Efficacy of moderate-intensity walking provided feedback by ECE PEDO on abdominal fat in overweight and obese women: A randomized, exercise study

Objectives: The aim of this study was to investigate the effectiveness of walking with Equipment for Clever Exercise (ECE PEDO) compared to supervised, moderate-intensity, aerobic, treadmill walking exercise in overweight and obese women. Patients and methods: Between September 2014 and January 2015, 28 women with overweight and obesity were assigned to two groups: supervised treadmill walking (Group 1, n=14) or walking with ECE PEDO (Group 2, n=14). The target heart rate (HR) corresponding to values of 50 to 70% VO2max were determined by submaximal treadmill test. Group 1 was instructed walking at their target HR on treadmill. The number of steps in a min corresponding to the target HR was calculated by a criterion pedometer and Group 2 was instructed walking in this step range recorded to the ECE PEDO giving audible feedback. Before and after a 12-week exercise program, all participants were evaluated by Body Mass Index (BMI) and waist circumference (WC). Ultrasonographic visceral fat thickness (VFT) and ergospirometric VO2max. Results: The VFT decreased in both walking groups in association with reduced WC and weight loss and also significant increases in the VO2max after exercise intervention (p<0.05). The VFT decreased only in women by walking with ECE PEDO compared to the other group (p<0.05). Conclusion: Our study results showed that both moderate-intensity exercise provided by a novel pedometer and supervised treadmill walking showed significant improvements in abdominal obesity and VO2max. © 2017 by Turkish Society of Physical Medicine and Rehabilitation

In spontaneous intracerebral hematoma patients, prediction of the hematoma expansion risk and mortality risk using radiological and clinical markers and a newly developed scale

Objective: In patients with spontaneous intracerebral hematoma (ICH), early-stage hematoma expansion has been associated with poor prognosis in literature. This study aimed to develop predictive parameter(s) as well as a new scale to define hematoma expansion and short-term prognosis in patients with ICH. Methods: In 46 patients with ICH, Glasgow Coma Scale (GCS) scores, non-contrast CT (NCCT) markers (hematoma volume on admission and follow-up, hypodensity, intraventricular hemorrhage, blend and island sign, BAT score), and modified Rankin Scale scores were evaluated for predicting the hematoma expansion risk and mortality risk. Furthermore, a newly developed scale called the ‘HEMRICH scale’ was constituted using the GCS score, hematoma volumes, and some NCCT markers. Results: Roc-Curve and Logistic Regression test results revealed that GCS score, initial hematoma volume value, hypodensity, intraventricular haemorrhage, BAT score, and HEMRICH scale score could be the best markers in predicting hematoma expansion risk whereas GCS score, intraventricular haemorrhage, BAT score, hematoma expansion, and HEMRICH scale score could be the best markers in predicting mortality risk (p = 0.01). Moreover, Factor analysis and Reliability test results showed that HEMRICH scale score could predict both hematoma expansion and mortality risks validly (Kaiser-Meyer-Olkin test value = 0.729) and reliably (Cronbach’s alpha = 0.564). Conclusion: It was concluded that the GCS score, intraventricular haemorrhage, and BAT score could predict both hematoma expansion risk and mortality risk in the early stage in patients with ICH. Furthermore, it was suggested that the newly produced HEMRICH scale could be a valid and reliable scale for predicting both hematoma expansion and mortality risk

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

Telling the Inexplicable through Memory: Sarah Kofman’s Rue Ordener Rue Labat and the Relocating of Holocaust Violence in Paris

This project is an analysis of Sarah Kofman’s autobiographical account of her memory and trauma in Rue Ordener Rue Labat. Using depictions of Holocaust narratives as they are found in the texts of Primo Levi and Hannah Arendt––primarily their ideas of the ‘Grey-Zone’ and ethical ambiguity, self-alienation and the notion of collective guilt in the Holocaust crime––an analysis is provided for similar accounts found in Sarah Kofman’s autobiographical novel. Beyond simply depicting these narratives in the text, this project also demonstrates how this helps to overcome the impossibility of writing about the Holocaust. Furthermore, this analysis looks at how Kofman relocates the violence of the Holocaust in Paris, resulting in a wider understanding of the Nazi genocide. The theoretical framework used in this work is inspired by Michael Rothberg’s Multidirectional Memory, in which he suggests understanding memory not as collective, but as multidirectional: as a subject for ongoing negotiation, cross-referencing and borrowing. This analysis is also shows how Kofman’s work falls into this category as it not only shows similarities to other texts on the Holocaust, but also demands a broader perspective on the Holocaust in presenting it as part of all humanity’s history.

Eğitim fakültesi öğrencilerinde akademk erteleme davranışı: cinsiyet, yaş, akademik başarı mükemmeliyetçilik ve deprasyonun rolü

The aim of the study was to investigate to what extent gender, age, academic achievement, depression and perfectionism predict academic procrastination among Faculty of Education students. The participants were 368 undergraduate students enrolled in five departments of Middle East Technical University, Faculty of Education. Data was collected by a questionnaire packet including demographic data form; Procrastination Assessment Scale-Students (PASS), Beck Depression Inventory (BDI) and Multidimensional Perfectionism Scale (MPS). The results of the multiple regression analysis for the total sample revealed that, self-oriented perfectionism, others-oriented perfectionism, academic achievement and depression were significant predictors of academic procrastination among Faculty of Education students. However age and socially prescribed perfectionism did not have any significant contribution to the prediction of academic procrastination. Predictive roles of the variables were differantiated across genders. While self-oriented perfectionism, others-oriented perfectionism, depression and academic achievement had significant predictive role on academic procrastination among females, self-oriented perfectionism was the only variable that had a significant contribution in predicting the academic procrastination of male students. Implications of the findings were discussed and some suggestions were made for further research.M.S. - Master of Scienc

Matematik öğretmen adaylarının türev kavramına ilişkin teknolojik pedagojik alan bilgilerinin öğrenci zorlukları bağlamında incelenmesi

MATEMATİK ÖĞRETMEN ADAYLARININ TÜREV KAVRAMINA İLİŞKİN TEKNOLOJİK PEDAGOJİK ALAN BİLGİLERİNİN ÖĞRENCİ ZORLUKLARI BAĞLAMINDA İNCELENMESİ Çağımızda teknoloji hayatımızın her alanında kendisine yer bulmakta ve her geçen gün yaygınlaşmaktadır. Teknoloji artık bilimin bütün dallarında kullanılmakta ve sürekli olarak gelişmektedir. Teknolojideki ilerlemeler sonucu üretilen teknolojik araçlar matematikçilerin pratiklerine, araştırma yöntemlerine hatta araştırma sorularına doğrudan yön vermiş ve vermeye devam etmektedir (Artigue, 2002; akt: Akkoç, 2008b). Dolayısıyla hayatımızda kendisine önemli bir yer bulan teknolojinin matematik öğretimi üzerine ciddi bir etkisi olmuş ve özellikle son 30 yılda çeşitli teknolojik araçların matematik öğretiminde kullanılması yaygın hale gelmiştir. Çeşitli ülkelerdeki matematik öğretim programları teknoloji ile matematik öğretiminin gerekliliğine ve önemine değinmektedir (NCTM, 1989, 1991, 2000). Ülkemizde ise Ağustos 2005’te yayınlanan yeni “Ortaöğretim Matematik Dersi Öğretim Programı” bilgisayar destekli matematik öğretimini önemle vurgulanmakta ve bilgisayar destekli matematik öğretiminin bir seçenek değil, sistemi tamamlayıcı bir rol üstlenmesi gerektiği belirtilmektedir (MEB, 2005). Nitekim bilgisayar yazılımları, bilimsel ve grafik hesap makineleri gibi teknolojik araçların teknik olarak nasıl kullanıldığını bilmek, bu teknolojik araçları etkin bir şekilde kullanarak öğretim yapabilmek anlamına gelmemektedir. Bu nedenle, öğretmenlere gerek hizmet öncesi gerekse hizmet içi öğretmen eğitiminde bu teknolojik araçların teknik olarak nasıl kullanıldığını öğretmek kendi başına yeterli olmayacaktır (Akkoç, Özmantar ve Bingölbali, 2008). Bununla birlikte teknolojik araçları kullanmanın pedagojik yönünün öğretmen ve öğretmen adayları eğitimlerinde kazandırılması gerekmektedir. Literatürde bu bilgi “Teknolojik Pedagojik Alan Bilgisi (TPAB)” olarak tanımlanmaktadır (Pierson, 1999; Niess, 2005). Bu doğrultuda şu an TÜBİTAK tarafından desteklenen 107K531 nolu “Matematik Öğretmen Adaylarına Teknolojiye Yönelik Pedagojik Alan Bilgisi Kazandırma Amaçlı bir Program Geliştirme” (Akkoç, 2008) başlıklı proje yürütülmektedir. Bu çalışma belirtilen projenin bir parçası olup öğretmen adaylarının TPAB’nin “öğrenci zorlukları” bileşeninde gelişimlerini incelemektedir. Proje kapsamında hazırlanan eğitimler 2008- 2009 eğitim öğretim yılında, Marmara Üniversitesi, Atatürk Eğitim Fakültesi Ortaöğretim Fen ve Matematik Ana Bilim Dalı, Matematik Öğretmenliği Bölümünde öğrenim gören, Seçmeli IIA ve Özel Öğretim Yöntemleri II dersine katılan 40 öğretmen adayına verilmiştir. Bu çalışmada belirtilen öğretmen adaylarından mikro öğretim yapan beş öğretmen adayının gelişimleri derinlemesine ortaya konmaktadır. Çalışmanın veri analizleri öğretmen adaylarının verilen eğitimler sonucunda türev kavramına yönelik TPAB’nin öğrenci zorlukları bileşeninde kayda değer bir gelişim gösterdiklerini ortaya çıkarmaktadır. Literatürde türev kavramına ilişkin bu zorluklar türev-limit, türev-eğim ve türev değişim oranı ilişkisi kurmadaki zorluklar şeklinde üç başlıkla belirtilmektedir. Eğitimler öncesinde öğretmen adayları belirtilen üç başlıkta öğrencilerin zorluk yaşayabileceklerini öngörmezken, eğitimler sonrasında öngörmektedirler. Öğrencilerin zorluk yaşamamaları amacıyla teknolojinin imkânlarından yararlanmakta ve teknolojinin kısıtlamalarını da avantaja çevirmeye çalışmaktadırlar. ANAHTAR KELİMELER: Teknolojik pedagojik alan bilgisi; öğrenci zorlukları; matematik öğretmeni yetiştirme; türev ABSTRACT INVESTIGATING TECHNOLOGICAL PEDAGOGICAL CONTENT KNOWLEDGE FOR DERIVATIVE CONCEPT: KNOWLEDGE OF STUDENT DIFFICULTIES Technological developments have been widely used in almost every area of our lives. Technology have been also used and been developing in every branch of science. Advances in technology have affected mathematicians’ practices and mathematical problems to be solved (Artigue, 2002). Therefore, teaching of mathematics is affected parallel to the advances in technology. Statements in various curriculums in different countries have emphasized the necessity and importance of teaching mathematics by using technology (NCTM, 1989, 1991, 2000). In Turkey, new mathematics curriculum which was announced in 2005 have emphasized the computer-assisted mathematics education. It states that the use of technology should have an integral role (MEB, 2005). Therefore, training pre-service teachers and teachers to use technological tools would not be enough in and of itself. Teachers should also have the pedagogical knowledge and skills for successful technology integration. This knowledge is defined as “Technological Pedagogical Content Knowledge (TPCK)” in mathematics education literature (Pierson, 1999; Niess, 2005). Using this framework, a project sponsored by Scientific and Technological Research Council of Turkey (TUBİTAK) entitled as “Developing a program for pre-service mathematics teachers which aims to develop technological pedagogical content knowledge” with project number 107K531 (Akkoç, 2008). This thesis is part of this project and focuses on one component of TPCK, namely “knowledge of student difficulties”. Within the project, a program is designed and implemented during “Teaching Methods II” and “Technology Assisted Mathematics Education” courses in the Department of Mathematics and Science Education in Atatürk’s Faculty of Education, Marmara University. This thesis focuses on a qualitative investigation of five pre-service mathematics teachers’ development. The analysis of data aims to reveal pre-service teachers’ development of TPCK in terms of “knowledge of students’ difficulties” component. In the literature, student difficulties with derivative concept have been investigated under three categories: derivative-limit relationship, derivative-slope relationship and derivative-rate of change relationship. Before TPCK workshops, pre-service teachers did not foreseen difficulties mentioned above. However, after TPCK workshops they could both foreseen and address these student difficulties. Furthermore, they effectively used computer software to address these difficulties. KEYWORDS: Technological pedagogical content knowledge; student difficulties, mathematics teacher education; derivativ

Düşünce tarzları ve beş büyük kişilik özelliğin tekrar gözden geçirilmesi

Bu çalışmanın iki amacı vardır. Birincisi kişilik ölçümünün ötesinde, zihinsel tarzların (genel olarak bilme, kavrama ve düşünce tarzları çerçevesinde) ölçümünün yararını daha fazla ortaya çıkarmaktır. İkincisi ise, Sternberg’in (1988) kişisel zihin yönetimi teorisinin, akademik çevre kadar akademik olmayan çevreye de uygulanabileceğini kanıtlamaktır. Düşünce Tarzları Envanteri (Sternberg & Wagner, 1992) ve NEO Beş-Faktör Envanteri (Costa & McCrae, 1992) Çin’deki 199 ilköğretim (secondary) okulu öğrencisinin ebeveynlerine uygulandı. Bulgular incelenen kişilik özelliklerindeki Zihinsel tarzların anlamlı olduğunu gösterdi. Sonuçlar akademik ve akademik olmayan çevrelerdeki Sternberg’in kişisel zihin yönetimi teorisinin geçerliliğini desteklemektedi

The factors affecting the level of patients' satisfaction of the applicants for emergency service

Bu çalışmanın amacı Uludağ Üniversitesi Tıp Fakültesi (UÜTF) Hastanesi Acil Servisine başvuran hastaların memnuniyet düzeyini değerlendirmek, hasta memnuniyetini etkileyen faktörleri saptamak ve gelecekte bu konuda yapılması planlanan iyileştirmelere yardımcı olmaktır.1 Mayıs-30 Haziran 2008 tarihleri arasında UÜTF Hastanesi Acil Servisine başvuran 18 yaş üzerindeki, araştırmaya katılmayı gönüllü olarak kabul eden hastalar çalışmaya alındı. Bilinç bozukluğu, iletişimi engelleyecek herhangi bir hastalığı, acil ameliyat gerekliliği olan ve aydınlatılmış onam alınamayan hastalar araştırma dışında bırakıldı. Araştırmaya alınan hastaların verileri araştırmacı tarafından hazırlanan anket formu kullanılarak toplandı. Anket formunda hastalara acil servis doktorları, hemşireleri, personeli, bilgilendirilmesi, tetkiklerin sonlanma süreleri, hastanenin fiziksel koşulları ve teknik donanımı gibi konularda memnuniyet düzeyleri soruldu.Araştırma süresince acil servise toplam 5865 hasta başvurmuş olup çalışmaya 600 hasta alındı. Yaşları 19-87 arasında olup, yaş ortalaması 40.7±16.6 olarak saptanan hastaların %51.2'si erkeklerden oluşmaktadır. %6.7'si triyaj 1, %24'ü triyaj 2 ve %69.3'ü triyaj 3 olarak tespit edilen hastaların %76.2'si herhangi bir nedenle beklemek durumunda kalmadan acil servisten taburcu edilmişlerdir. Yatışı yapılan 64 hastadan %45.3'ü yatış için acil serviste beklemiştir. Acil servis doktorlarının ve hemşirelerinin tıbbi bakım tecrübesinden memnun olma düzeyi sırasıyla %94.5 ve %91 olarak saptanmıştır. Acil serviste görevli doktor ve hemşirelerin davranışları ve tıbbi bakım tecrübeleri, hastanın tüm süreç boyunca bilgilendirilmesi ile acil servisteki bekleme süresi hasta memnuniyetinde önemli faktörlerdendir. Bu veriler ışığında, kurumun sürekliliğinin sağlanabilmesinin ancak hasta memnuniyetini misyon olarak kabul eden hastane idarecileri ve çalışanları ile mümkün olabileceği inancındayız.The aim of this study is to evaluate the level of satisfaction of the applicants for Emergency Service of Uludag University Medical Faculty Hospital (UUMFH), to analyze the factors that affect this and to help the improvements planned in the future.Between 1 May-30 June 2008 applicants for UUMFH over 18 were included to this study. The patients with altered mental status, any illness that will prevent communication, any patient that needs urgent surgery and couldn't sign the informed consent form were not included to this study. All the data were collected with a survey form prepared by the researcher. At that form patients were asked about their level of satisfaction for emergency service doctors, nurses and staff, keeping informed, time interval of their examinations, physical state and technical equipment of the hospital. During the examination period 600 of 5865 applicants has been selected randomly. Patients were between the ages of 19-87, average age was 40.7±16.6 and %51.2 was male. %6.7, %24 and %69.3 of the patients were established respectively as triage 1, triage 2 and triage 3 and %76.2 of them were discharged directly without waiting at the emergency service. %45.3 of the 64 patients who were hospitalized waited at emergency service before internalization. The satisfaction level of the patients for emergency doctors and nurses' medical care experience were %94.5 and %91 respectively.Attitudes and medical care experiences of doctors and nurses in charge at emergency service, keeping patients informed during the process and waiting time at emergency service are the major factors effecting patients' level of satisfaction. With this knowledge, we believe that the permanence of a corporation can be possible if hospital administers and staff could consider patients satisfaction as their mission