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The prominent method to teach clinical reasoning in preclinical years is case-based discussions. It necessitates hours of sessions. A randomised-controlled study has been conducted to determine whether preclinical students can develop illness scripts only by taking online formative testlets. A pre-test-post-test randomised-controlled design has been utilised. The intervention group (N = 20) answered general surgery questions for 18 days, while the control group (N = 19) received questions regarding urinary tract infections. These testlets were comprised of ContExtended Questions, which is a web-based tool to teach clinical reasoning. The performance was assessed by using Key-Feature Questions. While post-test scores were significantly higher than pre-test scores in the intervention group (p < 0.001), there was no statistically significant difference between the pre-test and post-test scores in the control group (p = 0.30). Taking formative case-based multiple-choice testlets without any additional teaching could assist preclinical students to learn clinical reasoning.

© 2022 John Wiley & Sons Ltd.Aims and Objectives: The aim of this study was to evaluate the clinical features of children with tracheostomy and the predictors of psychological status of their primary caregivers in order to determine the associations between the children's clinical course with their caregivers' psychological status. Background: The caregivers of children with tracheostomy are responsible for providing basic tracheostomy care at home. All these responsibilities may be associated with significant changes in family members' lifestyles, daily routines and family dynamics. Design: This study is a cross sectional study. Methods: Data of the family's socioeconomic status and clinical status of children with tracheostomy were noted in four paediatric pulmonology centers. The Beck Depression Inventory, Maslach Burnout Inventory, Zarit Caregiver Burden Scale, and Rosenberg Self-esteem Scale were used for psychological measurements of the caregivers. The STROBE checklist was used for this study. Results: Eighty-five children and their primary caregivers were enrolled in the study. The children's median age was 4.1 years. Thirty-eight of them were dependent on home ventilators. Twenty-one had bacterial colonisation. All children's primary caregivers were their mothers. Beck Depression Inventory scores of mothers of children with colonisation were higher. Number of hospitalizations in previous 6 months was related to mothers' emotional exhaustion and depersonalization scores. Duration of children's hospitalizations in previous 6 months was positively correlated to mothers' emotional exhaustion, depersonalization, and Beck Depression Inventory scores. Conclusions: Mothers of children with tracheostomy may experience psychological conditions, such as high levels of depression, burnout, burden and low levels of self-esteem. Frequent and long-term hospitalizations of children correlated with mother's depression and burnout. Therefore, primary caregivers should be evaluated and supported psychologically. Relevance to Clinical Practice: Preventing mothers of children with tracheostomy from experiencing psychological conditions such as depression, burnout, burden and low self-esteem can also increase the quality of care for children.

We aimed to evaluate cutoff values of immunoreactive trypsinogen (IRT)/IRT and determine relationship between IRT values and clinical characteristics of children with cystic fibrosis (CF). This study is cross-sectional study. Data of children with positive newborn screening (NBS) between 2015 and 2021 were evaluated in three pediatric pulmonology centers. Age at admission, sex, gestational age, presence of history of meconium ileus, parental consanguinity, sibling with CF, and doll-like face appearance, first and second IRT values, sweat chloride test, fecal elastase, fecal fat, biochemistry results, and age at CF diagnosis were recorded. Sensitivity and specificity of IRT cutoff values were evaluated. Of 815 children with positive NBS, 58 (7.1%) children were diagnosed with CF. Median values of first and second IRT were 157.2 (103.7-247.6) and 113.0 (84.0-201.5) μg/L. IRT values used in current protocol, sensitivity was determined as 96.6%, specificity as 17.2% for first IRT, and 96.6% sensitivity, 20.5% specificity for second IRT. Positive predictive value (PPV) was determined as 7.1%. When cutoff value for first IRT was estimated as 116.7 μg/L, sensitivity was 69.0% and specificity was 69.6%, and when cutoff value was set to 88.7 μg/L for second IRT, sensitivity was 69.0% and specificity was 69.0%. Area under curve was 0.757 for first and 0.763 for second IRT (p 0.001, p 0.001, respectively). PPV was calculated as 4.3%. Conclusion: Although sensitivity of CF NBS is high in our country, its PPV is significantly lower than expected from CF NBS programs. False-positive NBS results could have been overcome by revising NBS strategy. What is Known: • Although immunoreactive trypsinogen elevation is a sensitive test used in cystic fibrosis newborn screening, its specificity is low. • In countries although different algorithms are used, all strategies begin with the measurement of immunoreactive trypsinogen in dried blood spots. What is New: • In our study, it was shown that use of the IRT/IRT protocol for cystic fibrosis newborn screening is not sufficient for the cut-off values determined by the high number of patients. • Newborn screening strategy should be reviewed to reduce false positive newborn screening results.

Objective: A better understanding of public attitudes towards vaccination and recognition of associated factors with vaccine hesitancy or refusal is important regarding the control of the pandemic. Our aim was to analyze the public's attitudes toward COVID-19 vaccines and to identify factors affecting them. Materials and Methods: Data were drawn from the Turkish COVID-19 Snapshot Monitoring, between July-December 2020, a serial online cross-sectional survey. The sample comprised 3888 adult respondents. Attitudes to vaccines and trust were investigated in 3 periods corresponding to the timeline of pandemic-related events in Turkey. Results: In the third period of our study, in parallel with the increase in the spread of COVID-19, vaccine hesitancy/refusal increased significantly from 43.9% to 58.9% (P < .001). The significant predictors of vaccine refusal were female gender, being elder, and conspiracy thinking. Having a chronic illness, worrying more about loved ones and the health system being overloaded were significant predictors of vaccine willingness. Less compliance with preventive measures, less knowledge of prevention, reduced risk perception, and higher perception of media hype were COVID-19 variables that correlated with vaccine refusal. Trust in the Ministry of Health and medical professional organizations (e.g., Turkish Medical Association) was the lowest in the third period and vaccine refusal was significantly related to the decreased trust (P < .001, P = .002). Conclusion: Most respondents (approximately 60%) refused or hesitated to get a COVID-19 vaccine, though acceptability should be monitored when a vaccine becomes available. Health authorities should consider public trust, risk perception, and behavioral factors to improve COVID-19 vaccine acceptability.

Introduction No clear information exists about the factors affecting pleural thickening following parapneumonic effusion in children. We aimed to investigate factors that affect the resolving time of pleural thickening after parapneumonic effusion. Methods Between the years of 2007-18, 91 patients, which were followed due to diagnosis of pleural thickening after parapneumonic effusion, were assessed. Ages, complaints, physical examination findings, laboratory results, chest x-ray and ultrasonography findings, treatments, duration of treatment and recovery time of the patients were examined terms in of pleural thickening resolving time. Results The mean age of patients was 7.5 ± 5.0 years. Pleural thickening resolving time was 151 ± 6.8 days. The resolving time for pleural thickening was delayed with older ages, longer duration of complaints, fever before hospital admission and treatment, lower oxygen saturation at the time of admission, crackles in the physical examination, higher white blood cell count and pleural fluid density (p = 0.018, p = 0.001, p = 0.021, p = 0.020, p = 0.024, p = 0.025, p = 0.021, p = 0.019). In addition, the amount of effusion measured by thorax ultrasonography, fibrinolytic usage, and complications had a role in the delayed resolving time (p = 0.034, p = 0.001, p = 0.034). Pleural thickening resolved in 80% of the patients. Conclusion In this report, 80% of pleural thickening, following parapneumonic effusion resolved within 5 months. Patients who do not have a complication during follow-up are not required to monitor with frequent chest x-ray. Patients with a higher amount of pleural effusion, complications and need for fibrinolytic treatment should be followed more carefully.

We aimed to search if the renal parenchymal attenuation measurements on unenhanced CT scans could be useful in differentiating acutely obstructed kidneys from chronic cases or unobstructed kidneys.Unenhanced CT scans of 101 patients were retrospectively reviewed. Thirty-two patients with unilateral acute renal obstruction, 34 patients with unilateral chronic renal obstruction due to various reasons and 35 control subjects were included in the study. The parenchymal densities of both kidneys were measured, from the upper poles, middle portions, and lower poles of each kidney. The mean parenchymal densities of both kidneys were calculated in all three groups of subjects. Secondary signs of renal obstruction such as perinephric stranding, size of ureteral stone, degree of hydronephrosis were also noted for each kidney.The mean parenchymal attenuation value on the acutely obstructed side was lower than the unobstructed side, 24.21 ± 3.68 and 30.68 ± 4.75 respectively (p0.001). The mean parenchymal attenuation value on the acutely obstructed side (24.21 ± 3.68) was lower than both the chronically obstructed side (30.85 ± 4.53), and the control subjects (29.62 ± 3.03 on corresponding side). There was no statistically significant attenuation difference between right and left kidneys in the control group and chronic obstruction group.Renal parenchymal attenuation measurements and attenuation differences of both kidney of same patient could be useful in differentiating acute unilateral obstruction from chronic cases.

In this study it is aimed to determine the studies and used scales with students of health departments of universities in 1998-2008. PUBMED, Cochrane, EBSCO and Clinical Evidence data basis were searched between the dates 25 April - 15 June 2009. "Learning style" was used as key world for all data basis. The inclusion criteria were the date (1998-2008) and population (health department of universities) of study. We reached 25 full text articles. The study populations were comprises mostly medical and nursery students. Of the nine studies Kolb Learning Style Inventory, three studies Felder and Solomon's Learning Style Inventory and three studies VARK were used. There are many studies that have been used different scales/inventory in health area. The investigator should select any of them according to their subscales which are needed. (C) 2012 Published by Elsevier Ltd. Selection and/or peer review under responsibility of Prof. Dr. Huseyin Uzunboylu

It is aimed to determine the learning styles and the influential factors of term 1 students of Turkish and English Departments of medical faculty at Gazi University in 2009-2010 educational semesters. The population of the study comprises 374 students. Questions for demographic features, Grasha Reichman Students Learning Style Scale and academic performance scores were used for gathering data. Independent, collaborative and dependent learning styles scores were higher than other styles in Turkish department students. Independent and collaborative learning styles scores were higher than other styles in English department students. Competitive learning style scores of girls and boys were lower than other styles in both departments. It is determined that there were positive correlation between only Problem Based Learning score with collaborative learning style scores of Turkish department students; negative correlation was between Clinical Skill Education score with dependent learning style scores; and positive correlation between Evidence Based Medicine score with avoidant learning style scores of English department students. (C) 2012 Published by Elsevier Ltd. Selection and/or peer review under responsibility of Prof. Dr. Huseyin Uzunboylu

Knowing about the frequency of diseases, accidents and any condition related with the health constitute the main control and intervention programs that will apply in health. There is a need to determine the measurements for frequency of these conditions and data for determination of measurements. Even if surveillance or registration system of a country is very well, it can be insufficient to collect some other conditions related with health; in fact so many countries can not designate their basic data such as birth and death numbers. There are many methods for collecting health data, such as registration system, surveys, etc. Another method which has been using recently in epidemiology called “capture-recapture method”. [TAF Prev Med Bull 2008; 7(1.000): 75-80]

The treatment of tuberculosis (TB) requires long-term multiple drug use. Hyperuricemia is frequently reported in adults, but there are few data for the pediatric population. This study aimed to review drug-related side effects in pediatric patients that received treatment for TB. Patients with active TB undergoing treatment were followed for drug-related side effects. During the 7 year period, 23 patients with a mean age of 7.9 +/- 4.66 years were treated. Drug-related side effects were observed in 14 patients. Hyperuricemia occurred in 12 of the 14 patients, vs. hepatotoxicity in 2. In all, eight of the patients with hyperuricemia had >= 2 episodes during pyrazinamide (PZA) therapy. Based on these findings, we devised an algorithm that could be used for the management of hyperuricemia in patients receiving PZA because of TB, and recommend that hyperuricemia be closely monitored during PZA therapy.

OBJECTIVE: In this study we aimed to determine the knowledge level and behaviors of nurses towards AIDS and sexually transmitted disease (STD) who are working at Baskent University Ankara Hospital Design: There were 321 nurses at Baskent University Ankara Hospital at January 2005. Two hundred fifty six (79.7%) of them participated the study. The data was collected with a questionnaire. Main outcome measures: The nurses who were answered the question “Are you using any method in order to prevent STD?” as “needless” were accepted as “sexually inactive”. The level of AIDS knowledge was evaluated over 100 point scale. RESULTS: The mean age of nurses was 25.8±0.2 (19-38), while 69.8% of them were college or faculty graduate and 71.1% of them were single. AIDS (94.4%), syphilis (70.6%) and gonorrhea (60.2%) were the first three STD implicated by nurses. The average value of AIDS knowledge of nurses was 83.8±0.8. The average value of nurses who had bachelor’s degree or doctorate, who were at the 26-27 age group, who were married or widowed and sexually inactive group, but these differences were not statistically significant (p>0.05). Only 31 nurses (20.1%) declared that they have been using any preventive method for STD. CONCLUSIONS: It is determined, although the status of STD and AIDS knowledge of nurses are high, but the percentage of usage of any preventive method is low.

The objective of our study was to evaluate the ability of a respiratory navigator-triggered T2-weighted turbo spin-echo (TSE) sequence with a prospective acquisition correction (PACE) technique for MR cholangiopancreatography (MRCP) to depict the biliary anatomy of living donor liver transplantation (LDLT) donors.Forty potential LDLT donors who ranged in age from 19 to 54 years were prospectively evaluated with preoperative MRCP. MRCP was performed with a 1.5-T magnetic field using T2-weighted PACE TSE sequence. MRCP source data sets were processed with maximum-intensity-projection (MIP) and shaded surface display (SSD) algorithms. Findings were compared with intraoperative cholangiography. Biliary anatomy was classified according to the classification proposed by Huang and colleagues. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of MRCP for the detection of aberrant biliary anatomy were calculated.Intraoperative cholangiography and biliary exploration revealed that 27 donor candidates (67.5%) had conventional and 13 (32.5%) had aberrant biliary anatomy. Two donors (5%) had type B biliary anatomy; eight donors (20%), type C; two donors (5%), type D; and one donor (2.5%), unclassified. The sensitivity of MRCP source data sets in differentiating aberrant biliary anatomies from nonaberrant ones was 100%, the specificity was 88.9%, and the accuracy was 92.5%. PPV and NPV were 81.3% and 100%, respectively. The sensitivity of MIP images in differentiating aberrant biliary anatomies was 100%, the specificity was 88.9%, and the accuracy was 92.5%. PPV and NPV were 81.3% and 100%, respectively. The sensitivity, specificity, accuracy, PPV, and NPV of the SSD images in detecting aberrant biliary anatomies were 100%, 77.8%, 85%, 68.4%, and 100%, respectively.Preoperative MRCP using a respiratory navigator-triggered T2-weighted TSE sequence with a PACE technique accurately depicts the biliary anatomy in LDLT donors and may guide intraoperative management of the biliary tract.