Parameter estimation bias of dichotomous logistic item response theory models using different variables

The aim of this study was to examine the precision of item parameter estimation in different sample sizes and test lengths under three parameter logistic model (3PL) item response theory (IRT) model, where the trait measured by a test was not normally distributed or had a skewed distribution.In the study, number of categories (1-0), and item response model were identified as fixed conditions, and sample size, test length variables, and the ability distributions were selected as manipulated conditions. This is a simulation study. So data simulation and data analysis were done via packages in the R programming language. Results of the study showed that item parameter estimations performed under normal distribution were much stronger and bias-free compared to non-normal distribution. Moreover, the sample size had some limited positive effect on parameter estimation. However, the test length had no effect parameter estimation. As a result the importance of normality assumptions for IRT models were highlighted and findings were discussed based on relevant literature

Determination of Caregiver Burden and Social Support Levels among Caregivers Providing Care for Patients Hospitalized in Palliative Care Clinics

Providing care to someone with a chronic disease requires being physically, emotionally, and mentally energetic. In particular, the presence of a patient with a disease that requires palliative care changes daily activities and routines, increases responsibilities of those who take the responsibility for patient’s care and changes the roles in the family. The objective of this study was to determine the care burden and social support levels among the caregivers providing care for patients hospitalized in palliative care clinics. Materials and Methods: The population of this descriptive and correlational study consisted of caregivers taking care of patients treated at the Palliative Care Clinic of Training and Research Hospital between May and October 2018; the sample consisted of 73 caregivers who volunteered to join the study and were open to communication. Data were collected by questioning patients and their caregivers about their sociodemographic characteristics, using the Caregiver Burden Scale and the Multidimensional Scale of Perceived Social Support. Data analysis included percentages, the Kruskal-Wallis test, the Mann-Whitney U test, and the Spearman’s Correlation Coefficient. Results: The average caregivers’ age was 45.44±13.76 years; 75.3% of caregivers were females, 30.1% of caregivers were literate or had primary school degrees. Caregiver’s gender and educational levels were found not to affect caregiving and social support levels; however, the economic status affected caregiving and social support levels. There was a reverse correlation between the caregiver burden and their social support levels. Conclusions: With increased caregiver burden, their social support level decreased. Nurses caring for patients in palliative care clinics will benefit from educating and supporting caregivers about clinic and home care; it will result in a positive level of social support for both caregivers and patients receiving care

Çocukluk çağında gonad tümörleri

Giriş: Testis ve over tümörleri nadir görülen tümörlerdir ancak çocuklarda sıklığı yetişkinlere oranla daha yüksektir. İki taraflı da görülebilirler ancak sağ tarafı tercih ederler. Dördüncü dekatta pik yapmalarına rağmen her yaşta görülebilirler. Ergen ve çocuklarda en sık rastlanan genital neoplazma ise germ hücreli tümörlerdir. Akciğer, meme, kolon ve pankreas kanserlerinden sonra ölümlerin en sık nedenidir. Metod: Bu çalışmamızda retrospektif olarak Çocuk Onkoloji ve Çocuk Cerrahisi Kliniklerine son yedi yılda gonadal kitle nedeni ile başvuran hastaların epidemiyolojik ve klinik özellikleri gözden geçirilmiştir. Sonuç: Gonadal tümör teşhisi erkeklerde oldukça kolaydır. Dikkatli fizik muayene ile testiste kitle tespit edilebilir, hidrosel gibi, testiste kitle yapan hastalıklardan ayırt edil- melidir. Kızlarda şikâyetler belirsiz olduğu için teşhis genellikle kitle etkisi nedeni ile konulmaktadır. Bu nedenle yaş olarak daha geç tanı almaktadırlar. Kliniğe üriner sistem semptomları yada kabızlık ile gelen hastalarda mutlaka sorgulama ve fizik muayene dikkatle yapılmalı, gonadal tümörler unutulmamalıdı

Isolated scrotal skin relapse in a child with burkitt lymphoma

En hızlı büyüyen insan tümörü olan Burkitt lenfoma (BL), agresif bir B hücre neoplazisidir. Genellikle ekstranodal bir hastalık şeklinde ortaya çıkar. Ekstranodal alanlara metastazı da sıktır ancak cilt tutulumu nadirdir. On bir yaşında erkek hasta, karın ağrısı ve yutma güçlüğü şikayeti ile başvurdu. Batın sol alt kadranda tespit edilen kitleye uygulanan trucut biyopsi ile BL tanısı konuldu ve BFM-95 B hücreli Non-Hodgkin lenfomu (NHL) tedavi protokolü uygulandı. Hasta tedavi bitiminden 1,5 ay sonra sağ skrotal şişlik şikayeti ile tekrar başvurdu. Fizik muayenesinde, sağ skrotal ödem ve kızarıklık vardı. Skrotum cildinden yapılan biyopsi ile hastaya relaps BL tanısı konuldu ve LMB-Grup C tedavi protokolü uygulandı. Tedavi bitiminden 20 ay sonra hasta batında şişlik ve ağrı şikâyeti ile tekrar geldi. Muayenesinde; batında sol üst-orta kadranda bir kitle saptandı. Yapılan biyopsinin sonucu yine BL olarak rapor edildi ve hastaya COPM (vinkristin, prednizolon, siklofosfamid, metotreksat) tedavi protokolü ile birlikte rituksimab başlandı. Ancak santral sinir sistemi relapsı gelişti ve hasta kaybedildi. Bu olgu daha önce literatürde izole skrotal cilt relapsı bildirilmediği için sunulmuştur.Burkitt lymphoma (BL) that is the most rapidly growing human tumor is an aggressive B-cell neoplasia. It generally occurs as an extranodal disease. Its metastasis into extranodal areas is also frequent, however, its cutaneous involvement is rare. An 11-year-old male presented with the complaints of abdominal pain and difficulty in swallowing. The patient was diagnosed with BL by trucut biopsy that was performed for a mass identified in the left upper abdominal quadrant and B-cell Non-Hodgkin’s lymphoma (NHL) BFM 95 treatment protocol was applied. The patient applied again for the complaint of right scrotal swelling 1.5 months after the completion of therapy. On physical examination, right scrotal edema and redness were identified. The patient was diagnosed with relapsed BL by biopsy taken from scrotal skin and LMB-Group C treatment protocol was applied. The patient came again with the complaints of abdominal swelling and pain 20 months after the completion of therapy. On physical examination, a mass was detected in the left mid-upper quadrant of the abdomen. The result of biopsy was reported as BL again and COPM (cyclophosphamide, vincristine, prednisolone, and methotrexate) treatment protocol and rituximab were started. However, central nervous system (CNS) relapse developed and the patient was lost. This case was presented because isolated scrotal skin relapse has not been reported in the literature

Clinical experiences in primary retroperitoneal tumors

Amaç: Bu çalışmada Selçuk Üniversitesi Tıp Fakültesi 2011-2013 tarihleri arasında Çocuk Onkoloji Anabilim Dalı’nda takipli ve Çocuk Cerrahisi Kliniğince opere edilen toplam 22 retroperitoneal tümörlü hastaların kayıtları retrospektif olarak değerlendirildi. Olgular ve Yöntem: Retroperitoneal tümör nedeniyle 2011-2013 arasında cerrahi girişim yapılan olgular geriye dönük olarak incelendi. Primer retroperitoneal tümörü kontrol altına alınan, başka uzak organ metastazı olmayan cerrahi tedavi uygulanan olgular çalışmaya dahil edildi. Yaş, cinsiyet, primer tanı anında tümör evresi, cerrahi tedavi yöntemi, patolojik tanı ve takip açısından olguların dosyaları retrospektif olarak değerlendirildi. Bulgular: Olgularımızın 9’u (%40) erkek, 13’ü (%60) kızdı. Ortalama yaş erkeklerde 71 ay (3-132), kızlarda 37 ay (6-204) idi. Histopatolojik olarak olguların 15 (%68)’i nöroblastom, 4’ü (%18.5) wilms tümörü, 1’i (%4.5) embriyonal rabdomyosarkom, 1’i (%4.5) berrak hücreli sarkom, 1’i (%4.5) malign sinir kılıfı tümörü olarak değerlendirildi. Tanı anında olguların 8’i (%36) evre I, 7’si (%32) Evre III, 7’si (%32) evre IV safhasındaydı. Sonuç: Olgularımızın %68’i nöroblastom olup, tanı anında hastaların %64’ü evre III ve evre IV idi. Anatomik lokalizasyonları nedeniyle ileri evrelere kadar sessiz tümörler olan retroperitoneal tümörlerin çoğu nöroblastomdur ve genellikle ileri evrelerde tanı alırlar.Objective: In this study, Selcuk University Faculty of Medicine between 2011 - 2013 follow-up at the Department of Pediatric Oncology and Pediatric Surgery clinic was operated by a total of 22 patients with retroperitoneal tumors were evaluated retrospectively . Patients and Method: Retroperitoneal tumors were evaluated retrospectively during 2011-2013. The cases treated with primary retroperitoneal tumor, surgical treatment without other distant organ metastasis were included in the study. The files of the cases were primary diagnosis in terms of age, sex, tumor stage at the time of diagnosis, surgical treatment method, pathological diagnosis and follow-up reviewed retrospectively. Results: 9 out of 22 cases (40%) male and 13 (60%) were female. Male mean age of 71 months ( 3-132 ) in the girls 37 months ( 6-204 ) . The histological results, 15 (68%) of neuroblastoma , 4 (18.5%) Wilms, 1 (4.5% ) Embryonal Rhabdomyosarcoma , 1 (4.5% ) Clear cell sarcoma , 1 (4.5% ) malignant nerve sheath tumors were evaluated . Eight of the cases (36%) were stage I, 7 (32%) were stage III, 7 (32%) stage IV. Conclusion: In conclusion, 68% of our cases were neuroblastoma and 64% of the patients were stage III and stage IV at the time of diagnosis. Retroperitoneal tumors are generally diagnosed in advanced stages. We think that this is due to the anatomical localizations and the silent as far as the clinically advanced stage

The efficacy of cinacalcet in the treatment of hyperparathyroidism in Turkish hemodialysis patient population

WOS: 000393291900012OBJECTIVE: Cinacalcet reduces parathyroid hormone levels by increasing the sensitivity of the parathyroid gland to calcium. in this study, we firstly aimed to evaluate the efficacy of cinacalcet in Turkish hemodialysis patients. MATERIAL and METHODS: 4483 hemodialysis patients were screened and 469 patients who had used cinacalcet were included in the study. the patients were divided into 4 groups according to drug usage durations (Group 1: 3 months, Group 2: 6 months, Group 3: 9 months and Group 4: 12 months). the patients' Parathormone, Ca, P and CaxP levels at the 3rd, 6th, 9th and 12th months were compared to the start of treatment and previous months. RESULTS: the levels of Parathormone, Ca, P and CaxP significantly decreased compared to their initial levels in all groups (from 1412 pg/ml to 1222 pg/mL for Parathormone, p< 0,001) in the 3rd month. However, this reduction was not continued in the subsequent months (Parathormone: 1381 pg/ml for the 12th month). CONCLUSION: Cinacalcet may not provide adequate benefit in control of hyperparathyroidism in Turkish hemodialysis patient population

Hemşirelik öğrencilerinin kişilik özellikleri ile dövme-piercing yaptırma durumlarının karşılaştırılması

WOS: 000445937400023Purpose: The aim of this study is to perform a comparison of the personality characteristics of nursing students and their status regarding tattoos and piercings. Materials and Methods: The sample of this descriptive study consisted of the students of the nursing departments of one private and one public university in the year 2016-2017 (n=718). Data for the study was collected using an Information Form and the Hacettepe Personality Inventory via face to face interviews. Results: 8.9% of the students were found to have tattoos, and 11% were found to have piercings. When the mean scores taken by the participants from the Hacettepe Personality Inventory were compared according to their status regarding having tattoos and piercings, a statistically significant difference to the advantage of those without tattoos was found in the social adaptation dimension. No differences in the Hacettepe Personality Inventory mean scores of the students were found according to their status regarding having piercings. Conclusion: A majority of the students were found to not have tattoos and piercings. No significant difference could be found between the tattoo/piercing statuses of the students and their personality characteristics. These results are thought to be related to the cultural values the students were raised with and the dynamics of the society they live in.Amaç:. Bu araştırmanın amacı üniversite öğrencilerinin kişilik özellikleri ile dövme-piercing yaptırma durumlarını karşılaştırmaktır. Gereç ve Yöntem: Tanımlayıcı olarak yapılan bu araştırmanın örneklemini bir vakıf ve bir devlet üniversitesinde 2016-2017 eğitim-öğretim yılında tüm sınıflarda öğrenim gören 718 öğrenci oluşturdu. Araştırmanın verileri, araştırmacılar tarafından oluşturulan yapılandırılmış bilgi formu ve Hacettepe Kişilik Envanteri kullanılarak yüz yüze görüşme yöntemi ile toplandı. Bulgular: Öğrencilerin %8,9’unun dövme, %11,’sinin ise piercing yaptırdığı belirlendi. Hacettepe Kişilik Envanterinden öğrencilerin aldıkları ortalama puanlar incelendiğinde, sosyal uyum boyutunda dövme yaptırmayan öğrencilerin, ortalama puanlarının istatistiksel olarak anlamlı düzeyde yüksek olduğu belirlendi. Öğrencilerin piercing yaptırma durumlarına göre ise Hacettepe kişilik envanterinden aldıkları puan ortalamaları arasında istatistiksel olarak anlamlı bir farklılık bulunmadı. Sonuç: Öğrencilerin büyük bir çoğunluğunun dövme veya piercing yaptırmadığı belirlenirken, kişilik özellikleri ile dövme veya piercing yaptırma durumları arasında anlamlı bir farklılık bulunmadı. Bu sonucun öğrencilerin yetiştiği kültürel değerle ve içinde bulunduğu toplumun dinamikleriyle alakalı olabileceği düşünülmektedir