PubMed İndeksli Yayınlar Koleksiyonu / PubMed Indexed Publications Collection

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Citation Count: 53
Exploring the role of metacognition in obsessive-compulsive and anxiety symptoms
(Pergamon-elsevier Science Ltd, 2008) Irak, Metehan; Tosun, Ahmet
This study tests three hypotheses, predicting first that metacognition is highly correlated with anxiety and obsessive-compulsive (O-C) symptoms, second that it mediates the relationship between O-C symptoms and anxiety, and third that the meta-cognitive predictors of anxiety are different from the meta-cognitive predictors of O-C symptoms. The sample of the present study was 850 students selected from various universities in Turkey. Significant correlations between metacognition, O-C symptoms and anxiety were observed. Also, mediation analysis confirmed that metacognition fully mediated the relationship between O-C symptoms and anxiety. Consistent with our hypothesis, trait anxiety and O-C symptoms had different meta-cognitive predictors. Although, we expected that meta-cognitive beliefs would vary based on the sub-type of O-C symptoms, meta-cognitive beliefs did not differ according to the O-C symptom subtypes. We discussed results with reference to the literature of meta-cognition, anxiety and O-C symptoms. (c) 2008 Elsevier Ltd. All fights reserved.
Citation Count: 101
Adaptation, validity, and reliability of the metacognition questionnaire-30 for the Turkish population, and its relationship to anxiety and obsessive-compulsive symptoms
(Turkiye Sinir ve Ruh Sagligi dernegi, 2008) Tosun, Ahmet; Irak, Metehan
Objective: The present study aimed to evaluate the psychometric properties of the short form of the Metacognition Questionnaire (MCQ-30) in a population of Turkish university students. The metacognitions questionnaire (MCQ) measures individual differences in a selection of metacognitive beliefs, judgments, and monitoring tendencies considered important in the metacognitive model of psychological disorders. Method: The study included 850 university students from 15 Turkish universities. Mean age age of the participants was 21.22 years, 282 (33.17%) were female, and 558 (66.82%) were male. Results: Construct validity was evaluated by exploratory and confirmatory factor analysis (CIA). Exploratory factor analysis revealed that the Turkish version of MCQ-30 has 5 components, which is some factor structure as the original form. In addition, the fit indices of CIA suggested an acceptable fit to a 5-factor model consistent with the original MCQ-30. The Turkish MCQ-30 showed acceptable to good test-retest reliability, internal consistency, and convergent validity. Significant positive relationships between the subscales of MCQ-30 and measures of anxiety and obsessive-compulsive symptoms provided further support for the convergent validity of the Turkish version. Moreover significant negative correlations were observed between age and the MCQ-30 subscales, and the effect of gender was significant on some of the subscales. Conclusion: The psychometric properties of the Turkish version of MCQ-30 showed that the instrument is a valuable additional tool for the assessment of metacognition in Turkey.
Citation Count: 10
Perceptual conflict and response competition: Event-related potentials of the stroop effect
(Turkish Association of Nervous and Mental Health, 2009) Bekçi,B.; Karakaş,S.
Objective: The aim of the present study was to analyze electrophysiological activity associated with the Stroop effect. Method: The sample included 50 healthy volunteer adults (23 female and 27 male) from the university population. Stimulation, recording and analyses were carried under NeuroScan 4.2 hardware-software system. The effect of the experimental variables (stimulus congruency, response accuracy and electrode location) on event-related potentials (ERPs) was studied using 2×2×3 analysis of variance for repeated measures. Results: The Stroop effect was demonstrated as prolonged reaction time to incongruent stimuli and increased total number of missed stimuli. Principal components analysis (PCA) showed that Stroop performance was related such factors as selective attention, interference, and resistance to interference. The electrophysiological Stroop effect was demonstrated as increased amplitude of P3 and N4 peaks for incongruent stimuli, and of N2, P3, N3, and N4 peaks for incorrect responses. Conclusion: Increased amplitude of P3 and N4 peaks associated with stimulus-related activation has been suggested to reflect conflict detection process. The variations in amplitudes for incorrect responses were complicated. While the amplitude of the N2 and P3 components increased only for incongruent stimuli, those of the N3 and N4 components increased for both congruent and incongruent stimuli. It was concluded that these earlier and later activations were associated with response competition and error detection processes, respectively. In this respect, these findings support both the perceptual conflict and the response competition hypotheses of Stroop interference.
Citation Count: 44
Detection of Aflatoxin M₁ in Human Breast Milk and Raw Cow's Milk in Istanbul, Turkey
(int Assoc Food Protection, 2009) Keskin, Yasar; Baskaya, Ruhtan; Karsli, Seher; Yurdun, Tuerkan; Ozyaral, Oguz
This survey was undertaken to determine the extent of aflatoxin M-1 (AFM(1)) contamination in human breast milk and raw cow's milk in Istanbul. Turkey. Samples of human and raw cow's milk were collected randomly and analyzed for AFM(1) using an enzyme-linked immunosorbetn assay and high-performance liquid chromatography with fluorescence detection in which the,samples were cleaned up with immunoaffinity columns. In this study, AFM(1) was detected in 8 (13.1%) of 61 human breast milk samples examined (mean +/- SD level, 5.68 +/- 0.62 ng/liter range, 5.10 to 6.90 ng/liter) and 20 (33.3%) of 60 raw cow's milk samples examined (range, 5.40 to 300.20 ng/liter). Five (8.3%) of the positive raw cow's milk samples had AFM(1) levels (153.52 +/- 100.60 ng/liter; range, 61.20 to 300.20 ng/liter) that were higher than the maximum tolerance limit (0.05 ppb) stipulated by regulations in Turkey and some other countries.
Citation Count: 13
Perceptual Conflict and Response Competition: Event-Related Potentials of the Stroop Effect
(Turkiye Sinir ve Ruh Sagligi dernegi, 2009) Bekci, Belma; Karakas, Sirel
Objective: The aim of the present study was to analyze electrophysiologicol activity associated with the Stroop effect. Method: The sample included 50 healthy volunteer adults (23 female and 27 male) from the university population. Stimulation, recording and analyses were carried under NeuroScan 4.2 hardware-software system. The effect of the experimental variables (stimulus congruency, response accuracy and electrode location) on event-related potentials (ERPs) was studied using 2x2x3 analysis of variance for repeated measures. Results: The Stroop effect was demonstrated as prolonged reaction time to incongruent stimuli and increased total number of missed stimuli. Principal components analysis (PCA) showed that Stroop performance was related such factors as selective attention, interference, and resistance to interference. The electrophysiological Stroop effect was demonstrated as increased amplitude of P3 and N4 peaks for incongruent stimuli, and of N2, P3, N3, and N4 peaks for incorrect responses. Conclusion: Increased amplitude of P3 and N4 peaks associated with stimulus-related activation has been suggested to reflect conflict detection process. The variations in amplitudes for incorrect responses were complicated. While the amplitude of the N2 and P3 components increased only for incongruent stimuli, those of the N3 and N4 components increased for both congruent and incongruent stimuli. It was concluded that these earlier and later activations were associated with response competition and error detection processes, respectively. In this respect, these findings support both the perceptual conflict and the response competition hypotheses of Stroop interference.
Citation Count: 25
The Effect of Breast Self-Examination (Bse) Education Given to Midwifery Students on Their Knowledge and Attitudes
(Asian Pacific Organization Cancer Prevention, 2010) Beydag, Kerime Derya; Yurugen, Birsen; Hemşirelik / Nursing
This study was conducted in a descriptive and half-experimental format in order to determine the effect of breast self-examination (BSE) education given to 103 midwifery students from Halic University Sciences of Health School Midwifery Department on their knowledge and attitudes. After legal permission was obtained from the institution and verbal participation consent from the students, data were obtained using demographic and knowledge surveys, applied twice before and after education by the researcher between May-June 2010and evaluated with proportional calculations, Kruskal Wallis test, t-test and t-test for dependent groups. Mean age of the students is 20.2+/-1.52; 58.3% had no information about BSE and 73.8% were not doing BSE; 7.7% them stated that they had a family member with breast cancer. The knowledge level score was 43.2+/-10.6 before and 68.4+/-10.5 after the BSE education (p<0.05). A statistically significant difference persisted between the pre- and post-education scores taking knowledge, making BSE, and frequency of using BSE average scores of the students (p<0.05).
Citation Count: 8
Knowledge and Applications of the Midwives and Nurses at an Educational Hospital on the Early Diagnosis of Cervix Cancer
(Asian Pacific Organization Cancer Prevention, 2011) Beydag, Kerime Derya
This descriptive study was made to determine the knowledge levels and application situations of 96 midwives and nurses at an educational hospital in Istanbul. Data were collected with the survey form and evaluated using frequency distribution and chi-square significance tests. Almost two-thirds of the midwives and nurses included stated that they never go for routine gynaecological tests without any sysmptoms, over 50% stated that they did not see themselves as being under risk in the aspect of cervix cancer, and 18.7% had no information about risk factors. While 54.2% had experienced at least one pap smear test, 20.8% stated that they did not see having a pap smear test as mandatory. Over 90.0 about the HPV vaccine, mostly from visual and published media, and 78.1% wanted to have HPV vaccination. A statistically significant difference was found between the the knowledge levels and application situations of the midwives and nurses and their age groups, educational status, and marital status (p<0.05). Participants in the age group 32 and over, with undergraduate or more education, and who were married, had more knowledge and practical experience.
Citation Count: 11
Sexual abuse in childhood and postoperative depression in women with breast cancer who opt for immediate reconstruction after mastectomy
(Royal Coll Surgeons England, 2011) Clark, Louise; Holcombe, Christopher; Hill, Jonathan; Krespi-Boothby, Margorit Rita; Fisher, Jean; Seward, Joanna; Salmon, Peter
INTRODUCTION Breast reconstruction is routinely offered to women who undergo mastectomy for breast cancer. However, patient-reported outcomes are mixed. Child abuse has enduring effects on adults' well-being and body image. As part of a study into damaging effects of abuse on adjustment to breast cancer, we examined: (i) whether women with history of abuse would be more likely than other women to opt for reconstruction; and (ii) whether mood problems in women opting for reconstruction can be explained by greater prevalence of abuse. PATIENTS AND METHODS We recruited 355 women within 2-4 days after surgery for primary breast cancer; 104 had mastectomy alone and 29 opted for reconstruction. Using standardised questionnaires, women self-reported emotional distress and recollections of childhood sexual abuse. Self-report of distress was repeated 12 months later. RESULTS Women who had reconstruction were younger than those who did not. Controlling for this, they reported greater prevalence of abuse and more distress than those having mastectomy alone. They were also more depressed postoperatively, and this effect remained significant after controlling for abuse. CONCLUSIONS One interpretation of these findings is that history of abuse influences women's decisions about responding to the threat of mastectomy, but it is premature to draw inferences for practice until the findings are replicated. If they are replicated, it will be important to recognise increased vulnerability of some patients who choose reconstruction. Studying the characteristics and needs of women who opt for immediate reconstruction and examining the implications for women's adjustment should be a priority for research.
Citation Count: 8
Effect on anxiety of education programme about care of arteriovenous fistula in patients undergoing hemodialysis
(Sage Publications Ltd, 2012) Mollaoglu, Mukadder; Tuncay, Fatma Ozkan; Fertelli, Tulay Kars; Yurugen, Birsen; Hemşirelik / Nursing
Purpose: This study investigated the impact of education, provided to individuals, in whom AV fistula was preferred as a vascular access, regarding information and anxiety. Methods: This experimental study was performed on 32 patients undergoing hemodialysis between November 2009 and February 2010 in the Nephrology Clinic of Sivas Cumhuriyet University Hospital. Patients' data was collected by means of Personal Information Form (PIF), AV Fistula Information Form (AV-FIF), and Beck Anxiety Inventory (BAI); education brochures were used in order to inform the individuals. Collected data were assessed with SPSS. Statistical analyses were used in order to assess the data: percentage account, paired samples t test. Results: When comparing information and anxiety score of individuals prior to and following education about AV fistula care, it was seen that information and anxiety scores were low and high respectively, prior to the education. Following education, patients' information and anxiety scores became higher and lower respectively. All these results were statistically significant (P < 0.001). Conclusions: Education about fistula increased the information level about fistula care and decreased anxiety in patients undergoing hemodialysis. It is important to perform patient education regularly, because it increases the level of orientation towards illness and interventions in patients.
Citation Count: 7
Meiotic recombinations within major histocompatibility complex of human embryos
(Springer, 2012) Taylan, Fulya; Altiok, Ender
We studied the rate and pattern of recombinations within the extended major histocompatibility complex (MHC) locus of the human embryos obtained during preimplantation genetic diagnosis (PGD) for HLA compatibility. Recombinant allele frequency was on average 5.33 %, and recombination rate was 0.44 cM/Mb in the 12.2 Mb of the extended MHC locus. Recombination rate varied up to 14-fold (0.19-2.73 cM/Mb) between cases, and maternal recombination rate was on average 3.8 times higher than paternal alleles. More than 69 % of the recombination hot spots were clustered within the extended class II region where the recombination rate was 5.4 times more than that in extended class I region. These findings indicate the potential of PGD to study the mechanisms of linkage disequilibrium within MHC locus of human embryos, demonstrate the recombination characteristics within extended MHC loci of human embryos in comparison to sperm and family studies, and point to the significance of design and interpretation of PGD for HLA compatibility to avoid misdiagnosis because of meiotic recombinations.
Citation Count: 0
Development and Area Adaptation of Flow Charts Related to Gynecologic Oncology Nursing Practices
(Asian Pacific Organization Cancer Prevention, 2012) Beydag, Kerime Derya; Komurcu, Nuran
Aim: This one group semi-experimental study was performed to develop and adapt flow charts of nursing practices applied to gynecologic oncology patients to the field. Methods: The research was conducted between October 2008 and March 2009 in 6 hospitals in Istanbul (3 health ministry hospitals, 2 private hospitals and 1 university hospital) with effective programs. The scope of the study included 97 midwives/nurses who had been working as caregivers of gynecologic oncology patients in this unit at least for 6 months and who participated in this study voluntarily; 87 people composed the sample because of the absence of others on vacation or sick leave when the data were collected or who did not wish to participate. The data were in descriptive information form collected via "Forms to Determine the Efficiency of Flow Charts". Before data collection, risks related to gynecologic oncology problems were identified, a literature scanning was made for existing flow charts based on actual practices and the discovered charts were reviewed. As a result of the evaluations, it was decided to create 15 flow charts intended for risks, symptoms, operation processes and discharge. Questionnaires to determine activity were applied to participants before and after practice. Results: As a result of the study, it was determined that the efficiency of the flow charts increased significantly (p<0.01) after practice of the participants, nosignificant relationships (p>0.01) being apparent with age group, education level, occupational period in the job and in the gynecologic oncology field and evaluations of the practice before and after it was applied. Conclusion: The results of the study revealed that nursing participants in university and private hospitals and who supported the existence of a flow chart in the field evaluated the flow charts positively.
Citation Count: 45
A novel mutation in the interleukin-1 receptor antagonist associated with intrauterine disease onset
(2012) Altiok,E.; Aksoy,F.; Perk,Y.; Taylan,F.; Kim,P.W.; Ilkkan,B.; Sanal,O.
Deficiency of the IL-1 receptor antagonist (DIRA) is a recently described rare autoinflammatory disease, caused by loss of function mutations in IL1RN leading to the unopposed activation of the IL-1 pathway. We describe a novel nonsense mutation in the IL1RN gene, associated with early intrauterine onset, death and multiorgan involvement in a prematurely born baby. The protein prediction model indicated that the novel Q119X mutation would result in a nonfunctional protein by impairing the ability of the IL-1Ra to bind and antagonize signaling through the IL-1R. Since the disorder may mimic severe bacterial infections and the treatment with anakinra is life saving, we intend to raise awareness of the syndrome and the possibility of a founder mutation that may lead to the diagnosis of additional cases in Turkey. The clinical suspicion of DIRA is critical to avoid improper management of the patients with antibiotics alone and death from multiorgan failure. © 2012 Elsevier Inc.
Citation Count: 22
Factors Affecting the Death Anxiety Levels of Relatives of Cancer Patients Undergoing Treatment
(Asian Pacific Organization Cancer Prevention, 2012) Beydag, Kerime Derya
This descriptive study was performed to determine levels of the death anxiety levels of relatives of patients who being treated in a public hospital located in the Asian side of Istanbul and influencing factors. The sample was 106 patient relatives of patients from oncology or chemotherapy units of the hospital. Data were collected between May-June 2011 with the 15-item Death Anxiety Scale developed by Templer (1970) and adapted to Turkish by Senol (1989) and evaluated by number-percentage calculations, the Kruskal Wallis, Anova and t tests. Some 36.8% of the included group were aged 45 years and over, 57.5% were female and 65.1% were married. A statistically significant difference was found between the age groups, genders of the patient relatives, the period of cancer treatment regarding the death anxiety levels (p<0.05). The death anxiety levels of the patient relatives who were in the 17-39 age group, female and had a patient who was under treatment for less than 6 months were found to high as compared to others.
Citation Count: 28
Classification of Juvenile Myoclonic Epilepsy Data Acquired Through Scanning Electromyography with Machine Learning Algorithms
(Springer, 2012) Goker, Imran; Osman, Onur; Ozekes, Serhat; Baslo, M. Baris; Ertas, Mustafa; Ulgen, Yekta
In this paper, classification of Juvenile Myoclonic Epilepsy (JME) patients and healthy volunteers included into Normal Control (NC) groups was established using Feed-Forward Neural Networks (NN), Support Vector Machines (SVM), Decision Trees (DT), and Na < ve Bayes (NB) methods by utilizing the data obtained through the scanning EMG method used in a clinical study. An experimental setup was built for this purpose. 105 motor units were measured. 44 of them belonged to JME group consisting of 9 patients and 61 of them belonged to NC group comprising ten healthy volunteers. k-fold cross validation was applied to train and test the models. ROC curves were drawn for k values of 4, 6, 8 and 10. 100% of detection sensitivity was obtained for DT, NN, and NB classification methods. The lowest FP number, which was obtained by NN, was 5.
Citation Count: 9
Uncertainty of the sample size reduction step in pesticide residue analysis of large-sized crops
(Taylor & Francis Ltd, 2013) Omeroglu, P. Yolci; Ambrus, A.; Boyacioglu, D.; Majzik, E. Solymosne
To estimate the uncertainty of the sample size reduction step, each unit in laboratory samples of papaya and cucumber was cut into four segments in longitudinal directions and two opposite segments were selected for further homogenisation while the other two were discarded. Jackfruit was cut into six segments in longitudinal directions, and all segments were kept for further analysis. To determine the pesticide residue concentrations in each segment, they were individually homogenised and analysed by chromatographic methods. One segment from each unit of the laboratory sample was drawn randomly to obtain 50 theoretical sub-samples with an MS Office Excel macro. The residue concentrations in a sub-sample were calculated from the weight of segments and the corresponding residue concentration. The coefficient of variation calculated from the residue concentrations of 50 sub-samples gave the relative uncertainty resulting from the sample size reduction step. The sample size reduction step, which is performed by selecting one longitudinal segment from each unit of the laboratory sample, resulted in relative uncertainties of 17% and 21% for field-treated jackfruits and cucumber, respectively, and 7% for post-harvest treated papaya. The results demonstrated that sample size reduction is an inevitable source of uncertainty in pesticide residue analysis of large-sized crops. The post-harvest treatment resulted in a lower variability because the dipping process leads to a more uniform residue concentration on the surface of the crops than does the foliar application of pesticides.
Citation Count: 46
Effects on caregiver burden of education related to home care in patients undergoing hemodialysis
(Wiley, 2013) Mollaoglu, Mukadder; Kayatas, Mansur; Yurugen, Birsen; Hemşirelik / Nursing
Caring for a patient undergoing hemodialysis is highly stressful and can negatively affect a caregiver's physical and psychological well-being. This study was conducted to examine the effect of educational support concerning caregiver burden and given to the caregivers of hemodialysis patients. This experimental study was performed with 122 caregivers. Patients' data were collected by means of Personal Information Form and Zarit Caregiver Burden Scale (ZCBS). Characteristics of caregivers of hemodialysis patients were analyzed descriptively in terms of frequencies and percentages for categorical data, means, and standard deviations. Mann-Whitney U test, Kruskall-Wallis test, and percentages were used in the data analysis. The mean ZCBS score was 52.1 +/- 8.6 (range, 0-88). Among the caregivers, the mean score of the ZCBS was significantly higher in women, single, young, family relatives as daughter/sister/brother/daughter-in-law and town/district, high educational level (P<0.05). Moreover, the mean score of the ZCBS was significantly higher in caregivers who have health problems/diseases. In addition, this study explored the educational needs of home-based such as nutrition (35.2%), dialysis (27.8%), fistula care (20.4%), catheter care (18.8%), the information about chronic kidney disease (18.0%), blood pressure (17.2%), weight control (17.2%), hygiene (3.1%), and travel/exercise (6.5%). The post-educational mean scores (55.0 +/- 7.6) of caregiver burden were observed to be lower than the pre-educational scores (43.9 +/- 5.2), and the difference was found to be statistically significant. The home-based educational program demonstrated a decrease in the burden of hemodialysis caregivers.
Citation Count: 3
Estimation of the uncertainties of extraction and clean-up steps in pesticide residue analysis of plant commodities
(Taylor & Francis Ltd, 2013) Omeroglu, P. Yolci; Ambrus, A.; Boyacioglu, D.
Extraction and clean-up constitute important steps in pesticide residue analysis. For the correct interpretation of analytical results, uncertainties of extraction and clean-up steps should be taken into account when the combined uncertainty of the analytical result is estimated. In the scope of this study, uncertainties of extraction and clean-up steps were investigated by spiking 14C-labelled chlorpyrifos to analytical portions of tomato, orange, apple, green bean, cucumber, jackfruit, papaya and starfruit. After each step, replicate measurements were carried out with a liquid scintillation counter. Uncertainties in extraction and clean-up steps were estimated separately for every matrix and method combination by using within-laboratory reproducibility standard deviation and were characterised with the CV of recoveries. It was observed that the uncertainty of the ethyl acetate extraction step varied between 0.8% and 5.9%. The relative standard uncertainty of the clean-up step with dispersive SPE used in the method known as QuEChERS was estimated to be around 1.5% for tomato, apple and green beans. The highest variation of 4.8% was observed in cucumber. The uncertainty of the clean-up step with gel permeation chromatography ranged between 5.3% and 13.1%, and it was relatively higher than that obtained with the dispersive SPE method.
Citation Count: 7
Knowledge, Attitudes and Behaviour of Women Working in Government Hospitals Regarding Breast Self Examination
(Asian Pacific Organization Cancer Prevention, 2013) Yurdakos, Kursat; Gulhan, Yildirim Beyazit; Unalan, Demet; Ozturk, Ahmet; Sağlık Yönetimi / Healthcare Management
Background: Breast self examination (BSE), performed regularly every month, is one of the most important methods in the early diagnosis of breast cancer. This study was performed with the aim of establishing the knowledge, attitudes, and behavior of women working in government hospitals within the province of Samsun regarding BSE. Materials and Methods: This cross-sectional study was conducted between January-March 2012, on a total of 550 women (500 health personnel, and 50 general administration services (GAS) workers) from 7 government hospitals and the Cancer Early Diagnosis, Screening, and Education Centre (CEDSEC). Percentages were used for the descriptive statistics, and the chi-square test for the evaluation of statistical importance. Values of p<0.05 were accepted as significant. Results: The mean age of the participants was 36.2 +/- 15.3, and 42.5% were in the 30-39 year old age group, 78.0% being married. Seventy-eight point four percent (78.4%) of the health personnel and 76.0% of the GAS workers performed BSE. However, the rates of performing BSE regularly every month were only 25.6% and 5.0%. Within the health personnel, 1.4% stated that they did not perform BSE because they found it unnecessary as they had no history of breast cancer in their family, 3.6% did not do so due to fear and stress, 13.2% because they forgot, and 14.6% because they had no complaints. Some 22.2% of the health personnel and 52.0% of the GAS workers had undergone mammographic evaluation, the difference being significant (p<0.05), 84.1% of the health personnel and 61.9% of the GAS workers knowing symptoms of breast cancer. Conclusions: Women in society should be brought to a certain level of awareness and knowledge regarding BSE. It is of the utmost importance that health personnel, who carry the responsibility for counseling and enlightening society, should interiorize the necessary knowledge, attitudes and behavior.
Citation Count: 6
The effectiveness of transplant legislation, procedures and management: Cross-country evidence
(Elsevier Ireland Ltd, 2013) Bilgel, Firat
This article investigates the impact of legal determinants of cadaveric and living donor organ transplantation rates using panel data on legislative, procedural and managerial aspects of organ transplantation and procurement, government health expenditures, enrollment rates, religious beliefs, legal systems and civil rights and liberties for 62 countries over a 2-year period. Under living donor organ transplantation, we found that guaranteeing traceability of organs by law or performing psychiatric evaluation to living donors has a sizeable, negative impact on living transplant rates once the remaining determinants of living transplantation have been controlled for. Under cadaveric transplantation, our findings do not suggest an unequivocal and positive association between presumed consent, donor registries and cadaveric transplant rates. However, legally requiring family consent or maintaining written procurement standards for deceased donors has a sizeable, negative impact on cadaveric transplant rates. The latter finding suggests that informing families rather than asking for consent may be an effective strategy to raise procurement rates while respecting patient autonomy. Finally, we confirm that predominantly non-Christian countries have significantly higher living but lower cadaveric transplant rates. (C) 2013 Elsevier Ireland Ltd. All rights reserved.
Citation Count: 38
COST: Cognitive State Test, a brief screening battery for Alzheimer disease in illiterate and literate patients
(Cambridge Univ Press, 2013) Babacan-Yildiz, Gulsen; Isik, Ahmet T.; Ur, Emel; Aydemir, Emine; Ertas, Can; Cebi, Merve; Celebi, Arif
Background: The aim was to develop a brief screening battery, Cognitive State Test (COST), for detecting the presence of dementia in both illiterate and literate patients and to assess its validity and reliability. Methods: COST is a cognitive screening tool that consists of almost all cognitive domains. It takes 5-7 minutes to administer, and has a maximum score of 30. Data were obtained from 114 healthy volunteers and 74 Alzheimer dementia (AD) patients. Subjects' age divided into two groups: A1: <65 years; and A2: >= 65 years and their education level divided into three groups: E1: illiterate; E2: 1-5 years; and E3: >= 6 years. For assessing concurrent validity, total COST score was compared to the Clinical Dementia Rating (CDR), the Mini Mental State Examination (MMSE), the Montreal Cognitive Assessment (MoCA), and Basic Activities of Daily Living (BADL). Sensitivity and specificity were determined through a discriminant analysis using the Receiver Operating Characteristic (ROC) curves. Internal consistency was measured using Cronbach's coefficient alpha. Results: For normal and AD subjects, mean age was 64.9 +/- 9.8 years (50 women and 64 men) and 67.2 +/- 13.2 years (55 women and 19 men), respectively. Schooling ranged from 0-15 years (mean 5.7 +/- 4.2 and 3.3 +/- 3.8 years, respectively), and 21 and 37 subjects were illiterate, respectively. The COST significantly and positively correlated with MMSE and MoCA, and significantly and inversely correlated with CDR, the Geriatric Depression Scale (GDS), and BADL. In the E1, E2, and E3 education groups, the optimal cut-off points of COST chosen for diagnosis of AD were 23/24 (sensitivity: 81%, specificity: 99%), 24/25 (sensitivity: 75%, specificity: 86%), and 26/27 (sensitivity: 77%, specificity: 84%), respectively. When illiterate and literate subjects were then pooled, the optimal cut-off score of COST was 24/25, which yielded a sensitivity of 81% and a specificity of 87%. Reliability of the COST was good (0.86). Conclusion: The COST is a valid and reliable screening battery for detection of dementia both in the illiterate and the literate Alzheimer patients.

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