Introduction
Self‐transcendence is a human capacity for wellbeing by expanding one's personal boundaries and may act as a health‐promoting resource among adults ≥65 years. Therefore, the objectives ...of this meta‐analysis were to determine the mean score of self‐transcendence based on place of residence and gender, and to evaluate the correlations of self‐transcendence with meaning, sense of coherence, resilience and depression.
Methods
Based on inclusion criteria, 13 studies were included. Orwin Safe N and Egger's test assessed publication bias. The mean score of self‐transcendence and the correlation coefficients of the selected variables were estimated by random effects models.
Results
The self‐transcendence mean score (n = 1634) was low (M = 43.6) and a bit lower among those staying in care facilities (M = 42.8), but did not vary significantly across gender. The correlation coefficients were self‐transcendence_depression (r = −0.40), self‐transcendence_meaning‐in‐life (r = 0.53), self‐transcendence_resilience (r = 0.50) and self‐transcendence_sense of coherence (r = 0.28). The correlation coefficients, except for meaning‐in‐life, were homogeneous.
Conclusion
In a health‐promoting perspective, the concept of self‐transcendence can help to better understand wellbeing among older individuals and provide guidance for health professionals in facilitating wellbeing and health. The concept and theory of self‐transcendence can inspire health professionals in realising new health‐promoting approaches to support older individuals in maintaining health, wellbeing and independency.
Purpose
We aim to compare the efficiency and toxicity of three different 5-fluorouracil (5-FU) administration types in 5-FU, leucovorin, and oxaliplatin (FOLFOX) combination treatment for adjuvant ...therapy in colorectal cancer (CRC).
Methods
Five hundred and seventy patients with stage III colorectal carcinoma who received different FOLFOX regimens after curative resection were included. Patients were divided into three groups as FOLFOX-4, modified FOLFOX-6 (mFOLFOX-6), and mFOLFOX-4 for comparison of toxicity and disease-free survival (DFS) and overall survival (OS) times.
Results
Three-year DFS rates for FOLFOX-4, mFOLFOX-6, and mFOLFOX-4 groups were 65%, 72%, and 72%, respectively. Five-year OS rates for FOLFOX-4, mFOLFOX-6, and mFOLFOX-4 groups were 69%, 75%, and 67%, respectively. There was no statistically significant difference between the three treatment groups in terms of DFS and OS (
p
= 0.079, and
p
= 0.147, respectively). Among grade 1–2 adverse events (AE), thrombocytopenia, neuropathy, and stomatitis were more common in the mFOLFOX-6-treated group. The frequency of grade 1–2 nausea and vomiting were similar in mFOLFOX-6 (36.3% and 24%, respectively) and mFOLFOX-4 (32.4% and 24.7%, respectively) groups but were higher than that in the FOLFOX-4 (19.5% and 11.3%, respectively) group. Among the most common grade 3–4 AE, neutropenia (53.4%, 9%, and 13.5%, respectively) and diarrhea (10.5%, 2.2%, and 2.4, respectively) were more common in FOLFOX-4. The rate of anemia and febrile neutropenia was similar in treatment groups (
p
= 0.063, and
p
= 0.210, respectively).
Conclusion
In the adjuvant treatment of stage III CRC patients, three different 5-FU administration types in FOLFOX combination treatment can be used with similar efficiency and manageable toxicity.
This study aimed to determine the cepstral acoustic parameters that vary depending on age and gender in vocally healthy children, and to establish normative data for cepstral analysis.
Cepstral ...measurements are among the strongest predictors of auditory-perceptual evaluation of voice and differentiate between healthy and dysphonic voices. More spesificially, ceptral peak prominence is accepted to be as a strong acoustic predictor of breathiness and overall severity of dysphonia. Cepstral measures determine voice quality reliably not only in sustained vowel samples but also in running speech samples. Determining the parameters related to the acoustic profile of children with normal voices can lead us to a better understanding of the effect of changes in the larynx and vocal fold structure during growth and development. There is a limited number of norm studies examining the cepstral acoustic properties of pediatric voice. Determining norm-specific values and clinical guidelines of cepstral acoustics according to the age and gender in vocally healthy children are utmost important.
A total of 160 vocally healthy children were divided into the following four age groups: Group-I included children within the age range of 4–7 years, Group-II included 7–11 years, Group-III 11–14 years, and Group-IV included children within the age range of 14–18 years. An equal number of male and female participants were assigned to each group. PENTAX Medical CSL Model 4500 was used for recording all tasks. For acoustic analysis, Multi-Dimensional Voice Program and Analysis of Dysphonia in Speech and Voice were used.
Cepstral Peak Prominence (CPP), Cepstral Peak Prominence Standard Deviation (CPP SD), and Low-To-High Spectral Ratio (L/H Ratio) increased with age. It is found that the CPP parameter of all-voiced sentences and nasal-weighted sentences increased with age in boys, while no significant pattern was observed in any sample for girls. For L/H ratio, it can be said that there is a general increase with age in all speech samples, except for the vowel-weighted and voiceless plosive sentence samples, evident especially in the group above the age of 15 years. This study concluded that the CPP SD parameter in the vowel-weighted sentences increased with age in boys. It was also noticed in this study that CPP F0 standard deviation (SD) intervals were narrower in vowel-weighted, easy onset, and voiceless plosive sentence samples than in all-voiced, hard glottal attack and nasal-weighted sentence samples.
This study established cepstral acoustic normative values for a wide age range of the pediatric population. It is thought that age and gender specific cepstral acoustic findings presented in this study contributed to the related literature. In addition, to our knowledge, this is the first study that provides a normative cepstral acoustic database of the CAPE-V/Turkish sentences in the pediatric population.
BACKGROUND/AIMS: Neuroendocrine tumors (NET) presenting with multiple liver metastasis are a heterogeneous group of tumors and their prognosis differs greatly from each other according to their ...differentiation, grade, and possibly to their primary site of origin. MATERIALS AND METHODS: Seven patients diagnosed with NET who presented with multiple liver metastases between October 2014 and November 2018 were included in this retrospective study. The patients' details, their tumor characteristics, the local and systemic treatments administered, the response evaluation and their survival data were collected from the hospital files and analyzed. RESULTS: The median age of the 7 patients was 50 (range: 27-64) years. Carcinoid syndrome was present in two patients. The histopathology of all the patients were consistent with well-differentiated NET. As an initial treatment, one patient underwent right hepatectomy. All patients received somatostatin analog for a median of 20.7 months (range: 6-48 months) as an initial systemic treatment. One patient received radionuclide therapy and palliative radiotherapy for bone metastasis, one patient received trans arterial chemo embolization to the liver and one patient received capecitabine and temozolamide treatment after progression to somatostatin analog treatment. The median progression free survival and median overall survival (follow-up) was 15 months (range: 6-48 months) and 17 months (range: 8-48 months) respectively. All patients were still alive at the end of this study. CONCLUSION: Primary unknown well-differentiated NETs presenting with liver metastasis have different clinical and survival characteristics than primary known metastatic NETs. Treating these patients as the same disease may not be appropriate. Keywords: Neuroendocrine tumor, liver metastasis, prognosis
Background
Nurses are considered important healthcare professionals during the management of the pandemic process due to the considerable amount of time they spend in the face‐to‐face nursing of ...infected patients. To optimise the service of healthcare workers, it is recommended that the mental health needs of the health workforce are addressed.
Aims and Objectives
This study aimed to explore the experiences and coping strategies of Turkish nurses working in pandemic units.
Methods
A grounded theory design was applied. In‐depth interviews were conducted with 15 nurses. The data were analysed according to the constant comparative method.
Results
The study generated a core category (‘It was difficult working in the unknown, but our struggle to touch lives gave us strength’), showing that all nurses felt heroic via the satisfaction of touching patients’ lives and uncertain. Four main categories emerged: being caught in the pandemic, empowerment for coping with the struggle, challenges during the coping process and effects of the pandemic on life.
Conclusions
Nurses felt that their profession was sacred and valued by society, and comprehensive support had facilitated the process. Nurses had difficulty in managing their fear of infecting others and adapting to many new elements, the learning process and a lack of understanding of their role as team members. The nurses attending to the pandemic have experienced the effects of COVID‐19 on their lives, such as psychological growth, psychological symptoms and being labelled as high risk.
Relevance to clinical practice
Nurses would be further empowered by government and society's support and acceptance of professionalism in nursing. The findings suggest that the resources for the psychological support of nurses in the pandemic should be increased. Regular and intensive training for nursing is necessary to promote adaptation and efficacy in crisis management.
Abstract
To compare enzalutamide (E) and abiraterone acetate (AA) in terms of efficacy, survival and to characterize prognostic factors affecting survival in metastatic castration-resistant prostate ...cancer (mCRPC) patients. A total of 250 patients treated with E or AA in 5 centers were included. The number of patients with no prostate specific antigen (PSA) decline was higher in the AA group than that in the E group, and the proportion of patients with a PSA decline of ≥ 50% was higher in the E group (p = 0.020). Radiological progression free survival (rPFS) and overall survival (OS) were significantly longer in the E group when compared to that in the AA group (p < 0.001 and p = 0.027, respectively). In the E group, rPFS was significantly longer than that in the AA group in both pre- and post-docetaxel settings (p = 0.010 and p = 0.003, respectively). OS was similar in the pre-docetaxel setting; but in the post-docetaxel setting, E group had a significantly longer OS than the AA group (p = 0.021). In the multivariate analysis performed in the whole patient group, we found that good prognostic factors for rPFS were E treatment, being ≥ 75 years and a PSA decline of ≥ 50% while there was no factor affecting OS. With longer OS and PFS, E seems to be more suitable for mCRPC patients in the post-docetaxel setting than AA.
This study aimed to gain a deeper understanding of the experiences and opinions of mothers about sexual behaviours and sexual education of their children with DS who are AYAs in Turkey. The study ...utilised a classic grounded theory approach. In-depth interviews were conducted with 12 mothers. Data were analyzed by the constant comparative method. Mothers expressed that they could not address the sexual needs of their child because they did not feel they could provide sufficient care to their child. Mothers used pressure and control tactics and neglect of the sexuality to cope with their children’s sexuality. Mothers described their meaning of the sexuality, fear of stigmatization and gender issues as determinant factors on the dealing with the sexuality. They stated their knowledge about sexuality is not enough to provide sexual education. Many cultural issues such as gender, meaning of the sexuality and burden of care was described as determinant factors and difficulties to providing sexual education. Therefore, educational and supportive programmes for parents should be conducted. Comprehensive, valid and individualized sexual education program also should be provided AYAs with DS.
Evidence shows that women feel valued and satisfied after discussing their birth experiences. However, uncertainties persist surrounding the concept of postnatal debriefing practice.
To explore the ...opinions and expectations of women relating to postnatal debriefing and their experiences when the postnatal debriefing is not presented.
A descriptive qualitative study of 20 postnatal women was conducted using in-depth semi-structured interviews from April–May 2023. Thematic analysis was applied to the data collected in interviews.
Analysis of interview data generated three main themes and nine sub-themes. Women wanted to make sense of their birth experience They expressed their opinions on the components of postnatal debriefing They advocated for all women to be offered this practice by known healthcare professionals who interact with them They do not want to only talk about their birth experience but also meet their needs Women agree that expectations related to birth determine the need for the practice. They hoped for psychological adaptation by relieving their distress and gaining a sense of closure. The discussion process was expected to prevent reflection of trauma to the future and provide transition to the postnatal period.
The present study explored women perceptions and expectations of postnatal debriefing. Healthcare professionals should behave sensitively to women's expectations and needs in relation to their birth experience. Further research is warranted to clarify the components and effects of postnatal debriefing practice to develop consolidated guidance.
•Uncertainties surround the concept of postnatal debriefing.•It is common worldwide for women to feel traumatic emotions that can be caused by traumatic birth events.•Stress experienced after a traumatic birth event causes many significant adverse effects.•Women may feel valued and satisfied after discussing their birth experiences.•Women want to be offered postnatal debriefing to make sense of their birth experience.•Many women felt the practice would be beneficial for their health and well-being.•Researchers should prioritise clarification of the optimal components and effects of postnatal debriefing practice in order to develop consolidated guidance.•Healthcare professionals should consider women's expectations and needs in relation to their birth experience.
Objectives: Hepatitis B virus (HBV) affects a significant part of society and is characterized by high mortality and morbidity. Hepatitis B affects approximately 350 million people worldwide, many of ...whom are chronic patients. Especially being under immunosuppressive therapy is a risk factor for the reactivation of the disease. The aim of this study was to investigate the seroprevalence of HB in oncology patients. Materials and Methods: In this study, the seroprevalences of hepatitis B surface antigen (HBsAg), anti-hepatitis C virus, anti-HBs, and anti-hepatitis B core antibody (anti-HBc) immunoglobulin G (IgG) were retrospectively evaluated from the medical records of 84 patients who were diagnosed of cancer, and were admitted to the outpatient clinic of medical oncology in the Batman State Hospital within a period of one year (between January and December 2017). Results: Anti-HBc IgG was positive in 44 patients (52.2%),16 (36.4%) have received treatment for the prevention of HBV reactivation six of these patients were HBsAg positive No reactivation and no side effects occur in patients who received prophylactic antiretroviral treatment. Conclusion: In our study, both the proportion of patients with HBsAg positivity and the proportion of patients with natural immunity were found to be slightly higher than those in Turkey and worldwide. No patients with HB reactivation is important evidence of necessity effectiveness of prophylactic antiviral treatment.
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