THE CHALLENGES FACED BY SCHOOL COUNSELLORS IN THE REPORTING OF CHILD SEXUAL ABUSE

Identifying and reporting sexually abused children is one of the most important responsibilities of school counsellors. In this study, we aimed to determine the challenges of reporting child sexual abuse. We used a questionnaire form that was prepared by reviewing the literature about reporting sexual abuse. Participants were asked to state their level of knowledge of child sexual abuse, whether they had encountered such cases, whether they faced any challenges when notifying to authorities, and the possible solutions to problems encountered during this process. Of the school counsellors contacted, 40.9% of the participants stated that they encountered a claim of child sexual abuse at least once, but the majority of them (47.4%) could not report it to judicial authorities because of various reasons; such as being unsure whether the event was really happening, anticipating reactions towards them or school management, and fearing the school’s loss of reputation in the case of disclosure.  Article visualizations

Non-Syndromic Familial Unerupted Teeth: A Rare Contidion

A tooth that remains unerupted beyond the normal time of eruption and fails to erupt is called an impacted tooth. Maxillofacial surgeons encounter the problem of impacted teeth very often. Usually, impacted teeth involve the permanent dentition and they are rare in the primary dentition. Impaction of a primary tooth is a very rare entity. These rare cases are seen more frequently in primary second molars, followed by the order of the lower and upper centralincisor, lateral incisor and the canine teeth. Evolutionary and hereditary factors may cause uneruption. In this report, three cases of impacted primary teeth that belong to same familial members are presented. Father and sons. We extracted boy’s teeth but father refused treatment

EFSA NDA Panel (EFSA Panel on Dietetic Products, Nutrition and Allergies), 2013 . Scientific opinion on Dietary Reference Values for fluoride

Following a request from the European Commission, the Panel on Dietetic Products, Nutrition and Allergies (NDA) derived Dietary Reference Values (DRVs) for fluoride, which are provided as Adequate Intake (AI) from all sources, including non-dietary sources. Fluoride is not an essential nutrient. Therefore, no Average Requirement for the performance of essential physiological functions can be defined. Nevertheless, the Panel considered that the setting of an AI is appropriate because of the beneficial effects of dietary fluoride on prevention of dental caries. The AI is based on epidemiological studies (performed before the 1970s) showing an inverse relationship between the fluoride concentration of water and caries prevalence. As the basis for defining the AI, estimates of mean fluoride intakes of children via diet and drinking water with fluoride concentrations at which the caries preventive effect approached its maximum whilst the risk of dental fluorosis approached its minimum were chosen. Except for one confirmatory longitudinal study in US children, more recent studies were not taken into account as they did not provide information on total dietary fluoride intake, were potentially confounded by the use of fluoride-containing dental hygiene products, and did not permit a conclusion to be drawn on a dose-response relationship between fluoride intake and caries risk. The AI of fluoride from all sources (including non-dietary sources) is 0.05 mg/kg body weight per day for both children and adults, including pregnant and lactating women. For pregnant and lactating women, the AI is based on the body weight before pregnancy and lactation. Reliable and representative data on the total fluoride intake of the European population are not available

Serum Kreatinin Seviyelerinin Perkutan Nefrolitotripside Kanama Uzerine Etkisi

Amac: Perkutan nefrolitotripsi (PNL), urolojinin son yillarina damga vurmus, pek cok merkezde uygulanabilen, morbiditesi ve mortalitesi son derece dusuk bir tedavi yontemi olarak karsimiza cikmaktadir. Biz bu calismamizda, PNL oncesi serum kreatinin degerindeki yuksekligin post operatif kanama durumuna etkisini arastirmayi amacladik. Materyal ve Metod: Klinigimizde PNL uygulanmis olan hastalar arasinda ure ve kreatinin degerleri yuksek olan hastalar ayrildi. Bu hastalarin yaslari, tas boyutlari, cinsiyetleri, tedavi oncesi hematokrit degerleri ve ek ko-morbiditeleri kaydedilerek hastalarin bu degerlerine benzer degerleri olan hastalar ile diger grup olusturuldu. Serum kreatinin degerleri yuksek olanlar Grup 1, normal olanlar ise Grup 2 olarak adlandirildi. Hastalarin beden kitle endeksi, tas boyutlari, operasyon oncesi ve sonrasi kreatin degeri, operasyon oncesi ve sonrasi hematokrit degeri, preoperatif trombosit sayisi, koagulasyon parametreleri (aPTT, INR degerleri), trakt sayisi, operasyon suresi, preoperatif trombosit sayisi, tassizlik oranlari ve eritrosit transfuzyonu olup olmadigi kaydedilerek kiyaslandi. Bulgular: Gruplarda preoperatif kreatinin degerleri sirasi ile Grup 1 ve 2 icin 2,11 +/- 0,44 ve 0,98 +/- 0,27 idi. Tas boyutlari 1. Grup icin 29,41 +/- 3,83 mm, 2. Grup icin ise 29,49 +/- 2,99 idi (p=0,317). Hastalarin operasyon oncesi hematokrit degerleri 1 ve 2. Gruplar icin sirasiyla 44,88 +/- 5,61 ve 47,51 +/- 4,61 idi (p=0,381). Bu degerler operasyon sonrasi her iki grup icin sirasi ile 30,27 +/- 7,01 ve 37,74 +/- 7,11 idi (p=0,044). Sonuc: Calismamizda kreatinin degerlerinin PNL sonrasi kanama icin bir risk faktoru oldugu, serum kreatinin degerlerinin yuksekligi olan hastalarda, olmayanlara oranla hematokrit dususunun daha fazla oldugu gorulmektedir. [Cukurova Med J 2015; 40(2.000): 221-225

Comparison of Pneumatic, Ultrasonic and Combination Lithotripters in Percutaneous Nephrolithotripsy

Purpose We aimed to compare the outcomes of pneumatic (PL), ultrasonic (UL) and combined (PL/UL) lithotripsy performed in percutaneous lithotripsy (PNL) according to success rates and stone clearence. Materials and Methods The medical records of 512 patients treated with PNL between April 2010 and April 2013 were evaluated. Postoperative stone analysis revealed as calcium oxalate in 408 of these patients. The operation notes of 355 patients recorded in detail with complete parameters were reviewed. According to stone disintegration method, patients were divided into three groups: PL only in Group I, UL only in Group II, and UL/PL combination in Group III. Number of patients was 155, 110 and 90, respectively. Results Fluoroscopy screening time was significantly shorter in group II, and III compared to group I (p<0.001). The failure rates were 13.5% (21 patients) for group I, 3.6% (4 patients) for group II, and 3.3% (3 patients) for group III. There was a significant statistical difference in favor of group II and III by means of success (p=0.023). Group II and III had larger FSA, and this was statistically significant (p=0.032). Stone disintegration time (SDT) was 64.0±41.92 minutes for group I, 49.5±34.63 for group II, and 37.7±16.89 for group III. Group III has a statistically significant shorter SDT (p=0.011). Conclusions We concluded that, in cases with high stone burden, where faster and efficient lithotripsy is needed, combined ultrasonic / pneumatic lithotripter may be the ideal choice and in suitable cases ultrasonic lithotripter usage provides important advantages to the surgeon