The Relationship between "Self-Care Ability" and Psychological Changes among Hemodialysis Patients.

AIM: The study investigates and analyzes the relationship among the concepts of demoralization, posttraumatic growth, and self-care ability in patients undergoing hemodialysis. METHODS: The cross-sectional descriptive correlational study was conducted in 2017 on 150 hemodialysis patients selected through census in Buali Hospital, Ardabil, Iran. Demoralization scale, the posttraumatic growth inventory, and self-care questionnaire were used for cross-sectional data collection. Data were analyzed using descriptive statistics, Pearson and Spearman correlation coefficient. RESULTS: The mean and standard deviation of demoralization, posttraumatic growth, and self-care were 36.25 ± 18.84, 63.17 ± 17.71, and 33.89 ± 6.40, respectively. Self-care ability was positively associated with posttraumatic growth (r = 0.287) and negatively related to demoralization (r = -0.168). Self-care ability was also found to be desirable in 84.7% of the patients. CONCLUSIONS: Hemodialysis patients can experience both positive and negative psychological changes. Self-care ability is associated with reductions in negative psychological problems and increases in positive psychological changes. Health-care providers can, therefore, help hemodialysis patients to improve their psychological conditions by making plans for improving self-care abilities.

Agreement between total corneal astigmatism calculated by vector summation and total corneal astigmatism measured by ray tracing using Galilei double Scheimpflug analyzer / Concordancia entre el astigmatismo corneal total calculado mediante sumación vectorial, y el astigmatismo corneal total medido mediante trazado de rayos utilizando un analizador Galilei de doble cámara Scheimpflug

Purpose: To evaluate the agreement between total corneal astigmatism calculated by vector summation of anterior and posterior corneal astigmatism (TCAVec) and total corneal astigmatism measured by ray tracing (TCARay). Methods: This study enrolled a total of 204 right eyes of 204 normal subjects. The eyes were measured using a Galilei double Scheimpflug analyzer. The measured parameters included simulated keratometric astigmatism using the keratometric index, anterior corneal astigmatism using the corneal refractive index, posterior corneal astigmatism, and TCARay. TCAVec was derived by vector summation of the astigmatism on the anterior and posterior corneal surfaces. The magnitudes and axes of TCAVec and TCARay were compared. The Pearson correlation coefficient and Bland-Altman plots were used to assess the relationship and agreement between TCAVec and TCARay, respectively. Results: The mean TCAVec and TCARay magnitudes were 0.76 ± 0.57 D and 1.00 ± 0.78 D, respectively (P < 0.001). The mean axis orientations were 85.12 ± 30.26◦ and 89.67 ± 36.76◦, respectively (P = 0.02). Strong correlations were found between the TCAVec and TCARay magnitudes (r = 0.96, P < 0.001). Moderate associations were observed between the TCAVec and TCARay axes (r = 0.75, P < 0.001). Bland-Altman plots produced the 95% limits of agreement for the TCAVec and TCARay magnitudes from -0.33 to 0.82 D. The 95% limits of agreement between the TCAVec and TCARay axes was -43.0 to 52.1◦. Conclusion: The magnitudes and axes of astigmatisms measured by the vector summation and ray tracing methods cannot be used interchangeably. There was a systematic error between the TCAVec and TCARay magnitudes

Objetivo: Evaluar la concordancia entre el astigmatismo corneal total calculado mediante suma de los vectores del astigmatismo corneal anterior y posterior (TCAVec), y el astigmatismo corneal total medido mediante trazado de rayos (TCARay). Métodos: Este estudio incluyó a un total de 204 ojos derechos de 204 sujetos normales. Los ojos se midieron utilizando un analizador Galilei de doble cámara Scheimpflug. Los parámetros medidos incluyeron el astigmatismo queratométrico simulado utilizando el índice queratométrico, el astigmatismo corneal anterior utilizando el índice refractivo corneal, el astigmatismo corneal posterior, y TCARay. TCAVec se calculó mediante la suma de los vectores del astigmatismo en las superficies corneales anterior y posterior. Se compararon las magnitudes y ejes de TCAVec y TCARay. Se utilizaron el coeficiente de correlación de Pearson y los diagramas de Bland-Altman para valorar la relación y concordancia entre TCAVec y TCARay, respectivamente. Resultados: Los valores medios de las magnitudes TCAVec y TCARay fueron 0,76 ± 0,57 D y 1 ± 0,78 D, respectivamente (P < 0,001). Las orientaciones medias del eje fueron 85,12 ± 30,26 grados y 89,67 ± 36,76 grados, respectivamente (P = 0,02). Se encontraron fuertes correlaciones entre las magnitudes de TCAVec y TCARay (r = 0,96, P < 0,001). Se observaron asociaciones moderadas entre los ejes de TCAVec y TCARay (r = 0,75, P < 0,001). Los diagramas de Bland-Altman establecieron un 95% de límite de acuerdo para las magnitudes de TCAVec y TCARay de -0,33 a 0,82 D. Los límites de acuerdo del 95% entre los ejes de TCAVec y TCARay fueron de -43 a 52,1 grados. Conclusión: Las magnitudes y ejes de los astigmatismos medidos mediante suma de vectores y trazado de rayos no pueden intercambiarse. Se produjo un error sistemático entre las magnitudes de TCAVec y TCARay

Mean Posterior Corneal Power and Astigmatism in Normal Versus Keratoconic Eyes.

PURPOSE: To compare mean posterior corneal power and astigmatism in normal versus keratoconus affected eyes and determine the optimal cut-off points to maximize sensitivity and specificity in discriminating keratoconus from normal corneas. METHODS: A total of 204 normal eyes and 142 keratoconus affected eyes were enrolled in this prospective comparative study. Mean posterior corneal power and astigmatism were measured using a dual Scheimpflug camera. Correlation coefficients were calculated to assess the relationship between the magnitudes of keratometric and posterior corneal astigmatism in the study groups. Receiver operating characteristic curves were used to compare the sensitivity and specificity of the measured parameters and to identify the optimal cut-off points for discriminating keratoconus from normal corneas. RESULTS: The mean posterior corneal power was -6.29 ± 0.20 D in the normal group and -7.77 ± 0.87 D in the keratoconus group (P < 0.001). The mean magnitudes of the posterior corneal astigmatisms were -0.32 ± 0.15 D and -0.94 ± 0.39 D in the normal and keratoconus groups, respectively (P < 0.001). Significant correlations were found between the magnitudes of keratometric and posterior corneal astigmatism in the normal (r=-0.76, P < 0.001) and keratoconus (r=-0.72, P < 0.001) groups. The mean posterior corneal power and astigmatism were highly reliable characteristics that distinguished keratoconus from normal corneas (area under the curve, 0.99 and 0.95, respectively). The optimal cut-off points of mean posterior corneal power and astigmatism were -6.70 D and -0.54 D, respectively. CONCLUSION: Mean posterior corneal power and astigmatism measured using a Galilei analyzer camera might have potential in diagnosing keratoconus. The cut-off points provided can be used for keratoconus screening.

Distribution of the anterior, posterior, and total corneal astigmatism in healthy eyes.

PURPOSE: To evaluate the magnitude and axis orientation of the anterior, posterior, and total corneal astigmatism in normal healthy eyes of an Iranian population. METHODS: In a prospective cross-sectional study, ophthalmic and anterior segment parameters of 153 healthy eyes of 153 subjects were evaluated by Galilei dual Scheimpflug analyzer. The magnitude and axis orientation [with-the-rule (WTR), against-the-rule (ATR), and oblique] of the anterior, posterior, and total corneal astigmatism measurements (ACA, PCA, and TCA) were compared according to the age, sex, and other ophthalmic parameters. RESULTS: The mean ± SD age of the study population was 30 ± 5.9 years. The mean magnitude was 1.09 ± 0.76 diopters (D) for ACA, 0.30 ± 0.13 D for PCA, and 1.08 ± 0.77 D for TCA. Males had a significantly higher magnitude of PCA than females (p = 0.041). Most eyes had a WTR anterior astigmatism and an ATR posterior astigmatism. The WTR astigmatism had a higher mean magnitude compared to the ATR and oblique astigmatism in all the astigmatism groups, with a significant difference in the ACA and TCA groups (p < 0.05). PCA magnitude exceeded 0.50 D in only 7.8% of the subjects. ACA, PCA, and TCA were significantly correlated with each other and also had a significant correlation with the anterior and posterior maximum corneal elevation measurements (p < 0.001). CONCLUSION: The results of this study although are limited due to the small number of participants and confined to our demographics, provided information regarding a population that was not described before and may be helpful in obtaining optimum results in astigmatism correction in refractive surgery or designing new intraocular lenses.

Agreement between total corneal astigmatism calculated by vector summation and total corneal astigmatism measured by ray tracing using Galilei double Scheimpflug analyzer.

PURPOSE: To evaluate the agreement between total corneal astigmatism calculated by vector summation of anterior and posterior corneal astigmatism (TCAVec) and total corneal astigmatism measured by ray tracing (TCARay). METHODS: This study enrolled a total of 204 right eyes of 204 normal subjects. The eyes were measured using a Galilei double Scheimpflug analyzer. The measured parameters included simulated keratometric astigmatism using the keratometric index, anterior corneal astigmatism using the corneal refractive index, posterior corneal astigmatism, and TCARay. TCAVec was derived by vector summation of the astigmatism on the anterior and posterior corneal surfaces. The magnitudes and axes of TCAVec and TCARay were compared. The Pearson correlation coefficient and Bland-Altman plots were used to assess the relationship and agreement between TCAVec and TCARay, respectively. RESULTS: The mean TCAVec and TCARay magnitudes were 0.76±0.57D and 1.00±0.78D, respectively (P<0.001). The mean axis orientations were 85.12±30.26° and 89.67±36.76°, respectively (P=0.02). Strong correlations were found between the TCAVec and TCARay magnitudes (r=0.96, P<0.001). Moderate associations were observed between the TCAVec and TCARay axes (r=0.75, P<0.001). Bland-Altman plots produced the 95% limits of agreement for the TCAVec and TCARay magnitudes from -0.33 to 0.82D. The 95% limits of agreement between the TCAVec and TCARay axes was -43.0 to 52.1°. CONCLUSION: The magnitudes and axes of astigmatisms measured by the vector summation and ray tracing methods cannot be used interchangeably. There was a systematic error between the TCAVec and TCARay magnitudes.

A Study on the Psychometric Properties of Revised-nonverbal Pain Scale and Original-nonverbal Pain Scale in Iranian Nonverbal-ventilated Patients.

BACKGROUND AND AIMS: The nonverbal pain scale is one of the instruments which study pain in nonverbal-ventilated patients with regard to the changes of behavioral and physiological indices. The purpose of the study is to survey the psychometric properties of revised-nonverbal pain scale (R-NVPS) and original-nonverbal pain scale (O-NVPS) in ventilated patients hospitalized in critical care units. MATERIALS AND METHODS: Four nurses studied pain in sixty patients hospitalized in trauma, medical, neurology, and surgical critical care units using R-NVPS and O-NVPS at six times (before, during, and after nociceptive and nonnociceptive procedures). The test was repeated in 37 patients after 8-12 h. RESULTS: Cronbach's alpha coefficient for R-NVPS and O-NVPS was 0.8 and 0.76, respectively. The inter-rater correlation coefficient during different times was r = 0.89-0.96 for R-NVPS and r = 0.80-0.87 for O-NVPS. Test-retest correlation coefficient for R-NVPS and O-NVPS was r = 0.55-0.86 and r = 0.51-0.75, respectively. The meaningful difference in pain score between nociceptive and nonnociceptive procedures (P < 0.001) and a higher pain score in patients who confirmed pain (P < 0.001) showed a discriminant and criterion validity for both scales of NVPS, respectively. CONCLUSIONS: R-NVPS and O-NVPS can both be used as valid and reliable scales in studying pain in ventilated patient. However, in comparing the items, "respiration" (R-NVPS) had a higher sensitivity than "physiology II" (O-NVPS) in assessing pain.

Haemodynamic of blood flow through stenotic aortic valve.

Aortic valve (AV) stenosis is described as the deposition of calcium within the valve leaflets. With the growth of stenosis, haemodynamic, mechanical performances of the AV and blood flow through the valve are changed. In this study, we proposed two fluid-structure interaction (FSI) finite element (FE) models. The hyperelastic material model was considered for leaflets tissue. The leaflet tissue was considered stiffer in stenotic valve than the healthy leaflets because of its calcium content. Therefore, the valve could not open completely and this led to a decrease in the orifice area of the valve. The orifice area decreased from 2.4 cm2 for the healthy AV to 1.4 cm2 for the stenosis case. Mean pressure gradient increased in mid systole and the axial velocity experienced a three times increment in magnitude. Higher blood shear stress magnitudes were observed in stenotic valve due to the structure of the leaflet. In addition, strain concentration and higher stress values were observed on the leaflets in stenotic valve and the effective stress was greater than healthy case. In addition, pressure and velocity results were consistent with the echocardiography data literature. We have compared the performance of healthy and stenotic AV models during a complete cardiac cycle. Although improvements are still needed, there was good agreement between our computed data and other published studies.