Psychometric Support and Measurement Invariance of a Turkish Version of the Transformational Parenting Questionnaire.

Our primary objective in this study was to psychometrically evaluate the Transformational Parenting Questionnaire (TPQ) within the Turkish context. Secondarily, we aimed to determine whether the questionnaire demonstrated measurement invariance across children's genders and grade levels. We included 950 participants, aged 11-18 years (446 girls, 498 boys, 6 unspecified gender identity; Mage = 14.73, SD = 1.85 years). Confirmatory factor analysis provided support for the original 4-factor structure of the TPQ, and there was satisfactory criterion-related correlational validity between this instrument and the Satisfaction with Life Scale. The TPQ exhibited robust internal item reliability coefficients, and respondent's test-retest correlations over a 15-day interval suggested adequate item response consistency. Importantly, we confirmed measurement invariance of the scale across participants gender and educational grade levels. In summary, we found that the TPQ was a valid and reliable tool for assessing Turkish children's perceptions of transformative parenting behaviors.

Translation and Adaptation of the Reinjury Anxiety Inventory, the Sport Injury Rehabilitation Adherence Scale, and the Athletic Injury Self-Efficacy Questionnaire Into Turkish.

CONTEXT: Psychological difficulties can adversely affect rehabilitation outcomes and make return to sport more difficult. Identifying psychological difficulties is possible with valid and reliable measurement tools. The purpose of this study is to translate and culturally adapt the Reinjury Anxiety Inventory (RIAI), the Sport Injury Rehabilitation Adherence Scale (SIRAS), and the Athletic Injury Self-Efficacy Questionnaire (AISEQ) into Turkish and evaluate the psychometric properties of the Turkish versions. DESIGN: Cross-sectional study. METHODS: The instruments were forward- and back-translated, culturally adapted, and validated on 248 athletes and 34 physical therapists. The physical therapists of the athletes completed the SIRAS to evaluate the athletes. Statistical analysis included reliability tests (Cronbach alpha and test-retest), exploratory factor analysis, confirmatory factor analysis, and correlational analysis. Floor and ceiling effects (<15%) were also assessed. RESULTS: Confirmatory factor analyses revealed a satisfactory model fit for the RIAI and the AISEQ, and exploratory factor analysis revealed the 1-factor structure for the SIRAS as in the original. All 3 instruments displayed adequate internal consistency (Cronbach alpha coefficients ranged from .84 to .88) and test-retest reliability (coefficients ranged from .81 to .93). Convergent validity of the instruments was supported by significant correlations between the AISEQ and both the RIAI and the SIRAS. CONCLUSIONS: Our results suggest that the Turkish versions of the instruments were valid, consistent, and reliable in athletes who have serious injuries. Scores on these instruments could be useful for evaluating the contributions of psychological factors to return to sport following serious injuries. Clinicians are encouraged to use RIAI-Turkish (RIAI-TR), SIRAS-Turkish (SIRAS-TR), and AISEQ-Turkish (AISEQ-TR) together to make decisions about the treatment and rehabilitation plans of injured athletes.

Psychometric Properties and Measurement Invariance of the Positive Youth Development Scale - Turkish Version.

In this study, we translated to Turkish and evaluated the validity, reliability, and measurement invariance for respondent sex, grade level and analysis programs the Short Form and Very Short Form of the Positive Youth Development Scale (Turkish version). We had 435 youth, aged 11-17 years, complete the Short (34 items) and Very Short (17 items) Forms of the instrument. Confirmatory factor analysis revealed that both forms had a 5-factor structure, and validity testing showed good criterion-related correlation validity between this tool and the Satisfaction with Life Scale. The Short Form had adequate reliability coefficients, but the Very Short Form lacked sufficient reliability for some dimensions. Test-retest correlations were satisfactory for both forms. While the Short and Very Short Forms showed measurement invariance across gender and grade level, CFI, NNFI (TLI), and IFI values diverged between LISREL and AMOS analysis programs. In summary, our data suggest that the Short Form is a reliable measure of positive youth development, while the Very Short Form may not be as reliable due to insufficient confidence values.

Comparison of bleeding risk scores and evaluation of major bleeding predictive factors in patients with major bleeding due to vitamin K antagonist use.

Background: Major bleeding in the treatment of atrial fibrillation is closely associated with an increased risk of death and major adverse outcomes in both the short and long term, but all bleeding events are associated with a reduced quality of life. Bleeding events are also known to reduce medication adherence. In this sense, bleeding risk scores are important tools to help predict major bleeding. However, it is not clear which scoring system is superior. Aim: In this study, our aim was to compare bleeding risk scores and to examine the factors associated with bleeding in patients with major bleeding while using vitamin K antagonists. Methods: In this retrospective and single-center study, scoring, laboratory and demographic data were analyzed with SPSS 20.0 statistical program. Results: The mean age of a total of 1434 patients included in our study was 68.2 ± 11.3 years, range was 39-93 years and 769 (53.6%) of these patients were male. Of 588 patients with major bleeding, 93 (15.8%) had intracranial hemorrhage. Logistic regression analysis comparing the scoring systems among themselves revealed that the GARFIELD-AF scoring system had a predictive effect on major bleeding independent of the effect of other scoring systems (OR: 1.532, 95% CI 1.348-1.741, p < 0.001). The area under the curve (AUC) for GARFIELD-AF was 0.690 (0.662-0.718) as a result of the ROC analysis considering the best cut-off point of 3.2% calculated for 2 years. AUC 0.659 (0.630-0.687) for HAS-BLED, AUC 0.636 (0.606-0.665) for ORBIT and AUC 0.611 (0.5810.642) for ATRIA. When we compare the patient group with the control group, it can be said that intracranial hemorrhage occurred independently of INR and TTR values, unlike in the major bleeding group (p:0.129, p:0.545). Conclusion: In patients using vitamin K antagonists for atrial fibrillation, the GARFIELD-AF risk score was found to be superior to important bleeding risk scores such as HAS-BLED, ORBIT and ATRIA in terms of predicting major bleeding. It is an important result that intracranial hemorrhages, which have a special place among major hemorrhages, were independent of INR and TTR levels. It is noteworthy that 8.2% of patients with major bleeding had a history of minor bleeding in the last year.

The effects of cardiopulmonary resuscitation (CPR) performed out-of-hospital and in-hospital with manual or automatic device methods and laboratory parameters on survival of patients with cardiac arrest.

OBJECTIVE: Determining the predictive factors for cardiac arrest may be helpful in the management of in-hospital cardiac arrest (IHCA) and out-of-hospital cardiac arrest (OHCA) and in estimating the outcome. Therefore, in the present study, we aimed to investigate the effect of demographic data, cardiopulmonary resuscitation (CPR) initiating setting, compression method, and laboratory parameters on survival from cardiac arrest. METHODS: A total of 414 patients who met the inclusion criteria were included in the study. Patients were grouped into those who underwent out-of-hospital CPR and those who underwent CPR in the hospital and patients who received automatic compression and those who did not receive. In addition to pH, lactate and bicarbonate in arterial blood gas, CK-MB, troponin, urea, creatinine, calcium, potassium, and glucose were measured. RESULTS: The mean age of patients was 70.36±15.68 years, and 170 (41.1%) were female. Although the success rate of CPR in the OHCA group (22.2%) was lower than in the patients in the IHCA group (30.9%), the difference was not statistically significant. There was no difference between the two groups in the comparison of mechanical compression devices and manual compression. In the logistic regression analysis, high pH and low lactate values were found to be independent predictors of survival. CONCLUSION: The results of this study revealed no significant difference between IHCA and OHCA CPR applications and between manual and mechanical compressions in terms of survival in patients with cardiac arrest. In addition, higher pH levels and lower lactate levels measured during CPR were independent predictors of survival.

The associations of transformational leadership and team cohesion on the psychological health of young football players through basic psychological needs.

The present study examined the associations of transformational leadership behaviors and team cohesion with the psychological health (life satisfaction, positive and negative affect, and burnout) of athletes and the indirect relationship of basic psychological needs. The sample consisted of 252 (boys) players aged between 13 and 15. The model data fit was also verified. The results demonstrated that the transformational leadership behaviors of coaches were indirectly related to athletes' psychological health. Team cohesion was related to athletes' psychological health both directly and indirectly. Basic psychological needs played an indirect role in these relationships. Transformational leadership and team cohesion have important implications for the healthy development of young people.

Relationship Between Prognostic Nutritional Index and Contrast-Associated Acute Kidney Injury in Patients With Non-ST Segment Elevation Myocardial Infarction Undergoing Coronary Angiography.

Prognostic nutritional index (PNI), consisting of inflammatory-nutritional parameters, has been investigated in terms of outcomes and renal function in patients with coronary artery disease. The objective of this study is to assess the predictive power of the PNI in predicting the risk for developing contrast-associated acute kidney injury (CA-AKI), an important complication following coronary angiography in patients with non-ST-elevation myocardial infarction (NSTEMI). The study population (336 patients with the diagnosis of NSTEMI) was divided into two groups: patients with CA-AKI and patients without CA-AKI. The mean age of the whole population was 62.0 ± 12.7 (21-95) years. CA-AKI was detected in 68 (20%) patients. Prognostic nutritional index values were significantly (P < .001) lower in the CA-AKI (+) group. Low PNI values (cutoff < 48.5%) were independent predictors of CA-AKI with Odds ratio (OR): .913, 95% confidence interval (CI): .866-.962, P:.001, with a sensitivity 70.6% and specificity 69.4%. Prognostic nutritional index seems to be an easily assessable and promising scoring system that can be used in clinical practice for predicting the risk of developing CA-AKI.

Rivaroxaban and apixaban in patients with atrial fibrillation; a real-world data.

BACKGROUND: This study aims to analyze the real-life data of patients who were prescribed rivaroxaban and apixaban and to emphasize the points that we think will make a difference compared to randomized controlled studies. METHODS: The patients who accepted to participate in the study in whom rivaroxaban (15-20 mg) and apixaban (2.5-5 mg) were started with the diagnosis of atrial fibrillation between 01 January 2018 and 31 December 2019 and whose records were fully accessed through the hospital automation system were included in the study. RESULTS: One hundred and ninety-four (48.5%) of a total of 400 patients using rivaroxaban and apixaban were women. The mean age was 73.34 ± 10.45 years, and the age range was 41-98. There was no significant difference in terms of demographic characteristics, background information of the patients, and the medications. Drug-induced complications and mortality rates were also similar. The GFR change rates of the patients in both groups were similar even though the initial GFRs were significantly higher in rivaroxaban group. The mean age and ejection fractions of the patients using rivaroxaban 15 mg were found to be lower than those of patients using rivaroxaban 20 mg whereas the mean systolic blood pressure and HAS-BLED score were found to be higher. Ischemic stroke and mortality rates were higher in patients using 15 mg rivaroxaban than patients using 20 mg rivaroxaban. The rates of nonmajor bleeding in patients using rivaroxaban 15 mg were lower compared to those using 20 mg, and this difference was statistically significant. DISCUSSION: Stroke rates were found to be higher and to have similar bleeding rates compared to major clinical studies in our real-life analysis. However, high ischemic cerebrovascular event and low nonmajor bleeding rates are remarkable in low dose use of rivaroxaban. It is clear that there is a need to consider existing dose reduction criteria in terms of correct prescribing.

A real-world application of Markov chain Monte Carlo method for Bayesian trajectory control of a robotic manipulator.

Reinforcement learning methods are being applied to control problems in robotics domain. These algorithms are well suited for dealing with the continuous large scale state spaces in robotics field. Even though policy search methods related to stochastic gradient optimization algorithms have become a successful candidate for coping with challenging robotics and control problems in recent years, they may become unstable when abrupt variations occur in gradient computations. Moreover, they may end up with a locally optimal solution. To avoid these disadvantages, a Markov chain Monte Carlo (MCMC) algorithm for policy learning under the RL configuration is proposed. The policy space is explored in a non-contiguous manner such that higher reward regions have a higher probability of being visited. The proposed algorithm is applied in a risk-sensitive setting where the reward structure is multiplicative. Our method has the advantages of being model-free and gradient-free, as well as being suitable for real-world implementation. The merits of the proposed algorithm are shown with experimental evaluations on a 2-Degree of Freedom robot arm. The experiments demonstrate that it can perform a thorough policy space search while maintaining adequate control performance and can learn a complex trajectory control task within a small finite number of iteration steps.

Pseudo-Marginal MCMC Sampling for Image Segmentation Using Nonparametric Shape Priors.

Segmenting images of low quality or with missing data is a challenging problem. In such scenarios, exploiting statistical prior information about the shapes to be segmented can improve the segmentation results significantly. Incorporating prior density of shapes into a Bayesian framework leads to the posterior density of segmenting shapes given the observed data. Most segmentation algorithms that exploit shape priors optimize a cost function based on the posterior density and find a point estimate (e.g., using maximum a posteriori estimation). However, especially when the prior shape density is multimodal leading to a multimodal posterior density, a point estimate does not provide a measure of the degree of confidence in that result, neither does it provide a picture of other probable solutions based on the observed data and the shape priors. With a statistical view, addressing these issues would involve the problem of characterizing the posterior distributions of the shapes of the objects to be segmented. An analytic computation of such posterior distributions is intractable; however, characterization is still possible through their samples. In this paper, we propose an efficient pseudo-marginal Markov chain Monte Carlo (MCMC) sampling approach to draw samples from posterior shape distributions for image segmentation. The computation time of the proposed approach is independent from the training set size. Therefore, it scales well for very large data sets. In addition to better characterization of the statistical structure of the problem, such an approach has the potential to address issues with getting stuck at local optima, suffered by existing shape-based segmentation methods. Our approach is able to characterize the posterior probability density in the space of shapes through its samples, and to return multiple solutions, potentially from different modes of a multimodal probability density, which would be encountered, e.g., in segmenting objects from multiple shape classes. We present promising results on a variety of synthetic and real data sets.

Prognostic value of neutrophil/lymphocyte ratio in patients with pulmonary embolism.

AIM: Preliminary evidence suggests that inflammation plays a role in the development and prognosis of pulmonary embolism (PE). We used the neutrophil/lymphocyte ratio (NLR) as a measure of systemic inflammation and investigated its association with PE. MATERIALS AND METHODS: A total of 266 patients who were diagnosed with PE and a control group of 124 age- and sex-matched healthy subjects were included in this study. We further classified the PE patients into 2 groups: those who survived and those who died in the first 30 days. Baseline NLR was measured by dividing neutrophil count to lymphocyte count and was compared between the groups. RESULTS: Median NLR was significantly higher among patients with PE compared to the healthy control group (3.9 (interquartile range (IQR): 5.0) vs. 1.9 (IQR: 0.6), P < 0.001). Of the 266 patients with PE, 16 (6%) died within 1 month. Median NLR was significantly higher among PE patients who died compared to those who survived, as well (3.7 (IQR: 4.3) vs. 9.0 (IQR: 7.9), P < 0.001). The optimal cut-off values, sensitivities, and specificities of NLR for predicting PE and in-hospital mortality of PE were >2.565 and >5.465, 70.3% and 75.0%, and 92.7% and 67.6%, respectively. Multiple logistic regression analysis showed that NLR values of >5.465 could define those patients with a mortal clinical course independently (odds ratio: 13.446, 95% confidence interval: 3.141-57.566, P < 0.001).

Hemodynamic and oxygenation changes in surgical intensive care unit patients with fever and fever lowering nursing interventions.

The purpose of this study was to determine the effects of fever and nursing interventions to lower fever on hemodynamic values and oxygenation in febrile (temperature greater than 38.3°C) surgical intensive care unit patients. This retrospective study was conducted in 53 febrile patients out of 519 patients admitted to the surgical intensive care unit at a university hospital. Data were obtained from the medical records, laboratory files and nursing notes. Statistical analysis of the data was analyzed by repeated measures analysis of variance and a paired sample t-test. The average hourly urine output (F = 5.46; P = 0.002) and systolic blood pressure (F = 2.87; P = 0.03) were significantly lower after fever onset. Heart rate, respiratory rate, positive end-expiratory pressure settings and FiO(2) settings were unchanged after the development of fever. Diastolic blood pressure and oxygen saturation had non-statistically significant decreases. Nursing interventions for febrile patients consisted of medication administration (69.8%), ice (62.3%) and sponging with tepid water (62.3%). The present results showed that fever was associated with an increase in heart rate, decreased systolic arterial pressure, mean arterial pressure, oxygen saturation and hourly urine output.