DEVELOPMENT OF REFLECTIVE THINKING SCALE FOR SENIOR PRIMARY EDUCATION STUDENTS

The main purpose of this study is to develop a Reflective Thinking Scale to determine the reflective thinking levels of secondary school students. In this study, criterion sampling was employed, one of the purposeful sampling methods. The sample of the study consisted of 300 students in 6th, 8th and 8th grades in Emirdag, Afyonkarahisar. The items in the scale were graded according to 5-point Likert type. The sub-dimensions of the reflective thinking scale are reflection about action, reflection during action and reflection for action. While developing the scale, literature related to the definition of reflective thinking, reflective thinking process, characteristics of reflective thinking individuals, types of reflective thinking, ways of developing reflective thinking were examined. After examining these, a pool of items was created for the purpose of the reflective thinking scale. 52 items were selected from the pool of items and a draft scale was prepared, and 25 students in the 8th grade were pre-tested. Then, the items were presented to the expert opinion and applied to the 300 students attending 6th, 8th and 8th grades. Factor analysis was performed on the collected data. Kaiser-Meyer-Olkin (KMO) and Barlet tests were performed to determine the suitability of the data for factor analysis. Kaiser-Meyer-Olkin (KMO) value was found to be .900. Barlett's test was calculate as x2: 1859,813; sd: 231; p <.01. Confirmatory factor analysis was conducted within the framework of the validity studies of the reflective thinking scale. Confirmatory factor analysis fit indexes are as GF1 = .86; AGF1 = .83; RMR = .078; NNF1 = .94; CF1 = .95 and RMSEA = .071. After the first level confirmatory factor analysis, the second level confirmatory factor analysis was performed.          Article visualizations

Morphometric Evaluation of Coccyx with Microcomputed Tomography (Micro CT) and Computed Tomography (CT) Technology

Aim%253A We investigated the coccyx anatomy accurately in detail by microcomputed tomography (micro CT) and computed tomography (CT) to contribute to the data related to the coccyx anatomy and the potential clinical contribution of these datas in the treatment of coccyxs pathologies. Material and Methods%253A Twenty coccyges from embalmed cadavers were examined with a micro CT device. The inferior part of the sacrum and coccyx together with the surrounding soft tissue was removed safely. The tissue was scanned with a micro CT device, and all parameters were measured with micro CT image viewer programs. CT images of 29 patients without coccyx pathology were measured with OsiriX programs. Measured morphometric parameters with micro CT and CT were evaluated using statistical methods. Results%253A Generally, the morphometric parameters as mean values were larger in males than in females. Mean values for vertical length and coccyx width were higher for CT compared with micro CT images. Coccyx was more flat in the frontal plane in females. There were statistically significant differences between the micro CT and CT images regarding mean vertical length, width, lateral deviation angle, and sacrococcygeal angle and length of the vertebrae (p lt%253B 0.05). There were no statistically significant differences in number and width of the vertebrae (p gt%253B 0.05). Conclusion%253A We suggest that examining the normal coccyx morphology will help to better understand and treat the pathologic conditions of the coccyx. We believe our findings will contribute to the data related to the coccyx anatomy

Comparison of Survival Rates, Tumor Stages, and Localization in between Obese and Nonobese Patients with Gastric Cancer

Purpose. In this study we tried to determine the association between body-mass index (BMI), survival rate, and the stage of tumor at the time of diagnosis in patients with gastric cancer. Methods. A total of 270 gastric cancer patients’ hospital records were retrospectively evaluated. Patients were grouped according to their BMI at the time of tumor diagnosis. Tumor stages at admission were compared according to their BMI values. Results. There were no differences in OS among BMI subgroups (p=0.230). The percent of patients with stage III tumor was significantly higher in nonobese while the percent of stage IV tumor was surprisingly higher in obese patients (p was 0.011 and 0.004, resp.). Percent of patients who did not have any surgical intervention was significantly lower in overweight and obese patients than normal and/or underweight patients. Conclusions. At the time of diagnosis, obese patients had significantly higher percent of stage IV tumor than nonobese patients. Despite of that, there were no differences in survival rates among BMI subgroups. Our study results are consistent with “obesity paradox” in gastric cancer patients. We also did not find any relationship between BMI and localization of gastric tumor

Why do some patients with stage 1A and 1B endometrial endometrioid carcinoma experience recurrence? A retrospective study in search of prognostic factors

Objectives: Endometrial endometrioid carcinoma (EEC) is the most encountered subtype of endometrial cancer (EC). Our study aimed to investigate the factors affecting recurrence in patients with stage 1A and 1B EEC. Material and methods: Our study included 284 patients diagnosed with the International Federation of Gynecology and Obstetrics stage 1A/1B EEC in our center from 2010 to 2018. The clinicopathological characteristics of the patients were obtained retrospectively from their electronic files. Results: The median age of the patients was 60 years (range 31–89). The median follow-up time of the patients was 63.6 months (range 3.3–185.6). Twenty-two (7.74%) patients relapsed during follow-up. Among the relapsed patients, 59.1% were at stage 1A ECC, and 40.9% were at stage 1B. In our study, the one-, three-, and five-year recurrence-free survival (RFS) rates were 98.9%, 95.4%, and 92.9%, respectively. In the multivariate analysis, grade and tumor size were found to be independent parameters of RFS in all stage 1 EEC patients. Furthermore, the Ki-67 index was found to affect RFS in stage 1A EEC patients, and tumor grade affected RFS in stage 1B EEC patients. In the time-dependent receiver operating characteristic curve analysis, the statistically significant cut-off values were determined for tumor size and Ki-67 index in stage 1 EEC patients. Conclusions: Stage 1-EEC patients in the higher risk group in terms of tumor size, Ki-67, and grade should be closely monitored for recurrence. Defining the prognostic factors for recurrence in stage 1 EEC patients may lead to changes in follow-up algorithms

The impact of Ki-67 index, squamous differentiation, and several clinicopathologic parameters on the recurrence of low and intermediate-risk endometrial cancer

Endometrial endometrioid carcinoma (EEC) represents approximately 75-80% of endometrial carcinoma cases. Three hundred and thirty-six patients with EEC followed-up in the authors’ medical center between 2010 and 2018 were included in our study. Two hundred and seventy-two low and intermediate EEC patients were identified using the European Society for Medical Oncology criteria and confirmed by histopathological examination. Recurrence was reported in 17 of these patients. The study group consisted of patients with relapse. A control group of 51 patients was formed at a ratio of 3:1 according to age, stage, and grade, similar to that in the study group. Of the 17 patients with recurrent disease, 13 patients (76.5%) were Stage 1A, and 4 patients (23.5%) were Stage 1B. No significant difference was found in age, stage, and grade between the case and control groups (p > 0.05). Body mass index, parity, tumor size, lower uterine segment involvement, SqD, and Ki-67 index with p<0.25 in the univariate logistic regression analysis were included in the multivariate analysis. Ki-67 was statistically significant in multivariate analysis (p = 0.018); however, there was no statistical significance in SqD and other parameters. Our data suggest that the Ki-67 index rather than SqD needs to be assessed for recurrence in patients with low- and intermediate-risk EEC

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Correction to: Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

The original version of this article unfortunately contained a mistake

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Os Hamatum`Un Kemik Yapısının Mikro-Bilgisayarlı Tomografi (Mikro-Bt) Yöntemi ile Değerlendirilmesi

Hamate is a wedge shaped carpal bone which is narrow at its proximal side and wide at distal part. Dorsal and palmar surfaces are roughened by ligament attachments on these surfaces. Hamate bone could easily be distinguished from other carpal bones via its so called hamulus process which extends from distal part of the bone through its anterior. There have been very few Micro-CT studies in the literature related with hamate bone while some exist regarding its fractures, avascular necrosis and osteoblastoma. With its high resolution (9-15 micrometers) Micro-CT is becoming a widely used method which reveals fine structure of bone in addition to various tissues. The aim of this thesis study is to elucidate the bone structure of hamate by using Micro-CT method. 55 hamate bones which have structural integrity and no deformity are included in this study. In our study tissue volume, bone volume, percent bone volume (bone volume/tissue volume), bone surface, bone surface/volume ratio, trabecular number, trabecular thickness, trabecular seperation, structure model index and degree of anisotropy were evaluated with Micro-CT method. By the results of our detailed measurements we intended to contribute hamate bone related surgical operations of the wrist.ONAY SAYFASI iii YAYINLAMA VE FİKRİ MÜLKİYET HAKLARI BEYANI iv ETİK BEYAN v TEŞEKKÜR vi ÖZET vii ABSTRACT viii İÇİNDEKİLER ix SİMGELER VE KISALTMALAR xi ŞEKİLLER xii TABLOLAR xiii 1. GİRİŞ 1 2. GENEL BİLGİLER 2 2.1. Embriyoloji 2 2.2. Histoloji 4 2.3. Anatomi 5 2.4. El bileği bölgesinin biyomekaniği 7 2.5. Klinik 8 2.6. Mikro BT’nin prensipleri 8 3. GEREÇ ve YÖNTEMLER 9 3.1. Çalışma grubu 9 3.2. Görüntü değerlendirme yöntemi 9 3.3. Verilerin Toplanması 9 3.4. İstatistiksel Analizler 11 4. BULGULAR 13 4.1. Veri Analizi 13 4.2. Verilerin Değerlendirilmesi 13 4.2.1. Doku Hacmi (mm3) 13 4.2.2. Kemik Hacmi (mm3) 14 4.2.3. Yüzdelik kemik hacmi: Kemik hacmi/Doku hacmi (%) 14 4.2.4. Kemik yüzeyi (mm2) 14x 4.2.5. Kemik yüzey/hacim oranı (mm-1) 15 4.2.6. Trabeküler sayı (mm-1) 15 4.2.7. Trabeküler kalınlık (mm) 16 4.2.8. Trabeküler seperasyon (mm) 16 4.2.9. Yapı model indeksi 17 4.2.10. Anizotropi derecesi 17 4.3. Mikro-BT Görüntüleri 18 5. TARTIŞMA 21 6. SONUÇ VE ÖNERİLER 28 7. KAYNAKLAR 29 8.EKLER EK-1. Etik Kurul Kararı EK-2. Orjinallik Ekran Çıktısı EK-3. Dijital Makbuz 9. ÖZGEÇMİŞOs hamatum proksimal bölümü dar, distal bölümü geniş olan kama şeklindeki bir kemiktir. Dorsal ve palmar yüzleri buralara tutunan bağlar nedeniyle pürüzlüdür. Palmar yüzün distal bölümünden öne doğru uzanan ve hamulus ossis hamati denilen çıkıntısı vasıtasıyla diğer karpal kemiklerden kolaylıkla ayırt edilebilir. Literatürde os hamatum ile ilgili kırık, avasküler nekroz, osteoblastoma gibi olgularla karşılaşılmakta iken; os hamatum’un yapısının Mikro-BT ile incelendiği yeterli sayıda çalışma bulunmamaktadır. Mikro-BT yüksek çözünürlüğüyle (9-15 mikrometre) çeşitli dokulara ek olarak kemik dokusunun da hassas yapısını ortaya koyan bir yöntem olarak gittikçe yaygınlaşmaktadır. Bu tez çalışmasının amacı os hamatum’un kemik yapısının MikroBT yöntemi kullanılarak ortaya konmasıdır. Bu çalışmaya yapısal olarak bütünlük sağlayan ve herhangi bir deformitesi olmayan 55 adet os hamatum dahil edildi. Çalışmamızda os hamatum ile ilgili doku hacmi, kemik hacmi, yüzdelik kemik hacmi (kemik hacmi/doku hacmi), kemik yüzeyi, kemik yüzey/hacim oranı, trabeküler sayı, trabeküler kalınlık, trabeküler seperasyon, yapı model indeksi ve anizotropi derecesi Mikro-BT yöntemi ile değerlendirildi. Bu tez çalışmasından çıkan detaylı ölçüm sonuçları ile os hamatum ile ilgili el bileği cerrahi operasyonlarına katkı oluşturulacaktır

The synthesis of new N2S2-macrocyclic schiff base ligands and investigation of their ion extraction capability from aqueous media

Two new macrocyclic Schiff bases, (5) and (7), containing nitrogen-sulfur donor atoms were designed and synthesized by reaction of a,a' bis(o-aminophenylthio)-l,2-xylene with glyoxal and phthaldialdehyde, respectively. The liquid-liquid extraction of metal picrates such as Ag+, Hg2+, Cd2+, Zn2+, Cu2+, Ni2+, Mn2+, K+, and Na+ from aqueous phase to the organic phase was carried out using the novel ligands. The effect of chloroform and dichloromethane as organic solvents over the metal picrate extractions was investigated at 25 ± 0.1°C by using UV-visible spectrometry. The extractability and selectivity of the tested metal picrates were evaluated. The values of the extraction constants (log Kex) were determined for the extracted complexes