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Item Evaluation of Cardiopulmonary Resuscitation Knowledge Levels of Physiotherapists in Turkey(2023) Kilic, Rabia Tugba; Mese Buranse, Melike; Yosmaoglu, Hayri Baran; 0000-0001-7356-8500; IVH-4699-2023Purpose: The aim of this study was to evaluate the knowledge level of physiotherapists working in Turkey about Cardiopulmonary Resuscitation (CPR).Methods: It is a cross-sectional study conducted between August and October 2021. Data were collected by sending an online questionnaire form to a total of 275 physiotherapists, 164 (59.63%) male and 111 (40.37%) female, who agreed to participate in the study. In order to evaluate the level of CPR knowledge, the questionnaire prepared by taking the 2010 American Heart Association-European Resuscitation Council CPR guideline as a guide, consists of 26 questions and is self-administered.In the first part of the questionnaire, 5 questions containing personal information (age, gender, institution of employment, duration of employment, etc.); in the second part, there are 12 questions on the perception of CPR training and its value, and in the third part, 10 questions aiming to measure the current knowledge level about CPR. In the CPR knowledge score, 0-5 points range was evaluated as low, 6-10 point range was evaluated as high.Results: The most work setting was the hospital (41.50%) and the main scope of work was the musculoskeletal system (37.80%). While the rate of those who encountered a CA case anywhere was 28.40%, this rate was 20.70% in the work setting. Most of the participants (67.30%) had received CPR training. While 59.50% of those who received training found the training incompetent in CPR practice, 71.90% found themselves. CPR certificate was not related to field of study, age, gender and years of experience (p > 0.005). The rate of CPR certification among those working at the hospital was higher than those working at the university(p=0.014). The mean theoretical CPR knowledge score was 5 +/- 0.12, which showed that CPR knowledge levels were low.CPR knowledge score; It was higher in those who received CPR training than those who did not, and those who considered themselves competent in CPR practice compared to those who did not see it as sufficient (p=0.001).Conclusion: Our results showed that the majority of physiotherapists have CPR certification, but the majority of those with CPR certification have insufficient knowledge of CPR and feel incompotent in this regard.Future research that wishes to better evaluate the practice of CPR should evaluate physical therapists' actual CPR competence with hands-on methods rather than a theoretical assessment.Item Evaluation of the COVID-19 Rapid Antigen Test(2023) Sanli, Ozlem Oguc; Kuscu, Ozlem Ozkan; Incekas, Caner; 0000-0001-7899-0233; 0000-0001-9019-423XIntroduction: Coronavirus disease, is an infectious disease caused by the SARS-CoV-2. The gold standard method to diagnose is the reverse transcriptase polymerase chain reaction test. Rapid antigen tests can also be used for diagnosis. This study aims to compare the results of these two methods.Materials and Methods: Between November 2021 and July 2022, the study included 1811 patients who visited the emergency depart-ment with coronavirus-related symptoms and signs. Respiratory samples from these patients were simultaneously evaluated using both reverse transcriptase polymerase chain reaction and rapid antigen tests. The reverse transcriptase polymerase chain reaction tests were conducted using the BioSpeedy SARS-CoV-2 reverse transcriptase polymerase chain reaction kit (Bioeksen-Turkiye), while the rapid antigen tests were performed using the RapidForTM SARS-CoV-2 Ag (Vitrosens-Germany).Results: The comparison of the reverse transcriptase polymerase chain reaction test and rapid antigen test results showed a 90.67% sensitivity, 98.28% specificity, 91.27% positive predictive value, 98.15% negative predictive value, and 97.02% (1757/1811) accuracy. Qualitative results of both tests exhibited a very good agreement (Kappa= 0.892, p< 0.001). According to the reverse transcriptase polymerase chain reaction test, the sensitivity of the rapid antigen test was found to be 100% in 28 samples with a cycle threshold <17, 100% in 78 samples with a cycle threshold <20, 98.33% in 120 samples with a cycle threshold <22, and 96.28% in 215 samples with a cycle threshold <25.Conclusion: When the results of the study are evaluated, it is seen that the use of the rapid antigen test for screening purposes and confirmation of patients with negative test results by Reverse transcriptase polymerase chain reaction will provide advantages in terms of both time and cost. Due to the low sensitivity and high positive predictive value of the vitrosens rapid antigen test, we think that this test can be used in the first stage to accelerate the diagnosis of patients with high viral load, who are more likely to be infectious, to prevent transmission and to start their treatment quickly.Item The Effect of Scapular Stabilisation Exercises on Posture and Pain in Patients with Fibromyalgia: A Randomised Controlled Trial(2023) Polat, Hakan; Bayramlar, Kezban; Turhan, Begamhan; 0000-0003-0842-2059; B-8254-2018Background/Aims Fibromyalgia is a complex syndrome characterised by chronic widespread pain, postural problems, sleep disorders, fatigue and psychiatric disorders. This study investigated the effect of scapular stabilisation exercises on cervical posture and pain in patients with fibromyalgia.Methods The study included 59 patients between the ages of 18-60 years. Individuals were divided into two groups: the study group (n=29) and control group (n=30). Both groups underwent hot pack application, transcutaneous electrical nerve stimulation and ultrasonography before the exercises. This application continued for a total of 6 weeks in both groups, 5 days a week. After this treatment, the control group was asked to perform conventional shoulder exercises and the scapular stabilisation group was asked to perform scapular stabilisation exercises. The patients were evaluated in terms of pain and cervical posture.Results Pain levels significantly decreased in both groups after the treatment (P=0.019). A decrease in tragus-to-wall distance occurred in the conventional exercise group (P=0.005). Scapular stabilisation exercises were found to be more effective than conventional exercises In terms of pain (P<0.001) and cervical posture, (P=0.024).Conclusions Both exercise programmes reduced pain levels in patients with fibromyalgia. However, scapular stabilisation exercises were more effective at both reducing pain and improving posture. Physiotherapists can use scapular stabilisation exercises to patients with fibromyalgia to reduce pain, improve posture and reduce the load on the joints.Item Evaluation of Colposcopy After the Addition of Human Papillomavirus Testing to the Turkish Cervical Cancer Screening Program(2023) Gunes, Ali Can; Ozgul, Nejat; Turkyilmaz, Murat; Kara, Fatih; Unlu, Fahriye; Ayhan, Ali; Gultekin, Murat; 37994572Objective: To evaluate colposcopy performance following the human papillomavirus (HPV) DNA screening program in Turkey. Methods: Women aged 30-65 years are screened for cervical cancer every 5 years, with individuals positive for HPV 16 and/or 18 or other high-risk HPV types with abnormal cytology referred for colposcopy. Both HPV test and cytology are obtained at the same visit. If HPV is negative, cytology will not be assessed. However, if HPV is positive, both cytology and HPV genotyping will be performed. Colposcopy-require was defined as HPV 16/18 positivity or abnormal smear results with any hrHPV positivity, and the remaining patients (normal smear with hrHPV positivity other than HPV 16/18) were grouped as colposcopy non-required. National data on colposcopy outcomes and unnecessary performance rates in February 2018-2019 were evaluated via a questionnaire. Results: A total of 9808 patients were included, divided based on colposcopy requirement: 5751 (58.6%) patients required colposcopy and 4057 (41.4%) did not. Unnecessary colposcopy was performed on 90.1% of the non-required group (3657 of 4057 patients). In the colposcopy-required group, 4455 patients (79.9%) underwent punch biopsy; 3194 (57.1%), endocervical curettage (ECC); and 421 (7.5%), "see and treat" in the non-required group, the results were 2790 (76.3%), 1957 (53.2%), and 211 (5.7%), respectively. A total of 746 cervical intraepithelial neoplasia (CIN)-3 isolates were detected, including 702 using existing screening and triage with 94.1% sensitivity (702/746). Multiple biopsies were taken in 69.8% (n = 3110) of patients from the colposcopy-required group and 63.7% (n = 1777) from the non-required group. The ECC samples included 19 cervical cancers and 212 >= CIN-3 lesions in the colposcopy-required group, and four cancers and 41 >= CIN-3 lesions in the non-required group. The proportion of >= CIN-3 lesions detected by ECC only was 4.7% (35 of 746 >= CIN-3 lesions). Conclusion: Our results showed high rates of unnecessary colposcopies, and a high percentage of multiple and random punch biopsies and ECC.Item The Effect of Suture Materials with Different Absorption Times on Isthmocele: A Retrospective Study(2023) Yetkinel, Selcuk; Aytac, Pinar Caglar; Kalayci, Hakan; Cok, Tayfun; Durdag, Gulsen Dogan; Yaginc, Didem Alkas; Baran, Safak Yilmaz; Alemdaroglu, Songul; Kilicdag, Esra Bulgan; 0000-0002-2165-9168; 0000-0002-5064-5267; 37306162; AAL-1530-2021; AAC-9940-2020; AAI-9594-2021Objectives: With the increasing rate of cesarean operations, the formation of niches and related early and late complications have been observed more frequently. In this study, we examined the effects of using a suture material that can be absorbed faster than conventional sutures on the formation of niches.Material and methods:This study was designed as a retrospective study and completed with a total of 101 patients. During the cesarean operation, the uterus was closed with Rapide Vicryl center dot in 49 patients and Vicryl center dot in 52 patients. The uterine niche was measured with a sonohysterogram 6 months after the operation. The primary outcome of the study was determined as uterine niche formation and the secondary outcome was the post-menstrual spotting (PMS) rate.Results: Duration of surgery, intraoperative/postoperative blood loss, and hospitalization time were similar between the two groups. Niche formation was significantly lower in the Rapide Vicryl group (22.4%) when compared to the Vicryl group (42.3%) (p = 0.046). Also, PMS was observed significantly lower in the Rapide Vicryl group (16.2% and 52.8% in Rapide Vicryl and Vicryl groups, respectively; p = 0.002).Conclusions:The formation of niches and associated PMS rates were less with suture materials that were absorbed faster.Item Return and Volatility Connectedness in Electronic Warehouse Receipt Market of Turkey(2023) Acikgoz, Turker; 0000-0002-5613-1929; IYJ-0960-2023Over the course of the last century, globalization and integration have increased significantly around the world. The rise in economic and financial globalization and integration has increased the connectedness between national economies and financial markets and secured an important place in the systemic risk spillover. It is important to analyze the issue in terms of different markets. Food prices around the world have increased significantly over the last 20 years. The price and volatility increase associated with food products lead to important socioeconomic and social problems. In this context, it will be important for decision-makers to assess the issue from the perspective of financial markets and to understand and reveal the dynamic structure of food commodity markets. This study aims to examine the connectedness of return and volatility in the Electronic Warehouse Receipt (EWR) market, where agricultural commodities are traded in Turkey, and to analyze its dynamic structure that changes over time. In this study, the Diebold-Yilmaz connectedness measurement method based on the forecast error variance decomposition after the VAR (p) model was used to analyze the connectedness between financial assets. According to the results of the static analysis performed, it was observed that while the return connectedness in the EWR market is very low, the volatility connectedness is at a higher level than the return connectedness. Based on the results of the dynamic analysis, no trend was observed in return connectedness; however, rapid increases and decreases were observed for certain periods. On the other hand, while an increasing trend was observed in the dynamic analysis of volatility connectedness, sudden increases and decreases were observed during periods of crisis. Of all agricultural commodities, it was observed that barley was the asset that sent the most net shock into the system. The EWR market in Turkey has come up recently. The market's structure, dynamics, and synchronization with other markets are still at a low level. The spillover effect of return and volatility shocks in the market are also low. The findings of this study can be used by producers, financial market participants and various decision makers for risk management, hedging and profit maximization purposes.Item The Turkish Clinical Microbiology and Infectious Diseases Society (KLIMIK) Evidence-Based Guideline for the Diagnosis and Treatment of Brucellosis, 2023(2023) Simsek-Yavuz, Serap; Ozger, Selcuk; Benli, Aysun; Ates, Can; Aydin, Mehtap; Aygun, Gokhan; Azap, Alpay; Azap, Ozlem; Basaran, Seniha; Demirturk, Nese; Ergonul, Onder; Kocagul-Celikbas, Aysel; Kuscu, Ferit; Saricaoglu, Elif Mukime; Sayin-Kutlu, Selda; Turker, Nesrin; Turkoglu-Yilmaz, EmineAlthough brucellosis is very common in the world and Turkiye, there are no evidence-based guidelines to guide the diagnosis and treatment of the disease. This guide has been prepared by the Turkish Society of Clinical Microbiology and Infectious Diseases to provide evidence-based recommendations to physicians from different specialties interested in the diagnosis and treatment of brucellosis. The recommendations of the Clinical Practice Guide Development Guide of the Infectious Diseases Society of America (IDSA) were taken as the basis for preparing this guide. The guideline preparation group determined 20 questions considered to be important in the diagnosis and treatment of brucellosis, and the publications that could answer these questions prepared in PICO (Population/Patient [P], Intervention [I], Comparison [C], Outcome [O]) format, were searched in ULAKBIM Tr Dizin, PubMed, Cochrane databases without date restrictions. The Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) Working Group method was used to rank the evidence and determine the strength of the recommendations for each PICO question and for each individual outcome. Meta-analyses of comparative clinical studies were performed to answer the PICO questions. Individual participant data (IPD) meta-analyses with data obtained from case reports and case series were conducted in the absence of comparative clinical studies. It is planned to update the recommendations at regular intervals in line with the results of new studies.Item Validity and Reliability Study of the Unrealistic Family Expectations Scale in Turkish Culture(2023) Bali, Onur; Donmez, BurhanettinThe study aims to perform the validity and reliability analysis of Unrealistic Parental Expectations Scale in Turkish culture, developed by Imasa (2012). To do so, the scale was translated from English into Turkish language and validity and reliability analysis were conducted. Research data were collected from two different samples: the first sample consists of 229 and the second sample consists of 235 secondary school students. Validity of the scale was tested with exploratory and confirmatory factor analysis, and reliability was tested with Cronbach's Alpha internal consistency coefficient. The results of exploratory factor analysis indicated that while the original scale was consisting of 11 items in a single factor, the translated scale involved 10 items in a single factor explaining the 40% of variance of the structure. The confirmatory factor analysis data showed a good model-data fit of the scale's single factor structure. Concerning reliability, Cronbach's Alpha internal consistency coefficient was .83 for the first sample and .80 for the second sample. Therefore, the research findings show that the Turkish form of the Unrealistic Parental Expectations Scale is a valid and reliable measurement tool for determining secondary school students' perceptions of their parents' unrealistic academic expectations.Item The Changes with the New Legislations(2023) Bicakcioglu, Murat; Gedik, EnderOrgan transplantation is the most important option for the treatment of end-stage diseases. However, there is a large difference between the number of patients on the waiting list and the number of transplants performed. The gradual increase in this difference creates ethical problems related to organ transplantation. Ethical problems and other limitations require organ transplantation to be controlled by legal regulations. In our country, organ transplantation practice is carried out under the supervision of the state. Organ Transplant Practice Regulation has been updated by being published in the Official Gazette dated 09.12.2022 and numbered 32008. Possible end-of-life decisions in brain death are stated in accordance with the conditions of our country. "In cases where brain death is diagnosed, the organ preservation protocols applied are terminated in the absence of family or legal guardian approval regarding organ donation. In case of organ donation by the family or legal guardian, the organ preservation protocols needed for donor care are continued during the period until the transplantation of the organ to the waiting patient", and a solution has been presented to the intensive care physicians for the prognosis of the cases that donated or could not be donated.In the regulation in which the prerequisites of the brain death diagnostic criteria are specified, it is stated that the central body temperature should be =36 degrees C. With the new regulation, end-of-life decisions on brain death and changes made in relation to central body temperature have brought convenience in the diagnosis and follow- up process.Item Ethics and Clinical Communications(2023) Yesiler, Fatma Irem; Gedik, EnderThe diagnosis of brain death has medical, legal and ethical aspects. While the main determinant is the medical approach of the physician in terms of ethics, legal situations are also effective in the process. Non-harm, beneficence, respect for autonomy and justice are the principles that are widely accepted and form the basis of medical ethics. Understanding these principles is a must in order to talk about the ethics of brain death and organ transplantation. In the process of diagnosis and management of brain death, the physician should convey the process to the relatives of the patients in a clear and understandable language and in accordance with the educational-cultural levels of the relatives of the patients. The fact that the concept of brain death is misunderstood in the society or lack of knowledge creates social ethical problems. Special training should be given to health professionals for brain death awareness and early diagnosis, and their ability to resolve ethical problems should be strengthened. Human resources are of great importance in the diagnosis of brain death and in the process of organ transplantation from a cadaver. Communication skills are the mainstay of interaction within the clinic. Organ transplant coordinators should run the process smoothly by creating a bridge between the physician responsible for the case and the intensive care physicians. Such an approach will reduce ethical issues and ensure a successful diagnosis and donation process.