Effect of the coughing technique during subcutaneous heparin injection on pain severity and individual satisfaction. / Efecto de la técnica de la tos durante la inyección subcutánea de heparina sobre la severidad del dolor y la satisfacción individual.

to examine the effect of the medium intensity coughing technique during subcutaneous low molecular weight heparin injection on pain severity and individual satisfaction in general surgery patients. the prospective, quasi-experimental study included 100 patients who had been prescribed a subcutaneous low molecular weight heparin injection once in 24 hours. Each patient received two injections by the same researcher, one using the standard injection technique with medium intensity coughing technique and the other only the standard injection technique. there was a statistically significant difference between patients' mean scores on pain severity and satisfaction levels after injections administered by the two techniques (p= 0.000). Also, it was found that gender affected pain severity relating to the injection but did not affect the level of individual satisfaction. the medium intensity coughing technique was found to reduce pain severity and increase patient satisfaction in general surgery patients receiving subcutaneous low molecular weight heparin injections. Trial registration: NCT05681338.

examinar el efecto de la técnica de tos de mediana intensidad durante la inyección subcutánea de heparina de bajo peso molecular sobre la severidad del dolor y la satisfacción individual en pacientes de cirugía general. estudio prospectivo, cuasi experimental, que incluyó a 100 pacientes a los que se les prescribió una inyección subcutánea de heparina de bajo peso molecular una vez cada 24 horas. Cada paciente recibió dos inyecciones por el mismo investigador utilizando técnica de inyección estándar con técnica de tos de intensidad media y solo técnica de inyección estándar. hubo una diferencia estadísticamente significativa entre las puntuaciones medias de los pacientes sobre la intensidad del dolor y los niveles de satisfacción después de las inyecciones administradas por las dos técnicas (p= 0,000). Además, se encontró que el género afectó la severidad del dolor relacionado con la inyección, pero no afectó el nivel de satisfacción individual. se encontró que la técnica de tos de intensidad media reduce la severidad del dolor y aumenta la satisfacción del paciente de cirugía general que reciben inyecciones subcutáneas de heparina de bajo peso molecular. Registro del ensayo: NCT05681338.

examinar o efeito da técnica de tosse de média intensidade durante injeção subcutânea de heparina de baixo peso molecular na intensidade da dor e satisfação individual em pacientes submetidos à cirurgia geral. estudo prospetivo, quasi experimental que incluiu 100 pacientes que haviam recebido uma injeção subcutânea de heparina de baixo peso molecular em 24 horas. Cada paciente recebeu duas injeções pelo mesmo pesquisador usando a técnica de injeção padrão com técnica de tosse de média intensidade e apenas técnica de injeção padrão. houve diferença estatisticamente significativa entre as pontuações médias dos pacientes quanto à gravidade da dor e níveis de satisfação após as injeções administradas pelas duas técnicas (p = 0,000). Além disso, verificou-se que o sexo do paciente afetou a intensidade da dor relacionada à injeção, mas não afetou o nível de satisfação individual. a técnica de tosse de média intensidade reduz a intensidade da dor e aumenta a satisfação de pacientes submetidos à cirurgia geral recebendo injeções subcutâneas de heparina de baixo peso molecular. Registro do ensaio clínico: NCT05681338.

Challenges facing standardised patients representing equity-deserving groups: Insights from health care educators.

INTRODUCTION: Health professions training programmes increasingly rely on standardised patient (SP) programmes to integrate equity-deserving groups into learning and assessment opportunities. However, little is known about the optimal approach, and many SP programmes struggle to meet these growing needs. This study explored insights from health care educators working with SP programmes to deliver curricular content around equity-deserving groups. METHODS: We interviewed 14 key informants in 2021 who were involved in creating or managing SP-based education. Verbatim transcripts were analysed in an iterative coding process, anchored by qualitative content analysis methodology and informed by two theoretical frameworks: sociologic translation and simulation design. Repeated cycles of data collection and analyses continued until themes could be constructed, aligned with existing theories and grounded in empirical data, with sufficient relevance and robustness to inform educators and curricular leads. RESULTS: Three themes were constructed: (i) creating safety for SPs paid to be vulnerable, (ii) fidelity as an issue broader than who plays the role and (iii) engaging equity-deserving groups. SP work involving traditionally marginalised groups risk re-traumatization, highlighting the importance of (i) informed consent in recruiting SPs, (ii) separating role portrayal from lived experiences, (iii) adequately preparing learners and facilitators, (iv) creating time-outs and escapes for SPs and (v) building opportunity for de-roling with community support. CONCLUSIONS: SP programmes are well positioned to be allies and advocates to equity-deserving groups and to collaborate and share governance of the educational development process from its outset. SP programmes can support the delivery of curricular content around equity-deserving groups by advocating with curricular leadership, building relationships with community partners, facilitating co-creation and co-delivery of educational content and building safety into simulation.

Clinical nurses' knowledge and practices on routine care related to the prevention of complications of peripheral intravenous therapy: A cross-sectional study.

AIM: The aim of this descriptive and cross-sectional study was to determine the knowledge and practices of nurses related to the prevention of peripheral intravenous therapy (PIT) complications, and to identify the influencing factors. METHODS: The study adopted a cross-sectional and descriptive design and was conducted between April and August of 2018 with a total of 214 clinical nurses. The data collection tools employed were a 12-item sociodemographic questionnaire and a 16-item questionnaire on knowledge and practices related to the prevention of peripheral intravenous therapy complications. RESULTS: The mean knowledge scores of the nurses were found to be 81.54 ± 12.06 (min: 50, max: 100). No statistically significant difference was found to exist between the scores, and the variables of the nurses' gender, length of employment in the health profession, type of work, training received related to PIT complications, and self-competence level in PIT complications. CONCLUSION: The nurses were found to have high knowledge levels; however, their practices for preventing PIT complications differed. Standardized practice procedures and workplace training are needed in order to transform nurses' knowledge into practice with regard to the prevention of PIT complications.

A Phenomenological Analysis of Experiences and Practices of Nurses Providing Palliative and End of Life Care.

The aim of this study was to describe the experiences and practices of nurses providing palliative and end of life care. The study was conducted in the palliative care unit of a territory hospital in Turkey. The sample consisted of 11 nurses who had been working as palliative care nurses for at least one year. The face to face interview method was used to collect data, with a semi-structured in-depth individual interview. 5 main themes and 24 sub-themes were emerged in relation to the experiences and practices of the nurses. The majority of participant nurses pointed that inadequacy in the number of nurses, secondary nursing care activities, refusal of treatment, cultural and ethical problems were barriers in the provision of nursing care. They frequently experienced ethical issues when caring for end of life patients, and for this reason they felt the need for ethics counselling which they could consult.

Determining Covid-19 Vaccine Literacy Levels of Nursing Students.

This study aimed to determine nursing students' levels of COVID-19 vaccine literacy and the affecting variables. This descriptive research was carried out on 391 students receiving education at Bursa Uludag University Nursing Department between January and March 2022. Research data were collected using a "Student Introduction Form" and the "COVID-19 Vaccine Literacy Scale". The mean total score of the nursing students included in the study on the COVID-19 Vaccine Literacy Scale was 2.80±0.44. The mean scores of the students on the subscales were 2.41±0.58 for functional skills, 2.99±0.55 for interactive/critical skills. There was a significant difference between the students' grades, place of residence, and income status and their mean total COVID-19 Vaccine Literacy Scale score and mean interactive/critical skills subscale score (p<0.05). On the other hand, the variables of gender, COVID-19 positivity, and COVID-19 positivity in family member(s) were not associated with COVID-19 Vaccine Literacy (p>0.05). In this study, it was determined that the COVID-19 vaccine literacy levels of nursing students were moderate and that some of the variables affected vaccine literacy.

Building a theoretical model for virtual interprofessional education.

BACKGROUND: Virtual interprofessional education (IPE) has emerged as a promising alternative to traditional in-person IPE. However, theoretical frameworks to support virtual interprofessional learning are not well established. Two theoretical frameworks emerged as relevant to virtual IPE: (1) the Canadian Interprofessional Health Collaborative (CIHC) interprofessional learning framework and (2) Dornan's Experience-Based Learning Model (ExBL) of workplace learning. In this study, we sought to explore virtual IPE using both frameworks to develop new theoretical understandings and identify assumptions, gaps and barriers. METHODS: This was a qualitative study. Semi-structured interviews were conducted with medical and nursing student participants (n = 14) and facilitators (n = 3) from virtual IPE workshops. Transcripts were analysed using directed content analysis methodology, informed by the CIHC and ExBL frameworks. Themes were explored using mind-mapping transitional coding. Data collection and analysis were continued iteratively until themes with adequate conceptual depth, relevance and plausibility were identified. RESULTS: Three themes were identified: (1) a shift in the balance of personal and professional, (2) blunted sociologic fidelity and (3) uncertainty and threats to interpersonal connections. Professional distinctions and hierarchies are blurred virtually. This contributed to an increased sense of psychological safety among most learners and lowered the threshold for participation. Separation from workplace sociologic complexity facilitated communication and role clarification objectives. However, loss of immersion may limit deeper engagement. Interprofessional objectives that rely on deeper sociological fidelity, such as conflict resolution, may be threatened. Informal interactions between learners are hindered, which may threaten organic development of interprofessional relationships. CONCLUSIONS: Role clarification and communication objectives are preserved in virtual IPE. Educators should pay close attention to psychological safety and sociologic fidelity-both to leverage advantages and guard against threats to connection and transferability. Virtual IPE may be well suited as a primer to in-person activities or as scaffolding towards interprofessional workplace practice.

Quality in Standardized Patient Training and Delivery: Retrospective Documentary Analysis of Trainer and Instructor Feedback.

Background An important aspect of developing and maintaining a high-quality standardized patient (SP) program is incorporating quality assurance processes. Trainer and instructor feedbacks are considered critical in achieving these goals. The aim of this study is to determine programmatic and systematic issues in the scope of quality assurance and improvement through trainer and instructor feedback on SP performance. We also presented a logic model based on a synthesis of the current literature to ensure the development and maintenance of a quality management culture in the SP program. Methods A retrospective analysis of SP scoring was conducted, and written feedback forms completed by trainers and instructors in a large Canadian university's SP program were collected. The previous six years (2014-2020) of SP feedback forms in the scope of quality assurance were reviewed and analyzed. Descriptive statistics were utilized to analyze the ratings. Thematic analysis was conducted on the data gathered from the written feedback. Results A total of 138 feedback forms were reviewed and analyzed in the study. The mean ratings given by the trainers for feedback and professionalism were 4.27 ± 1.29 and 4.77 ± 0.8, respectively. The mean ratings given by the instructors for knowledge of case information, appropriate responses, and affect were 4.84 ± 0.64, 4.86 ± 0.35, and 4.71 ± 0.76, respectively (from a range of 1 to 5). Four key themes emerged from the written feedback: nonverbal behaviors in simulation activity or feedback sessions, providing feedback from the patient perspective, consistency between role portrayal and scenario, and adapting easily to changing situations. Conclusions Component scoring on SP performance did not discriminate individual issues, but the qualitative comments identified certain specific issues. Further research is needed to establish standards of continuous quality improvement (CQI) within an SP program.

The Role of Standardized Patient Programs in Promoting Equity, Diversity, and Inclusion: A Narrative Review.

PURPOSE: Integrating equity, diversity, and inclusion (EDI) in curricula for training health professionals is a frequent institutional goal. The use of standardized (or simulated) patient programs (SPPs) to support EDI in health sciences training is not well described. Here the authors present a theoretical model based on a synthesis of the literature for using SPPs in EDI training, along with a narrative review of the available literature. METHOD: The authors searched PubMed, Scopus, Science Direct, and Google Scholar databases for studies published between January 2000 and October 2019 describing the use of SPPs to support EDI in health sciences education. Studies were included if they described standardized patient (SP) education involving EDI and reported empiric data about its design, delivery, or effectiveness. The authors conducted a narrative review and provided a synthesis of the available literature, identifying key themes. RESULTS: Out of 117 studies identified, 17 met the inclusion criteria. Most studies (53%; n = 9) focused on cultural competence; many focused on communication with diverse patients (29%; n = 5) or health inequity (18%; n = 3). Studies employed portrayal of diversity (71%; n = 12) or learning objectives supported by diversity (29%; n = 5) as approaches to EDI relevant to SP training. Three primary themes emerged: improving cultural competence, effective communication with diverse patients, and highlighting health inequalities. CONCLUSIONS: This review outlines approaches to EDI-based SPPs, with the perspectives and priorities of institutional approaches in mind. SP education around specific EDI issues is reported; however, programmatic approaches to EDI by SPPs are lacking. More research is needed to provide further evidence for the challenges, effectiveness, and outcomes of developing and implementing EDI-based SPPs in health sciences education.

Examining the effect of simulation-based learning on intravenous therapy administration' knowledge, performance, and clinical assessment skills of first-year nursing students.

BACKGROUND: Most nurses at some point of, or throughout, their career will be involved in infusion care. Therefore, it is important to provide a realistic learning environment to nursing students regarding how to safely practice intravenous (IV) therapy administration. OBJECTIVES: The aim of this study was examining the effect of simulation-based learning on IV therapy administration knowledge, performance and clinical assessment skills of first-year nursing students. METHODS: This study was a randomized controlled quasi-experimental study. A total of 62 students was included in the study. The students were randomly assigned to either hybrid simulation (HS) (n = 31) or low fidelity simulation (LFS) (n = 31) groups. In the HS group, each student performed in the standardized patients using moulage, and the LFS group each student was performed with mannequin using visuals. Each of the students' level of IV therapy administration knowledge, performance and clinical assessment and satisfaction and self-confidence score was evaluated. RESULTS: After the lecture, demonstration and simulation training, there was a statistically significant difference between groups in terms of knowledge (p < 0.05), IV catheter insertion performance in simulation and clinical (p = 0.00; p = 0.00) and clinical assessment to classify IV therapy complications on real patients (p = 0.00). Also, satisfaction and self-confidence scale scores of the students in the HS were significantly higher than in the LFS group (p = 0.00). However, there was no significant difference in simulation design scale scores between the two groups (p = 0.164). CONCLUSION: The students in the HS group better transferred they had learned in the teaching environment to clinical practice. Also, the results show that creating an effective environment in simulation had a positive effect on the development of the students' clinical skills.

Talking the talk in junior interprofessional education: is healthcare terminology a barrier or facilitator?

BACKGROUND: Use of healthcare terminology is a potential barrier to interprofessional education (IPE). This study describes how junior learners perceive and classify healthcare terminology in IPE settings. METHODS: We conducted a mixed methods study involving 29 medical, 14 nursing, and 2 physician assistant students who had previously attended or were registered to participate in educational activities at McMaster University's Centre for Simulation-Based Learning. 23 participants identified "inclusive" or "exclusive" terminology in a series of scenarios used for IPE workshops using an online survey. We collated lists of "inclusive" and "exclusive" terminology from survey responses, and characterized the frequencies of included words. 22 students participated in focus group discussions on attitudes and perceptions around healthcare terminology after attending IPE workshops. We identified themes through an iterative direct content analysis of verbatim transcripts. RESULTS: Students analyzed 14 cases, identifying on average 21 terms per case as healthcare terminology (28% of overall word count). Of the 290 terms identified, 113 terms were classified as healthcare terminology, 46 as inclusive and 17 as exclusive by > 50% of participants. Analysis of focus group transcripts revealed 4 themes: abbreviations were commonly perceived as complex terminology, lack of familiarity with terminology was often attributed to inexperience, simulation was considered a safe space for learning terminology, and learning terminology was a valued IPE objective. CONCLUSIONS: While students perceive a lot of healthcare terminology in IPE learning materials, categorization of terminology as "inclusive" or "exclusive" is inconsistent. Moreover, healthcare terminology is perceived as a desirable difficulty among junior learners, and should not be avoided in IPE.

An Examination of the Relationship between Fear of Coronavirus (COVID-19) in First Year Nursing Students and Their Attitudes to the Profession.

This study was conducted with the aim of determining the fear of coronavirus (COVID-19) and attitudes to the profession in first year nursing students, and examining the relationship between them. The descriptive study was conducted in April and May 2021 with first year students at the Nursing Department of Bursa Uludag University. The research sample consisted of 156 students who participated voluntarily in the study. A Student Description Form, a Coronavirus (COVID-19) Fear Scale and an Attitude Scale for the Nursing Profession were used to collect research data. It was found that the nursing students included in the study had mean scores of 161.49±19.54 on the Attitude Scale for the Nursing Profession (ASNP) and 17.50±5.87 on the COVID-19 fear scale, and that there was a significant positive correlation between the two scores. The means scores on the ASNP and COVID-19 Fear Scale of female students and of students who experienced fear during the pandemic were significantly higher than those of other students (p<0.05). It was also determined that the attitude scores of students who had chosen the nursing department willingly were significantly higher than those of other students (p<0.05).

The relationship between health sciences students' perceptions of health news and their attitudes to using complementary and alternative medicine.

PURPOSE: Written-visual and social media play a significant role in accessing knowledge about health issues. Media coverage of complementary and alternative medicine (CAM) can affect the beliefs, attitudes, behaviors and decisions to use of CAM the individuals. The research was planned as a descriptive, cross-sectional study was to evaluate the relationship between the health sciences students' perceptions of health news and their attitude towards using CAM. METHOD: The sample included 736 students studying in a Department of Nursing, Physiotherapy and Rehabilitation, and Nutrition and Dietetics program in a Faculty of Health Sciences. A Students' Description Form, The Perception of Health News Scale (PHNS), and The Attitude towards Using Complementary Treatments Scale (ACTS) were used to collect the data in this study. RESULTS: The students' mean PHNS scores were found to be 81.05 ± 13.42, and their mean ACTS scores were 30.07 ± 6.56. There was a statistically significant difference between HS students' mean PHMS scores and usage of CAM and following of health news on the written-visual media (p < 0.05). There was a statistically significant difference between HS students' mean ACTS scores and their department of study, year of study, usage of CAM, education on CAM, usage of social media, following of health news on the written-visual media and following health news on social media (p < 0.05). A weak positive correlation was found between the students' PHNS scores and their ACTS scores (r = 0.189, p = 0.000). CONCLUSION: In the conclusion of our research, it was found that HS students' perception of health news may affect their attitudes towards using CAM.

The effectiveness of scenario-based learning to develop patient safety behavior in first year nursing students.

The aim of this study was to examine the effect of scenario-based learning (SBL) compared to traditional demonstration method on the development of patient safety behavior in first year nursing students. During the 2016-2017 academic year, the Fundamentals of Nursing course curriculum contained the teaching of demonstration method (n=168). In the academic year 2017-2018 was performed with SBL method in the same context (n=183). Objective Structured Clinical Examination (OSCE) that assesses the same three skills was implemented in both academic terms to provide standardization so that students could evaluated in terms of patient safety competency. It was found that students' performance of some of the steps assessed were not consistently between the demonstration and SBL methods across the three skills. There was a statistically significant difference between demonstration method and SBL method for students' performing the skill steps related to patient safety in intramuscular injection (p<0.05) Our results suggest that the integration of SBL into the nursing skills training may be used as a method of teaching in order to the development of patient safety skills.

Clinical use of copeptin in migraine patients admitted to the emergency department.

PURPOSE: The purpose of this study was to investigate the clinical use of copeptin to evaluate migraine attacks in the Emergency Department. An additional aim was to detect changes in serum copeptin levels in migraine patients during attack and attack-free periods. METHODS: This prospective case-control study included 52 migraine patients and 51 healthy individuals with similar demographic characteristics. Blood samples were collected from migraine patients both in attack and attack-free periods. RESULTS: The mean copeptin levels in the patients group in the attack and attack-free periods were 689.28 and 576.68 pg/ml, respectively, whereas they were 608.68 pg/ml in the control group. There was a significant difference in the mean copeptin level in the attack period and attack-free periods (p = 0.026). The sensitivity and specificity of copeptin in detecting headache episodes in migraine patients were 58.8% and 60.7%, respectively, at a cut-off value of 388.67 pg/ml. CONCLUSION: This is the first study to investigate the diagnostic efficacy of serum copeptin levels in migraine patients. Although the diagnostic efficacy of serum copeptin levels for migraines was unsatisfactory, it could be helpful at management of migraine patients in ED.

Evaluation of Bachelor's Degree Nursing Program Assessment by Nurses Working at A University Hospital: A Cross-Sectional Study from Turkey.

The aim of this study was to examine the evaluation of integrated program, traditional and problem based programs in nursing by nurses working in a university hospital. The population of the study consisted of the 288 nurses. In the collection of research data, use was made of a Nurses' Description Form and the Bachelor's Degree Nursing Program Assessment Scale (BNPAS). It was found that the total mean BNPAS scores of nurses graduating from the integrated educational program were higher than those of nurses graduating from traditional and problem-based learning educational programs (p < 0.05). The total mean BNPAS scores of nurses who followed professional scientific publications after graduation were higher than the scores of those who did not, and the difference was found to be significant (p < 0.05). It was concluded that nurses had positive assessment of the bachelor's degree programs from which they graduated.

Quantitative Data for Transcutaneous Electrical Nerve Stimulation and Acupuncture Effectiveness in Treatment of Fibromyalgia Syndrome.

Aim. To evaluate the effects of acupuncture and transcutaneous electric nerve stimulation (TENS) applications on the quantitative electroencephalography (qEEG) changes and to evaluate their therapeutic effects in patients with fibromyalgia syndrome (FMS). The study included 42 patients with FMS and 21 healthy volunteers. The patients were randomly assigned to two groups (n=21 in each) to undergo either TENS or acupuncture application. In both acupuncture and TENS groups, baseline electroencephalography (EEG) recording was performed for 10 min and, then, TENS or acupuncture was performed for 20 min, followed by another 10 min EEG recording. Baseline qEEG findings of FMS patients in the TENS and acupuncture groups were similar. Delta and theta powers over the frontal region of FMS patients were lower than controls. Theta powers of right posterior region were also lower than controls. In the TENS group, after the treatment, an increase was observed in the alpha power of the left anterior region as well as a decrease in pain scores. In the acupuncture group, an increase was determined in the alpha power of the right and left posterior regions as well as a decrease in pain score after the treatment. The power of low- and moderate-frequency waves on resting EEG was decreased in the patients with FMS. Decreased pain and increased inhibitor activity were found on qEEG after TENS and acupuncture applications. In conclusion, both TENS and acupuncture applications seem to be beneficial in FMS patients.

Practices in Human Dignity in Palliative Care: A Qualitative Study.

Respecting and valuing an individual's existential dignity forms the basis of nursing and medical practice and of nursing care. The objective of the study was to determine the approach to human dignity that nurses and physicians have while providing palliative care. This qualitative study was performed using a phenomenological research design. In-depth semistructured interviews were conducted in 9 nurses and 5 physicians with human dignity approach in palliative care. Following the qualitative Colaizzi method of analyzing the data, the statements made by the nurses and physicians during the interviews were grouped under 8 categories. Consistent with the questionnaire format, 8 themes and 43 subthemes of responses were determined describing the human dignity of the nurse and the physicians. The results of the study showed that in some of the decisions and practices of the nurses giving nursing care and physicians giving medical care to palliative care patients, while they displayed ethically sensitive behavior, on some points, they showed approaches that violated human dignity and showed lack of awareness of ethical, medical, and social responsibilities.

Comparison of intravenous pantoprazole and ranitidine in patients with dyspepsia presented to the emergency department: a randomized, double blind, controlled trial.

BACKGROUND: This study aimed to compare pantoprazole, a proton-pomp inhibitors (PPIs), and ranitidine, a H2 receptor antagonists (H2RA), in ceasing dyspeptic symptoms in the emergency department (ED). METHODS: This randomized, double-blinded study compared the effectiveness of 50 mg ranitidine (Ulcuran(®)) and 40 mg pantoprazole (Pantpas(®)), given in a 100 mL saline solution by an intravenous rapid infusion within 2-4 minutes in patients with dyspepsia presented to the ED. Pain intensity was measured at baseline, 30 and 60 minutes after the drug administration. RESULTS: A total of 72 patients were eligible for the study. Of these patients, 2 were excluded from the study because the initial visual analogue scale (VAS) scores were under 20 mm and 4 were excluded from the statistical analysis because of being diagnosed as having other causes of epigastric pain despite being allocated to one of the study groups. Thirty-three patients in the pantoprazole group and 33 patients in the ranitidine group were analyzed ultimately. The mean age of the patients was 36.6±15 years, and 26 (39.4%) patients were male. Both of the groups reduced pain effectively at 30 [27.6±28 (18 to 37) vs. 28.3±23 (20 to 37), respectively] and 60 minutes [39.6±39 (26 to 53) vs. 42.3±25 (33 to 51), respectively]. There were 13 (39.4%) patients in the pantoprazole group and 8 (24.2%) patients in the ranitidine group who required additional drug at the end of the study (P=0.186). CONCLUSION: Intravenous pantoprazole and ranitidine are not superior to each other in ceasing dyspeptic symptoms at 30 and 60 minutes in the ED.

Comparison of SVM and ANFIS for snore related sounds classification by using the largest Lyapunov exponent and entropy.

Snoring, which may be decisive for many diseases, is an important indicator especially for sleep disorders. In recent years, many studies have been performed on the snore related sounds (SRSs) due to producing useful results for detection of sleep apnea/hypopnea syndrome (SAHS). The first important step of these studies is the detection of snore from SRSs by using different time and frequency domain features. The SRSs have a complex nature that is originated from several physiological and physical conditions. The nonlinear characteristics of SRSs can be examined with chaos theory methods which are widely used to evaluate the biomedical signals and systems, recently. The aim of this study is to classify the SRSs as snore/breathing/silence by using the largest Lyapunov exponent (LLE) and entropy with multiclass support vector machines (SVMs) and adaptive network fuzzy inference system (ANFIS). Two different experiments were performed for different training and test data sets. Experimental results show that the multiclass SVMs can produce the better classification results than ANFIS with used nonlinear quantities. Additionally, these nonlinear features are carrying meaningful information for classifying SRSs and are able to be used for diagnosis of sleep disorders such as SAHS.