Background: Hypoglycemia during hospitalization occurs in patients with and without diabetes. The aims of this study were to determine the incidence, associated risk factors, and short-and long-term outcome of hypoglycemia among hospitalized elderly patients. Methods: This is a case-control study conducted at geriatric and medicine departments. All patients 70 years or older with documented hypoglycemia hospitalized within 1 year (n ϭ 281) were compared with a nonhypoglycemic group of 281 elderly, randomly selected patients from the same hospitalized population. Results: Among 5404 patients 70 years or older, 281 (5.2%) had documented hypoglycemia. Compared with the nonhypoglycemic group, we found the following characteristics to be true in the hypoglycemic group: there were more women than men (58% vs 44%; p ϭ .001); sepsis was 10 times more common (p Ͻ .001); malignancy was 2.8 times more common (p ϭ .04); the mean serum albumin level was lower (2.8 g/dL vs 3.4 g/dL, p Ͻ .001); and the mean serum creatinine and alkaline phosphatase levels were higher (p Ͻ .001 for both). Diabetes was known in 42% of the hypoglycemic group and in 31% of the nonhypoglycemic group (p ϭ .03); 70 patients in the hypoglycemic group were taking sulfonylureas or insulin. Multivariate logistic analysis showed that sepsis, albumin level, malignancy, sulfonylurea and insulin treatment, alkaline phosphatase level, female sex, and creatinine level were all independent predictors of developing hypoglycemia. In-hospital mortality and 3-month mortality were about twice as high in the hypoglycemic group (p Ͻ .001). Multivariate analysis of mortality found that sepsis, low albumin level, and malignancy were independent predictors, whereas hypoglycemia was not. Conclusions: Hypoglycemia was common in elderly hospitalized patients and predicted increased in-hospital 3-and 6-month cumulative mortality. However, in a multivariate analysis, hypoglycemia was not an independent predictor for mortality, implying that it is only a marker.

Background Coronary artery disease is one of the most important health problems among heart diseases in the world, with high morbidity and mortality. Lifestyle changes in particular are recommended in the latest guidelines for implementing secondary prevention. Aim The aim of this study was to evaluate the effectiveness of telehealth interventions as a part of secondary prevention compared to routine care in those with coronary artery disease. Method The systematic review with meta‐analysis was performed in accordance with Cochrane methods. Science Direct, Springer Link, Web of Science, Cochrane Central Register of Controlled Trials, CINAHL, MEDLINE, ProQuest and Network Digital Library databases were searched between 2000 and 2018 up to February 2018. The studies chosen conformed to PICOS inclusion and exclusion criteria. The risk of bias was assessed using the Cochrane risk of bias tool. Preferred Reporting Items for Systematic Reviews and Meta‐Analyses guideline was used in reporting the study. Results Twenty‐four studies with a total of 6773 study participants met the inclusion criteria. It was found that telephone call interventions were the most commonly used, text message interventions came second with seven studies, telephone calls in combination with messages were used in four studies and telemonitoring was used in two studies. Compared to routine care, telehealth interventions had moderate significant effects in reducing waist circumference, total cholesterol and triglyceride, improving medication adherence and physical activity, and had small significant effects in reducing blood pressure and smoking cessation. No significant publication bias was found in the main outcomes. Conclusion Results showed that the telehealth interventions yielded positive outcomes in lifestyle changes for coronary artery disease. Therefore, telehealth interventions can be used for effective secondary prevention by health professionals who care for individuals with coronary artery disease. Additionally, this study will provide guidance for studies on the development of telehealth intervention.

The aim of the study was to describe nurses' attitudes and beliefs towards discussing sexuality with patients. Sexual health is a state of physical, emotional, mental and social well-being in relation to sexuality. Sexual dysfunction occurs quite commonly in the community. A descriptive and comparative design was adopted to explore Turkish nurses' attitudes and beliefs towards discussing sexuality with patients. The rate of participation of nurses was found to be 89 %. Data collection form consisted of two parts: demographic information and the inventory of Sexuality Attitudes and Beliefs Survey (SABS). Mean scores of the nurses SABS was 41.58 ± 7.67. Status of offering counselling on sexuality was found to be significantly related to the SABS scores (p \ 0.05). The majority of nurses (72.2 %) disagreed with spending more time to discuss sexual concerns with their patients, 68.9 % viewed sexuality as 'too private an issue to discuss'. In this study, it was established that nurses were aware of the concerns of the patients about sexuality, but their practical attempts to relieve those concerns were not adequate. In view of these results, it is recommended that sexuality should be discussed more openly in basic education curriculum and that inservice training on the issue of sexuality and health should be addressed.

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Background Patients’ lifestyle changes after myocardial infarction reduce the risk of infarction. Nursing interventions are important for the initiation and maintenance of lifestyle adaptation. Aim The aim of this study was to evaluate the effect of education and telephone follow‐up intervention based on the Roy Adaptation Model for improving myocardial infarction patients’ self‐efficacy, quality of life and lifestyle adaptation. Method In this parallel, randomised controlled trial, patients were randomly allocated to a control group or an intervention group (n = 33/group). The control group received routine care, while the intervention group received routine care plus a telephone follow‐up intervention, which consisted of a predischarge education programme and three telephone follow‐up sessions. Data were collected before discharge, in the 12th week after discharge between April 2016 and August 2017. All outcomes were assessed at baseline and at 12 weeks, and included quality of life, coping adaptation process, self‐efficacy and lifestyle changes. The CONSORT checklist was used in the study. Results In the 12th week after discharge, patients in the intervention group had significant improvements in self‐efficacy, quality of life and coping adaptation process compared with the control group. The intervention group also had more adaptation lifestyle changes concerning patients nutrition and physical activity in the 12‐week follow‐up. Conclusion This study demonstrated that education and telephone follow‐up intervention based on Roy Adaptation Model was had positive and significant results after 12 weeks compared with usual care. The findings of this study are important for supporting nursing practice and health professionals who care for individuals with myocardial infarction to develop nursing care.