89 research outputs found

    Have The European Union Guidelines been a Driving Force in the Inclusion of Children’s Rights into the German “Sachunterricht” Course Curriculum?

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    It is observed that efforts are made to benefit from the perspective of the Universal Convention on the Rights of the Child and to undertake the protection and promotion of children’s rights more effectively in countries that are members of the European Union/membership process with the European Union Agreement (Lisbon Treaty) which came into force in 2009. In this direction, the European Union Guidelines on the Promotion and Protection of Children’s Rights were published to guide the EU member countries and their countries in the process of membership in their work on children’s rights. So, the research purposed primarily to examine the status of children’s rights in the official Sachunterricht course curriculum used in the German education system in line with the EU Guidelines. In the research, a holistic multiple-state pattern was adopted from the qualitative research approach patterns. In the process of obtaining research data, the document review method was used. The official Sachunterricht course curriculum in sixteen states in the Federal Republic of Germany was examined in this scope. As a consequence of the research, it was concluded that the content included in the curriculum in most states is in line with the EU Guidelines. However, we saw just a few curricula have that there are statements of attainment and study examples regarding children’s right to protection and participation. At this point, studies can be put forward to make all education curricula more compatible with EU Guiding Principles. These studies should ensure that the teaching curricula that countries will use address children’s rights and related learning outcomes and teaching activities aimed at recognizing children’s rights, preventing discrimination against them, building a culture of universal peace, and preparing children for responsible lives in a free society

    A qualitative research on the experiences of businesses in the pandemic process

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    Pandemi sürecinde işletmelerin prensiplerinde bir takım değişimler meydana gelmiştir. Bu değişimleri gerçekleştirirken işletme/çalışanlarının deneyimlerinin ortaya konması sürecin meydana getirdiği sonuçları anlayabilmek adına önem arz etmektedir. Araştırmanın amacı pandemi sürecinin işletme ve çalışanlar üzerindeki sonuçların tespit edilmesidir. Bu kapsamda araştırmada pandemi sürecinden etkilenen işletmelerin katılımcılarıyla görüşmeler yapılarak, işletmelerin ve çalışanların deneyimlerinin elde edilmesi ve anlamlandırılması amaçlanmaktadır. Araştırmada nitel veri toplama tekniklerinden derinlemesine görüşmelerle veriler elde edilmiştir. Bu kapsamda yarı yapılandırılmış görüşme tekniği kullanılmıştır. Verilerin analizinde yorumlayıcı fenomenolojik analiz kullanılmıştır. Yarı yapılandırılmış görüşmeler çerçevesinde katılımcılara 4 temel soru ve temel soruları destekleyen sondaj sorular yöneltilmiştir. Görüşmeler sonucunda elde edilen verilerin dökümleri yapılarak araştırmacılar tarafından kodlamaya tabi tutulmuştur. Kodlardan hareketle kategoriler oluşturulmuştur. Her bir kod kendisine uyan kategoriler içerisine aktarılmıştır. Kendi içerisinde benzer olanlar aynı temada toplanmıştır. Elde edilen bulgular çerçevesinde “Süreçte Yaşananlar”, “Sürecin İşletmeye Yansıması”, Sürecin Çalışanlara Yansıması”, “Süreçte Alınan Önlemler” ve “Sürece Dair Tavsiyeler” olmak üzere 5 tema yer almaktadır. Araştırmanın sonucunda işletme sahibi/çalışanı kişilerin; pandemi sürecinde maddi zorluklar yaşadığı, sosyal ilişkilerinin öncesine göre azaldığı, çalışma prensiplerinde birtakım değişiklikler olduğu ve bu süreci atlatabilmek adına işletmelerinde mesafe ve hijyen gibi önlemler aldıkları sonucuna ulaşılmıştır. İşletme sahipleri/çalışanları sürecin daha iyi yönetebilmesi için temasın önlemesinin, kurallara uyulmasının ve tedbirlerinin devam ettirilmesinin üzerinde durmuştur.During the pandemic process, some changes have occurred in the principles of businesses. While making these changes, it is important to reveal the experiences of the enterprise/employees in order to understand the results of the process. The aim of the research is to determine the consequences of the pandemic process on the business and employees. In this context, it is aimed to obtain and make sense of the experiences of businesses and employees by conducting interviews with the participants of the businesses affected by the pandemic process. In the research, data were obtained through in-depth interviews from qualitative data collection techniques. In this context, semi-structured interview technique was used. Interpretive phenomenological analysis was used in the analysis of the data. Within the framework of semi-structured interviews, 4 basic questions and sounding questions supporting the basic questions were asked to the participants. The data obtained as a result of the interviews were transcribed and coded by the researchers. Categories were created based on the codes. Each code has been transferred into categories that fit it. Those that are similar in themselves are gathered under the same theme. Within the framework of the findings obtained, there are 5 themes: Experiences in the Process", "Reflection of the Process to the Business", Reflection of the Process to the Employees", "Measures Taken in the Process" and "Recommendations Regarding the Process". As a result of the research, the owner/employee of the business; It has been concluded that he has experienced financial difficulties during the pandemic process, his social relations have decreased compared to before, there have been some changes in his working principles, and they have taken measures such as distance and hygiene in their enterprises in order to overcome this process. The business owners/employees emphasized the prevention of contact, the observance of the rules and the continuation of the precautions in order to better manage the process

    Interscalene block applied by an experienced anesthesiologist has a good anesthetic effect, a long duration of action, and less postoperative pain after arthroscopic shoulder procedures independent of surgery type and operation duration

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    This study aims to evaluate the severity of postoperative pain and the time to the onset of pain after arthroscopic surgical treatment of rotator cuff tear or instability under interscalene block. Patients and methods: Between October 2015 and June 2016, a total of 172 patients (82 males, 90 females; mean age: 47.9±16.9 years; range, 15 to 83 years) who underwent shoulder arthroscopy under interscalene block by a single surgeon were retrospectively analyzed. The relationship between the postoperative 24-h Visual Analog Scale (VAS), the time to the onset of pain with the type of surgical procedure (rotator cuff repair, n=101 or instability surgery, n=71), and the duration of surgery (<30 min n=92; ≥30 min n=80) was examined. Results: No significant relationship was found between the type of surgical procedure, VAS scores, and the onset of pain after the block (p=0.577 and p=0.780, respectively). No significant relationship was found between the operation duration, and VAS, and the onset of pain after the block (p=0.570 and p=0.408, respectively). The mean duration until the start of postoperative pain was 734±313 (range, 60 to 1,440) min. There was no statistically significant difference in the need for rescue analgesics at the postoperative 24th h and the duration of surgery between the two groups (p=0.393 and p=0.675, respectively). Conclusion: Our study results show no significant difference in the time for the onset of postoperative pain and the VAS scores according to the characteristics of the surgical procedure, operation duration, or age and sex of the patient. Shoulder arthroscopy performed by experienced surgeons under interscalene block eliminates the need for analgesics within the first 12 h postoperatively

    Does One Trigger The Other? Coexistence of Gout and Haglund: A Case Report

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    Heel pain is one of the common clinical conditions of musculoskeletal diseases. Heel pain can occur with infectious, inflammatory, mechanical and vascular causes. Haglund's deformity, one of the causes of heel pain, is an abnormal bone formation located in the posterosuperior part of the calcaneus. Achilles enthesopathy, Haglund deformity and lesions in the posterior heel are considered Haglund Syndrome. The diagnosis of Haglund Syndrome is made clinically and radiologically. In the diagnosis of Haglund syndrome, direct radiography and magnetic resonance imaging are used in radiological examination. The bony prominence on the lateral radiograph of the foot supports the diagnosis. The differential diagnosis of Haglund Syndrome with rheumatic diseases such as gout and seronegative spondyloarthritis should be made. Gout is an inflammatory rheumatic disease characterized by the accumulation of monosodium urate crystals in tissues caused by hyperuricemia. In this article, a case diagnosed with gout accompanying bilateral Haglund Syndrome is presented in the light of current literature

    Optimization Of Enamel Coatings On Heat Exchanger Plates Used In Rotary Air Preheaters Of Thermal Power Plants

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    Tez (Yüksek Lisans) -- İstanbul Teknik Üniversitesi, Fen Bilimleri Enstitüsü, 2015Thesis (M.Sc.) -- İstanbul Technical University, Institute of Science and Technology, 2015Günümüzde fosil yakıtların giderek azalması ve elektrik üretim maliyetlerinin artması sonucunda, termik santrallerde verim oldukça büyük önem kazanmıştır. Termik santrallerde kullanılan döner tip hava ısıtıcılar santral verimini arttıran önemli elemanlardır. Bu ısıtıcılar, ısı iletimini, ısı değiştirici plakalar aracılığıyla sağlarlar.  Isı değiştirici plakalarda meydana gelen sülfürik asit korozyonu ve küllerin birikmesiyle oluşan kirlenme problemi, ısı değiştirici plakalara zarar vererek, ısı iletiminin sağlıklı bir şekilde devam etmesini engellemektedir. Isı iletiminin istenilen seviyede devam ettirilebilmesi için bu plakalar sülfürik asit korozyonuna ve kirlenemeye karşı dayanıklı emaye kaplama ile kaplanırlar.  Tezin literatür kısmında, termik santrallerde kullanılan ısı değiştirici plakalar, bu plakalarda karşılaşılan problemler, emaye kaplama yapısı, emayeleme türleri ve emaye kaplama prosesi hakkında genel hatlarıyla bilgiler verilmiştir. Deneysel çalışmalar kısmında, ilk olarak deneylerde altlık malzeme olarak kullanılan düşük karbonlu çelik levhaların yüzeyleri temizlenerek emaye kaplamaya hazır hale getirilmiştir. Ayrıca düşük karbonlu çelik levhalar karakterize edilerek kimyasal bileşimi, yüzey pürüzlülüğü, ıslatma açısı ve sertlik değeri belirlenmiştir. Altlık malzemeler karakterize edildikten sonra emaye kaplama işlemine geçilmiştir. Emaye kaplama, yaş (hava destekli spreyleme) ve kuru (elektrostatik toz spreyleme) kaplama yöntemleri kullanılarak iki farklı kaplama kalınlığında (150±10 µm ve 250±10 µm), düşük karbonlu çelik levhalar üzerinde oluşturulmuştur. Kaplama işlemlerinden sonra emaye kaplı numuneler pişirilerek son haline geline getirilmiştir.  Deney numuneleri hazır hale geldikten sonra, X-ışınları difraksiyon (XRD), optik mikroskop, taramalı elektron mikroskobu (SEM) incelemeleri yapılarak emaye kaplamalar karakterize edilmiştir. Ayrıca yapışma mukavemeti ve sülfürik asit korozyon dayanım testleri için test düzenekleri kurulmuştur. Emaye kaplamaların yapışma mukavemetleri, termal şok dirençleri ve sülfürik asit korozyonuna karşı dayanımları, kaplama kalınlığına ve kaplama yöntemine bağlı olarak incelenmiş ve aynı kaplama kalınlığı için kaplama yöntemine göre karşılaştırılmıştır.                 Sonuç olarak yapışma mukavemeti ve sülfürik asit korozyon dayanım testleri birlikte değerlendirildiğinde, 150±10 µm kalınlığında ve yaş kaplama yöntemi (hava destekli spreyleme) ile kaplanan emaye kaplamaların  daha yüksek yapışma mukavemetine ve sülfürik asit korozyon dayanımına sahip olduğu tespit edilmiştir.  Ayrıca kaplamasız düşük karbonlu çelik levhalar ile emaye kaplı çelikler levhalar kıyaslandığında, emaye kaplamanın çelik yüzey sertliğini ve çeliğin sülfürik asit korozyon dayanımını önemli ölçüde arttırdığı tespit edilmişitir.Today, due to decrease of fossil fuels and high costs of electricity generation, productivity in thermal power plants has become highly important. Rotary air preheaters are critical elements that reduce electricity generation costs by increasing the efficiency of thermal power plants. These heaters transmit heat of combustion gases to the cold combustion air in order to preheat it before the injection into the boiler. Thus, an additional energy is not consumed in order to heat combustion air required for the burning of fuel.   Rotary air preheaters provide heat conduction via the heat exchangers plates. Heat conduction is the most important parameter affecting the efficiency of rotary air preheaters. Higher heat conduction increases the efficiency of rotary air preheater, and thus thermal power plant efficiency is also increased. In the light of this information, improvement of the design of the heat exchanger plates, selection of suitable materials and coatings can be summarized as the studies that can be done for improving the efficiency of heat exchanger plates. Sulfuric acid corrosion is the most significant problem, which is encountered on the cold stage of rotary air preheaters. Formation of sulphuric acid on the metal surfaces can cause a severe sulphuric acid corrosion of heat exchanger plates and thereby significantly shorten the lifetime of the components of the heat exchanger plates. In addition, the integrity of corroded parts can be broken, which can cause the  disruption of heat conduction. This leads to a drop in efficiency in thermal power  plants, and therefore causes an increase in the cost of electricity generation. From this point of view, heat exchanger plates must be coated with a sulfuric acid-resistant protective coating. A possible way to limit this phenomenon is to discharge the flue gases at a temperature above the temperature of the Sulfuric Acid condensation (known as said above as “dew point” temperatures and proportional to the content of sulfur trioxide present in the flue gases themselves), jeopardizing however the energy saving and the efficiency of the boiler operation.  Unfortunately, the sulfuric acid corrosion is not only problem affecting the rotary air preheaters. Ash and unburned carbon particles deposited on the heat exchanger plates causes clogging of the channel between these plates. This phenomenon reduces the heat transmission quality. It is necessary to coat with a protective coating to prevent fouling of heat exchanger plates. Corroded heat exchanger plates should be changed as new ones. Avoid the frequent replacement of the heat exchanger plates operating at low temperatures, it means not only to save the direct cost due to the supply of new plates but also to avoid the others direct costs involved with the shutdown of the unit for the plates replacement. Increase of the operating life and the delay of plates replacement, has forced the technology to target a very well selected materials to be used in the manufacture of heat exchanger plates. For example, for the “hot” air preheaters layers (those still operating above the dew point), carbon steel is used for the exchange plates; this material is significantly corroded by sulfuric acid but the working temperature to which it is submitted, generally does not permit the acid condensation and the corrosion is quite limited. For the "intermediate" air preheaters layers (where they exist), either the carbon steel or the corten steel are used. Corten is a steel similar to the carbon steel where small amount of copper has been added. This element gives some resistance to the corrosion of the sulfuric acid. For the “cold” air preheaters layers (those that theoretically should work to the limit of the acid temperature condensation or below it), enameled steel is use for the heat exchange due sulfuric acid corrosion. Enamel coatings can be used as a successful protective coating for heat exchanger plates thanks to their high wear resistance, hardness, heat transmission coefficient and sulphuric acid resistance. Enamel is a material, which can be produced by mixture of frits and other constituents. Enamels main constituent is silica (SiO2). However, silica cannot be used as its original state due to its high melting point and thermal expansion coefficient. Also silica (SiO2) adhere to steel very poorly. Therefore, silica (SiO2) must be modified by adding various constituents in order to obtain an enamel. These various constituents can be categorized as refractories, fluxes, adhesion agents, opacifiers and coloring agents. Refractories are added to mixture of enamel to give amorphous structure and improve the mechanical strength. Alumina can be given as an example of refractories. Alumina (Al2O3) increases the hardness of the enamel. In addition, alumina (Al2O3) increases chemical and abrasion resistance of the enamel. Fluxes are added to mixture of enamel to reduce the melting and firing point of the enamel. Borax (Na2B4O7) and alkaline oxides such as oxides of sodium (Na2O), potassium (K2O), lithium (Li2O), calcium (CaO), magnesium (MgO) can be given as the examples of fluxes. Adhesion agents are added to mixture of enamel to ensure good adhesion steel/enamel interface. Adhesion agents are always added to ground-coat enamel. Nickel oxide (NiO), molybdenum oxide (MoO), cobalt oxide (CoO), copper oxide (CuO) can be given as the examples of adhesion agents. For an aesthetic appearance, opacifiers and colouring agents are added to mixture of enamel. Titanium dioxides (TiO2), antimony oxide (Sb2O5), zirconium oxide (ZrO2), tin oxide (SnO) are some of the examples of opacifiers and colouring agents. The heat exchanger plates used in thermal power plants, the problems encountered in these plates, enamel coating structure, enamelling types and enamel coating process were given in the literature section of the thesis.  In the experimental studies section, surfaces of  low carbon steel plates cleaned and thus they became ready for enameling. In addition, low carbon steel plates were characterized by determining chemical composition, and investigation of surface roughness, contact angle and the hardness values. After the characterization of  substrate materials finished, the enamel coating process started. As a first step in the enamel coating process, the enamel mixtures were prepared for wet and dry enamel coating methods. For wet enamel coating method, frits and other additives are mixed with water to obtain enamel slurry. For dry enamel coating method, frits mixed only with silicon oil to prevent powder agglomeration. The prepared wet enamel was applied on steel substrate by using air-assisted spraying method. The prepared powder enamel was applied on steel substrate by using electrostatic powder spraying method. For each method, enamel coating thickness value was 150 ± 10 µm and 250 ± 10 µm. After the coating process, enamel coated samples were fired.  Enamel coatings were characterized by using X-ray diffraction (XRD), optical microscope, scanning electron microscope (SEM). Bubble structure of enamel coating was examined by using optical microscope. Steel/enamel interface was examined by using scanning electron microscope (SEM). Hardness and surface roughness values of the enamel coatings were determined. In addition, testing apparatus were prepared for impact and sulfuric acid corrosion resistance tests. Adhesion strength of the enamel coatings examined by using impact test equipment and micro scratch tester. Adhesion strength, thermal shock resistance and sulfuric acid corrosion resistance of the enamel coatings were investigated depending on the coating method and thickness. In addition, the coating methods were compared for the same thickness.  As a result of this study, it was observed that enamel obtained by wet enamel coating method (air-assisted spraying) contains higher number of bubble in their structure compared to the enamel obtained by dry enamel coating method (electrostatic powder spraying). It was also found that bubble formation increases with increase in coating thickness. In addition, it was found that the most successful enamel coated samples were the ones which obtained by wet enamel coating method (air-assisted spraying) and 150 ± 10 µm thickness. This enamel coating has great sulfuric acid corrosion resistance and high adhesion strength. Moreover, it was understood that the hardness and sulfuric acid corrosion resistance of the steel surface could be improved with enamel coating.Yüksek LisansM.Sc

    Ülkeleri̇n ekonomi̇k göstergeleri̇ni̇n veri̇ madenci̇li̇ği̇ anali̇zi̇

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    Data Mining is becoming a famous analysis day by day to reveal the hidden information within big data. In the study, we use data mining techniques on the economic indicators of the countries. The four data mining techniques are to be implemented on the dataset. Making homogenous groups of the countries whose economic characteristics are similar are obtained by the Clustering Algorithm. After the clustering algorithm is performed, we pass to Association Rule Data Mining to investigate the most exported products by Switzerland to the other countries. With the clustering and association rule mining, we complete the first stage of the data mining that is so-called as unsupervised learning. In the second stage, we build up both classification and regression models with panel data based on the new variables that are obtained by the Principal Component Analysis. The main aim of the second stage is to determine the most important economic predictor variables that have an effect on the grouping of the countries and have an effect on the main economic indicators such as Gross Domestic Product (GDP), Gross National Product (GNP), etc.Veri Madenciliği, verinin içinde saklı gizli bilgiyi ortaya çıkarmak için kullanılan ve günden güne popüler olan bir yöntemdir. Bu çalışmada, veri madenciliği yöntemleri, ülkelerin ekononomik indikatörleri üzerinde uygulanmaktadır. Dört veri madenciliği tekniği veri seti üzerinde uygulanmaktadır. Ekonomik açıdan birbirine benzeyen ülke gruplarının oluşturulması Kümeleme Algoritması ile elde edilmektedir. Kümeleme algoritmasından sonra, İsviçre tarafından dünyaya en fazla ihraç edilen ürünleri soruşturmak için İlişki Kuralları Veri Madenciliği kullanılır. Kümeleme ve İlişki Kuralı Veri Madenciliğiyle, veri madenciliğinin ilk kısmı olan ve denetimsiz öğrenme olarak adlandırılan kısım tamamlanmış olmaktadır. İkinci kısımda, veri boyutunu indirgemek amacıyla kullanılan Temel Bileşenler Analizi ile elde ettiğimiz yeni değişkenlere dayalı sınıflandırma ve panel veri ile regresyon modelleri inşaa ederiz. İkinci kısmın temel amacı, ülkelerin gruplandırılması ve Gayrı Safi Yurtiçi Hasıla ve Gayri Safi Milli Hasıla gibi ana ekonomik göstergeler üzerinde etkisi olan en önemli ekonomik tahmin edici değişkenleri belirlemektir.M.S. - Master of Scienc

    Late Cenozoic Geodynamic Evolution of Simav (Kutahya) and Surroundings

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    The Late Cenozoic geodynamic evolution of Simav (Kutahya) and surroundings was determined by dating active tectonic structures in the region (Simav Fault and Simav Detachment Fault) and granitic and volcanic rocks of the Egrigoz Magmatic Complex. Additionally it was revealed that the currently normal Simav Fault, in previous periods acted as a strike-slip fault according to dating studies of fault planes and field observations. Dating of the fault planes along the Simav Fault determined that initiation of the Simav Fault occurred in the interval between 19.3-26.1 Ma. In this period the Simav Fault demonstrated strike-slip fault behavior in a compressional regime. The results of dating studies of the Egrigoz and Koyunoba Plutons (21.9-26.3 Ma) reveal that the unroofing of these plutons was related to the Simav Detachment Fault (20.0-27.4 Ma). Additionally the presence of volcanism in the time period was identified (7.1-21.3 Ma). The Simav Fault which displayed previous strike-slip character currently has listric normal fault behavior after a tectonic regime change in the Plio-Quaternary. The transition from extensional-compressional regime to a regional extensional regime and cause of the tectonic regime change is thought to be related to the complex subduction process (slab-pull and and roll-back) between the African Plate and Anatolian Plate in the Eastern Mediterranean

    “Stay away from us!”: a research on the experience of stigma of individuals with covid-19

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    Covid-19 pandemisiyle toplulukçu bir yapıdan bireysele doğru bir kayma olmuştur. Bireyler daha az bir arada olma, kendini izole etme, toplumdan soyutlama gibi birtakım tedbirlerle karşı karşıya kalmıştır. Bu tedbirler her ne kadar sağlık durumunu iyileştirmeye yönelik olsa da sosyal bütünlüğün bozulmasına neden olmuştur. İnsanlar çok aşırı kurallara bağımlı hale gelerek kuralsızlıklara veya kendilerine hastalık bulaştıracağını düşündükleri şeylere karşı tahammülsüzleşmişlerdir. Bu durum da toplumun Covid-19 olan bireylere karşı ayrımcılık ve damgalama gibi çeşitli tepkiler geliştirmelerinin yolunu açmıştır. Buna binaen bu çalışmanın amacı Covid-19 hastalığını geçirmiş bireylerin süreçte yaşadıkları damgalanma tecrübelerini ortaya çıkarmaktır. Bu amacı yerine getirirken nitel araştırma yöntemlerinden fenomenoloji deseni kullanılmıştır. 15 katılımcıyla derinlemesine görüşmeler yapılmıştır. Elde edilen verilerin analizi sonucunda Covid-19 tanısı alan bireylerin tepkileri ve tedavi sürecinde yaşananlar şeklinde iki tema elde edilmiştir. Covid-19 sürecinde yaşananlar “çevreden destek görme” ve “damgalamalarla yüzleşme” şeklindedir. Covid-19 geçirmiş bireylerin hastalığı saklama ve paylaşma eğilimi içerisine girdikleri ve gerek ailesi tarafından gerekse sosyal çevre tarafından “kaçma”, “acıma”, “dışlama”, “etiketleme” gibi damgalayıcı davranışlarla karşı karşıya geldikleri sonucuna ulaşılmıştır.With the Covid-19 pandemic, there has been a shift from a collectivist structure to the individual. Individuals have faced some measures such as less togetherness, self-isolation and isolation from society. Although these measures were aimed at improving the health status, they caused the deterioration of social integrity. People have become too dependent on rules and have become intolerant of irregularities or things they think will infect them. This situation has paved the way for the society to develop various reactions such as discrimination and stigmatization against individuals with Covid-19. Based on this, the aim of this study is to reveal the stigmatization experiences of individuals who have had Covid-19 disease in the process. While fulfilling this purpose, phenomenology pattern, one of the qualitative research methods, was used. In-depth interviews were conducted with 15 participants. As a result of the analysis of the data obtained, two themes were obtained as the reactions of individuals diagnosed with Covid-19 and what happened during the treatment process. What happened during the Covid-19 process is in the form of "seeing support from the environment" and "confronting stigma". It has been concluded that individuals who have had Covid-19 tend to hide and share the disease and are faced with stigmatizing behaviors such as "escape", "pity", "exclusion", "labeling" by both their families and the social environment
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