Psychological Changes of Music and Fine Arts Students in the Education Process: A Comparative Longitudinal Study.

BACKGROUND: This study aimed to determine the changes in psychological distress, anxiety, and depressive symptoms in students from the fine arts faculty in the first 2 years of their education in Turkey, in comparison with students from other faculties, and to reveal the causes of psychological distress, anxiety, and depression in fine arts students. METHODS: The General Health Questionnaire (GHQ-12), Beck Depression Inventory (BDI), and Spielberger State-Trait Anxiety Inventory (STAI) were applied to students from Faculty of Fine Arts and the Faculties of Economics and Sport Sciences (controls) in the first week of the 2017-2018 academic year. Students also completed a questionnaire measuring their possible stressful life events (at timepoint T1). The process was repeated for the same students in the second year (T2). The changes between the two time¬points were examined prospectively. RESULTS: A total of 96 fine arts students agreed to participate at T1 and 66 at T2 (68.8%); for the controls, it was 259 at T1 and 182 (70.3%) at T2. The fine arts students at T1 included 15 music majors, 45 cinema and television, and 36 handi¬crafts, sculpture, and painting. Their average age at T1 was 21.0 yrs (SD 5.8) and 54.2% were male; for the other students, it was 19.4 yrs (2.7) and 56.0% male. Fine arts students' GHQ-12 score averages increased significantly from T1 to T2 (11.7 to 14.3, p=0.002). Their BDI score averages increased from 10.3 to 12.3 (p=0.044). Moreover, their S-Anxiety score averages increased from 41.1 at T1 to 44.1 at T2 (p=0.008). However, the increase in T-Anxiety scores was not statistically significant. None of the control students' test scores varied between the two timepoints (p>0.05). At T2, for fine arts students, there was no significant difference between female and male students in terms of GHQ-12, BDI, and S-Anxiety scores. However, T-anxiety scores were higher in female students. By linear regression analysis, "worrying about the future (individual)" was found to be a determinant on all scale scores in fine arts students. CONCLUSION: The psychological indicators increased significantly in fine arts students during the first year of their education.

Tolerability and efficacy of second-line antifibrotics in patients with idiopathic pulmonary fibrosis.

BACKGROUND: The antifibrotic drugs nintedanib and pirfenidone reduce disease progression in idiopathic pulmonary fibrosis (IPF) and have also shown to improve survival. Switching first-line antifibrotic drug may required in IPF due to disease progression or intolerable adverse effects. The aim of this study was to assess the safety and efficacy of second-line antifibrotic treatment in patients with IPF. MATERIAL AND METHODS: This retrospective, multicenter study was conducted at three referral interstitial lung disease centers who received first-line antifibrotics more than one month and switched the treatment to a second-line antifibrotic agent during January 2016-June 2021. The drug's safety was evaluated based on the type of adverse effect. Disease progression was defined as an absolute decline in FVC of >10% within 12 months with or without radiological progression. RESULTS: Among 629 consecutive patients with IPF, 66 patients switched antifibrotics. The median duration of antifibrotics was 13 (1-41) months prior to the switch, and 14 (2-42) months after the switch. The mean age was 70.6 ± 8.9 years and, median FVC (%) was 72.1 ± 18.7 at the initiation of first-line antifibrotics. The most common reason for the switch was disease progression (56%) followed by severe adverse effects (SAEs) (44%). SAEs were significantly less observed after the switch compared before the switch (43.9% vs12.1%, respectively, p < 0.001). Eighteen patients had adverse effects due to second-line antifibrotics. Among these patients, 10 had mild adverse effects and 8 had severe adverse effects. While there was no change in the FVC (%) values in 30.3% patients 12 months after the first-line antifibrotic treatment (before the switch), there was no change in the FVC (%) values in 40% patients at the end of 12 months after the switch. Fourteen patients (42.4%) who received antifibrotic treatment before the switch had more than 10% decline in FVC (%) at the end of 12 months. Eight patients (32.0%) had 10% or more decline in FVC (%) 12 months after the switch. CONCLUSION: Patients with IPF who do not tolerate first-line antifibrotic treatment or those showing disease progression despite treatment, switching antifibrotics may be a feasible management strategy.

Depression and Psychological Distress in Medical Students, A Prospective Study.

Introduction: The aim of the study is to determine the changes in psychological distress and depressive symptoms of medical students in the first two years of their education process, in comparison with other faculty students. Methods: All first-year students in the Faculties of Medicine, Economics and Sport Sciences were asked to fill out a detailed self-reported questionnaire aimed at measuring possible stressful life events and habits, General Health Questionnaire (GHQ-12), Beck Depression Inventory (BDI) during the first week of their first semester in 2017-2018. This process was repeated to the same students again in the second year, and the change was examined prospectively. Results: The GHQ-12 score average increased from 11.19 to 13.7 in medical students (p<0.001). The prevalence of psychological distress increased from 53.8% to 61.8%. The BDI score average was 8.04 in the beginning and reached 10.1 in the second year (p<0.001). Depressive symptom prevalence increased from 8.8% to 19.5%. No significant increase was observed in the GHQ-12, BDI score average, depressive symptoms, and psychological distress prevalence of other faculty students. The incidence of depressive symptoms in medical students was 15.9%. As a result of multivariate analysis, "dissatisfaction with social activities" and "exposure to psychological pressure and violence" which were stressful life events were statistically associated with both GHQ-12 and BDI. Conclusion: It was determined that the mental health of the students was negatively affected in the first year of medical school education. It is recommended to raise awareness for medical students at risk of mental illness and to plan interventions that will protect their mental health.

Amyotrophic lateral sclerosis in Antalya, Turkey. A prospective study, 2016-2018.

OBJECTIVE: The aim of the study is to find the prevalence and incidence of amyotrophic lateral sclerosis in Antalya and to define patient characteristics. METHODS: The study represents five major districts in the Antalya metropolitan region, with a population of 1,286,943, which is defined as the provincial center. In cooperation with the neurology departments of all hospitals and private practices, existing cases were identified and new cases were recorded with continuous monitoring. Detailed demographic and clinical features of each patient were recorded, Revised El-Escorial Criteria were used for diagnosis. Incidence and prevalence rates are standardized by age based on USA 2016 population. RESULTS: Point prevalence rates of 2016, 2017 and 2018 are 3.7, 4.7 and 5.4 per hundred thousand, respectively. Standardized prevalence rates for the US population are 5.5, 7.1 and 8.6 per hundred thousand in the same order. The incidence rate in 2017 is 1.4 per hundred thousand, and 2018 is 1.2. Standardized incidence rates for the US population are 2.1 and 1.8 per hundred thousand, respectively. About 75.6% of the cases were classified as definite, 11.0% probable, 11.0% possible, 2.4% probable laboratory-supported. The male/female ratio is 2.0 for total cases and 2.8 for new cases. The site of onset is spinal in 81.7% of patients and bulbar in 18.3%. CONCLUSIONS: ALS rates detected in Antalya and the general features of the disease show similarities with European countries rather than Asian countries and comply with the literature.