STEM Yaklaşımı ile Basınç Konusu Öğretiminin Ortaokul 7. Sınıf Öğrencilerinin Akademik Başarılarına ve STEM’e Yönelik Tutumlarına Etkisi

The objective of this study is to determine the effect of a teaching module on the topic of pressure, developed with STEM approach, on the academic achievements of the students as well as on their attitudes towards STEM. The study employed the explanatory sequential design, as one of of mixed method research designs. On the quantitative aspect of the study, a pre-test and post-test control group, quasi-experimental design was used, while phenomenological design was utilized for qualitative aspects. The sample group of the research comprises of 33 7th grade students studying in a village school located in a district of one of the metropolitan municipalities in Turkey for the Spring Semester of the 2017-2018 school year. A STEM education approach was used in the experimental group for teaching the subject of “Pressure” while utilizing the approach as stipulated in the curriculum for the control group. An academic achievement test, an attitude scale for STEM, semi-structured interviews, and the student diaries are the data collection tools used in the study. A significant difference was found between the experimental group and the control group, with the former showing increased academic achievement over the latter in the research. A significant difference was also found between the experimental group and the control group, with the former showing more positive attitudes towards STEM than were shown by the latter. The opinions of the students on STEM education were analyzed in order to study the results obtained from quantitative data. Five themes – feelings and opinions, positive aspects, skills gained, features and problems faced, and the learning process were obtained—as well as 26 codes—with the content analysis of semi-structured interviews and students’ diaries. It was concluded that involving STEM-based implementations in teaching the subject “Pressure” increased the academic success rate and attitude scores of students while helping the students to develop positive perceptions of STEM education. In future studies, certain influences of STEM education implementations, such as self-confidence of students, the ability to present creative solutions, communication skills, for example, may be studied.Bu çalışmanın amacı, basınç konusunda STEM yaklaşımı ile geliştirilen bir öğretim modülünün, öğrencilerin akademik başarılarına ve STEM’e yönelik tutumlarına etkisinin belirlenmesidir. Çalışmada karma yöntem araştırması desenlerinden açıklayıcı sıralı desen kullanılmıştır. Çalışmanın nicel boyutunda ön test-son test kontrol gruplu yarı deneysel desen, nitel boyutunda ise olgubilim deseninden faydalanılmıştır. Araştırmanın örneklemi, 2017-2018 eğitim öğretim yılı güz döneminde, Türkiye’de yer alan büyükşehirlerden birinin ilçesine bağlı bir köy okulunda öğrenim görmekte olan 7. sınıf öğrencisi 33 kişiden oluşmaktadır. Basınç konusunun öğretiminde, deney grubunda STEM eğitimi kullanılırken kontrol grubunda öğretim programının ön gördüğü yaklaşım kullanılmıştır. Akademik başarı testi, STEM’e yönelik tutum ölçeği, yarı yapılandırılmış görüşmeler ve öğrenci günlükleri çalışmada kullanılan veri toplama araçlarıdır. Araştırma sonucunda, akademik başarı açısından deney grubu ile kontrol grubu arasında deney grubu lehine anlamlı bir fark bulunmuştur. Aynı zamanda STEM’e yönelik tutumlar açısından da deney grubu ile kontrol grubu arasında deney grubu lehine anlamlı bir farklılık olduğu görülmüştür. Nicel verilerden elde edilen sonuçların daha derinlemesine incelenmesi için öğrencilerin STEM eğitimine ilişkin görüşleri incelenmiştir. Yarı yapılandırılmış görüşmeler ile öğrenci günlüklerinin içerik analizi sonucu duygu ve düşünceler, olumlu yönler, kazanılan beceriler ve özellikler, yaşanan sorunlar ve öğrenme süreci olmak üzere 5 tema ve 26 kod elde edilmiştir. Basınç konusunun öğretiminde STEM temelli uygulamalara yer verilmesinin, öğrencilerin akademik başarı ile tutum puanları üzerinde artış sağladığı ve öğrencilerin STEM eğitimine ilişkin olumlu düşünceler geliştirmelerine yardımcı olduğu görülmüştür. Gelecek çalışmalarda STEM eğitimi uygulamalarının öğrencilerin özyeterlik inançları, yaratıcı problem çözme becerileri, iletişim becerileri gibi farklı değişkenler üzerindeki etkileri araştırılabilir

Anesthetic management of pregnant patient with valvular heart disease

During pregnancy, while the blood volume, cardiac output, heart rate increase, the systemic vascular resistance decreases. Hemodilution and physiological anemia can be seen.These changes can be tolerated by pregnant healthy women but they can be an overload on the heart with pregnant women who have cardiac diseases. For this reason the peripartum morbidity and mortality increase. The selection of anesthesia in these patients varies according to the type of cardiac disease, drugs used,and to the urgency of the surgery. Our case was a 32 year-old who had four gravity, two parity and two abortions. Caesarean section was planned for the patient at 39 weeks of gestation In the preoperative examination we learned that she had underwent a percutaneous mitral balloon valvuloplasty five years ago. In echocardiography the mitral valve area was 1 square centimeter, 30 aortic insufficiency was detected and pulmonary artery pressure was 35 mm Hg. The spinal-epidural anesthesia was performed through the L4-L5 intervertebral space with the patient in the sitting position. Perioperative anesthesia and analgesia was provided by epidural catheter. As a result we believe that the low-dose combined spinal-epidural anaesthesia will be more stable on the hemodynamics in the implementation of cesarean section in pregnant women with heart disease and we believe that providing postoperative analgesia via an epidural catheter may prevent the adverse effects such as tachycardia, hypertension and agitation.Gebelikle birlikte kan hacmi, kalp debisi, kalp hızı artarken sistemik vasküler direnç azalır. Hemodilüsyon ve fizyolojik anemi görülür. Bu değişiklikler sağlıklı kadınlar tarafından tolere edilebilirken kalp hastalığı olan gebelerde kalp üzerinde ayrı bir yük oluşturmaktadır. Bunun sonucunda peripartum morbidite ve mortalite artmaktadır. Bu hastaların anestezi seçimi kalp hastalığının tipi, kullanılan ilaçlar, cerrahinin aciliyetine göre değişmektedir. 32 yaşında olan hastamızın 4 gebelik, 2 doğum ve 2 abortusu mevcuttu. Hastamıza 39 haftalık gebeliği ne-deniyle sezeryan planlanmıştı. Preoperatif mu-ayenesinde 5 yıl önce perkütan mitral balon valvüloplasti geçirdiği öğrenildi. Ekokardiyog-rafide mitral kapak alanı 1 cm2 olduğu, 30 aort yetmezliği ve pulmoner arter basıncı 35 mm Hg olarak tespit edildi. Hastaya lomber 4-5 verteb-ra aralığından oturur pozisyonda kombine spi-nal–epidural anestezi yapıldı. Epidural katater yoluyla perioperatif ve postoperatif anestezi ve analjezi sağlandı. Sonuç olarak kalp hastalığı olan gebelerde sezaryen uygulamasında düşük doz kombine spinal-epidural anestezi ile hemo-dinaminin daha stabil olacağını ve epidural ka-tater yoluyla da postoperatif analjezi sağlanarak taşikardi, hipertansiyon, ajitasyon gibi olumsuz etkilerin önleneceğini düşünüyoruz

An incidental detection of aortic aneurysm on Tc-99m MAG3 renal scintigraphy

A 71-year-old man with newly diagnosed hypertension was referred for Technetium-99m mercaptoacetyltriglycine (Tc-99mMAG3) renal scintigraphy to evaluate the recent onset of impairmentin renal functions. Dynamic imaging revealed activity flowwhich was suspicious for aortic aneurysm (AA) with a concurrent decrease in left renal blood flow. CT angiography of the thoracoabdominal aorta confirmed that this area corresponded to AA. The purpose of this report was to present the first case of incidental detection of AA on Tc-99m MAG3 scintigraphy and highlight the importance of correlative imaging for thediagnosis of abnormal radioactivity accumulation in the regionof vascular structures

Can Tc-99m labeled erythrocyte scintigraphy be an alternative non-invasive method to endometriosis diagnosis?

Background: Endometriosis is defined as the implantation of endometrial gland and stroma ectopically outside the uterus. Clinically, it is a hormone dependent benign disease accompanied by pelvic pain and infertility. The aim of this study was to demonstrate the activated implants with 99m-Tc labeled erythrocyte scintigraphy (99mTc-RBCs) in patients with recurrent endometriosis and compare the results with pelvic MRI results.Methods: Patients who were diagnosed histopathologically as endometriosis either with operation and / or therapeutic laparascopy or laparotomy and, were included to present study. Thirty patients, who were diagnosed as recurrence by clinical, and laboratory terms and 10 healthy volunteer (control group) patients were included in the study. Between the second and fifth days of menstruation when the endometriotic lesions were highly activated, radionuclide imaging was performed by 99mTc-RBCs and compared with pelvic MRI findings.Results: In 27 patients out of 30 patients (90%) pathological accumulation of radioactivity foci with 99mTc-RBCs were present. The focal pathological accumulation was significant in 26 patients and moderate in 1 patient. In 22 patients (81.5%) the increased radioactivity accumulation in radionuclide images was concordant with MRI images. Regarding the MRI as reference, the sensitivity of 99mTc-RBCs was determined as 96%, specificity 29%, positive predicitive value 81% and negative predictive value was 66%.Conclusions: Imaging of endometriosis regions with 99m-Tc-RBCs can be an alternative diagnostic procedure for the patients with recurrent endometriosis

Short-term outcome of early electrical cardioversion for atrial fibrillation in hyperthyroid versus euthyroid patients*

Background: Atrial fibrillation (AF) is the most common cardiac complication of hyperthyroidism. The influence of the time of cardioversion on hyperthyroidism-induced AF remains unclear. The aim of this study was to compare short-term outcomes of early electrical cardioversion for AF in hyperthyroid and euthyroid patients. Methods and Results: Sixty-seven subjects with persistent AF (duration, 10 days–12 months) were divided into two groups according to thyroid function: Euthyroid (Group 1, n = 36, female/male: 23/13, mean age: 61.77 ± 10.45 years) and hyperthyroid (Group 2, n = 31, female/male: 10/21, mean age: 65.43 ± 6.40 years). Two patients were excluded for unsuccessful cardioversion (one in each group). In Group 2, 19 patients had clinical and 11 had subclinical hyperthyroidism. Following transthoracic and transesophageal echocardiography, cardioversion was performed until the highest energy was reached (270 J) or until sinus rhythm was achieved. AF recurrence was detected in 13 of 35 patients (37.1%) in Group 1 and in 11 of 30 patients (36.9%) in Group 2 (p = 0.96) at one month. Recurrence rate was higher in the clinical hyperthyroid patients than in the subclinical hyperthyroid patients (52.6% vs 9.1%, p = 0.021), but neither the clinical nor the subclinical hyperthyroid subgroups were significantly different from Group 1 in terms of recurrence rate (p = 0.27 and p = 0.13, respectively). Conclusions: Electrical cardioversion should be performed for patients with persistent AF and hyperthyroidism as soon as possible. (Cardiol J 2012; 19, 1: 53–60

Effects of Enzyme-Producing Probiotic Bacteria Isolated from the Gastrointestinal Tract of Trout on the Growth Performance, Survival, and Digestive Enzyme Activity of Rainbow Trout Fry (Oncorhynchus mykiss)

In this study, we investigated the effects of enzyme-producing probiotic bacteria isolated from the gastrointestinal tract of rainbow trout on the growth performance, feed conversion ratio, and digestive enzyme activity, of fry (Oncorhynchus mykiss). Three isolates (G8/2013, T7/2013 and U5/2013) of candidate bacteria elicited the highest protease, lipase, and amylase activities, respectively. Isolates were identified as Aeromonas sp., Bacillus sp. and Citrobacter braakii by morphological, physiological, biochemical characterizations as well as 16S rRNA gene sequence analysis. The fry basal diet was supplemented with probiotics at varying concentrations; G8 group, Aeromonas sp. 1.72 x 108 CFU/g; U5 group, Bacillus sp. 3.01 x 108 CFU/g; T7 group, C. braakii 2.96 x 108 CFU/g and a mixed group (same bacterial concentrations), and control group (no bacteria). The rainbow trout fry were fed ad libitum in triplicate treatments with supplemented and non-supplemented probiotic diets for 70-days. The total bacterial count in the intestine was significantly higher in the mixed group (30th and 50th days) and U5 group (50th and 70th days) compared with the control group. However, there was no significant difference in weight gain, specific growth rate (SGR), feed conversion ratio (FCR), nutrient digestibility, or digestive enzyme activity among the groups.

Liver stiffness value obtained by point shear-wave elastography is significantly related with atrial septal defect size

PURPOSEThe increase in volume and pressure in the right atrium (RA) and right ventricle (RV) has been shown to increase the liver stiffness (LS). In the literature, there is no information about the changes in LS value in patients with atrial septal defect (ASD). The aim of our study was to investigate the change of LS values obtained by point shear-wave elastography (pSWE) in patients with ASD and the clinical utility of pSWE for this disease.METHODSThis cross-sectional study included 66 patients with ostium secundum ASD: 21 patients with no indication for ASD closure (Group I), 38 patients who underwent ASD closure (Group II), and 7 patients who had ASD with Eisenmenger syndrome (Group III). All patients underwent echocardiography and pSWE. Increased LS was accepted as ≥7 kPa.RESULTSLS values as well as transaminases, clinical signs of heart failure and functional and structural heart abnormalities (increase of RA and RV diastolic dimensions, tricuspid regurgitation pressure gradient [TRPG], ASD size and decrease of ejection fraction, tricuspid annular plane systolic excursion) significantly increased from Group I to Group III (P < 0.001 for all comparisons). Mean LS values for Group I, Group II, and Group III were 5.16±1.55 kPa, 7.48±1.99 kPa, and 13.9±2.58 kPa, respectively. In multivariate linear regression analysis, ASD size and TRPG were significantly associated with LS increase. Only ASD size independently predicted abnormal LS increase ≥7 kPa according to multivariate logistic regression. Clinical value of LS increase was comparable to TRPG for detection of Eisenmenger syndrome; in the receiver operating curve analysis, area under the curve was 0.995 for LS (P < 0.001) and 0.990 for TRPG (P < 0.001). At 10 kPa threshold, LS determined the Eisenmenger syndrome with 100% sensitivity and 91.5% specificity.CONCLUSIONLS value assessed by pSWE was significantly increased in ASD patients with closure indication and Eisenmenger syndrome compared to patients without ASD closure indication and was comparable with TRPG in regards to Eisenmenger syndrome identification. ASD size significantly associated with LS and independently predicted abnormal LS increase ≥7 kPa

The impact of teaching the subject “pressure” with STEM approach on the academic achievements of the secondary school 7th grade students and their attitudes towards STEM

WOS: 000466836800009The objective of this study is to determine the effect of a teaching module on the topic of pressure, developed with STEM approach, on the academic achievements of the students as well as on their attitudes towards STEM. The study employed the explanatory sequential design, as one of mixed method research designs. On the quantitative aspect of the study, a pre-test and post-test control group, quasi-experimental design was used, while phenomenological design was utilized for qualitative aspects. The sample group of the research comprises of 33 7th grade students studying in a village school located in a district of one of the metropolitan municipalities in Turkey for the Spring Semester of the 2017-2018 school year. A STEM education approach was used in the experimental group for teaching the subject of "Pressure" while utilizing the approach as stipulated in the curriculum for the control group. An academic achievement test, an attitude scale for STEM, semi-structured interviews, and the student diaries are the data collection tools used in the study. A significant difference was found between the experimental group and the control group, with the former showing increased academic achievement over the latter in the research. A significant difference was also found between the experimental group and the control group, with the former showing more positive attitudes towards STEM than were shown by the latter. The opinions of the students on STEM education were analyzed in order to study the results obtained from quantitative data. Five themes - feelings and opinions, positive aspects, skills gained, features and problems faced, and the learning process were obtained -as well as 26 codes-with the content analysis of semi-structured interviews and students' diaries. It was concluded that involving STEM-based implementations in teaching the subject "Pressure" increased the academic success rate and attitude scores of students while helping the students to develop positive perceptions of STEM education. In future studies, certain influences of STEM education implementations, such as self-confidence of students, the ability to present creative solutions, communication skills, for example, may be studied

Turkish adaptation of the attitude towards STEM scale: a validity and reliability study

WOS: 000466168300005The purpose of this study was to establish the validity and reliability of Turkish version of the Attitude towards STEM Scale developed by The Friday Institute for Educational Innovation (2012) for measuring middle school students' attitudes towards STEM. The sample of the study consisted of 1323 middle school students (6th, 7th, and 8th graders) who were selected conveniently from 3 metropolitan cities located in different regions of Turkey in the fall semester of the 2017-2018 academic year. The original version of the scale consists of 37 items and it is a 5-point Likert scale. Confirmatory Factor Analysis (CFA) was conducted for the data obtained from the Turkish version of the scale in order to check whether they fit the four-factor structure of the original scale. The analysis of data showed that it fits the four-factor structure. The reliability of each factor and the whole scale were checked by computing Cronbach's coefficient of Alpha (alpha). Cronbach's alpha coefficients for the whole scale and the mathematics, science, engineering, and technology, and 21th-century skills were found to be as .91, .86, .87, .86, and .88, respectively. Based on the findings obtained in this study, The Attitude towards STEM Scale was adapted into Turkish in a valid and reliable way