Feasibility of virtual reality and comparison of its effectiveness to biofeedback in children with Duchenne and Becker muscular dystrophies.

INTRODUCTION/AIMS: The utilization of virtual reality (VR) and biofeedback training, while effective in diverse populations, remains limited in the treatment of Duchenne and Becker muscular dystrophies (D/BMD). This study aimed to determine the feasibility of VR in children with D/BMD and compare the effectiveness of VR and biofeedback in children with D/BMD. METHODS: The study included 25 children with D/BMD. Eight children in the control group participated in a routine follow-up rehabilitation program, while the remaining children were randomly assigned to the VR (n = 9) and biofeedback (n = 8) groups for a 12-week intervention. The following evaluations were performed before, during (week 6), and after treatment: Muscle pain and cramps, laboratory studies, muscle strength, timed performance, function (Motor Function Measurement Scale-32, Vignos, and Brooke Scales), and balance (Pediatric Functional Reach Test and Balance Master System). Motivation for rehabilitation was determined. RESULTS: The median ages were 9.00 (VR), 8.75 (biofeedback), and 7.00 (control) years. The study found no significant differences between groups in pretreatment assessments for most measures, except for tandem step width (p < .05). VR and biofeedback interventions significantly improved various aspects (pain intensity, cramp frequency, cramp severity, muscle strength, timed performance, functional level, and balance) in children with D/BMD (p < .05), while the conventional rehabilitation program maintained patients' current status without any changes. The study found VR and biofeedback equally effective, with VR maintaining children's motivation for rehabilitation longer (p < .05). DISCUSSION: The study showed that both VR and biofeedback appear to be effective for rehabilitation this population, but additional, larger studies are needed.

Artemisinin May Disrupt Hyphae Formation by Suppressing Biofilm-Related Genes of Candida albicans: In Vitro and In Silico Approaches.

This study aimed to assess the antifungal and antibiofilm efficacy of artemisinin against Candida (C.) species, analyze its impact on gene expression levels within C. albicans biofilms, and investigate the molecular interactions through molecular docking. The antifungal efficacy of artemisinin on a variety of Candida species, including fluconazole-resistant and -susceptible species, was evaluated by the microdilution method. The effect of artemisinin on C. albicans biofilm formation was investigated by MTT and FESEM. The mRNA expression of the genes related to biofilm was analyzed by qRT-PCR. In addition, molecular docking analysis was used to understand the interaction between artemisinin and C. albicans at the molecular level with RAS1-cAMP-EFG1 and EFG1-regulated genes. Artemisinin showed higher sensitivity against non-albicans Candida strains. Furthermore, artemisinin was strongly inhibitory against C. albicans biofilms at 640 µg/mL. Artemisinin downregulated adhesion-related genes ALS3, HWP1, and ECE1, hyphal development genes UME6 and HGC1, and hyphal CAMP-dependent protein kinase regulators CYR1, RAS1, and EFG1. Furthermore, molecular docking analysis revealed that artemisinin and EFG1 had the highest affinity, followed by UME6. FESEM analysis showed that the fluconazole- and artemisinin-treated groups exhibited a reduced hyphal network, unusual surface bulges, and the formation of pores on the cell surfaces. Our study suggests that artemisinin may have antifungal potential and showed a remarkable antibiofilm activity by significantly suppressing adhesion and hyphal development through interaction with key proteins involved in biofilm formation, such as EFG1.

Bayesian interpretation of the prefrontal P2 ERP component based on stimulus/response mapping uncertainty.

The brain can be seen as a predictive system continuously computing prior information to guess posterior probabilities minimizing sources of uncertainty. To test this Bayesian view of the brain, event-related potentials (ERP) methods have been used focusing on the well-known P3 component, traditionally associated with decision-making processes and sources of uncertainty regarding target probability. Another ERP component linked with decision-making is the prefrontal P2 (pP2) component, which has never been considered within the Bayesian framework. To test which source of uncertainty could be associated with the pP2, uncertainty induced by target probability and stimulus-response (S/R) mapping were modulated in three visuomotor tasks. Results showed that the pP2 had the largest amplitude in the task with the largest uncertainty regarding the S/R mapping and degraded as the S/R mapping became more predictable. The P3 was maximal in the tasks with larger uncertainty regarding the target probability. While we confirmed the P3 association with target probability, we extended our knowledge on the pP2 associating it with S/R mapping uncertainty. This component, which has been previously localized within the anterior insular cortex, may minimize S/R mapping uncertainty allowing response-related evidence accumulation and comparing current events with internal representations to extract action-related probabilities.

Factors and Processes Facilitating Recovery from Coercion in Mental Health Services-A Meta-Ethnography.

BACKGROUND: Being subjected to or witnessing coercive measures in mental health services can have a negative impact on service users, carers and professionals, as they most often are experienced as dehumanising and traumatic. Coercion should be avoided, but when it does happen, it is important to understand how the experience can be processed so that its consequences are managed. METHOD: A systematic review and meta-ethnography was used to synthesise findings from qualitative studies that examined service users', staff's and relatives' experiences of recovery from being exposed to coercive measures in mental health care settings. We identified, extracted and synthesised, across 23 studies, the processes and factors that were interpreted as significant to process the experience. RESULTS: Recovery from coercion is dependent on a complex set of conditions that support a sense of dignity and respect, a feeling of safety and empowerment. Being in a facilitating environment, receiving appropriate information and having consistent reciprocal communication with staff are the means through which these conditions can be achieved. People employ strategies to achieve recovery, both during and after coercion, to minimise its impact and process the experience. CONCLUSIONS: The findings point to the importance of mental health care settings offering recovery-oriented environments and mental health professionals employing recovery-oriented practices, that would empower service users to develop strategies for managing their mental distress as well as their experiences in mental health care in a way that minimises traumatisation and fosters recovery.

Dual task impact on functional mobility and interaction of functional level and balance in patients with Duchenne muscular dystrophy.

BACKGROUND: Dystrophin, a protein crucial for various brain regions governing higher-order functions like learning and memory is notably absent in individuals with Duchenne muscular dystrophy (DMD). This absence of dystrophin in the brain is believed to underlie cognitive challenges in DMD. Cognitive and motor challenges observed in DMD could potentially hinder the execution of dual tasks. RESEARCH QUESTION: Is there a significant correlation between dual-task performance, functional mobility, and balance in children with DMD? METHOD: The study included 28 participants (14 DMD, 14 typical development). Timed Up and Go (TUG) test results were recorded for single and dual-task conditions (motor-motor, cognitive-motor). Functional level was assessed using Motor Function Measurement-32 (MFM-32), Brooke Upper Extremity Scale, and Vignos Scale. Balance was evaluated using Balance Master System and Pediatric Functional Reach Test (PFRT). RESULTS: Significant differences in TUG test scores across conditions were observed in both DMD and typical development groups (p < 0.05). Children with DMD exhibited longer completion times compared to typical development children (p < 0.05). Among children with DMD, there was a significant correlation between TUG scores in different task conditions and balance assessment (p < 0.05, r = 0.571 to -0.819). Lower MFM-32 scores in DMD children were correlated with worse TUG performance across conditions (p < 0.05, r = 0.586 to -0.868). SIGNIFIANCE: This study sheds light on the multifaceted nature of dual-tasking challenges in individuals with DMD, thereby contributing to a deeper understanding of the implications for rehabilitation strategies.

Effect of anticipatory multisensory integration on sensory-motor performance.

Multisensory integration (MSI) is a phenomenon that occurs in sensory areas after the presentation of multimodal stimuli. Nowadays, little is known about the anticipatory top-down processes taking place in the preparation stage of processing before the stimulus onset. Considering that the top-down modulation of modality-specific inputs might affect the MSI process, this study attempts to understand whether the direct modulation of the MSI process, beyond the well-known sensory effects, may lead to additional changes in multisensory processing also in non-sensory areas (i.e., those related to task preparation and anticipation). To this aim, event-related potentials (ERPs) were analyzed both before and after auditory and visual unisensory and multisensory stimuli during a discriminative response task (Go/No-go type). Results showed that MSI did not affect motor preparation in premotor areas, while cognitive preparation in the prefrontal cortex was increased and correlated with response accuracy. Early post-stimulus ERP activities were also affected by MSI and correlated with response time. Collectively, the present results point to the plasticity accommodating nature of the MSI processes, which are not limited to perception and extend to anticipatory cognitive preparation for task execution. Further, the enhanced cognitive control emerging during MSI is discussed in the context of Bayesian accounts of augmented predictive processing related to increased perceptual uncertainty.

A Nonpharmacologic Treatment for Anxiety in Older Adults Based on Cognitive-Motor Training With Response-Generated Feedback.

OBJECTIVES: Simultaneous combinations of cognitive and physical exercises (cognitive-motor dual-task training [CMDT]) are more effective than physical and cognitive training alone in counteracting the decline of older adults and promoting physical and psychological well-being. The CMDT can be particularly effective in improving cognitive and functional abilities. Here, we validated an innovative nonpharmacologic intervention for anxiety and general well-being in older people by combining CMDT and response-generated feedback (RGF) principles. As outcomes, anxiety, cognitive functions, and functional mobility were evaluated. In addition, electroencephalographic methods were employed to investigate the neural basis of the possible intervention effects. METHODS: Thirty older adults were divided into an experimental group trained using a CMDT + RGF protocol and a control group using the CMDT only. The CMDT + RGF consisted of the simultaneous execution of whole-body exercises, cognitive tasks that were realized using interactive devices, and continuous feedback on every response. RESULTS: Results showed decreased anxiety and increased response speed in the experimental group, and both groups improved their functional ability and response accuracy after the intervention. According to electroencephalographic results, both groups showed an increase in the bilateral prefrontal cortex anticipatory activity, but the experimental group also showed a further increase in the left prefrontal cortex and in the premotor areas anticipatory functions. DISCUSSION: This study confirms the effectiveness of the proposed intervention on anxiety by adopting a nonpharmacology treatment that could affect public and individual health costs by proposing an alternative approach to expensive medications and psychotherapy and could significantly improve older adults' quality of life.

Motor-cognitive exercise with variability of practice and feedback improves functional ability and cognition in older individuals.

BACKGROUND: Motor-cognitive dual-task training seems the most favorable form of exercise for functional and cognitive improvements in older individuals.  The optimal exercise regime is still uncertain, and the potential benefits of qualitative parameters of exercise prescription such as feedback provision and practice variability are mostly unknown. AIMS: To verify the effects of a motor-cognitive dual-task training with feedback provision and variability of practice for improving functional ability and cognition in older individuals. METHODS: Thirty individuals (3 men) aged over 65 years were tested on walking speed, static and dynamic balance, lower limb strength, and cognition before and after a 5-week motor-cognitive intervention. Training consisted of twice weekly, 30 min gross-motor coordination exercises with variable practice conditions combined with stimulus-response cognitive tasks generated by an interactive device. Participants were divided into an experimental group and a control group, respectively receiving and nonreceiving feedback during training. A 2 × 2 ANOVA was used to verify the effects of training. RESULTS: Both groups improved static and dynamic balance (p < 0.05), walking speeds (p < 0.05), lower limb strength (p < 0.05) and cognitive functions with greater gains observed in the experimental group (p < 0.01). DISCUSSION: Variability of practice applied to motor-cognitive dual-task training is effective for improving, in only 5 weeks, functional ability and cognitive processing in older individuals. These changes were possibly afforded through motor and cognitive enhancement induced by exercise complexity. Provision of feedback seems to particularly benefit cognitive functions. CONCLUSIONS: Brief motor-cognitive dual-task training using practice variability and feedback seems effective for counteracting the age-related cognitive and functional decline.

COVID-19 Vaccine Acceptance, Trust in Vaccine, Anxiety Levels, and Related Factors in Turkish Society.

BACKGROUND: Vaccine acceptance and trust in vaccines pose a complex process affected by many factors. The present study was conducted to determine coronavirus disease 2019 (COVID-19) vaccine acceptance, trust in vaccines, anxiety levels, and related factors in Turkish society. METHODS: The data of this cross-sectional and descriptive-correlational study were collected with the snowball method by using an online questionnaire throughout Turkey. The study was conducted between March 15 and April 3, 2021, with 3148 participants from 7 regions and 81 cities in Turkey. RESULTS: It was found that the participants accepted the vaccine at 72.8%, and the trust rate in the vaccine was 66.0%. It was also found that women, single participants, those who had immune system diseases, and with COVID-19 had higher Coronavirus Anxiety Scale scores at significant levels. According to Logistic Regression Analysis, gender, age, trust in the vaccine, perception of risk levels regarding COVID-19, and coronavirus anxiety levels are factors affecting the intentions of participants to accept/reject the vaccine. It was determined that male participants were more likely to accept the coronavirus vaccine (P = 0.028). It was found that health-care employees had higher trust in the coronavirus vaccine (P = 0.006) and acceptance rates (P = 0.010) at significant levels compared with the general population. CONCLUSION: The COVID-19 vaccine acceptance rate in Turkish society was found to be high, and the level of trust in vaccines and anxiety levels were above the moderate level.

Advancing dentistry: fractal assessment of bone health in pediatric patients with celiac disease using dental images.

OBJECTIVES: To assess the effects of a gluten-free diet on bone structure in children with celiac disease using fractal analysis on panoramic radiographs. METHOD AND MATERIALS: A total of 49 patients with celiac disease aged 6 to 13 years, separated into two groups as previously and newly diagnosed, and a control group of 32 healthy individuals were evaluated. In previously and newly diagnosed patients with celiac disease, body mass index Z-scores were calculated, calcium, alkaline phosphatase, vitamin D3, and parathormone levels were measured, and bone mineral density Z-scores were obtained from dual energy x-ray absorptiometry. In all patients, the fractal dimensions of the right and left temporomandibular condyles were evaluated with the fractal analysis method on panoramic radiographs. RESULTS: The mean values of serum biomarker levels and the body mass index and bone mineral density Z-scores for both celiac groups were within the normal reference range. No statistically significant difference was determined between right and left condyle fractal dimensions values in the three groups examined. In terms of both right and left condyle fractal dimensions values, there was a statistically significant difference between groups. The highest fractal dimensions values were determined in the previously diagnosed group. CONCLUSIONS: Differences in fractal dimensions values were observed among patients with celiac disease following the gluten-free diet. Utilizing fractal analysis on panoramic radiographs can prove valuable for dental practitioners in evaluating bone mineral density due to its cost-effectiveness, easy accessibility, and reduced radiation exposure for patients, enabling them to provide comprehensive oral health care and potential early interventions for patients with celiac disease.

Sex Differences in Cognitive-Motor Dual-Task Training Effects and in Brain Processing of Semi-Elite Basketball Players.

In the current study, we aimed at evaluating the possible sex differences in cognitive-motor dual-task training (CMDT) effects on the sport and cognitive performance of semi-elite basketball athletes. Moreover, we investigated the CMDT effects on proactive brain processing using event-related potential (ERP) analysis. Fifty-two young basketball athletes (age 16.3 years) were randomly assigned into an experimental (Exp) group performing the CMDT, and a control (Con) group executing standard motor training. Before and after a 5-week training intervention, participants' motor performance was evaluated using dribbling tests. Cognitive performance was assessed by measuring response time and accuracy in a discrimination response task (DRT). Brain activity related to motor and cognitive preparation was measured through the Bereitschaftspotential (BP) and the prefrontal negativity (pN) ERP components. The CMDT involved the simultaneous execution of dribbling exercises and cognitive tasks which were realized using interactive technologies on the court. Results showed that both groups had some enhancements from pre- to post-tests, but only the Exp group enhanced in the dribbling exercise. In the DRT after the CMDT, females performed faster than males in the Exp group. All groups, except for the Con group of males, performed the DRT more accurately after the training. According to the ERP results, in the Exp group of males and in Exp and Con group of females, we found an increase in pN amplitude (associated with better accuracy); in the Exp group of females and in Exp and Con group of males, we found an increase in BP (associated with better response time). In conclusion, the present study endorsed the efficacy of the proposed CMDT protocol on both the sport and cognitive performance of semi-elite basketball players and showed that the neural basis of these benefits may be interpreted as sex-related compensatory effects.

Microbiological and clinical characteristics of Streptococcus pneumoniae serotype 3 infection and risk factors for severe outcome: A multicenter observational study.

BACKGROUND/PURPOSE: Serotype 3 has persisted to be an important cause of invasive pneumococcal disease in adults in the post-vaccine era. We aimed to investigate clinical and microbiological characteristics of Streptococcus pneumoniae serotype 3 infection in Taiwan and identify the risk factors associated with severe clinical outcome. METHODS: A multicenter observational study was conducted to analyze serotype 3 isolates collected between 2012 and 2021. Demographics, comorbidities, and risk categories were statistically compared with clinical outcome. Antimicrobial susceptibility testing and multilocus sequence typing were performed. RESULTS: A total of 146 isolates were collected, including 12 isolates regarded as colonizers. Among 134 infected cases, 54 (40.3%) were aged 65 and older. Mortality was significantly associated with diabetes mellitus, immunosuppression, immunodeficiency, high-risk status, and older age. Susceptibility rates were high to levofloxacin (98.9%), moxifloxacin (100%), vancomycin (100%), and ceftriaxone (97.3%). 25.3% (37/146) of the isolates showed intermediate susceptibility and 0.7% (1/146) showed resistance to penicillin. ST180 was the dominant sequence type. ST13 and ST9625 isolates were less susceptible to penicillin and ceftriaxone. CONCLUSIONS: Serotype 3 infection showed a high mortality rate, especially in patients with older ages and comorbidities. Although the incidence rates decreased during the COVID-19 pandemic, serotype 3 remained as an important cause of infection after the implementation of PCV13. Developing a more effective vaccine against serotype 3 and monitoring the antimicrobial-resistant sequence types are necessary.

In vitro antifungal and antibiofilm activities of novel sulfonyl hydrazone derivatives against Candida spp.

BACKGROUND: The aim of this study was to investigate the antifungal and antibiofilm activity of the new sulfonyl hydrazones compound derived from sulphonamides. METHODS: In this study, new sulfonyl hydrazone series were synthesized via a green chemistry method. The structures of the synthesized compounds were characterized by elemental analyses and spectroscopic methods. The antifungal activities of the Anaf compounds against Candida strains under planktonic conditions were tested. The biofilm-forming ability of Candida strains was determined and the inhibitory effects of Anaf compounds on Candida biofilms compared with fluconazole were measured by MTT assay. Expression analysis of biofilm-related genes was investigated with qRT-PCR. The statistical analysis was performed using a one-way ANOVA test. CANDIDA: strains was determined and the inhibitory effects of Anaf compounds on Candida biofilms compared with fluconazole were measured by MTT assay. Expression analysis of biofilm-related genes was investigated with qRT-PCR. The statistical analysis was performed using a one-way ANOVA test. RESULTS: A total of 16 (45.7%) out of 35 Candida isolates were determined as strong biofilm producers in this study. C. albicans was the most biofilm producer, followed by C. krusei and C. lusitaniae. The Anaf compounds had a broad spectrum of activity with MIC values ranging from 4 µg/ml to 64 µg/ml. Our data indicated that the Anaf compound had a significant effect on inhibiting biofilm formation in both fluconazole-susceptible and -resistant strains. The expression levels of hypha-specific genes als3, hwp1, ece1 and sap5 were downregulated by Anaf compounds. CONCLUSIONS: Our study revealed that the Anaf compounds had antifungal activity and inhibited fungal biofilms, which may be related to the suppression of C. albicans adherence and hyphal formation. These results suggest that Anaf compounds may have therapeutic potential for the treatment and prevention of biofilm-associated Candida infections.

Turkish validity and reliability study of "Nursing Students' perceptions of Clinical Stressors Scale".

BACKGROUND: Clinical education is a significant part of nursing education, but students frequently perceive it as stressful. There is no valid and reliable scale to determine the clinical stressor perceptions of nursing students in Turkey. OBJECTIVE: The study aims to adapt the "Nursing Students' Clinical Stressor Perceptions Scale" (NSPCSS) into Turkish and perform its validity and reliability study for nursing students. METHOD: The research was conducted in a methodological design between 30 September 2021 and 1 November 2021. The sample consisted of 304 nursing students. RESULTS: "The Cronbach's alpha" reliability coefficient of the NSPCSS is 0.912. The retest coefficient is 0.90 and the item correlation values are between 0.404 and 0.689. CONCLUSION: The study has shown that the NSPCSS-TR is a valid and reliable assessment tool to evaluate clinical stressors in nursing students.

The Dominance of Anticipatory Prefrontal Activity in Uncued Sensory-Motor Tasks.

Anticipatory event-related potentials (ERPs) precede upcoming events such as stimuli or actions. These ERPs are usually obtained in cued sensory-motor tasks employing a warning stimulus that precedes a probe stimulus as in the contingent negative variation (CNV) paradigms. The CNV wave has been widely studied, from clinical to brain-computer interface (BCI) applications, and has been shown to emerge in medial frontoparietal areas, localized in the cingulate and supplementary motor areas. Several dated studies also suggest the existence of a prefrontal CNV, although this component was not confirmed by later studies due to the contamination of ocular artifacts. Another lesser-known anticipatory ERP is the prefrontal negativity (pN) that precedes the uncued probe stimuli in discriminative response tasks and has been localized in the inferior frontal gyrus. This study aimed to characterize the pN by comparing it with the CNV in cued and uncued tasks and test if the pN could be associated with event preparation, temporal preparation, or both. To achieve these aims, high-density electroencephalographic recording and advanced ERP analysis controlling for ocular activity were obtained in 25 volunteers who performed 4 different visuomotor tasks. Our results showed that the pN amplitude was largest in the condition requiring both time and event preparation, medium in the condition requiring event preparation only, and smallest in the condition requiring temporal preparation only. We concluded that the prefrontal CNV could be associated with the pN, and this activity emerges in complex tasks requiring the anticipation of both the category and timing of the upcoming stimulus. The proposed method can be useful in BCI studies investigating the endogenous neural signatures triggered by different sensorimotor paradigms.

Experiences and Psychosocial Difficulties of Frontline Health Care Workers Struggling With COVID-19 in Turkey: A Qualitative Study.

AIM: This study was performed to explore the experiences and the psychosocial difficulties faced by nurses and physicians involved in the treatment and care for COVID-19 adult patients in the intensive care unit. METHOD: The interpretative phenomenological approach was used, and the data were gathered between June and July, 2020 in Rize using face-to-face interviews. The sample consisted of 10 nurses and 5 physicians. The thematic analysis was utilized to analyze the data. The Consolidated Criteria for Reporting Qualitative Research (COREQ) were followed in the study. RESULTS: The experiences of nurses and physicians were categorized under three themes and subcategories. The theme of "Going Through Psychosocial Changes" was divided into decreased emotional well-being and experiencing social changes, the theme of "Work-Related Challenges" was divided into losing the routines and economic concerns, and the theme of "Felt Gains" was divided into realizing one's worth and increased motivation. CONCLUSION: The study revealed that nurses and physicians are supported, respected, and described as heroes by Turkish society. However, they are psychologically and socially adversely affected, they display negative and positive emotions, and experience psychological growth. In addition, nurses complain about insufficient and unfair payment. Despite all these challenges, nurses and physicians continue to work with increasing emotional resistance. It is recommended to be aware of the problems that they experience during and after the COVID-19 pandemic, protect their mental health, provide adequate economic support, especially for nurses, and take necessary measures by collecting data that may be a guide for subsequent outbreaks.

Comparison of Preoperative and Postoperative Sexual Dysfunction in Male Patients with Lumbar Disc Herniation.

AIM: To compare preoperative and postoperative sexual dysfunction in male patients diagnosed with lumbar disc herniation (LDH). MATERIAL AND METHODS: This study was conducted in a single group with a pretest?posttest design. The sample included 32 male patients with LDH admitted to the neurosurgery outpatient clinic of a state hospital between August 1, 2019 and November 1, 2020 and who were about to undergo operation. The data were collected using a questionnaire form developed by the researchers, the Golombok?Rust Inventory of Sexual Satisfaction (GRISS), and the Visual Analogue Scale (VAS). Descriptive statistical methods, Mann?Whitney U test, Wilcoxon test, and Spearman correlation analysis were used to evaluate the data. Significance was evaluated at the level of p < 0.05. RESULTS: Before LDH surgery, male patients had problems with sub-dimensions of sexual function, such as frequency, communication, avoidance, touching, impotence, and premature ejaculation. A significant improvement was achieved after the operation in the communication sub-dimension and pain levels. The mean preoperative and postoperative VAS scores of the patients were 8.18 ± 1.20 and 1.28 ± 1.08, respectively. CONCLUSION: Lumbar disc surgery has a positive effect on sexual function and reduces pain levels. Since there is a strong relationship between LDH and sexual dysfunction, taking sexual history from patients should be part of routine medical history, and psychiatric care and consultation should be offered if necessary.

The Effect of Group Art Therapy on Loneliness and Hopelessness Levels of Older Adults Living Alone: A Randomized Controlled Study.

AIM: This study was aimed to test group art therapy using clay as a medium as a method to cope with feelings of loneliness and hopelessness in older adults. METHOD: This study was a randomized controlled study. A total of 60 older adults who lived alone were enrolled in the study. Thirty subjects were randomly assigned to six 1.5-hour weekly sessions of group art therapy using clay, and interviewed face-to-face twice (intervention group (IG)), and 30 subjects were randomly assigned to be interviewed face-to-face twice (control group (CG)). The effects of interventions were measured using the UCLA Loneliness Scale (UCLA-LS) and the Beck Hopelessness Scale (BHS). Loneliness and hopelessness levels in the IG and CG were measured at the beginning (pre-test) and the end (post-test) of the study. This study was conducted using the CONSORT statement. The group art therapy trial is registered at the US National Institutes of Health (ClinicalTrials.gov) #NCT04295083. RESULTS: A statistically significant difference was found between the pre-test and post-test scores of the IG and CG, with respect to the loneliness and hopelessness levels among older adults living alone. CONCLUSION: Clay-based group art therapy can contribute toward decreasing the sense of loneliness and hopelessness in older adults. Nurses using group art therapy for older adults will realize the psychological healing aspects and effectiveness of this intervention and recognize it as an effective method for the psychological growth of older adults and the reduction in their levels of loneliness and hopelessness.

An Updated Comparison of Current Impression Techniques Regarding Time, Comfort, Anxiety, and Preference: A Randomized Crossover Trial.

OBJECTIVE: To compare digital and conventional impressions in terms of impression time, and comfort, anxiety and preference of the patients. METHODS: Digital scans (Trios 3 Cart) and conventional impressions (irreversible hydrocolloid material, hand-mixed) were randomly performed on 39 patients by a single experienced operator in 14-21 day intervals (cross-over design). Impression time, comfort score with visual analog scale (VAS), anxiety level with State-Trait Anxiety Scale, and preference with a questionnaire were recorded. Two techniques were compared with the independent t-test in terms of time, comfort, and anxiety. Patient'-operator' assessment and time-comfort relationship were calculated using Pearson correlation test. RESULTS: No statistical difference was found between the two impression techniques in terms of time (P = .231). The digital technique was found to be more comfortable than the conventional technique in both operators' and patients' comfort scores (P < .001). There was no statistical difference between two techniques with regards to anxiety (P = .668). Patients' and operators' comfort scores showed a strong correlation (P < .001), but no correlation was found between comfort and time (P > .05). CONCLUSION: Digital scan and conventional impression were similar in terms of impression time, and anxiety of patients. Conversely, patients were more satisfied with the digital technique and preferred it.

Subtype distribution and molecular characterization of Blastocystis from hemodialysis patients in Turkey.

INTRODUCTION: The aim of this study was to determine the Blastocystis prevalence and subtypes in hemodialysis patients in Turkey. METHODOLOGY: Eighty-four patients diagnosed with end-stage renal failure who were undergoing hemodialysis and 20 healthy volunteers were enrolled. Blastocystis presence was investigated by native-Lugol, trichrome staining, PCR using STS primers, and DNA sequencing analysis. RESULTS: Among the stool samples from the hemodialysis patients, 9.52% (8/84) were found to be Blastocystis-positive with the native-Lugol and trichrome staining. Seven of the eight Blastocystis isolates were subtyped using STS primers. Blastocystis subtype distribution was as follows: one had ST1, two had ST2, two had ST3, two had ST3+ST6, and one was not subtyped. Blastocystis positivity was detected in two healthy control (2/20, %10), one subject had ST1, and the other was not subtyped. All subtypes identified by PCR were confirmed by the sequencing analysis. In the two samples that had mixed subtypes (ST3+ST6) when using the STS primers, only ST3 was detected in the sequencing analysis. Although some patients have multiple symptoms, the most common symptoms in Blastocystis positive patients were bloating (5/8), diarrhea (4/8), nausea and vomiting (2/8), and gas and weight loss (1/8). Also, only one patient had Giardia intestinalis. CONCLUSIONS: This was the first study to determine the Blastocystis subtypes in hemodialysis patients. A rare subtype, ST6, was identified in two of the patients. Thus, the ST6 infections were attributable to transmission from poultry infections. The presence of this unusual subtype suggests the need for further extensive studies of hemodialysis patients.