Clinical course of psoriasis patients that discontinued biologics during the COVID-19 pandemic

BackgroundSince psoriasis is a chronic disease, it is not recommended to discontinue the treatment agents used. However, in real life, the treatment of psoriasis patients may be interrupted for various reasons. During the pandemic period, the treatment of many patients was also interrupted. ObjectivesTo evaluate relapse and clinical worsening in psoriasis patients whose biological therapy was interrupted during the pandemic and reveal associated factors. MethodsThe study included patients aged >= 18 years, who were followed up with moderate and severe chronic psoriasis controlled by the last biological agent [Psoriasis Area Severity Index (PASI) 75 response achieved] but had to discontinue their treatment during the pandemic. The patients' demographic and clinical characteristics, clinical course after the discontinuation of these agents, presence of clinical worsening, and relapse were evaluated. Risk factors were analyzed with the logistic regression analysis. ResultsThe study included 169 patients, with a mean age of 47.3 +/- 14.5 (18-87) years. The mean biologics-free time was 18.2 +/- 12.3 (2-56) weeks. Clinical worsening was detected in 41.4% and relapse in 48.5% of the patients. The significant risk factors for clinical worsening and relapse in both univariate and multivariate analyses were alcohol use during the biologics-free period, total time off biologics, and the presence of an additional triggering factor. The use of secukinumab and ustekinumab was found to be a protective factor against clinical worsening in multivariate analyses. ConclusionAs the biologics-free period is prolonged, the likelihood of clinical worsening and relapse increases, therefore, we do not recommend discontinuing biological agents

Patient use of complementary and alternative medicine for psoriasis vulgaris and factors believed to trigger the disease: A multicenter cross-sectional study with 1621 patients

Introduction: Due to the chronic recurrent nature of psoriasis vulgaris (PV) and lack of definitive treatment for the disease, patients often resort to alternative treatments. Physicians seem to have low awareness of this issue. Objectives: To elicit the perceptions of 1,621 PV patients on complementary and alternative medicine (CAM) and examine factors reported to worsen PV. Methods: The patients sociodemographic characteristics, Psoriasis Area Severity Index (PASI), Dermatology Life Quality Index (DLQI), disease duration, and severity were recorded, and the patients CAM use was questioned in detail. The patients were also asked about factors that worsened PV and their experiences with a gluten-free diet. Results: Of the patients, 56.51% had used CAM. The mean age, illness duration, PASI scores and DLQI of those using CAM were significantly higher. CAM use was significantly higher in those with facial, genital involvement, and arthralgia/arthritis. The patients mostly referred to CAM when PV became severe (46.4%). Of the CAM users, 45.52% used herbal topicals. The physicians of 67.03% did not inquire whether they used CAM. Of the participants, 37.73% considered that stress worsened their disease. Gluten-free diet did not affect PV symptoms in 52.22%. Conclusions: Patients CAM use is often overlooked by dermatologists. Our results showed that more than half the patients used CAM and did not share this information with their physicians. Therefore, the awareness of physicians should be increased and patients should be asked about the use of CAM and directed to the appropriate medical treatment options by physicians

Habits of using social media and the internet in psoriasis patients

Introduction: Psoriasis significantly affects the patients quality of life, which often leads patients to seek online information about this disease. Objectives: To explore the habits of patients with psoriasis related to their use of social media (SM) and the internet to obtain information about their disease. Methods: 1,520 patients completed the survey and the Dermatology Life Quality Index (DLQI) questionnaire. The Psoriasis Area Severity Index scores (PASI) and clinical data of the patients were recorded by their physicians. Results: Of the 1,114 patients that reported using SM and internet, 48.38% regularly and 31.14% sometimes resorted to obtain information about psoriasis. The use of SM and internet for psoriasis was statistically significantly higher among young people (P = 0.000), those with university or higher education (P = 0.009), higher DLQI (P = 0.000) and PASI (P = 0.011) scores, facial (P = 0.050), scalp (P = 0.032), hand (P = 0.048), genital (P = 0.001) and inverse (P = 0.000) involvement, and arthralgia/arthritis (P = 0.006). The participants mostly used the Google (86%) and Facebook (41%). More than half of the participants (62.8%) expected dermatologists to inform society that psoriasis is not contagious. Conclusions: Internet and SM being widely available and offering substantial information to be easily accessed make it very attractive for patients to use these platforms to investigate diseases, including psoriasis. If what is presented on SM conflicts with what the physician says, patients mostly trust the latter, but at the same time, they tend not to share the results of their online inquiries with their physicians

Ortaokullarda sağlıkla ilgili beden eğitimi reformu sonrası öğrencilerin fiziksel aktivite düzeyleri ve öğretmen deneyimleri.

The purpose of this study was to examine physical activity level of students and experiences of teachers after the Health-Related Physical Education Reform in secondary schools. Participants were 153 seventh grade students (83 girls and 70 boys) and their physical education teachers (six teachers) from three public secondary schools with limited, moderate and good physical infrastructure for physical education/activity in Ankara. For data collection, pedometer was used to measure students’ physical activity level and semi-structured interviews were conducted with teachers. Quantitative data was analyzed by descriptive statistics, Analysis of Variances and Paired Sample t Test. Interview data was analyzed by content analysis method. According to the findings, students met approximately 28% and 31% (girls and boys) of daily physical activity recommendations during the school time. Boys were more physically active than girls during school time (p0.05). Interview findings revealed that teachers’ practices in physical education setting influenced by their a) perception of school principals, students, other physical education teachers and parents’ expectations, b) perception of physical education related educational policies, social setting and physical setting in the school, c) knowledge of physical education curriculum and d) knowledge of subject matter and its teaching.M.S. - Master of Scienc

BEDEN EĞİTİMİ ÖĞRETMENLERİ İÇİN VERİYE DAYALI KARAR VERME MESLEKİ ÖĞRENME TOPLULUĞUNUN ETKİLİLİĞİ VE ÖĞRENCİLERİN BİLGİ VE FİZİKSEL AKTİVİTE DÜZEYLERİNE ETKİSİ

The purpose of this study was two-fold; (1) to design a data-based decision-making professional development (DBDM-PD) program for secondary school physical education teachers and (2) to examine the effects of this program on teachers' data use and instructional practices and their students’ learning. The study includes a needs analysis on the designing of this program in the form of the professional learning community (PLC), its implementation with a theoretical framework behind the design, and an evaluation of the program’s effectiveness by comprehensively examining teachers' satisfaction, professional learning outcomes, transfer of learning to instruction and their students' learning. The participants were 12 teachers (six in the experimental group and six in the control group) and their 331 seventh-grade students. A mixed method with a between-groups experimental design was used in this study. While qualitative data were gathered through semi-structured interviews with teachers, observations, field notes, and video recordings of PLC meetings, quantitative data were collected via the "Health Related Fitness Knowledge Test” and “The Physical Activity Questionnaire.” According to the findings of constant comparison analysis, participating in the DBDM-PD program improved awareness of data use in teaching and the professional knowledge and skills of teachers; in addition, this improvement has been reflected in their instructional practices regarding health-related knowledge (HrF) and physical activity. Mixed between-within-subject ANOVA results showed that experimental group students’ HrF knowledge level and physical activity level increased significantly compared to the control group (p < .05). It is recommended to disseminate DBDM-PD programs for physical education teachers.Bu çalışmanın amacı (1) ortaokul beden eğitimi öğretmenleri için bir veriye dayalı karar verme mesleki gelişim (VDKV-MG) programı tasarlamak ve (2) bu programın öğretmenlerin veri kullanımı, öğretim uygulamaları ve öğrencilerinin öğrenmeleri üzerindeki etkilerini incelemektir. Çalışma, bu programın mesleki gelişim topluluğu (MGT) şeklinde tasarlanmasına ilişkin bir ihtiyaç analizini, tasarımın arkasındaki teorik çerçeveyle birlikte uygulanmasını ve öğretmenlerin memnuniyetini, mesleki öğrenme çıktılarını, öğrendiklerini öğretime aktarmalarını ve öğrencilerinin öğrenmelerini kapsamlı bir şekilde inceleyerek programın etkililiğinin değerlendirilmesini içermektedir. Katılımcılar 12 öğretmen (altı deney grubu ve altı kontrol grubu) ve onların 331 yedinci sınıf öğrencisinden oluşmaktadır. Bu çalışmada gruplar arası deneysel desene sahip karma bir yöntem kullanılmıştır. Nitel veriler öğretmenlerle yapılan yarı yapılandırılmış görüşmeler, gözlemler, alan notları ve MGT toplantılarının video kayıtları aracılığıyla toplanırken, nicel veriler ise "Sağlıkla İlgili Fiziksel Uygunluk Bilgi Testi" ve "Fiziksel Aktivite Anketi" aracılığıyla toplanmıştır. Sürekli karşılaştırma analizi bulgularına göre, VDKV-MG programına katılmak, öğretmenlerin öğretimde veri kullanımına ilişkin farkındalıklarını ve mesleki bilgi ve becerilerini geliştirmiş; ayrıca bu gelişme, sağlıkla ilgili fiziksel uygunluk (SiFU) bilgisi ve fiziksel aktiviteye ilişkin öğretim uygulamalarına da yansımıştır. Karışık ölçümler için iki yönlü varyans analizi sonuçları, deney grubu öğrencilerinin SiFU bilgi düzeyi ve fiziksel aktivite düzeyinin kontrol grubuna kıyasla anlamlı şekilde arttığını göstermiştir. Beden eğitimi öğretmenleri için VDKV-MG programlarının yaygınlaştırılması önerilir.Ph.D. - Doctoral Progra

Spor imkanları birbirinden farklı ortaokullarda öğrenim gören öğrencilerin okul süresince fiziksel aktivite düzeylerinin incelenmesi

Middle school physical education (pe) program has recently been reformed with an emphasis on health-related pe in Turkey. The name of compulsory pe classes for all students has been changed into “Physical Education & Sport”, and its weekly class hours have been set as 2 hours/week. In addition, an elective “Sport & Physical Activity” course that students could take 2 or 4 class hours/weekly has been offered (MoNE, 2013a, b). This study aimed to examine physical activity (pa) level of students during school time in middle schools with different sport related facilities by students’ gender and attendence of elective Sport and Physical Activity course. Participants were 153 seventh grade students (girls n = 83 and boys n = 70) from three public middle schools with limited, moderate and good physical infrastructure for pa in Ankara. Pa level of students were measured with pedometer during five consecutive school days. ANOVA and paired sample t test were used for data analysis. According to the findings, sport facilities of schools had no effect on students’ pa levels during school time (p>.05). Boys were more physically active than girls during school time (p.05). Erkek öğrenciler kız öğrencilerden okul saatleri boyunca fiziksel olarak daha aktiftir (p<.05). Kız öğrenciler sağlık otoritelerince önerilen günlük fiziksel aktivite düzeyinin (kızlar için: 12.000 adım/gün; erkekler için: 15.000 adım/gün) % 28’ini, erkek öğrenciler ise % 31’ini okul süresinde karşılamaktadır (Tudor-Locke ve diğ., 2004). Seçmeli Spor ve Fiziki Etkinlikler dersine katılan öğrenciler sadece zorunlu Beden Eğitimi ve Spor dersine katılan öğrencilerden okul saatleri boyunca fiziksel olarak daha aktiftir (p<.05). Sonuç olarak, sadece okul spor imkanlarının geliştirilmesinin öğrencilerin fiziksel aktivite düzeyini geliştirmeyeceği anlaşılmaktadır. Öğretmenlerin sağlıkla ilgili beden eğitimi öğretimi yetkinliklerinin geliştirilmesine ihtiyaç duyulmaktadır. Seçmeli dersler öğrencilerin okul sürecindeki fiziksel aktivite düzeyini artırmada etkilidir. Öğrenciler genel olarak okul içinde geçirdikleri zamanda fiziksel olarak yeterince aktif değildir. Öğrencilerin okul süresinde fiziksel aktivite düzeyini artıracak yeni stratejiler geliştirilmelidir

Experiences of university students during an active week practice for transferring knowledge into life after a health-related physical activity intervention

Sağlık için fiziksel aktivite eğitimi sağlık, zindelik ve fiziksel uygunluk kavramlarının temellerini öğretmeyi amaçlamaktadır. Bu çalışmanın amacı “Sağlık için fiziksel aktivite ve spor” dersine katılan üniversite öğrencilerinin ders yılı sonunda günlük 10.000 adım hedefini içeren “Aktif Hafta Uygulaması” sırasındaki deneyimlerini incelemektir. Araştırma; 1) aktif hafta uygulaması boyunca öğrencilerin ne kadarı günlük 10.000 adım hedefine ulaşmıştır? 2) öğrencilerin günlük 10.000 adım hedefine ulaşmasını kolaylaştıran ve zorlaştıran unsurlar nelerdir? 3) aktif hafta süresince kullandıkları teknolojik aletler ve uygulamalar nelerdir? sorularına cevap aramaktadır. Çalışma, 2016-2017 eğitim- öğretim yılı güz döneminde lisans programında her bölümden öğrencinin alabildiği seçmeli sağlık için fiziksel aktivite ve spor dersine katılan 45 öğrenci (15 kadın, 30 erkek) ile yapılmıştır. Öğrencilerden “Aktif Hafta Uygulaması” süresince yaptıkları etkinlikler ve adım sayıları ile ilgili günlük tutmaları istenmiştir. Ayrıca, öğrenci deneyimleri ile ilgili veriler açık uçlu sorular içeren bir anket yoluyla öğrenme yönetim sistemi üzerinden toplanmıştır. Öğrencilerin %53.33’ü “aktif” (bilgiyi yaşama etkili bir şekilde transfer edebilen), %28.88’i “orta düzeyde aktif” (bilgiyi yaşama transfer edebilen), %17.77’si “Düşük seviyede aktif” (bilgiyi yaşama transfer edemeyen) olarak saptanmıştır. Öğrenci deneyimlerinin içerik analizi yöntemi ile analizi sonucunda katılımcıların bilgiyi yaşama transfer etmelerini kolaylaştıran ve zorlaştıran unsurların (1) bireysel (2) sosyal çevre (3) fiziksel çevre (4) okul sağlık/spor politikaları ve (5) diğer temalarına ayrıştığı görülmüştür. Öğrencilerin aktif hafta boyunca adımsayar, akıllı saat ve çeşitli telefon uygulamalarını kullandıkları anlaşılmıştır. Sonuç olarak, sağlık için fiziksel aktivite bilgisinin yaşama aktarıldığı aktif hafta uygulaması benzer dersler/eğitim müdahaleleri için anlamlı bir çalışmadır. Bu dersler/eğitim müdahaleleri tasarlanırken öğrencilerin amaca ulaşmasını kolaylaştıran, engelleyen unsurlar ve süreçte kullandıkları teknolojilerin dikkate alınması önerilir.Health-related physical activity intervention aims to teach the fundamentals of health, wellness and fitness concepts. The purpose of the study is to examine the experiences of university students during an active week practice aiming to reach daily 10.000 steps goal after an “Health-related physical activity and sports” course for transferring knowledge into life. This study seeks; 1) how many of the students reached the daily 10.000 steps goal during the active week practice? 2) what are the challenges and facilitators to reach the daily 10.000 steps goal? 3) what are the used technological tools and applications? The study was conducted with 45 students (15 female, 30 male) participating in an elective health-related physical activity and sports course that can be taken by undergraduate students from all departments in the fall semester of the 2016-2017 academic year. Students are asked to keep a diary of their activities and number of steps during “Active Week Practice”. In addition, data related to student experiences were collected with an open-ended questionnaire through learning management system. Of the students, 53.33% were “active” (able to transfer knowledge into life effectively), 28.90% were “moderately active” (able to transfer knowledge into life), 17.77% were “inactive” (not able to transfer knowledge into life). The results of the content analysis revealed that challenges and facilitators for students are divided to (1) individual (2) social environment (3) physical environment (4) school health/sports policy and (5) other themes. Moreover, it is understood that students used pedometer, smart watch, and various phone applications during the active week. As a result, active week practice is a meaningful study for similar courses/educational interventions. It is suggested that challengesfacilitators and used technologies should be taken into account while these courses/educational interventions are designed

Public Health Rep

In an investigation of the prevalence of safety packaging of medications, 131 randomly selected Minneapolis and St. Paul households with children were surveyed in 1985. Of the 1,953 oral medications in these households (mean was 14.9 per home), 43.3 percent did not have safety packaging. Over-the-counter medications were less likely to have safety packaging than prescription medications (over-the-counter 53.1 percent, prescription 25 percent). This high prevalence of medications without safety packaging in households with children could increase the risk of childhood poisoning. Strategies to reduce this potential risk are discussed.2116650PMCnul

Orta Doğu Teknik Üniversitesi Spor Müdürlüğü Tarafından Sunulan Sağlık için Spor Programının Geliştirilmesi

Bu projenin amacı Orta Doğu Teknik Üniversitesi Spor Müdürlüğü tarafından sunulan Sağlık için Spor (SİS) programını incelemek ve geliştirmektir. Bu amaçla; 1. Hâlihazırda üniversitede sunulan SİS programı amaçları, uygulamaları ve çıktıları açısından değerlendirilecektir, 2. Daha önce başka çalışmalarda fiziksel aktivite alışkanlığı geliştirmede etkililiği gösterilmiş “Bağlamlararası Kuram” (Transtheoretical Model) bakış açısı ile hazırlanmış bir eğitim yaklaşımının Orta Doğu Teknik Üniversitesindeki etkililiği incelenecektir, 3. SİS programı antrenörleri için “antrenör eğitimi” programı geliştirilecektir

The role of leptin, soluble leptin receptor, resistin, and insulin secretory dynamics in the pathogenesis of hypothalamic obesity in children

In this study, we have investigated the role of leptin, soluble leptin receptor(sOb-R), resistin, and insulin secretory dynamics in the development of hypothalamic obesity