Science Fiction as an Instructional Strategy: Foundations, Procedures, and Results for Pre-service Teachers.

Science fiction (SF) combines realistic and imaginary elements of science and technology and develops students' imagination, creativity, and interest in science. Therefore, the aim of this study is to examine SF stories written by pre-service science teachers (PSTs) in terms of various textual and science variables. The case study of SF story writing aimed to develop a theoretical framework to analyze how narrative elements, plot structure, agency, the nature of science content, characteristics of the SF genre, and ethics in scientific research are included in the stories of a group of Turkish PSTs. The participants of the study were 58 pre-service teachers enrolled in the science education department at a public university in Turkey. Working in groups, they wrote 13 different SF stories. The stories were analyzed with a rubric including two parts: narrative and other story elements and the characteristics of the SF genre. The results showed that the stories included fictional and realistic features of science and technology, scientific concepts, and details about scientific realities. The stories addressed the social and cultural embeddedness of scientific knowledge and details about the scientific method. However, the originality is limited in many stories as they had traces from popular movies, books, and TV series. The stories did consider a range of ethical issues, including unauthorized experimentation and manipulating scientific information for personal, political, and financial interests. The current study could contribute to the literature about the use and assessment of SF stories in science education. Supplementary Information: The online version contains supplementary material available at 10.1007/s10763-021-10244-4.

Clinical awareness and knowledge of breast cancer-related lymphedema among a group of psychiatrists in Turkey - An online survey.

Background: The point-of-view and role of physiatrists are important in the clinical care of breast-cancer-related-lymphedema (BCRL) patients to set up management and rehabilitation strategies. Aim: The aim of this study was to determine the awareness and knowledge of BCRL among a group of physiatrists regarding its causes, symptoms, treatment, and management in Turkey. Subjects and Methods: The participants were asked to answer a 10-min web survey, including 19 questions. In addition to their demographical and logistic properties, the questionnaire elicited data on the knowledge, education, and awareness of the physiatrists on the diagnosis and treatment of BCRL. Results: In total, 127 female and 44 male physiatrists completed the survey. Also, 71% of the participants were aged between 31 and 50 years, mostly working in metropoles and tertiary hospitals for more than 5 years. Further, 63.7% of the participants expressed that they had knowledge about BCRL; however, detailed knowledge of lymphedema treatment was low, as 67.9% of the physiatrists reported that they had no comprehensive information about complete-decongestive-therapy. Nearly half of the participants did not believe that once lymphedema has clinically manifested, a patient can eventually be treated for BCRL. Also, 87% of the participants had attended less than two educational events related to BCRL in the past 5 years. In all, 94.7% of the physicians determined a great need for education and awareness of the current literature about BCRL. Conclusion: The awareness and knowledge of lymphedema is moderate but detailed information, knowledge, and education about lymphedema and its treatment are low among a group of physiatrists. With the growing number of breast cancer survivors, physiatrists' awareness and education about BCRL are crucial to improve the quality of care of patients.

Temporomandibular disorders in ankylosing spondylitis: a cross-sectional, monocentric study.

There are contradictory results in the relevant literature about the relationship between objective determinants of craniocervical posture and temporomandibular disorder (TMD), whereas no study has worked on ankylosing spondylitis (AS) and TMD relationship. We conducted this study to test the predictors of TMD in AS patients and its relationship with craniocervical posture. AS patients aged between 18 and 50 years consecutively admitted to our outpatient clinics were recruited. TMD was diagnosed by 'Diagnostic Criteria for Temporomandibular Disorders (DC/TMD)'. Spinal mobility was assessed by BASMI; disease activity by ASDAS-CRP and neck disability by Neck Disability Index. Craniocervical posture was assessed on lateral cervical X-ray by measuring the craniocervical angle, cervical curvature angle, suboccipital distance, atlas-axis distance, and anterior translation distance. A total of 98 (58.2% female) patients with a mean age of 37.4 ± 8.2 years were enrolled in this study. TMD was diagnosed in 58 (59.2%) patients. Spinal mobility and craniocervical posture measurements were similar among the two groups. Smoking, bruxism (in females), neck disability and AS disease activity (in males) were higher in TMD patients. Multivariate analysis revealed active smoking (aOR 6.9; 95% CI 1.8-25.6; p = 0.004), bruxism in females (aOR 17.9; 95% CI 2.0-159.2; p = 0.01), high ASDAS in males (aOR 11.8; 95% CI 1.2-122.5; p = 0.038) and neck disability (aOR 12.7; 95% CI 3.8-42.9; p < 0.001) as independent risk factors for TMD in AS patients. No relationship between the craniocervical posture measurements and TMD was found in AS patients. Active smoking, high disease activity in males, bruxism in females and neck disability were found as predictors of TMD in AS patients.

LIMPRINT Study: The Turkish Experience.

Background: Lymphedema and chronic edema is a major health care problem in both developed and nondeveloped countries The Lymphoedema Impact and Prevelance - International (LIMPRINT) study is an international health service-based study to determine the prevalence and functional impact in adult populations of member countries of the International Lymphoedema Framework (ILF). Methods and Results: A total of 1051 patients from eight centers in Turkey were recruited using the LIMPRINT study protocol. Data were collected using the core and module tools that assess the demographic and clinical properties as well as disability and quality of life (QoL). Most of the Turkish patients were recruited from specialist lymphedema services and were found to be women, housewives, and having secondary lymphedema because of cancer treatment. The duration of lymphedema was commonly <5 years and most of them had International Society of Lymphology (ISL) grade 2 lymphedema. Cellulitis, infection, and wounds were uncommon. The majority of patients did not get any treatment or advice before. Most of the patients had impaired QoL and decreased functionality, but psychological support was neglected. Although most had social health security access to lymphedema centers, nevertheless access seemed difficult because of distance and cost. Conclusion: The study has shown the current status and characteristics of lymphedema patients, treatment conditions, the unmet need for the diagnosis and treatment, as well as burden of the disease in both patients and families in Turkey. National health policies are needed for the prevention, diagnosis, and treatment in Turkey that utilize this informative data.

The approach of physiatrists to low back pain across Europe.

BACKGROUND: Low back pain (LBP) is the most common type of musculoskeletal pain, thus it is one of the most commonly encountered conditions in Physical and Rehabilitation Medicine. The physicians who are primarily responsible for the nonsurgical management of LBP are physiatrists. OBJECTIVE: The present study aimed to investigate the approaches of physiatrists to low back pain across Europe. Preferences, tendencies, and priorities in the diagnosis, management, and treatment of LBP, as well as the epidemiological data pertaining to LBP in PRM practice were evaluated in this Europe-wide study. METHODS: The study was conducted under the control of the European Society of Physical and Rehabilitation Medicine (ESPRM) Musculoskeletal Disorders Research Committee. A total of 576 physiatrists from most European countries participated in the survey. RESULTS: The results show that physiatrists frequently deal with patients with LBP in their daily practice. Most patients are not referred to other departments and are treated with various conservative methods. Less than one-fifth of patients are primarily referred for surgery. The physiatrists believe that a clear diagnosis to account for cases of low back pain is rarely established. The most common diagnosis is discopathy. History and physical examination remain the most valuable clinical evaluation tools for low back pain according to physiatrists. Less than half the patients require a magnetic resonance imaging. Non-steroidal anti-inflammatory drugs are the most commonly prescribed drugs for low back pain. Exercise, back care information, and physical therapy are the preferred conservative treatments. More than half of the physiatrists offer interventional treatments to patients with low back pain. CONCLUSION: The present study is a preliminary report that presents the attitudes of European physiatrists in the management of low back pain. Further researches are warranted to standardize the conservative management of LBP.

The reliability and validity of Lymphedema Quality of Life Questionnaire-Arm in Turkish patients with upper limb lymphedema related with breast cancer.

OBJECTIVES: This study aims to adapt Lymphedema Quality of Life Questionnaire-Arm (LYMQOL) into Turkish and to test its reliability and validity in Turkish patients with upper limb lymphedema related with breast cancer. PATIENTS AND METHODS: Between June 2015 and November 2015, the Turkish LYMQOL-Arm was obtained using forward-backward translation method and administered to a total of 135 female patients (mean age 51.8±9.8 years; range, 31 to 82 years) with upper limb lymphedema with European Organization for Research and Treatment of Cancer-QoL Breast Cancer-specific version (EORTC QLQ-BR23) and Functional Assessment of Cancer Therapy-Breast-4 (FACT-B+4) questionnaires. A test-retest interval of seven-days was used to assess the reliability. The validation studies were carried-out by means of construct-validity using Spearman's rank correlation-coefficient. Internal consistency and test-retest-reliability were assessed using Cronbach's alpha and intra-class correlation-coefficient (ICC), respectively. RESULTS: 135 patients completed the questionnaire with upper limb lymphedema related with breast cancer completed the questionnaires. The mean lymphedema duration was 21.1±28.7 (median: 6) months. Internal consistency and reliability of the Turkish LYMQOL-Arm was good with Cronbach's alpha (0.88-0.90) and test-retest ICC (0.45-0.71). External construct validity was highly confirmed by expected correlations with comparator scales, EORTCQLQ-BR23 and FACT-B+4 (p<0.01). CONCLUSION: The Turkish version of the LYMQOL-Arm is a valid and reliable tool for evaluating QoL in female patients with upper limb lymphedema related with breast cancer.

The Importance of Awareness and Education in Patients with Breast Cancer-Related Lymphedema.

Upper extremity lymphedema occurs in one of five women after breast cancer treatment and causes significant morbidity. Women often report being uninformed regarding awareness of lymphedema and other side effects after the cancer surgery. The aim of the study was to assess the postoperative information and education about lymphedema in patients with lymphedema related to breast cancer surgery in the rehabilitation unit of a tertiary hospital. One hundred eighty patients who had admitted to lymphedema rehabilitation unit between September 2013 and February 2015 were recruited to the study. The demographic properties of women, duration, and grade of lymphedema were recorded. The patients were asked whether they had received any information about awareness of lymphedema or whether they have been educated for reducement of the risk of lymphedema after the breast cancer surgery. One hundred eighty women with a mean age of 52.9 ± 10.7 years (27-53) and with a mean lymphedema duration of 19.8 ± +39.4 months were included. Ninety-eight (54.4 %) patients had grade 1, 80 (44.4 %) patients had grade 2, and 2 (1.11 %) patients had grade 3 lymphedema. Among the participants, only 35 (19.5 %) had reported that they had received information or education about lymphedema. One hundred forty-five patients (80.5 %) were not informed or trained about the development of lymphedema. The degree and duration of lymphedema were lower in patients that had been informed or educated about lymphedema as compared to the patients who had not been informed or educated, but the difference was not statistically significant (p = 0.052). Only a minor group of patients (19 %) had received information and education about lymphedema and there is an unmet need for education or information about lymphedema after breast cancer treatment, especially in developing countries. The nonsignificant correlation between education and the degree and duration of lymphedema was thought to be related with the incongrous numbers of the subgroups. In conclusion with the growing population of breast cancer survivors, patient awareness and education about postoperative lymphedema risk after the cancer surgery is warranted.

The effect of isokinetic and aerobic exercises on serum interleukin-6 and tumor necrosis factor alpha levels, pain, and functional activity in patients with knee osteoarthritis.

OBJECTIVES: The aim of this study is to investigate the effects of isokinetic and aerobic exercise training programs on serum pro-inflammatory cytokine levels, pain, and functional activity in patients with knee osteoarthritis (OA). METHODS: Forty-two postmenopausal women and men with knee OA according to American College of Rheumatology diagnostic criteria were included. Patients were randomized into isokinetic and aerobic exercises and control groups. In intervention groups, patients were included in predetermined exercise programs 3 times per week for 6 weeks. Severity of pain, functional activity status, muscle strength, functional capacity, and serum cytokine levels were evaluated at baseline and at the 6th week. RESULTS: At the end of 6th week, there was no statistically significant decrease in serum pro-inflammatory cytokine levels in both the exercise groups, although C-reactive protein levels exhibited a strong trend toward significance. We found a significant decrease in visual analog scale and Western Ontario McMaster Osteoarthritis Index scores, and significant increase in functional capacity and muscle strength in both the exercise groups compared with those in the control group.

The relationship between body mass index and footprint parameters in older people.

BACKGROUND: The relationship of body mass index (BMI) with footprint parameters has been studied in paediatric populations, but there are limited data regarding the effects of BMI on parameters in the elderly. OBJECTIVES: To establish the relationship between BMI and static footprint parameters in the elderly population. METHODS: 128 subjects aged 65 and above with no history of lower extremity surgical intervention and no significant lower extremity weakness were included in the current study. BMI and footprint parameters of arch angle, Chippaux-Smirak index (CSI), Staheli index (SI), arch index (AI) and footprint index (FI) were measured for each subject, and statistical analysis was done to investigate the correlation between BMI and the parameters. RESULTS: Weak correlations detected between all calculated indices and angles with BMI, except the left foot arch angle. CSI, SI and AI of the right foot were found to be positively correlated with BMI, while a negative correlation between the arch angle and FI of right foot was shown with BMI. CONCLUSIONS: The results reveal a relationship between BMI and footprint parameters that are indicative of flatfoot in the elderly. This could be due either to confounding of the footprint measure by fat or possibly due to an as yet unknown structural change that requires further evaluation.

Pulmonary abnormalities on high-resolution computed tomography in ankylosing spondylitis: relationship to disease duration and pulmonary function testing.

The aim of this study was to identify the pulmonary abnormalities on high-resolution computed tomography (HRCT) in patients with ankylosing spondylitis (AS) and to examine the relationship with the duration of disease and pulmonary function test (PFT) results. Twenty male AS patients with a mean age of 37.1 ± 9.4 years were enrolled in this study. The patients were assigned into 2 groups according to disease duration: patients with disease duration <10 years (n = 10) and ≥ 10 years (n = 10). All patients underwent clinical examination, PFT and HRCT. HRCT revealed abnormalities in 14 patients (70%). The most common findings were apical fibrosis (45%) and emphysema (25%). HRCT findings were more prominent in late AS patients (disease duration ≥ 10 years) (P = 0.015). PFT were considered as abnormal in 4 patients (20%). While 3 patients had a restrictive type pulmonary deficiency, one patient had a mild obstructive pattern. Three of these patients had concomitant HRCT abnormalities. On the other hand, 10 patients with normal PFT had abnormalities on HRCT. These findings suggest that pulmonary involvement in AS patients without respiratory symptoms could be sensitively detected by HRCT. However, the clinical significance of these radiological abnormalities should be examined in further prospective studies.

Quality of life in patients with ankylosing spondylitis: relationships with spinal mobility, disease activity and functional status.

The aim of this study was to evaluate quality of life (QOL) in patients with ankylosing spondylitis (AS) and to determine the relationships between QOL and clinical variables including spinal mobility, disease activity and functional status. Forty-eight adult patients who fulfilled the modified New York criteria for AS were included in the study. After detailed physical examination, disease-specific instruments: the Bath ankylosing spondylitis disease activity index (BASDAI) and the Bath ankylosing spondylitis functional index (BASFI) were applied. QOL was assessed using short form-36 (SF-36). The mean age of the patients was 37.0 ± 9.7 years and the mean duration of symptoms was 11.7 ± 8.4 years. Most affected domains of SF-36 were bodily pain, vitality, and physical role, respectively. No significant correlations were found between SF-36 subgroup scores and chest expansion, wall-tragus distance, chin-sternum distance, and floor-finger tip distance. Only modified Schober correlated with two SF-36 domains: physical role and bodily pain. BASDAI and BASFI scores had significant negative correlations with all SF-36 domains except for general health. Identification of QOL in patients with AS is very important in evaluation of illness-related sufferings and development of new management strategies.

Evaluation of cardiac autonomic functions in patients with ankylosing spondylitis via heart rate recovery and heart rate variability.

OBJECTIVE: The aim of this study was to evaluate heart rate variability (HRV) and heart rate recovery (HRR) in otherwise healthy ankylosing spondylitis (AS) patients and control subjects. METHODS: A total of 28 patients with AS and 30 volunteers matched for age and sex were enrolled. All subjects underwent HRV analysis, exercise testing (ET), and transthoracic echocardiography. HRR indices were calculated by subtracting first, second, and third minute heart rates (HR) from the maximal HR. RESULTS: The AS and control groups were similar with respect to age (28.7 ± 5.7 vs. 29.3 ± 5.8 years), gender distribution [(male/female) 24/4 vs. 26/4], and left ventricular ejection fraction (LVEF) (63.8 ± 2.8% vs. 65.7 ± 3.6%). Mean HRR1 (24.8 ± 4.2 vs. 28.8 ± 5.5, P = 0.001) and HRR2 (42.0 ± 4.4 vs. 48.0 ± 6.3, P = 0.001) values were significantly higher in control group. SDNN, SDANN, RMSDD, and PNN50 significantly decreased; LF and LF/HF increased in AS patients compared with control subjects. CONCLUSIONS: Patients with AS has lower HRR and HRV indices with respect to normal subjects. Cardiac autonomic functions might be involved in AS patients even in patients without cardiac symptoms.

Depression scores and associated factors in pregnant and non-pregnant women: a community-based study in Turkey.

The aims of this study were to evaluate and compare the depression scores of pregnant and non-pregnant women, and to identify the factors associated with depression scores in the two groups. This community-based study was conducted in a primary health care center catchment area in Ankara (population: 17,838) in January 2003. At the beginning of the study, the trimesters of all pregnant women (n = 66) were determined and as a control group (n = 138), two non-pregnant women matched for age and parity characteristics living in the same area were selected for each pregnant woman. Each participant completed a questionnaire and the Beck Depression Inventory (BDI). One-way ANOVA, univariate correlation, and multiple linear regression analyses were used in statistical evaluation. Depression scores of pregnant and non-pregnant women, and women at different trimesters of pregnancy were similar. Using a cut-off score > or = 18 on the BDI, 26.5% of non-pregnant women, 27.3% of pregnant women, 25.0% of pregnant women in their first and second trimester, and 30.0% of third trimester pregnant women were found to be depressive. According to multiple linear regression analysis, age, age at marriage, and the number of people living in the home were associated with depression in both groups. Depression scores were similar in pregnant women and non-pregnant controls. There were different associations between depression score and the study groups' characteristics.

Spontaneous unilateral accessory nerve palsy: a case report and review of the literature.

Isolated spinal accessory nerve (SAN) palsy is a well-recognized complication of surgical prodecures in the posterior triangle of the neck. Various rare etiological factors were also described. Whatever the etiology, the typical clinical features of SAN palsy can be listed as atrophy/weakness of the trapezius muscle and moderate winging of the scapula. It is imperative to promptly diagnose this condition in the early stage to avoid long-term impairment and to have a better functional outcome. Herein, we present a patient with a diagnosis of spontaneous spinal accessory nerve palsy, which was rarely reported in the relevant literature.

Thoracic outlet syndrome: another cause for unilateral palmar hyperhidrosis.

One of the most important therapeutic goal in hyperhidrosis treatment is to seek for the underlying cause and to tailor the treatment accordingly. A detailed history and prompt physical examination are needed to clarify the etiological factor. In this study, we report a 34-year-old woman with a diagnosis of thoracic outlet syndrome presenting with complaints of pain, numbness, and fatigue in her left arm and ipsilateral palmar hyperhidrosis. Thus, we want to highlight a specific potential cause of secondary hyperhidrosis, which can otherwise be easily overlooked, and furthermore, which has a completely different treatment strategy.

Congenital contracture of the quadriceps muscle: confirming the diagnosis with magnetic resonance imaging.

Congenital contracture of the quadriceps muscle can be defined as progressive loss of knee flexion due to fibrosis within the muscle without a history of trauma or intramuscular injection into the thighs. In the course of time, secondary changes might develop and vitiate the end result so this rare childhood disease needs particular attention for early diagnosis and treatment. Herein, we report a 14-year-old girl presented with inability to bend her knees completely. The clinical and radiological assessment was detailed with magnetic resonance imaging findings.

HIV infection and shoulder pain: a challenging case.

With better understanding of the pathogenesis of AIDS and the advent of anti-retroviral medications, patients with HIV are living longer and the probability that they will suffer musculoskeletal complications are increasing. There is a vast array of musculoskeletal impairments including rheumatologic, infectious, and non-infectious conditions. We report a 53-year-old man with longstanding shoulder pain, weakness, and spasticity of the upper extremity which was diagnosed as adhesive capsulitis secondary to brain abscess. Musculoskeletal problems may be complicated with neurological involvement as in our case and patients should be investigated for possible underlying life-threatening disease.

Evaluation of awareness of diabetes mellitus and associated factors in four health center areas.

OBJECTIVE: As in all chronic diseases, providing patients with necessary information about Diabetes Mellitus (DM) and educating them are the best method of control of DM and preventing further complication. The aim of this study was to investigate the awareness of DM and related factors in diabetics. METHODS: This cross-sectional study was conducted in four health centre areas of Ankara (n = 96,348) between 1997 and 2000. In these areas, the researches were visited every home and detected the total of 2136 diagnosed patients with DM. 62.5% of diabetics (1334) participated in the study in which a face-to-face interview was conducted to fill in a questionnaire followed by eye examination and fasting blood glucose level testing. Chi-square test and logistic regression analyses were performed to investigate the relationships between factors. RESULTS: Statistical analysis has shown that mean age of respondents was 57.4 +/- 10.9 years and majority were female (67.9%) and older onset DM (96.6%). Mean duration of DM was 7.8 +/- 6.5 years. Only 28.6% of patients (n = 382) have had informed about DM. The main information resource was found to be hospitals (76.4%), then media 19.1% and primary health care centers (PHCC) 3.9%. Patients who graduated from university were 13.5 times; who were under 50 years of age were 1.92 times; who have had prior eye examination were 1.84 times and who had co-morbidities were 1.52 times more likely to have informed about DM than the other groups. CONCLUSION: Awareness of DM amongst diabetics is very low and mainly determined by their education levels. The PHCC play a very small role in dissemination of information towards diabetics. PRACTICE IMPLICATIONS: Results from this study have implications for patient education efforts. Accurately, clinicians need to strive to improve overall levels of patients' awareness and knowledge of their specific conditions, regardless of their literacy. Many opportunities exist for raising diabetic's awareness of their disease and linking diabetic's growing health awareness with those health promoting behaviors known to reduce morbidity and mortality.

The age at menopause and associated factors at the health center area in Ankara, Turkey.

OBJECTIVES: This study is performed in one health center area in Ankara, Turkey on a women population of 50-65 years in order to demonstrate menopausal status of women, age at menopause and factors related with the age at menopause. METHODS: This is a cross-sectional study which has been performed on a women population of 50-65 years. The local population was 17,153 in this area by 2001. All of the household determining forms are screened in order to detect the all of the women who were in 50-65 years group, then name and addresses of the these women's are listed. There were 1089 women aged 50-65 years who were constituting 7% of the population. After choosing the first name randomly from the list of the women, 1/3 systematic sampling method was used and, the number of the women in the sampling was 363 (95% C.I., +/-5% S.E.). The response rate among those eligible women who were contactable during the study was 99% (360/363). Data were collected by interviews through questionnaires. The questionnaire consisted of a series of questions concerning age at menopause, socioeconomic status, age at menarche, age at first pregnancy, regularity of menstrual cycles, parity, duration of breast feeding, use of OCs, BMI, smoking habit, age at menopause of the mother and the sister. Chi-square and t-test methods were used for statistical analyses. RESULTS: 4.2% of the women were in premenopause, 13.3% were in perimenopause, 72.8% were in natural menopause and 9.7% were in surgical menopause. Average age at natural menopause was 47+/-4.2 years. Education, age at menarche, smoking, age at menopause of the mother and the sister were found to be related with the age at menopause. CONCLUSIONS: Ninety-six percent of the women over age of 50 years, are at menopause or perimenopause. The results of this study suggest that, for factors of genetic and age at menarche, there are not many possibilities for the lifestyle changes that would modify age at menopause with the subsequent reduction in risk for chronic diseases, but daughters or sisters of women with an early menopause and women who smoked or less educated could be counselled with respect to family timing.