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Authors at the boundary: Interaction of local and general scientific literature
No full textHow a scientific literature is shaped both at the local and general level is an important question to answer. One practical way of achieving this task is to identify the roles played by authors (academicians) as actors creating and disseminating knowledge in the relevant literature. To this end, this study examines roles undertaken by authors in the field of learning organizations. Identifying role typologies first requires revealing the author citation network in the field. Citation network is a matrix that summarizes citations and citation numbers between authors. To construct this matrix, articles in the local and general literature in the field of learning organizations, published and indexed between January 01, 2015 and February 20, 2017, were collected from Google Scholar by using the Java-based Selenium Library. An author citation network with 19,525 actors was created from this list. A social network analysis was conducted to identify author roles, followed by a discussion of what these roles mean for the local literature. Despite defining four typologies, observing only one type of role typology indicates that the local literature is not well integrated with the general literature. This study recommends strategic assessments for increasing the contribution ability of local literature to general one. Using this approach, it would be possible to find answers to the questions of which roles to develop via which authors and relationships, and how to remove the obstacles to development of local literature
FREQUENCY OF POLYPHARMACY AND RISK FACTORS IN THE ELDERLYIN BURDUR
No full textIntroduction: Polypharmacy is common among the elderly. This study aimed to determine the frequency of polypharmacy and the risk factors in the elderly.
Materials and Method: This cross-sectional study will be analysed in three stages (polypharmacy, drug characteristics and drug interaction). Herein, the first stage (polypharmacy) was conducted at Burdur city centre and the connected villages. A total of 400 of 11,360 subjects aged >= 65 years who were registered with family physicians in Burdur city centre were selected using a systematic sampling method. A questionnaire of 30 questions about socio-demographic variables and rational drug use was distributed among the subjects. Subsequently, the subjects were asked to bring their own drugs from home that they were actively using or not currently using, and their drug-using behaviour was analysed via specific questions.
Results: The average number of different drugs possessed by the subjects at home was approximately 6 (5.95 +/- 4.30). A total of 64.9% of the drugs were used regularly, 21.3% were used occasionally and 13.8% were previously used but not currently used. The median number +/- standard deviation of the drugs that were used regularly, used occasionally and previously used but not currently used was 3.86 +/- 3.36, 1.27 +/- 1.75 and 0.82 +/- 1.82, respectively. According to the results of multivariate analysis, the presence of diabetes, hypertension, respiratory system or cardiovascular (except hypertension) diseases, visual impairment or hearing disorders significantly increased the total drug use (p<0.05).
Conclusion: Chronic diseases and living in the city centre are the main risk factors leading to polypharmacy. Therefore, interventions must be undertaken by monitoring and reducing chronic diseases and providing training on rational drug use in the provincial centres
Comparison of Three Surgical Techniques in Pilonidal Sinus Surgery
No full textOur study aims to compare the surgical outcome of Limberg transposition flap, Karydakis flap, and primary closure after excision to treat sacrococcygeal pilonidal sinus disease. A total of 634 patients with pilonidal sinus who underwent surgery were evaluated retrospectively from January 2014 to January 2016. The patients were divided into three groups. Limberg transposition flap (LTF) was performed in 131 patients (group 1), Karydakis flap (KF) was performed in 232 patients (group 2) and primary closure (PC) after excision was performed in 271 patients (group 3). Patient demographics, operative and postoperative outcomes were recorded and analyzed retrospectively. The mean age (p=0.98), sex ratio (p=0.74) and removed sinus volume (p=0.67) were not statistically different between groups. Mean operative time was 54.3 ± 6.4 min for group 1, 46.8 ± 10.5 min for group 2, and 26.9 ± 5.8 min for group 3 respectively (p=0.01). When the length of hospital stay was compared, there was a significant difference in favor of primary closure (p=0.01). Regarding early surgical complication, Karydakis flap technique was superior to other groups (p<0.001). The recurrent rate was higher in the primary closure group (p<0.001). In our study, the primary closure method regarding the duration of surgery and hospitalization; Karydakis method regarding postoperative complications (seroma, hematoma, wound dissociation, infection, recurrence) were superior to the other two methods
Career Indecision and Career Anxiety in High School Students: An Investigation through Structural Equation Modelling
No full textPurpose: The purpose of this study is to investigate the relationship between career indecision and career anxiety (career anxiety in terms of the effect of family and choice of profession) in high school students through structural equation modeling (SEM). Research Methods: The method used in the study is the relational model. The study group consisted of 444 students studying at 11th and 12th-grades. Research data was collected using The Scale for Career Anxiety and Career Decision Inventory. Findings: According to the model established, it was concluded that career indecision had an important effect on career anxiety in terms of family effect and choice of profession. In other words, for high school students, as scores related to career indecision increased, their scores related to career anxiety they experienced in terms of family effect and choice of profession also increased. Implications for Research and Practice: In order to decrease career anxiety that high school students experience during the career decision process, it is suggested to determine reasons for career indecision, and to plan career guidance process. In addition, supporting occupational development process with family guidance and professional counseling studies, giving weight to counseling services within the scope of attention, abilities and occupational values, supporting career research, and creating opportunities would also support professional decision-making skills. By this way, difficulties in decision-making related to occupational indecision and career anxiety may be precluded. (c) 2018 Ani Publishing Ltd. All rights reserve
Neonatal effects of thyroid diseases in pregnancy and approach to the infant with increased TSH: Turkish neonatal and pediatric endocrinology and diabetes societies consensus report
No full textThyroid functions in the fetus and newborn carry importance in terms of the baby’s health and development of the central nervous system. Maternal iodine deficiency, exposure to iodine, thyroid diseases (Hashimoto thyroiditis, Graves’) and drugs used by the mother affect thyroid functions in the fetus. Reflections of these effects are observed immediately after delivery. Investigation of the mother in terms of thyroid diseases during pregnancy, recognition and appropriate assessment of the required conditions, screening of all newborns in the first days of life in terms of congenital hypothyroidism, timely and appropriate evaluation of the screening results, early diagnosis and appropriate treatment of cases of congenital hypothyroidism, assessment and management of cases of transient thyroid hormone disorders and close monitoring of the thyroid functions and development of patients in whom treatment has been initiated with a diagnosis of hypothyroidism are crucial in terms of developmental outcomes of the babies who have thyroid function disorders or hypothyroidism. This guideline was written with the objective of guiding pediatricians, neonatologists and pediatric endocrinologists in the issue of assessment, diagnosis and management of thyroid function disorders and thyroid diseases concerning the fetus and baby during gestation and neonatal period. © Copyright 2018 by Turkish Pediatric Association
A single-center experience of post-transplant lymphoproliferative disorder (PTLD) cases after pediatric liver transplantation: Incidence, outcomes, and association with food allergy
No full textBackground/Aims: We evaluated our 16-year single-center experience of pediatric post-transplant lymphoproliferative disorder (PTLD) cases who underwent liver transplantation between 2001 and 2017.
Materials and Methods: Of the 236 pediatric patients who underwent liver transplantation between 2001 and 2017, the clinical and laboratory data of eight patients diagnosed with PTLD were reviewed. The pre-transplant Epstein-Barr virus (EBV) status of 172 patients was also recorded.
Results: The total incidence of PTLD was 3.4%. The incidence of PTLD was 10% in pre-transplant EBV immunoglobulin G (IgG)-seronegative patients and 0.8% in pre-transplant EBV IgG-seropositive patients. The mean age of the patients at liver transplantation was 2.71 +/- 3.21 years, and four patients were aged below 1 year at the time of transplantation. PTLD was diagnosed at 21.81 +/- 18.1 months after transplantation. The primary site of involvement was variable among patients: peripheral and mediastinal lymph nodes, stomach and intestine, transplanted graft, bone marrow, and nasopharynx. The eosinophil count varied greatly among patients, with a mean value of 524.62 +/- 679/mm3. Three patients had a food allergy and were administered an elimination diet at the time of PTLD diagnosis. Six patients had PTLD of B-cell origin. One patient died due to neutropenic sepsis during chemotherapy, whereas seven patients were followed up in full remission for 7.75 +/- 4 years.
Conclusion: PTLD is a life-threatening complication of solid-organ transplantation with a heterogeneous clinical spectrum. Food allergy had a close association with PTLD. A close follow-up of patients with risk factors and an early diagnosis with appropriate treatment may lead to a better outcome
Prevalence of Anal Incontinence and Constipation in Female Patients with Urinary Incontinence
No full textObjective: To investigate the prevalence of anal incontinence and constipation in patients with urinary incontinence.
Materials and Methods: Adult female patients who presented with the complaint of urinary incontinence were evaluated with anal incontinence and constipation assessment survey prepared on the basis of "the International Consultation on Incontinence Questionnaire-Short Form", "the Overactive Bladder 8-Question Awareness Tool" and "the Rome 3" criteria.
Results: Two hundred female patients with urinary incontinence were evaluated. The patients were in the age group of 18-88 with the average age of 55.24 +/- 16.86 standard deviation. Stress incontinence was present in 19.5%, urge incontinence in 36% and mixed incontinence in 44.5% of the subjects. Seventy-seven percent of patients presented with flatal incontinence, 7.5% with fecal incontinence and 52.5% presented with constipation. There was no difference between sub-groups created according to age groups and types of urinary incontinence in terms of frequency of gastrointestinal symptoms. The incidence of constipation was statistically significantly higher in patients presenting with findings of urinary incontinence for more than 1 year and in those with overactive bladder (p< 0.01 and p< 0.001, respectively).
Conclusion: Flatal incontinence was found in 77%, fecal incontinence in 7.5% and constipation in 52.2% of female adult patients with urinary incontinence. The incidence of constipation was higher at the level of statistical significance in patients presenting with findings of urinary incontinence for more than 1 year and in those with overactive bladder
A Structural Model for Students' Adoption of Learning Management Systems: An Empirical Investigation in the Higher Education Context
No full textWith the recent advances in information technologies, Learning Management Systems have taken on a significant role in providing educational resources. The successful use of these systems in higher education is important for the implementation, management and continuous improvement of e-learning services to increase the quality of learning. This study aimed to identify the factors affecting higher education students' behavioral intention towards Learning Management Systems. A research model was proposed based on the belief factors of the technology acceptance model; namely perceived usefulness, perceived ease-of-use and external factors including self-efficacy, enjoyment, subjective norm, satisfaction, and interactivity and control. Then, a self-reported questionnaire was distributed online. A total of 470 higher education students participated in the survey. The proposed structural model was assessed and validated using structural equation modeling, in particular the partial least square method. The predictors of behavioral intention were identified as perceived usefulness, perceived ease of use, enjoyment, subjective norm, satisfaction, and interactivity and control with the validated structural model. The relationships between the influencing factors provided an insight about the students' behavioral intention towards the use of Learning Management Systems. It is expected that the academicians and practitioners will benefit from the design and findings of the current study in their future research
Rationale and design of the EACVI AFib Echo Europe Registry for assessing relationships of echocardiographic parameters with clinical thrombo-embolic and bleeding risk profile in non-valvular atrial fibrillation
No full textThe European Society of Cardiology (ESC) guidelines for management of atrial fibrillation (AF) recommend the use of CHA(2)DS(2)VASc risk score for assessment of thromboembolic (TE) risk, whereas the stratification of bleeding risk should be obtained by HAS-Bleed to balance the most appropriate anticoagulation (OAC) therapy. However, men with CHA(2)DS(2)VASc score=1 and women with CHA(2)DS(2)VASc=2, who are at intermediate TE risk, represent a grey zone where guidelines do not provide a definite OAC indication. Accordingly, implementation of risk stratification with echocardiography could be extremely useful. Both prospective and cross-sectional studies on transthoracic echocardiography (TTE) prediction of TE events and studies utilizing transoesophageal echocardiographic parameters as surrogate markers of TE events makes sustainable the hypothesis that echocardiography could improve TE prediction in non-valvular AF. Moreover, considering the close association of AF and stroke, all echo-Doppler parameters that have shown to predict AF onset and recurrence could be useful also to predict TE events in this clinical setting. Accordingly, EACVI AFib Echo Europe Registry has been designed as an observational, cross-sectional study, with the aim of evaluating: (i) left atrial (LA) size and function together with left ventricular geometry, systolic and diastolic functions in paroxysmal, persistent, and permanent AF; (ii) relationships of structural/ functional parameters with clinical TE and bleeding risk profile. By the AFib Echo Europe Registry, we expect to collect data on echocardiographic phenotype of patients with AF. The large data set accumulated will be useful to test the level of agreement of different echocardiographic measurements with the available risk scores
Risk Factors for Fatal Pulmonary Hemorrhage following Concurrent Chemoradiotherapy in Stage 3B/C Squamous-Cell Lung Carcinoma Patients
No full textWe aimed to identify the fatal pulmonary hemorrhage- (FPH-) related risk factors in stage 3B/C squamous-cell lung carcinoma (SqCLC) patients treated with definitive concurrent chemoradiotherapy (C-CRT). Medical records of 505 stage 3B/C SqCLC patients who underwent 66 Gy radiotherapy plus 1-3 cycles of concurrent chemotherapy with available pretreatment thoracic computerized tomography scans were retrospectively analyzed. Primary end-point was the identification of FPH-related risk factors. Examined factors included the basal patient and tumor characteristics with specific emphasis on the tumor cavitation (TC) status, tumor size (TS) and cavitation size (CS), tumor volume and cavitation volume (TV and CV), relative cavitation size (RCS = CS/Ts), and relative cavitation volume (RCV=CV/TV). FPH emerged in 13 (2.6%) patients, with 12 (92.3%) of them being diagnosed 0.14 (37.5% versus 11.1% for RCV 0.14. Diagnosis of >90% FPHs <= 12 months of C-CRT stresses the importance of close and careful follow-tip of high-risk patients after C-CRT for multidisciplinary discussion of possible invasive preventive measures