Analyzing of relationship between teachers’ individual innovativeness levels and their tpack self-efficacies

Individual characteristics of people such as approach to technology, knowledge level and perceptions come into prominence.  Rogers is classified individuals in five different categories (innovators, early adaptors, early majority, late majority, laggards) in terms of their innovation characteristics and states them as individual innovativeness. Having an individual innovativeness level is a factor which not only may influence people’s skills concerning use of technology but also may influence teachers’ technological integration level in the class. This study aims to determine the effect of teachers’ individual innovativeness level on technological integration process. In line with this purpose, TPACK self-efficacies scale and individual innovativeness scale have been applied to 421 teachers employed in Turkey in 2013-2014 education years. Teachers’ individual innovativeness levels, TPACK skill conditions and predictive power level of individual innovativeness on TPACK skills have been researched. As a result of this research, it has been understood that a great majority of teachers consider themselves as early majority and early adaptors as well as being advanced level in terms of TPACK skills. In addition it has been concluded that there is a positive and important relationship between individual innovativeness and TPACK, while individual innovativeness becomes an important predictor of TPACK skills.

An alternative route for petroclival tumors: Without mastoidectomy and superior petrosal sinus ligation: A cadaveric study

Objective: Retrosigmoid approach and presigmoid approach and its derivatives including retrolabyrinthine, translabyrinthine, and transpetrosal approaches have long been used for reaching posterior and middle cranial fossa. In neurosurgery perspective, many types of tumors arise extradurally and surgical resection of these tumors is still challenging. We aimed to describe a modified way to approach posterior and middle fossa to contribute to the surgical management of petroclival tumors with posterior extension. Methods: Modified sigmoid approaches were performed bilaterally in 5 fresh adult cadaver heads. Results: In this approach, it was possible to reach the middle and posterior fossa with a single craniotomy. Temporal dura matter was dissected from the temporal bone with extradural gentle dissection. In addition, sigmoid sinus and superior petrosal sinus (SPS) were dissected off from the petrous bone meticulously. Subsequently, the posterolateral superior arcuate petrosectomy was performed with high-speed surgical drill extradurally by protecting the semicircular canal, labyrinthine channel, and cochlea. Dura matter was elevated for 1.5 cm with retractor above the mastoid bone. Dura was opened from an alternative area of Trautmann’s triangle. After having exposed and opened the dura, posterior fossa was reached at the level of 7.-8. cranial nerves. Conclusion: We described an alternative route which seems to be a feasible way to reach posterior and middle fossa without mastoidectomy and SPS ligation. Notably, this technique can be applicable to petroclival tumor surgery after more anatomic studies with cadaveric specimens

Single-fraction gamma-knife radiosurgery with or without previous surgery for cavernous sinus meningiomas: A single-center experience and systematic literature review

Background: The most effective treatment method for meningiomas is surgical treatment. However, complete resection of cavernous sinus meningiomas is quite difficult. The biggest reasons for this are; narrow surgical corridor, the optic chiasm is the close relationship between the cranial nerves and anterior cerebral and internal carotid arteries. Gamma knife radiosurgery (GKRS) may be a good option in these lesions with high mortality and morbidity. Aim: This study aimed to evaluate and compare the early effects at a mean of 6 months and 3 years and outcomes between surgery followed by gamma knife radiosurgery (GKRS) and GKRS alone for cavernous sinus meningiomas. Methods: We included 20 patients with cavernous sinus meningioma treated via single fraction Leksell Gamma Knife Perfexion (Elekta Instruments; Stockholm, Sweden) between 2015 and 2018. The mean age of the patients was 54.95 (range: 32-77) years. Nine patients underwent primary surgery (for the resection of extracavernous components of the tumor) followed by GKRS (for the resection of intracavernous components of the tumor) (group A). Meanwhile, 11 patients were managed with GKRS alone (group B). The tumor volume ranged from 2.8 to 32.8 (mean: 14.76) cm3 and the isodose to the tumor margin from 10 to 13.5 (mean: 11.65) Gy. Results: In total, 20 patients were followed up at a mean time of 18.95 (range: 6-36) months. The mean Karnofsky Performance Score of the patients was 95.2%. The mean follow up times of groups A and B were 23.6 and 15 months, respectively. Meanwhile, only patients with a follow up time of at least 6 months were included in the study. The mean follow up time after GKRS in group A was 17.6 months. There was no change in the tumor volume in 15% of patients. In the remaining cases, the tumor volume decreased. The mean tumor regression rates were 82.2% in Group A and 17.7% in Group B. The tumor volume did not decrease in three patients (n = 1, group A and n = 2, group B). Cranial nerve deficits improved, worsened, and remained stable in 46.6%, 26.6%, and 26.6% of cases, respectively. The temporary morbidity rate was 10%. In group A, transient postoperative diabetes insipidus was observed in one patient and atelectasis in another. None of these complications affected the final status of patients. The mortality rate after treatment was 0%. Conclusion: Volume staged GKRS is safe and effective for cavernous sinus meningioma. GKRS is effective for long term tumor growth control and has a low complication rate. Hence, it is the preferred management strategy for tumors with a suitable volume (average tumor diameter: 3 cm or volume: 10 cm3 ). In tumors with a volume of more than 10 mL and/or without a 3 mm safety margin with the optical system, it is recommended to prepare for radiosurgery by cytoreducing the tumor volume surgically. Based on our opinion, the best results were obtained by GKRS to the intracavernous

Single step therapy for abscess foci localized at different parts of the body using trocar type catheter: Results of two year-experience

Objectives: The aim of this study was to emphasize the feasibility and cost effectiveness of trocar type catheter in percutaneous abscess drainage under imaging guidance and to determine the clinical efficacy of the method.Materials and methods: From June 2008 to December 2010, 48 patients who were referred to interventional radiology unit, in order to undergo percutaneous abscess drainage. All was data including age, the organ or the part of the body where the abscess was localized and size of abscess were recorded. Forty-two (87%) patients underwent drainage with ultrasonographic guidance, while 6 (13%) underwent with computed tomography guidance. One pediatric patient underwent systemic sedation anesthesia (with remiphentanyl and midazolam) and the rest of the patient with local anesthesia (with prilocain hydrochlorid). Catheterization procedure with which abscess drainage was done accepted as technically successful.Results: Imaging guided percutaneous abscess drainage procedures were performed with trocar type catheter to localized abscesses in different organs or systems in 48 patients (25 men, 23 women, mean age 52 years, range 2-82 years). Technical success was 100% in all cases. No patient had a complication during the procedure. Time to extraction of percutaneous catheter after drainage procedure was 5-28 days (mean 11.2 days). There was no recurrence except for a case, in which an abscess at the splenectomy site was successfully drained.Conclusion: Percutaneous drainage with imaging guidance using the trocar type catheter should be preferred because of its feasibility, cost-effectiveness, and reduced rate of complications in treating abscesses, which localized at different organ systems

Public Policy Analysis on the Integration of Syrian Children into National Education System in Turkey

2011’de Suriye’de başlayan olayların giderek şiddetlenmesi ve milyonlarca insanınkomşu ülkelere sığınmak zorunda kalmasıyla birlikte, göçmenlerin temel sorunlarındanbiri olan eğitim ve uyum sorunu ortaya çıkmıştır. Özellikle Türkiye’ye gelen Suriyeli sığınmacıların çoğunun kampların dışında yaşaması, çocuklara yönelik eğitim ihtiyacınınkarşılanması için yeni kamu politikalarının yapılması zorunluluğunu ortaya çıkarmıştır.Geçici eğitim merkezlerindeki sınıf mevcutlarının yüksekliği, Türkçe derslerinin yetersizliği, sonraki örgün eğitimin aşamalarına uyum güçlüğü gibi sorunların varlığı, bukonudaki kamu politikalarının analizini gerektirmektedir. Bu çalışma Türkiye’de geçicikoruma statüsü altında bulunan Suriyeli çocukların, ulusal eğitim sistemine uyumlarınınsağlanabilmesine yönelik bir kamu politikası analizi oluşturmak amacıyla yapılmıştır.Üretilen seçenekler süreç modeliyle değerlendirilmiştir.With the exacerbation of the incidents started at 2011 in Syria and as millions of people had to take refuge in neighboring countries, education and integration concerns, which are among the most basic problems of the immigrants has emerged. The fact that most of the Syrian asylum seekers especially coming to Turkey live outside the refugee camps triggered the need for developing new public policies to satisfy the training needs of the children. The high numbers of students at the Temporary Education Centers, the insufficiency of the Turkish courses, the existence of the problems as the difficulty of transition to the following formal education step require the analysis of the related public policies. This study was conductved to constitute a public policy analysis related to the integration of the Syrian children, who are under the umbrella of a temporary protection status in Turkey, into the national education system. The alternative models developed were evaluated with the process model of public policy analysis

Biomechanical changes in the cervical spine alignment after lumbar dynamic stabilization

Objective: The aim of this study is to determine the biomechanical changes in cervical spine parameters following the surgical correction of lumbar deformity with dynamic stabilization, and to evaluate how the preoperative parameters are related to these changes. Materials and Methods: Anteroposterior and lateral scoliosis radiographs of 20 patients were obtained, who underwent a dynamic stabilization (DynesysR, Zimmer, USA) and Safinaz screw peek rod placement procedures for lumbar deformity. The cervical spine parameters in the radiographs were measured in Surgimap program by an independent researcher, and they were classified into 5 categories and compared by using the Wilcoxon test in preoperative and early postoperative periods. The data were collected and analyzed using IBM SPSS Statistics 25th Edition. Results: Between all the parameters examined, the changes in the patients’ T1 Slop Angle were found to be statistically significant (p value<0.05). Depending on this, it was concluded that dynamic stabilization of lomber deformity could change the biomechanical loads in the postoperative cervical spine alignment. Conclusion: Dynamic stabilization surgery for spinal deformity, which is conducted to restore sagittal balance, can also lead to biomechanical improvement in the cervical spine alignment

Biomechanical changes in cervical spine sequencing after rigid lumbar stabilization

Objective: Surgical stabilization of the thoraco-lumbar spine can induce biomechanical changes in other spinal regions, potentially influencing postoperative outcome. This study detected biomechanical changes in cervical spine sequencing and identify preoperative parameters associated with these changes following rigid stabilization surgery for degenerative lumbar spinal disease. Materials and Methods: Twenty patients (10 males and 10 females, mean age 64.6 years) with lumbar degeneration receiving rigid stabilization (polyaxial screws and titanium rods) were included in the study. Preoperative and postoperative anterioposterior and sagittal scoliosis x-rays were retrospectively evaluated by an independent researcher using SurgimapR (Nemaris Inc., USA). Preoperative and postoperative cervical spine parameters were compared using Wilcoxon test. A p<0.05 was considered statistically significant for all tests. Results: Among the 20 patients enrolled, 4 each were treated for degenerative disc disease, 5 had spinal stenosis, and 3 had spondylolisthesis, while 5 were treated for the previously operated spinal instability and 3 for spondylolysis. The highest instrumentation level was L1 and the lowest was L5. Radiological measurements were obtained by calibrating Surgimap for each patient using standard techniques. The T1 slope angle was significantly reduced post-surgery (p<0.05), and the magnitude of this reduction was enhanced by greater improvement in the lumbar long segment angle after rigid stabilization (p<0.05). Conclusion: Rigid stabilization for degenerative lumbar spine disease can also affect sagittal balance and alter biomechanical loads in postoperative cervical spine sequencing

Efficacy of middle meningeal artery embolization in treatment resistant spontaneous intracranial hypotension caused subdural hematoma: Report of two cases and review of the literature

Spontaneous intracranial hypotension (SIH) most commonly manifests as bilateral subdural hematoma (SH). SIH cases mostly resolve spontaneously but further treatment would be needed via blind epidural blood patch (EBP). Cerebrospinal fluid (CSF) leakage in EBP-refractory cases can be treated surgically only if the localization of CSF leakage is detectable but it cannot be possible in most of the cases. Also surgical evacuation of SH secondary to SIH (SH-SIH) is not favorable without blocking the CSF leakage. Thus the management of these patients is a challenge and alternative treatment options are needed. Although middle meningeal artery embolization (MMAE) is an effective treatment option in non-SIH SH, there is no report about its application in the treatment of SH-SIH. We present two cases of SH-SIH which their clinical and radiological findings were completely resolved by bilateral MMAE treatment