State Hospital Research Articles

Determination of the Prevalence of Postpartum Depression and Its Affecting Factors in Turkish Mothers and Syrian Refugee/Asylum Seeker Mothers.

This study aimed to determine the prevalence of postpartum depression and the factors that influence postpartum depression in Turkish and Syrian refugee mothers. The participants were administered the Personal Information Form and the Edinburgh Postnatal Depression Scale in the 6th week of the postpartum period. While the number of Turkish mothers participating in the study was 66, the number of Syrian mothers was 71. The study was conducted in Çubuk Halil Şıvgın State Hospital in 2022. The postpartum depression prevalence was found to be 16.7% in Turkish mothers and 0% in Syrian mothers. Turkish mothers' postpartum depression mean score was found to increase due to factors such as being exposed to social violence by the spouse, having had an abortion before, having had a stillbirth before, living in a nuclear family, losing a child before, having an acute social problem in the postpartum period, having full-term delivery, and being primipara. Syrian mothers' postpartum depression mean score (p < .05) was found to increase due to factors such as having had an abortion before, experiencing problems during pregnancy, experiencing an acute social problem in the postpartum period, being primigravida, and losing a child before. The postpartum depression rate was found to be 2.29 times higher in Turkish mothers compared to Syrian mothers.

The effects of death anxiety on diet-fluid restriction non-adherence in hemodialysis patients.

The study was performed to examine the effects of death anxiety on diet-fluid restriction non-adherence in hemodialysis patients. This descriptive, cross-sectional, and correlational study was performed with 118 hemodialysis patients who received treatment in the dialysis unit of a university hospital and a state hospital in Elazığ, eastern Turkey. The study data were obtained with the "Descriptive Data Form", "Death Anxiety Scale", and "Dietary and Fluid Restriction Non-Adherence Scale". The average Death Anxiety Scale total score of the patients was 10.00 ± 4.75. The "Duration of non-adherence with diet" mean score was 1.66 ± 1.70, "Degree of non-adherence with diet" mean score was 1.24 ± 1.19, "Duration of non-adherence with fluid restriction" mean score was 1.61 ± 1.71, and "Degree of non-adherence with fluid restriction" mean score was 1.16 ± 1.13. The independent variable Death Anxiety Scale significantly and negatively affected the dependent variable "Duration of non-adherence with diet", "Degree of non-adherence with diet", "Duration of non-adherence with fluid restriction", and "Degree of non-adherence with fluid restriction". Hemodialysis patients face serious death anxiety, their degree of non-adherence with diet-fluid restriction was low as death anxiety scores increased, and the degree of non-adherence with diet-fluid restriction decreased.

Public Hospital Workers' Views on the Process of Switching from the Hospital Information Management System to the e-Health Information System in a Province

The purpose of this study is to investigate the views, reasons for satisfaction, and difficulties encountered by medical staff members regarding the Hospital Information Management System (HIMS) in state hospitals located in Amasya and its surrounding areas. It also assesses the knowledge and experiences of healthcare professionals with e-Health apps in public hospitals, emphasizing their opinions and recommendations for assistance, training, adaptation, and involvement throughout the integration of these applications into healthcare services. The goal of the study is to better understand how healthcare professionals feel about digital technologies and to provide suggestions for raising the caliber of healthcare services. The Amasya Provincial Health Directorate oversees four facilities where the research was carried out. Following permission by the ethics committee, data gathering was underway on April 22, 2024, with a pilot research carried out in April of the same year. There are 913 healthcare workers in the population, and a minimum sample size of 405 at a 95% confidence interval was found to be appropriate. Using the'stratified, simple random' approach, the sample was selected and split into three strata based on occupational groupings. With a median age of 37, 38.8% of the 405 participants were female. 34.2% of physicians, 33.7% of midwives, nurses, and health officers, and 40.4% of medical secretaries and data entry staff expressed satisfaction when HIMS satisfaction was analyzed. The system's capacity to decrease errors and enhance workflow was one of the primary factors contributing to user satisfaction. Furthermore, 42.7% of individuals worked nights. Compared to other professional groups, physicians utilized e-health applications like e-prescription and e-report more frequently. Physicians were more likely to employ telemedicine than other healthcare professionals, who were less knowledgeable in this field. The study recommends developing training methodologies specific to various professional groups and expanding the use of e-Health applications. The study highlights the need for regular in-service training, a more robust technical infrastructure, and user-friendly interfaces to boost healthcare personnel' satisfaction with e-Health. In summary, this study offers important information for strengthening e-Health and HIMS applications and presents important suggestions for raising the caliber of healthcare services through digital transformation.

Differences in the rates of admission and major orthopedic surgery care between Turkish and displaced children injured in a major earthquake.

The burden of displacement makes child refugees, asylum seekers, and migrant children less resistant to medical problems. On February 6, 2023, the southeast and the southcentral regions of Türkiye were struck by two sequential large earthquakes. The study aimed to analyze the characteristics of musculoskeletal injuries and the initial orthopedic surgery data resulting from the earthquake and compare the differences between Turkish and displaced children, particularly those who underwent major musculoskeletal interventions at the four state hospitals of the Adana metropolitan region. The retrospective study analyzed the medical records of the survivors admitted to the four general hospitals run by the government in the Adana, Türkiye metropolitan area between February 06, 2023, and February 13, 2023, the first seven days following the earthquake. The analysis data included age, gender, nationality, time of admission, types and localization of injuries, and treatment methods. The number of cases under 18 years of age requiring orthopedic intervention was 969. The distribution of the cases based on nationality was as follows: there were 517 Turkish (53.35%), 371 Syrian (32.71%), and 81 children of unknown nationality (CUN) (8.36%). The files show that the patients requiring surgery, including fasciotomy, fracture surgery, and amputation (n = 281), were mainly treated at the level I trauma center (n = 171, 60.85%). In terms of the daily distribution of admissions based on the type of musculoskeletal injuries, the admissions of children with foot fractures in the first days were significantly increased (p = 0.0134). Regarding surgery rates, the fracture surgery and fasciotomy rates were significantly higher in cases admitted earlier. (p < 0.0001 and p = 0.0009, respectively). In terms of nationality, there were no significant differences regarding the date of admission, the number of cases who underwent amputations, and the discharge number and types. The study revealed that after the severe earthquake disaster, the state hospitals of the Adana metropolitan region provided unbiased healthcare for all the region's children. Regarding orthopedic care, the response was given accordingly in this particular disaster, highlighting that level I trauma centers should always be ready for such intensity due to the short preparation time in case of a severe disaster.

Patients with symptomatic cholelithiasis at a safety net hospital: Early surgeon involvement matters.

Gallstones are a common diagnosis in the United States; though many patients remain asymptomatic, others develop symptoms. Standard of care for symptomatic cholelithiasis is cholecystectomy, but many do not undergo surgery. The purpose of this study is to identify factors that influence receipt of cholecystectomy for symptomatic cholelithiasis at a safety net hospital. This is a retrospective study performed at a large, academic, tertiary care and safety net state hospital. Patients who presented with symptomatic cholelithiasis were included. Same admission cholecystectomy and elective outpatient cholecystectomy were considered success/standard of care, and readmission cholecystectomy or no cholecystectomy were considered failures/not standard of care. Of 376 patients, a substantial minority were Spanish speaking, and almost half had public insurance. 23.7% were successfully treated, and 76.3% had failure in management. A larger number of patients in the group that had successful treatment had surgery consultation, 67.4%. Only 28.5% of patients saw a surgeon as an outpatient within 30days of their visit. On multivariable analysis, patients who were provided a surgery consultation were more likely to receive standard of care. Age, sex, language, smoking status, lack of insurance, and alcohol use were not associated. Surgery consultation during presentation for symptomatic cholelithiasis was associated with receipt of same admission, or outpatient elective cholecystectomy, or successful management. There should be a low threshold to involve a surgeon for symptomatic cholelithiasis.

The Great Tularemia Outbreak in Sivas: Evaluation of 205 Cases

This study aimed to report a tularemia outbreak in Sivas and describe the epidemiological and diagnostic characteristics of the patients. Patients aged 18 and over followed up with a diagnosis of tularemia in Sivas Cumhuriyet University Hospital, Sivas Numune State Hospital, and Sivas State Hospital Infectious Diseases Outpatient Clinics and wards between November 2023 and May 2024 were evaluated. 205 adult patients with tularemia were included. The most common symptoms were sore throat (73.2 %, n=150), swelling in the neck (70.2 %, n = 144), and fatigue (55.1 %, n = 113). The most common form was oropharyngeal (82.4 %, n = 169) and glandular (14.6 %, n = 30). Lymphadenopathy was detected in 182 (88.8 %) patients, the most is cervical lymphadenopathy (60 %, n = 123). Lymph node drainage/excision was performed on 50 patients (24.3 %). There have been no deaths in this outbreak. This study presents patient data from the tularemia outbreak in Sivas.

The Role of Inflammatory Markers in Distinguishing Endometrial Polyp: Single Center Results

Objective: To investigate the role of inflammatory markers in predicting the presence of endometrial polyps in patients undergoing endometrial sampling due to abnormal uterine bleeding. Methods: The pathology results of patients who presented to Akçakoca State Hospital with abnormal uterine bleeding and underwent endometrial sampling between May 2023 and July 2023 were retrospectively examined. The demographic characteristics of the patients, platelet-lymphocyte, neutrophil-lymphocyte and lymphocyte-monocyte ratios and systemic immune inflammation index were calculated. Patients were categorized into endometrial polyps and other benign pathologies according to the pathological diagnosis. Malignant and premalignant lesions were not included in the study. The examination results and inflammatory markers were compared between these two groups. Results: 89 patients were included in the study. While the pathological finding in 38 patients was an endometrial polyp, other benign pathologies were found in 51 patients. No significant difference was found in terms of hemoglobin, hematocrit, lymphocytes, monocytes, platelets, neutrophils and PDW variables in patients with endometrial polyps (p&gt;0.05). PLR (platelet-to-lymphocyte ratio) and SII (systemic immune-inflammatory index) were significantly higher in the endometrial polyp group compared to other benign pathologies (p

The Effect of Virtual Reality on Pain, Anxiety, Physiological Parameters, and Postspinal Headache in Patients Undergoing Spinal Anesthesia: A Randomized Controlled Trial

PurposeThe purpose of this research was to determine the effect of virtual reality (VR) on pain, anxiety, physiological parameters, and postspinal headache in patients undergoing spinal anesthesia. DesignThis was a randomized controlled experimental trial. MethodsThe research was conducted in the operating room unit of the state hospital in Hakkari-Şemdinli District Center between May 2021 and June 2022. Data were collected using the Descriptive Information Form, visual analog scale (VAS), verbal category scale (VCS), State-Trait Anxiety Inventory, and the Application Registration Form to record preoperative and postoperative oxygen saturation and heart rate. FindingsWhen the groups’ VAS and VCS mean scores were compared for head and incision site pain, the mean scores of headache and incision site pain in both groups were found to be significantly lower in the experimental group patients (P < .001). In addition, the difference between the groups in headache VAS and VCS mean scores at all hours was statistically significant; incision site pain VAS and VCS mean scores were significantly lower between the groups at all hours, except the 1st and 2nd hours (P < .001). While there was no significant difference in the State-Trait Anxiety Inventory (SAS) pretest mean scores between the groups (P > .05), the SAS post-test mean scores of the experimental group were significantly lower (P < .05). The mean heart rate in the intraoperative and postoperative periods and the mean saturation in the postoperative period differed significantly between the groups (P < .05). The difference between the blood pressure averages before, during, and after the operation was not statistically significant in both groups (P > .05). While nausea and vomiting was significant in the experimental group only at the 2nd hour (P < .05), it was not statistically significant at the other hours (P > .05). ConclusionsVR was found to effectively reduce pain, anxiety, postspinal headache, and increase the oxygen saturation level in the postoperative period in patients who underwent spinal anesthesia. Hence, VR is an effective treatment for patients who have undergone surgery under spinal anesthesia.

Market Factors, Not Quality, Influence Reimbursement for Pancreaticoduodenectomy in an Era of Price Transparency.

The Centers for Medicare and Medicaid Services (CMS) price transparency rule tries to facilitate cost-conscious decision-making. For surgical services, such as pancreaticoduodenectomy (PD), factors mediating transparency and real-world reimbursement are not well described. The Leapfrog Survey was used to identify United States hospitals performing PD. Financial and operational data were obtained from Turquoise Health and CMS Cost Reports. Chi-square tests and modified Poisson regression evaluated associations with reimbursement disclosure. Two-part logistic and gamma regression models estimated effects of hospital factors on commercial, Medicare, and self-pay reimbursements for PD. Of 452 Leapfrog hospitals, 295 (65%) disclosed PD hospital or procedure reimbursements. Disclosing hospitals were larger (beds >200: 81.0% vs. 71.3%, p = 0.04), reported higher net margins (0.7% vs. -2.1%, p = 0.04), more likely for-profit (26.1% vs. 6.4%, p < 0.001), and teaching-affiliated (82.0% vs. 65.6%, p < 0.001). Nonprofit status conferred hospitalization reimbursement increases of $8683-$12,329, while moderate market concentration predicted savings up to $5066. Teaching affiliation conferred reimbursement increases of $4589-$16,393 for hospitalizations and $644 for procedures. Top Leapfrog volume ratings predicted an increase of up to $7795 for only Medicare hospitalization reimbursement. Nondisclosure of hospital and procedural reimbursements for PD remains a major issue. Transparency was noted in hospitals with higher margins, size, and academic affiliation. Factors associated with higher reimbursement were non-profit status, academic affiliation, and more equitable market share. Reimbursement inconsistently tracked with PD quality or volume measures. Policy changes may be required to incentivize reimbursement disclosure and translate transparency into increased value for patients.

Harnessing Natural Language Processing and High-Dimensional Clinical Notes to Detect Goals-of-Care and Surrogate-Designation Conversations.

Advance care planning, involving goals-of-care and surrogate-designation conversations, is crucial for patient-centered care. However, determining the optimal timing and participants for these conversations remains challenging. This study explored the frequency, timing, and predictors of documenting two advance care planning elements, goals-of-care and surrogate-designation conversations, in clinical notes for patients with advanced illness. In this retrospective observational study, we leveraged high-dimensional data and natural language processing (NLP) to analyze clinical notes and predict the presence or absence of advance care planning conversations. We included notes for patients treated at a Midwestern United States hospital who had advanced chronic conditions and eventually passed away. We manually labeled a gold-standard dataset (n = 913 notes) for the presence or absence of advance care planning conversations at the note level, achieving excellent inter-annotator agreement (90.5%). Training and testing four NLP models to detect goals-of-care and surrogate-designation conversations revealed that a transformer-based model (Bidirectional Encoder Representations from Transformers [BERT]) achieved the highest accuracy, with an F1 score of 93.6. We then deployed the BERT model to a high-dimensional corpus of 247,241 notes for 4,341 patients and detected goals-of-care and surrogate-designation conversations in the records of 85% and 60% of patients, respectively. Temporal analysis revealed that goals-of-care and surrogate-designation conversations were first documented at medians 28 and 8 days before death, respectively. Patient characteristics and referral to specialty palliative care emerged as significant factors associated with documenting these conversations. Our findings demonstrate the potential of NLP, particularly Transformer-based models like BERT, to accurately detect goals-of-care and surrogate-designation conversations in clinical narratives. This study identified significant temporal patterns, including late documentation, and patient characteristics associated with these conversations. It highlights the value of high-dimensional data in enhancing our understanding of advance care planning and offers insights for improving patient-centered care in clinical settings. Future research should explore the integration of these models into clinical workflows to facilitate timely and effective advance care planning discussions.

EXAMINING THE INSTITUTIONS PREFERRED BY UNIVERSITY STUDENTS WHILE RECEIVING HEALTH SERVICES

People who want to receive health services choose the institution or organization from which they will receive service based on different reasons, not the type of disease. This study was conducted to determine which institution students studying in the field of health prefer while receiving health care and for what reason. A survey consisting of 21 questions was applied to associate degree students studying at the health services vocational school of a private university in Istanbul. When the answers to the questions and statements in the survey were examined, the statement 'Indicate the health institution you would prefer to go to first in case of an illness or illness' was answered by 'State Hospital (56.3%)', 'In case of an illness, state your reason for choosing the health institution you prefer to go to first.' 'Because it is close/easy to reach' (39.2%), 'Where did you last apply for health care?', 'Public Hospital (53.2%)', 'For what reason did you apply for health care before this application? 'For My New Complaint (46%)', 'What health institution would you definitely not consider applying to in case of illness/illness?', 'Family Health Center (29%)', 'Indicate the reason for not applying to this institution that you would definitely not consider applying to in case of illness.' to 'I Cannot Have Every Test Done (24%)', 'Are there times when you need health care but you do not apply?' The answers to the question were 'Yes (76.8%)', to the statement 'Indicate the reason for not seeking health care.', 'Not caring about the disease (29%)' and 'Not being able to access health care (29%)'. Within the framework of the findings obtained, other health institutions should also be made attractive in order to alleviate the high demand for public hospitals.

Morphometric Assessment of the Piriform Aperture and Its Clinical and Forensic Applications

Abstract Background: The piriform aperture (PA) is a midface structure that forms the anterior skeletal boundary of the nose. It is highly variant due to its physiological adaptations to the climate. Its variations are useful in forensic identification and reconstructive surgeries of the face. This study aimed at determining the PA’s dimensions and their accuracy in sex determination. Materials and Methods: The PA’s dimensions were retrospectively examined using 336 (199 males and 137 females) adult cranial computed tomography images in the database of the radiology unit of a university teaching hospital in Delta State, Nigeria, following institutional authorization. The aperture’s index was calculated as a ratio of height to width. The data were analyzed using Statistical Package for the Social Sciences Version 23. The sexual dimorphism in the parameters was assessed using an independent t-test. Association among the continuous variables was analyzed by Pearson’s correlation test. P = 0.05 was considered statistically significant. The percentage accuracy for correct sex prediction was assessed using the discriminant function analysis. Results: A significant relationship between dimensions with sex was observed (P &lt; 0.05). The width of the aperture was the best sex-discriminating parameter (70.2%). The overall accuracy for sex discrimination using the aperture’s dimensions was 75.0%. Conclusion: This study provides the standard ranges for the PA’s width and height, valuable for surgical planning. These dimensions were sexually dimorphic and demonstrated an acceptable overall accuracy of correct sex allocation (75%). Consequently, this aperture may be utilized as a supplementary tool in conjunction with other methods for sex determination within studied population.

Prognostic Value of Shock Index, Modified Shock Index, and Age Shock Index in Patients with Sepsis in the Intensive Care Unit

Objective: We aimed to evaluate the usability of the Shock Index (SI), Modified Shock Index (MSI), and Age Shock Index (ASI) in predicting clinical outcomes and mortality in sepsis patients followed in the intensive care unit. Methods: Records of patients admitted to the intensive care unit of Muş State Hospital between January 2022, and April 2024, who developed sepsis were retrospectively recorded from the hospital data system. Results: A total of 127 patients were included in the study. The average age of these patients was found to be 50.83±12.01 years. The average age of discharged patients was 46.14±10.12 years, while the average age of deceased patients was 58.54±10.89 years. In the gender distribution, 63.78% of all patients were male and 36.22% were female (p=0.028). SI was determined as 0.88±0.33 in discharged patients and 1.11±0.32 in deceased patients (p=0.0002). MSI was found to be 1.45±0.33 in discharged patients and 1.68±0.32 in deceased patients (p=0.00001). ASI was determined as 40.73±18.41 in discharged patients and 64.94±22.85 in deceased patients (p=0.0001). The cut-off value for SI was found to be 0.76, with an AUC value of 0.69. The cut-off value for the MSI was determined to be 1.35, with an AUC value of 0.72. The cut-off value for the ASI was found to be 38.76, with an AUC value of 0.85. Conclusion: All three shock indices were statistically significant in predicting mortality in sepsis patients. We believe they are valuable indices that can be used bedside and non-invasively in intensive care units.

The effect of using a local skin cooling device on arteriovenous fistula cannulation pain and comfort level of patients on hemodialysis: A single-blind randomized controlled study.

The study aimed to investigate the impact of the using local skin cooling on arteriovenous fistula cannulation pain and the comfort levels of hemodialysis patients. The single-blind randomized controlled trial was formed with 50 patients between June 20, 2023, and July 31, 2023, in the hemodialysis units of two state hospitals in Turkey. Patients were randomly assigned to either the experimental group (n = 25) or the control group (n = 25) using the block randomization method. This data were collected through the use of the CoolSense device, the "Patient Information Form," the "Verbal Category Scale," and the "General Comfort Scale." Patients in the experimental group received the local skin cooling for five seconds during arteriovenous fistula cannulation, while the control group followed the standard hospital protocol. The study was registered on Clinical Trials (NCT06144801). The study revealed that the application of the local skin cooling during arteriovenous fistula cannulation significantly reduced pain and increased patients' comfort levels, demonstrating an anesthetic effect (p < 0.001). Furthermore, it was observed that as pain levels decreased, patient comfort levels increased (p < 0.001). It is concluded that the using lokal skin cooling is an effective tool for reducing pain and enhancing comfort during arteriovenous fistula cannulation in hemodialysis patients.

Comparison of the effect of face-to-face and video-based breastfeeding education methods on breastfeeding success

BackgroundDespite the well-documented benefits of breastfeeding, many first-time mothers encounter challenges. This study compares the efficacy of traditional face-to-face breastfeeding education (FtFE) versus video-based breastfeeding education (VBE) on improving breastfeeding practices and self-efficacy among primiparous mothers.MethodsUsing a sequential, quasi-experimental design, 70 primiparous mothers were enrolled from a State Hospital in Turkey and systematically divided into two groups: FtFE (n = 35) and VBE (n = 35). The study spanned from January to June 2023 and the assessments of statuses of breastfeeding self-efficacy and skilles was performed in two distinct phases for each group. In the first phase, mothers were administered the scale of breastfeeding self-efficacy short (BSES) to measure baseline breastfeeding self-efficacy and the scale of LATCH tool to assess baseline breastfeeding skills. Subsequently, the research groups received FtFE and VBE interventions. In the second phase, 2 weeks later, mothers were interviewed again, and the BSES scale was re-administered to evaluate changes in their breastfeeding self-efficacy levels.ResultsThe pre-test scores of BSES and LATCH tools of the FtFE and VBE groups were found similar (p > 0.05). The post-test score of BSES of the FtFE was significantly higher than that of the VBE group (p > 0.05). In the FtFE group, the post-test score of BSES was significantly higher compared to the pre-test score of BSES (p < 0.05). In the VBE group, the post-test score of BSES was higher compared to the pre-test score of BSES but this difference did not reached statistical significance (p > 0.05).Conclusion and recommendationsFtFE is more effective in informing mothers compared to VBE. However, VBE also positively affectes breastfeeding success. Further research is needed to explore the long-term impacts of these educational approaches on breastfeeding compliance.

Evaluating different samples & techniques for hr-HPV DNA genotyping to improve the efficiency of risk profiling for oral & cervical cancers in Sikkim, India.

Background & objectives Oral and genital HPV infection in men may be a source of cervical diseases in their women partners as well as disease in themselves. This study aimed to evaluate and compare the performance of Hybrid Capture 2 (HC2) in physician-collected cervical samples and qPCR in self-collected urine and oral gargle samples of women and men, respectively, for hr-HPV infection status and genotyping. Methods One thousand and two hundred biological samples were collected from 200 women (urine, oral gargle, and cervical smear) and 200 men (urine and oral gargle) visiting a referral hospital in the remote Himalayan State of Sikkim. The extracted genomic DNA from urine and gargle samples were profiled for hr-HPV genotypes using quantitative polymerase chain reaction (qPCR) and HC2 for cervical samples. Results In women, hr-HPV was detected in 17.5 per cent of cervical samples by HC2, 25.5 per cent of urine, and 7 per cent of gargle samples by qPCR. For men, hr-HPV was detected in 8 per cent urine and 5 per cent gargle samples by qPCR. Among the HPV-positive women, 56 per cent of urine samples and 20 per cent of oral samples showed single-genotype infection, while the remaining had multiple genotypes. Amongst the HPV-positive men, 62.7 per cent of urine samples and 85.7 per cent of oral samples showed single-genotype infection while the remaining had multiple genotypes. Compared to Pap, the area under ROC was good for HC2 (AUC=0.89) and for qPCR (AUC= 0.852). Interpretation & conclusions HC2 for cervical and qPCR-based HPV DNA assay for urine and gargle sample is suitable for risk profiling for cervical cancer (CC) and oral cancer (OC) screening programmes.

The Optimal Prediction Model for Successful External Cephalic Version.

The majority of breech fetuses are delivered by cesarean birth as few physicians are trained in vaginal breech birth. An external cephalic version (ECV) can prevent cesarean delivery and the associated morbidity in these patients. Current guidelines recommend that all patients with breech presentation be offered an ECV attempt. Not all attempts are successful, and an attempt does carry some risks, so shared decision-making is necessary. To aid in patient counseling, over a dozen prediction models to predict ECV success have been proposed in the last few years. However, very few models have been externally validated, and thus, none have been adopted into clinical practice. This study aims to use data from a U.S. hospital to provide further data on ECV prediction models. This study retrospectively gathered data from Carle Foundation Hospital and used it to test six models previously proposed to predict ECV success. These models were Dahl 2021, Bilgory 2023, López Pérez 2020, Kok 2011, Burgos 2010, and Tasnim 2012 (GNK-PIMS score). A total of 125 patients undergoing 132 ECV attempts were included. A total of 69 attempts were successful (52.2%). Dahl 2021 had the greatest predictive value (area under the curve [AUC]: 0.779), whereas Tasnim 2012 performed the worst (AUC: 0.626). The remaining models had similar predictive values as each other (AUC: 0.68-0.71). Bootstrapping confirmed that all models except Tasnim 2012 had confidence intervals not including 0.5. The bootstrapped 95% AUC confidence interval for Dahl 2021 was 0.71 to 0.84. In terms of calibration, Dahl 2021 was well calibrated with predicted probabilities matching observed probabilities. Bilgory 2023 and López Pérez were poorly calibrated. Multiple prediction tools have now been externally validated for ECV success. Dahl 2021 is the most promising prediction tool. · Prediction models can be powerful tools for patient counseling.. · The odds of ECV success can estimated based on patient factors and clinical findings.. · Of the six tested models, only Dahl 2021 appears to have good predictive value and calibration..

THE MEDIATING ROLE OF ORGANIZATIONAL COMMITMENT IN THE EFFECT OF ORGANIZATIONAL COMMUNICATION QUALITY ON JOB SATISFACTION

The study has multiple purposes. The first purpose is to measure the impact of organizational communication on organizational commitment and job satisfaction. The second purpose is to measure the impact of organizational commitment on job satisfaction. The third and final purpose is to determine the mediating role of organizational commitment in the impact of organizational communication quality on job satisfaction. The study data was obtained using a survey method from 390 healthcare workers in a state hospital in Izmir. Correlation and multiple regression analyses were conducted to determine the relationships between variables. The analysis results indicate that organizational communication has a significant and positive impact on organizational commitment and job satisfaction. Additionally, it was found that organizational commitment has a substantial and positive effect on job satisfaction. Furthermore, it was determined that organizational commitment plays a mediating role in the effect of organizational communication on job satisfaction.

Balance impairment and associated factors among stroke survivors in public hospitals of Amhara regional state: a multicenter cross-sectional study

IntroductionBalance impairment is one of the common impairments in patients after stroke. It can lead to depression reduced speed of mobility, dependent on assistive device and reduce quality of life. However, evidence on balance impairment and its risk factors among stroke survivors in Ethiopia was lacking particularly in the study area. Therefore, this study aimed to investigate prevalence and associated factors of balance impairment among stroke survivor’s attendee at an outpatient clinic in Amara regional state comprehensive specialized hospital.MethodsAn institutional based cross-sectional study was conducted from April1-June 30, 2022. A total of 400 participants were selected using the systematic random sampling technique. Standard Berg balance scale tool and semi-structure questionnaire was used. Multicollinearity and model fitness were checked. Variables with a p-value of less than 0.25 in the Bivariable regression were entered into a multivariable logistic regression and p value < 0.05 was used as cutoff point for significant variables.ResultThe prevalence of balance impairment was 51.5% (95% CI (46.58, 56.39). Being depressed (AOR = 12.25:95% CI (4.727, 31.779), using walking aids (AOR = 8.76:95%CI3.469, 22.117)), abnormal speed (AOR = 6.73:95%CI (2.671, 16.977)), did not have physiotherapy treatment (AOR = 3.96:95%CI (1.483, 10.586), and unmarried (AOR = 2.71, 95% CI = 1.061, 6.903) were significantly associated with balance impairment.Conclusion and recommendationThe prevalence of balance impairment in the study was high. Being depressed, use walking aids, did not have physiotherapy treatment, abnormal speed of mobility, and unmarried were significantly associated factors. Therefore; it is better to give greater emphasis for those factors.

Alterations in the Antimicrobial Resistance Profile of Acinetobacter baumannii Strains Isolated from Intensive Care Unit Patients: Five-Year Follow-up in Cappadocia

Background: This study aims to determine alterations in the antibiotic resistance status of Acinetobacter baumannii strains isolated from lower respiratory tract samples of patients in intensive care units over the years. Methods: In this comprehensive study, A. baumannii strains isolated from aspirate and sputum samples of patients hospitalized in intensive care units of a second-stage state hospital between January 2018 and December 2022 were meticulously and retrospectively investigated and analyzed for antimicrobial resistance. Results: The rate of aspirate and sputum samples in the study was 18.1% (754/4151); The positivity rate of cultures was 51.7% (390/754); The rate of those associated with A. baumannii was found to be 65.6% (256/390).. 90.2% of the isolates were isolated from the general intensive care unit (231/256). The rates of A. baumannii isolated from aspirate and sputum samples were 67.4% (213/316) and 58.1% (43/74), respectively. The carbapenem resistance rate in A. baumannii isolates grown in aspirate samples was 96.5%, fluoroquinolone resistance was 91.7%; The carbapenem resistance rate in sputum samples was 96.1% and fluoroquinolone resistance was 90.9%. The most effective antibiotics against A. baumannii strains isolated from both aspirate and sputum samples were colistin 100% (n=256), TMP/SXT 55.8% (143/256), tigecycline 50.3% (129/256), respectively. Conclusion: Our study reveals a concerning trend-a high frequency of multidrug-resistant A. baumannii isolates are being identified in the Central Anatolia region of our country. This high prevalence, which is a cause for immediate concern, underscores the urgent and immediate need for robust infection control measures to curb the spread of A. baumannii in hospitals.