMS: The aim of the study is comparing the psychiatric symptom in Type1 DM, Type 2 DM and controls. METHODS: The study was designed as case control study and conducted between September 2011 and April 2012 to the Diabetes Clinic. Age, gender and education level matched 70 type 1 diabetics, 68 type 2 diabetics and 70 controls included to the study. SCL-90-R [Symptom Check List-90 (Revised)] test is used for determining the psychiatric symptom rates. RESULTS: It was found that the rate of somatization, interpersonal sensitivity, anger-hostility and additional scales were significantly different in type 1, type 2 diabetics and controls ((p = 0.023, p = 0.008, p = 0.018 and p = 0.039, respectively). Compared to control group, being a patient with type 1 or type 2 Diabetes found as a risk factor for somatization, depression, anger-hostility and additional scales. Moreover being a patient with type 1 DM was found as a risk factor for having OBS symptoms (p = 0.039) and type 1 DM was protective against having interpersonal sensitivity symptoms (p = 0.006). CONCLUSION: In diabetic patient groups, an increase in the rate of psychiatric symptoms was observed. Therefore a careful psychiatric examination is required in DM.

The prevalence and risk factors for osteoporosis among 18- to 49-year-old Turkish women.

The aim of this study was to determine the prevalence of osteoporosis and associated risk factors in Turkish women aged 18-49 years. A population-based, cross-sectional study was conducted between January and April 2014. The sample (n = 1,792) was comprised of women aged 18-49 years, who resided in Cubuk, Ankara, Turkey, and were selected by simple random sampling. The data were collected in face-to-face interviews using an Individual Information Form and an Osteoporosis Risk Estimation Scale. Bone mineral density was assessed using standard dual-energy X-ray absorptiometry. Multiple logistic regression and chi-square analyses were used for analyses. Most participants (80.1%) were at low risk of developing osteoporosis, while 6.9% were at medium to high risk of developing the disease. From bone mineral density levels, 33.3% were osteopenic; 4.0% were osteoporotic; 33.3% were osteopenic at the femoral neck; and 6.7% were osteoporotic at the lumbar vertebra L1-L4. Further, results of multiple logistic regression analyses showed that osteoporosis risk was significantly associated with smoking, having light skin, multiparity, and having a family history of osteoporosis (p < .05). These results indicated that public health screening strategies for protecting women's bone health at earlier ages than previously thought might be beneficial.

The Frequency of Unplanned Rehospitalization and Associated Factors in Gyneoncology Patients: A Retrospective Study.

OBJECTIVE: In this study, we aim to analyze rate and associated factors with unplanned rehospitalization in gynecological cancer patients. MATERIALS AND METHODS: The electronic database query (2007 to 2014) was used to evaluate rehospitalization rates within 90 days of index admission in patients with gynecological cancer. Multivariable logistic regression was used to identify factors associated with rehospitalization. RESULTS: Mean patient age was 59.05 ± 11.96 years (minimum, 32 years; maximum, 85 years). A total of 152 patients' data were evaluated. Seventy-three patients (48.0%) were rehospitalized within 90 days of discharge. The median length of index hospital stay (from 3 to 34 days) was 8.90 ± 6.03 days. The most common rehospitalization causes includes pain (24.6%), recurrence (21.9%), ascites (13.7%), surgical site infection (12.3%), acute reoperation (9.6%), thromboembolism (8.2%), renal failure (5.5%), ileus/obstruction (2.7%), and lymphedema (1.4%). In multivariable logistic regression model, difference was found between history of operation, receive chemotherapy, development of the complication during hospitalization comorbidities as well as multiparity variables, and rehospitalization (P < 0.05). CONCLUSIONS: Unplanned rehospitalization after discharge for gynecological cancer is common with significant associated risk factors and patient outcomes. Integrated multidisciplinary health care strategies, such as safe transition, communication, patient and family education, accurate medication reconciliation, and short-interval outpatient follow-up may help to prevent rehospitalization after discharge and improve patient outcomes.

Reference ranges of handgrip strength from 125,462 healthy adults in 21 countries: a prospective urban rural epidemiologic (PURE) study.

BACKGROUND: The measurement of handgrip strength (HGS) has prognostic value with respect to all-cause mortality, cardiovascular mortality and cardiovascular disease, and is an important part of the evaluation of frailty. Published reference ranges for HGS are mostly derived from Caucasian populations in high-income countries. There is a paucity of information on normative HGS values in non-Caucasian populations from low- or middle-income countries. The objective of this study was to develop reference HGS ranges for healthy adults from a broad range of ethnicities and socioeconomically diverse geographic regions. METHODS: HGS was measured using a Jamar dynamometer in 125,462 healthy adults aged 35-70 years from 21 countries in the Prospective Urban Rural Epidemiology (PURE) study. RESULTS: HGS values differed among individuals from different geographic regions. HGS values were highest among those from Europe/North America, lowest among those from South Asia, South East Asia and Africa, and intermediate among those from China, South America, and the Middle East. Reference ranges stratified by geographic region, age, and sex are presented. These ranges varied from a median (25th-75th percentile) 50 kg (43-56 kg) in men <40 years from Europe/North America to 18 kg (14-20 kg) in women >60 years from South East Asia. Reference ranges by ethnicity and body-mass index are also reported. CONCLUSIONS: Individual HGS measurements should be interpreted using region/ethnic-specific reference ranges.

Reference ranges of handgrip strength from 125, 462 healthy adults in 21 countries: a prospective urban rural epidemiologic (PURE) study

Background The measurement of handgrip strength (HGS) has prognostic value with respect to all-cause mortality, cardiovascular mortality and cardiovascular disease, and is an important part of the evaluation of frailty. Published reference ranges for HGS aremostly derived from Caucasian populations in high-income countries. There is a paucity of information on normative HGS valuesin non-Caucasian populations from low- or middle-income countries. The objective of this study was to develop reference HGS rangesfor healthy adults from a broad range of ethnicities and socioeconomically diverse geographic regions. Methods HGS was measured using a Jamar dynamometer in 125,462 healthy adults aged 35-70 years from 21 countries inthe Prospective Urban Rural Epidemiology (PURE) study. Results HGS values differed among individuals from different geographic regions. HGS values were highest among thosefrom Europe/North America, lowest among those from South Asia, South East Asia and Africa, and intermediate among thosefrom China, South America, and the Middle East. Reference ranges stratified by geographic region, age, and sex are presented. These ranges varied from a median (25th–75th percentile) 50 kg (43–56 kg) in men 60 years from South East Asia. Reference ranges by ethnicity and body-mass index are also reported...

Validation and comparison of three formulae to estimate sodium and potassium excretion from a single morning fasting urine compared to 24-h measures in 11 countries.

BACKGROUND AND OBJECTIVES: Although 24-h urinary measure to estimate sodium and potassium excretion is the gold standard, it is not practical for large studies. We compared estimates of 24-h sodium and potassium excretion from a single morning fasting urine (MFU) using three different formulae in healthy individuals. METHODS: We studied 1083 individuals aged 35-70 years from the general population in 11 countries. A 24-h urine and MFU specimen were obtained from each individual. A subset of 448 individuals repeated the measures after 30-90 days. The Kawasaki, Tanaka, and INTERSALT formulae were used to estimate urinary excretion from a MFU specimen. RESULTS: The intraclass correlation coefficient (ICC) between estimated and measured sodium excretion was higher with Kawasaki (0.71; 95% confidence interval, CI: 0.65-0.76) compared with INTERSALT (0.49; 95% CI: 0.29-0.62) and Tanaka (0.54; 95% CI: 0.42-0.62) formulae (P <0.001). For potassium, the ICC was higher with the Kawasaki (0.55; 95% CI: 0.31-0.69) than the Tanaka (0.36; 95% CI: -0.07 to 0.60; P <0.05) formula (no INTERSALT formula exists for potassium). The degree of bias (vs. the 24-h urine) for sodium was smaller with Kawasaki (+313 mg/day; 95% CI: +182 to +444) compared with INTERSALT (-872 mg/day; 95% CI: -728 to -1016) and Tanaka (-548 mg/day; 95% CI: -408 to -688) formulae (P <0.001 and P = 0.02, respectively). Similarly for potassium, the Kawasaki formula provided the best agreement and least bias. Blood pressure correlated most closely and similarly with the 24-h and Kawasaki estimates for sodium compared with the other two formulae. CONCLUSION: In a diverse population, the Kawasaki formula is the most valid and least biased method of estimating 24-h sodium excretion from a single MFU and is suitable for population studies.

Validation and comparison of three formulae to estimate sodiumand potassiumexcretion froma singlemorning fasting urine comparedto 24-hmeasures in 11countries

Background and objectives: Although 24-h urinarymeasure to estimate sodium and potassium excretion isthe gold standard, it is not practical for large studies. Wecompared estimates of 24-h sodium and potassiumexcretion from a single morning fasting urine (MFU) usingthree different formulae in healthy individuals.Methods: We studied 1083 individuals aged 35–70 yearsfrom the general population in 11 countries. A 24-h urineand MFU specimen were obtained from each individual. Asubset of 448 individuals repeated the measures after 30–90 days. The Kawasaki, Tanaka, and INTERSALT formulaewere used to estimate urinary excretion from a MFU specimen.Results: The intraclass correlation coefficient (ICC)between estimated and measured sodium excretion washigher with Kawasaki (0.71; 95% confidence interval, CI:0.65–0.76) compared with INTERSALT (0.49; 95% CI:0.29–0.62) and Tanaka (0.54; 95% CI: 0.42–0.62)formulae (P<0.001). For potassium, the ICC was higherwith the Kawasaki (0.55; 95% CI: 0.31–0.69) than theTanaka (0.36; 95% CI: 0.07 to 0.60; P<0.05) formula(no INTERSALT formula exists for potassium). The degreeof bias (vs. the 24-h urine) for sodium was smaller withKawasaki (R313 mg/day; 95% CI: R182 to R444)compared with INTERSALT ( 872 mg/day; 95% CI: 728to 1016) and Tanaka ( 548 mg/day; 95% CI: 408 to 688) formulae (P<0.001 and P»0.02, respectively).Similarly for potassium, the Kawasaki formula provided thebest agreement and least bias. Blood pressure correlatedmost closely and similarly with the 24-h and Kawasakiestimates for sodium compared with the other twoformulae.Conclusion: In a diverse population, the Kawasaki formulais the most valid and least biased method of estimating24-h sodium excretion from a single MFU and is suitablefor population studies.

Sialolith characterization by scanning electron microscopy and X-ray photoelectron spectroscopy.

The objective of this study has been to characterize sialolith, a calcium phosphate deposit that develops in the human oral cavity, by high-resolution field emission scanning electron microscopy (SEM) and X-ray photoelectron spectroscopy (XPS). The morphological and chemical data obtained helped in the determination of their formation mechanism in salivary glands. Sialoliths in the submandibular salivary glands may arise secondary to sialodenitis, but not via a luminal organic nidus. We believe this is the first study that characterizes a sialolith by XPS.