Adapting Global Standards to a Changing World

In 1996, Ira Millstein received a phone call from Paris. It came from the Organization for Economic Co-operation and Development (OECD) asking him to head a small international group of distinguished businesspeople, including Sir Adrian Cadbury. Their assignment would be to provide economists and policy makers with advice for future work in the area of corporate governance. At the time, the topic was little understood among policy makers and its wider economic implications were rarely discussed. But OECD, already well known for its analysis of both macroeconomics and structural policies, wanted to change that. They looked at corporate governance as an increasingly important field of economic reform and believed that the experiences of business, legal scholars and economists could help in shaping better policies and advice

Energy Evaluation and Economic Impact Analysis of Green Roofs Applied to a Pilot Region in Aegean Coast of Turkey

This paper examines the energy savings, environmental benefits, and economic impact of green roof systems applied to a “micro” region in Western Turkey. This subdivision (Artur) in Karaaðaç, Izmir, consists of 1729 residential units, mostly used as summer homes. The units are in 45m2, 60m2, 90m2, and 105m2 sizes. Five different plant types were considered to be blended and planted in two different choices of growth media. Thermal benefits of the vegetated roofs to the pilot site were evaluated using appropriate heat transfer equations. For analyzing the impact of use of such systems on the local economy, monetary injection into the local economy was calculated and a multiplier effect of 2.66 was assumed. Net present value (NPV) of the generated income for the first 10 years was calculated to be approximately $14.5 million. In addition, approximately 300 new local jobs over a period of 10 years were estimated to be created.Green roofs, Economic impact, Energy conservation, Turkey

Perspectives of Preservice Teachers on the Statements Related to Preservice Teachers and Competence of Lecturers

This study aims to find out the attitude of preservice teachers of Ağrı İ.Ç. University Faculty of Education who study at the Department of Elementary Turkish Education to the statements related to preservice teachers and competence of lecturers. A-) The statements related to preservice teachers includes following statements: “Productivity of the courses taken in the school enable them to understand the qualifications that a teacher must have.”, “Students take advantages of the education process which brings them sufficient teaching experience”, ”During their education, students experience many fascinating features related to teaching professions which they haven’t seen before.”, ”Opportunities and facilities that the students have in the school let them have rich variety of experiences related to communication with people.”, ”The students who have thought that they couldn’t be teacher understand they are in wrong to assume it after they experience teaching.” B-) The statements related to competence of lecturers includes following statements: “Lecturers have enough professional competence since they have received decent undergraduate education.”, “Lecturers can convey their knowledge to students by showing their class related to class management and employing different methods to teach since they don’t teach the lessons with the exception of their professional fields.”, “Lecturers can plan the teaching-learning process successfully thanks to their professional teaching knowledge.”, “Scientific dignity that the lecturers have thanks to their competence makes them reach the exemplary positions.”, “The high level of service delivery qualifications which the lecturers have thanks to their competence makes the students apply their knowledge to real life.” A questionnaire which includes questions related to A-) the statements related to preservice and B-) the statements related to competence of lecturers is conducted to determine the attitudes of preservice teachers towards. A-) The statements related to preservice teachers and B-) The statements related to competence of lecturers. The sample for the research is composed of 121 preservice teachers of Ağrı İ.Ç. University Faculty of Education who study at the Department of Elementary Turkish Education. According to the findings of the research; it is seen that the preservice teachers have answered the questions containing information on A-) the statements related to preservice and B-) the statements related to competence of lecturers with variable rates. The results which are mentioned above make it possible to come to that conclusion that preservice teachers have responded to questionnaire which is reliable according to its Cronbach’s Alpha value (α=0.91) in varying ratios (Field, 2013)

Usefulness of Serum D-Dimer Level in Acute Renal Infarction

Acute renal infarction (ARI) is a rarely encountered disease in emergency services, but is of particular importance owing to higher mortality and morbidity rates in the absence of early diagnosis and intervention. On the other hand, urolithiasis cases are admitted to emergency departments very frequently with the complaint of pain. ARI with non-specific symptoms or urolithiasis-like pain would increase the likelihood of being omitted in crowded emergency rooms. Previous studies reported supportive diagnostic role in ARI of increased serum lactate dehydrogenase and C-reactive protein levels and white blood cell count in the presence of hematuria; however, none mentioned D-dimer as a likely diagnostic or prognostic marker. We hereby present 2 case reports where a contrast-enhanced tomographic scan performed on the basis of suspicions raised by high serum D-dimer levels which established the definitive diagnosis ARI. Our aim was to emphasize that serum D-dimer may be used as a criterion for supporting or excluding the thromboembolic events, such as renal and mesenteric infarction

The magic of frequencies - 432 Hz vs. 440 Hz: Do cheerful and sad music tuned to different frequencies cause different effects on human psychophysiology? A neuropsychology study on music and emotions: Frekansların sihri – 432 Hz 440 Hz’e karşı: Ayrı frekanslara göre akortlanmış neşeli ve hüzünlü müzikler insan psikofizyolojisi üzerinde farklı etkiler yaratır mı? Müzik ve duygular üzerine bir nöropsikoloji araştırması

The present study aims to see whether music (cheerful and sad) tuned to different frequencies (432 Hz vs. 440 Hz) cause different effects on the listener’s emotions. In the research, the effects of cheerful and sad music samples at different frequencies were examined within the framework of variables such as Heart Rate Variability (HRV), emotions felt and mood. The study was carried out with a total of 51 participants (31 women comprising 60.8% of the study group, and 20 men comprising 39.2% of the study group) who have not received music education. The average age of the participants is 22.19 (S = 1.08, range = 20-25). In the study, the activation levels of the autonomic nervous system were assessed using Heart Rate Variability (HRV), whereas the moods of the participants before listening music were assessed using the Profile of Mood States (POMS) scale. Finally, The Geneva Emotional Music Scales (GEMS) was used to assess the potential emotions and mood state to appear after listening music. All music samples used in the study (one cheerful and one sad per participant) were chosen by the relevant participant. The conversion of the samples recorded at 440 Hz tuning frequency, to 432 Hz was carried out with a Max/MSP patch designed specifically for the study. The findings of the study show that the cheerful and sad music tuned to different frequency levels (432 Hz vs. 440 Hz) do not induce significant variation in sympathetic and parasympathetic activation levels. However, regardless of the tuning, the participants who listened cheerful music reported higher levels of relaxation after listening. Moreover, again regardless of the tuning, according to GEMS results, the participants experienced higher levels of sublimity compared to unease, and also higher levels of unease compared to vitality. The analysis regarding cheerful music, in turn, found that the participants, this time, experienced higher levels of vitality compared to sublimity, and higher levels of sublimity compared to unease. In the most comprehensive analysis with no reference to the cheerful or sad character of the sample, the participants who listened 440 Hz pieces reported rather negative mood after listening music compared to the participants who listened 432 Hz pieces. Moreover, men were observed to report even higher levels of negative mood after listening 440 Hz pieces, compared to their mood after listening 432 Hz pieces. All the findings thus reached imply that different tunes lead to variation in reported moods, even though they do not bring about changes in sympathetic and parasympathetic activation levels. ​Extended English summary is in the end of Full Text PDF (TURKISH) file.   Özet Bu çalışmanın amacı, 432 Hz ve 440 Hz frekanslara göre ayarlanmış müziklerin (neşeli ve hüzünlü) duygu oluşumunda bir fark yaratıp yaratmayacağını değerlendirmektir. Farklı frekanslardaki neşeli ve hüzünlü müzik örneklerinin yarattığı etkiler, Kalp Hızı Değişkenliği (KHD), hissedilen duygular ve duygu durumu gibi değişkenler çerçevesinde incelenmiştir. Araştırma, müzik eğitimi almayan 31'i (%60.8) kadın, 20'si (%39.2) erkek toplam 51 kişiyle gerçekleştirilmiştir. Katılımcıların genel yaş ortalaması 22.19’dur (S = 1.08, ranj = 20-25). Çalışmada otonom sinir sistemi aktivasyonunu değerlendirmek için Kalp Hızı Değişkenliği (KHD) ölçümü; müzik dinleme öncesi anlık duygu durumunu (mood) değerlendirmek için Duygu Durumu Profili Ölçeği (POMS) ve müzik dinleme sonrası oluşan muhtemel duyguları değerlendirmek için Cenova Duygu Müzik Ölçeği (GEMS) kullanılmıştır. Çalışmada kullanılan bütün müzik örnekleri (bir neşeli, bir hüzünlü) her bir katılımcının kendisi tarafından belirlenmiştir. 440 Hz akort frekansına göre kaydedilmiş örneklerin 432 Hz frekansa dönüştürülmesi çalışmaya özgü geliştirilmiş bir Max/MSP patch uygulaması ile yapılmıştır. Bulgular, farklı frekanslara (432 Hz ve 440 Hz) göre dinlenen neşeli ve hüzünlü müziklerin, sempatik ve parasempatik aktivasyon düzeyleri arasında anlamlı bir fark yaratmadığını göstermiştir. Ancak akort türünden bağımsız olarak, neşeli müzik dinleyen katılımcılar müzik dinleme sonrası daha fazla gevşeme hissettiklerini bildirmişlerdir. Bunun yanı sıra katılımcıların, akort türünden bağımsız olarak GEMS ölçeğine göre hüzünlü müzik dinleme sonrası yücelik (sublimity) duygusunu canlılık (vitality) ve huzursuzluk (unease) duygusundan daha fazla hissettiği; huzursuzluk duygusunu ise canlılık duygusundan daha fazla hissettiği belirlenmiştir. Neşeli müzik için yapılan analiz sonucunda katılımcıların neşeli müzik dinleme sonrası canlılık duygusunu yücelik ve huzursuzluk duygularından daha fazla hissettiği; yücelik duygusunu ise huzursuzluk duygusundan daha fazla hissettiği görülmüştür. En genel değerlendirmede müzik türünden bağımsız olarak, 440 Hz ile müzik dinleyen katılımcıların 432 Hz ile müzik dinleyen katılımcılara göre müzik dinleme sonrası olumsuz duygu durumunun daha yüksek olduğu; ayrıca erkeklerin kadınlara göre 440 Hz müzikleri dinleme sonrası olumsuz duygu durumunun 432 Hz müzikleri dinleme sonrası olumsuz duygu durumundan daha yüksek olduğu görülmüştür. Elde edilen tüm bulgular akort türünün sempatik ve parasempatik aktivasyon düzeyleri arasında bir farklılaşma yaratmasa da duygu durumu üzerinde bir farklılaşmaya neden olduğunu ima etmektedir

Asymmetrical Bilateral Traumatic Hip Dislocation with Segmental Femur Fracture

Introduction: Hip dislocations are extremely rare, but they are orthopedic emergencies that need to be immediately intervened. Traumatic hip dislocations are usually unilateral and occur toward the posterior region. Bilateral traumatic hip dislocations, on the other hand, are rarer. Asymmetric occurrence of bilateral traumatic hip dislocations is even rarer. The possibility of spontaneous hip dislocation in a healthy person is very unlikely. This is because ligaments wrapping the hip joint make it quite stable. Thus, hip dislocation usually occurs due to a high-energy trauma. Case Report: In this paper we report a unique female patient with asymmetric bilateral traumatic hip dislocation accompanied by a segmental fracture of the femur due to a traffic accident. The patient's right hip was reduced under sedoanalgesia at the emergency department and the left hip was reduced under anesthesia at operating room. Avascular necrosis did not develop at her 2-year follow-up; however, she has been re-operated after developing nonunion in the left femoral segmental fracture. Conclusion: In conclusion, hip dislocations should be treated in first six hours due to the risk of avascular necrosis. Uncomplicated hip dislocations without accompanied fractures can be treated with sedoanalgesia in emergency service settings. However hip dislocations which are complicated with accompanied fractures should be reduced in operation rooms without delay

Kardiyak resenkronizasyon tedavisine yanıtın öngörülmesinde sistemik bağışıklık-inflamatuvar indeksinin rolü

Aim: Cardiac resynchronization therapy (CRT) is a reliable treatment modality in patients with systolic dysfunction. However, not every patient appears to benefit from CRT. The systemic immune inflammation index (SII) is closely linked to the poor prognosis of various cardiovascular disorders. However, there is no study investigating whether SII has predictive value in determining response to CRT in dilated cardiomyopathy patients. Therefore, we intend to investigate the association between SII and response to CRT. Methods: A total of 220 patients (mean age 61.2±10.8 years; 120 men) implanted with CRT were involved in this study. Echocardiographic and laboratory measurements were evaluated prior to CRT. Response to CRT was determined as a≥ 15% decrease in left ventricular end-systolic volume at one-year follow-up. Results: Patients grouped as CRT responders and non-responders. Of these, 143 (64.6%) were considered to be CRT responders, while the remaining 77 (33.4%) were non-responders. Female sex (OR: 3.823, CI: 1.568-9.324 p=0.003), QRS duration (OR: 1.224, CI: 1.158-1.335 p<0.001), and SII (OR: 0.996 CI: 0.995-0.997 p<0.001) were shown to be independent predictors of CRT response in multivariate analysis. A cut-off value of SII >825 estimated no response to CRT with 80% sensitivity and 75% specificity. Conclusions: SII was associated with unresponsiveness to CRT. Therefore, it may be used to determine optimal patient selection for CRT implantation in routine clinical practice.Amaç: Kardiyak resenkronizasyon tedavisi (KRT), sistolik disfonksiyonu olan hastalarda güvenilir bir tedavi yöntemidir. Ancak, KRT'nin faydası belli hasta grupları ile sınırlıdır. Sistemik immün inflamatuvar indeks (SII), çeşitli kardiyovasküler bozuklukların kötü prognozu ile ilişkilidir. Bununla birlikte, dilate kardiyomiyopati hastalarında SII'nin KRT'ye yanıtı belirlemede prediktif değeri olup olmadığını araştıran bir çalışma bulunmamaktadır. Bu nedenle, bu çalışmada SII ile KRT'ye yanıt arasındaki ilişkiyi araştırmak amaçlandı. Yöntemler: Bu çalışmaya KRT implante edilen toplam 220 hasta (ortalama yaş 61,2±10,8 yıl; 120 erkek) dahil edildi. KRT öncesi ekokardiyografi ve laboratuvar ölçümleri değerlendirildi. KRT'ye yanıt, bir yıllık takipte sol ventrikül sistol sonu hacminde ≥ %15 azalma olarak belirlendi. Bulgular: Hastalar, KRT'ye yanıt verenler ve yanıt vermeyenler olarak gruplandırıldı. Bunlardan 143'ü (%64,6) KRT'ye yanıt veren olarak kabul edilirken, kalan 77'si (%33,4) yanıt vermeyendi. Kadın cinsiyet (OR: 3.823, CI: 1.568-9.324 p=0.003), QRS süresi (OR: 1.224, CI: 1.158-1.335 p<0.001) ve SII (OR: 0.996 CI: 0.995-0.997 p<0.001) çok değişkenli analizde KRT yanıtının bağımsız öngörücüleri olarak bulundu. SII >825'lik bir sınır değeri, %80 duyarlılık ve %75 özgüllük ile KRT'ye yanıt olmadığını öngördürmüştür. Sonuç: Bu çalışmada SII’nin KRT'ye yanıtsızlığı öngördüğü gösterilmiştir. Bu nedenle SII rutin klinik uygulamada KRT implantasyonu için optimal hasta seçimini belirlemede kullanılabilir

The Value of Cervical Length Measurement at 10-15 and 20-25 Weeks to Predict Preterm Birth

Amaç: Düşük riskli gebelerde, 10-15. haftalar ve 20-25. haftalar arasında ölçülen serviks uzunluğu ile preterm doğum ilişkisini belirlemek amaçlanmıştır. Yöntemler: İstanbul Eğitim ve Araştırma Hastanesi Gebe Polikliniğine Nisan 2008- Ocak 2009 tarihleri arasında rutin antenatal takip amacıyla başvuran, çalışma kriterlerine uyan 118 gebe ile çalışma grubumuz oluşturuldu. Çoğul gebelikler, daha önce preterm doğum yapanlar, kronik hastalığı olanlar, bilinen uterin anomalisi olanlar ve fetal anomalili gebelikler çalışma dışı tutuldu. 37. gebelik haftasından önceki doğumlar preterm doğum grubunu, 37. gebelik haftasından sonraki doğumlar term doğum grubunu oluşturdu. Bulgular: Çalışma kapsamındaki gebelerin %88,99'u 37. gebelik haftasının üzerinde, %11,01'i 37. gebelik haftasının altında doğum yaptı. Term grupta 10-15. ve 20-25. haftalardaki servikal uzunluk değerleri, preterm gruba göre anlamlı derecede fazla bulunmuştur (p<0,01, p<0,001). Preterm doğum için eşik değer 10-15 hafta servikal uzunluk ölçümleri için 41,4 bulunurken, 20-25 hafta için 33,7 bulundu. Sonuç: Asemptomatik gebelerin taranmasında ve riskli olguların belirlenmesinde 20-25. haftada yapılan transvaginal ulatrasonografi etkili görülmektedir. Erken doğum açısından kötü obstetrik öyküye sahip olan ve risk altında olan gebelerin taranmasına daha erken başlanıp başlanmayacağı konusunda daha ileri çalışmalara ihtiyaç vardır.Objective: We aimed to predict the risks of preterm labor by measuring the cervical length between 10 and 15 weeks gestation and between 20 and 25 weeks gestation, in low risk pregnants. Methods: Our study group was formed in the outpatient clinic of the Ministry of Health Istanbul Education and Research Hospital with 118 pregnants who fulfilled the inclusion criteria and wished to attend our study during routine antenatal screening. Delivery before 37 weeks gestation constituted the preterm labor group, delivery after 37 weeks gestation constituted the term group. Multiple pregnancies, previous preterm delivery, chronic diseases, history of preterm labor, previously diagnosed uterine abnormalities and fetal anomalies were stated as exclusion criteria. Results: In our study pregnant patients who delivered after 37 weeks gestation constituted 88.99% (n: 105) of the study group, whereas 11.01% (n: 13) pregnant patients delivered before 37 weeks gestation. Cervical length measurements in both 10-15 weeks and 20-25 weeks were significantly higher in the term group (p&lt;0.01, p&lt;0.001). Cut off value of cervical length for preterm labor was found as 41.4 among 10 to 15 gestation weeks and 33.7 among 20 to 25 gestation weeks. Conclusion: Transvaginal sonography performed at 20 to 25 gestational weeks has an impressive role when screening asymptomatic pregnants and defining the risks. We need more studies to decide whether to begin earlier screening or not for preterm labor when an individual has a poor obstetric history and is under such risks