Development of relationship with patient self efficacy scale: Gender, department, and grade level differences.

BACKGROUND: Self-efficacy has become a cross-disciplinary concept. In the field of healthcare, this concept is considered crucial for nurses; who play an important role in improving the health and well-being of the community. AIMS: The aim of this study was to develop a "Relationship-with-the-patient self-efficacy scale" (RPSES). METHODOLOGY: A sample of 331 university students (310 females and 21 males; 168 from the midwifery and 162 from the nursing departments) were enrolled in the study. Out of 24 items, 8 behavior items with the highest factor loadings were selected regarding the nurse-patient-relationship self-efficacy according to the results of the preliminary exploratory factor analysis. RESULTS: The final exploratory factor analysis revealed that the selected 8 items of RPSES had a single factor, explaining 83.28% of the total variance. The Cronbach alpha reliability coefficient was c alculated as 0.97. CONCLUSION: This scale has beendemonstrated to be a valid and reliable instrument.The analyses unfolded that RPSES scores of the students were not different between men and womenand did not differ by the departments the students attended; however, the RPSES scores were different by the grade levels of the students (juniors and seniors). The fourth graders' RPSES scores were higher than those of third graders.

Apraxia in Parkinson's disease and multiple system atrophy.

OBJECTIVE: To determine praxis function in patients with Parkinson's disease (PD) and multiple system atrophy (MSA). METHODS: Nineteen patients with PD and 16 patients with probable MSA were recruited into study. Twenty-five age-matched, healthy subjects were included as controls. The Mayo Clinic praxis test battery was applied. Pantomime tasks, including oral/facial, trunk, and upper extremity movement, were used to evaluate ideomotor apraxia (IMA). Sequential tasks, including Luria test for ideational apraxia (IDA) and use of actual objects, were also tested. In addition, Standardized Mini Mental Test (MMSE), Hamilton Depression (HAM-D), and Anxiety (HAM-A) Scales were used. RESULTS: Mean ages of the study participants were 66 +/- 7, 68 +/- 5, and 65 +/- 7 years in PD, MSA, and control groups, respectively. Mean total praxis score was significantly lower for patients with PD (92.4 +/- 4) and MSA (75.9 +/- 18) than for controls (97.4 +/- 2) (P = 0.000). Transitive performances of upper extremities and sequential tasks were significantly impaired in patients with PD compared to control subjects (P < 0.05). There was no correlation between total praxis scores and sum scores of tremor, bradykinesia, and rigidity of both of the upper limbs of patients with PD. Subgroup praxis scores were substantially worse in MSA group (P < 0.0001). Compared to control subjects, mean scores for MMSE, HAM-D, and HAM-A tests were significantly worse in MSA group, but, for PD patient group, only HAM-A scores were worse. CONCLUSION: Our results indicate that although not a presenting symptom, IMA and IDA may be features of MSA and, to a lesser degree, of PD. Also, it seems to be unrelated to the motor features of patients with PD.

Spontaneous cerebellar strokes. Clinical observations in 60 patients.

This is a retrospective study carried out by clinical analysis of the authors' experience in 60 patients with cerebellar strokes--of which 39 were spontaneous cerebellar hemorrhage and 21 were cerebellar infarction--to compare the clinical presentation, course, and prognosis. Hypertension was found to be the most important etiologic factor. Clinical differentiation of cerebellar hemorrhage from infarction was not possible, but the management was similar in both entities. Computerized tomography was necessary to make diagnosis of the stroke mechanism. In evaluating outcome, the authors conclude that the most important single factor affecting the prognosis was the early correct diagnosis.

Distribution and occurrence of the insect pathogenic alga Helicosporidium sp. (Chlorophyta: Trebouxiophyceae) in the predator beetle Rhizophagus grandis G: yll. (Coleoptera: Rhizophagidae)-rearing laboratories.

The distribution and occurrence of the insect pathogenic algae Helicosporidium sp. (Chlorophyta: Trebouxiophyceae) in the predator beetle Rhizophagus grandis (Coleoptera: Rhizophagidae)-rearing laboratories were studied and reported here for the first time. The insect pathogenic alga Helicosporidium sp. infection was observed in all R. grandis-rearing laboratories. The infection rate reached more than 20% which is significant among the samples in some R. grandis-rearing laboratories. The infection rates of the examined beetles showed noticeable differences between localities and years. There was no significant difference in the infection levels of male and female beetles. These results showed that Helicosporidium sp. is one of the factors that decrease efficiency of the R. grandis-rearing laboratories.

Isolation of some pathogenic bacteria from the great spruce bark beetle, Dendroctonus micans and its specific predator, Rhizophagus grandis.

Some bacteria were isolated from Dendroctonus micans and its specific predator, Rhizophagus grandis. Six bacteria from D. micans were identified as Bacillus pumilus, Enterobacter intermedius, Citrobacter freundii, Cellulomonas flavigena, Microbacterium liquefaciens and Enterobacter amnigenus, three bacteria from R. grandis as Klebsiella pneumoniae, Pantoea agglomerans and Serratia grimesii, on the basis of fatty acid methyl ester analysis and carbon utilization profile by using Microbial Identification and Biolog Microplate Systems. Their insecticidal effects were tested on larvae and adults of D. micans.

Ischemic stroke subtypes: risk factors, functional outcome and recurrence.

The etiology of ischemic stroke affects its prognosis, outcome and management. Our aims were to determine risk factors, clinical and imaging variables and prognostic differences in acute ischemic stroke subtypes. In this study, we prospectively investigated 264 consecutive patients with acute ischemic stroke between 1996 and 2000. All of the patients were categorized to one of four major ischemic stroke subtype based on TOAST (Trial of Org 10172 in Acute Stroke Treatment) criteria. The mean age was greater in patients with stroke of undetermined etiology (SUE). Prevalence of hypertension was higher in patients with lacunar infarct (LAC) than other subtypes. Smoking was less frequent in patients with cardioembolism (CARD). The mean infarct size was largest in patients with large artery atherosclerosis (LAA) while there were no differences in location or conversion of the infarct into hemorrhage. The proportion of the patients with milder neurological deficits at entry was higher in patients with LAC subtype. The rate of independent patients were different between subtypes: 62% in LAC, 43% in CARD, 38% in SUE, 35% in LAA at discharge ( p=0.01), and 91% in LAC, 69% in CARD, 59% in SUE, 60% in LAA at 6 months ( p<0.001). Recurrence rates were not different between groups. We conclude that risk factors, clinical imaging variables are different among ischemic stroke subtypes and that neurological status on admission and during follow-up strongly favors LAC.

Importance of cranial nerve involvement in nasopharyngeal carcinoma. A clinical study comprising 124 cases with special reference to clinical presentation and prognosis.

A review of nasopharyngeal carcinomas (NPCs) treated in the Hacettepe University Hospitals is presented. One hundred twenty-four patients between the ages of 3 years and 72 years were managed in the period 1968-1992. Of these cases, 48 had only cranial nerve (CN) involvement on admission. The most commonly affected CNs were the VIth and the Vth, in that order. The prognostic significance of this finding is obvious, because early diagnosis and treatment is vital in a cancer patient. This study includes retrospective analysis of 124 patients with NPC. The patients were investigated with respect to clinical and radiological diagnosis and outcome. Our results also show that CN involvement in NPC usually requires careful neuro-otological examination. It is suggested that increased knowledge and understanding of the disease among neurosurgeons, neurologists and ENT surgeons would improve the prognosis of patients with NPC.

Salmonella encephalopathy with seizure and frontal intermittent rhythmic delta activity.

A 54-year-old woman was admitted to our clinic with frequent convulsions. Subsequently she developed a toxic look, rigidity, confusion and severe encephalopathy. Salmonella typhii was isolated from the blood cultures and she was diagnosed with Salmonella encephalopathy. The prominent electrophysiological finding was the frontal intermittent rhythmic delta activity (FIRDA) in electroencephalograph (EEG). After treatment EEG revealed normal activity. The presence of FIRDA is not a specific finding but this kind of EEG change has not been reported before. Diffuse encephalopathy due to endotoxins might be the reason. We propose that S. typhii encephalopathy was the cause of FIRDA which is a sign of diffuse encephalopathy.