Development and psychometric analysis: Fluoride varnish parent attitude, belief scale.

OBJECTIVE: To develop a scale to determine parents' attitudes and beliefs regarding fluoride varnish. DESIGN AND METHODS: This study had a cross-sectional design and was conducted between 2019 and 2021. A total of 810 parents were included in the study sample. Exploratory factor analysis (EFA), confirmatory factor analysis (CFA), discriminant validity, and convergent validity methods were used to estimate the scale validity. For reliability, the Cronbach alpha coefficient, item-total correlation coefficients, and test-retest method were used. RESULTS: As a result of psychometric analysis, the scale was found to have a three-factor structure. The factor loads of the items were between 0.838 and 0.715. The three-factor construct showed a good fit in confirmatory factor analysis (X2 (41): 110.06, p <.001; RMSEA: 0.065; RMSR, 0.02; GFI, 0.95; and NFI, 0.94). Cronbach's α coefficient on the scale was 0.85. The item-total correlation of the scale was found to be between 0.355 and 0.626. The test-retest intra-class correlation coefficient of the scale was 0.72. CONCLUSIONS: This study suggests that the developed scale is a reliable tool to evaluate the attitudes and beliefs of parents toward fluoride varnish. It is thought that the scale will make a contribution to public health.

UV mutagenesis for lipase overproduction from Bacillus cereus ATA179, nutritional optimization, characterization and its usability in the detergent industry.

In this study, the wild-type Bacillus cereus ATA179 was mutagenized by random UV mutagenesis to increase lipase production. The mutant with maximum lipolytic activity was named Bacillus cereus EV4. The mutant strain (10.6 U/mL at 24 h) produced 60% more enzyme than the wild strain (6.6 U/mL at 48 h). Nutritional factors on lipase production were investigated. Sucrose was the best carbon source, (NH4)2HPO4 was the best nitrogen source and CuSO4 was the best metal ion source. Mutant EV4 showed a 32% increase in lipase production in the modified medium. The optimum temperature and pH were found to be 60 °C and 7.0, respectively. CuSO4, CaCl2, LiSO4, KCl, BaCl2, and Tween 20 had an activating effect on the enzyme. Vmax and Km values were found to be 17.36 U/mL and 0.036 mM, respectively. The molecular weight was determined as 28.2 kDa. The activity of lipase was found to be stable up to 60 days at 20 °C, 75 days at 4 °C, and 90 days at -20 °C. The potential of lipase in the detergent industry was investigated. The enzyme was not affected by detergent additives but was effective in removing stains in fabrics contaminated with oily substances.

Lipase from new isolate Bacillus cereus ATA179: optimization of production conditions, partial purification, characterization and its potential in the detergent industry.

In this study, 341 Bacillus sp. strains were isolated from agricultural soils of Turkey. The potent extracellular lipase producer was selected. It was identified by 16S rRNA, named as Bacillus cereus ATA179. Optimal nutritional and physical parameters for lipase production were determined. Sucrose as the carbon source, (NH4)2HPO4 as the nitrogen source, CaCl2 as the metal ion were obtained. The best results of physical parameters were stated at 45°C, pH 7.0, shaking rate 50 rpm, inoculation amount 7% and inoculum age 24 h. ATA179 strain showed a 51% increase in enzyme production in the modified medium created by optimizing nutritional and physical conditions. Optimum pH value and temperature were found as 6.0 and 55 °C, respectively. CaCl2, Tween 20, Triton X-100 had an activating effect on enzyme activity. Vmax and Km kinetic values were found as 18.28 U/mL and 0.11 mM, respectively. The molecular weight was determined as 47 kDa. Lipase was found to be stable up to 75 days at -20 ºC. The potential of the enzyme in detergent industry was also investigated. It was not affected by detergent additives, but was found to be effective in removing oils from contaminated fabrics. This new lipase may have potential to be used in detergent industry.

Emergency Service Perceptions and Experiences of Patients: "Not A Great Place, But Not Disturbing".

This study was conducted to determine the emergency department experiences and perceptions of a group of patients who applied to the tertiary emergency department. The study was carried out using a qualitative approach. Forty patients who were admitted to the emergency department were included in the study. Data were collected by face-to-face interview. The frequency count (f) and participant codes (P) were used for the presentation of the findings. The themes and frequency counts obtained by analyzing the interviews with the patients were as follows: "Uncertainty/Obscurity: Anxiety and fear (f = 108)," "Waiting/being patient (f = 39)," "Pain and procedures (f = 119)," "Doctor and nurse comforting attitudes (f = 98)," "Being treated and recovering (f = 48)," "Calm and comfortable environment (f = 14)." This study showed that the emergency department is generally perceived as a healing environment, the most important need of the participants is to relieve the anxiety and fear caused by the unknown and the pain they feel.

Factors that predict the perception of spirituality and spiritual care of nurses working in high-risk units and the effect of death anxiety.

PURPOSE: Spirituality contributes to the health and well-being of individuals. This study investigates the factors that predict the spirituality perceptions and the effect of death anxiety of nurses. DESIGN AND METHODS: This was a cross-sectional study, 382 nurses working in four public hospitals intensive care and emergency departments setting in two different cities in Turkey. FINDINGS: Variables predicting the total and subscale scores of the Spirituality and Spiritual Care Rating Scale of nurses were determined by linear multiple regression analysis. Except for the religiousness subscale, the satisfaction level of nurses was found to be a significant predictor in total of Spirituality and Spiritual Care Scale. PRACTICE IMPLICATIONS: Nurses working in high-risk units are unclear about their perception of spirituality and spiritual care.

Adaptation of the Dementia Attitudes Scale into Turkish.

INTRODUCTION: The aim of this study was to assess psychometric properties of the Turkish version of the Dementia Attitudes Scale which is developed to determine attitudes towards dementia. METHODS: 326 volunteered students between the age of 20-44 years, studying in Manisa Celal Bayar University Faculty of Medicine and Faculty of Health Sciences are included in this methodological study. Data of the study were collected with "Demographic Data Form", "Dementia Attitudes Scale" and "UCLA-Geriatrics Attitudes Scale". For the analysis of the data, the SPSS and Lisrel software were used. RESULTS: The Cronbach's alpha coefficient of the Dementia Attitudes Scale is 0.84 which is quite high. Confirmatory factor analysis has supported three factor-structure of the scale: "Supporting attitude", "Accepting attitude" and "Exclusionary attitude". Confirmatory factor analysis revealed goodness of fit coefficients as 0.076 for RMSEA, 2.86 for the chi-square/sd, and 0.93 for CFI. The analysis showed that the adapted scale fits the model very well. The scale can discriminate between demographic characteristics and attitudes to dementia. The scale significantly correlates with UCLA-Geriatric Attitudes Scale measuring attitude towards the elderly. CONCLUSION: Dementia Attitude Scale is a valid and reliable scale that can be used in studies evaluating the attitude towards dementia.

A qualitative study of the operating room experience of patients who underwent surgery under spinal anesthesia: "It was like an adventure".

This study aimed to explore the experiences of the people who underwent orthopedic surgery under spinal anesthesia and to report their feelings and thoughts. The study was carried out using a qualitative approach. Twenty-one patients were interviewed who underwent orthopedic surgery on the first or second postoperative day. Content analysis was performed after the collection of raw data. NVIVO 12 Pro software was used for data analysis. The frequency count (f) and participant codes (P) were used for the presentation of the findings. The themes and frequency counts obtained by analyzing the interviews with the patients were as follows: "Time passed like watching a movie" (f = 213), "Like an adventure" (f = 587), and "See, feel, look" (f = 405). Five of 21 participants (23.8%) stated that they would not recommend spinal anesthesia. The findings generally indicated the anxiety caused by the unknown, fear in the preanesthetic period, operation experienced like an adventure, and a process generally completed with satisfaction.

Reliability and validity of the Turkish version of the Individual-Level Abortion Stigma Scale: a methodological study.

OBJECTIVES: The aim of this study was to assess the reliability and validity of the Turkish version of the Individual-Level Abortion Stigma Scale. SETTING: Three hospitals affiliated to Public Hospitals Union General Secretariat in Manisa, a city located in Western Turkey. DESIGN: This was a methodological study. PARTICIPANTS: A total of 230 women aged 22-49 years who previously underwent abortion and volunteered to participate in the study. PRIMARY AND SECONDARY OUTCOME MEASURES: Data analysis was performed using the SPSS and LISREL software. The Content Validity Index was calculated based on the values obtained from expert opinions. In the reliability analysis, Cronbach's alpha values were calculated for the overall scale and its subscales. To test the stability of the scale over time, the scale was readministered to 30 women in the study 15 days later and the test-retest values (Pearson's correlation coefficients) were determined. In the validity analysis, the exploratory and confirmatory factor analyses were performed. In the exploratory factor analysis, the principal component analysis was performed using the varimax rotation and the factor loading of the scale was examined. Confirmatory factor analysis was performed to investigate the item-factor construct of the scale. RESULTS: The Content Validity Index was calculated as 0.86. The Cronbach's alpha values ranged between 0.83 and 0.94. The item-total correlation coefficients ranged between 0.36 and 0.72, and the test-retest reliability was 0.96 for the overall scale and its subscales (p<0.05). The total variance revealed by five factors was 75%. Confirmatory factor analysis of the scale revealed an acceptable compliance level (root mean square error of approximation=0.092, χ2/df=2.91, Goodness of Fit Index=0.831, Comparative Fit Index=0.928, p<0.001). CONCLUSIONS: The results suggest that this scale has the potential for use in research and clinical settings to measure abortion stigma among women.

The Reflections of Final Year Medical Students About Nursing Home: "Loneliness and Abandonment".

BACKGROUND: Population aging is a global phenomenon with opportunities and challenges. The numbers and proportions of older people are increasing in almost every country. This study aimed to evaluate the perceptions of nursing homes among final-year medical students. METHODS: This qualitative study used the word association test as a data collection tool to obtain the reflections regarding nursing homes among final-year students, and the concept of "nursing homes" was defined in face-to-face interviews of the volunteer students. RESULTS: Analysis of data collected from 51 students regarding nursing homes resulted in five main categories (old age [frequency, f=74], positive affect emotions [f=66], negative affect emotions [f=165], loneliness [f=75], and abandonment [f=46]) based on the reflections that the term "nursing home" evoked among the students. In the present study, the final-year students primarily used more negative expressions. CONCLUSION: Qualitative studies with students, such as those included in the present study, can provide important clues for the development of educational curriculum and social health policies.

The Effect of Abdominal Massage on Constipation in the Elderly Residing in Rest Homes.

Constipation is a health problem commonly seen in the elderly. In the present study, the effect of abdominal massage on constipation in the elderly was examined. The study sample consisted of 22 elderly people residing in a nursing home in the province of Manisa who were suffering from constipation in June 2014 to February 2015. The following were used to collect data: a case identification form; the Rome III Functional Constipation Diagnosis Criteria Form; the Bristol Stool Scale, consisting of the Recall Bias and Visual Scale Analog; and the Standard Diary Constipation Monitoring Form. The comparison of the mean scores obtained before, during, and after the implementation of abdominal massage in the elderly revealed that the number of bowel movements, stool weight, and stool consistency scores increased during and after the implementation. The differences between the mean intra- and postimplementation scores in terms of stool weight and between the pre- and postimplementation mean scores in terms of stool consistency were not statistically significant. There was a statistically significant difference between straining scores except for those obtained during intra- and postimplementation application. It was determined that abdominal massage increased the number of bowel movements, stool weight, and stool consistency, decreased the mean scores for straining, and decreased inability to completely empty the bowels (except on the implementation days).

Perception scale of barriers to contraceptive use: a methodological study.

BACKGROUND: The objective of this study was to design and develop the Perception Scale of Barriers to Contraceptive Use (PSBCU) as a measurement tool for the qualitative assessment of the barriers and obstacles women perceived with regard to contraceptive use or low rates of contraceptive use in women using family planning services. METHOD: The data for this methodological study were collected using the face-to-face interview technique from 320 married women between the ages of 15-49 who were attending clinics at the Hafsa Sultan Hospital, CBU. The data collection tools used in the study, which was carried out from May to September 2014, were the "Introductory Information Form" and the "Perception Scale of Barriers to Contraceptive Use". Language validity and construct validity (explanatory factor analysis) were applied in order to test the validity of the Perception Scale of Barriers to Contraceptive Use. RESULTS: Kaiser Meier Olkin (KMO) analysis was performed to determine the availability of the scale for the size of participants. The sample adequacy calculated as the KMO value was 0.916 and the Bartlett's Test of Sphericity (X2 = 6721.793 p < 0.000) sample size analysis value was found to be sufficient for factor analysis. The total Cronbach's Alpha coefficient of 34 items which included three factors explaining 54.95% of the variance after Varimax rotation was calculated to be 0.95. The largest factor was the "cognitive domain" explaining 18.89% of the variance, followed by the "emotional domain" explaining 18.05% of the variance, and finally the "social domain" explaining 18.01% of the variance. Item-total score correlation coefficients of scale items were found to be between 0.54 and 0.83. CONCLUSIONS: The study demonstrateded that the "Perception Scale of Barriers to Contraceptive Use" was valid and reliable. We believe that the scale is suitable for use by women in a family planning education and training programs in order to evaluate their situation. It should also be assessed for validity and reliability for different groups (adolescents, men, etc.).

Prevalence of urinary incontinence and lower urinary tract symptoms in school-age children.

PURPOSE: To investigate the prevalence of lower urinary tract symptoms (LUTS) and urinary incontinence (UI) in elementary school aged children in Manisa. MATERIALS AND METHODS: Dysfunctional Voiding and Incontinence Scoring System (DVIS) which was developed in Turkey is used. A total of 416 children, 216 (51.9%) male and 200 (48.1%) female were recruited in this study. RESULTS: Mean age of children was 10.35 ± 2.44 years (median10 years). Daytime UI frequency was 6.7% (28 child), nocturnal incontinence 16.6% (69 child) and combined daytime and nocturnal incontinence 4.1% (17 child). There was no statistically significant difference in the prevalence of nocturnal and or daytime UI between male and female gender. Mean DVIS score was 2.65 ± 3.95 and gender did not affect total DVIS points. The mean ages of achieving daytime bowel and bladder control were all significantly correlated with DVIS points. DVIS points were positively correlated with the history of UI of the family. Total points were increased when the father was unemployed. CONCLUSION: UI negatively influences health related quality of life of the family and child, so it is important that awareness of the UI and symptoms of lower urinary tract dysfunction.

Awareness of breast cancer risk factors and practice of breast self examination among high school students in Turkey.

BACKGROUND: Young breast cancer patients have a lower rate of survival than old breast cancer patients due to being diagnosed at advanced stages. Breast self-examination makes women more "breast aware", which in turn may lead to an earlier diagnosis of breast cancer. The purpose of this study was to investigate knowledge and practice of breast self-examination and to determine knowledge of risk factors for breast cancer among high school students. METHODS: This is a descriptive and cross-sectional study. It was conducted in a high school in Manisa, Turkey. The study sample included 718 female high school students. A socio-demographic characteristics data form, knowledge of breast self examination and risk factors for breast cancer form and breast self examination practice form were used to collect data. RESULTS: The female high school students had insufficient knowledge about breast self-examination and a low percentage of students reported that they had performed breast self examination monthly. The most common reason for not doing breast self- examination was "not knowing how to perform breast self-examination" (98.5%). Most of the students had little knowledge of the risk factors for breast cancer. The most widely known risk factor by the students was personal history of breast cancer (68.7%). There was a significant relation between breast self-examination practice and age, school grade, knowledge about breast cancer and knowledge about breast self- examination. CONCLUSION: There is a need to increase knowledge of adolescent females about the risks of breast cancer and benefits of early detection. In fact, health care professionals can develop effective breast health care programs and help young women to acquire good health habits.

The association of self-esteem, depression and body satisfaction with obesity among Turkish adolescents.

BACKGROUND: The purpose of this study was to determine the prevalence of overweight and obesity and to examine the effects of actual weight status, perceived weight status and body satisfaction on self-esteem and depression in a high school population in Turkey. METHODS: A cross-sectional survey of 2101 tenth-grade Turkish adolescents aged 15-18 was conducted. Body mass index (BMI) was calculated using weight and height measures. The overweight and obesity were based on the age- and gender-specific BMI cut-off points of the International Obesity Task Force values. Self-esteem was measured using the Rosenberg Self-Esteem Scale, and depression was measured using Children's Depression Inventory. Logistic regression analysis was used to examine relationships among the variables. RESULTS: Based on BMI cut-off points, 9.0% of the students were overweight and 1.1% were obese. Logistic regression analysis indicated that (1) being male and being from a higher socio-economical level were important in the prediction of overweight based on BMI; (2) being female and being from a higher socio-economical level were important in the prediction of perceived overweight; (3) being female was important in the prediction of body dissatisfaction; (4) body dissatisfaction was related to low self-esteem and depression, perceived overweight was related only to low self-esteem but actual overweight was not related to low self-esteem and depression in adolescents. CONCLUSION: The results of this study suggest that school-based adolescents in urban Turkey have a lower risk of overweight and obesity than adolescents in developed countries. The findings of this study suggest that psychological well-being of adolescents is more related to body satisfaction than actual and perceived weight status is.