The Mediating Role of Interpersonal Relationships and Self-Differentiation in The Relationship Between Attachment Styles and Social Phobia

The aim of this study was to examine the relationships between social phobia, attachment styles, interpersonal relationships, and self-differentiation and to determine the mediating role of interpersonal relationships and self-differentiation in the relationship between attachment styles and social phobia. A total of 314 people, 197 (62.7%) women, and 117 (37.3%) men, aged between 18 and 70 years (30.60±11.66), were included in the study conducted in Istanbul. They were used as data collection tools Liebowitz Social Phobia Scale, Scale of Dimensions Interpersonal Relationship, Relationship Scales Questionnaire, and Self-Differentiation Scale. Parallel mediation analyzes were performed using Hayes's PROCESS macro plug-in based on the Bootstrap method. According to the results of the correlation analysis, weak and moderately significant relationships were found between the variables. The mediation analysis findings revealed, that approval dependence, trusting others, and emotional reactivity have parallel mediation effects in the relationship between secure attachment and social phobia-anxiety; that approval dependence and trusting others have parallel mediation effects in the relationship between secure attachment and social phobia-avoidance; that trusting others and emotional reactivity have parallel mediation effects in the relationship between dismissing attachment and social phobia-anxiety and avoidance; that approval dependence and trusting others had parallel mediation effect in the relationship between fearful attachment and social phobia-anxiety and avoidance; that approval dependence, trusting others and emotional reactivity had parallel mediation effect in the relationship between obsessive attachment and social phobia-anxiety; and that approval dependence and trusting others had parallel mediation effect in the relationship between preoccupied attachment and social phobia-avoidance. A total of 8 significant models explained between 4% and 19% of the variance. It can be said that the findings of the study can contribute to the determination of the variables mediating the relationship between attachment and social phobia and the development of clinical interventions for these variables

Investigation of the relationship between adolescents’ attitudes towards sexual education and their parents’ gender perceptions

Cinsel eğitim, bireye fiziksel, duygusal ve cinsel gelişim hakkında gerçek ve yanlışsız bilgiler vermektir. Bu eğitim doğumdan başlayarak ergenlik dönemine hatta tüm hayat boyu devam eden bir süreçtir. Bu araştırmanın genel amacı ergenlerin cinsel eğitime yönelik tutumları ile ebeveynlerinin toplumsal cinsiyet algıları arasındaki ilişkiyi incelemektir. Ergenlik dönemi çocukların cinsel eğitime yönelik tutumları ile ebeveynlerin toplumsal cinsiyet algıları nicel araştırma deseni kullanılarak tanımlanmıştır. Araştırmanın çalışma grubunu, Kayseri il merkezinde bulunan Anadolu Lisesi, Anadolu İmam Hatip ve Mesleki Teknik Anadolu Lisesine kayıtlı 320 öğrenci ve ebeveynleri oluşturmaktadır. Araştırmada veri toplama araçları olarak, ergenler ve ebeveynlerine ilişkin bilgileri içeren “Kişisel Bilgi Formu” ile ergenlerin cinsel eğitime yönelik tutumlarını belirlemek üzere “Cinsel Eğitime Yönelik Tutum Ölçeği (CEYTÖ)” ve ebeveynlerin toplumsal cinsiyet algılarını belirlemek için ise “Toplumsal Cinsiyet Algısı Ölçeği (TCAÖ)” kullanılmıştır. Araştırma yapılan korelasyon analizi sonucunda ergenlerin cinsel eğitime yönelik tutumu ile ebeveynlerinin toplumsal cinsiyet algıları arasında pozitif yönde düşük-orta seviye de bir ilişki olduğu ortaya çıkmıştır. Ebeveynlerin toplumsal cinsiyet algıları cinsiyetlerine göre incelendiğinde, kadınların lehine anlamlı bir fark olduğu ortaya çıkmıştır. Çocukların cinsel eğitime yönelik tutumlarında cinsiyete göre farklılık görülmemesi bir diğer sonuç olarak karşımıza çıkmaktadır. Ergenlik dönemindeki çocukların yanlış kaynaklardan cinsel bilgilere ulaşmasını önleyebilmek için ders müfredatlarına etik sınırlar çerçevesinde cinsel eğitim dersinin eklenmesi önerilmektedir.Sexual education is to give real and accurate information about physical, emotional and sexual development to the individual. Sexual education is to give adolescents and children real and false information about the function and function of the organs that carry out reproduction. This education is a process starting from birth to adolescence and even the whole life. The general purpose of this study is to examine the relationship between adolescents 'attitudes towards sexual education and their parents' gender perceptions. Adolescence children's attitudes towards sexual education and parents' gender perceptions were identified using a quantitative research design. Anatolian High School, located in the city center of Kayseri, consists of 320 students enrolled in Anatolian Imam Hatip and Vocational Technical Anatolian High School and their parents. As data collection tools, the "Personal Information Form" containing information about adolescents and their parents, the "Attitude Scale towards Sexual Education (CEYTÖ)" to determine the attitudes of adolescents towards sexual education and the "Gender Perception Scale (TCAÖ)" to determine the parents' perception of gender.)" used. As a result of the correlation analysis conducted, it was revealed that there was a positive low-medium level relationship between the attitude of adolescents towards sexual education and their parents' gender perceptions. When the gender perceptions of the parents were examined on the basis of gender, it was found that there was a significant difference in favor of women. Also another result is that there is no difference in children's attitudes towards sexual education according to gender. In order to prevent adolescents from accessing sexual information from wrong sources, it is recommended to add a sexual education course to the curriculum within the framework of ethical limits

The Mediating Role of Emotion Lability and Emotion Regulation in The Relationship Between Social-Emotional Adaptation with Behavior Regulation and Social Skills Among Preschool Children

Self-regulation is defined as an individual's ability to control and regulate their own behavior; this skill, forming the foundation of social adjustment, influences one's ability to interact with their environment and manage relationships. Emotion regulation, on the other hand, involves the ability to manage emotional responses and is believed to establish a critical connection between social adjustment and self-regulation. In this study, the aim is to determine the mediating role of emotion regulation in the relationship between behavioral regulation, social skills, and social-emotional adjustment skills using two different models.The study included a total of 216 children aged 5 and 6. Data were collected using the Socio-Demographic Information Form, Emotion Regulation Scale (ERS), Child Behavior Rating Scale (CBRS), and Marmara Social-Emotional Adaptation Scale (MSEAS). When socio-demographic variables were evaluated in terms of social competence and social-emotional adjustment scores according to gender, significant differences were found in favor of girls. Significant differences were also found in favor of children with working mothers when evaluated based on the mother's employment status. There were moderate significant correlations found between emotion regulation, child behavior assessment, and social-emotional adjustment. According to the mediation analyses, there was a partial mediating effect of emotion variability/negativity and emotion regulation in the relationship between behavior regulation and social-emotional adjustment. Similarly, there was a partial mediating effect of emotion variability/negativity and emotion regulation in the relationship between social competence and social-emotional adjustment. It is thought that the finding that children's emotion regulation and emotion variability/negativity mediate the relationship between social-emotional adjustment, social competence, and behavior regulation will contribute to the literature

A Clinical Experience: Endoscopic and Surgical Management of Bezoars

Objective:This study aims to evaluate the cases treated for gastrointestinal obstruction due to bezoar in terms of clinical-radiological-endoscopic features and treatment methods.Method:Among the patients treated for acute mechanical intestinal obstruction (AMIO) in our hospital between January 2014 and December 2019, 33 patients with bezoar-related AMIO were included in the study. The cases were examined in terms of the presence of comorbidity, tomography and endoscopy features, and treatment modalities.Results:A history of intraabdominal surgery was found in 82% of patients (n=27) and a history of upper gastrointestinal surgery in 60% (n=20). DM accompanied in 27% of the patients (n=9) and psychiatric disorder in 18% (n=6). With computered tomography, gastric dilatation was observed in 9 patients, jejunal in 9 patients, jejunoileal in 9 patients, and dilatation in all bowel segments in 6 patients. Endoscopy was performed in 12 patients; 9 had peptic ulcers, 3 were normal. Seventeen cases were treated with laparotomy, 9 cases with a laparoscopic enterotomy, and 3 cases with endoscopic procedures. 4 cases were treated with a Coca-Cola injection from a nasogastric catheter, which was successful.Conclusion:It is difficult to diagnose bezoar-related AMIO with clinical findings. Radiological and endoscopic methods are important in diagnosis. Although endoscopic methods are also used successfully for therapeutic purposes, surgical methods are used in distal locations and complicated cases

Efficacy of subsequent treatments in patients with hormone-positive advanced breast cancer who had disease progression under CDK 4/6 inhibitor therapy

Background: There is no standard treatment recommended at category 1 level in international guidelines for subsequent therapy after cyclin-dependent kinase 4/6 inhibitor (CDK4/6) based therapy. We aimed to evaluate which subsequent treatment oncologists prefer in patients with disease progression under CDKi. In addition, we aimed to show the effectiveness of systemic treatments after CDKi and whether there is a survival difference between hormonal treatments (monotherapy vs. mTOR-based). Methods: A total of 609 patients from 53 centers were included in the study. Progression-free-survivals (PFS) of subsequent treatments (chemotherapy (CT, n:434) or endocrine therapy (ET, n:175)) after CDKi were calculated. Patients were evaluated in three groups as those who received CDKi in first-line (group A, n:202), second-line (group B, n: 153) and ≥ 3rd-line (group C, n: 254). PFS was compared according to the use of ET and CT. In addition, ET was compared as monotherapy versus everolimus-based combination therapy. Results: The median duration of CDKi in the ET arms of Group A, B, and C was 17.0, 11.0, and 8.5 months in respectively; it was 9.0, 7.0, and 5.0 months in the CT arm. Median PFS after CDKi was 9.5 (5.0–14.0) months in the ET arm of group A, and 5.3 (3.9–6.8) months in the CT arm (p = 0.073). It was 6.7 (5.8–7.7) months in the ET arm of group B, and 5.7 (4.6–6.7) months in the CT arm (p = 0.311). It was 5.3 (2.5–8.0) months in the ET arm of group C and 4.0 (3.5–4.6) months in the CT arm (p = 0.434). Patients who received ET after CDKi were compared as those who received everolimus-based combination therapy versus those who received monotherapy ET: the median PFS in group A, B, and C was 11.0 vs. 5.9 (p = 0.047), 6.7 vs. 5.0 (p = 0.164), 6.7 vs. 3.9 (p = 0.763) months. Conclusion: Physicians preferred CT rather than ET in patients with early progression under CDKi. It has been shown that subsequent ET after CDKi can be as effective as CT. It was also observed that better PFS could be achieved with the subsequent everolimus-based treatments after first-line CDKi compared to monotherapy ET.Breast Cancer Consortiu

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

An Investigation of the Effect of Play-Based Education on Behavioral Self- Regulation Skills of Children

Bu araştırma, Oyun Temelli Davranışsal Öz-Düzenleme Eğitim Programının anaokula devam eden 48-60 ay arası çocukların davranışsal öz-düzenleme becerilerine etkisini belirlemek amacı ile yapılmıştır. Bu amaç doğrultusunda, araştırma, kontrol gruplu ön test-son test modeline dayalı deneysel bir çalışma olarak yürütülmüştür. Araştırmanın çalışma grubu, 2014-2015 eğitim öğretim yılında Ankara İli Altındağ ilçesine bağlı anaokuluna devam eden, 27 deney, 27 kontrol grubu olmak üzere toplam 54 çocuktan oluşmuştur. Araştırmada, çocuklar ve anne babaları hakkında bilgi almak için Kişisel Bilgi Formu, davranışsal öz-düzenleme becerilerinin belirlenebilmesi için ise doğrudan ölçüm aracı Baş-Ayak-Diz-Omuza Dokunma Yönergeleri (BADO-DY) ve öğretmen görüşlerini içeren Çocuk Davranış Değerlendirme Ölçeği (ÇODÖ) araştırmacı tarafından geçerlik güvenirlik çalışması yapılarak kullanılmıştır. Deney grubuna araştırmacı tarafından geliştirilen Oyun Temelli Davranışsal Öz-Düzenleme Eğitim Programı uygulanmış, kontrol grubu ise kendi sürecine bırakılmıştır. Verilerin analizinde, çocukların ve ailelerin demoŞekilbilgilerine ilişkin dağılımları frekans ve yüzde değerleri olarak verilmiştir. Deney ve kontrol grubu ön test-son test karşılaştırmalarında non-parametrik testlerden Mann Whitney-U ve Wilcoxon İşaretli Sıralar testi kullanılmıştır Araştırma sonucunda, deney ve kontrol grubu çocuklar arasında Baş-Ayak -Diz-Omuza Dokunma Yönergeleri (BADO-DY) ve Çocuk Davranış Değerlendirme Ölçeği (ÇODÖ) son test puanları açısından, deney grubu çocuklarının lehine anlamlı farklılık görülmüştür. Araştırmadan elde edilen sonuçlara göre, çocukların davranışsal öz-düzenleme gelişimlerine yönelik etkinliklerin sistemli olarak ele alınmasının okula hazır olma ve akademik becerilerin geliştirilmesi açısından gerekliliği önerilmiştir.The present study aimed to investigate the effect of the Play-Based Behavioral Regulation Education Program on behavioral regulation skills of preschoolers aging 48-60 months. Accordingly, the study was designed as an experimental study based on the pretest-posttest model with a control group. The study group of the research was comprised of a total of 54 children, 27 enrolled in the experimental group and 27 in the control group, attended to a nursery school in Altındağ district of Ankara province during 2014-2015 educational year. In the study, the Personal Information Form was used to collect information about children and their parents, and in order to determine behavioral regulation skills of children, the direct measurement tool of Head-Toes-Knees-Shoulders Touching Instructions (HTKS) and Child Behavior Rating Scale(CBRS), which collected the teacherzs views, were used upon validity and reliability study by the researcher. The experimental group received the Play-Based Behavioral Regulation Education Program as developed by the researcher unlike the control group. Distributions as regards the demographic data of children and families were provided in frequency and percentage values in the analysis of the data. Non-parametric Mann Whitney-U and Wilcoxon Signed- Rank tests were used for comparing the pretest-posttest results between the experimental and control groups. As a result of the study, there was a significant difference between the children in favor of the experimental group as regards the Head-Toes-Knees-Shoulders Touching Instructions (HTKS) and Child Behavior Rating Scale(CBRS), posttest scores. It was suggested based on the findings of the study that systematic consideration of activities towards development in childrenzs behavioral regulation was necessary for improving the school readiness and academic skills

Adaptation of Child Behavior Rating Scale (CBRS) to Turkish:Validity and Reliability Study

Bu araştırmanın amacı Çocuk Davranış Değerlendirme Ölçeği (ÇODDÖ) Türkçe formunun geçerlik ve güvenirlik çalışmasını yapmaktır. Araştırmada okulöncesi eğitim kurumuna devam eden 36-72 ay arası 591 çocuğun verisi kullanılmıştır. Geçerlik analizi için kapsam geçerliği, yapı geçerliği ve ölçüt-bağımlı geçerliği incelenmiştir. Ölçeğin yapı geçerliğini incelemek için uygulanan doğrulayıcı faktör analizi sonucunda 17 madde ve 2 faktörden oluşan modelin kabul edilebilir düzeyde uyum verdiği görülmüştür (?=1160.67, ?/sd= 4.88, RMSEA=0,09, CFI=0.97, NFI=0.97, NNFI=0.96 ve IFI=0.97). Güvenilirlik analizi için iç tutarlılık göstergesi olarak Cronbach Alfa değerleri, madde-toplam puan korelasyonları, %27'lik alt-üst değerler arası farklılık ve test-tekrar test güvenirliği hesaplanmıştır. Madde-toplam puan korelasyonları 0,56 ile 0,87 arasında, %27'lik alt-üst değerler arasındaki farklara ilişkin t değerleri 11.8 ile 43.9 arasında değişmektedir. Ölçeğin alt boyutlarına ilişkin Cronbach Alfa güvenirlik katsayısı, .84.96 aralığında bulunmuştur. Araştırma sonuçları, ölçeğin Türkçe formunun okul öncesi çocukların öz düzenleme becerilerini değerlendirmede kullanılabilecek geçerli ve güvenilir bir ölçme aracı olduğunu göstermektedirThe present study aimed to conduct validity and reliability study for the Turkish version the Child Behavior Rating Scale (CBRS). Data from 591 children aging 30-72 months and attending to preschool education institutions were used for the purposes of the study. Content validity, construct validity, and criterion-referenced validity were examined for the validity analysis. It was seen that the model comprising of 17 items and 2 factors was well fit as a result of the confirmatory factor analysis conducted for testing the construct validity of the scale (?=1160.67, ?CFI =0.97, NFI = 0.97, NNFI = 0.96, and IFI=0.97), Cronbach's Alpha values as an indication of internal consistency, item-total score correlations, difference between 27% of higher and lower values, and testretest reliability were examined for reliability analysis. Item-total score correlations difference between 0,56 and 0,87, 27% of higher and lower t values between 11.8 and 43.9. Cronbach's Alpha reliability coefficient for sub-domains of the scale was between .84 and .96. The findings of the study suggested that the Turkish version of the scale was a valid and reliable measurement instrument for use in assessment of self-regulation skills of preschool childre