Evaluation of the efficacy of a new inactivated vaccine against Staphylococcus aureus, Echerchia coli and Mycoplasma bovis mastitis in cows.

Staphylococcus aureus, Escherichia coli and Mycoplasma bovis are the most commonly isolated mastitis pathogens. The aim of this study was to evaluate the efficacy of a new mixed vaccine against mastitis caused by  Staphylococcus aureus, Escherichia coli, and Mycoplasma bovis. For this purpose, a mixed inactivated vaccine was administered subcutaneously to 24 heifers as one dose (2 mL) on the 45th day before birth and the second dose 21 days later. In 9 heifers, 2 mL of PBS was administered as placebo instead of vaccine. Then, heifers were divided into 3 groups as 7 vaccinated and 3 unvaccinated animals. Staphylococcus aureus, Escherichia coli, and Mycoplasma bovis were administered to the groups through intramammary route. Three vaccinated heifers were considered the common control without bacteria in all groups. The parameters considered to assess the effect of vaccination were clinical findings, bacterial count in milk, somatic cell count, and antibody titers. Clinical signs were observed only in the unvaccinated placebo group. Bacteria count and somatic cell count in milk increased in vaccinated and unvaccinated heifers. However, this increase was less in vaccinated animals and gradually returned to the normal level. In the unvaccinated heifers, it was ever high. Serum antibody titers were measured before and after vaccination. Antibody titers were high in vaccinated heifers after vaccination and were negative in unvaccinated heifers. In conclusion, the mixed vaccine had beneficial effect against Staphylococcus aureus, Escherichia coli, and Mycoplasma bovis mastitis and stimulated the immune response of vaccinated heifers.

Stress and sleep quality in palliative care.

OBJECTIVES: Palliative care patients experience problems in sleep quality due to stress, chronic diseases, and physical and psychosocial problems. Our aim is to determine the perceived stress and sleep quality levels of our palliative care patients and their related factors. METHODS: This cross-sectional, descriptive research was conducted between November 2023 and February 2024 at a palliative clinic located in Ankara, Turkey, that is affiliated with a training and research hospital. In the research, a data form, the Perceived Stress Scale and the Pittsburgh Sleep Quality Index were used as data collection instruments. Kolmogorov-Smirnov and Shapiro-Wilk tests, and Mann-Whitney U and Kruskal-Wallis H tests were used for the analysis. RESULTS: The total score on the Perceived Stress Scale was determined to be 35.81±7.45. The total score for Pittsburgh Sleep Quality Index was 13.20±3.20. Significant relationships were found between insufficient self-efficacy scores and habitual sleep efficiency, daytime dysfunction and total Pittsburgh Sleep Quality Index scores. Significant relationships were found between insufficient self-efficacy scores and sleep latency, habitual sleep efficiency, daytime dysfunction and total Pittsburgh Sleep Quality Index scores. CONCLUSIONS: This study determined that certain descriptive characteristics of palliative care patients affect their sleep quality and perceived stress level, as well as that some components of sleep quality and perceived stress level are related. Palliative care is holistic in nature, encompassing symptom management; therefore, the importance of patients' psychosocial integrity should not be overlooked. Consequently, identifying components that may hinder symptom management and addressing the patient comprehensively will be crucial.

Longing for a Voice: A Qualitative Study.

Tracheostomy involves a challenging care process in which both patients and caregivers have difficulty communicating. Loss of speaking ability negatively affects caregivers as well as patients. The objective of this study was to examine the experiences of caregivers of patients with tracheostomy during care and after the first vocal exercise. This is a qualitative interview study using in-depth interviews. We used Colaizzi's method of data analysis. The interviews were carried out with 17 caregivers from March to July 2023. Two main themes were identified: the communication process and the first time hearing the patient's voice. In addition, communication techniques, difficulty in communication, providing motivation, and emotions were considered as subthemes. A better quality of care can be provided by understanding the experiences of caregivers of patients with tracheostomy, by sharing feelings and thoughts, and by using patient-specific communication methods.

Factors influencing the length of stay in the palliative care unit in patients discharged home: results from a tertiary hospital in Turkey

Background/aim: Increased length of stay (LOS) in the palliative care unit (PCU) is a serious burden to the patients and the health care system. The predictors of longer LOS in a PCU have not been reported so far from Turkey. Our aim in this study was to evaluate the factors associated with the LOS in the PCU of a tertiary hospital. Materials and methods: This cross-sectional analysis of a retrospective cohort evaluated adult patients' medical records admitted to the PCU between 2017 and 2019. The main inclusion criteria were 4 or more days of palliative unit stay and being discharged home during the study period. Data on demographics, chronic diseases, mobilization disability, route of feeding, tracheostomy, sleep disturbances, pressure ulcers, and antidepressant use were collected. Potential factors associated with prolonged LOS tertiles were examined by ordinal regression analysis. Results: A total of 287 discharges from the PCU to home were analyzed. Mean (SD) age was 70.5 (15.8) years, and there was a male predominance (55.7%). The majority of patients had malnutrition, mobility limitation, hypertension, malignant disease, and sleep disturbances. Median LOS was 15 days (4­79). Mean age, hypertension, infections, mobilization limitation, tube feeding, permanent tracheostomy, and pressure ulcers increased from the short stay tertile (4­12 days) to the medium stay tertile (13­20 days) and long stay tertile (>21 days) of LOS. Mobilization limitation [p = 0.013, OR: 2.34 (95% CI: 1.19­4.60)], tube feeding [p = 0.001, OR: 2.63 (95% CI: 1.49­4.66)], permanent tracheostomy [p = 0.007, OR: 4.10 (95% CI: 1.48­11.36)], and hypertension diagnosis [p = 0.023, OR: 1.80, (95% CI: 1.09­2.98)] on admission were associated with being in the medium stay or long stay tertiles of LOS compared to the lowest tertile. Conclusion: A longer length of PCU stay is associated with mobilization limitation, tube feeding, permanent tracheostomy, and hypertension. We found no evidence that age, infections or pressure ulcers on admission were associated with extra LOS in the PCU in patients discharged home.