Factors affecting breastfeeding motivation in primiparious mothers: An application of breastfeeding motivation scale based on self-determination theory.

Researchers aim to adapt the breastfeeding motivation scale and to determine the effect of socio-demographic characteristics, obstetric properties and breastfeeding status on type of breastfeeding motivation. The study sample consisted of 250 mothers those who were primiparious. We recorded the telephone numbers of mothers staying in the Postpartum Services of the hospitals and applied data collection tools by home visits at eighth week postnatal. The autonomous motivations of the mothers who were exclusively breastfeeding their babies were higher than those partially breastfeeding. In addition, advanced age, high education level, nonsmoking status and breastfeeding support were factors that positively affected breastfeeding motivation.

Genetic and environmental factors in human osteoporosis.

Osteoporosis is a common disorder, with prolongation of the average life span it has become a major public health problem. On the formation of osteoporosis genetic factors and environmental influences could play a role then it is considered as multi-factorial. Because a variety of functions to affect susceptibility to the formation of osteoporosis VDR-F, VDR-B, COL1A1, ESR1X, ESR1P and CTR are thought to be candidate genes. In this study, the aim is to investigate the relationship between these genes polymorphism and bone mineral density (BMD) values of lumbar vertebra and femoral neck in 188 Turkish people. Lumbar spine and femoral neck BMD of the individuals included in the study were measured by the dual X-ray absorptiometry method. The genotyped polymorphisms by simultaneous amplification of five regions of the genome, containing six SNPs of interest and detecting the amplified product, using the kit MetaBone Clinical Arrays(®). Statistical analyses indicated that; VDR-B gene polymorphisms major (P = 0.013), VDR-F polymorphisms have minor (P = 0.082) effect on femur BMD. None of the other genes has any significant effect on spinal BMD. Patient age, body mass index and diet has significant effect on femoral and spinal BMD. Osteoporosis is a multi-factorial disease and many genetic and non-genetic risk factors contribute to the development of osteoporosis. Early detection of a genetic predisposition to osteoporosis should allow delay and/or limit unfavorable changes in the bone tissue.

The importance of measuring intraocular pressure using a tonometer in order to estimate the postmortem interval.

AIM: The purpose of this study is to evaluate postmortem eye changes and to investigate the relationship between these changes and time elapsed after death. MATERIAL AND METHOD: The eyes of 100 noncriminal cases who had died while being treated at Eskisehir Osmangazi University (ESOGU) hospital were evaluated for corneal turbidity and tache noire macroscopically, and also repeatedly evaluated by ophthalmoscope, pupilometer, and tonometer at intervals until removal from hospital. The postmortem time, corneal turbidity, development of tache noire, pupil size, intraocular pressure (IOP), and fundus findings were recorded. The relationship between these findings and the postmortem interval (PMI) was evaluated. RESULTS: No relationship between tache noire development and postmortem time (P > 0.05) was found. The corneal turbidity ratio increased significantly at 8 hours after decease (P < 0.01). No relationship between right-left pupil size and postmortem time (P > 0.05) was found. There was, however, a significant relationship between the fundus findings and postmortem time. Over time, the first optic disc becomes pale, then vascular clarity decreases and segmentation increases. The right and left IOP related significantly to postmortem time and decreased gradually as time passed (P < 0.05). Application of linear, exponential, and power equations showed that IOP can be used to estimate postmortem time by a 2 hour interval with a 95% probability. CONCLUSIONS: This study shows that corneal turbidity and IOP have a significant relationship with postmortem time and can be used to estimate a postmortem interval with other postmortem findings. This study provides data that would support the idea that such examination might be useful in estimating postmortem interval.

Sexual differences in the completed suicides in Turkey.

The aim of this study was to determine whether there is a difference between men and women in terms of suicide age, suicide method and suicide reason in Turkey. This study recruited 17,327 cases that had committed suicide between 1990 and 2000. Of all the cases who committed suicide during a period of 11 years, 61.1% were men, 38.9% women. The highest suicide score fell into the age group 15-24 (P<0.001). The most frequently used methods for suicide were self-hanging (48.2%) and use of firearms (19.2%) (P<0.001). The proportion of those committing suicide taking chemicals (drugs, etc.) was higher in women than in men (P<0.001). The most frequently seen reasons for suicide were illness and (33.8%) unsatisfactory relationships (33.0%) (P<0.001, each one). Women committed suicide much more because of unsatisfactory relationships, whereas for men it was due to illness (20.8% and 14.6%, respectively). There were significant differences between men and women in terms of suicide age, suicide method and suicide reason in Turkey. When evaluating suicide cases it is essential that the differences between sexes be taken into consideration.

Sex-related differences in methods of and reasons for suicide in Turkey between 1990 and 2010.

OBJECTIVE: To analyse suicides occurring in Turkey between 1990 and 2010 according to sex, age, reason and method. METHODS: Data concerning suicides occurring in Turkey between 1990 and 2010 were obtained from annual records published by the Turkish Statistical Institute. Data were analysed according to sex, age, reason for suicide and suicide method. RESULTS: The crude suicide rate was 2.42 per 100 000 population in 1990 and 4.02 per 100 000 population in 2010. The highest number of suicides was seen in those aged 15-24 years. In this age group, the number of suicides in females was significantly higher than in males. The most common suicide method in Turkey was hanging. Men used firearms more frequently than women. All the reasons for suicide occurred in a higher number of males than females; however, the difference between males and females was more significant for economic problems, relationship problems and educational failure. The leading reason for suicide in females was relationship problems. CONCLUSION: Detecting population subgroups with a high suicide risk and obtaining regional demographic data are of great importance for future studies on suicide prevention.

Comparison of radiation-induced oral mucositis scoring systems.

BACKGROUND: A number of oral toxicity scoring systems have been described, but their direct comparison has rarely been undertaken and little data exists. An impediment to mucositis research has been the lack of an accepted, validated scoring system. The objective of this study was to design a test and validation of scoring systems. MATERIALS AND METHODS: Forty-three patients with head and neck malignancies who had been irradiated were evaluated. Five different mucositis scoring systems (World Health Organization, Radiation Therapy Oncology Group, "Hickey", "Van der Schueren" and "Makkonen") were compared with each other. RESULTS: Daily mucositis scores demonstrated a high correlation among scoring systems (P < 0.05 and coefficient of correlation kappa and r = 0.5-0.95). Objective mucositis scores demonstrated a strong correlation with symptoms. CONCLUSIONS: All scoring systems were equally valid. The exact grading of mucositis is achieved by combining clinical information about pain and nutritional status with oral mucosal reactions.

Validity of the Turkish version of the European Heart Failure Self-Care Behavior Scale.

OBJECTIVE: The specific purpose of this study was to investigate the validity of the Turkish version of the European Heart Failure Self-care Behavior Scale by applying to 494 Turkish Heart Failure Patients. METHODS: The study was conducted as a cross-sectional sample survey, between October 2012 and January 2013. The 494 patients who applied with a diagnosis of heart failure were included in the study after determining the clinical diagnosis and type of treatment. Cronbach's alpha coefficient was used to evaluate the validity and reliability of the scale. Exploratory and confirmatory factor analyses were applied for the determination of the sub-factors of the scale in Turkish adaptation; content, item and factor adaption. Structural Equation Modeling was used for the purpose of creation and supervision of the structural models of the scale. RESULTS: Cronbach's alpha coefficient of internal consistency of Turkish version of the Scale was found to be 0.69. According to the results of the factor analysis, it was determined that the data is in a form suitable for factor analysis and the data have the assumption of multivariate normal distribution. The goodness of fit measures used for the validity of Structural Equation Modeling were obtained to be RMSEA=0.047 (CI=0.00-0.079), AGFI=0.83, GFI=0.91 respectively. CONCLUSION: The scale is divided into 4 sub-factors according to the Structural Equation Modeling. The European Heart Failure Self-care Behavior Scale is a scale that easily applied to measure the behavior of self-care in heart failure patients. In addition, the scale reaches the conclusion as soon as possible and does not require additional training for researchers. Further, patients can apply themselves the scale easily.

Comparison of semiparametric, parametric, and nonparametric ROC analysis for continuous diagnostic tests using a simulation study and acute coronary syndrome data.

We aimed to compare the performance of three different individual ROC methods (one from each of the broad categories of parametric, nonparametric and semiparametric analysis) for assessing continuous diagnostic tests: the binormal method as a parametric method, an empirical approach as a nonparametric method, and a semiparametric method using generalized linear models (GLM). We performed a simulation study with various sample sizes under normal, skewed, and monotone distributions. In the simulations, we used estimates of the ROC curve parameters a and b, estimates of the area under the curve (AUC), the standard errors and root mean square errors (RMSEs) of these estimates, and the 95% AUC confidence intervals for comparison. The three methodologies were also applied to an acute coronary syndrome dataset in which serum myoglobin levels were used as a biomarker for detecting acute coronary syndrome. The simulation and application studies suggest that the semiparametric ROC analysis using GLM is a reliable method when the distributions of the diagnostic test results are skewed and that it provides a smooth ROC curve for obtaining a unique cutoff value. A sample size of 50 is sufficient for applying the semiparametric ROC method.

MEFV mutations in patients with familial Mediterranean fever in the Black Sea region of Turkey: Samsun experience [corrected].

OBJECTIVE: To investigate MEFV mutations among patients with familial Mediterranean fever (FMF), their relatives, and healthy controls in the Black Sea region of Turkey; to compare 3 different MEFV mutation analysis methods; to evaluate the role of MEFV mutations in the diagnosis of FMF; and to investigate the role of M694V in the development of amyloidosis. METHODS: In total, 890 subjects (625 patients, 165 relatives, 100 healthy controls) were included in this prospective study. MEFV mutations were studied with the amplification refractory mutation system (ARMS; n = 335), polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP; n = 335), and reverse hybridization assay (FMF StripAssay; n = 693). RESULTS: All methods were used in 79 patients. The ratio of false negativity was about 2% using ARMS compared to PCR-RFLP. The FMF StripAssay was used to investigate 9 more mutations and detected 17 mutations in 14 patients. The M694V/M694V genotype was more common in patients with amyloidosis (37%) compared to patients without amyloidosis (18%) (p = 0.009). The frequency of MEFV carriers was 27%. The frequency of individuals having 2 mutations among asymptomatic relatives of FMF patients was 6%. CONCLUSION: The FMF StripAssay is a reliable and time-saving method. In spite of detection of new mutations and developments in MEFV assay technology, there were patients in whom no mutation was detected. Our data, combined with previous studies, show that patients having M694V/M694V carry a risk for amyloidosis.