Küresel iklim değişikliğinde birleşmiş milletlerin rolü ve Kyoto dönemlerinin Türkiye'deki gelişim süreci ve uygulamaları

İklim değişikliği sorunu küreselleşmenin etkisiyle birlikte uluslararası boyut kazanan bir çevre sorunu haline gelmiştir. 1992 yılında gerçekleşen Rio Konferansı'ndan bu yana iklim değişikliği sorunu hakkında bir farkındalık yaratılmış, 1997 yılında gerçekleşen 3. Taraflar Konferansı'nda şekillenen Kyoto Protokolü'nde, Ek-I listesinde yer alan ülkelerin Kyoto I.Yükümlülük Dönemi'ni kapsayan 2008-2012 yıl aralığı için sera gazı azaltımı kararı alınmıştır.Ancak 2012 sonrası için oluşturulacak iklim değişikliği rejiminde, Hükümetlerarası İklim Değişikliği Paneli (IPCC) raporlarının da belirttiği gibi yerküre ısısının 2°C ile sınırlandırılması için yeni anlaşmaya sera gazı azaltımı konusunda gelişmekte olan ülkelerin de dahil edilmesi gerçeği müzakereleri şiddetlendirmiş ve umutla beklenen 2009 Kopenhag İklim Zirvesi'nde uzlaşmaya varılamamıştır. Sonraki müzakerelerde özellikle ülkelere getireceği ekonomik maliyetler sebebiyle genel ve kapsayıcı bir anlaşma üzerinde karar birliği sağlanamamıştır. Bu çalışmada son dönemde meydana gelen gelişmeler ışığında özellikle 2015 Paris İklim Zirvesi'nin, Kyoto Protokolü II. Yükümlülük Dönemi'nin bitimini izleyen 2020 sonrası dönemi için bir anlaşmayla sonuçlanıp sonuçlanmayacağı ve Türkiye'nin iklim değişikliği müzakerelerindeki pozisyonu ve nasıl bir "Ulusal Katkı" sağlayacağı analiz edilmiştir.The problem of climate change has become an environmental issue that has gained international dimension with the effect of globalization. Since the Rio Conference in 1992, awareness has been raised about the issue of climate change and the countries included in Annex-1 of the Kyoto Protocol shaped in the 3rd Conference of the Parties, which took place in 1997, a gas reduction decision was taken for Kyoto Protocol's First Commitment Period including 2008-2012 year interval. However, in the climate change regime to be established for the post-2012, as the Intergovernmental Panel on Climate Change (IPCC) reports also pointed out, the inclusion of developing countries in the new deal to limit global warming to 2 °C has intensified negotiations and the hopefully anticipated 2009 Copenhagen Climate Summit no compromise was reached. In subsequent negotiations, a decision on a general and inclusive agreement has not been reached due to the economic costs to be brought to the countries in particular. In this study, especially the recent developments in the light of the 2015 Paris Climate Summit for it was analyzed whether it would result in an agreement for the post-2020 period following the end of Kyoto Protocol's Second Commitment Period and the position of Turkey in climate change negotiations and what kind of "National Contribution" it would provide

Dereceli puanlama anahtarına yönelik öz-yeterlilik ölçeğinin geliştirilmesi

The purpose of this study is to develop a valid and reliable measurement tool determining teachers’ self-efficacy regarding rubrics. Especially in educational environments, rubrics are measurement tools used in the assessment phase of student products usually based on higher-order thinking skills. Determination of teachers’ self-efficacy regarding rubrics can give researchers an idea on how often and how accurately teachers use such tools. For this reason, the existence of a tool accurately measuring self-efficacy variable is necessary. This study’s sample consists of 641 elementary, middle and high school teachers. To determine teachers’ self-efficacy levels regarding rubrics, 47-item draft was developed. As a result of validity and reliability analyzes, a 28-item measurement tool with a four-factor structure was obtained. The total scale’s and sub-factors’ internal consistency is quite high. Using this scale, researchers can examine the relationships between teachers’ self-efficacy and various variables that play an important role in education. In addition, comparative studies on the intended use of rubrics can be conducted by determining teachers’ self-efficacy levels regarding rubrics.Bu araştırmanın amacı, öğretmenlerin Dereceli Puanlama Anahtarları (DPA)’na yönelik özyeterliklerini belirleyen geçerli ve güvenilir ölçme aracı geliştirmektir. Dereceli puanlama anahtarları özellikle eğitim ortamlarında öğrencilerin üst düzey zihinsel becerilerine dayalı ortaya koydukları ürünlerin değerlendirilmesi aşamasında kullanılan ölçme araçlarıdır. Öğretmenlerin DPA’ya yönelik öz yeterliklerinin belirlenmesi, onların bu tür araçları ne sıklıkla ve doğru olarak kullandıkları konusunda araştırmacılara bir fikir verebilir. Bu nedenle özyeterlik değişkenini doğru olarak ölçen bir aracın varlığı gereklidir. Temel araştırma modeline dayalı olan bu araştırmanın örneklemini, ilköğretimde ve ortaöğretimde çalışan 641 öğretmen oluşturmaktadır. Öğretmenlerin dereceli puanlama anahtarına yönelik öz yeterlilik düzeylerini ortaya koymak için 47 maddeden oluşan taslak form hazırlanmıştır. Ölçeğin geçerliğini belirlemek için kapsam geçerliği, temel bileşenler analizi, madde toplam korelasyonu, alt-üst %27’lik gruplar için madde analizi ve doğrulayıcı faktör analizi yapılmıştır. Ölçeğin güvenirliği ise iç tutarlılık olarak incelenmiş ve Cronbach alfa değeri ile test edilmiştir. Analizlersonucunda 28 maddeden oluşan ve dört faktörlü bir yapıya sahip ölçek elde edilmiştir. Ölçeğin tamamının ve alt faktörlerinin iç tutarlılık katsayısı oldukça yüksektir. Bu ölçeğe dayalı olarak araştırmacılar öğretmenlerin özyeterliğiileeğitimde önemli rol oynayan farklı değişkenler arasındaki ilişkilerincelenebilirler. Ayrıca öğretmenlerin DPA’ya yönelik öz yeterlilikdüzeyleri belirlenerek DPA’larınkullanım amaçlarına dayalı karşılaştırmalı çalışmalar yapılabilir

A sydenham chorea attack associated with COVID-19 infection

The coronavirus disease 2019 (COVID-19) caused by SARS-CoV-2 appeared in Wuhan, China in December 2019 and quickly spread around the world and is considered a global pandemic. This disease, which is pre-infected with respiratory and cardiovascular system symptoms, can also occur in many organ systems. Since the beginning of the pandemic, cases related to neurological involvement have been reported in the literature and studies coercing neurological findings and complications have been published. COVID-19 can cause wide spectrum of neurological phenotypes from severe to milder. To the best of our knowledge, our case is the first report describing the chorea in a patient associated with COVİD-19. In this article, we aim to present a patient who was admitted with chorea on the 3rd day of the COVID-19 followed by Sydenham chorea, which had already improved. This report expands the phenotypic spectrum of COVID-19 and suggests that COVID-19 can be associated with or trigger chorea

Clinical outcomes of cyclin-dependent kinase 4-6 (CDK 4-6) inhibitors in patients with male breast cancer: A multicenter study.

BACKGROUND: Since breast cancer is less common in men than in women, data on the use of new therapeutic agents, including cyclin-dependent kinase 4–6 (CDK 4–6) inhibitors, are limited in patients with metastatic hormone receptor positive (HR+), human epidermal growth factor receptor 2-negative (HER2-) male breast cancer. Therefore; we aimed to investigate the treatment responses of metastatic HR+, HER2-male breast cancer patients treated with CDK 4–6 inhibitors in a multicenter real-life cohort. METHODS: Male patients with a diagnosis of HR+ and HER2-metastatic breast cancer, treated with any CDK 4–6 inhibitor, were included in the study. Demographic and clinical characteristics of the patients were recorded. We aimed to determine progression-free survival (PFS) time, response rates and drug related side effects. RESULTS: A total 25 patients from 14 institutions were recruited. The mean age at diagnosis was 57 years. Median follow-up was 19.53 (95% CI: 14.04–25.02) months. The overall response rate was 60%. While the median PFS was 20.6 months in the whole cohort, it wasn't reached in those using CDK 4–6 inhibitors in first line and 10 months in the subsequent lines (p:0.009). No new adverse events were encountered. CONCLUSION: In our study, we found that CDK 4–6 inhibitors are effective and safe options in men with HR+ and HER2-metastatic breast cancer as in women. Our results support the use of CDK 4–6 inhibitor-based combinations in the first-line treatment of HR+ and HER2-metastatic male breast cancer

The efficacy of palbociclib and ribociclib in the first-line treatment of metastatic hormone receptor-positive, human epidermal growth factor receptor 2-negative breast cancer in male patients: a Turkish oncology group (TOG) study.

IntroductionMale breast cancer, comprising approximately 1% of all breast cancer cases, often leads to the exclusion of male patients as a criterion in clinical trials. While the efficacy of Cyclin-dependent kinases 4 and 6 (CDK 4/6) inhibitors has been established in metastatic hormone receptor-positive (HR +) and human epidermal growth factor receptor 2-negative (HER2 -) breast cancer in women, limited data exist on their effectiveness in male patients.We aimed to evaluate the efficacy and safety of palbociclib or ribociclib in male patients with breast cancer.IntroductionMale breast cancer, comprising approximately 1% of all breast cancer cases, often leads to the exclusion of male patients as a criterion in clinical trials. While the efficacy of Cyclin-dependent kinases 4 and 6 (CDK 4/6) inhibitors has been established in metastatic hormone receptor-positive (HR +) and human epidermal growth factor receptor 2-negative (HER2 -) breast cancer in women, limited data exist on their effectiveness in male patients.We aimed to evaluate the efficacy and safety of palbociclib or ribociclib in male patients with breast cancer.MethodsThis study is a multicenter, retrospective study. We included male patients with HR + and HER2-metastatic breast cancer who received palbociclib or ribociclib as first-line treatment. Our primary endpoints were progression-free survival (PFS), overall response rates (ORR), and drug-related adverse effects.ResultsA total of 46 male patients from 27 institutions were enrolled. The median age at initiation of CDK 4/6 inhibitors was 63.64 +/- 13.69 years, with a median follow-up of 21.33 (95% CI 14.92-27.74) months. The ORR were 84% for palbociclib and 76.2% for ribociclib. The mPFS for the entire cohort was 28.06 months (95% CI 18.70-37.42). No significant difference in PFS was observed between palbociclib and ribociclib (mPFS: 24.46 months (95% CI 11.51-37.42) vs 28.33 months (95% CI 14.77-41.88), respectively, p = 0.211). No new adverse events were reported.DiscussionThis study demonstrates that palbociclib and ribociclib are effective and safe options for first-line treatment in male patients with HR + /HER2 - metastatic breast cancer. However, further prospective studies are warranted to establish their efficacy in this population

The effect of sleep disorders on quality of life in patients with epilepsy: A multicenter study from Turkey

Objective: We aimed to investigate sleep disorders in patients with epilepsy (PWE) and to investigate the effects of sleep disorders on quality of life. Methods: In our multicenter study conducted in Turkey, 1358 PWE were evaluated. The demographic and clinical data of the patients were recorded. The Insomnia Severity Index (ISI), Epworth Sleepiness Scale (ESS), Pittsburgh Sleep Quality Index (PSQI), Beck Depression Inventory (BDI), and Quality of Life in Epilepsy Inventory-10 (QOLIE-10) were administered. Results: The mean age of 1358 patients was 35.92 ± 14.11 (range, 18–89) years. Seven hundred fifty-one (55.30 %) were women. Some 12.7 % of the patients had insomnia (ISI > 14), 9.6 % had excessive daytime sleepiness (ESS > 10), 46.5 % had poor sleep quality (PSQI > 5), and 354 patients (26.1 %) had depressive symptoms (BDI > 16). The mean QOLIE-10 score was 22.82 ± 8.14 (10–48). Resistant epilepsy was evaluated as the parameter with the highest risk affecting quality of life Adjusted odds ratio (AOR = 3.714; 95 % confidence interval (CI): [2.440–5.652] < 0.001)). ISI (AOR = 1.184; 95 % CI: [1.128–1.243]; p < 0.001), ESS (AOR = 1.081; 95 % CI: [1.034–1.130]; p < 0.001), PSQI (AOR = 0.928; 95 % CI: [0.867 – 0.994]; p = 0.034), BDI (AOR = 1.106; 95 % CI: [1.084–1.129]; p < 0.001), epilepsy duration (AOR = 1.023; 95 % CI: [1.004–1.041]; p = 0.014), were determined as factors affecting quality of life. Significance: Sleep disorders are common in PWE and impair their quality of life. Quality of life can be improved by controlling the factors that may cause sleep disorders such as good seizure control, avoiding polypharmacy, and correcting the underlying mood disorders in patients with epilepsy

Re-examining the characteristics of pediatric multiple sclerosis in the era of antibody-associated demyelinating syndromes.

Background: The discovery of anti-myelin oligodendrocyte glycoprotein (MOG)-IgG and anti-aquaporin 4 (AQP4)-IgG and the observation on certain patients previously diagnosed with multiple sclerosis (MS) actually have an antibody-mediated disease mandated re-evaluation of pediatric MS series. Aim: To describe the characteristics of recent pediatric MS cases by age groups and compare with the cohort established before 2015. Method: Data of pediatric MS patients diagnosed between 2015 and 2021 were collected from 44 pediatric neurology centers across Turkiye. Clinical and paraclinical features were compared between patients with dis-ease onset before 12 years (earlier onset) and >= 12 years (later onset) as well as between our current (2015-2021) and previous (< 2015) cohorts. Results: A total of 634 children (456 girls) were enrolled, 89 (14%) were of earlier onset. The earlier-onset group had lower female/male ratio, more frequent initial diagnosis of acute disseminated encephalomyelitis (ADEM), more frequent brainstem symptoms, longer interval between the first two attacks, less frequent spinal cord involvement on magnetic resonance imaging (MRI), and lower prevalence of cerebrospinal fluid (CSF)-restricted oligoclonal bands (OCBs). The earlier-onset group was less likely to respond to initial disease-modifying treatments. Compared to our previous cohort, the current series had fewer patients with onset < 12 years, initial presentation with ADEM-like features, brainstem or cerebellar symptoms, seizures, and spinal lesions on MRI. The female/male ratio, the frequency of sensorial symptoms, and CSF-restricted OCBs were higher than reported in our previous cohort. Conclusion: Pediatric MS starting before 12 years was less common than reported previously, likely due to exclusion of patients with antibody-mediated diseases. The results underline the importance of antibody testing and indicate pediatric MS may be a more homogeneous disorder and more similar to adult-onset MS than previously thought