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Equity in assessment: Addressing systemic barriers for visually impaired students
No full textThis qualitative study explores barriers that visually impaired students face in Turkey's highstakes educational assessments, employing the social model of disability. Through semistructured interviews with 24 visually impaired adults (aged 20-42), three themes emerged: (1) Accessibility and Accommodation Challenges, including inadequate braille materials, inaccessible exam centers, and untrained readers; (2) Lack of Teacher Training, reflecting educators' unpreparedness and discriminatory attitudes; and (3) Technological Solutions and Gaps, where assistive tools like screen readers are beneficial but limited by cost and infrastructure. Findings reveal how Turkey's assessment system, rooted in a medical model, perpetuates inequities, particularly for low-income students. Inconsistent accommodations, such as extra time and reliance on poorly trained readers, hinder equitable participation. The study proposes standardized accommodations, universal design for learning (UDL)-based teacher training, and state-funded technologies to transform assessment practices. Focusing on visually impaired students' voices challenges normative paradigms and contributes to global discourses on inclusive education. Turkey's experiences offer lessons for low- and middle-income countries (LMICs), where resource constraints mirror these barriers, and high-income nations, where inconsistent implementation persists. The findings advocate a social-relational model, redefining disability as a product of structural obstacles, and call for proactive, inclusive assessment systems worldwide
Disaster Awareness and Attitude with a Focus on Social Work: Are We Ready?
No full textDisasters, both natural and man-made, occur unexpectedly and can profoundly impact communities based on their nature, origins, and resulting damage. Disasters affect public health. Enhancing global communication networks, conducting disaster awareness studies, and developing disaster prevention and warning systems are essential for combating disasters. The competency and knowledge of professionals involved in disaster management are crucial, with social workers playing a critical role in both combating and responding to such crises. Integrating multidimensional disaster awareness into undergraduate education is a key strategy within T & uuml;rkiye's disaster prevention policies. This study assessed the disaster awareness and attitudes of senior social work students in Ankara, engaging 300 undergraduate participants. The findings indicated that female students exhibited greater disaster awareness, and that prior disaster experiences positively influenced both awareness levels and the willingness to join crisis intervention teams. Participation in first aid training significantly enhanced disaster-related attitudes, with those who experienced loss in disasters reporting higher cognitive, affective, and behavioral scores than those who did not. Furthermore, training in psychosocial support positively impacted disaster awareness. The results underscore the need to refine undergraduate social work education to align with national disaster policies. The study is expected to contribute to the social work literature both nationally and internationally
Pediatric myxoma case diagnosed with acute arterial ischemia and ischemic stroke and its management
No full textÇenelerde İlaçlara Bağlı Gelişen Osteonekroz Teşhisi ve Alternatif Tedavi Yöntemleri
No full textMRONJ’ın patogenezine dair kesin kanıtlar bulunmamaktadır ve genel kabul görmüş bir tedavi yöntemi mevcut değildir. Kemik remodelasyonunun baskılanması, mekanik hasarın azalmasına ve nekrotik kemik alanlarının birikmesine neden olur. Terapötik dozlarda kullanılan bifosfonat türevi ilaçlar, osteoklastların rezorptif aktivitesini inhibe ederken osteoblastların farklılaşmasını ve kemik yapımını da etkiler. Bu durum, kemik yenilenmesini bozar ve azalan kemik remodelizasyonu nedeniyle avasküler nekroz riskini artırır. MRONJ tanısında; Tip I Kollajen C-terminal Telopeptid (CTX), N-terminal Telopeptid (NTX), TRACP 5b, RANKL/OPG oranı, Total Alkalen Fosfataz (TALP), Kemik Spesifik Alkalen Fosfataz, Kemik Sialoproteini, Piridinolini, Deoksipiridinolini ve Hidroksiprolin gibi kemik yıkım belirteçleri değerlendirilmektedir. Bilgisayarlı tomografi (BT), MRONJ’nin değerlendirilmesinde standart yöntemlerden biridir. Tedavi ise ağrının giderilmesi, yumuşak ve sert dokulardaki sekonder enfeksiyonun kontrolü ve nekrozun ilerlemesinin önlenmesini hedeflemektedir. Parathormon, PRP, lazer, ozon tedavisi, kemik morfogenetik proteinler, pentoksifilin ve floresan boyama rehberliğinde cerrahi debridman gibi alternatif tedavi yöntemleri araştırılmaktadır. Bifosfonatlara alternatif olabilecek ilaçlar arasında denosumab, stronsiyum ranelat, teriparatid, EDTA ve stromal vasküler fraksiyon hücreleri (SVF) yeralmaktadır. Ancak bunların kesin protokol haline gelmesi için daha fazla çalışmaya ihtiyaç vardır. Diş hekimlerinin bu ilaçların etkileri ve olası komplikasyonları konusunda bilgilendirilmesi önemlidir.There is currently no specific evidence regarding the pathogenesis of MRONJ and no definitively accepted treatment. Inhibition of bone remodeling is thought to lead to reduced mechanical damage and the resulting accumulation of areas of bone necrosis. When used in therapeutic doses, bisphosphonates inhibit the resorptive activity of osteoclasts, while stimulating the differentiation and bone deposition of osteoblasts. As a result, the bone regeneration mechanism is impaired and the risk of avascular necrosis increases as a result of decreased bone remodeling. Bone resorption markers type I Collagen (Ctx) C-Terminal Telopeptide, Type I Collagen (NTX) N-Telopeptide, Tetrate Resistance Acid Phosphatase Isoform 5b (TRACP 5b), Nuclear Receptor Activator (RANKL) / Osteoprotegerin (OPG), Total Alkaline Phosphatase It has been reported that BRONJ is diagnosed by examining (Talp), Bone Specific Alkaline Phosphatase, Bone Sialoprotein, Pyridnoline, Deoxypyridnoline, Hydroxyproline values. CT is considered a standard method in the evaluation of MRONJ. Treatment of medication-induced osteonecrosis of the jaw basically aims to relieve pain, control secondary infection in soft and hard tissues, and minimize the progression of bone necrosis. Alternative treatment methods for MRONJ such as parathormone, platelet-rich plasma, laser applications, ozone treatment, use of bone morphogenic proteins, pentoxifylline, and surgical debridement guided by fluorescent staining method are also mentioned. The drugs that may be alternatıve to bıphosphonates are Denosumab, Strontıum Ranelate (Sr), Teriparatide, Edta, Stromal Vascular Fractıon Cells (Svf) but further studies are needed to be accepted as a definitive protocol. Despite the complications of bisphosphonate group drugs, their use is widespread and increasing due to their numerous indications. Informing dentists about the mechanism of bisphosphonate-derived drugs, denosumab and anti-angiogenic drugs the treatment of MRONJ and alternative drugs to these group drugs are important for the management of complications that develop due to these drugs
Crafting wellness: exploring the effectiveness of a single-item mental health measure for young children and their mothers
No full textBackgroundRecognizing the integral role of parental emotional and behavioral health in shaping a supportive family environment crucial for a child's emotional well-being, a practical tool for evaluating mental health in both preschool children and their mothers are necessary. In this methodological study conducted across eight provinces in Turkey, we aimed to develop and assess the psychometric properties of a single-item mental health measure for physically healthy children aged 2-5 years and their mothers.MethodThe study included 411 child-mother pairs recruited from tertiary care hospitals, with subjects selected from well-child departments. Various psychometric assessments were employed, including the Strengths and Difficulties Questionnaire (SDQ) for children, Depression, Anxiety, and Stress Scale (DASS-21), Patient Health Questionnaire-4 (PHQ-4) for mothers, and single-item measures for both child and maternal mental health [mother-reported mental health of child (MRCMH) and self-reported mental health of mother (SRMH)]. Data were collected at two time points: baseline evaluation for validity testing and test-retest evaluation at the 3rd week.ResultsThe MRCMH indicated excellent validity, with sensitivity and specificity for detecting borderline and abnormal mental health difficulties in children at 90%, 100%, and 83%, respectively. The SRMH revealed sensitivity and specificity of 62% and 78% for identifying maternal depression, 57% and 76% for anxiety, 63% and 76% for stress, and 54% and 87% for psychological distress, respectively. Construct validity analyses revealed significant correlations between MRCMH and SDQ scores, as well as between SRMH and DASS-21 and PHQ-4 scores. Test-retest reliability, assessed through intraclass correlation coefficients, indicated varying agreement levels, with the highest agreement observed for SDQ total difficulties and the lowest for SRMH. Further exploration of the measures' sensitivity and specificity revealed noteworthy accuracy in detecting child mental difficulties and maternal psychological distress. Correlational analyses between baseline and 3-week scores highlighted the stability of MRCMH and SRMH over time.ConclusionThis research contributes valuable insights into the psychometric properties of single-item measures for child and maternal mental health, offering a potential tool for clinicians and researchers. The outcomes can inform public health strategies and interventions aimed at promoting positive mental health outcomes in preschool children and their mothers
Energy Entrepreneurship, Sustainability, Innovation and Financing: Practical Applications and Future Directions
No full textFactors Affecting Survival in Older Patients on Enteral Nutritional Support
No full textAims: The effects of clinical and laboratory characteristics on survival outcomes in older patients receiving enteral nutrition (EN) support are unclear. Methods: We analysed the effects of clinical characteristics, comprehensive geriatric assessment scores and duration of nutritional support use on the survival outcomes of older patients who received enteral nutritional support in our Geriatrics Clinic. Results: Three hundred and thirty-nine patients were analysed, of whom 211 (62.2%) were female. The median age was 81 years (range: 65-102). Oral nutritional support was given to 321 (94.7%) patients, and 18 (5.3%) were given nutritional support via percutaneous endoscopic gastrostomy (PEG). The median MNA-SF, ADLs, IADL, MMTs and GDS-SF scores were 8 (1-14), 5 (0-6), 4 (0-8), 22 (0-30) and 5 (0-15), respectively. Male sex (HR = 2.403, 95% CI = 1.355-4.273; p = 0.003), older age [75-84 vs. 65-74 years; HR = 2.960, 95% CI = 1.010-8.677; p = 0.048 and > 85 versus 65-74 years; HR = 5.504, 95% CI = 1.854-16.335; p = 0.002], higher LDH (HR = 1.004, 95% CI = 1.002-1.006; p < 0.001), lower IADL score (HR = 1.215, 95% CI = 1.102-1.336; p < 0.001) and shorter ENS duration (HR = 1.269, 95% CI = 1.122-1.436; p < 0.001) were associated with worse survival. With a 1-month reduction in the enteral feeding period, the risk of death in the 5th month increased by 1.215 times, and the risk of death in the 10th month increased by 1.171 times; this effect diminished over time. The median survival of patients on nutritional support via PEG was 12 +/- 2.9 months (range 6.2-17.7). The 1-year survival rate in the PEG group was 50%, and the 3-year survival rate was 12%. In the ONS group, the 1-year survival rate was 78%, and the 3-year survival rate was 55%. Conclusions: Our results suggest that male sex, older age, high LDH levels, low IADL scores and shorter ENS duration may be associated with adverse survival outcomes in older patients receiving EN support
Biyoloji Temelli Tasarım Yaklaşımları: Canlı Organizmaların Tasarım Disiplinlerine Dahil Edilmesi
No full textBu makale, biyolojinin tasarımla kesişimini ele alarak miselyum, alg ve bakteri gibi canlı organizmaların tasarım uygulamalarındaki potansiyelini araştırmaktadır. Çalışmada, literatür taramasına dayalı nitel bir yöntem izlenmiş; yapı endüstrisi, mimarlık, ürün ve malzeme tasarımı alanlarıyla biyolojinin kesiştiği örnek projeler incelenmiştir. Bu kapsamda çalışma, biyotasarımın tasarım disiplinlerine getirdiği yenilikçi bakış açılarını disiplinler arası bir perspektifle değerlendirmekte ve doğayla birlikte üretim anlayışına dair özgün bir çerçeve sunmaktadır. Bulgular, canlı organizmaların tasarıma entegre edildiğinde çevresel etkilere uyum, düşük enerji tüketimi ve biyolojik olarak parçalanabilirlik gibi avantajlar sunduğunu; ancak bakım ihtiyacı, dayanıklılık gibi sınırlılıkların da bulunduğunu ortaya koymuştur. Sonuç olarak, biyotasarımın sadece ekolojik değil, düşünsel bir dönüşüm sunduğu ve doğayla iş birliğine dayalı disiplinler arası tasarım stratejileri geliştirmek için önemli bir potansiyel taşıdığı değerlendirilmiştir.This article explores the intersection of biology and design by examining the potential of living organisms such as mycelium, algae, and bacteria in design practices. A qualitative methodology based on literature review is adopted, focusing on exemplary projects where biology intersects with architecture, construction, product, and material design. The study evaluates biodesign from an interdisciplinary perspective, offering a framework for nature-driven production approaches. Findings reveal that integrating living organisms into design enables environmental adaptability, low energy consumption, and biodegradability, while also presenting limitations such as maintenance needs and material durability. Ultimately, the research suggests that biodesign provides not only ecological but also conceptual and cultural transformation, holding potential for developing design strategies based on cooperation with nature
Pelvik organ prolapsusu olan kadınlarda semptomatik rahatsızlık düzeyi ile temporomandibular ekleme ait parametrelerin ilişkisinin incelenmesi
No full textAmaç: Çalışmamızın amacı, pelvik organ prolapsusu (POP) olan kadınlarda temporomandibular ekleme (TME) ait parametrelerin semptomatik rahatsızlık düzeyi üzerindeki etkisinin incelenmesidir. Yöntemler: Tanımlayıcı epidemiyolojik araştırma olarak planlanan çalışmamıza, uzman bir hekim tarafından POP tanısı alan 50 kadın dâhil edildi. Katılımcıların POP’a ilişkin semptomatik rahatsızlık düzeyi “Pelvik Organ Prolapsusu Distres Envanteri-6 (POPDE-6)” ile değerlendirildi. TME’ye ait parametreler kapsamında masseter kası üzerindeki tetik nokta varlığı palpasyon yöntemi ile, TME’ye ait hareketlerin değerlendirilmesi cetvel ile, TME’nin fonksiyon kısıtlılığı ise “Çenenin Fonksiyon Kısıtlanma Skalası-20 (ÇFKS-20)” ile bir kereye mahsus olmak üzere değerlendirildi. İstatistiksel analiz, POPDE-6 bağımlı değişken, TME’ye ait parametreler ise bağımsız değişkenler olarak ele alınarak çoklu regresyon analizi ile gerçekleştirildi. Bulgular: ÇFKS-20’nin POPDE-6 üzerinde istatistiksel olarak pozitif yönde anlamlı bir etkisi (p=0,008, B=0,386); sol lateral hareketin ise POPDE-6 üzerinde negatif yönde anlamlı bir etkisi (p=0,012, B=-0,472) bulunurken, TME ait diğer parametrelerin POPDE-6 üzerinde istatistiksel olarak anlamlı bir etkisi bulunmadı (p>0,05). Sonuç: Çalışmamızın sonuçları, TME’ye ait parametrelerin POP’a ait semptomatik rahatsızlık düzeyi üzerinde farklı etkiler göstermesi nedeniyle, klinikte POP tanısı alan bireylerde TME’ye ait parametrelerin de değerlendirilmesinin gerekliliğini vurgulamaktadır.Aim: The aim of this study was to investigate the effect of temporomandibular joint (TMJ) parameters on the level of symptomatic discomfort in women with pelvic organ prolapse (POP). Methods: 50 women diagnosed with POP by a specialist were included in this descriptive epidemiological study. The symptomatic discomfort level of the participants was evaluated with the “Pelvic Organ Prolapse Distress Inventory-6 (POPDI-6)”. Within the scope of the parameters of TMJ, the presence of a trigger point on the masseter muscle is determined by palpation method, TMJ movements by a ruler, and the functional limitation of TMJ is measured by “Jaw Function Limitation Scale-20 (JFLS-20)”. It was evaluated on a one-time basis. Statistical analysis was carried out by multiple regression analysis, considering POPDI-6 as the dependent variable and TMJ parameters as independent variables. Results: While ÇFKS-20 had a statistically significant positive effect on POPDE-6 (p=0,008, B=0,386); left lateral movement had a significant negative effect on POPDE-6 (p=0,012, B=-0,472), other TMJ parameters had no statistically significant effect on POPDE-6 (p>0.05). Conclusion: The results of this study emphasize the necessity of evaluating TMJ parameters in individuals diagnosed with POP in the clinic, since TMJ parameters have different effects on the symptomatic discomfort level of POP