Relationship between Teachers' Cultural Values and Preference for Whistle Blowing

Bilgi uçurma örgüt içinde ortaya çıkan yasa dışı veya etik dışı eylemlerin, durumu düzeltebilecek birilerine haber verilmesidir. Bu araştırma, öğretmenlerin sahip oldukları kültürel değerler ile olası bilgi uçurma tercihleri arasında bir ilişki olup olmadığını belirlemeyi amaçlamaktadır. Araştırma tarama modeline göre desenlenmiştir. Çalışma grubunu, İstanbul'da görev yapan 246 öğretmen oluşturmaktadır. Katılımcıların % 61'i kadın ve % 39'u erkektir. Veri toplama araçları alanyazından elde edilmiştir. Analiz sonunda öğretmenlerin cinsel taciz, rüşvet ve hırsızlık olaylarına tanık olduklarında, dışa, kimliğini açıklayarak resmi olmayan yollarla bilgi uçurabilecekleri ortaya çıkmaktadır. Öğretmenler toplulukçu kültürel değere daha yüksek düzeyde sahiptir. Son olarak kültürel değerler ile bilgi uçurma tercihleri arasında pozitif yönde anlamlı ilişkinin olduğu belirlenmiştir.Whistle-blowing means disclosing of illegal or immoral practices in organizations to persons who would able to fix that action. This research aims to identify the relationship between the teachers' cultural values and their possible whistle-blowing intentions. The research was designed as scanning model. The research group includes 246 teachers 61% of which was female and 39% of which was male. The instruments were constructed by the literature. The results revealed that the teachers would blow whistle externally, identified, and informally when that would observe sexual abuse, bribery, and theft. The teachers had collectivism cultural value more than the other one. Lastly, there was positive significant relationship between the cultural value and the choice of whistle blowing

Keratokonus hastalarında Mini-Skleral lens kullanımı

Amaç: Keratokonus hastalarında mini-skleral lensin görsel performansını ve lens uyumunu optik koherens tomografi (OKT) ile değerlendirmek.Gereç ve Yöntem: Yirmi dört keratokonus hastasının 29 gözüne mini-skleral lens (Esclera; Mediphacos Ltd., Belo Horizonte, Brezilya) uygulandı. Başlangıç uyumunun değerlendirilmesinde, deneme lensleri kullanıldı. Lens uyumu, floresein paterni ve ön segment OKT (RTVue, Optovue Inc., Fremont, CA) görüntülemesi ile değerlendirildi. Lens uygulandıktan 30-45 dakika sonra korneal-limbal açıklık ve periferik yerleşim bölgesinin uyumunu içeren lens uyum parametreleri, OKT ile değerlendirildi. Lens uygulamasının öncesinde ve sonrasında; yüksek ve düşük kontrastlı görme keskinliği (GK), konfor, görmenin subjektif performansı (5 puanlı Likert skalası) ve genel memnuniyeti [100 mm görsel analog skalası (GAS)] değerlendirildi.Bulgular: Lens uygulaması sonrasında; ortalama desimal yüksek kontrastlı GK (en iyi düzeltilmiş gözlükle GK: 0,40±0,14 vs skleral lens ile GK: 0,93±0,12 p<0,0001) ve ortalama düşük kontrastlı GK’deki (en iyi düzeltilmiş gözlükle GK: 0,60±0,24 vs skleral lens ile 1,15±0,18, p<0,0001) artışın istatistiksel olarak anlamlı olduğu görüldü. Ortalama santral korneal açıklık 120,7±24,5 µm idi. Keratometrik değerler ile skleral lensin sagital derinliği arasında korelasyon görülmedi. Başarılı uyum için gereken ortalama lens deneme sayısı 2,2 lens (aralık: 1-8) idi. Hastalar lens ile yüksek skorda konfor (ortalama skor: 4,69; aralık: 4-5), görme (ortalama skor: 4,62; aralık: 3-5) ve genel memnuniyet (ortalama GAS skor: 88,1; aralık: 70-100) bildirdi.Sonuç: Keratokonus hastalarında, mini-skleral lens ile yüksek ve düşük kontrastlı GK değerlerinde artış ve yüksek hasta memnuniyeti sağlandı. Ön segment OKT görüntülemesi, lens uyumunun değerlendirilmesini kolaylaştırdı.Amaç: Keratokonus hastalarında mini-skleral lensin görsel performansını ve lens uyumunu optik koherens tomografi (OKT) ile değerlendirmek.Gereç ve Yöntem: Yirmi dört keratokonus hastasının 29 gözüne mini-skleral lens (Esclera; Mediphacos Ltd., Belo Horizonte, Brezilya) uygulandı. Başlangıç uyumunun değerlendirilmesinde, deneme lensleri kullanıldı. Lens uyumu, floresein paterni ve ön segment OKT (RTVue, Optovue Inc., Fremont, CA) görüntülemesi ile değerlendirildi. Lens uygulandıktan 30-45 dakika sonra korneal-limbal açıklık ve periferik yerleşim bölgesinin uyumunu içeren lens uyum parametreleri, OKT ile değerlendirildi. Lens uygulamasının öncesinde ve sonrasında; yüksek ve düşük kontrastlı görme keskinliği (GK), konfor, görmenin subjektif performansı (5 puanlı Likert skalası) ve genel memnuniyeti [100 mm görsel analog skalası (GAS)] değerlendirildi.Bulgular: Lens uygulaması sonrasında; ortalama desimal yüksek kontrastlı GK (en iyi düzeltilmiş gözlükle GK: 0,40±0,14 vs skleral lens ile GK: 0,93±0,12 p<0,0001) ve ortalama düşük kontrastlı GK’deki (en iyi düzeltilmiş gözlükle GK: 0,60±0,24 vs skleral lens ile 1,15±0,18, p<0,0001) artışın istatistiksel olarak anlamlı olduğu görüldü. Ortalama santral korneal açıklık 120,7±24,5 µm idi. Keratometrik değerler ile skleral lensin sagital derinliği arasında korelasyon görülmedi. Başarılı uyum için gereken ortalama lens deneme sayısı 2,2 lens (aralık: 1-8) idi. Hastalar lens ile yüksek skorda konfor (ortalama skor: 4,69; aralık: 4-5), görme (ortalama skor: 4,62; aralık: 3-5) ve genel memnuniyet (ortalama GAS skor: 88,1; aralık: 70-100) bildirdi.Sonuç: Keratokonus hastalarında, mini-skleral lens ile yüksek ve düşük kontrastlı GK değerlerinde artış ve yüksek hasta memnuniyeti sağlandı. Ön segment OKT görüntülemesi, lens uyumunun değerlendirilmesini kolaylaştırdı

The HYLAN M Study: Efficacy of 0.15% High Molecular Weight Hyaluronan Fluid in the Treatment of Severe Dry Eye Disease in a Multicenter Randomized Trial

The aim of the HYLAN M study was to investigate if symptoms and/or signs of patients suffering from severe dry eye disease (DED) can be improved by substituting individually optimized artificial tear therapy by high molecular weight hyaluronan (HMWHA) eye drops. In this international, multicenter study, patients with symptoms of at least ocular surface disease index (OSDI) 33 and corneal fluorescein staining (CFS) of at least Oxford grade 3 were included. A total of 84 per-protocol patients were randomized in two study arms. The control group continued to use their individual optimum artificial tears over the study period of eight weeks; in the verum group, the artificial tears were substituted by eye drops containing 0.15% HMWHA. At the week 8 visit, the average OSDI of the verum group had improved by 13.5 as compared to the control group (p = 0.001). The best corrected visual acuity (BCVA) had improved by 0.04 logMAR (p = 0.033). CFS, tear film break-up time (TBUT), Schirmer I, lid wiper epitheliopathy (LWE), mucocutaneous junction (Yamaguchi score), and tear osmolarity were not significantly different between the verum and control groups (p > 0.050). We conclude that for most patients with severe DED, 0.15% HMWHA eye drops provide excellent improvement of symptoms without impairment of dry eye signs

Efficacy and safety of low-concentration, bisulphite-containing, intracameral epinephrine and topical atropine treatments for the prevention of intraoperative floppy iris syndrome

Purpose: The aim of this study was to evaluate the efficacy and safety of topical atropine and topical atropine combined with intracameral low-concentration, bisulphite-containing epinephrine treatment for the prophylaxis of intraoperative floppy iris syndrome.Materials and methods: Seventy-two eyes of 55 male patients who were treated with alpha-adrenergic antagonist medications for benign prostatic hyperplasia were included in this study. Standard premedication with topical cyclopentolate, phenylephrine, tropicamide and ketorolac was applied to all of the patients. In 22 cases no further prophylactic method was used (Group-NP), while in 29 cases topical atropine drops was instilled 12h and 30min before surgery (Group-A) and in 21 cases 1:16000 epinephrine was injected to the anterior chamber at the beginning of surgery (Group-EA) in addition to topical atropine prophylaxis.Results: In Group-NP, 62.8% of the cases developed IFIS, while development of IFIS was significantly lower in Group-A (17.2%, p=0.0004) and Group-EA (9.5%, p<0.0001). Posterior capsule rupture was observed in two cases (9.1%) in Group-NP, in one case (3.4%) in Group-A and was not observed in Group-EA. There was no statistically significant difference between the groups for the development of surgical complications. We did not observe any adverse events or significant endothelial cell loss (p=0.462).Conclusions: Our results indicate that preoperative use of topical atropine reduces the incidence of IFIS. Use of low-concentration, bisulphite-containing epinephrine is more effective in the prevention of IFIS and does not cause preservative related endothelial damage. This prophylaxis may be preferred when preservative free epinephrine is not available

Penetrating keratoplasty for endothelial decompensation in eyes with buphthalmos

Purpose. To evaluate the prognosis and complications of Penetrating keratoplasty (PKP) for corneal decompensation in eyes with buphthalmos and to analyze the risk factors for graft failure. Patients and Methods. Clinical records of 13 adult and three pediatric patients who underwent PKP for endothelial decompensation with a previous diagnosis of congenital glaucoma of a total of 3,663 corneal transplantations performed in our department between January 1987 and December 2001 were reviewed retrospectively. During the study period, a total of 33 PKPs was performed in 20 eyes with buphthalmos. The median age of the patients at the time of PKP was 39 years (range, 3 to 72). All patients had a history of intraocular surgery, including multiple glaucoma surgeries, cataract extraction, and PKP. The impact of pre-, intra-, and postoperative factors on graft failure and duration of graft clarity was analyzed. Results. Fifty-five percent (11/20) of the eyes received only one graft, 25% (5/20) received two, and 20% (4/20) received three grafts. During a mean follow-up of 87.2 months (range, 4.5-72), graft failure occurred in 18 of 33 grafts (54%). Seven (7/18, 39%) had immunologic graft rejection, and 11 (11/18, 61%) had nonimmunologic graft failure. At the end of the followup, 75% (15/20) of the eyes had clear grafts. Duration of graft clarity was found to be significantly shorter in regrafts compared with that of primary grafts (27.0+/-27.7 versus 56.4+/-41.0 months, p = 0.02). After PKP, intraocular pressure (IOP) was uncontrolled in 12 (12/33, 36%) grafts. Nine of 20 eyes (45%) required an average of 3.2 cyclodestructive procedures per eye for pharmacologically resistant elevated IOP. The final postoperative vision improved in 70% (14/20) of the eyes and the best visual acuity postoperatively (75% greater than or equal to20/400) was significantly better than the preoperative visual acuity (25% greater than or equal to20/400, p = 0.0001). Conclusions. Endothelial decompensation due to congenital glaucoma is a very rare indication for PKP. The incidence of graft failure is high, and nonimmunologic reasons are the leading causes of graft failure in this high-risk population. Visual acuity can be significantly improved but is usually still very limited by advanced glaucomatous optic nerve damage and amblyopia. Efficient control of IOP before and after PKP is mandatory in eyes with buphthalmos to avoid graft failure and progress of glaucomatous optic nerve atrophy

Hydroxychloroquine improves dry eye symptoms of patients with primary Sjogren's syndrome

The objective of the study is to investigate the effect of hydroxychloroquine (HCQ) on subjective and objective parameters of dry eye in patients with primary Sjogren's disease and to evaluate the association of tear fluid B-cell activating factor (BAFF) level with the response. Thirty-two patients with primary Sjogren's disease were enrolled in this prospective study. All patients included in the study completed at least a 48-month run-in period of using hydroxychloroquine. Patients were then instructed to drop the treatment for 3 months. Baseline and post cessation of treatment (baseline and 3 months) evaluations included, subjective symptom scoring, fluorescein and lissamine green staining, Schirmer's test, tear break-up time (BUT) and tear fluid BAFF assessments. Significant worsening was observed in, tear break up-time (TBUT) (7.9 +/- A 3.4 vs. 5.9 +/- A 2.9, P < 0.001) lissamine green of staining of the ocular surface (1.3 +/- A 0.9 vs. 1.8 +/- A 0.8, P < 0.01) and corneal fluorescein staining scores (2.2 +/- A 2.1 vs. 4.6 +/- A 3.3, P < 0.003) between on and off HCQ treatment, respectively. Similarly, gritty sensation and burning sensation were significantly changed at week 12 compared to baseline evaluation (1.18 +/- A 1.02 vs. 1.7 +/- A 1.05, P < 0.007 and 1.1 +/- A 1.0 vs. 1.6 +/- A 1.2, P < 0.0, respectively). Disease duration significantly correlated with baseline OSDI (r = 0.38, P < 0.04) and the average daily use of artificial tears (r = 0.36, P < 0.04). The mean BAFF levels were 0.8 +/- A 0.5 and 4.0 +/- A 0.7 ng/ml for baseline and week 12 evaluation, respectively (P < 0.0001). The results of this study suggest that HCQ may alleviate symptoms and signs of dry eye in pSS and decreases tear fluid BAFF levels