Browsing by Author "Dogan, N"

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    ADHD and its associations with pregnancy, birth, developmental and medical-related characteristics
    Yüksel, AE; Dogan, N; Tahillioglu, A; Bilaç, O; Uysal, T; Ercan, ES
    This study aimed to examine possible associations between Attention-Deficit/Hyperactivity Disorder (ADHD) and pregnancy-related, birth-related, developmental, medical, and surgical history characteristics. The sample was derived from a non-referred community sample aged 6 to 14. 91 cases with ADHD and 264 without any psychopathology were compared in terms of psychological and physical problems in pregnancy, mode of delivery, birth complications, developmental stages, injuries, medical and surgical diseases. A semi-structured clinical interview was applied to diagnose the children. ADHD Rating Scale-IV (ADHD-RS-IV) was completed by the parents. Male gender, delay in talking time, and physical injury history predicted increased risks for ADHD. Although having any surgery, and in particular, tonsillectomy did not predict ADHD, inguinal hernia surgery alone predicted an increased risk for ADHD even when controlled for gender. Psychological problems during pregnancy were associated with elevated inattention (IN) and hyperactivity-impulsivity (HI) scores, but not associated with ADHD as a diagnosis. Elevated IN scores but not HI scores were associated with a physical injury history. Although the mode of delivery and physical disease history were not associated with ADHD, asthma increased the likelihood for higher HI scores. The findings have crucial clinical implications that address several points. The findings suggest ADHD may have associations with some negative neurodevelopmental, medical, and surgical history characteristics. The predictivity of inguinal hernia surgery for ADHD might depend on the exposure to general anesthesia at younger ages. Hence, children who had these features should carefully be screened for ADHD.
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    CADASIL with Atypical Clinical Symptoms, Magnetic Resonance Imaging, and Novel Mutations: Two Case Reports and a Review of the Literature
    Sari, US; Kisabay, A; Batum, M; Tarhan, S; Dogan, N; Coskunoglu, A; Cam, S; Yilmaz, H; Selcuki, D
    Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is a hereditary microangiopathy with adult onset caused by a missense mutation in the NOTCH3 gene in chromosome 19p13. It presents with autosomal dominant arteriopathy, subcortical infarctions, and leukoencephalopathy. Its common clinical presentations are seen as recurrent strokes, migraine or migraine-like headaches, progressive dementia, pseudobulbar paralysis, and psychiatric conditions. Two patients with CADASIL syndrome, whose diagnosis was made based on clinical course, age of onset, imaging findings, and genetic assays in the patients and family members, are presented here because of new familial polymorphisms. The first patient, with cerebellar and psychotic findings, had widespread non-confluent hyperintense lesions as well as moderate cerebellar atrophy in cranial magnetic resonance scanning. The other patient, with headache, dizziness, and forgetfulness, had gliotic lesions in both cerebral hemispheres. CADASIL gene studies revealed a new polymorphism in exon 33 in the first patient. In the other patient, the NOTCH3 gene was identified as a new variant of p.H243P (c.728A>C heterozygous). By reporting a family presenting with various clinical symptoms in the presence of new polymorphisms, we emphasize that CADASIL syndrome may present with various clinical courses and should be considered in differential diagnoses.
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    Validation of Pre-Adolescent Decision-Making Competence in Turkish students
    Çevik, YD; Dogan, N; Daghan, G; Mumcu, FK; Somyürek, S; Karaman, H
    The objective of this study was to adapt the Pre-Adolescent Decision-Making Competence Test to Turkish, which was originally developed in English by Weller, Levin, Rose and Bossard (2012) for assessing decision-making competence of children between the ages of 9 and 14. For this purpose; a) the test and instructions were translated into Turkish, b) the Turkish test was administered to a group of 398 students as a pilot, c) retest was administered to a group of 97 students, and finally, d) a group of 382 students was subject to a norm study. The Confirmatory Factor Analysis model created by the data of the pilot administration was well adapted, and one-factor model was verified for construct validity. As the construct of the test was altered, a Confirmatory Factor Analysis was performed on the data obtained from the norm study. A construct similar to that acquired from the data of the first test administration and the results obtained have even relatively better fit indices. Although the reliability values were less than what was expected, Cronbach's Alpha coefficient of internal consistency was similar to the results obtained from the original test.
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    Is Nurse Workforce Sufficient in Intensive Care Units in Turkey. Results of the Multicenter Karia Study
    Uyan, A; Durmus, G; Sezak, N; Pepe, F; Kaygusuz, T; Öztoprak, N; Özdemir, K; Aksoy, F; Erol, S; Koç, MM; Öncül, A; Çagan Aktas, S; Çaskurlu, H; Çelebi, G; Kandemir, O; Özger, S; Harman, R; Demiray, K; Ari, A; Alkan Çeviker, S; Esen Yildiz, I; Menekse, S; Senol, G; Sari, S; Dogan, M; Ugurlu, K; Arslan, M; Akdemir, I; Firat, P; Kürekçi, Y; Çaglayan, D; Uçar, M; Gözüküçük, R; Elmaslar Mert, HT; Alay, H; Erdogan, H; Demirel, A; Dogan, N; Koçak, F; Güven, E; Ünsal, G; Sipahi, H; Isikgöz Tasbakan, M; Arda, B; Ulusoy, S; Sipahi, OR
    Introduction: In this multicenter study, we analysed the magnitude of healthcare worker (HCW) [infection control practitioner (ICP), nurses and others] workforce in hospitals participated in the study. Materials and Methods: This study was performed in 41 hospitals (with intensive care units-ICU) located in 22 cities from seven regions of Turkey. We analysed the ICP workforce, nursing and auxiliary HCW (AHCW) workforce in ICUs, number of ICU beds and occupied beds in four different days [two of which were in summer during the vacation time (August 27 and 31, 2016) and two others in autumn (October 12 and 15, 2016)]. The Turkish Ministry of Health (TMOH) requires two patients per nurse in level 3 ICUs, three patients per nurse in level 2 ICUs and five patients per nurse in level 1 ICUs. There is no standardization for the number of AHCW in ICUs. Finally, one ICP per 150 hospital beds is required by TMOH. Results: The total number of ICUs, ICU beds and ICPs were 214, 2377 and 111, respectively in he 41 participated centers. The number ICPs was adequate only in 12 hospitals. The percentage of nurses whose working experience was <1 year, was; 19% in level 1 ICUs, 25% in level 2 ICUs and 24% in level 3 ICUs. The number of patients per nurse was mostly <5 in level 1 ICUs whereas the number of patients per nurse in level 3 ICUs was generally >2. The number of patients per other HCW was minimum 3.75 and maximum 4.89 on weekdays and on day shift while it was minimum 5.02 and maximum 7.7 on weekends or on night shift. When we compared the number of level 1, 2 and 3 ICUs with adequate nursing workforce vs inadequate nursing workforce, the p value was <0.0001 at all time points except summer weekend night shift (p=0.002). Conclusion: Our data suggest that ICP workforce is inadequate in Turkey. Besides, HCW workforce is inadequate and almost 1/4 of nurses are relatively inexperienced especially in level 3 ICUs. Turkish healthcare system should promptly make necessary arrangements for adequate HCW staffing.
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    Are Soap, Paper Towel and Alcohol-based Disinfectants Easily Accessible in Intensive Care Units in Turkey?: Results of the Phokai Study
    Uyan, A; Durmus, G; Sezak, N; Özdemir, B; Kaygusuz, T; Öztoprak, N; Özdemir, K; Aksoy, F; Özgültekin, A; Koç, MM; Öncül, A; Çagan Aktas, S; Isik, B; Çelebi, G; Evik, G; Özger, S; Harman, R; Dindar Demiray, EK; Özkören Çalik, S; Alkan Çeviker, S; Yildiz, IE; Isik, ME; Senol, G; Sari, S; Dogan, M; Ugurlu, K; Arslan, M; Akgül, F; Koç, F; Kürekçi, Y; Çaglayan, D; Uçar, M; Gözüküçük, R; Elmaslar Mert, HT; Alay, H; Erdogan, H; Demirel, A; Dogan, N; Koçak, F; Güven, E; Ünsal, G; Sipahi, H; Yamazhan, T; Arda, B; Ulusoy, S; Sipahi, OR
    Introduction: Hand hygiene is one of the most effective infection control measures to prevent the spread of healthcare-associated infections (HCAI). Water, soap, paper towel and hand disinfectant must be available and adequate in terms of effective hand hygiene. The adequacy of hand hygiene products or keeping water-soap and paper towel is still a problem for many developing countries like Turkey. In this multicenter study, we analyzed the adequacy in number and availability of hand hygiene products. Materials and Methods: This study was performed in all intensive care units (ICUs) of 41 hospitals (27 tertiary-care educational, 10 state and four private hospitals) from 22 cities located in seven geographical regions of Turkey. We analyzed water, soap, paper towel and alcohol-based hand disinfectant adequacy on four different days, two of which were in summer during the vacation time (August, 27th and 31st 2016) and two in autumn (October, 12th and 15th 2016). Results: The total number of ICUs and intensive care beds in 41 participating centers were 214 and 2357, respectively. Overall, there was no soap in 3-11% of sinks and no paper towel in 10-18% of sinks while there was no alcohol-based hand disinfectant in 1-4.7% of hand disinfectant units on the observation days. When we compared the number of sinks with soap and/or paper towel on weekdays vs. weekends, there was no significant difference in summer. However, on autumn weekdays, the number of sinks with soap and paper towel was significantly lower on weekend days (p<0.0001, p<0.0001) while the number of hand disinfectant units with alcohol-based disinfectant was significantly higher (p<0.0001). Conclusion: There should be adequate and accessible hand hygiene materials for effective hand hygiene. In this study, we found that soap and paper towels were inadequate on the observation days in 3-11% and 10-18% of units, respectively. Attention should be paid on soap and paper towel supply at weekends as well.