Turku City Hospital

Pressure Injuries (PIs) are frequent, preventable complications in Intensive Care Units (ICUs), leading to morbidity, mortality, and increased healthcare costs. Alternating Pressure Air Mattresses (APAMs) have been proposed to reduce PI incidence, but real-world data remain scarce. To assess the effectiveness and cost-efficiency of APAMs in preventing PIs among critically ill patients. This retrospective cohort study was conducted in a 10-bed tertiary ICU, comparing patients before and after APAM implementation. Multivariate logistic regression identified independent PI risk factors, and a cost-effectiveness model was developed using Number Needed to Treat (NNT) and treatment costs. APAM use reduced overall PI risk by 33% (RR = 0.67; 95% CI 0.45-0.98) and Stage III-IV ulcer risk by 84% (RR = 0.16; 95% CI 0.05-0.53). The NNT was 23, corresponding to net savings of USD 121,750 over five years for a 10-bed ICU, with cost recovery achieved within 4.3-months. Length of Stay (LOS) and prolonged mechanical ventilation independently increased PI risk by 19% and 13% per day, respectively. APAMs' benefit was attenuated in patients with extended LOS and ventilation. Sepsis and respiratory failure increased PI risk in univariate analysis but lost significance after adjustment, indicating mediation by LOS and ventilation. APAMs eliminated the need for negative pressure wound therapy in this cohort. APAMs significantly reduced severe PI incidence and treatment requirements in critically ill patients, demonstrating cost-effectiveness. Their protective effect was limited in patients with prolonged ICU stay or ventilation. Multicenter randomized trials are warranted, especially in diabetic and septic populations.

The global rise in cesarean section (CS) rates has made effective, opioid-sparing postoperative analgesia a clinical priority. The erector spinae plane block (ESPB) and retrolaminar block (RLB) are trunk blocks increasingly incorporated into multimodal analgesia protocols; however, comparative evidence between these two techniques following CS remains limited. This retrospective, single-center study analyzed adult women undergoing elective CS under spinal anesthesia, without the use of general anesthesia. The primary outcome was total tramadol consumption within 24 h postoperatively. Secondary outcomes included time to first rescue analgesia, VAS scores at 1, 6, 12, and 24 h, 24-h ObsQoR-11 T score, time to discharge, and incidence of adverse events. Of 126 screened patients, 122 were analyzed (ESPB n = 64; RLB n = 58). ESPB significantly reduced 24-h tramadol consumption compared with RLB (130.94 mg vs. 141.9 mg; p = 0.001) and prolonged the time to first rescue analgesia (7.86 ± 1.50 vs. 6.78 ± 1.28 h; p = 0.001). VAS scores were significantly lower in the ESPB group at 6 h (p = 0.005) and 12 h (p < 0.001), with no differences at 1 or 24 h. ObsQoR-11 T scores and discharge times were comparable between groups. Adverse events were infrequent; hypotension occurred in 10.9% of ESPB patients and 5.2% of RLB patients (p = 0.246). In elective CS, ESPB provided superior early postoperative analgesia and reduced opioid consumption compared to RLB. ESPB appears to be a rational choice when prolonged analgesia and opioid sparing are prioritized in the early postoperative period, whereas RLB may serve as a reliable alternative in settings emphasizing technical simplicity and hemodynamic stability.

The aim of this study was to determine the effect of respiratory problems and nutritional characteristics on sleep quality in children and the factors related to this effect. This descriptive and cross-sectional study was conducted in a hospital between October 2023 and July 2024. Data were collected using child information form and Pediatric Sleep Questionnaire: Sleep-disordered breathing subscale. Data were analyzed by computer with 95% confidence interval. A total of 101 children with an average age of 7.3 years and their mothers participated in the study. The mean sleep quality scale score was 0.22 points. The quality of sleep was influenced by nutrition, especially the number and timing of snacks, daytime sleep duration, number of nighttime waking, characteristics of the sleep environment, presence of respiratory disorders or attention deficit hyperactivity disorder, and sleep disorder diagnosed by polysomnography. The health of their mothers was also found to be an important factor. In order for children to have a healthy growth and development period, their sleep needs should be met in a healthy way. It is important to ensure sleep and nutritional regularity for sleep quality. It was observed that individual and family-based interventions are necessary for a healthy sleep pattern.

Türk Dünyasının bir parçası olan Karakalpak Türkleri, günümüzde Özbekistan Cumhuriyetine bağlı Karakalpakistan Özerk Cumhuriyetinde yaşamaktadır. Karakalpakalar, bugünkü yurtları olan Aral Gölü ve Amuderya boylarında oluşmuşlardır. Türkistan’ın bir parçası olan Karakalpakistan, tarihte Türkistan hanlıkları, Rus Çarlığı ve SSCB ve nihayetinde Özbekistan Cumhuriyeti bünyesinde kalmıştır. Rus Çarlığı’nın Türkistan’da hâkimiyet kurmasıyla XIX. yüzyıl sonu-XX. yüzyıl başında Karakalpakistan’da millî fikir akımları gelişmeye başlamıştır. Karakalpak şairler, Ruslara karşı şiirleriyle ve fikirleriyle güçlü durmaya çalışmışlardır. Karakalpakistan’da ünlü şairlerden Ajiniyaz, Berdak ve Öteş, Sıdık Tokpanoğlu, Abdikadir Bekimbetoğlu, Seyfulgabit Macitov, Ömer Süyürbekoğlu, Ayapbergen Musaoğlu, Kulmurat gibi şairler de millî fikir akımlarının gelişmesine katkıda bulunmuşlardır. Bu şairlerin fikirleri XX. yüzyılın başında diğer Karakalpak şair-düşünürler tarafından da temsil edilmiştir. Karakalpak Türkleri arasında sözlü kültürün yaygın olmasının da etkisiyle Türk kültürüne dair öğeler, şairlerin sözlerine yansımıştır. Rus Çarlığı’nın Karakalpaklara uyguladığı baskılar, Karakalpak Türk kimliğinin sözlü ve yazılı kültür üzerinden halka etki etmesine de neden olmuştur. Bu makalemizde XIX. yüzyıl sonu-XX. yüzyıl başında Karakalpakistan’da ortaya çıkan millî akımların öncü şairleri ve onların da katkısıyla Ceditçiliğin bölgede etkisini incelemeye çalıştık.

BACKGROUNDIn this aging population, lumbar spinal stenosis (LSS) reduces walking distance and impairs functionality. The definitive treatment is still controversial.AIMTo assess the efficacy of physical therapy and surgery in improving function and reducing pain levels in patients with LSS, both in the short and long term.METHODSThis prospective study screened patients aged 50-80 years with LSS and divided them into two groups based on certain criteria: Surgical and conservative. The conservative group received a supervised physical therapy and exercise program for 45 minutes, five days a week, for one month. The surgery group underwent micro endoscopic decompression surgery based on their LSS levels. Assessments, conducted before treatment and at one-month and one-year intervals, included the participants' walking distance, pain level using the visual analog scale, functionality using the Istanbul low back pain disability index (ILBDI) and Swiss Spinal Stenosis Questionnaire (SSS) Scale, and activities of daily living level using the Nottingham Extended Activities of Daily Living.RESULTSThe study comprised 40 participants, equally divided into surgical and conservative treatment groups, with no significant demographic differences. After one year, both groups exhibited similar changes in walking distance and pain levels. However, the conservative group demonstrated significantly greater improvements in sub-parameters of functional activity and symptom severity of the SSS. After one year, the surgical group showed greater functionality, as assessed by ILBDI, and superior improvement in activities of daily living compared to the conservative group.CONCLUSIONBoth treatments showed comparable efficacy in core outcomes (pain, walking distance). However, complementary advantages were observed: Conservative management demonstrated superior improvement in SSS functional subscales, while surgery yielded greater gains in daily living activities and low-back-pain-related disability.

To evaluate the outcomes and acceptability of the Community-based Participatory Occupational Well-being Intervention for Educators. This pilot study used a sequential explanatory mixed-method intervention study design in which the post-intervention qualitative data were embedded in the quasi-experimental pre-test-post-test data to explain and expand the intervention outcomes and to evaluate intervention acceptability. This study received an ethical statement from the UEF Committee on Research Ethics (7/2021 15.4.2021) and followed the ethical principles of the Declaration of Helsinki. The quantitative pre-and post-test data were collected using an electronic questionnaire among health care educators (intervention n = 19, comparison n = 22). The 1-year intervention included (i) an online course, formation of (ii) an occupational well-being development team, which (iii) planned and (iv) implemented community-specific development actions. Qualitative interview data were collected from participants (n = 9) 3 months post-intervention. The quantitative data were analysed statistically and the qualitative data by deductive-inductive content analysis. The main results were merged into a joint display as mixed-method meta-inferences. Positive changes were found in occupational well-being, promoting activities and workplace support. Educators experienced improvements in work organisation processes and reflection on occupational well-being issues. The study found no significant change in the overall self-assessed level of occupational well-being. The intervention framework was considered functional, with workload issues as the main barriers. The main limitations of this study were a small sample size and a long intervention period, which challenged participant engagement and outcome evaluation. The intervention enables community-level occupational well-being development, and it can be applied in health care educators' work communities. The study suggests refining the intervention in terms of information provision, time resources and community-level orientation and discussion.