Development and validation of the stigma scale for epilepsy in Turkey

ObjectiveEpilepsy is a chronic disease with an increased risk of stigma. The aim of this study was to investigate the efficacy of a scale developed by the authors to determine the level of stigma in Turkish patients with epilepsy and their relatives.MethodsIn this pilot study, two scales were developed, one consisting of 32 questions for the patients and one of 20 questions for the patients' relatives. Initially, a total of 30 patients with epilepsy and 30 relatives of the patients were included. The Cronbach's alpha coefficient was calculated in a reliability analysis of validity applying the scales to 302 patients and 201 relatives of the patients. The Pearson correlation coefficient was used for the reliability analysis of the test-retest. The t-test was used in paired series, and factor analysis was conducted. The correlation between the clinical and demographical data and the stigma scores was evaluated.ResultsThe scales were applied to participants twice under the same conditions in one-week interval. In the test-retest analysis, the internal consistency of the scales was high and reliable. In the analysis of the patients, the Cronbach's alpha value of the scale was found to be 0.915. In the factor analysis, the questions were grouped into five factors including social isolation, discrimination, insufficiency, false beliefs, and stigma resistance. The factors with the highest contribution to the stigma level were social isolation and discrimination. In the stigma scores, a significant correlation was found between the age of the patient, frequency of seizures, education status, level of income, and the amount of antiepileptic drugs used. In the analysis of the patients' relatives, the Cronbach's alpha value of the scale was found to be 0.892. In the factor analysis, the questions were classified as discrimination, prejudgments, and false beliefs. The factor which most contributed to the stigma level was discrimination. A significant correlation was found in the stigma scores between sex, education status, marital status, and income distribution.ConclusionAccording to our study results, it is clearly seen that both patients and their relatives suffer from epilepsy-associated stigma. Patients with epilepsy and their relatives are faced with discrimination in society, resulting in social isolation. We, therefore, believe that both patients and their relatives should be informed in detail about discrimination to overcome this challenge.     

Predictors of Serious Consequences of Falls in Residential Aged Care: Analysis of More Than 70,000 Falls From Residents of Bavarian Nursing Homes

Background/ObjectiveFalls are common in nursing homes and cause a high burden of injuries. The objective of this study was to analyze factors associated with serious consequences of falls in nursing home residents.DesignProspective observational study.SettingFalls were recorded over 1 year, covering all residents from 528 nursing homes in Bavaria, Germany.ParticipantsThe database consisted of 70,196 falls.MeasurementsThe standardized form included information about date, time, sex, age, functional status, location of fall, activity leading to the fall, footwear, and about potential consequences, such as transfer to hospital or a suspected fracture. Transfer to hospital was the main outcome and served as surrogate for a serious fall. The association of potential risk factors with hospital transfer after a fall was estimated in multiple logistic regression models.ResultsSerious falls were associated with increasing age, being female, and less restricted functional status. Walking compared with transferring, and particularly the morning hours were also associated with a serious fall. Compared with midday, for example, the time period between 6 am and 8 am was associated with a more than 60% increased chance of transfer to hospital. Inappropriate footwear and weekends were associated with serious falls only in women.ConclusionSome observed factors or indicators associated with transfer to hospital are modifiable and targeted interventions may reduce injuries or costs after a fall.     

Efficacy of a high quality O1/Campos foot-and-mouth disease vaccine upon challenge with a heterologous Korean O Mya98 lineage virus in pigs

In 2010 serotype O foot-and-mouth disease virus of the Mya98 lineage/SEA topotype spread into most East Asian countries. During 2010–2011 it was responsible for major outbreaks in the Republic of Korea where a monovalent O/Manisa vaccine (belonging to the ME-SA topotype) was applied to help control the outbreaks. Subsequently, all susceptible animals were vaccinated every 6 months with a vaccine containing the O/Manisa antigen. Despite vaccination, the disease re-occurred in 2014 and afterwards almost annually. This study focuses on the in vivo efficacy in pigs of a high quality monovalent commercial O₁/Campos vaccine against heterologous challenge with a representative 2015 isolate from the Jincheon Province of the Republic of Korea. Initially, viral characterizations and r₁ determinations were performed on six viruses recovered in that region during 2014–2015, centering on their relationship with the well characterized and widely available O₁/Campos vaccine strain. Genetic and antigenic analysis indicated a close similarity among 2014–2015 Korean isolates and with the previous 2010 virus, with distinct differences with the O₁/Campos strain. Virus neutralisation tests using O₁/Campos cattle and pig post vaccination sera and recent Korean outbreak viruses predicted acceptable cross-protection after a single vaccination, as indicated by r₁ values, and in pigs, by expectancy of protection. In agreement with the in vitro estimates, in vivo challenge with a selected field isolate indicated that O₁/Campos primo vaccinated pigs were protected, resulting in a PD50 value of nearly 10. The results indicated that good quality oil vaccines containing the O₁/Campos strain can successfully be used against isolates belonging to the O Mya98/SEA topotype.     

Endocannabinoid mechanism in amphetamine-type stimulant use disorders: A short review

Recent evidence shows that the endocannabinoid system is involved in amphetamine-type stimulants (ATS) use disorders. To elucidate the role of the endocannabinoid system in ATS addiction, we reviewed results of studies using cannabinoid receptor agonists, antagonists as well as knockout model. The endocannabinoid system seems to play a role in reinstatement and relapse of ATS addiction and ATS-induced psychiatric symptoms. The molecular mechanisms of this system remains unclear, the association with dopamine system in nucleus accumbens is most likely involved. However, the function of the endocannabinoid system in anxiety and anti-anxiety effects induced by ATS is more complicated. These findings suggest that the endocannabinoid system may play an important role in the mechanism of ATS addiction and provide new idea for treating ATS addiction.