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Background: Communication of people with Parkinson's disease (PwPD) is negatively affected. For PwPD with communication difficulties, it is important to use self‐assessment tools as a primary assessment approach to evaluate their perspectives on communication. It is also important to evaluate PwPDs with self‐assessment scales in order to determine in which situations their communicative effectiveness is affected and to include them in the intervention plan. Aims: To create a Turkish version of the Communicative Effectiveness Survey‐Revised (CES‐R), to examine its validity and reliability, and to investigate its applicability in PwPD. Method: The study included 106 PwPD and 106 healthy participants. The original form of the CES‐R was adapted into Turkish according to international guidelines. Every participant completed the Turkish version of CES‐R and the Voice Handicap Index‐10 form. The adapted scale was retested 2 weeks later. Outcomes and Results: Because the Kaiser‐Meyer‐Olkin coefficient was 0.956 in the exploratory factor analysis of the CES‐R and p < 0.01 for Bartlett's Test, the data set is 'perfectly' suitable for factor analysis. In the explanatory factor analysis applied in the CES‐R scale, the total explanatory ratio of the two dimensions was determined as 63.5%, and the validity condition was met. Cronbach's alpha coefficient was 0.958 in the PwPD group and 0.955 in the control group and the scale was found to be at the 'high reliability' level. Conclusion: The CES‐R is a valid, reliable, and useable self‐assessment scale for Turkish PwPD. Furthermore, this adaptation research was developed to assess possible communication difficulties for PwPD. With this tool, difficulties in communication skills that can be identified by a comprehensive evaluation should also be studied in the intervention processes. What this paper adds: What is already known on the subject: Self‐assessment tools are suggested as a primary use when evaluating people with Parkinson's disease (PwPD) with communication difficulties. The CES‐R is one of these self‐assessment scales. However, the validity and reliability study of the Communicative Effectiveness Survey‐Revised (CES‐R) in Turkish has not been conducted. What this paper adds to existing knowledge: This study demonstrates the validity and reliability of the Turkish CES‐R scale and its applicability to PwPD. Furthermore, this scale can be used in assessment procedures for possible communication difficulties for PwPD. What are the potential or actual clinical implications of this work?: The scale, which is unidimensional in the literature, was found to have two dimensions with eigenvalues > 1 in the Discovery Factor analysis in this study. The first dimension was named communication in general situations (CGS) and the second dimension was named communication in difficult situations (CDS). It is thought that this scale will be useful in research and clinics for the comprehensive assessment of PwPD with communication difficulties before and after treatment. [ABSTRACT FROM AUTHOR]

This study aimed to determine the prevalence of urinary tract infections in patients with urinary catheterization receiving home health services and the affecting factors. The population of this descriptive study consisted of patients who had lived in the central districts of Erzurum between February and March 2022, were actively registered to home health services, had a urinary catheter and met the research criteria. The period prevalence method (3 months) was used in the study, and 121 patients constituted the study sample. The study data were collected using a Sociodemographic and Information Form on Urinary Catheter. Before the home visit, patients' relatives were asked to clamp the urinary catheter. After completing the data collection forms, a sufficient amount of urine was taken from the attached urinary catheter, put into the urine and culture cup/tube, and labelled with a barcode. The samples were sent to the laboratory within 15 min at the latest. The medical specialist evaluated the results, and the necessary pharmacological treatment was delivered to the patient. Of the patients with indwelling urinary catheters who received home health services, 94.2% had a urinary tract infection. Moreover, it was determined that there was a statistically significant correlation between the presence of urinary tract infection in patients and the variables of constipation, frequency of perineal cleaning, and the use of toilet paper. It was concluded that the prevalence of urinary tract infections is very high in patients with urinary catheterization receiving home health services. [ABSTRACT FROM AUTHOR]

Background: Online collaboration tools have been identified as potentially effective means for enhancing student learning, motivation, and engagement in science education. However, their effectiveness in improving science education outcomes among middle school students remains uncertain. Objectives: The study aimed to investigate the impact of online collaboration tools on science education outcomes among middle school students, focusing on learning achievement, engagement, and motivation. Methods: A quasi‐experimental design with a pretest‐posttest control group was used in this study. A total of 60 eighth‐grade middle school students were involved in the study, with both the experimental and control groups comprising 30 students each. The experimental group incorporated the use of digital collaboration platforms, including Asana, Slack, and Team Viewer, as instrumental components of group project execution and discussion in their science lessons. Conversely, the control group adhered to the current educational approach in Turkey, characterized by the employment of an inquiry‐based learning strategy in their science instruction. Data was collected over eight weeks using a science achievement test, engagement scale, and science motivation scale. Results: The experimental group demonstrated significantly higher post‐test scores compared to the control group, suggesting that online collaboration tools positively impacted science education outcomes. Additionally, survey data indicated high levels of engagement and motivation among the experimental group students when using the online collaboration tools. Conclusions: The findings support the notion that online collaboration tools can effectively enhance learning, motivation, and engagement in science education among middle school students. These results have significant implications for educators, educational institutions, policymakers, and curriculum developers. Further research is needed to examine the potential of these tools in various educational contexts and with different student populations. This will help broaden the understanding of how online collaboration tools can be integrated into diverse learning environments, potentially benefiting a larger number of students and further improving science education outcomes. Lay Description: What is already known about this topic: Technology's role, particularly online collaboration tools, in enriching science education is undebatable (Donkin & Rasmussen, 2021; Rahmawati et al., 2022). Such tools have been theorized to bolster student learning outcomes, motivation, and engagement (Donnelly et al., 2013; Ekici, 2017; Khazanchi & Khazanchi, 2019). Yet, the empirical evidence validating their efficacy in science educational settings remains sparse. What this paper adds: This research delves into the influence of online collaboration tools on science learning outcomes among middle school learners. Data indicates that employing these digital tools substantially elevates student performance, as gauged by a science achievement test. Furthermore, students navigating through these online collaborative platforms recorded elevated levels of both engagement and motivation. The primary effectiveness of online collaboration tools stems from their ability to foster specific behaviours, such as increased communication frequency and structured task management, which can amplify learning and group collaboration through their facilitated structured interactions. Implications for practice and/or policy: This study's conclusions offer pivotal insights for educators, academic institutions, policy framers, and curriculum architects. Online collaborative platforms exhibit promise in amplifying student outcomes and engagement within the realm of science education. It is imperative to broaden this research scope to discern the tools' potential across varied educational environments and diverse student demographics. There is a compelling case for stakeholders, especially educators and policymakers, to contemplate incorporating these online tools into science pedagogy, aiming to magnify student learning experiences and engagement levels. [ABSTRACT FROM AUTHOR]

Although leisure constraints that individuals have to cope with can negatively affect their social inclusion and satisfaction with life, little research has addressed the link between these variables. Therefore, the current paper examined the moderator role of leisure constraints on the relationship between satisfaction with life and leisure constraints among adults living in five different European countries. The respondents were 1,382 women and 877 men adults. The findings of analysis revealed that all factors used in the study accounted for 15% of the variance in satisfaction with life and social inclusion had a significant and positive impact on satisfaction with life. As a result, it can be said that leisure constraints had a moderating effect on the relationship between satisfaction with life and social inclusion. The present research study recommends that social inclusion should be encouraged through decreasing to leisure constraints to increase the life satisfaction. [ABSTRACT FROM AUTHOR]

Background: There are deficiencies in ensuring the permanence of some theoretical information taught in nursing education and transferring it to practice environment. Mobile‐assisted teaching can be useful to eliminate deficiencies. The aim of this study was to determine the effect of mobile‐assisted teaching on nursing students' learning ventrogluteal injection. Methodology: The study was conducted in Turkey between February and June 2022. This study is a single group pre‐posttest intervention. The study sample consisted of 354 students studying in the 2nd, 3rd and 4th grades in Turkey. After the students completed the Introductory Characteristics Form and Ventrogluteal Region Information Suggestion Form in the pre‐test, the researchers sent a ventrogluteal injection animation video to their mobile phones. The students who watched the video completed the Ventrogluteal Region Information Suggestion Form and Mobile Education Activity Form in the final test. Results and Conclusion: There was a statistically significant difference between the pre‐posttest score medians of the students (p < 0.001). While the preference of the students for the ventrogluteal region in intramuscular injection was 28.5% before mobile learning, it increased to 51.1% after the training. In this study, after the training given through mobile learning, the knowledge level of the students about ventrogluteal injection and their preferences for ventrogluteal injection increased. In line with these results, mobile‐assisted education should be used in nursing education. Lay Description: What is already known about this topicDue to the high number of students per teaching staff in Turkey, it takes time for the theoretical education of the students to turn into practice.It is recommended that students prefer and use the ventrogluteal (VG) region for intramuscular drug injection.The students had difficulties because the nurses guiding them in clinical practice did not use the VG area.There are difficulties in applying the VG region injection in practice. What this paper addsMobile‐based intramuscular injection skill application increased the knowledge level of the students.Mobile applications make it easier to remember the learned information and apply it in the clinic. Implications for practice and/or policyMobile applications demonstrating skill practice provide a resource for nursing students to watch and learn whenever they want.It ensures that the student is always ready for invasive procedures to be performed on the patient in the clinic. [ABSTRACT FROM AUTHOR]

Background: Self‐assessments for adults who stutter are recommended as a primary evaluation tool for including their views on stuttering. Evaluating adults who stutter with self‐assessment scales is important. However, there is no tool in the Turkish literature that provides this measurement. Aims: To develop the Turkish version of The Wright and Ayre Stuttering Self‐Rating Profile (WASSP) in order to analyse its validity and reliability, and investigate its applicability for Turkish‐speaking individuals. Methods & Procedures: The study included 120 adults who stutter (aged 18–54 years). All the participants completed The Wright and Ayre Stuttering Self‐Rating Profile—Turkish version (WASSP‐TR) and the SF‐36 form. The reliability analysis involved the calculation of Cronbach's alphas for test–retest and the Pearson product‐moment correlation coefficient for internal consistency. The validity analysis, in turn, involved a confirmatory factor analysis for construct validity and testing correlations with the SF‐36 for criterion validity. Outcomes & Results: Internal consistency coefficients of the WASSP‐TR were reported to be high (> 0.70). The correlations between the WASSP‐TR and its subscales showed significant results (0.858–0.966) (p < 0.01). The correlation between the subscales of the WASSP‐TR and the SF‐36 was reported to be consistent (from −0.492 to 0.747). There was a positive correlation between stuttering severity groups and the WASSP‐TR scores (p < 0.01). Conclusions & Implications: The WASSP‐TR is a valid and reliable scale for Turkish‐speaking adults who stutter. What this paper addsWhat is already known on the subjectSelf‐assessment tools are recommended as a primary use when assessing adults who stutter. The WASSP is one of these measurement tools. However, the adaptation, validity and reliability study of the WASSP to Turkish has not been investigated.What this paper adds to existing knowledgeThis study shows that the Turkish version of the WASSP scale is valid and reliable and can be used with adults who stutter. Furthermore, the present adaptation study has been developed in order to evaluate social–emotional aspects of stuttering.What are the potential or actual clinical implications of this work?A tool that includes evaluating the behaviour, cognition, affect and participation areas as well as the stuttering behaviours of adults who stutter was adapted. This tool is expected to be useful for comprehensive evaluation of adults who stutter in clinics, in research and for pre/post‐therapy. [ABSTRACT FROM AUTHOR]

Background: Flipped classroom (FC) model has become increasingly popular in dental education (DE) with its strengths for students. However, major concerns are lack of interaction, unwillingness to complete the assignments, low engagement during the pre‐class activities because of an unwell‐designed instructional setting of FC. Objectives: The recent study aims to investigate the effects of video‐driven discussions integrated into the flipped classroom (VdDs‐FC) model on dental students' (DSs) learning achievement, practical performance, and higher‐order thinking skills in a restorative dentistry course. Methods: This study adopted a sequential explanatory design from mixed‐methods research. A total of 96 DSs participated in a dentistry faculty of Türkiye. They were randomly divided into two groups: VdDs‐FC group and the conventional flipped classroom (c‐FC) group. Results and conclusions: The results showed that the VdDs‐FC model had significant positive effects on the practical performance of DSs in practical subjects and their problem‐solving and critical thinking skills. However, there was no significant difference between the two groups in learning achievement and creativity. The use of FC in the c‐FC group did not lead to any difference in the students' achievements. Moreover, the qualitative results indicated that the VdDs‐FC model has the potential for enhancing peer learning, practical classroom activities, and higher‐order thinking skills. Implications: This study also includes several instructional implications and suggestions for educators, researchers, and practitioners on use of FC in dentistry. Lay Description: What is already known about this topic: Flipped learning has become a rapidly growing area of dentistry research.Discussion board could be beneficial to increasing dental students' higher order thinking skills, especially problem solving and critical thinking.Video‐driven discussions into flipped classroom provide several opportunities for practical performance in dental education, not for theoretical knowledge. What this paper adds: Video‐driven discussions into flipped classroom model is proposed.We compared two learning environments by including traditional flipped classroom.We found that the integrated model with flipped classroom can have a positive impact on students' achievement.Online discussions usage contributed to higher cognitive, affective, and behavioural learning outcomes.Based on interview data, the proposed model supports peer learning. Implications for practice and/or policy: Dental educators should integrated the digital discussion boards as out‐of‐class activities in the pre‐clinical dental training.From dental educators' perspective, they should be carefully trained in FC design (interaction elements, material design, integration with different methods, etc.).From instructional design perspective, micro videos should have case‐based or problem‐based activities to discuss.From learner perspective, an integration of the flipped classroom with different technologies could have a positive effect on increasing learning. [ABSTRACT FROM AUTHOR]

Background: Turkish has a rich system of noun suffixes, and although its complex suffixation system may seem daunting, it can actually present a learning opportunity for children. Despite its unique features, Turkish has not been studied extensively, especially in the case of children with language deficits, such as developmental language disorder (DLD). Most of the extant studies are focused on bilingual children, and the results are somewhat mixed. Aims: To focus on the noun morphology system of Turkish‐speaking preschoolers with DLD and compare their use with that of two groups of typically developing (TD) children. Moreover, to investigate the nature of their noun suffix errors in detail. Methods & Procedures: We report data from a total of 80 monolingual children, 40 children with DLD (age range = 4;0–7;10), 20 TD age‐matched children (4;0–7;3) and 20 younger mean length of utterance (MLU)‐matched children (2;0–4;3). The data for this study came from language samples obtained from children in individual clinical assessment sessions. Outcomes & Results: The children with DLD made less use of noun suffixes than both the younger and the age‐matched TD children. The use of the unmarked (nominative case) form in place of an overt suffix was the most likely error by all groups. Suffix‐change alternations required beyond vowel harmony seemed to pose real problems for these children. Conclusions & Implications: These results suggest that even when a language appears to provide significant advantages for the learning of noun morphology, children with DLD do not succeed in closing the gap. Certain factors such as morphophonological changes beyond vowel harmony, multiple allomorphs for the same suffix type and accusative suffixes that are not uniformly applied in the adult input were found to be significant predictors of the DLD group's difficulty with noun suffixes. Because these same factors can serve as characteristics of other languages, a child's difficulties might seem to be language specific (e.g., a particular allomorph in the language), but may actually be based on a broader difficulty (e.g., dealing with multiple allomorphs for the same suffix). Accordingly, factors that transcend a single language should be considered during clinical assessment and therapy. What this paper adds?What is already known on this subject?The current literature on the use of noun suffixes by Turkish‐speaking children with DLD is very limited. Although Turkish is often described as a learner‐friendly language, the degree to which children with DLD enjoy these learning benefits is unknown.What does this paper add to existing knowledge?Turkish children with DLD are less accurate in noun suffixes than both age‐matched and younger control groups. For this group, the central problem seems to be increased complexity in morphophonology rather than difficulty with suffixation more generally.What are some of the clinical applications of this study?For clinicians who work with Turkish‐speaking children with DLD, priority should be given to morphophonology. These children would benefit from treatment that focuses on how to attach different allomorphs to different open‐class words. Because factors such as morphophonological complexity operate in other languages, the findings have broader clinical implications. In particular, regardless of the target language, clinicians should consider the possibility that these broader factors, rather than language‐specific details, are the basis for a child's difficulty. [ABSTRACT FROM AUTHOR]

Background: There is a scarcity of studies on online flipped learning in teacher education classes. Many studies have found that student learning is improved in flipped learning environments; however, this is still an open question. Much of the literature employs quantitative methods to reveal the effect of flipped learning on certain variables such as engagement, performance, and so on, but there have been few studies that investigate the Community of Inquiry variables perceived by learners in flipped learning environments. Objectives: This study investigated the levels of teaching, social, and cognitive presence of teacher candidates in an online flipped learning community, whether these variables were related to academic achievement, and teacher candidates' experiences with the online flipped learning approach. Methods: A case study research design was used in this study. Without any face‐to‐face meetings, the course was delivered using an online flipped learning approach. While quantitative data were collected from 34 teacher candidates, 16 teacher candidates participated in the qualitative part of the study. Focus group interviews, an open‐ended questionnaire, a Community of Inquiry Scale, and teacher candidates' course grades were used to collect data. Both descriptive and content analysis were used to analyze the data. Results and Conclusions: In the current study, effective online flipped learning design fostered teaching presence, with perceived teaching presence having the highest mean and perceived social presence having the lowest. Course videos prepared by the instructor, as well as synchronous activities such as peer presentations, questions, and video discussion, all contributed to cognitive presence through the practice of theoretical knowledge. Although none of the variables in the community of inquiry were related to academic achievement, computer‐based games like Kahoot contribute to a positive online flipped learning community. Many benefits of online flipped learning have been stated, including providing active, flexible, autonomous, and interactive instruction through the use of technology, creating a fun learning environment, and increasing perceived learning and interaction with the instructor. Lay Description: What is already known about this topic: The contribution of flipped learning to achievement is still an issue open to discussion.There are limited studies investigating the Community of Inquiry variables perceived by learners in flipped learning environments.Instructors need effective flipped learning designs, especially for teacher candidates as teachers teach the way they have been taught.Face‐to‐face learning activities are the driving force behind effective flipped learning which is replaced by synchronous meetings in online flipped learning. What this paper adds: This study adds to limited research related to the online flipped learning model in teacher training learning environments.This study uses both quantitative and qualitative methods to investigate how teacher candidates perceive Community of Inquiry variables (teaching presence, social presence, and cognitive presence) in the online flipped learning environment.This study designs an effective online flipped learning course with online plays and synchronous activities.This study reveals the experiences of teacher candidates in terms of activities, their contribution to learning, communication, and community of inquiry perceptions. Implications for practice and/or policy: Effective online flipped learning designs foster teacher presence.Synchronous activities should include peer presentations, questions, or jigsaw activities to increase social and cognitive presence.Course videos prepared by the instructor contribute to cognitive presence through the practice of theoretical knowledge in synchronous meetings.Computer‐based plays such as Kahoot contribute to a positive online flipped learning community. [ABSTRACT FROM AUTHOR]

The aim of this study was to investigate the effect of using dynamic geometry software (GeoGebra) on the eighth‐grade students' conceptual understanding and the retention of learning regarding linear equations and slope. In this study, a quasi‐experimental design with pre‐test, post‐test and delayed post‐test was employed. This study was conducted with 52 eighth‐grade Turkish students (experimental group, n = 25; control group, n = 27). While GeoGebra software‐supported instruction was carried out in the experimental group, textbook‐based direct instruction was continued in the control group. Data were collected with the conceptual understanding test (CUT) which consists of 38 questions including open‐ended, multiple choice and fill in the blanks. CUT was applied to the experimental and control groups as a pre‐test and post‐test at both the beginning and the end of the instruction, respectively. Seven weeks after the instruction, CUT was applied to both groups as a retention test. Data were analysed through SPSS 17.0 statistical software by using a t‐test and ANCOVA test. It was indicated in the study results that GeoGebra software‐supported instruction for eighth‐grade students regarding linear equations and slope did significantly improve both their conceptual understanding and retention of learning in comparison to textbook‐based direct instruction. Lay Description: What is already known about this topic?: The subject of functions and their graphs are the basis of many mathematical concepts and subjects such as logarithm, limit, derivative and integral.It is indicated in many studies that middle‐grade students have some misconceptions and difficulties in learning the concept of a straight line and slope.It was determined in previous studies conducted at different grade level that using dynamic geometry software (DGS) increases students' mathematics achievement according to traditional instruction.There is a need for research investigating the effect of using GeoGebra software on eighth grade students' conceptual understanding and retention of learning regarding linear equations and slope. What this paper adds?: A quasi‐experimental design with pre‐test, post‐test and delayed post‐test was conducted.Using GeoGebra software had positive effects on eighth‐grade students' conceptual understanding regarding linear equations and slope.The learning environment with GeoGebra software increased the retention of learning. The implications of study findings for practitioners: This research provided evidence regarding the effects of using GeoGebra software on eighth‐grade students' conceptual understanding and retention of learning in mathematics.In future studies, the long‐term effects of GeoGebra on other mathematics topics and other learning outcomes within similar settings should be examined. [ABSTRACT FROM AUTHOR]

This study aims to investigate how working memory (WM) performances and instructional strategy choices affect learners' complex cognitive task performance in online environments. Three different e-learning environments were designed based on Merrill's (2006a) model of instructional strategies. The lack of experimental research on his framework is the main argument of this paper. The participants' WM processes with the n-back task scores were used for defining their WM performances. This study is designed as repeated measures. Thirty-five undergraduate students completed complex cognitive tasks three times. According to their WM groups, the participants were assigned to experimental conditions randomly by counterbalancing. The main results of the study indicated that although no performance differences were observed in complex cognitive tasks across instructional strategies, there was a statistically significant change observed across WM groups in favour of those who had high WM performances. The interaction effect did not have an effect on participants' overall performance. These results indicate that cognitive differences lead to different outcomes when the instructional design is set to be the same for all. Therefore, it is concluded that instructional design choices could take individual cognitive differences into account when developing adaptive e-learning environments. Lay Description What is already known about this topic: E-learning environments are often considered to be complex environments mainly because of their navigational nature (i.e., design of hyperlinks and the tools embedded within the system for personal and collaborative use)., Yet, from the learners' perspective, it is not clear whether it is the content or merely the design choice that could make the online environment (more) complex., Moreover, cognitive differences play a crucial role during individuals' interactions with(in) the course materials., When measuring the performance on cognitive tasks, working memory (WM) performance is a strong predictor., What this paper adds: The literature on Merrill's instructional strategies which is one of the instructional models in designing how to teach complex tasks is mainly limited to conceptual discussions., Using different instructional strategies did not significantly change individuals' performances when dealing with complex cognitive tasks., Individuals with high level working memory performance performed significantly better., Implications for practice and/or policy: Cognitive differences lead to different outcomes when the instructional design is set to be the same for all., Studies in the field of mind, brain and education (MBE) may provide additional necessary tools not only for practitioners but also for instructional designers to better design personalized e-learning environments in the future. [ABSTRACT FROM AUTHOR]

This study aimed to investigate the effects of augmented reality (AR) activities on students' academic achievement and motivation in a biology course. For this purpose, a mixed study was conducted, and a pretest and posttest control group model was used. In addition, the opinions of the experimental group students and the teacher about the AR activities were taken, and classroom observations were made during the study. The study group consisted of 40 (22 female and 18 male) ninth‐grade biology course students. The control group followed the biology course programme, whereas the experimental group students conducted AR activities in addition to the course programme using tablets. Consequently, it was found that the motivation of the students in the experimental group increased more than that of the students in the control group. However, no significant difference was found between the academic achievement scores of the groups. The teacher and the students stated that AR activities might be effective in increasing course success and motivation. Lay Description: What is already known about this topic: Biology is one of the fields that cover too many abstract and invisible contents.Abstract and invisible course contents cause misunderstandings and low academic achievement.Augmented reality (AR) technology stands out with its visualization feature.AR appears to be an effective technology for making invisible subjects visible and giving concrete examples for abstract content in biology education.What this paper adds: AR activities could positively affect students' motivation in biology courses.Students' perceptions of the augmented reality into classroom are highly positive.AR activities raise students' participation to the course.However, AR does not significantly affect students' academic achievement.Implications for practice and/or policy: More long‐term and interaction‐based AR activities in a school with proper infrastructure might influence students' academic achievement positively.AR materials that have better image quality, more interesting design for students, and more interactivity will increase the effectiveness of instruction.It could be beneficial to use more AR technology when preparing curricula and textbooks. [ABSTRACT FROM AUTHOR]

Learning letters is an important area of language learning, conducive to the beginning of reading and writing. Indeed, today's generation prefers to learn through digital games rather than through formal teaching processes. Inspired by this need, the researcher designed this study (a) to test the effectiveness of an instructional digital game, "Kes Sesi," designed to teach letter recognition skills and (b) to briefly present its instructional development process, which was based on the ADDIE model. This was a quasi‐experimental study with two treatment groups and a control group involving 87 kindergarteners. Treatment groups played the game for 12–6 weeks for learning, 6 weeks for practice. The control group continued with its regular class activities. One treatment group played the game based on predefined sound categorization, the other without any categorization. A test on children's sound recognition abilities was administered three times as a pretest, a midtest, and a posttest. The treatment groups performed significantly better than the control group. The game enhanced the kindergarteners' ability to practice uncategorized content while it enhanced their ability to learn categorized content. The results are promising in that Kes Sesi can be useful in self‐supported learning contexts with little adult input and with minimum outside interference. Lay Description: What is already known about this topic: Learning letters is an important area of language learning, conducive to the beginning of reading and writing.There is a variety of research studies on digital games for learning in the literature.It is a challenge to teach preschool children letters. What this paper adds: There seems to be a gap when it comes to experiments on kindergarteners' early reading skills.Although there are many relevant games in the market, there are no studies investigating kindergarteners' sound recognition skills through game playing on mobile technology.This study has its unique feature in terms of providing a sample article on "Design, development and application of learning tools and systems," which is a topic within the Journal's scope. Implications for practice and/or policy: Digital educational games such as "Kes Sesi" can be useful in self‐supported learning circumstances with little adult input or intervention.Similar educational games can be designed by taking the current research study as an example, and it is believed that it will encourage production of many similar games.Students' performances reach an optimal level when educational games are used after the teacher helps them construct their learning and guide them in this endeavor. [ABSTRACT FROM AUTHOR]

Are pregnancy and birth‐related parameters important risk factors in the development of urinary incontinence (UI)? The aim of this study is to examine the prevalence of UI and associated risk factors in Turkish women in the third postpartum month. Incontinence after childbirth is a common problem. A cross‐sectional study that included 370 women in third postpartum month in Çanakkale is presented in this paper. Wagner's quality of life scale questionnaire exploring the risk factors for UI was used as the principle data collection tool. All women gave consent prior to inclusion in the study. Chi‐square, t test, Mann‐Whitney U test and Binary logistic regression were used for comparison. The prevalence of self‐reported postpartum UI was 35.9%. In this study; age, educational level, parity, number of normal birth, nocturia and constipation were determined to be the associated risk factors for postpartum UI in univariate analysis. When examining these risk factors by using logistic regression, it was found that the number of birth being 2 increased UI 2.7 times (P = 0.002, 95% CI:1.434‐5.324), the number of birth being 3 or more increased UI 20.3 times (P = 0.001, 95% CI:7.130‐58.332) and nocturia being 3 times and more increased UI 2.6 times (P = 0.041, 95% CI:1.042‐6.790). Pregnancy and birth‐related parameters are important risk factors in development of UI. It would be useful to increase the awareness in women in pregnancy and the postpartum period, by providing health training and consultancy services about UI protection and the reduction of risk factors. [ABSTRACT FROM AUTHOR]

The aim of this study is to investigate the effect of students' flipped learning readiness (FLR) on engagement, programming self‐efficacy, attitude towards programming, and interaction intensity in the information and technology classrooms where programming is taught with the flipped classroom (FC) model. The study group of this research, which is designed by the relational screening method, consists of 371 students studying in middle school. Structural equation model was used for the data analysis. The results of the study revealed that FLR and its indicators in the programming teaching conducted with the FC model are significant predictors of engagement, attitude, programming self‐efficacy, and interaction intensity. FLR is most strongly related to programming self‐efficacy, whereas it is most weakly related to interaction. The most striking result of this study is that the FC model is an effective option in terms of providing engagement, interaction, self‐efficacy, and learner attitude, which are the key components for the success of the instruction. It is thought that this study assists to create an awareness on the impact of FLR on students, on subjects that frame in‐class attitudes, and behaviours of students. Lay Description: What is already known about this topic: Programming skills are important for the acquisition of basic skills of the 21st century.Flipped learning is an opportunity for effective programming teaching.Flipped learning readiness (FLR) has an important role in FC.However, in order for effective face‐to‐face learning to take place, it is crucial that students are able to take on the responsibility of learning outside the classroom, that is, the e‐learning readiness of their students. What this paper adds: We use FC applications in teaching programming to children.We have examined the key variables to be successful in a course involving the teaching of complex skills such as programming with FC.We brought proposals for practical education and researchers to be carried out programming instruction in FC. [ABSTRACT FROM AUTHOR]

SUMMARY Objective: The objective of this paper is to detect the incidence of insulin resistance (IR) in Chronic Kidney disease (CKD) patients and the presence of impaired fasting glucose (IFG), impaired glucose tolerance (IGT) and diabetes mellitus (DM) in patients with/without IR. Methods: We enrolled 113 patients with CKD. Biochemical parameters were investigated. Results: IFG was found 59.3% of patients with CKD. Age (p = 0.012), BMI (p = 0.036), TG (p = 0.008), HbA1c(p = 0.002), hs-CRP (p = 0.015) levels were higher in patients with IFG. According to the results of Oral glucose tolerance test (OGTT), 69% of patients with CKD had a detected carbohydrate metabolism disorder, 9.7% had DM, 59.3% had IGT. In patients with IFG 13.6% had DM, 31.8% IGT, in patients without IFG 4.2% had DM and 29.8% IGT. The mean HOMA-IR and insulin levels were 3.03 ± 1, 97/11.9 ± 7.13. IR was detected 23% of patients with CKD. In patients with IR; FBG (p = 0.003), serum insulin (p = 0.001), TG (p = 0.05) and HbA1c (p = 0.004) levels were elevated. 31.3% of patients with IFG were found to be IR. Conclusion: Carbohydrate metabolism disorder and insulin resistance are found in patients with CKD. Most patients with CKD who are elderly, obesity or overweight offer targets for additional risk factors. For these reasons, screening for DM may be recommended. [ABSTRACT FROM AUTHOR]

All over the world, poor and illiterate girls living in rural areas are at higher risk of becoming underage marriage than well‐educated girls living in cities. Early marriages exacerbate inequalities between females and males in society and violate children's and women's rights. This study aimed to demonstrate temporal changes in the prevalence of child marriage and underage childbearing in Turkey by exploring the causes of regional variations in the schooling rate. Our retrospective, descriptive and register‐based study obtained input data on childbirth, marriage, population and schooling from official statistics published by the Turkish Statistical Institute (TURKSTAT) and the Republic of Turkey Ministry of National Education. Based on official statistics, underage childbearing rates decreased from 2002 to 2019 in Turkey. This study outlined significant regional variations in the ratio of childbearing female under 18 to the population that were higher in the northeastern, central eastern, and southeastern Anatolia regions of Turkey than in other regions. During the same period, there were downward trends in the number of legal marriages of female aged 16–17 and the number of underage females who gave birth in contrast with an increasing population of girls living in Turkey. In terms of welfare, education and healthcare, developments in Turkey were considered to have contributed to the downward tendency of childbearing and marriages of underage females. However, an increase in the schooling rate of girls was the critical determinant of the observed tendency. Therefore, officially setting the compulsory education age to 18 can help to prevent underage marriage and childbearing. [ABSTRACT FROM AUTHOR]

Two cross‐sectional studies were conducted with undergraduate and graduate students (mean age = 22 years) in two university campuses in different regions of Turkey to investigate confrontations between conservative religious people and secular‐liberal people and the roles of fundamentalism and authoritarianism for these groups. Study 1 investigated the connections between traditional religiosity and liberties and the impact of religious fundamentalism with a sample of 482 participants. Using hierarchical multiple linear regression and bootstrapping analysis, religiosity was seen as negatively connected to three components of liberties. It was shown that religious fundamentalism had an indirect effect on this connection. In Study 2, with a sample of 260 participants, the negative connection between traditional religiosity with liberties was confirmed. Further, it was found that particularly the conservatism dimension of right‐wing authoritarianism played an explanatory role in this connection. In addition, as an extension of the two studies, it was observed that secular‐liberal participants supported civil liberties in general, but they expressed opposition to freedom of religion in particular, indicating that the antagonism between religious and secular people may also stem from secular‐liberal people. It was found that dimension of aggression of left‐wing authoritarianism played an explanatory role in connection to this aspect. [ABSTRACT FROM AUTHOR]

Background: Intensive care nurses play an important role in the management of critically ill patients including identification of cardiac arrhythmias. Interventions to improve arrhythmia identification can be expensive, time‐consuming, and are not always successful. Aims: This study aimed to explore the effectiveness of using short message service (SMS) messaging to improve intensive care nurses' cardiac arrhythmia interpretation skills. Design: This study was a prospective, two‐group, assessor‐blinded, randomized controlled trial with a pretest‐posttest experimental design. Methods: The study was conducted from February 2020 to February 2021 for the intervention as well as the control group, in a teaching hospital in northwest Turkey. The intervention group was sent the one‐way SMS messages on cardiac arrhythmias via WhatsApp during an 8‐week period, whereas the control group did not receive any intervention. The Cardiac arrhythmias assessment questionnaire (CAAQ) was used to measure outcomes. The data were analysed using ANCOVA and an independent t‐test. Results: A total of 66 intensive care nurses were randomly assigned to either the intervention or the control group. The ANCOVA analysis indicated that ICU nurses who received SMS messages about cardiac arrhythmias two times a week had significantly increased CAAQ scores (P < 0.001) with a large effect size (partial eta‐squared = 0.588). Conclusion: This study concluded that using SMS messages as a training tool has a positive influence on cardiac arrhythmias interpretation skills among ICU nurses. Relevance to clinical practice: Using SMS messages could be an alternative, effective, and innovative approach to improve nurses' clinical practice skills. [ABSTRACT FROM AUTHOR]

Objectives: The present study attempted to adapt and validate the Turkish version of the Camberwell Assessment of Need for the Elderly (CANE‐T). Methods: The data of this methodological study were collected from 610 older people who volunteered between September 10 and December 15, 2019. The SPSS 20 and LISREL software were used to perform reliability (internal reliability, parallel forms reliability/equivalent forms, and test–retest reliability) and validity (exploratory factor analysis and confirmatory factor analysis) analyses for the CANE‐T. Results: The Kaiser–Meyer–Olkin test revealed the sampling adequacy to be 0.72. After deleting four items (psychological distress, behavior, alcohol, and money) with a factor loading below 0.30 from the dataset, it was found that the scores on the scale explained 55% of the total variance. Besides, the confirmatory factor analysis revealed the following fit indices: p < 0.05, root mean square error of approximation (RMSEA) = 0.08, root mean square residuals (RMR) = 0.07, standardized root mean square residual (SRMR) = 0.07, goodness‐of‐fit index (GFI) = 0.88, and adjusted goodness‐of‐fit index (AGFI) = 0.84. Concerning reliability, Cronbach's α values were calculated to be 0.78 for 'Physical Needs', 0.74 for 'Psychophysiological Needs', 0.75 for 'Security Needs', 0.75 for 'Social Needs', and 0.75 for 'Health Needs'. Conclusions: Overall, it was concluded that the 20‐item five‐factor CANE‐T is a valid and reliable tool to measure the needs of older adults in the Turkish context. [ABSTRACT FROM AUTHOR]

Background: During the COVID‐19 pandemic, intensive care nurses may experience ethical issues related to fear of transmission, limited resources, and increased workload. Nurses' moral sensitivity and courage may have a role in dealing with these problems. Aim: The purpose of this study was to assess intensive care nurses' moral sensitivity and moral courage during the COVID‐19 pandemic. Design: Descriptive cross‐sectional survey. Methods: A total of 362 nurses working in the intensive care units of pandemic hospitals in Turkey participated in the study between January and March 2021. Data were obtained using a personal information form, the Moral Sensitivity Questionnaire, and the Nurses' Moral Courage Scale. A link to the online data collection tools was sent to the management of participating institutions, who forwarded it to nurses. Reporting followed the CHERRIES guidelines. Results: In this study, the response rate of nurses was 89%. The nurses' total mean moral sensitivity score was 90.70 ± 28.89 and their mean moral courage score was 82.08 ± 13.51. A weak inverse correlation was found between the nurses' moral sensitivity and moral courage scores (r = −.176, p =.001). Total moral sensitivity score differed significantly according to years of Intensive care unit (ICU) experience (p =.007). Total moral courage scores increased significantly with education level (p =.012), years of nursing experience (p =.016), and willingness to work in the ICU (p <.001). Conclusion: The study suggests that nurses working in the intensive care unit during the pandemic had moderate moral sensitivity and high levels of moral courage. Nurses' sociodemographic characteristics and ICU work conditions may affect their moral sensitivity and moral courage. Relevance to Clinical Practice: The results of this study can help guide efforts to improve moral courage and sensitivity and address ethical issues among ICU nurses. [ABSTRACT FROM AUTHOR]

Background: Intensive care settings are characterized by their structure, which constantly changes in parallel with scientific and technological developments, the uncertainty of the lifeline between birth and death, the challenges in the fair distribution of limited resources, the participation of individuals in medical decisions, and witnessing the pain experienced by individuals. These characteristics also affect the level of moral distress, which can make it difficult for ICU nurses to provide the most appropriate individualized care for their patients. Aims: The purpose of this study was to determine the moral distress levels and individualized care perceptions of intensive care nurses. Study design: This study employed a cross‐sectional descriptive survey design. Methods: This descriptive study was conducted with 128 nurses working in the intensive care units of a university hospital in Turkey. Data were collected using an 'Information Form', 'the Moral Distress Scale', and 'the Individualized Care Scale‐Nurse Version'. Results: 78.9% of the nurses stated that there was staff shortage, and 36.0% stated that the physical conditions were not suitable for care in the intensive care units in which they worked. The mean score on the Moral Distress Scale was 79.2 ± 46.4. The mean total score on the Individualized Care Scale‐Nurse Version was 3.5 ± 0.8. Conclusion: This study revealed that the intensive care nurses had moderate levels of moral distress and good levels of individualized care perceptions although there was no significant relationship between their moral distress levels and individualized care perceptions. Also, the nurses adopted care behaviours supporting patients' feelings and autonomy. Relevance to clinical practice: In our study, the intensive care nurses did not reflect their moderate‐level moral distress in the individualized care provided. It could be beneficial to measure intensive care nurses' moral distress and care levels at frequent intervals so that early precautions could be taken to prevent the accumulation of moral distress and care difficulties among intensive care nurses. [ABSTRACT FROM AUTHOR]

Objective: This study aims to evaluate whether the training offered about child abuse and neglect to families in which there are disagreements and problems between parents will be effective in enhancing awareness. Background: Even if families are the places where children are the safest, they sometimes constitute the risky groups in terms of neglect and abuse. Parents could perpetrate physical and emotional abuses against their children due to conflicts with their spouses. Method: The research was conducted as a pre‐test–post‐test quasi‐experimental study. A total of 142 parents (71 couples) took part in the research. The Socio‐Demographic Information Form, the Abuse Awareness Scale – Parent Form and the Revised Dyadic Adjustment Scale were used as the data collection tools. Awareness training on child neglect and abuse, created by the researcher, was given to parents. Results: Before the training, the mean of pre‐test scores obtained by participant parents from the AAS‐PF was 62.5 ± 7.77 points. The mean of post‐test scores obtained by participant parents from the AAS‐PF was 47.5 ± 4.94 points. There was a statistically significant relationship between participant parents' AAS‐PF and RDAS scores. Implications: In line with the findings obtained from the research, disagreements between spouses pose a risk for children in terms of neglect and abuse. The education program on child neglect and abuse given to parents raises awareness and reduces the risk. [ABSTRACT FROM AUTHOR]

Background: Adverse events are often encountered in surgical intensive care units (ICUs), and most of them occur due to preventable errors. Establishment of a patient safety culture is recommended for preventing and reducing these errors. Aims: This study was performed to investigate the relationship between surgical ICU nurses' patient safety culture and adverse events. Design: This was a cross‐sectional descriptive study. Methods: The study was performed in the surgical ICUs of four university hospitals in Izmir province, Turkey and was conducted in accordance with the Declaration of Helsinki and approved by an Ethics Committee. The sample comprised 113 nurses working in the surgical ICUs of the hospitals between November 2018 and February 2019. Data were collected using a questionnaire that comprised a demographic form, adverse events form, and patient safety culture hospital questionnaire. Student's t test, one‐way analysis of variance, and logistic regression analyses were used to evaluate the data. P values <.05 were considered significant. Results: At the end of the study, nurses' level of patient safety culture was found to be intermediate (65.5%), with the highest average positive response rate (PRR) obtained for teamwork within the units (65.5%) and the lowest average PRR obtained for the frequency of adverse event reporting (25.3%). There was a significant correlation between patient safety culture and adverse events (r = 0.027, P <.05). Conclusions: Surgical ICUs nurses' level of patient safety culture was average, and there was a significant correlation between patient safety culture and adverse events. Relevance to clinical practice: Managers should establish a reliable system for reporting adverse events and encourage ICU nurses to report them. It is very important to adopt a non‐punitive approach at instances when an adverse event is reported. [ABSTRACT FROM AUTHOR]

Aim: To examine the effects of breastfeeding support given by video call on anxiety, breastfeeding self‐efficacy, and newborn outcomes. Methods: We conducted a randomized controlled experimental trial with 72 women and their babies. Participants were randomly assigned to the intervention (video call) group (VCG: standard care + video call) and control group (CG: standard care). The primary outcomes of this study were the mean postpartum maternal anxiety level and the mean breastfeeding self‐efficacy level. The secondary outcome was neonatal outcomes. This study followed the CONSORT (Consolidated Standards of Reporting Trials) checklist. Results: Women in VCG had lower anxiety levels than the CG at postpartum 2 weeks (mean difference [MD] 25.42, p =.000) and 1 month (MD 47.72, p =.000). The breastfeeding self‐efficacy level of women in the VCG was higher than the CG at postpartum 2 weeks (MD 13.18, p =.007) and 1 month (MD 10.1, p =.001). The newborns in VCG had higher weight gain and daily breastfeeding frequency than the CG at the postpartum second week (MD 9.64, p =.001, MD 2.88, p =.000; respectively) and 1 month (MD 47.16, p =.000, MD 2.98, p =.000; respectively). There were lower rates of challenges of breastfeeding, hyperbilirubinemia, and feeding with formula in VCG than CG at the postpartum second week (p =.043, p =.043, p =.039; respectively). Conclusions: Breastfeeding support via video calling has positive effects on maternal anxiety, breastfeeding self‐efficacy, and newborn health. Postpartum caregivers may benefit from video calling for breastfeeding support. [ABSTRACT FROM AUTHOR]

Objective: This descriptive and cross‐sectional study aims to assess the surgical handwashing practices of operating room staff. Design: Single‐blind study. Methods: The study was conducted with 66 staff (surgeons and operating room nurses) employed in the surgery department of a university hospital in Turkey. Data were collected using a Staff Information Form prepared in light of the literature to collect the participants' sociodemographic data and the Surgical Hand Washing Procedure Checklist developed according to the guidelines of the Centers for Disease Control and Prevention (CDC), World Health Organization (WHO) and Association of Surgical Technologists (AST). The staff assigned to operating rooms were identified, and then, their surgical handwashing practices were observed by one of the researchers. Findings: Of the participants, 77.3% were dressed suitable to the operating room field, 56.1% appropriately wet both of their hands and forearms, and 72.7% used a sufficient amount of antiseptic solution (3–5 ml) in their palms. More than half of them (51.5%) inappropriately performed the procedure of surgical handwashing (applying an antiseptic solution to hands and arms with circular motions, starting from the fingertips up to 3–5 cm above their elbows for a minute), and 47% incorrectly performed the procedure of rinsing hands and arms while keeping the hands above the elbows under running water and passing arms through the water in one direction during this process. Conclusion: In the study, it was determined that none of the team members completed the preparation, application and drying steps of the surgical handwashing procedure. Therefore, it is necessary to make arrangements that will facilitate the handwashing procedures of the personnel. Personnel‐related problems, such as the duration of washing and drying methods, are possible to be avoided with periodic in‐service training and with posters demonstrating the washing stages, which might lead to behavioural changes. [ABSTRACT FROM AUTHOR]

This study examines the Gezi Park protests in Turkey by corroborating the idea that the process of social identity leadership through social media contributes to the formation of protestor identity, which, in turn, allows people to participate in collective action. Specifically, we argued that evaluations of social media posts in terms of the three dimensions of the Identity‐Leadership Model (ILM)—identity prototypicality, advancement and the entrepreneurship of leaders, play a crucial role in collective action participation via identification with newly shaped protestor group. To address this argument, a retrospective survey study was conducted with a sample of 403 Turkish citizens who participated in the Gezi Park protests. Analyses showed that the three dimensions of ILM predicted the identification with the emergent protestor group. Furthermore, people's evaluations of social media users regarding group prototypicality, identity advancement and the entrepreneurship dimensions, based on their social media posts predicted participation in the Gezi Park protests following the calls of different types of social media accounts (personal, anonymous and institutional). In addition to this, identification with the protestor group significantly mediated the relationships between evaluations on social media accounts' leadership features between participation in collective action. We believe that our findings show that social identity leadership through social media contributes to the formation of a protestor group and identity which in turn, helps explain participation in collective action. [ABSTRACT FROM AUTHOR]

Background: Physical, psychological, and social impairments are becoming more common in the world due to internet use and excessive use. Purpose: This study was conducted to determine the relationship between social media addiction (SMA) and the perception of loneliness in the high school period when peer influence is important. Methodology: This cross‐sectional study was conducted with a total of 988 students studying at four high schools in Ankara, the capital city of Turkey, in the fall semester of 2019‐2020. The research data were collected using Introductory Information Form, Social Media Addiction Scale (SMAS), and UCLA Loneliness Scale. Results: According to the findings, 67.2% of the students had different degrees of SMA. It was found that 7.8% of the students had a high or very high degree of addiction. Loneliness levels of the students were found to be high (UCLA mean 62.78). A strong negative correlation (p < 0.01) was found between loneliness and all the subscales of the SMAS except the busyness subscale. Conclusions: The findings demonstrate the social media addiction and the perception of loneliness in high school students are related at a level that cannot be ignored. Future research should evaluate social media addiction and loneliness together with other psychological markers. [ABSTRACT FROM AUTHOR]

Problem: Preventive and supportive nursing care interventions of school nurses are very important in the early adolescence period, in which the significant physical and sexual changes occur. One ramification of these changes may be social appearance anxiety. This study was carried out to investigate the effects of resilience on social appearance anxiety among early adolescents. Methods: The study was a cross‐sectional design. The study data were collected between February and June 2018. Study sample consists of 495 early adolescents studying at a state secondary school in Turkey. The data were gathered using personal information form, Social Appearance Anxiety Scale (SAAS), and Child and Young Resilience Measure (CYRM‐12). The data were analyzed using the independent‐sample t test, one‐way analysis of variance, and multiple linear regression methods. Findings: In the present study, the mean age of early adolescents was found to be 11.90 (1.07) years. The mean scores of students in SAAS and CYRM‐12 were 31.79 (13.30) and 52.96 (5.86), respectively. Social appearance anxiety scores of early adolescents were found to have a negative effect on the resilience levels (β = −0.294). Conclusions: It can be suggested to teach adolescents, the interventions about the use of active coping skills aiming to decrease social appearance anxiety and to increase the resilience. [ABSTRACT FROM AUTHOR]

Purpose: This study examined difference in the levels of internet addiction across internet activities, and the associations of cognitive distortions with internet addiction and internet activities. Methods: This is a cross‐sectional study involving 638 adolescents. Data were collected using a personal information form, the Internet Addiction Scale and The Children's Negative Cognitive Error Questionnaire. Data were analyzed using SPSSv23 and descriptive methods, independent samples t‐test, linear regression, logistic regression were performed. Findings: The prevalence of internet addiction in adolescents was found to be 16.9%. The internet addiction scores of adolescents who use the internet for online gaming, visiting pornographic sites, using and chatting on social media, and aimless browsing are higher. Catastrophizing, personalization, and selective abstraction cognitive distortions explain internet addiction variance at a level of 17.5%. Selective abstraction predicts online gaming and aimless browsing, personalization predicts pornographic site visiting, and catastrophization predicts doing homework on the internet. Conclusion: Online gaming, visiting pornographic sites, using and chatting on social media and internet aimless browsing are distinctive of internet addiction. Internet addiction and various internet activities are associated with cognitive distortions. Mental health nurses should help adolescents to become aware of their cognitive distortions and to produce more functional thoughts. [ABSTRACT FROM AUTHOR]

Purpose: To determine the relationship between attitude towards nursing diagnosis, critical thinking motivation, and problem‐solving skills of nursing students during distance learning. Method: The descriptive and correlational study was conducted with 450 first‐year nursing students from four universities. The "Positions on Nursing Diagnosis Scale," "Critical Thinking Motivational Scale," and "Problem Solving Inventory" were used for data collection in June–July 2021. Findings: The students' mean score of nursing diagnosis perception was 114.90 ± 18.47, the score for expectancy main subdimension of critical thinking motivation was 4.17 ± 1.16 and the score for value main subdimension was 4.81 ± 1.12, and score for problem‐solving skills was 90.65 ± 19.03. A statistically significant positive correlation was found between nursing diagnosis perception and subdimension of critical thinking motivation scores (p < 0.001) and problem‐solving skills score (p < 0.001). The linear regression model established to examine the effect of other scales on nursing diagnosis perception was found to be statistically significant (F = 17.516, p < 0.001). As the expectancy score increases by one unit, the perception of nursing diagnosis score increases 3.452 times (p = 0.001), the cost score increases by one unit, the perception of nursing diagnosis score increases by 3.894 (p = 0.001), and the problemsolving skills score increases by one unit, the perception of nursing diagnosis score decreases by 0.246 (p < 0.001). Conclusions: To conclude that nursing diagnosis perception, critical thinking motivation, and problem‐solving skills of nursing students were high and have a relationship with each other during distance education. As nursing diagnosis perception scores of students increase, their critical thinking motivation and problem‐solving skills also increase. Implications for Nursing Practice: The high skills of critical thinking and problem solving have an important place effectively to identify the nursing diagnosis more quickly and easily in the nursing care process. [ABSTRACT FROM AUTHOR]

Aim: To describe the experiences of intensive care nurses who provided care to Covid‐19 patients and their perceptions towards the disease and their work conditions during the pandemic. Introduction: Identification of experiences and perceptions of intensive care nurses towards disease, care and their workplace conditions when providing care to Covid‐19 patients will inform decision‐makers about improvements that can be implemented. Background: The Covid‐19 pandemic has led to increased strain and workplace‐related health risks to intensive care nurses, but it has also provided a unique experience and opportunities for learning and development. Methods: A descriptive qualitative study was conducted with 10 intensive care unit nurses working in seven hospitals in Istanbul, Turkey. Snowball sampling method was used, and the data were collected by semistructured online interviews. A thematic analysis was performed. The Consolidated Criteria for Reporting Qualitative Research were followed. Findings: Five major themes were identified: 'death and fear of death', 'impact on family and social lives', 'nursing care of Covid‐19 patients', 'changing perceptions of their own profession: empowerment and dissatisfaction', and 'experiences and perceptions of personal protective equipment and other control measures'. Discussion: Intensive care nurses experience an increased risk of infection and psychological burden, and they lack a sense of professional satisfaction. Improvements to working conditions are needed to support nurses caring for patients during the pandemic. Conclusion: The pandemic increased the workload and responsibilities of intensive care nurses and led to increases in their work‐related health risks and challenges with care. However, it also increased nurses' awareness about the importance of their professional roles. Implications for nursing practice and policies: There is a need to improve working conditions and develop nursing standards for the care of Covid‐19 patients in intensive care units. [ABSTRACT FROM AUTHOR]

Aim: The aim of study was to evaluate the effectiveness of the training material based on low‐level environmental fidelity simulation in drug‐dose calculation skills in senior nursing students. Methods: A quasi‐experimental design with one group. The sample included senior nursing students attending a nursing school in Turkey in the period December 2012–January 2013. Eighty‐two senior nursing students were included in the sample. Data were obtained using a data collection form which was developed by the researchers. A paired‐sample t‐test was used to compare the pretest and post‐test scores. Results: The difference between the mean pretest score and the mean post‐test score was statistically significant (P < 0.05). Conclusion: This study revealed that the training material based on low‐level environmental fidelity simulation positively impacted accurate drug‐dose calculation skills in senior nursing students. [ABSTRACT FROM AUTHOR]

Lockdown and social distancing measures during the COVID‐19 pandemic increase women's responsibilities and influence their mental health. This study aimed to assess the effect of COVID‐19 social distancing measures on mental well‐being and burnout levels of women using an online cross‐sectional survey in Turkey. The Warwick‐Edinburgh Mental Well‐being Scale, The Burnout Measure, and Sociodemographic form were used in this study. All analyses were performed on a sample of 438 women aged between 18 and 65. The mean score of mental well‐being was 47.86 (SD = 10.04) and the mean score of burnout was 3.86 (SD = 1.16). Being younger than 30 years old (t = 2.14, P = 0.033), having undergraduate education or above (F = 5.09, P = 0.007), part‐time working (F = 5.39, P = 0.005), attending to school (t = 2.68, P = 0.008), having COVID‐19 symptoms (t = 6.01, P < 0.001), and perceiving spousal emotional support (F = 3.47, P = 0.016) were the factors associated with high burnout. Being older than 30 years old (z = −3.11, P = 0.002), full time working (H = 11.96, P = 0.003), not attending to school (z = −2.09, P = 0.036), perceiving spousal emotional (H = 13.22, P = 0.004), or social (H = 13.11, P = 0.004) support were the factors associated with higher mental well‐being. Age (β = −0.03, P = 0.001), having two or more children (β = 0.42, P = 0.015), and perceiving COVID‐19 symptoms (β = −0.73, P < 0.001) were the predictors of women's burnout. This study shows that mental well‐being and burnout levels of women in Turkey have been considerably affected as a result of social distancing measures taken with the first wave of the pandemic. Findings signal the immediate need for targeted mental health nursing interventions. Therefore, technology‐based mental health support programmes are recommended to be designed and utilized by mental health nurses. [ABSTRACT FROM AUTHOR]

This study aimed to determine whether women aged 20 or older living in the city of Diyarbakir had urinary incontinence or not. The study was carried out with a total of 410 women. The research data were collected between December 2017 and March 2018. As the data collection tool, a questionnaire form developed in line with the related literature, Bristol female lower urinary tract symptoms (BFLUTS) questionnaire and healthy lifestyle behaviours scale (HLBS II) were used. The women had an average age of 35.86 ± 10.98. Of all the women, 66.9% of them had complaints of urinary incontinence, and 48.9% suffered from Stress UI. The total BFLUTS scores increased at older ages. However, this result was not found statistically significant (p > 0.05). A significant relationship was found between the BFLUTS scores and being 40 or older, giving birth or more than one birth, chronic disease, BMI > 25, frequent urinary tract infection and gynaecological surgery (p < 0.05). There was no statistically significant difference between UI and the HLBS II results (p > 0.05). The results of multi regression analysis revealed a significant relationship between UI and giving birth (p < 0.05), yet no relationship was found between other risk factors (p > 0.05). UI is quite a common problem, which is not considered important, though. In the present study, being older than 40, giving birth and giving birth twice or more, having a chronic disease, BMI > 25, frequent urinary tract infection and gynaecological surgery were all influential on UI. Giving birth seemed to be the determiner of UI. [ABSTRACT FROM AUTHOR]

Background: Environmental factors such as loud sounds and bright lights in intensive care units can cause sleep disorders and delirium. Aim: The present study aims to investigate the effects of the overnight use of earplugs and eye masks by intensive care patients on their sleep quality and the degree of delirium. Study Design: This randomized controlled experimental study was conducted on the patients admitted to a coronary intensive care unit. Methods: The patients in the experimental group used earplugs and eye masks during the night, while those in the control group received only routine care. Data were collected using an information form, the Richards‐Campbell sleep questionnaire (RCSQ), and the intensive care delirium screening checklist (ICDSC). Results: The study included a total of 84 patients, 42 in the experimental group and 42 in the control group. The baseline average score of the patients in the experiment group on the RCSQ was 40.11 ± 16.55, with a Time 1 average score of 64.09 ± 14.07 and a Time 2 average score of 72.07 ± 11.75; their baseline average score on the ICDSC was 0.47 ± 0.50, with a Time 1 average score of 0.33 ± 065 and a Time 2 average score of 0.19 ± 039. The baseline average score of the patients in the control group on the RCSQ was 44.07 ± 7.30, with a Time 1 average score of 46.97 ± 9.22 and a Time 2 average score of 47.04 ± 11.53; the baseline average score of the control group on the ICDSC was 0.42 ± 0.50, with a Time 1 average score of 0.50 ± 0.70 and a Time 2 average score of 0.57 ± 0.66. A statistically significant difference was found between the Time 1 and Time 2 average scores of the experimental and control groups on the RCSQ and between the Time 2 average scores of the experimental and control groups on the ICDSC (U = 198.00, P <.001; U = 70.000, P <.001; U = 614.000, P = ·004 respectively). Conclusions: The earplugs and eye masks used by the intensive care patients overnight were associated with an increase in sleep quality and a decrease in the degree of delirium. Relevance to Clinical Practice: The use of earplugs and eye masks is recommended for intensive care units in supporting sleep quality and preventing delirium. [ABSTRACT FROM AUTHOR]

Background: There are many factors, which affect the bowel evacuation of neurosurgical intensive care unit (NICU) patients, resulting in constipation. Aim and objectives: The aim of this study was to investigate effect of abdominal massage on bowel evacuation and the risk of constipation in NICU patients. Design: A prospective, randomized‐controlled clinical trial. Methods: The sample of this study included 80 NICU patients. The patients were randomly assigned to abdominal massage and control groups. The constipation risk of all the patients was assessed with Constipation Risk Assessment Scale (CRAS). The patients in the abdominal massage group received a total of 30 minutes of massage, 15 minutes every morning and evening, until the first defecation. The bowel sounds of all patients in the abdominal massage and control groups were assessed on a daily basis. The days when bowel sounds were heard and the first defecation took place were recorded in a Bowel Evacuation Form. Results: The risk of constipation was higher in the patients in the abdominal massage (CRAS score 19.02 ± 1.81) and control groups (CRAS score 20.45 ± 2.61). The time of return of bowel sounds and the time of the first defecation were earlier in the abdominal massage group, compared to the control group (P <.05). In the control group, there was a weak correlation (P =.004) between the CRAS score and the time of return of bowel sounds, while there was a moderate correlation between the CRAS score and the time of the first defecation (P <.001). Conclusion: Our study results show that the risk of constipation is high in NICU patients, and abdominal massage is an effective nursing intervention to shorten the time of return of bowel sounds and the time of the first defecation. Relevance to clinical practice: Nurses can safely apply abdominal massage to improve bowel evacuation in NICU patients. [ABSTRACT FROM AUTHOR]

Aim: The effects in cultural and health provisions can lead to different unmet support needs. Hope is seen as an important support, a supportive power, and an efficient coping strategy for cancer caregivers. The purpose of this study in Turkish society is to determine supportive care needs of caregivers of cancer patients, to determine the hope levels of those caring for cancer patients and foresee how variables and hope can trigger needs. Methods: To identify the unmet needs and hope levels of caregivers of advanced cancer patients in Turkish society. Data were collected using the Supportive Care Needs of Caregivers Scale and Herth Hope Index. Results: More than half of the advanced cancer caregivers (56.51%) reported unmet care needs. Their unmet needs and hope levels were above average. Regression analysis showed the total score for hope was related to health care and information needs, work‐social needs. Conclusion: Hope was related to health care and information needs and work‐social needs. Oncology nurses should focus on the unmet needs of caregivers, taking into account their cultural differences in order to raise their hopes. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this study was to compare clinical, cytokine and microbiological responses after quadrant‐based scaling and root planing (Q‐SRP), full‐mouth SRP (FM‐SRP) and full‐mouth disinfection (FMD) in patients with generalized aggressive periodontitis (GAgP), which is currently termed as generalized stage‐III and grade‐C periodontitis. Methods: Forty‐two patients with GAgP were randomly assigned into groups as Q‐SRP, FM‐SRP or FMD with chlorhexidine. Clinical parameters were recorded, and gingival crevicular fluid (GCF) and subgingival plaque samples were collected at baseline, 3 and 6 months after treatment. GCF levels of interleukin (IL)‐1β and IL‐17 were analysed using ELISA. Quantities of six bacterial species were determined using qPCR. Results: Clinical parameters improved significantly in all groups at 3 and 6 months (p < 0.05). Percentage of sites with probing depth >6 mm was lower in the FMD than Q‐SRP group at 3 and 6 months (p < 0.05). FMD showed significantly higher percentage of pocket closure compared with Q‐SRP and FM‐SRP at both 3 and 6 months after treatment (p < 0.05). The IL‐1β levels decreased only in the FMD group (p < 0.05), whereas no changes were found in IL‐17 levels in any group. The levels of five out of six bacterial species decreased at 3 and/or 6 months only in the FMD group (p < 0.05). Conclusions: The FMD treatment appears to offer superior outcome than Q‐SRP and could be the first choice for patients with GAgP. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to evaluate the educational concerns and awareness level among dental hygiene students during the COVID‐19 pandemic. Materials and Methods: A questionnaire, created via Google Forms, was sent electronically to 240 dental hygiene students from Turkey, of which 223 replied to the survey. The questionnaire was divided into 4 parts and consisted of 24 close‐ended questions. Results: The main symptoms of COVID‐19 were correctly recognized by 71% of the students, and 40.2% of the students were aware of the transmission routes. Of all, 77.1% of the students expressed fear of getting infected, 96.9% believed that they would more likely get infected while performing dental procedures, and 91% believed that dental hygienists' cross‐contamination risk was high. Furthermore, 69.5% of the students stated that their undergraduate education process was negatively affected, 59.6% appreciated ongoing online education, and 31.8% wanted face‐to‐face clinical internships. Conclusions: Although most of the students were aware of the transmission routes and preventive measures of COVID‐19, concerns regarding disease transmission among them remain. Students appreciated the ongoing online education and believed that face‐to‐face education is risky during this current pandemic. However, they believe that this process can adversely affect their professional knowledge and especially practical skills. A balance must be struck between sustaining an effective dental hygiene education process and containing the spread of COVID‐19. [ABSTRACT FROM AUTHOR]

Objectives: The aim of the study was to investigate the impact of stage‐grade of periodontitis and self‐reported signs and symptoms on oral health‐related quality of life. Methods: The diagnosis of periodontitis was based on the 2017 World Workshop on the Classification of Periodontal and Peri‐Implant Diseases and Conditions. The Turkish version of Oral Health Impact Profile‐14 (OHIP‐14) was used to assess oral health‐related quality of life (OHRQoL) and the participants were requested to state their symptoms associated with periodontal diseases. Results: One hundred and sixty‐six patients were included in the study with a mean age of 46.54 ± 9.24 years. The participants with Stage IV and Grade C periodontitis had the highest total OHIP‐14 scores (median 20.00 [min.‐max, 3.00–35.00] and median 18.50 (min.‐max, 0.00–36.00]; respectively). The OHIP‐14 scores (mean ± SD) were significantly associated with the symptoms of bleeding gums (13.64 ± 9.39), sore gums (18.00 ± 10.47), swollen gums (17.42 ± 10.91), bad breath (15.82 ± 9.44), loose teeth (20.00 ± 8.66) and drifting teeth (24.56 ± 8.46). Conclusions: This study demonstrates a significant association between OHRQoL and periodontitis. Stage‐grade of periodontitis and its symptoms were associated with poor quality of life. [ABSTRACT FROM AUTHOR]

Purpose: This study assessed the effects of massage therapy using 5% lavender oil on the severity of restless legs syndrome (RLS) and the quality of life (QoL) of patients on hemodialysis (HD). Design and methods: This is a randomized placebo‐controlled study with a pretest–posttest design. This study was conducted from January 30, 2019, to May 6, 2019, at HD centers in Turkey, and it includes 58 participants—31 study patients and 27 controls. Data were collected using patient identification form, RLS severity rating scale, Kidney Disease Quality of Life Scale (KDQOLTM‐36) and patient follow‐up charts. As per the massage therapy protocol, the patients in the study and control groups received massage therapy with lavender oil and baby oil, respectively. Findings: RLS severity significantly decreased in all follow‐up weeks in the study group and in the first, second, and third follow‐up weeks in the control group. There were significant differences between the groups in terms of KDQOLTM‐36 subscales and total scores at the initial and final follow‐ups. Conclusion: In HD patients, massage with lavender oil lessened the severity of RLS and improved the QoL. Accordingly, this therapy can be recommended to HD patients. Clinical relevance: Massage therapy during HD sessions is easy, inexpensive, and patient‐friendly with no side effects. It is known to reduce symptoms and enable the patients to easily perform daily activities of living. Massage therapy with lavender oil is effective and can be easily applied to patients with RLS by nurses. Trial registration: This study was registered under the Clinical Trials protocol registration system (NCT04630470) upon completion. [ABSTRACT FROM AUTHOR]

What are the beliefs and behaviours of men students attending health‐related faculties at a university regarding testicular self‐examination? This study was conducted with the aim of identifying the approaches of men students attending health‐related faculties at a university towards testicular self‐examination, determining their levels of awareness of testicular self‐examination and contributing to early diagnosis of testicular tumours. Testicular cancer is a disease that can result in death if not diagnosed early, but high treatment success rates can be achieved if diagnosed early. Lack of knowledge related to the risks created by testicular cancer and to testicular self‐examination, which is very important for early diagnosis in young men, is revealed to be among the reasons for delay in diagnosis and treatment. The study was conducted between September and November 2019 in health‐related faculties of a state university in southern Turkey. The study universe consisted of a total of 370 men students studying in fourth grade in health‐related faculties nursing, medicine and dentistry. A 'Descriptive Characteristics Form' and 'Champion's Health Belief Model Scale' were used as data collection tools. Percentage, Levene's test, one‐way analysis of variance (ANOVA), chi‐square and eta squared were used to evaluate the data. While 59.6% of students in the nursing faculty stated that they had previously received information related to testicular self‐examination, 72% of students in the medical faculty and 67.7% of students in the dentistry faculty stated that they had not previously received information about this issue. Among students in the nursing faculty who had received information, it was determined that 75.0% had learnt about it in lessons and that 45.9% had performed testicular self‐examination. Regarding the arithmetic means of the sub‐dimension scores of the Champion's Health Belief Model Scale according to faculty attended, there was a significant difference in the benefits (F(2,168) = 4.915; p = 0.08), barriers (F(2,168) = 4.831; p = 0.09) and self‐efficacy/confident (F(2,168) = 5.816; p = 0.04) sub‐dimensions. The study revealed that testicular self‐examination implementation rates and attitudes towards testicular self‐examination among university students studying at health‐related faculties were low. [ABSTRACT FROM AUTHOR]

High-performance work systems ( HPWSs) are seen as important in helping strengthen competitive strategies of developed-country multinational enterprises ( DC MNEs). Commensurate with global competitive pressures and internationalization strategies, emerging-country MNEs ( EC MNEs) and indigenous firms are also increasingly adopting HPWSs. HPWSs are not only seen as simply performance enhancing systems, but also as facilitators of internationalization. MNEs represent an important test bed for the HPWSs and their applicability in different national contexts. In this article, we contribute to the extant literature by focusing on HPWS adoption level within domestic subsidiaries of DC MNEs and EC MNEs along with stand-alone indigenous firms in a single-country setting by keeping the host-country environment as constant. © 2015 Wiley Periodicals, Inc. [ABSTRACT FROM AUTHOR]

Problem: The study was conducted to examine the effects of laughter therapy on happiness level and self‐esteem in 5th grade students. Methods: This study used an experimental study with pretest posttest control group. The study population consisted of 5th grade students studying at a secondary school in Turkey. There were six branches in the 5th grade. Groups were randomly selected from among these 5th grade classes to include 29 students in the intervention group and 32 in the control group. Laughter therapy sessions were applied to the intervention group twice a week for 4 weeks. No intervention was offered to the control group. The data were collected by a questionnaire, the School Children's Happiness Inventory, and the Coopersmith Self‐Esteem Inventory. Results: It was determined that there was a statistically significant difference between the groups in terms of the School Children's Happiness Inventory (p <.05) but no significant difference was found according to the groups' scores on the Coopersmith Self‐Esteem Inventory (p >.05). Conclusions: In this study, it was determined that laughter therapy increased the happiness level of students yet had no effect on their self‐esteem. It is recommended to organize laughter therapy activities in schools to increase the happiness levels of students. [ABSTRACT FROM AUTHOR]

Aim: To determine the psychological resilience and perceived stress levels of healthcare workers in COVID‐19 intensive care units. Methods: The study was conducted with 418 physicians and nurses in Turkey between July and August 2020. The data were collected with an online survey consisting of a personal information form, the Brief Resilience Scale, and the Perceived Stress Scale. Results: The study sample comprised 32.5% physicians and 67.5% nurses. Fear of transmission of COVID‐19 from the patients in their care was stated by 92.6% of the physicians and 95.7% of the nurses. Almost all of the participants (99.3%) were afraid of transmitting COVID‐19 to their families. The psychological resilience level of the physicians (18.42 ± 2.25) participating in the study was higher than that of the nurses (17.88 ± 2.00), and the perceived stress level was lower. It was determined that most physicians and nurses strengthened their team/work friendship bonds during the pandemic, but the motivation to work decreased. Conclusion: The study results suggest that frontline intensive care workers should be closely monitored as a high‐risk group for psychological problems. The provision of better personal protective equipment, together with on‐going monitoring and provision of psychological support, and strong family support will increase the resilience of frontline healthcare workers. [ABSTRACT FROM AUTHOR]

Frontline healthcare professionals during the pandemic were exposed to the risk of novel coronavirus disease 2019 (COVID‐19) worldwide. In this study, we aimed to explore the experiences of nurses who were diagnosed with COVID‐19. This qualitative, descriptive study was conducted between July 20 and September 29, 2020. A total of 17 nurses were included by using purposeful and snowball sampling methods and interviewed. Video interviews were conducted through WhatsApp using a semistructured in‐depth interview form. Data were analyzed using the content analysis method. The experiences of nurses at the time of COVID‐19 diagnosis were categorized into three main themes: (a) personal experiences, (b) thoughts on the reasons for getting infected, and (c) social experiences. In conclusion, we shed light on the experiences of frontline nurses during pandemic who were exposed to COVID‐19. Individual, organizational, and social regulations and actions are needed for the management of the pandemic. [ABSTRACT FROM AUTHOR]

The purpose of this cross‐sectional study was to examine factors associated with nurses' resilience during the COVID‐19 pandemic. Data were collected in the latter half of 2020 from 904 nurses across Japan, Republic of Korea, Republic of Turkey, and the United States. The questionnaire included the Connor‐Davidson Resilience Scale 10, plus demographics and 20 questions about practice environment, workplace safety concerning infection control, COVID‐related experience, and organizational support. Fear of becoming infected, intention to leave nursing, and having had a positive COVID‐19 test were inversely associated with resilience (p < 0.05). Regression analysis indicated that U.S. nurses had significantly greater resilience than nurses in the other countries examined (p < 0.001). Nurses reporting organization support and those who participated in policy and procedure development had higher resilience scores (p < 0.01). Organizational support, involving nurses in policy development, and country of practice were found to be important resilience factors in our research, which aligns with other findings. Further research is recommended to determine the optimal practice environment to support nurse resilience. [ABSTRACT FROM AUTHOR]

Background: It is important to develop self‐management behaviours in adolescents to prevent chronic kidney disease progression. Objectives: This study evaluates the effect of a self‐management program that was developed based on individual and family self‐management theory to aid adolescents with chronic kidney disease in the acquisition of competencies in the management of their disease. Design: This is a randomized controlled study. Participants: The study was conducted with 20 intervention and 20 control patients, who were treated at two hospitals in Ankara between December 2018 and May 2019. Measurements: Self‐Management Assessment Form, Paediatric Quality of Life Inventory‐Adolescent Form and clinical parameters. A training program, specific to chronic kidney disease, was administered over three sessions in a group training setting when the patients came to the clinic for follow‐up. After the training program was completed, the patients were monitored for three months through home visits once every two weeks, totalling six visits. Results: Following the application of self‐management training, a statistically significant difference was found self‐management knowledge and behaviours, quality of life and anxiety mean scores of intervention and control group (p <.05), a significant decrease in only blood urea nitrogen among the clinical parameters when compared to the control group. Conclusions: In this study, a self‐management training program was developed based on Individual and Family Self‐Management Theory, aiming to have a positive effect on the self‐management behaviours of adolescents in the cognitive and psychosocial domains. [ABSTRACT FROM AUTHOR]

Objectives: This study was conducted to develop and evaluate a theoretical model to explain the relationships among participation in individual and social activities, compliance with prevention guidelines, and the perception of fatalism and fear of COVID‐19. Methods: Cross‐sectional survey of 1,067 participants who were >18 years of age living in different provinces of Turkey recruited between August 15, 2020 and October 15, 2020. We used covariant structural analysis to assess the relationships of the constructs of the theoretical model. Results: Significant fits were detected for Model 1 (χ2 = 924,389, p <.001, comparative fit index or CFI = 0.944), and for Model 2 (χ2 = 2,253,751, p <.001, CFI = 0.926). The predetermination and luck subdimensions reduce the fear of COVID‐19, while the pessimism subdimension and compliance with preventive measures increase the fear. Conclusion: In public health crises such as COVID‐19, it is important to plan scientific knowledge‐based public education; take initiatives in accordance with the cultural, social, economic, religious, and local characteristics of the societies; and conduct public health studies covering the whole society. [ABSTRACT FROM AUTHOR]