Digital Addiction in Children and Affecting Factors.

This study was conducted to identify the digital addiction levels of secondary school students in Northern Cyprus and the factors affecting them. The study was a descriptive, cross-sectional and methodological study. In this study, seven primary and secondary schools were selected randomly in Northern Cyprus and a total of 844 students were included in the study. The children scored 48.12 ± 17.46 points on the "Digital Addiction Scale for Children". Gender, economic status, age, reasons for using the internet, own cell phone, duration of cell phone and computer use, own computer, mother's education and place of residence significantly affected the children's digital addiction level (p < 0.05). Digital tools have entered many areas of our lives and while they have positive and helpful aspects, their negative aspects are coming to light day by day. Especially with the COVID-19 pandemic, digital tools have entered our lives more and children have encountered digital tools at an earlier age. It is thought that there is a need to warn about the negative and harmful effects of digital tools on children and to inform families more about this issue. It is recommended not to ignore the negative effects of digital tools and to implement practices to prevent addiction under parental supervision.

Socially assistive robots in health and social care: Acceptance and cultural factors. Results from an exploratory international online survey.

AIM: This study explored the views of an international sample of registered nurses and midwives working in health and social care concerning socially assistive robots (SARs), and the relationship between dimensions of culture and rejection of the idea that SARs had benefits in these settings. METHODS: An online survey was used to obtain rankings of (among other topics) the extent to which SARs have benefits for health and social care. It also asked for free text responses regarding any concerns about SARs. RESULTS: Most respondents were overwhelmingly positive about SARs' benefits. A small minority strongly rejected this idea, and qualitative analysis of the objections raised by them revealed three major themes: things might go wrong, depersonalization, and patient-related concerns. However, many participants who were highly accepting of the benefits of SARs expressed similar objections. Cultural dimensions of long-term orientation and uncertainty avoidance feature prominently in technology acceptance research. Therefore, the relationship between the proportion of respondents from each country who felt that SARs had no benefits and each country's ratings on long-term orientation and uncertainty avoidance were also examined. A significant positive correlation was found for long-term orientation, but not for uncertainty avoidance. CONCLUSION: Most respondents were positive about the benefits of SARs, and similar concerns about their use were expressed both by those who strongly accepted the idea that they had benefits and those who did not. Some evidence was found to suggest that cultural factors were related to rejecting the idea that SARs had benefits.

Serotype distribution of Streptococcus pneumoniae and pneumococcal vaccine coverage in adults in Turkey between 2015 and 2018.

OBJECTIVE: To evaluate the serotype distribution and antibiotic resistance in pneumococcal infections in adults and to provide a perspective regarding serotype coverage of both current and future pneumococcal vaccines. PATIENTS AND METHODS: This passive surveillance study was conducted with the Streptococcus pneumoniae strains isolated from the specimens of patients with pneumonia (materials isolated from bronchoalveolar lavage), bacteraemia, meningitis, pleuritis and peritonitis between 2015 and 2018. Serogrouping and serotyping were performed by latex particle agglutination and by conventional Quellung reaction using commercial type-specific antisera, respectively. The strains were analysed for penicillin, cefotaxime, erythromycin and moxifloxacin susceptibilities by E-test. RESULTS: In the whole study group (410 samples from adults aged ≥18 years), the most frequent serotypes were 3 (14.1%), 19 F (12%) and 1 (9.3%). The vaccine coverage for PCV13, PCV15, PCV20 and PPV23 was 63.9%, 66.6%, 74.1% and 75.9%, respectively, in all isolates. Penicillin non-susceptibility in invasive pneumococcal disease (IPD) was 70.8% and 57.1% in the patients aged <65 and ≥65 years, respectively. About 21.1% and 4.3% of the patients with and without IPD had cefotaxime resistance. Non-susceptibility to erythromycin and moxifloxacin was 38.2% and 1.2%, respectively. CONCLUSIONS: The results revealed that novel PCV vaccines may provide improved coverage as compared with the currently available vaccine, PCV13. The significant antibiotic resistance rates imply the need to extend the serotype coverage of the vaccines. Continuing the surveillance in pneumococcal diseases is critical to explore the serotype distribution and incidence changes of IPD cases in the population and to inform policy makers to make necessary improvements in the national immunization programmes.Key messagesThis multicentre study demonstrated the most recent serotype distribution and antibiotic resistance in adult population in Turkey.Shifting from PCV13 to novel conjugated vaccines will significantly increase the coverage.Continuing the surveillance in pneumococcal diseases is critical to explore the serotype distribution changes and the incidence of cases with invasive pneumococcal disease in the population.

Enactment of compassionate leadership by nursing and midwifery managers: results from an international online survey.

AIM: To explore the views of an international sample of nursing and midwifery managers concerning attributes that they associate with compassionate management. METHOD: A cross-sectional online survey. Using a snowballing sampling method, 1217 responses were collected from nursing and midwifery managers in 17 countries. A total of complete 933 responses to a question related to which actions and behaviours indicated that a manager was exercising compassionate leadership were analysed for this paper. First, content analysis of the responses was conducted, and second, a relative distribution of the identified themes for the overall sample and for each participating country was calculated. RESULTS: Six main themes were identified describing the attributes of a compassionate leader: (1) Virtuous support, (2) Communication, (3) Personal virtues of the manager, (4) Participatory communication, (5) Growth/flourishing/ nurturing and (6) Team cohesion. The first three themes mentioned above collectively accounted for 63% of the responses, and can therefore be considered to be the most important characteristics of compassionate management behaviour. CONCLUSION: The key indicators of compassionate management in nursing and midwifery which were identified emphasise approachability, active and sensitive listening, sympathetic responses to staff members' difficulties (especially concerning child and other caring responsibilities), active support of and advocacy for the staff team and active problem solving and conflict resolution. While there were differences between the countries' views on compassionate healthcare management, some themes were widely represented among different countries' responses, which suggest key indicators of compassionate management that apply across cultures.

Investigation of the relationship between periodontal and systemic inflammation in children with Sickle Cell Disease: A case- control study.

Periodontal diseases are chronic inflammatory diseases and tissue destruction increases with oxidative stress in periodontal tissues. Periodontal diseases are associated with systemic diseases such as diabetes, cardio-vascular diseases and rheumatoid arthritis by means of systemic inflammation. Sickle cell disease (SCD) is a chronic inflammatory disease in which vaso-occlusive crisis and endothelial dysfunction are present. It is not known whether the chronic systemic inflammation seen in SCD affect periodontal tissues. The aim of this study was to investigate the relationship between periodontal and systemic inflammation in children with SCD. Forty-three children with SCD and 43 healthy children were included in the study. Physical, dental and periodontal statuses were examined, blood and saliva samples were taken. Levels of pro-inflammatory and oxidative stress mediators in serum and saliva were evaluated. The periodontal findings of the groups were similar. The majority of the subjects in both groups had gingival inflammation. In SCD group, significantly higher serum high sensitive C-reactive protein (Hs-CRP), interleukin (IL)-6, IL-8, tumor necrosis factor (TNF)-α, total oxidant status (TOS), nitric oxide (NO) and salivary IL-6 were observed (p < 0.05). There were positive correlations between salivary IL-6 levels and serum Hs-CRP levels (r = 0.303, p < 0.05). In addition; it was determined that salivary IL-6, TNF-α and NO levels were increased 3-6 times in children with a history of painful crisis or acute chest syndrome compared to children who had never had a painful crisis or acute chest syndrome. Although, observed oral health status was similar in both groups, salivary cytokine levels were increased in children with SCD. The higher salivary cytokine levels may be associated with chronic systemic inflammation and vaso-occlusion observed in children with SCD.

Compassion fatigue in nurses and influencing factors.

PURPOSE: To investigate compassion fatigue in nurses and the factors influencing the condition. DESIGN AND METHODS: This descriptive, comparative, and cross-sectional study was conducted in state and university hospitals in the Turkish Republic of Northern Cyprus. A purposive sampling method was used. FINDINGS: Almost all of the nurses have experienced low to moderate levels of compassion fatigue. Factors affecting the severity include age, years of seniority, service, marital status, children, and type of hospital. PRACTICE IMPLICATIONS: Recommendations for reducing compassion fatigue are as follows: establishing clinical practice policies that reduce the development and possible consequences of compassion fatigue in addition to education and resilience training.

[Investigation of Fosfomycin Susceptibility in Extended Spectrum Beta-Lactamase Producing Enteric Bacteria by Disk Diffusion, Automated System and Agar Dilütion Kit]. / Genislemis Spektrumlu Beta-Laktamaz Üreten Enterik Bakterilerde Fosfomisin Duyarliliginin Disk Difüzyon, Otomatize Sistem ve Agar Dilüsyon Kiti ile Arastirilmasi.

Due to the increase of bacteria that develop resistance to classical antibiotics in recent years, fosfomycin has become one of the antibiotics gaining importance again. Fosfomycin exerts its bactericidal effect on many bacteria by binding to a cytoplasmic enzyme, MurA, and inhibiting the enzyme enopurivil transferase, which is involved in peptidoglycan synthesis. Bacteria producing ESBL are common pathogens in nosocomial infections and resistance is frequently encountered in their treatment. Fosfomycin is considered as an alternative drug in these infections. With its reintroduction, it is important to establish reliable and reproducible susceptibility testing methods for fosfomycin. In this study, it was aimed to evaluate the utility of disk diffusion, agar dilution kit and automated MicroScan methods (Beckman Coulter, Brea, CA, ABD) for fosfomycin susceptibility of ESBL-producing enteric bacteria. The study included 120 ESBL positive isolates of enteric bacteria (89 Escherichia coli, 31 Klebsiella pneumoniae) cultivated from the samples sent to the Microbiology Laboratory of the Mersin University Medical Faculty of Medicine Hospital between May 2019 and November 2019. Fosfomycin susceptibilities of the isolates included in the study were tested by disk diffusion, automated MicroScan and the commercial agar dilution kit. In the study, 37 (30.8%) of 120 isolates were determined as resistant to fosfomycin by disk diffusion method and six (5%) of the isolates were found to be resistant to fosfomycin with the MicroScan automatized system. With the agar dilution kit, 11 (9.1%) of 120 isolates were found to be resistant as the minimum inhibitory concentration (MIC) values were > 32 µg/ml. Fosfomycin resistance was significantly higher in K.pneumoniae isolates than E.coli isolates by agar dilution method (p= 0.006). Ertapenem resistance was detected in seven of 120 isolates. All seven isolates that were resistant to ertapenem were susceptible to fosfomycin by agar dilution method. All three isolates, which were found resistant to colistin, were susceptible to fosfomycin by agar dilution method. In the study, the categorical agreement of the disk diffusion and MicroScan methods in E.coli isolates with the agar dilution was high and the error rates were low. For K.pneumoniae, categorical concordance was calculated as 22.5% for disk diffusion test and 74.1% for MicroScan, while major and minor error rates were found to be quite high. As a result; fosfomycin is thought to be an alternative drug option in the treatment of infections caused by especially carbapenem and colistin resistant bacteria, with its high activity on ESBL-producing enteric bacteria. It has been determined that there is a great agreement between the agar dilution, which is the reference method for the determination of fosfomycin resistance for E.coli, and the MicroScan and disk diffusion methods, and that the disk diffusion method which provides ease of use in terms of cost and labor compared to the agar dilution method, can be used as a reliable method. However, it has been demonstrated that the agar dilution method should be used in K.pneumoniae isolates. Nevertheless; It was concluded that if the automatized system is used in laboratories where agar dilution cannot be performed, the results should be interpreted carefully, since the error rates are very high.

The Importance of Being a Compassionate Leader: The Views of Nursing and Midwifery Managers From Around the World.

INTRODUCTION: Despite the importance of compassionate leadership in health care, many of the existing publications do not account for the effect of culture. The aim of this study is to explore the views of nursing and midwifery managers from different countries in relation to the definition, advantages, and importance of compassion. METHODOLOGY: A cross-sectional, descriptive, exploratory online survey was conducted across 17 countries, containing both closed and open-ended questions. Data from N = 1,217 respondents were analyzed using a directed hybrid approach focusing only on qualitative questions related to compassion-giving. RESULTS: Four overarching themes capture the study's results: (1) definition of compassion, (2) advantages and importance of compassion for managers, (3) advantages and importance of compassion for staff and the workplace, and (4) culturally competent and compassionate leadership. DISCUSSION: Innovative research agendas should pursue further local qualitative empirical research to inform models of culturally competent and compassionate leadership helping mangers navigate multiple pressures and be able to transculturally resonate with their staff and patients.

Attitudes of three generations of women toward gender roles.

PURPOSE: This study was conducted to investigate the attitudes of three generations of women regarding gender roles. DESIGNS AND METHODS: In this study, 58 female students, their mothers, and grandmothers participated. Percentages and means, χ2 test, Kruskal Wallis test, and multiple regression analysis were used to analyze the data. FINDINGS: The findings obtained in this study showed that 91.5% of the students, 89.8% of the mothers, and 84.6% of the grandmothers had an egalitarian attitude regarding gender roles. The egalitarian attitudes of students were affected onefold by the attitudes of mothers, whereas grandmothers' attitudes affected the attitudes of students 1.1 times. These two variables explain 48% of the status of having egalitarian attitudes of the students. PRACTICAL IMPLICATIONS: Students had more traditional attitudes regarding gender roles than their mothers and grandmothers.

[Dihydropteroate Synthase (DHPS) Gene Mutations and Mitochondrial Large Subunit (mtLSU) rRNA Genotype Variations in Pneumocystis jirovecii Strains]. / Pneumocystis jirovecii Izolatlarinin Dihidropteroat Sentaz (DHPS) Gen Mutasyonlari ve Mitokondriyal Büyük Alt Birim (mtLSU) rRNA Genotip Varyasyonlarinin Belirlenmesi.

Pneumocystis jirovecii is an atypical fungus that causes Pneumocystis pneumonia (PCP) in HIV/AIDS and immunocompromised patients. Antibiotics containing sulfa and sulfone groups are widely used in PCP prophylaxis and treatment. Especially, long-term use of trimethoprim sulfamethoxazole (TMP-SMX) is known to cause certain point mutations associated with drug resistance in the P.jirovecii dihydropteroate synthase (DHPS) gene. In addition, DHPS and mitochondrial large subunit (mtLSU) rRNA genotype characterization provides important data on the epidemiology of P.jirovecii. In this study, it was aimed to investigate the DHPS and mtLSU rRNA gene polymorphisms of P.jirovecii strains isolated from immunocompromised patients in Mersin University Hospital. In this study, 16 P.jirovecii positive samples, which isolated from 96 patients samples, between August 2016 and February 2018, were included. P.jirovecii mtLSU rRNA genotypes were determined by sequence analysis according to polymorphisms at the 85th and 248th nucleotide positions. Nested PCR and RFLP method was applied for mutation analysis of DHPS locus, 165th and 171st nucleotide positions. In the DHPS mutation analysis, 12/16 (75%) wild type (W165/W171) and 4/16 (25%) mutant type (M165/W171) were detected. Two mutant types belonged to HIV/AIDS positive patients with PCP and had a history of prophylaxis; the other 2 mutant types belonged to patients with colonization. In the study, a history of prophylaxis in 3 (19%) of the 16 patients were recorded, and mutant type was detected in these 2 of 3 patients. According to mtLSU-rRNA analysis, 3 different genotypes were obtained from 16 P.jirovecii isolates. In our region, genotype 2 (43.75%; n= 7) was the most common genotype, genotype 1 (37.5%; n= 6) was the second common and genotype 3 (18.75%; n= 3) was the least one. Genotype 4 was not detected in our region. When DHPS and mtLSU-rRNA were evaluated as multilocus, five different genotypes were observed. As a result, these findings provided important data on P.jirovecii epidemiology in our region and potential drug-resistant strains showed a risk of transmission in immunosuppressive patients. Multicenter studies involving more P.jirovecii isolates are needed to better define the epidemiology of P.jirovecii in our region and in our country.

[Investigation of Pneumocystis jirovecii Infection and Colonization in Immunocompromised Patients with Pneumonia]. / mmün Sistemi Baskilanmis Pnömonili Hastalarda Pneumocystis jirovecii Enfeksiyon ve Kolonizasyonlarinin Arastirilmasi.

Pneumocystis jirovecii is an atypical fungus that causes P.jirovecii pneumonia (PCP) in immunocompromised patients. Currently, while the incidence of AIDS-related PCP is decreasing, PCP has become more common in HIV-negative immunosuppressive patients as a result of increased diseases requiring immunosuppressive therapy. In this study, it was aimed to investigate PCP and colonizations by microscopy, polymerase chain reaction (PCR) and Krebs von den Lungen-6 (KL-6) tests in symptomatic immunosuppressive inpatients with the sign of radiologically atypical pneumonia in Mersin University Hospital. A total of 96 patients, between August 2016 and February 2018 were included in the study. Seventy two (75%) of the 96 patients were under immunosuppressive therapy. P.jirovecii was investigated in the respiratory tract samples [sputum (n= 88), tracheal aspirate (n= 6) and bronchoalveolar lavage (n= 2)] by mtLSUrRNA nested PCR and microscopic staining methods [immunofluorescence assay (IFA), Toluidine Blue O (TBO)], and KL-6 levels were tested in serum samples. P.jirovecii was detected in 16 (16.7%) samples by PCR, in five (5.2%) samples by IFA, in three (3.1%) samples by TBO stain method. When IFA was taken as a reference test, sensitivity and specificity of TBO and PCR were calculated as 60% and 100%; 100% and 87.9%, respectively. In P.jirovecii PCR positive patients, the distribution of underlying diseases; cancer (n= 6), hematological malignancy (n= 3), HIV/AIDS (n= 3), COPD (n= 2), and interstitial lung disease (n= 2) were found as 11 (68.75%) of the 16 positive patients, received immunosuppressive therapy (HIV positive non-Hodgkin lymphoma); of the 3 (18.75%) patients of were immunocompetent, and only 2 (12.5%) were HIV/AIDS. Five of the 16 PCR positive the patients that have positive microscopic examination were definited PCP [HIV/AIDS (n= 3), lung cancer (n= 1), interstitial lung disease (n= 1)]; three patients were PCR positive and microscopy negative probable PCP [multiple myeloma (n= 1), interstitial lung disease (n= 1), cholangiocellular carcinoma (n= 1)] and eight other patients were identified as colonized. In the study, when the frequency of the detection of P.jirovecii was evaluated according to the underlying diseases, it was found statistically significantly higher only in HIV/AIDS patients (p= 0.012). When KL-6 was evaluated among the patients defined as PCP/possible PCP and colonization, sensitivity and specificity were determined as 62.5% and 75%, respectively. As a result, nested PCR method was found as sensitive and successful for the detection of P.jirovecii from sputum samples. KL-6 test was not found sufficient for the differentiation of colonization and the infection in PCR positive patients. The results obtained in the study showed that PCP should be on the differential diagnosis list according to the immune status and the clinical features of the inpatients. More researchs are required with more patients to achieve for detailed reliable results in these groups. In addition, molecular epidemiological studies related to genotyping and resistance against anti-PCP drugs are needed to understand P.jirovecii infections in our region and country.

Serotype distribution of Streptococcus pneumonia in children with invasive disease in Turkey: 2015-2018.

Objectives: To determine the serotype distribution of pneumococcus causing invasive pneumococcal disease (meningitidis, bacteremia and empyema) in children in Turkey, and to observe potential changes in this distribution in time to guide effective vaccine strategies. Methods: We surveyed S. pneumoniae with conventional bacteriological techniques and with real-time polymerase chain reaction (RT-PCR) in samples of cerebrospinal fluid (CSF), blood and pleural fluid. S. pneumoniae strains were isolated from 33 different hospitals in Turkey, which are giving health services to approximately 60% of the Turkish population. Results: A total of 167 cases were diagnosed with invasive pneumococcal disease between 2015 and 2018. We diagnosed 52 (31.1%) patients with meningitis, 104 (62.2%) patients with bacteremia, and 11 (6.6%) patients with empyema. Thirty-three percent of them were less than 2 years old and 56% less than 5 years old. Overall PCV13 serotypes accounted for 56.2% (94/167). The most common serotypes were 19 F (11.9%), 1 (10.7%) and 3 (10.1%). Conclusions: Besides the increasing frequency of non-vaccine serotypes, vaccine serotypes continue to be a problem for Turkey despite routine and high-rate vaccination with PCV13 and significant reduction reported for the incidence of IPD in young children. Since new candidate pneumococcal conjugate vaccines with more serotype antigens are being developed, continuing IPD surveillance is a significant source of information for decision-making processes on pneumococcal vaccination.

Topics of Addiction in Turkish Nursing Programs: A Summary.

Addiction is a serious health issue. The measured rates of substance abuse in Turkey are lower than those in Western countries; however, recent studies show a significant increase in the prevalence of substance abuse and that the age of onset of substance abuse has decreased. There is a lack of literature about the topic of addiction in the undergraduate nursing programs in Turkey. Therefore, the aim of this current study was to examine the presence of addiction content in nursing education in Turkey among state and foundation universities.A descriptive, survey research design was used in this study. One hundred twelve state universities and 64 foundation universities that provide undergraduate education in Turkey were screened using the database of the Council of Higher Education. Researchers found that 89.09% of the state universities and all the foundation universities included the topic of addiction and/or substance addiction somewhere in their undergraduate nursing programs. The courses were primarily elective courses, and availability of the coursework varied. Given the impact of substance and process addictions, the authors conclude with a recommendation that the topic of addiction be offered as a discrete, mandatory course in the undergraduate nursing curricula of all universities offering nursing programs.

A Study of Bullying Against Nursing Students.

BACKGROUND: Many institutions have conducted research on the subject of bullying. The literature includes many studies of the effects of widespread bullying among primary and secondary school students. Bullying against hospital nurses and also bullying against university students are well-known and frequently discussed research topics. Yet, the exposure of nursing students to bullying has not been sufficiently explored, and few studies have focused on the issue of bullying against nursing students. PURPOSE: The aim of this study is to examine bullying against nursing students, including the rate of bullying, types of bullying, and responses to the negative effects of bullying. METHODS: This study was conducted on 202 nursing students (including sophomores, juniors, and seniors) during the 2013-2014 academic year. The participation rate was 88.5%. The Negative Attitudes Scale was used to collect data, and descriptive statistics were used in data analysis. RESULTS: Participants were evenly distributed between women (49.5%) and men (50.5%). The median age of participants was 21.58 ± 2.28 years; the frequency of bullying was 78.1%. The types of bullying were pejorative statements about the nursing profession (11.3%); low grades used as a form of punishment (9.9%); work, homework, and job rotation used as punishment in lieu of training (9.4%); impossible workloads (9.0%); and the spreading of rumors and gossip (7%). CONCLUSIONS/IMPLICATIONS FOR PRACTICE: This study indicates that the participants were exposed to high levels of bullying. As exposure to bullying negatively affects the job attitudes of nursing students, further studies are necessary to develop strategies to prevent horizontal bullying.

Transseptal suturing technique in septoplasty: impact on bacteremia and nosocomial colonization.

Although effects of Merocel® nasal packs and silicone splints on nasal flora alterations and bacteremia formation after septoplasty were assessed before, the effect of transseptal suturing technique has not been studied yet. The objective of this study is to compare nasal flora alterations and bacteremia occurrence rates between Merocel packs, silicone splints, and transseptal suturing technique in septoplasty. Ninety patients were divided into three groups randomly: Merocel packing (Group M), silicone splint (Group S), and transseptal suturing without packing (Group T). Group M and S received prophylactic antibiotics and antibiotic pomade application to packs, whereas neither antibiotic prophylaxis nor topical pomade was applied to Group T. Preoperative, after pack removal and 1 month after pack removal nasal swab cultures and preoperative, immediately after surgery and 24 h after surgery blood cultures were taken from all patients. Group M increased Methicillin-sensitive Staphylococcus aureus (MSSA) colonization (p = 0.003) and decreased normal flora colonization (p = 0.038), whereas Group S and T did not affect MSSA or normal flora colonization (p > 0.05). Antibiotic prophylaxis did not affect MSSA colonization (p = 0.14), whereas decreased normal flora colonization (p = 0.029). Transseptal suturing did not prevent bacteremia formation. Postoperative increasing of MSSA colonization in nasal cavity for septoplasty patients can be prevented by using transseptal suturing technique or silicone splints instead of Merocel packing, rather than applying prophylactic antibiotic treatment. Using transseptal suturing does not prevent bacteremia formation during septal surgery. These findings should be kept in mind to prevent postoperative life-threatening infective complications of septoplasty especially in immunosuppressive patients and patients with cardiovascular diseases.

Exploring Nurses' Meaning and Experiences of Compassion: An International Online Survey Involving 15 Countries.

PURPOSE: In recent years, there has been much focus on compassion in nursing care, and concern has been raised in a number of reports and media stories regarding decreased compassion. The aim of this study was to explore similarities and differences in the understanding and demonstration of compassion in nursing practice across 15 countries. DESIGN: A total of 1,323 nurses from 15 countries responded to questions in relation to compassion, via an international online survey. RESULTS: The data revealed the impact of sociopolitical influences on perceptions of compassion, and the conscious and intentional nature of compassion. DISCUSSION AND CONCLUSION: The study demonstrated shared understandings of the importance of compassion as well as some common perceptions of the attributes of compassionate care. The differences reported were not as significant as had been expected. IMPLICATIONS FOR PRACTICE: Further research is needed to explore the country and culture differences in the enactment of compassion.

Job satisfaction and burnout among paediatric nurses.

PURPOSE: This study aims to determine factors of job satisfaction and burnout levels of paediatric nurses. METHODS: A total of 165 nurses working in paediatric clinics completed the Minnesota job satisfaction scale and the Maslach burnout scale. FINDINGS: Average scores of the emotional exhaustion and depersonalisation score were low, while personal accomplishment scores were high. A high level of job satisfaction, being married, increased age and a decreased number of assigned patients were significantly associated with a low level of burnout. CONCLUSIONS: Paediatric nurses experience burnout at significant levels. The most important variable that affected job satisfaction was income. IMPLICATIONS FOR NURSING PRACTICE: The results of the study could guide development of strategies that might prevent or alleviate burnout of paediatric nurses.

The Value of E-Learning for the Prevention of Healthcare-Associated Infections.

BACKGROUND Healthcare workers (HCWs) lack familiarity with evidence-based guidelines for the prevention of healthcare-associated infections (HAIs). There is good evidence that effective educational interventions help to facilitate guideline implementation, so we investigated whether e-learning could enhance HCW knowledge of HAI prevention guidelines. METHODS We developed an electronic course (e-course) and tested its usability and content validity. An international sample of voluntary learners submitted to a pretest (T0) that determined their baseline knowledge of guidelines, and they subsequently studied the e-course. Immediately after studying the course, posttest 1 (T1) assessed the immediate learning effect. After 3 months, during which participants had no access to the course, a second posttest (T2) evaluated the residual learning effect. RESULTS A total of 3,587 HCWs representing 79 nationalities enrolled: 2,590 HCWs (72%) completed T0; 1,410 HCWs (39%) completed T1; and 1,011 HCWs (28%) completed T2. The median study time was 193 minutes (interquartile range [IQR], 96-306 minutes) The median scores were 52% (IQR, 44%-62%) for T0, 80% (IQR, 68%-88%) for T1, and 74% (IQR, 64%-84%) for T2. The immediate learning effect (T0 vs T1) was +24% (IQR, 12%-34%; P300 minutes yielded the greatest residual effect (24%). CONCLUSIONS Moderate time invested in e-learning yielded significant immediate and residual learning effects. Decision makers could consider promoting e-learning as a supporting tool in HAI prevention. Infect Control Hosp Epidemiol 2016;37:1052-1059.

Serotype distribution of Streptococcus pneumoniae in children with invasive diseases in Turkey: 2008-2014.

Successful vaccination policies for protection from invasive pneumococcal diseases (IPD) dependent on determination of the exact serotype distribution in each country. We aimed to identify serotypes of pneumococcal strains causing IPD in children in Turkey and emphasize the change in the serotypes before and after vaccination with 7-valent pneumococcal conjugate vaccine (PCV-7) was included and PCV-13 was newly changed in Turkish National Immunization Program. Streptococcus pneumoniae strains were isolated at 22 different hospitals of Turkey, which provide healthcare services to approximately 65% of the Turkish population. Of the 335 diagnosed cases with S. pneumoniae over the whole period of 2008-2014, the most common vaccine serotypes were 19F (15.8%), 6B (5.9%), 14 (5.9%), and 3 (5.9%). During the first 5 y of age, which is the target population for vaccination, the potential serotype coverage ranged from 57.5 % to 36.8%, from 65.0% to 44.7%, and from 77.4% to 60.5% for PCV-7, PCV-10, and PCV-13 in 2008-2014, respectively. The ratio of non-vaccine serotypes was 27.2% in 2008-2010 whereas was 37.6% in 2011-2014 (p=0.045). S. penumoniae serotypes was less non-susceptible to penicillin as compared to our previous results (33.7 vs 16.5 %, p=0.001). The reduction of those serotype coverage in years may be attributed to increasing vaccinated children in Turkey and the increasing non-vaccine serotype may be explained by serotype replacement. Our ongoing IPD surveillance is a significant source of information for the decision-making processes on pneumococcal vaccination.

Association of Personality Traits and Risk of Internet Addiction in Adolescents.

PURPOSE: This cross-sectional, descriptive study analyzes the association between personality traits and internet addiction in adolescents. METHODS: The study was conducted with 328 adolescents attending two high schools in the Aegean region of Turkey. The data were collected using a sociodemographic information questionnaire, the Internet Addiction Scale and the Adjective Based Personality Scale from students who gave their informed consent to participate. Data were assessed by descriptive statistics, t tests, and logistic regression analysis, using SPSS software. RESULTS: The students had an average age of 16.43 ± 1.47 years and 40.5% were female. The percentage of subjects at risk of internet addiction was 15.9% (n = 52), and 42.4% (n = 22) of them reported that the amounts of time they spent online was acceptable. We found statistically significant differences in the average subdimensional scores for extraversion (t = 2.310, p < .050) and openness to experience (t = 3.35, p < .001), and between students at risk of internet addiction (n = 52) and those who were not (n = 276). CONCLUSIONS: Adolescents who were found to be at risk of internet addiction nevertheless reported on the survey questionnaires that the amount of time they spent online was acceptable. The study determined that participants' risk of internet addiction was associated with their levels of extraversion and openness to experience.