Establishment and practice of prerequisite programs on food businesses : a case study in dairy industries

Özellikle son yıllarda, canlıların sağlıklı bir yaşam sürdürebilmeleri için gerekli olan gıdaların güvenliğinin sağlanmasında gıda işletmelerinde HACCP'in temel ilkelerini esas alan birçok yönetim sistemleri uygulanmaktadır. Bu tür sistemlerin gıda işletmelerinde kurulması ve etkin olarak uygulanması amacıyla oluşturulması gereken ön gereksinim programlarının nasıl uygulanacağı bu araştırma ile süt sektörü örnek alınarak belirlenmiştir. Süt işletmesinde işletmenin yapısı, üretim çeşitliliği, bulunduğu ülke ve uygulanacak gıda güvenliği yönetim sistemine bağlı olarak ön gereksinim programları oluşturulmalıdır. Bu suretle Avrupa Birliği'ne girme sürecinde olan ülkemizdeki gıda işletmelerinde rekabet edebilir, mantığa dayanan, uygulanabilir ve bilimsel bazlı HACCPtemelli gıda güvenliği yönetim sistemlerinin oluşturularak sürekliliği sağlanabilecektir.In recent years, a number of management systems based on basic principles of HACCP in food plants for food safety. The establishment and effective implementation of such systems in dairy industry have been modeled, considering pre-requisite programs. The pre-requisite programs must be established in a dairy plant depending on the criteria including depending on the structure of the plant, diversity of production, country and food safety management system that will be applied. In this way, competitive, logic-based, and practical food safety management systems based on HACCP should be created and sustainability of these systems should be provided in the food plants in our country which is at the process of entering the European Union

Zi̇hi̇nsel ve bedensel engelli̇ çocuğun sağlıklı kardeşleri̇ni̇n yaşam kali̇teleri̇ni̇n karşılaştırılması

Amaç: Ailede engelli bir çocuğun doğumu, aile üyelerinin yaşamlarını, duygularını ve davranışlarını olumsuz yönde etkileyen bir durumdur. Bu çalışma, farklı özür gruplarına sahip çocuların sağlıklı kardeşlerinin yaşam kalitesinin karşılaştırılması amacıyla planlanmıştır. Yöntem: Çalışmaya zihinsel engelli 44 çocuğun (Grup 1; 25 erkek, 19 kız) ve bedensel engelli 50 çocuğun (Grup 2; 31 erkek, 19 kız) bedensel veya zihinsel engeli olmayan sağlıklı kardeşleri (N=94) dahil edilmiştir. Zihinsel ve bedensel engelli çocukların kaba motor fonksiyon düzeyleri Kaba Motor Fonksiyon Sınıflama Sistemi(KMFSS) ile belirlenmiştir. Kardeşlerin yaşam kalitesi “Çocuklar İçin Yaşam Kalitesi Ölçeği (ÇİYKÖ)” ile değerlendirilmiştir. ÇİYKÖ puanının yüksek olması yaşam kalitesinin iyi olduğunu gösterir. Bulgular: Zihinsel engelli çocukların kaba motor fonksiyon düzeyleri 13’ünün KMFSS seviye III, 12’sinin seviye II, 11’inin seviye I, 7’sinin seviye V, 1’inin seviye IV’tür. Bedensel engelli çocukların KMFSS düzeyi 20’sinin seviye II, 12’sinin seviye V, 9’unun seviye I, 5’inin seviye IV, 4’ünün seviye III’tür. Zihinsel engele sahip çocukların sağlıklı kardeşlerinin (26 erkek, 18 kız) yaş ortalaması 13.70±3.70 yıl, bedensel engelli çocukların kardeşlerin yaş ortalaması 11.56±3.60 yıldır. Grup 1’in ÇİYKÖ-Fiziksel Sağlık (ÇİYKÖ-FS) ortalama puanı 602.16±196.26, ÇİYKÖ-Psikososyal Sağlık(ÇİYKÖ-PS) puanı 1361.59±93.11 ve ÇİYKÖ Toplam(ÇİYKÖ-T) puanı 1963.75±282.16’dır. Grup 2’nin ÇİYKÖ-FS puanı 653±229.13, ÇİYKÖ- PS puanı 1379±142.51 ve ÇİYKÖ-T 2032±364’tür. Grupların yaşam kalitesi karşılaştırıldığında istatistiksel olarak anlamı farkın olmadığı görülmüştür (p>0.05). Tartışma: Bedensel ve zihinsel engelli çocukların sağlıklı kardeşlerinin yaşam kaliteleri çok iyi değildir. İster bedensel ister zihinsel engelli olsun, engelli kardeşin olması sağlıklı kardeşlerin yaşam kalitelerini benzer derecede olumsuz etkilemiştir

Effecti̇veness of neurodevelopmental treatment (bobath concept) on postural control and balance i̇n cerebral palsi̇ed chi̇ldren

Introduction: The aim of this study was to show the effects of an 8-week Neurodevelopmental Treatment (NDT) on postural control and balance in diparetic or hemiparetic Cerebral Palsied children (CPC). Patient and Methods: 15 CPC (aged 5-15 yrs) were included in this study. All participants recruited from Denizli Yağmur Çocukları Special Education and Rehabilitation Center. The Gross Motor Function Classification System and the Gross Motor Function Measure were used to evaluate the CPC. Balance ability was assessed using by a 1-Min. Walking Test (1MWT), Modified Timed Up and Go Test, and Pediatric Balance Scale. Functional Independence Measure for Children (WeeFIM) was used to evaluate the independence in terms of daily living activities of the CPC. Postural control was assessed using by Seated Postural Control Measure (SPCM). An 8-week NDT based intensive postural control and balance training was applied to the CPC in one session (60 min.) 2 days in a week. All participants were evalutated twice (before and after the treatment program). Results: After the treatment program, all participants showed statistically significant improvements in terms of gross motor function (p<0,01). They also showed statistically significant improvements about 1MWT, MTUGT, PBS, and WeeFIM (p<0,01). SPCM-Alignment and SPCM-Function scores increased after the treatment program compared to before treatment (p<0,01). Discussion: The results obtained from this study indicate that an 8-week NDT based intensive postural control and balance training is an effective approach in order to improve functional motor level and functional independency improving postural control and balance diparetic or hemiparetic CPC

Serebral palsili çocukların klinik özellikleri i̇le i̇letişim yetenekleri arasındaki i̇lişki

Amaç: Serebral Palsi (SP)’li çocuklar motor problemlerin yanında özürlülüğe neden olabilen pek çok bozukluklara sahiptirler ve iletişim bozukluğu da bunlardan birisidir. Bu çalışmanın amacı SP’li çocukların klinik özellikleri ile iletişim yetenekleri arasındaki ilişkiyi incelemektir. Gereç ve Yöntem: Denizli il merkezinde faaliyet gösteren Yağmur Çocukları Özel Eğitim Merkezi’nde tedavileri devam eden 2-18 yaş arası n=188 (K:84, E:104) SP’li çocuk çalışmaya dâhil edildi. Tüm katılımcılara demografik veri formu dolduruldu. Çocukların iletişim fonksiyonları İletişim Fonksiyon Sınıflandırma Sistemi (IFSS) ile değerlendirildi. Sonuçlar: SP’li çocukların yaş ortalaması 97,48±57,93 ay idi. SP’nin klinik tipleri içinde IFSS’ye göre; Seviye 1’de spastiklerin %43,7’si, diskinetiklerin %20’si, ataksiklerin %0’ı, hipotoniklerin ise %5,3’ü bulunuyordu. Seviye 5’te ise spastiklerin %24,1’i, diskinetiklerin %60’ı, ataksiklerin %25’i, hipotoniklerin ise %26,3’ü bulunuyordu. Bu dağılım istatistiksel olarak da anlamlıydı (p < 0,01). IFSS’ye göre SP’nin ekstremite dağılımı içinde Seviye 1’de hemiparetiklerin %54,5’i, diparetiklerin %52,3’ü, quadriparetiklerin %14,9’u, paraparetiklerin ise %60’ı bulunuyordu. Seviye 5’te ise hemiparetiklerin %7,3’ü, diparetiklerin %11,4’ü, quadriparetiklerin %44,6’sı ve paraparetiklerin %20’si bulunuyordu. Bu dağılım istatistiksel olarak da anlamlıydı (p < 0,01). Tartışma: SP’li çocuklarda klinik tip, ekstremite dağılımı ve SP nedenlerinin iletişim fonksiyonları üzerinde anlamlı etkileri olduğu görülmüştür

Relationship between hand functions and balance in cerebral palsied children

INTRODUCTION: This study was planned to examine the relationship between hand function and balance in Cerebral Palsied Children (CPC). MATERIALS AND METHODS: 15 diparetic or hemiparetic CPC, ages between 5‐15, were included in the study. They were at Level I, II or III according to Gross Motor Function Classification System (GMFCS), and we applied Neurodevelopmental Therapy(NDT) them. Intensive NDT program were applied 8 weeks. Evaluations were repeated before and after treatment. RESULTS: There were improvements in hand functions and balance skills. After treatment both MACS and balance tests’ scores changed in percentages. Thus hand functions and balance skills were correlated. But these correlations were not statistically significant. DISCUSSION: Hand functions have a relationship with balance. Better hand functions make the CPC set balance better by providing a good upper extremity functions. Good upper extremity functions provide better balance reactions. CPC could be able to set his/her balance by moving upper extremities

Relationship between hand functions and balance in children with cerebral palsy

Introduction: This study was planned to examine the relationship between hand function and balance in children with Cerebral Palsy(CP). Methods: 15 diparetic or hemiparetic CP children, between the ages of 5-15, was included in the study. They were at Level I, II or III according to Gross Motor Function Classification System (GMFCS), applied Neurodevelopmental Therapy(NDT). Intensive NDT were applied to increase the functional and motor skills for 8 weeks. Evaluations were repeated before and after treatment. MACS for functional hand using skills, 10 meter-walk test, 1 minute-walking test and Pediatric Balance Scale for balance capabilities of children with CP were used. Results: Mean ages of the patients were 120.40±31.69 months and 7(46.7%) were female, and 8(53.3%) were male. 8(53.3%) patients were diparetic, 2(13.3%) were right hemiparetic and 5(33.3%) were left hemiparetic. According to the distribution of the pre-treatment MACS, 7 patients for level I, 7 patients for level II and 1 patient for level III were in the study, and after treatment all patients were in Level I. Although improvements were detected in hand function and balance scores after treatment, hand using skills and balance scores were not correlated. Conclusion: It is known dexterity and balance in children with CP could be improved with proper treatment and clinical recommendations, and good functional hand using is effective on development of balance, positively. It is important to evaluate children and disability and interventions improving the functionality is required, while rehabilitation programs are planned

Stress and depression levels of mothers who give care to children with cerebral palsy and mental retardation: a comparison study

Purpose:Assessment of mothers who give care to children with Cerebral Palsy (CP) and mentally retarded children (MR) by Bakas Caregiving Outcomes Scale and Caregiver Strain Index. Materials and methods: Fifty-six mothers living in Denizli (children with CP n=33, children with MR n=23) were included the study. Stress of mothers of CP and MR children at the process of giving care, were assessed with Bakas Caregiving Outcomes Scale and Caregiver Strain Index and conditions of depression were assessed with Beck Depression Inventory. Motor development levels of children with CP and MR were determined with Classic Motor Development Level. Results: When Classic Motor Development Level of children with CP were compared with Bakas Caregiving Outcomes Scale of mothers, a statistically significant and negative correlation was found (p=0.01). In comparison of Bakas Caregiving Outcomes Scale of mothers having children with CP and MR, there was a statistically significant difference towards stress burden of mothers with cerebral palsy children was higher (p=0.03). Conclusion: We found that caregiving stress of mothers of children with CP was higher. Better motor development level provides less burden of caregiving and depressive symptoms of mothers in disabled childre

Stress and depression levels of mothers who give care to children with cerebral palsy and mental retardation: a comparison study

Purpose:Assessment of mothers who give care to children with Cerebral Palsy (CP) and mentally retarded children (MR) by Bakas Caregiving Outcomes Scale and Caregiver Strain Index. Materials and methods: Fifty-six mothers living in Denizli (children with CP n=33, children with MR n=23) were included the study. Stress of mothers of CP and MR children at the process of giving care, were assessed with Bakas Caregiving Outcomes Scale and Caregiver Strain Index and conditions of depression were assessed with Beck Depression Inventory. Motor development levels of children with CP and MR were determined with Classic Motor Development Level. Results: When Classic Motor Development Level of children with CP were compared with Bakas Caregiving Outcomes Scale of mothers, a statistically significant and negative correlation was found (p=0.01). In comparison of Bakas Caregiving Outcomes Scale of mothers having children with CP and MR, there was a statistically significant difference towards stress burden of mothers with cerebral palsy children was higher (p=0.03). Conclusion: We found that caregiving stress of mothers of children with CP was higher. Better motor development level provides less burden of caregiving and depressive symptoms of mothers in disabled children