Supporting mental health, wellbeing and study skills in Higher Education:an online intervention system

Abstract Background Dealing with psychological and study skill difficulties can present a challenge for both Higher Education (HE) students, who suffer from them, but also for HE Institutions and their support services. Alternative means of support, such as online interventions, have been identified as cost-effective and efficient ways to provide inclusive support to HE students, removing many of the barriers to help-seeking as well as promoting mental health and wellbeing. Case presentation The current case study initially outlines the rigorous approach in the development of one such online intervention system, MePlusMe. It further highlights key features that constitute innovative delivery of evidence-based psychological and educational practice in the areas of mental health, promotion of wellbeing, support of mood and everyday functioning, and study-skills enhancement. Conclusions This case study aims to present the innovative features of MePlusMe in relation to current needs and evidence-basis. Finally, it presents future directions in the evaluation, assessment, and evidence of the fitness-for-purpose process

Problematic online behaviors among adolescents and emerging adults: associations between cyberbullying perpetration, problematic social media use, and psychosocial factors

Over the past two decades, young people's engagement in online activities has grown markedly. The aim of the present study was to examine the relationship between two specific online behaviors (i.e., cyberbullying perpetration, problematic social media use) and their relationships with social connectedness, belongingness, depression, and self-esteem among high school and university students. Data were collected from two different study groups via two questionnaires that included the Cyberbullying Offending Scale, Social Media Use Questionnaire, Social Connectedness Scale, General Belongingness Scale, Short Depression-Happiness Scale, and Single Item Self-Esteem Scale. Study 1 comprised 804 high school students (48% female; mean age 16.20 years). Study 2 comprised 760 university students (60% female; mean age 21.48 years). Results indicated that problematic social media use and cyberbullying perpetration (which was stronger among high school students) were directly associated with each other. Belongingness (directly) and social connectedness (indirectly) were both associated with cyberbullying perpetration and problematic social media use. Path analysis demonstrated that while age was a significant direct predictor of problematic social media use and cyberbullying perpetration among university students, it was not significant among high school students. In both samples, depression was a direct predictor of problematic social media use and an indirect predictor of cyberbullying perpetration. However, majority of these associations were relatively weak. The present study significantly adds to the emerging body of literature concerning the associations between problematic social media use and cyberbullying perpetration

Antiinflammatory Therapy with Canakinumab for Atherosclerotic Disease

Background: Experimental and clinical data suggest that reducing inflammation without affecting lipid levels may reduce the risk of cardiovascular disease. Yet, the inflammatory hypothesis of atherothrombosis has remained unproved. Methods: We conducted a randomized, double-blind trial of canakinumab, a therapeutic monoclonal antibody targeting interleukin-1β, involving 10,061 patients with previous myocardial infarction and a high-sensitivity C-reactive protein level of 2 mg or more per liter. The trial compared three doses of canakinumab (50 mg, 150 mg, and 300 mg, administered subcutaneously every 3 months) with placebo. The primary efficacy end point was nonfatal myocardial infarction, nonfatal stroke, or cardiovascular death. RESULTS: At 48 months, the median reduction from baseline in the high-sensitivity C-reactive protein level was 26 percentage points greater in the group that received the 50-mg dose of canakinumab, 37 percentage points greater in the 150-mg group, and 41 percentage points greater in the 300-mg group than in the placebo group. Canakinumab did not reduce lipid levels from baseline. At a median follow-up of 3.7 years, the incidence rate for the primary end point was 4.50 events per 100 person-years in the placebo group, 4.11 events per 100 person-years in the 50-mg group, 3.86 events per 100 person-years in the 150-mg group, and 3.90 events per 100 person-years in the 300-mg group. The hazard ratios as compared with placebo were as follows: in the 50-mg group, 0.93 (95% confidence interval [CI], 0.80 to 1.07; P = 0.30); in the 150-mg group, 0.85 (95% CI, 0.74 to 0.98; P = 0.021); and in the 300-mg group, 0.86 (95% CI, 0.75 to 0.99; P = 0.031). The 150-mg dose, but not the other doses, met the prespecified multiplicity-adjusted threshold for statistical significance for the primary end point and the secondary end point that additionally included hospitalization for unstable angina that led to urgent revascularization (hazard ratio vs. placebo, 0.83; 95% CI, 0.73 to 0.95; P = 0.005). Canakinumab was associated with a higher incidence of fatal infection than was placebo. There was no significant difference in all-cause mortality (hazard ratio for all canakinumab doses vs. placebo, 0.94; 95% CI, 0.83 to 1.06; P = 0.31). Conclusions: Antiinflammatory therapy targeting the interleukin-1β innate immunity pathway with canakinumab at a dose of 150 mg every 3 months led to a significantly lower rate of recurrent cardiovascular events than placebo, independent of lipid-level lowering. (Funded by Novartis; CANTOS ClinicalTrials.gov number, NCT01327846.

Pooled analysis of WHO Surgical Safety Checklist use and mortality after emergency laparotomy

Background The World Health Organization (WHO) Surgical Safety Checklist has fostered safe practice for 10 years, yet its place in emergency surgery has not been assessed on a global scale. The aim of this study was to evaluate reported checklist use in emergency settings and examine the relationship with perioperative mortality in patients who had emergency laparotomy. Methods In two multinational cohort studies, adults undergoing emergency laparotomy were compared with those having elective gastrointestinal surgery. Relationships between reported checklist use and mortality were determined using multivariable logistic regression and bootstrapped simulation. Results Of 12 296 patients included from 76 countries, 4843 underwent emergency laparotomy. After adjusting for patient and disease factors, checklist use before emergency laparotomy was more common in countries with a high Human Development Index (HDI) (2455 of 2741, 89.6 per cent) compared with that in countries with a middle (753 of 1242, 60.6 per cent; odds ratio (OR) 0.17, 95 per cent c.i. 0.14 to 0.21, P <0001) or low (363 of 860, 422 per cent; OR 008, 007 to 010, P <0.001) HDI. Checklist use was less common in elective surgery than for emergency laparotomy in high-HDI countries (risk difference -94 (95 per cent c.i. -11.9 to -6.9) per cent; P <0001), but the relationship was reversed in low-HDI countries (+121 (+7.0 to +173) per cent; P <0001). In multivariable models, checklist use was associated with a lower 30-day perioperative mortality (OR 0.60, 0.50 to 073; P <0.001). The greatest absolute benefit was seen for emergency surgery in low- and middle-HDI countries. Conclusion Checklist use in emergency laparotomy was associated with a significantly lower perioperative mortality rate. Checklist use in low-HDI countries was half that in high-HDI countries.Peer reviewe

Global variation in anastomosis and end colostomy formation following left-sided colorectal resection

Background End colostomy rates following colorectal resection vary across institutions in high-income settings, being influenced by patient, disease, surgeon and system factors. This study aimed to assess global variation in end colostomy rates after left-sided colorectal resection. Methods This study comprised an analysis of GlobalSurg-1 and -2 international, prospective, observational cohort studies (2014, 2016), including consecutive adult patients undergoing elective or emergency left-sided colorectal resection within discrete 2-week windows. Countries were grouped into high-, middle- and low-income tertiles according to the United Nations Human Development Index (HDI). Factors associated with colostomy formation versus primary anastomosis were explored using a multilevel, multivariable logistic regression model. Results In total, 1635 patients from 242 hospitals in 57 countries undergoing left-sided colorectal resection were included: 113 (6·9 per cent) from low-HDI, 254 (15·5 per cent) from middle-HDI and 1268 (77·6 per cent) from high-HDI countries. There was a higher proportion of patients with perforated disease (57·5, 40·9 and 35·4 per cent; P < 0·001) and subsequent use of end colostomy (52·2, 24·8 and 18·9 per cent; P < 0·001) in low- compared with middle- and high-HDI settings. The association with colostomy use in low-HDI settings persisted (odds ratio (OR) 3·20, 95 per cent c.i. 1·35 to 7·57; P = 0·008) after risk adjustment for malignant disease (OR 2·34, 1·65 to 3·32; P < 0·001), emergency surgery (OR 4·08, 2·73 to 6·10; P < 0·001), time to operation at least 48 h (OR 1·99, 1·28 to 3·09; P = 0·002) and disease perforation (OR 4·00, 2·81 to 5·69; P < 0·001). Conclusion Global differences existed in the proportion of patients receiving end stomas after left-sided colorectal resection based on income, which went beyond case mix alone

?-si?nüklei?n ve parki?nson

Parkinson disease is an age-related disorder. It was seen all part of society. It is existed by genetic predisposition and different effects. The disease usually starts insidously and its symptoms progress slow but causing acceleration. Middle brain gets narrow according to normal brain in Parkinson, pigmentation is decreased in substantia nigra pars compacta, loss of dopaminergic neurons which produce dopamine and Lewy body formation are observed. Accumulation of formation-like cc-synuclein which plays formation of Lewy body, causes dopaminergic neuron losses by 50-60 % and so that mistakes of dopamine releasing prevent neuron transmission. It is seen that symptoms of Parkinson and Parkinson-like neurodegenerative disorders which have signs like shaking, defeat of posture, slowing of understanding, senile, hard to see, hard to smell, are increasing day by day. ?-synuclein is expressed in especially subtantia nigra pars compacta in middle brain, hypocampus, amyglada and cerebral cortex areas. After ?-synuclein which is presinaptic protein, is expressed cytoplasma of neuron which have many presynaptic ends, is moved axon ends. Mutation which is determined in gene where codes cc-synuclein protein, is first gene mutation which causes Parkinson, ?-synuclein protein which is coded by ?-synuclein gene in 4q21-22 human chromosome contains 140 amino acid residuses. ?-synuclein have important roles at stages of neuronal life. They play important roles in physiologically arrangement of neurotransmitter vesicul, transporters and certain enzymes and transporting fatty acids in neuron cytoplasm. It participates dopamine biosynthesis and protection of dopamine balance. It also functions axonal transport. In addition, ?-synuclein controls expression of secretion vesicul. ?-synuclein is tranformed into its pathological forms by lossing its normal structure as a consequence of several factors. Pathological ?-synuclein forms also cause Parkinson by acting effective role in neuron degeneration. Oligomer formation from pathological ?-synuclein forms, don't damage neuron cell until a stage. If they change fibrile by increasing oligomer forms with protofibril which doesn't change fibrile, accumulate body of neuron and axon ends, participate formation of Lewy body. Lewy bodies act effective role in neuron pathology and Parkinson development. The other factors which are effective in neuron pathology are oxidative stress, over-produce, low pH, high temperature, injuries in destruction, mutations of ?-synuclein gene among them. There are important studies about A53T, A30P and E46K missense mutations in ?-synuclein gene which induces Parkinson. These mutations cause Lewy body aggregations by changing of ?-synuclein to fibril formation and showing its effects different way. A30P mutations impair vesicul membrane binding of ?-synuclein which contains dopamine by causing changes in three dimension of ?-synuclein. As a consequence, defects appear in releasing of dopamine and uptaking from dopamine vesicule. In conlusion, ?-synuclein gene mutations which cause defects in ?-synuclein metabolic pathway, and Lewy bodies which are formed by different effects with defects in producing and releasing of dopamine act effective role in Parkinson disease by causing damages in dopaminergic neuron with their death

An evaluation on management of environmentally protected areas in the context of recent amendments in the regulations

*Bu çalışma Aksaray Üniversitesi ev sahipliğinde düzenlenmiş olan 5. Ulusal Kentsel ve Çevresel Sorunlar ve Politikalar Kongresi’nde bildiri olarak sunulmuştur.Türkiye’de 1983 yılında “Çevre Kanunu”nun kabul edilmesi ve Türkiye’nin çevre konusunda taraf olduğu uluslararası sözleşmeler, sahip olunan çevresel değerlerin korunması yönünde bilinçli ve sistematik çalışmaların başlatılmasını ve sürdürülmesini sağlamıştır. Ancak gerek küresel düzeyde gerekse de ulusal düzeyde çevrenin ve çevresel değerlerin korunmasına yönelik bilinç gün geçtikçe gelişmektedir. Bunların yanında Türkiye’nin Avrupa Birliği adaylığı süreci de çevre yönetimi konusunda olumlu katkılar yapmıştır. Bu olguların etkisiyle bir taraftan çevre mevzuatı, diğer taraftan da çevre yönetimi/çevresel alanların korunmasına yönelik yönetim faaliyetleri değişmekte ve yeni bir çehre kazanmaktadır. Bu kapsamda 2011 yılında merkezi yönetim düzeyinde çevre yönetiminin yeniden yapılandırılması gerçekleşmiş ve Çevre ve Orman Bakanlığı kapatılarak çevrenin korunması ve geliştirilmesi sorumluluğu Çevre ve Şehircilik Bakanlığına verilmiştir. Aynı zamanda önemli bir korunan alan kategorisi olan özel çevre koruma bölgelerinden sorumlu olan Özel Çevre Koruma Kurumu Başkanlığı kapatılmıştır. Anılan Başkanlığa 383 sayılı KHK ile verilen görev, yetki ve sorumluluklar Çevre ve Şehircilik Bakanlığına devredilmiştir. Bakanlığın çalışmaları sonucunda çıkarılan “Korunan Alanların Tespit, Tescil ve Onayına İlişkin Usul ve Esaslara Dair Yönetmelik” ve buna dayalı olarak yapılan işlemler neticesinde mevzuatımıza girmiş olan “milli parklar”, “tabiat parkları”, “tabiatı koruma alanları”, “doğal sit alanları”, “özel çevre koruma bölgeleri” gibi korunan alanlar yanında doğal sit alanları için “kesin korunacak hassas alan” “nitelikli doğal koruma alanları” gibi yeni koruma statüleri de oluşturulmuştur. Bu çalışma ile Türkiye’de çevre yönetimi ve korunan alanlara ilişkin mevzuat düzenlemeleri özetlenmektedir. Çalışmanın temel amacı, Türkiye’de 2010’dan sonra korunan alanlara yönelik ortaya çıkan gelişmeleri mevzuat ve yönetim açısından incelemektir. Bu kapsamda Cumhurbaşkanlığı Hükümet Sistemine geçiş ile birlikte genelde çevre yönetimi, özelde korunan alanların yönetimine ilişkin gelişmeler de ele alınmış ve değerlendirilmiştir.Commencement and prosecution of informed and sistemical studies to protect our possessed environmental values in Turkey is provided by agreement of “Environment Law” in 1983 and international conventions which Turkey being party to. Furthermore, awareness to protect environment and environmental values, arises day by day both in global and national scale.. Beside all these, Turkey’s process to become a member of Europian Union contributes on environment management.. In the light of these facts environment regulations on one hand and environment management/management acts to protect environmental areas on the other hand are changing and having a new face. Within this scope, in 2011, environmental management at the central government level was restructured and the Ministry of Environment and Forestry was closed and the responsibility for the protection and development of the environment was given to the Ministry of Environment and Urbanization. At the same time, the Specially Protected Environmental Agency, which is responsible for specially protected environmental areas, has been closed. The duties, powers and responsibilities assigned to the Presidency by the Decree Law No. 383 have been transferred to the Ministry of Environment and Urbanization. As a result of the studies of the ministry, Regulation on Procedures and Principles Related to Determination, Registration, and Confirmation of Protected Areas is executed. With the operations performed according to this regulation, new statutes like “sitrictly protected sensitive area” and “qualified natural protection areas” are constituted along with statutes like “national park”, “natural park”, “protected wildlife reserve”, “natural protection areas”, “specially protected environment area. In this study legislative arrengements related to protected areas in Turkey are summarized. The main aim of the study is to examine the developments occurring after 2010 in Turkey for protected areas in terms of legislation and administration. In this context, with the transition to the Presidential Government System, the developments in the management of the environment in general and the management of the protected areas in particular have been considered and evaluate