Aydin Kahraman, Handan; İpek Çoban, Gülay; Bozcu Kartal, Ebru

Objective: This study aimed to evaluate the risk of medical device-related pressure injury (MDRPI) development among patients exposed to medical devices and to assess the clinical utility of the Medical Device-Related Pressure Injury Risk Assessment Scale (MDRPIS). Methods: This clinical assessment study included 132 patients receiving care in intensive care, palliative care, and home-care units. The MDRPIS total score ranges from 8 to 27, with scores of 8–12 indicating high risk, 13–21 indicating moderate risk, and 22–27 indicating low risk. The scale was used to assess MDRPI risk associated with life-sustaining medical devices. Its psychometric performance was evaluated through analyses of internal consistency, criterion validity against the Braden Scale, and diagnostic accuracy using receiver operating characteristic (ROC) analysis. Results: The MDRPIS demonstrated strong discriminative ability for identifying patients at risk of MDRPI, with an area under the curve (AUC) of 0.822. A cut-off score of ≤16 was identified as the optimal threshold for detecting high-risk patients. Patients with MDRPIS scores of 16 or lower had a significantly higher incidence of MDRPI than those classified as low risk (p < 0.001). Respiratory support devices, particularly non-invasive ventilation (NIV)/continuous positive airway pressure (CPAP) masks and tracheostomy flanges or securement devices, were identified as the most significant risk factors for injury development. The highest incidence of MDRPI was observed among patients in intensive care units, followed by those in palliative care and home-care settings, indicating a statistically significant concentration of device-related risk in high-acuity care environments (p < 0.05). Conclusions: Clinical settings, particularly intensive care and palliative care units, should incorporate the MDRPIS into routine risk assessment protocols to facilitate targeted preventive interventions, including prophylactic dressings and advanced fixation techniques for patients using high-risk devices such as NIV masks and tracheostomy securement systems. The systematic implementation of the MDRPIS may support more effective allocation of nursing resources and enhance patient safety by enabling the early identification and prevention of avoidable device-related pressure injuries. Furthermore, the findings indicate that an MDRPIS score of 16 or below represents a clinically meaningful threshold for initiating preventive interventions.

Kantar, Yusuf; Aslan, Yusuf Ertuğrul; Eden, Arif Onur; Bilgin, Yasin; Tanrıverdi, Orhan; Yurttutan, Abdullah Emre; Çimen, Erdem Yakup; Sarı, Fatih Mehmet

Background: Smartphone screen exposure has increased substantially among young adults and has been associated with headache and sleep disturbances. This study aimed to investigate the associations between smartphone screen time, headache severity, sleep duration, and sleep quality in young adults presenting to the emergency department with headache. Methods: This single-center case–control study was conducted in the emergency department of a tertiary university hospital between November 2025 and April 2026. A total of 300 participants aged 18–40 years were enrolled, including 150 patients with headache and 150 controls without headache. Daily smartphone screen time was obtained from the built-in smartphone records for the preceding completed seven-day period, headache severity was assessed using the 11-point Numeric Rating Scale, and sleep quality was evaluated using the validated Turkish version of the Single-Item Sleep Quality Scale. Results: Participants with headache had longer smartphone screen time (7.0 vs. 5.0 h/day; p < 0.001), shorter sleep duration (7.0 vs. 8.0 h/day; p = 0.005), and poorer sleep quality (5.0 vs. 7.0; p < 0.001) than controls. Screen time correlated with headache severity (ρ = 0.430, p < 0.001) and inversely with sleep quality after adjustment for study group (partial ρ = −0.185, p = 0.001). Nonlinear multivariable modeling showed an association with headache presentation (p < 0.001); relative to 6 h/day, the aOR at 7 h/day was 8.83 (95% CI: 5.00–15.60), with a plateau at higher exposures. Conclusions: Longer device-recorded smartphone screen time was associated with headache presentation and severity in young adults. Participants with headache also reported poorer sleep quality and shorter sleep duration. These findings suggest relevant associations between smartphone exposure, sleep, and headache but do not establish causality or a clinical screen-time threshold. Prospective studies are warranted.

Yapıcı, Furkan

Background: Knee osteoarthritis (KOA) is often framed as degenerative knee pain, yet behaves as a decades-long care pathway in which medication, injections, comorbidity, productivity loss, and surgery accumulate into a major economic footprint. This critical narrative review synthesizes pharmacoeconomic and pharmacoepidemiologic evidence across that pathway. Methods: Structured source identification was conducted in PubMed, Web of Science, Scopus, and Google Scholar for publications from 2000 to 2026, with citation tracking. Sources were appraised against predefined critical-interpretation domains and mapped narratively rather than pooled; no meta-analysis was performed. Results: Global Burden of Disease 2019 estimates approximately 364.6 million prevalent KOA cases worldwide. Reported evidence indicates that KOA spending is highly concentrated: in a large U.S. claims analysis, knee arthroplasty was performed in approximately 8.8% of patients yet accounted for 61.5% of KOA-related costs, whereas hyaluronic acid represented 3.0% of overall costs; the remaining pathway burden was distributed across years of outpatient care, analgesics, injections, and other nonsurgical utilization. Medication and injection findings were stage- and phenotype-dependent, and observational studies associated opioid exposure with higher fall risk, healthcare utilization, and cost. Intra-articular hyaluronic acid was repeatedly associated with longer time to arthroplasty, interpreted here as an association limited by confounding and immortal-time bias, not a causal effect; platelet-rich plasma value remained price- and durability-sensitive. Conclusions: KOA economics resembles an iceberg—arthroplasty is the visible peak, while the submerged mass is years of pathway-level care. Value-based policy should measure the full pathway, not the surgical episode, using linked claims, registries, patient-reported outcomes, and productivity data.

Oruç, Abdurrahman; Cengiz, Ekrem

Background/Objectives: Measuring perceived social support after disaster remains an unresolved psychometric problem. Most instruments do not jointly capture the source of support (from whom it comes) and its function (how it operates). None has been validated in a disaster-survivor sample with retrospectively framed items. We developed and validated the Perceived Social Support in Disasters Scale (PSSDS-28), a 28-item measure integrating both dimensions. Methods: In Phase 1, a PRISMA 2020-guided systematic review; a two-round Delphi with eight experts, cognitive interviews (n = 12); and a pilot study (N = 150) produced a 31-item form. In Phase 2, face-to-face data were collected from 607 adults affected by the 6 February 2023 Kahramanmaraş earthquakes (Türkiye). Multiple analytic frameworks converged on a five-factor, 28-item structure comprising family–relative, social environment, institutional, emotional, and instrumental–informational support. Results: The correlated five-factor model fit the independent validation sample well (CFI = 0.954, RMSEA = 0.076, and SRMR = 0.072) and outperformed a one-factor alternative (ΔCFI = 0.222). Blocks showed strong internal consistency (ordinal α = 0.852–0.949), composite reliability (0.865–0.950), and adequate test–retest stability (ICC = 0.542–0.909). Scalar measurement invariance held across six groupings, with no meaningful differential item functioning. Convergent and discriminant evidence supported construct validity, and common-method variance was negligible. Institutional (M = 3.29) and instrumental–informational support (M = 2.99) scored lowest—a profile a global score would conceal. Conclusions: The PSSDS-28 provides promising initial psychometric evidence for a multidimensional post-disaster assessment instrument situated at the perceived–received interface, a target that general-purpose scales are not designed to capture. Criterion-related validity, cross-cultural validity, and cross-disaster replicability remain to be demonstrated.

Gürsoy, Nurcan; Gürsoy, Ersan

Background: Retinitis pigmentosa (RP) is a progressive inherited retinal dystrophy that affects daily functioning, psychological well-being, and social participation. Although quantitative research describes disease burden, less is known about how individuals experience progressive vision loss in everyday life and within healthcare and social contexts. Methods: This qualitative study used semi-structured face-to-face interviews with adults diagnosed with RP. Purposive sampling was applied to ensure variation in demographic and clinical characteristics. Interviews were conducted in a tertiary ophthalmology clinic in Erzincan, Türkiye, between June and October 2025. Audio recordings were transcribed verbatim and analyzed using Braun and Clarke’s reflexive thematic analysis. Reporting followed the Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist. Results: Sixteen participants (P1–P16) were included. Five themes were identified: (1) making sense of the illness and the diagnostic journey; (2) functional loss and the negotiation of independence; (3) psychological adaptation and identity reconstruction; (4) social relationships and social encounters; and (5) interaction with systems and the environment—accessibility and healthcare. Participants described early symptom normalization, delayed diagnostic pathways, and uncertainty persisting after diagnosis. Independence was shaped by safety concerns, environmental barriers, and reliance on support. Psychological adjustment fluctuated between fear of progression and efforts to sustain resilience. Social participation was influenced by support networks, concerns about being a burden, and stigma linked to invisible disability. Conclusions: Living with RP extends beyond visual impairment; building on prior qualitative work, our findings contextualize these experiences in Türkiye, highlighting how accessibility gaps, bureaucratic encounters in public institutions, and cost barriers within healthcare and public services can shape uncertainty, independence, and social participation.

Sari, Fatih Mehmet; Bilgin, Yasin; Kilic, Mert; Cimen, Erdem Yakup; Yurttutan, Abdullah Emre; Eden, Arif Onur

Background/Objectives: Ambulance-transported patients represent an important subgroup of emergency department (ED) admissions and may demonstrate distinct temporal presentation patterns. However, studies simultaneously evaluating broad diagnostic categories according to both time-of-day and seasonal variations among ambulance-transported patients remain limited. Methods: This retrospective observational study included 37,188 patients transported to the emergency department of a tertiary university hospital by ambulance between December 1, 2024, and November 30, 2025. Patients were categorized into twelve major diagnostic groups according to ICD-10-based clinical diagnoses. Temporal analyses were performed according to seasons and time-of-day intervals (nighttime, daytime, and evening). Associations between diagnostic categories and temporal variables were evaluated using chi-square analysis. Results: Trauma was the most common diagnostic category (19.9%), followed by cardiovascular (16.3%), gastrointestinal (10.3%), and respiratory diseases (10.1%). Significant associations were observed between diagnostic categories and both seasonal distribution (χ2 = 446.482, df = 33, p < 0.001) and time of presentation (χ2 = 642.883, df = 22, p < 0.001). Respiratory diseases were most frequent during winter (32.7%), whereas trauma-related admissions peaked during summer (32.4%). Psychiatric presentations predominantly occurred during evening hours (53.2%), while gastrointestinal diseases demonstrated the highest proportion of nighttime admissions (24.2%). Trauma-related admissions were more common among males (63.6%), whereas neurological, gastrointestinal, metabolic, and psychiatric presentations were slightly more frequent among females. The mean age of the cohort was 49.02 ± 25.12 years. Conclusions: Ambulance-transported emergency department patients demonstrate significant seasonal and time-of-day variations across major diagnostic categories. Awareness of these temporal patterns may contribute to improved emergency department organization, ambulance deployment, staffing strategies, and healthcare resource management.

Ötügen, Taha Emre; Akyol, Fethi; Karataş, Talha; Ataş, Gamze; Taş, Hakan Gökalp; Kuyrukluyıldız, Ufuk

Background: Effective postoperative pain control after cesarean delivery is essential for facilitating early mobilization and reducing analgesic requirements. Ultrasound-guided fascial plane blocks, such as the transversus abdominis plane (TAP) and transversalis fascia plane (TFP) blocks, are increasingly used as components of multimodal analgesia; however, direct comparative data between these techniques remain limited. Methods: In this prospective observational study, 90 patients undergoing repeat cesarean deliveries under spinal anesthesia were administered either a bilateral ultrasound-guided transversus abdominis plane (TAP) block or a transversus fascia plane (TFP) block in accordance with standard clinical practice. The intensity of postoperative pain, assessed both at rest and during movement, was determined using VAS scores at 3, 6, 12, and 24 h after surgery. The time until first ambulation and additional postoperative analgesic consumption beyond the standardized baseline analgesic regimen over the first 24 postoperative hours were also evaluated. Results: The patients who were administered a TFP block had diminished postoperative pain levels, reduced additional postoperative analgesic requirements, and expedited mobilization relative to those administered a TAP block. The TFP group had considerably lower movement-related pain levels within the first 24 h following surgery. Opioid-related adverse effects were comparable between groups. Conclusions: After a repeat cesarean delivery, applying a TFP block was linked to better postoperative analgesia and fewer analgesic requirements than applying a TAP block. These findings suggest that TFP blocks may represent an effective component of multimodal analgesia in obstetric anesthesia.