The effect of epilepsy self-management on productivity at work.

BACKGROUND: Epilepsy is a significant public health concern and the most common neurological disorder. Lack of understanding of the disease may magnify the challenges faced by employees with epilepsy, including effective management of symptoms, and full participation in workplace and work productivity. AIM: Study aimed to evaluate epilepsy self-management skills of working individuals with epilepsy and to determine the impact of it on productivity at work. METHODS: The study adopted a cross-sectional design and involved 111 individuals with epilepsy. Data collection was carried out using a socio-demographic characteristics form, the "Epilepsy Self-Management Scale" and the "Endikot Work Productivity Scale." RESULTS: The average age was 35.76 ± 3.39 in the study. The majority of the participants (57.7 %) were women. Additionally, 33.3 % were private sector employee, and 39.6 % held a bachelor's degree. The mean score of the Epilepsy Self Management Scale was 3.91 ± 0.15, the total score of Endikot Work Productivity Scale was 39.84 ± 6.33. A negative significant correlation was observed between epilepsy self management and work productivity. Moreover, women (3.94 ± 0.17) and healthcare workers (3.97 ± 0.06) had higher scores of epilepsy self management. While men (40.43 ± 0.15) demonstrated higher productivity scores, public servants (35.61 ± 0.34) had lower scores compared to others (p < 0.05). CONCLUSIONS: The findings of this study suggest that improved self-management of epilepsy among working individuals leads to increased work productivity. The epilepsy-management skills of women and healthcare workers was higher. Furthermore, men exhibited lower productivity levels, while woman and public servants displayed higher.

Validity and reliability study of the turkish version epilepsy self-stigma scale (ESSS-T).

AIM: We translated the Epilepsy Self-stigma Scale (ESSS) into Turkish and aimed to examine the Turkish version ESSS (ESSS-T) validity and reliability. MATERIALS AND METHOD: From April to August 2023, patients with epilepsy (PWE) were recruited from the neurology outpatient clinic of Ataturk University Hospital in the eastern Turkish city of Erzurum (inclusion criteria: age 18 years or older and adequate reading and speaking ability in Turkish). We conducted our survey using a self-administered questionnaire. The questionnaire consisted of the ESSS-T after appropriate translation by back-translation, and self-esteem (the Rosenberg's Self-Esteem Scale, RSES), depression (the Neurological Disorders Depression Inventory for Epilepsy, NDDI-E), and general stigma (the Stigma Scale for Epilepsy, ESE) for construct validity. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were used to test factorial validity. Also, Cronbach's alpha coefficient was calculated to verify reliability. RESULTS: Of the 126 patients, 106 agreed to give informed consent and responded to the questionnaire (84.1 % response rate). The results of EFA suggested the same three-factor structure as in the original version, but CFA showed some limitations in interpreting the three-factor structure and it may be safer to understand it as a unifactorial structure. The alpha coefficients were also validated by the ESSS-T. The alpha coefficients were α = 0.74 for the ESSS-T scale as a whole and α = 0.69-0.74 for each subscale, which were generally acceptable values. CONCLUSION: The Turkish version of the ESSS proved valid and reliable. It is a measurement tool with a three-dimensional structure. It can be used to assess the self-stigmatization of patients with epilepsy in Turkey.

Do Maternal Heart Diseases Affect Fetal Cardiac Functions?

OBJECTIVES: To investigate whether fetal cardiac function is affected by underlying heart disease in pregnant women. METHODS: A total of 100 pregnant women who were ≥34 gestational weeks were included in the study, 40 in the maternal heart disease (MHD) group diagnosed with heart disease and 60 in the control group. All cardiac diseases in pregnant women were diagnosed preconceptionally and categorized according to the New York Heart Association (NYHA) classification system. Fetal cardiac functions of study groups were evaluated by M-mode, color tissue Doppler imaging (c-TDI), and pulsed wave Doppler. RESULTS: Tricuspid annular plane systolic excursion and myocardial performance index (MPI) values were significantly higher and isovolumetric relaxation time was prolonged in the MHD group. The MPI value was found higher in MHD group with NYHA Class II compared to those with NYHA Class I. No significant change in any of the fetal tricuspid annular peak velocity values measured by c-TDI in the MHD group. There were no differences in fetal cardiac functions and perinatal outcomes between pregnant women with acquired and congenital heart diseases. Patients in NYHA Class II had lower birth weight, 1st and 5th minute APGAR scores, and higher neonatal intensive care unit admission rates. CONCLUSIONS: Underlying heart diseases in pregnant women can cause alterations in the systolic and diastolic function of the fetal heart. High fetal MPI values detected in cardiac patients may indicate that cardiac pathologies during pregnancy affect fetal cardiac globular myocardial function. Cardiac pathologies that progress with restricted physical activity may cause changes in fetal cardiac function and may be associated with adverse perinatal outcomes.

Comparison of VEGF-A levels in women with threatened abortion, early pregnancy loss and uncomplicated healthy pregnancies.

INTRODUCTION: To estimate the possible role of VEGF-A in predicting poor early pregnancy outcomes including threatened abortion and early pregnancy loss. METHODS: We conducted a prospective case-control study with three groups of pregnant women diagnosed with threatened abortion, early pregnancy loss, and uncomplicated healthy pregnancies between 01 March 2023 and 15 March 2023. Maternal serum VEGF-A concentration was measured using the Sandwich-ELISA method in accordance to the commercial kit's instructions. There were 30 patients in each 3 group and the gestational age of the patients was between 6 and 14 weeks. The Kruskal-Wallis test was performed for comparing the median values between the groups. Mann-Whitney U test was conducted for pairwise comparisons. RESULTS: VEGF-A levels were compared between 3 groups and a statistically significant difference was found (p = 0.007). There was a moderately significant correlation between VEGF-A levels and poor early pregnancy outcomes. For poor early pregnancy outcomes, the area under the curve (AUC) was 0.75 (95% CI: 0.64-0.85). The best balance of sensitivity/specificity in ROC curves was 0.60 (63.3% sensitivity, 74.3% specificity). DISCUSSION: In conclusion, this study pointed out the increased VEGF concentrations in pregnant women with threatened miscarriage and early pregnancy loss. VEGF-A may be a potential biomarker for the indication of poor early pregnancy outcomes.

Examination of health literacy and personal impact of epilepsy in patients with epilepsy.

AIM: We conducted this study to examine the impact of health literacy on the personal impact of epilepsy in patients with epilepsy. METHOD: We conducted this cross-sectional and correlational study with 125 individuals who were admitted to the neurology outpatient clinic of a university hospital in eastern Turkey, who met the research criteria, and who accepted to participate in the study. We collected the data by using the "Descriptive Information Form (DIF)", "The Personal Impact of Epilepsy Scale (PIES)", and "Health Literacy Scale (HLS)". RESULTS: We found that the mean HLS total score of the participants was 104.84 ± 22.88. We also found the mean PIES total score to be 27.08 ± 18.56. Regression results using PIES as a dependent variable reported that the model created was statistically significant (F (21,83) = 11.398, p < 0.05). Among the variables included in the model, income status and HLS were negative (ß = -0.209; ß = -0.194; ß = -0.364, respectively) predictors of the PIES total score. However, seizure status in the last year, number of drugs used, and seizure type were positive predictors of the PIES total score. We found that the variables included in the analysis explained 74% of the total PIES score. CONCLUSION: In conclusion, the health literacy level (HLL) of the participants was sufficient or very good, and the effect of the disease on individuals with epilepsy was low. The effect of the disease on individuals with epilepsy decreased as the level of health literacy increased.

The effects of strength of religious faith on post-traumatic growth in patients with epilepsy.

AIM: This study was conducted to examine the effects of strength of religious faith on post-traumatic growth in patients with epilepsy. METHOD: This cross-sectional and correlational study was conducted with 112 participants who were admitted to the neurology outpatient clinic of a university hospital in eastern Turkey, who met the research criteria and agreed to participate in the study. The data were collected by using "Descriptive Information Form", "Santa Clara Strength of Religious Faith Questionnaire (SCSRFQ)", and "Post-traumatic Growth Inventory (PTGI)". Santa Clara Strength of Religious Faith Questionnaire SCRFSQ has a maximum strength of faith score of 40 points and the PGTI has a maximum growth after a traumatic event score of 105 points. RESULTS: Mean SCSRFQ total score of the participants was found to be 31.04 ± 5.17. Mean PTGI total score was found to be 60.54 ± 16.50. As a result of the regression analysis, it was found that the independent variable affected the dependent variable PTGI total score significantly (F(1,110) = 13.999, p = 0.000). It was also found that the independent variable affected the PTGI total score positively (ß = 0.336) and explained 11% of the PTGI total score (p < 0.001). CONCLUSION: It was found that the participants had high strength of religious faith score and moderate post-traumatic growth score. It was found that post-traumatic growth increased as strength of religious faith increased.

Effect of maternal autoimmune diseases on fetal pulmonary artery Doppler indices: A case-control study.

OBJECTIVE: To compare the fetal pulmonary artery Doppler indices of pregnant women with autoimmune diseases such as systemic lupus erythematosus (SLE), Sjögren's syndrome (SS), and antiphospholipid syndrome (APS) with healthy pregnant women. METHODS: Thirty-nine pregnancies were included in the case group, 19 of them SLE, 12 with SS, and eight with APS. The gestational age-matched 54 healthy pregnant women were included in the control group. Peak systolic velocity, time-averaged velocity, systolic/diastolic ratio, pulsatility index, resistance index, acceleration time (AT), ejection time (ET), and AT/ET ratio were obtained from pulmonary artery waveform by using spectral Doppler ultrasound. RESULTS: Significantly shorter AT and lower AT/ET ratio were detected in the case group (p = < .001, p = < .001, respectively). The shortening of AT and decreasing of the AT/ET ratio were more predominant in the APS group. However, there was no significant difference between the SLE, SS, and APS groups in fetal pulmonary artery Doppler indices. Also, a moderate correlation was found between maternal disease duration (years) and fetal pulmonary artery AT (r = -.516, p = .001) and AT/ET ratio (r = -.558, p = < .001). CONCLUSION: Fetal pulmonary artery Doppler indices may be affected in maternal autoimmune diseases. Further studies are needed to evaluate fetal pulmonary Doppler indices such as AT and AT/ET ratio to predict neonatal respiratory morbidity and lung maturation in pregnant women with SLE, SS, and APS.

The assessment of fetal cardiac functions in pregnancies with autoimmune diseases: a prospective case-control study.

OBJECTIVES: This study aimed to assess the effect of the inflammatory process on fetal cardiac functions in pregnant women with autoimmune diseases (AID). METHODS: This prospective study included 36 pregnant women with diagnosed AID. Nineteen systemic lupus erythematosus, 12 antiphospholipid syndrome, 5 Sjögren's syndrome, and 72 healthy pregnancies were included. Fetal cardiac functions were evaluated with pulsed-wave, tissue Doppler, and M-mode echocardiography. RESULTS: Sociodemographic data were similar in both groups. Significant increases were found in tricuspid E (43.5 ± 0.9, p<0.001) and A (59.2 ± 2.2, p<0.001) and E/A (0.74 ± 0.03, p<0.001), E'/A' (0.64 ± 0.15, p<0.001), E/E' (6.5 ± 0.6, p<0.001), and left ventricular myocardial performance index (0.54 ± 0.03, p=0.005). We demonstrated a significant decrease in tricuspid E' (6.7 ± 0.6, p<0.001) and S' (6.9 ± 1, p<0.001) and in TAPSE (7.7 ± 0.5, p=0.002). We also found a significantly prolonged PR interval (130 ± 8, p<0.001). There was a significant increase in E' (6.8, p=0.033) and a significant decrease in E/E' ratio (6.4, p=0.027) in the group using hydroxychloroquine (HCQ) compared to non-users. CONCLUSIONS: We found that pregnancy with autoimmune diseases affects fetal heart functions. Additionally, hydroxychloroquine may positively affect the heart of AID fetuses. This information might be useful to clinicians in the follow-up of cardiovascular diseases.

The utility of systemic immune-inflammation index and systemic immune-response index in the prediction of adverse outcomes in pregnant women with coronavirus disease 2019: Analysis of 2649 cases.

AIM: To investigate the association of systemic immune-inflammation index (SII) and systemic immune-response index (SIRI) with adverse perinatal outcomes in pregnant women with coronavirus disease 2019 (COVID-19). METHODS: The cases were divided into (1) the Mild-moderate COVID-19 group (n = 2437) and (2) the Severe-critical COVID-19 group (n = 212). Clinical characteristics, perinatal outcomes, SII (neutrophilXplatelet/lymphocyte), and SIRI (neutrophilXmonocyte/lymphocyte) were compared between the groups. Afterward, SII and SIRI values were compared between subgroups based on pregnancy complications, neonatal intensive care unit (NICU) admission, and maternal mortality. A receiver operator characteristic analysis was performed for the determination of optimal cutoff values for SII and SIRI in the prediction of COVID-19 severity, pregnancy complications, NICU admission, and maternal mortality. RESULTS: Both SII and SIRI were significantly higher in complicated cases (p < 0.05). Cutoff values in the prediction of severe-critical COVID-19 were 1309.8 for SII, and 2.3 for SIRI. For pregnancy complications, optimal cutoff values were 973.2 and 1.6. Cutoff values of 1045.4 and 1.8 were calculated for the prediction of NICU admission. Finally, cut-off values of 1224.2 and 2.4 were found in the prediction of maternal mortality. CONCLUSION: SII and SIRI might be used in combination with other clinical findings in the prediction of poor perinatal outcomes.

Photoluminescence and thermoluminescence properties of pure and rare-earth-doped ZrO2 prepared by Pechini-type sol-gel.

In this article, photoluminescence (PL) and thermoluminescence (TL) properties of ZrO2 , ZrO2 :Dy3+ , ZrO2 :Dy3+ -Gd3+ , ZrO2 :Dy3+ -Yb3+ , ZrO2 :Dy3+ -Er3+ , and ZrO2 :Dy3+ -Sm3+ phosphors synthesized by the Pechini method were investigated. The crystal structure, thermal properties, morphology, PL and TL properties were investigated using X-ray powder diffraction (XRD), differential thermal analysis/thermogravimetric analysis (DTA/TGA), scanning electron microscopy (SEM), PL and TL, respectively. The room temperature emission bands corresponding to 4 F9/2  â†’ 6 HJ (J = 9/2, 11/2, 13/2 and 15/2) transitions of Dy3+ ions were measured. The phosphors were analysed using Tm -TSTOP , variable dose, and computerized glow curve fitting methods. Reusability, dose-response, and fading characteristics were investigated. The phosphors have a natural TL emission that vanished by heating treatment. Moreover, new peaks with similar properties to the natural emissions were observed after high-dose irradiation and long-term fading experiments. The glow curves of the phosphors have 13 individual peaks and many low- and high-temperature satellite peaks. The origin of the peaks is ZrO2 host material and doping with rare-earth ions (Gd3+ , Dy3+ , Yb3+ , Er3+ and Sm3+ ) does not lead to a new glow peak. The dopants cause drastic changes in individual peak intensities of ZrO2 .The initial fading rates of all the phosphors are relatively fast, but they slow down as time goes on.

Discovery of a novel lactate dehydrogenase tetramerization domain using epitope mapping and peptides.

Despite being initially regarded as a metabolic waste product, lactate is now considered to serve as a primary fuel for the tricarboxylic acid cycle in cancer cells. At the core of lactate metabolism, lactate dehydrogenases (LDHs) catalyze the interconversion of lactate to pyruvate and as such represent promising targets in cancer therapy. However, direct inhibition of the LDH active site is challenging from physicochemical and selectivity standpoints. However, LDHs are obligate tetramers. Thus, targeting the LDH tetrameric interface has emerged as an appealing strategy. In this work, we examine a dimeric construct of truncated human LDH to search for new druggable sites. We report the identification and characterization of a new cluster of interactions in the LDH tetrameric interface. Using nanoscale differential scanning fluorimetry, chemical denaturation, and mass photometry, we identified several residues (E62, D65, L71, and F72) essential for LDH tetrameric stability. Moreover, we report a family of peptide ligands based on this cluster of interactions. We next demonstrated these ligands to destabilize tetrameric LDHs through binding to this new tetrameric interface using nanoscale differential scanning fluorimetry, NMR water-ligand observed via gradient spectroscopy, and microscale thermophoresis. Altogether, this work provides new insights on the LDH tetrameric interface as well as valuable pharmacological tools for the development of LDH tetramer disruptors.

Determination of self-efficacy of patients diagnosed with epilepsy.

This study was conducted to determine the self-efficacy of patients diagnosed with epilepsy. This descriptive-correlational study was conducted between November-December 2020 with individuals diagnosed with epilepsy and living in the eastern province of Turkey. The sample of the study consisted of individuals diagnosed with epilepsy (101 persons) who were living in this province and agreed to participate in the study. According to the findings obtained from the study, the Epilepsy Self-efficacy Scale Total Mean Score of the individuals was found to be 226.38 ± 45.23. The scale does not have a cut-off point, and the total score that can be obtained from the scale varies between 0 and 310. An increase in the score obtained indicates high self-efficacy. It can be said that the self-efficacy levels of the sampled individuals are also high. It was found that there was a negative correlation between the first diagnosis age and the seizure management sub-dimension, and a positive statistically significant correlation between the age of the individuals and the age of the first seizure. The Epilepsy Self-efficacy Scale Total Mean Score of the individuals was found to be statistically high in those who received information regarding the disorder and used their drug/drugs regularly. It is suggested to conduct the study in larger groups. It is recommended to carry out studies to increase epilepsy self-efficacy.

Genotoxicity evaluation of a new phthalazine substituted ß-lactam derivative in human lymphocytes.

The aim of present study, to evaluate the genotoxic potential of 1-(4-(3,3-dimethyl-1,6-dioxo-2,3,4,6,11,13-hexahydro-1H-indazolo[1,2b] phthalazine-13yl)phenyl)-2-phenylazetidine-3-yl-acetate which was synthesised assuming that it may be a pharmaceutical raw material and found to inhibit human carbonic anhydrase I, II isozymes. To determine the genotoxic potential of this phthalazine substituted ß-lactam compound, chromosomal aberration (CA) and micronucleus (MN) tests were implemented in human peripheral blood lymphocytes. In these tests, lymphocyte cultures were treated with four concentrations (30, 15, 7.5, 3.75 µg/mL) of test compound and simultaneously with negative control (sterile distilled water), solvent control (DMSO) positive control (MMC). According to our results, CA frequencies were significantly increased in two high applied concentrations (30, 15 µg/mL) compared with negative and solvent control. MN frequencies were significantly increased in three applied concentrations (30, 15, 7.5 µg/mL) except lowest concentration (3.75 µg/mL) compared with solvent control. Mitotic indices were also affected by treatment with test compound. The obtained results provide evidence to demonstrate that new phthalazine substituted ß-lactam derivative can exert genotoxic and cytotoxic effects in peripheral human lymphocytes especially at high concentrations.

Fracture resistance of endodontically treated premolars restored with CAD-CAM onlays.

PURPOSE: To evaluate the fracture resistance of endodontically treated premolars restored with CAD-CAM onlay restorations. METHODS: 60 extracted mandibular first premolars were selected and at first divided into three groups regarding treatment options: MOD onlay with buccal cusp coverage, MOD onlay with buccal cusp coverage + endodontic treatment, MOD onlay with buccal cusp coverage + endodontic treatment + fiber post. Then, all groups were divided into subgroups (n=10) according to the restorative material used: IPS e.max CAD and Lava Ultimate. Each group was submitted to 5,000 thermal cycles, embedded in acrylic resin and secured in a universal testing machine respectively. A compressive load was applied until fracture, at a crosshead speed of 0.5 mm/minute. Statistical significance among each group was analyzed using one-way ANOVA and Bonferroni tests. RESULTS: Statistically, endodontically treated IPS e.max onlays had numerically the lowest average fracture resistance [753.1 (± 224.9) N/mm² ] among all treatment options. IPS e.max onlays treated with fiber posts had significantly higher resistance than that of endodontically treated IPS e.max CAD group (P= 0.013). Endodontically treated teeth restored with Lava Ultimate onlays [1,381.0 (± 471.7) N/mm²] showed significantly higher averages of fracture resistance than IPS e.max CAD onlays. CLINICAL SIGNIFICANCE: CAD-CAM composite (resin nanoceramic) onlays resist greater forces compared to ceramic restorations. Fiber posts could improve the fracture resistance of endodontically treated mandibular premolars following the ceramic CAD-CAM onlays.

Turkish validity and reliability of the Personal Impact of Epilepsy Scale.

AIM: This study evaluated the validity and reliability of the Turkish Personal Impact of Epilepsy Scale (PIES). MATERIALS AND METHOD: This methodological study was carried out at a university hospital in Erzurum, eastern Turkey between January and April 2021. The data were collected from 126 patients who agreed to participate in the study within these dates via face-to-face interviews, a personal information form, and the Turkish PIES. The PIES consists of 25 items, scored between 0 and 4, and three subscales. The scale itself is a 5-point, Likert-type scale. Following the scale's translation process, its content and construct validity were evaluated. Exploratory and confirmatory factor analysis were conducted for construct validity and item analysis, and internal consistency analysis took place to confirm the scale's reliability. RESULTS: As a result of the evaluations and analyses, the Turkish PIES's content validity index was 0.94. In the exploratory analysis, the scale's total variance rate was 70.82%. The Cronbach's alpha value of the Seizures subscale was 0.728, that of the Medication Side Effects subscale was 0.947, for the Comorbidities subscale it was 0.929, and the total scale's Cronbach's alpha value was 0.954. The results of the EFA (Exploratory Factor Analysis) and CFA (Confirmatory Factor Analysis) showed that the Turkish PIES, per its 25 items and three-factor structure, is a sufficient measurement instrument. Good fit index values were also obtained as a result of the CFA. CONCLUSION: The Turkish version of the PIES is a valid and reliable instrument to evaluate the effects of seizures, medication side effects, mood/social state, and quality of life of patients with epilepsy.

Investigation of knowledge and attitudes of military nurses about epilepsy.

BACKGROUND: The knowledge and attitudes of military nurses are important for the quality of care of the individuals they care for. AIM: This descriptive study aimed to determine the knowledge and attitudes of military nurses towards epilepsy. METHOD: An introductory information form, an epilepsy knowledge scale, and an epilepsy attitude scale were used to collect data from 115 military nurses through social media. RESULTS: The average score of the epilepsy knowledge scale was 14.04 ±â€¯2.25, and that of the epilepsy attitude scale was 57.23 ±â€¯4.39. While education, marital status, and having a relatives who are patients with epilepsy (PWE) did not affect knowledge and attitudes, encountering an epileptic seizure affected attitudes. CONCLUSION: The knowledge of military nurses regarding epilepsy was high, and their attitudes towards the illness were positive.

The relationship between the perceptions of stigma expressed by the relatives of patients with epilepsy and sociodemographic factors: The case of eastern Turkey.

PURPOSE: Stigma is a significant risk that exists in the immediate vicinity of patients with epilepsy. The present study was performed to determine the stigma perceptions of the relatives of patients with epilepsy in Turkey. METHOD: The study was conducted with the relatives (aged 18-70 years) of 137 patients with epilepsy who were referred to a neurology outpatient clinic in a city east of Turkey. The Epilepsy Stigma Scale Patient's Relative Form and a Personal Information Form were used to collect data. RESULT: The relatives of the patients were found to be moderately stigmatized. There was a statistically significant difference between the stigma mean scores of the relatives of the patients whose income was more than their expenditures and other income groups. It was also determined that those whose income was more than their expenditures had higher scores in the discrimination and prejudgment subdimensions; those residing in villages had higher scores in the prejudgment subdimension; those with a low education level had higher scores in the false belief subdimension; and the siblings of patients with epilepsy had higher scores in the prejudgment subdimension. CONCLUSION: The results of our study indicate that the relatives of patients with epilepsy suffer from stigma. The differences in terms of the discrimination, prejudgment, and false belief subdimensions between different income statuses, education statuses, places of residence, and degrees of relationship refer to the problems that need to be overcome.

The validity and reliability of the type 2 diabetes and health promotion scale Turkish version: a methodological study.

OBJECTIVE: A healthy promotion is important for maintaining health and preventing complications in patients with type 2 diabetes. AIM: The aim of the present study was to examine the psychometrics of a recently developed tool that can be used to screen for a health-promoting lifestyle in patients with type 2 diabetes. METHOD: Data were collected from outpatients attending diabetes clinics. The Type 2 Diabetes and Health Promotion Scale (T2DHPS) and a demographic questionnaire were administered to 295 participants. Forward-backward translation of the original English version was used to develop a Turkish version. Internal consistency of the scale was assessed by Cronbach's alpha. An explanatory factor analysis and confirmatory factor analysis used validity of the Type 2 Diabetes and Health Promotion Scale - Turkish version. RESULTS: Kaiser-Meyer-Olkin (KMO) and Bartlett's sphericity tests showed that the sample met the criteria required for factor analysis. The reliability coefficient for the total scale was 0.84, and alpha coefficients for the subscales ranged from 0.57 to 0.92. A six-factor solution was obtained that explained 59.3% of the total variance. The ratio of chi-square statistics to degrees of freedom (χ2 /df) 3.30 (χ2 = 1157.48/SD = 350); error of root mean square approximation (RMSEA) 0.061; GFI value of 0.91 and comparative fit index (CFI) value was obtained as 0.91. CONCLUSIONS: Turkish version of The T2DHPS is a valid and reliable tool that can be used to assess patients' health-promoting lifestyle behaviours. Validity and reliability studies in different cultures and regions are recommended.

Levels of Care Burden and Self-efficacy for Informal Caregiver of Patients With Cancer.

This descriptive study was conducted to determine the levels of self-efficacy and caregiver burden experienced by caregivers for patients with cancer. The study was conducted at the oncology clinic of a hospital in Erzurum city, Turkey. The study sample consisted of 101 caregivers of patients hospitalized with a diagnosis of cancer. The Self-Efficacy Scale Turkish version and the Zarit Caregiver Burden Scale, which is a sociodemographic questionnaire, were used for data collection. The level for the burden of care for caregivers to patients with cancer was moderate, and the level of self-efficacy was moderate. A statistically significant, positive relationship was found between the scores for the Care Burden Scale and the Completing Behavior Subscale (r = 0.213; P < .05). A statistically significant, negative relationship was observed between the mean scores of the Care Burden Scale with Self-Efficacy Scale's total score (r = -0.104; P < .05), Sustaining Behavior Subscale (r = -0.324; P < .01), and Initiating Behavior Subscale (r = -0.199; P ≤ .05). Therefore, initiatives focused on self-efficacy levels should be developed to increase the abilities of caregivers for patients with cancer.

RBBP8 syndrome with microcephaly, intellectual disability, short stature and brachydactyly.

Primary microcephaly is clinically variable and genetically heterogeneous. Four phenotypically distinct types of autosomal recessive microcephaly syndromes are due to different RBBP8 mutations. We report on a consanguineous Pakistani family with homozygous RBBP8 mutation c.1808_1809delTA (p.Ile603Lysfs*7) manifesting microcephaly and a distinct combination of skeletal, limb and ectodermal defects, mild intellectual disability, minor facial anomalies, anonychia, disproportionate short stature and brachydactyly, and additionally talipes in one patient.