Dokuz Eylül Üniversitesi Hastanesi

The submental artery island flap is a versatile option in head and neck reconstruction. This flap may be used for the coverage of perioral, intraoral, and other facial defects, leaving a relatively acceptable donor-site scar. In this study, the submental region of 13 formalin-fixed cadavers was dissected bilaterally. Comprehensive anatomical information regarding the pedicle of the flap and its relationship with the important adjacent structures is provided. The mean values of the measurements of the facial and submental arteries were as follows: the facial artery was 2.7 mm in diameter at the origin, and it crossed the mandibular border 26.6 mm from the mandibular angle. The origin of the submental artery was 27.5 mm from the origin of the facial artery, 5.0 mm from the mandibular border, and 23.8 mm from the mandibular angle. The diameter of the submental artery was 1.7 mm at the origin. The artery was found mostly to course superficial to the submandibular gland. In one case, the artery passed through the gland. The total length of the submental artery was 58.9 mm. The artery anastomosed with the contralateral artery in 92 percent of the cadavers. The submental artery was deep to the anterior belly of the digastric muscle in 81 percent of the cases. This study presents detailed anatomical data about the location, dimension, and relationship of the facial artery, the submental artery, and the submental vein that may be useful during dissection of the submental artery island flap.

BACKGROUND: Hidradenitis suppurativa (HS) is a chronic, relapsing inflammatory disease of skin, characterized by recurrent draining sinuses and abscesses, predominantly in skin folds carrying terminal hairs and apocrine glands. METHOD: This study reviewed 54 sites in 27 patients with moderate to extensive chronic inflammatory skin lesions treated surgically in our hospital from 2004 through 2009, with a follow-up of at least 6 months. RESULT: A total number of 54 operative procedures were performed during the study period with 42% (23 sites) involving the axilla, 20% (11 sites) involving the gluteal area, %24 (13 sites) involving the perineal area and 12% (7 sites) involving the inguinal region. CONCLUSION: Conservative treatment methods have little or no effects especially on gluteal, perineal/perianal, axillary hidradenitis suppurativa. The morbidity associated with the established form of this disease is significant, and the only successful treatment is wide surgical excision.

The presence and distribution of lithium, which is used in a variety of applications in current technology and will be a strategic component in near future technology, has been investigated within the scope of some of Turkey's borate and non-borate Neogene basins and recent lakes. Clay samples from the Turkish borate deposits, Soma lignite basin, and Beypazari trona basin, and water samples from Acigöl, Salda, Yarisçi, Burdur, Egirdir, Tersakan, Bolluk, Karapinar (Acigöl), and Tuzgölü lakes were studied. Analytical results show that the lithium values obtained from clays of borate deposits vary between 0.17 and 0.58% Li2O, and lake water samples contain between 0.30 and 325 mg/l Li+. Lithium is mostly bounded in the clay minerals at the borate deposits. While, the Beypazari trona deposit has lithium between 10 and 46 ppm, the Soma lignite basin does not contain lithium. Therefore, lithium is mainly related to evaporatic formations. These lithium amounts indicate that both the waters of Tuzgölü lake and the clays associated with borate deposits are potential lithium resources, and that they may be considered for economic use in the near future. In western Turkey, geothermal sources mostly depend on the graben faulting system; they also contain minor amounts of lithium.

The aim of the research is to determine mobbing implications encountering in educational institutions andmethods of coping with mobbing. This study tries to make a realistic assessment about practices of mobbing and offers precautions against them. Sampling of research was education institutions. Participants arecomposed of instructors working in different education institutions. Purposive sampling method is used inthe study. Sampling techniques based on the criteria was taken into account for determining of workinggroup. Semi-structure interview is used in this study which covered qualitative data collection techniques.As a data collection tool is used semi-structured interview form developed by researchers. Draft of the semistructured interview form gets the final form through with the expert opinions. In this study, views of victims subject to mobbing implications in educational institutions are identified and problems encounteredby these victims in the mobbing process are investigated. The main finding of this study shows that the vi* Dr., esenaltunay@yahoo.com** Öğr. Gör., Dokuz Eylül Üniversitesi, gulsinoral@hotmail.com*** Prof. Dr., Uluslararası Kıbrıs Üniversitesi-Lefkoşe, myalcinkaya@ciu.edu.trews of victims of mobbing have similarities in terms of the main points of mobbing. However, these viewsof victims of mobbing display certain diversity in terms of sub-themes.

Self-directed learning is an important outcome of nursing education. Although problem-based learning is believed to facilitate self-directed learning, previous studies have reported conflicting results. This longitudinal survey explored the perceived changes in self-directed learning for 4 years in a baccalaureate nursing education program with an integrated problem-based learning curriculum. Fifty of 59 students (response rate, 85%) completed the Self-Directed Learning Readiness Scale at five different time points: at the beginning of each academic year and at program completion. Scores were significantly lower during the first academic year compared with other years, and fourth-year scores were significantly higher than in previous years. Scores on the three subscales (i.e., self-management, desire for learning, and self-control) increased significantly during the 4 years of the program. These findings support self-directed learning as a maturational process. Implications for nursing faculty and curriculum development are discussed.

Bu araştırmanın amacı Türkiye’deki üniversitelerde muhasebe alanında yapılmış kayıtlı ve ulaşılma olanağı bulunan yüksek lisans ve doktora tezlerinin; profilini, alana katkılarını, içerik ve konu açısından zaman içindeki yönelimini belirlemektir. Çalışma 1984-2012 yılları arasında muhasebe alanında yazılan ve erişime açık 656 lisansüstü tezi kapsamaktadır. Tezler içerik analizi yöntemi kullanılarak konularına, kullanılan yönteme, geliştirilen öneri ve alana katkı gibi belirli kriterlere göre incelenerek sınıflandırılmıştır. Araştırma verileri Excel programında değerlendirilmiştir. Veri toplama aracı olarak Yükseköğretim Kurulu Ulusal Tez Merkezi’nden yararlanılmıştır.

The aim was to evaluate the nutritional situation of patients admitted to the Postoperative Acute Care Unit using classic methods of objective anthropometry, systemic evaluation methods, and Nutrition Risk in Critically Ill (NUTRIC) score, and to compare them as a predictor of morbidity and mortality.At admission to the postoperative care unit, patients undergoing various surgeries were assessed for the following items: Subjective Global Assessment (SGA), Nutritional Risk Index (NRI), Nutritional Risk Screening (NRS)-2002, Mini Nutritional Assessment (MNA), Charlson comorbidity index (CCI), and NUTRIC score, anthropometric measurements, serum total protein, serum albumin, and lymphocyte count. Patients were monitored for postoperative complications until death or discharge. Correlation of complications with these parameters was also analyzed.A total of 152 patients were included in the study. In this study a positive correlation was determined between mortality and NRS-2002, SGA, CCI, Acute Physiology and Chronic Health Evaluation , Sepsis-related Organ Failure Assessment, and NUTRIC score, whereas a negative correlation was determined between mortality and NRI. There was a correlation between NUTRIC score and pneumonia, development of atrial fibrillation, delirium, renal failure, inotrope use, and duration of mechanical ventilation. In our study group of postoperative patients, MNA had no predictive properties for any complication, whereas SGA had no predictive properties for any complications other than duration of hospital stay and mortality.The NUTRIC score is an important indicator of mortality and morbidity in postoperative surgical patients. NRI correlated with many postoperative complications, and though SGA and NRS were correlated with mortality, they were not correlated with the majority of complications. MNA was determined not to have any correlation with any complication, mortality, and duration of hospital stay in our patient group.

BACKGROUND: The immune system in renal transplant (Tx), Continuous Ambulatory Peritoneal Dialysis (CAPD) and hemodialysis (HD) patients have been suppressed and antibody response to vaccination is weaker than that of the normal population. Additionally immune response to vaccination also differs from each other in aforementioned three groups resulting from different levels immunosuppression. In the present study, detection of antibody response to influenza vaccine as an indicator of the level of immunity in Tx, CAPD and HD patients was aimed PATIENTS AND METHODS: Forty-eight patients (17 Tx, 16 CAPD and 15 HD) and 10 healthy adults, as a control group were enrolled into the study. Purified, split-virus, commercial trivalent influenza vaccine (VAXIGRIP--Pasteur Merieux Connaught, single dose of 0.5 ml into the deltoid muscle) containing 15 microg of each hemagglutinin of A/Johannesburg/82/96 (H1N1), A/Nachang/933/95 (H3N2) and B/Harbin/07/94 (B) strains were administered to all subjects. Serum samples were collected before and 1 month after vaccination to determine antibody titers. Hemagglutination-inhibition test (HI) was applied for determination of antibody response. The antibody response against each strain was measured separately. In addition to measurement of antibody response, increments in antibody titer (n-fold increase in titer), proportion of patients with protective antibody levels and seroconversion levels were taken into account. Wilcoxon paired 2 test and Mann-Whitney U test were applied for statistical analysis. p < 0.05 was accepted as significance level. RESULTS: Significant increases in antibody titers for all three antigens were observed in the study groups after vaccination (p = 0.001). However, the increase in titer of H3N2 was lower in Tx, CAPD and HD patients than that of the control group (1.0-2.0 vs 5.00) (p = 0.01). The proportion of protective antibody titers and seroconvertions were increased after vaccination in all subjects. Proportions of patients with protective antibody titers after vaccination were lower in Tx, CAPD and HD groups in comparison to control group. CONCLUSION: Although antibody titers in Tx, CAPD and HD patients presented significant increases after vaccination, the proportions of patients with protective antibody titers were lower in comparison to control group. Tx, CAPD and HD patients should be vaccinated every year to be able avoid potential morbidity and mortality of the influenza infection. Trial of high dose vaccination protocols may be useful to increase the proportion of patients with protective antibody levels.

Apart from the fact that human-like robots are still one of the most interesting topics in science fiction, artificial intelligence (AI) continues to develop rapidly as a popular phenomenon for all sectors. Although the idea that this rapid rise of AI means the rise of humanity has been voiced by many, the point of how AI will affect humanity continues to raise doubts in certain parts of the society. In this study, it is aimed to determine the perceptions of middle school students, which are a part of the future of humanity, towards the concept of AI, on which many discussions have been made, through metaphors. The sample consisted of 339 seventh and eighth grade students of four secondary schools in the central districts of Afyonkarahisar and Izmir in the 2019-2020 academic year. This study used a qualitative approach utilizing metaphor analysis as a research tool to investigate phenomena. Participants were asked the complete the sentence “Artificial intelligence is like.................., because ..................” Data were analyzed using content analysis. Participants’ metaphors for AI were grouped under 11 categories: smart, brain, nature, security, humanistic, the dilemma of good and evil, service, object, technology, life, and time. The data obtained showed that the participants generally used positive metaphors to describe AI, that is, they had positive perceptions about AI. However, in this study, which focused on the AI perceptions of middle school students, all of the metaphors collected under 11 conceptual categories containing positive and negative perceptions were examined and interpreted separately. It is thought that educational computer systems can be designed to shape students' perceptions of AI. Teachers can consider students' perceptions of AI by using AI-assisted teaching and designing content to enhance students' learning skills.

Ama: Bu alma, hayat her boyutu ile derinden etkileyen gncel pandemi olan Covid-19 nceliklidir. Covid-19; Aralk 2019'da in'in Hubei blgesi bakenti Wu-han'da balamtr. 11 Mart 2020'de salgn "pandemi" olarak ilan edilmitir. Salgn, hepimizde

İnternetten sağlıkla ilgili bilgilere hızlı ve kolay bir şekilde ulaşabilmek mümkün hale gelmiştir. Bu durum e-sağlık okuryazarlığı ve siberkondri kavramlarını günümüzde önemli hale getirmiştir. Bu çalışma ile bireylerin e-sağlık okuryazarlığı ve siberkondri düzeylerinin demografik özelliklere göre farklılık gösterip göstermediğinin; ayrıca e-sağlık okuryazarlığı ile siberkondri düzeyleri arasındaki ilişkinin belirlenmesi amaçlanmıştır. Araştırma, Aralık 2019- Ocak 2020 aylarında İstanbul’da gerçekleştirilmiştir. Araştırma sonucunda katılımcıların yaşına, eğitim durumuna, medeni durumuna ve çalışma durumuna göre e-sağlık okuryazarlık düzeylerinin istatistiksel olarak farklılık göstermediği; ancak katılımcıların cinsiyetine göre e-sağlık okuryazarlık düzeylerinin istatistiksel olarak farklılık gösterdiği belirlenmiştir. Katılımcıların cinsiyetine, yaşına, medeni durumuna ve çalışma durumuna göre siberkondri düzeylerinin istatistiksel olarak farklılık göstermediği; ancak katılımcıların eğitim durumuna göre siberkondri düzeylerinin istatistiksel olarak farklılık gösterdiği belirlenmiştir. E-sağlık okuryazarlığı ile siberkondri düzeyleri arasında pozitif yönlü ve düşük düzeyde bir ilişki olduğu belirlenmiştir.

Hastane ortamnda ocuklar birok korku

Dünya nüfusu yaşlanırken bir sosyal politika aracı olarak yaşlı politikaları özel önem atfedilen konular arasında yerini almaktadır. Birleşmiş Milletler Teşkilatının İnsani Gelişme Raporları toplumda çocuklar ve engellilerin yansıra yaşlıların da afetlerde ve iklim değişikliği sonucu ortaya çıkan risklerden etkilenen en kırılgan gruplar olduğunu vurgulamaktadır. Yaşlı bireyler kronik hastalıkları, fiziksel engelleri, işitme ve görme kayıpları nedeniyle, normal yaşamlarında özel ihtiyaçlarını karşılarken yardıma gereksinim duyabilmektedir. Afet-acil durumlarda örneğin sıcak ve soğuk hava koşulları ile salgın hastalık durumları kronik hastalığa sahip yaşlı bireylerin sağlık durumunu kötüleştirmekte, hayatlarını tehdit etmekte özel olarak korunması gereken nüfus kesimini oluşturmaktadırlar. Afet riskleri altında diğer bireylere göre daha savunmasız ve kırılgan olduklarından, acil durum ve afetlerde hazırlık, afetler sırasındaki müdahale ve afet sonrası yardım mekanizmalarında yaşlılar ülkemizde de özel olarak ele alınması gereken dezavantajlı gruplardan biri olarak karşımıza çıkmaktadır. Bu çalışmada yaşlı bireylerin kronik hastalıkları ve fiziksel engelleri, genç bireyler göre yavaş hareket etmelerine neden olan kırılganlıkları (hassasiyetleri) nedeniyle özel durumları karşısında geliştirilen önlemler, uygulamalar ve sonuçlarının Dünya örnekleri ışığında incelenmesi ve ülkemiz için öneriler geliştirilmesi amaçlanmıştır. Çalışmada Amerika Birleşik Devletleri, Japonya’da ve Avrupa ülkelerinde belirli acil durum ve afetlerde yaşlı gruplara yönelik gerçekleştirilen hizmetler, alınan önlemler ve kurumsal yapı örnekleri incelenmektedir. Konuya yönelik ülkemizde yerel yönetimlerin, merkezi ve taşra teşkilatlarının yaşlı hizmetlerinin acil durum ve afetlerde yaşlı-duyarlı afet yönetimi planlama süreçlerinin geliştirilmesine yönelik öneriler sunulmaktadır. Sonuç olarak afet yönetimi ile uyumlu bir sosyal politika zemini her açıdan yerel afet müdahale kapasitesini ve toplumun afete dirençliliğini arttıracaktır.

Orbital exenteration is a surgical procedure that results in devastating functional and aesthetic losses. Many reconstructive techniques, ranging from spontaneous epithelialization to free flaps, have been described for orbital exenteration defects. The temporalis muscle flap is one of the most frequently used flaps to obliterate the orbital cavity, but only a small portion of the muscle can be used for this purpose because most of the muscle is used as the pedicle. The reverse temporalis muscle flap based on the superficial temporal vessels is a versatile flap by which the entire temporalis muscle can be elevated and carried to defects beyond the midline. The authors have used this flap for orbital reconstruction after exenteration in 6 patients with successful results. This flap enables placement of highly vascularized tissue that provides the reconstructive goals of primary healing, obliterates dead space with separation of the orbit from the nasal cavity or sinuses, provides the potential for early postoperative radiotherapy, and offers possible flaps that can be used in combination for complex, wide defects.

Anti-tumor necrosis factor alpha (TNF-alpha) inhibitors are effective in the treatment of various inflammatory rheumatic conditions. Increased risks of serious infections are the major issues concerning the long-term safety of these agents. We present a case of a young male Behcet's patient whose disease was complicated by cytomegalovirus (CMV) colitis. Colitis started 10 d after the third Infliximab dose and responded to the cessation of TNF blocking treatment and administration of ganciclovir. Tumor necrosis factor alpha and interferon gamma act at several levels in combating viral infections. CMV infections should be kept in mind and included in the differential diagnosis of severe gastrointestinal symptoms in patients receiving anti-TNF agents.

Studies on surgical repair techniques of the peripheral nerve are still trying to improve the outcome. There are many studies on the effects of various neurotrophic factors on the transected peripheral nerve. Muscular neurotization, which is the direct implantation of the nerve to the target denervated skeletal muscle, is one of the techniques used when the primary repair of the peripheral nerves is not possible. The effects of nerve growth factor (NGF), which is one of the primary neurotrophic factors, on the reinnervation of denervated muscles by neurotization is investigated in this experimental study. The denervated soleus muscle was neurotized via peroneal nerve implantation (group 1), and NGF was administered to the neurotized muscle (group 2). All animals were evaluated at weeks 8, 10, and 12 using electromyography. Muscle contractility, muscle weight, and histological morphometric tests were performed at week 12. The experimental groups were compared with each other and normal control values. Electromyographically, group 2 (direct nerve implantation + NGF) demonstrated better reinnervation in all evaluations. The study of muscle weight showed that the muscle mass was 75% of the normal soleus muscle in group 1 and was 85% of the normal side in group 2 at the end of week 12. In group 1, the twitch force was 56% of the normal soleus muscle and was 71% in group 2. Tetanic force was 53% of the normal soleus muscle in group 1 and 68% in group 2. Histological morphometric studies revealed that there was a decrease in the density of the motor end plates in group 1, but there was no statistically significant difference between the normal soleus muscles and the NGF applied to group 2. The positive effects of NGF on the neurotization of denervated muscles seen in this study suggest that it may be useful for treating some difficult reconstructions caused by denervation.

Bu çalışmada, Borsa İstanbul’da (BIST) işlem gören teknoloji şirketlerinin mali performansları TOPSIS (Technique for Order Preference by Similarity to Ideal Solution) yöntemi kullanılarak analiz edilmiştir. Çalışmada ilk olarak kullanılacak finansal oranlar belirlenmiş ve bu oranlar her şirket için ayrı ayrı hesaplanmıştır. Gerçekleştirilen analiz sonucunda 2010-2015 yılları arasında performans açısından en başarılı şirketler sırasıyla, ASELS, LINK, ARMDA, LINK, INDES ve DGATE şeklinde gerçekleşmiştir. Ayrıca, şirketlerin ilgili dönemlere yönelik finansal performanslar sıralamaları ile borsa getiri sıralamaları da analiz edilmiş ve herhangi anlamlı bir ilişki tespit edilememiştir.

Machine selection is an important and difficult process for the firms, and its results may generate more problems than anticipated. In order to find the best alternative, managers should define the requirements of the factory and determine the necessary criteria. On the other hand, the decision making criteria for choosing the right equipment may vary according to the type of the manufacturing facility, market requirements, and consumer assigned criteria. This study aims to find the best machine alternative among the three machine offerings according to twelve evaluation criteria by integrating entropy method with SAW method.

Bu almada lkemizde faaliyet gsteren ve ayn zamanda BST'de (Borsa stanbul) ilem gren otomotiv sektrnde faaliyette bulunan firmalarn performanslarnn ok kriterli karar verme yntemleri

The aim of the study is to develop a general attitude scale towards e-learning to measure students&amp;#039;general attitudes towards e-learning at the Faculty of Education. As a result of the literature review, a-50-attitude item was written for the first draft of the scale. 567 university students from Buca Faculty of Education studying at Dokuz Eylul University participated into the study. The literature was reviewed to be able to decide which methods should be used for the validity and reliability analysis. After applying different methods, the lower 27% and upper 27% group means difference and item-total correlation method were used for item elimination. After selecting items according to the criteria of having high t-value, factor analysis was used and Cronbach&amp;#039;s Alpha was calculated. Factor analysis showed that this 20-item e-learning attitude scale can be used both with single factor and two factors. Single factor of the general attitude towards e-learning scale explained %45.12 of the total variance. Two factors scale explained %52.23 of the total variance. Cronbach&amp;#039;s Alpha coefficient is 0.93 for single factor scale. These results indicated that general attitude scale towards e-learning was valid and reliable and can be used for measuring higher education students&amp;#039; attitudes towards e-learning.