This study examines the effects of the bundle of antimicrobial stewardship measures for prophylactic antibiotics among thoracic surgery patients. A local protocol, based on current guidelines starting from December 2014, was developed by the Infection Control and Thoracic Surgery Teams. The effects of this protocol were assessed by monitoring a total of 1380 patients before and after its implementation from January 1, 2011, to December 31, 2022.

Objective: Improvements in SARS-CoV-2 diagnosis with easy, rapid and cost-effective approaches are required to control the COVID-19 pandemic. Antigen tests result in 5 to 30 minutes, providing an advantage over polymerase chain reaction (PCR) in duration. We tested the performance of the i-test COVID-19 rapid antigen test to real-time reverse transcriptase PCR in 200 symptomatic COVID-19 suspected patients. The cycle threshold (Ct) values of the patients were found to be between 21.6 and 34.4. The Ct value of 10 patients who tested positive in the PCR test was >30. We found that the sensitivity and specificity of the antigen test were 80.6 % and 93.7 %, respectively, for samples with a Ct value of <30, and overall agreement between antigen and PCR test was 91.6 % for these samples. i-test COVID-19 rapid antigen test can be used for screening in schools, factories, nursing homes, and everywhere where PCR test is unavailable.

Objective: The study aimed to investigate the reliability of ChatGPT’s answers to medical questions, including those sourced from patients and guide recommendations. The focus was on evaluating ChatGPT’s accuracy in responding to various types of infectious disease questions. Materials and Methods: The study was conducted using 200 questions sourced from social media, experts, and guidelines related to various infectious diseases like urinary tract infection, pneumonia, HIV, various types of hepatitis, COVID-19, skin infections, and tuberculosis. The questions were arranged for clarity and consistency by excluding repetitive or unclear ones. The answers were based on guidelines from reputable sources like the Infectious Diseases Society of America (IDSA), Centers for Disease Control and Prevention (CDC), European Association for the Study of Liver Disease (EASL) and Joint United Nations Programme on HIV/AIDS (UNAIDS) AIDSinfo. According to the scoring system, completely correct answers were given 1-point, and completely incorrect ones were given 4-points. To assess reproducibility, each question was posed twice on separate computers. Repeatability was determined by the consistency of the answers’ scores. Results: In the study, ChatGPT was posed with 200 questions: 107 from social media platforms and 93 from guidelines. The questions covered a range of topics: urinary tract infections (n=18 questions), pneumonia (n=22), HIV (n=39), hepatitis B and C (n=53), COVID-19 (n=11), skin and soft tissue infections (n=38), and tuberculosis (n=19). The lowest accuracy was 72% for urinary tract infections. ChatGPT answered 92% of social media platform questions correctly (scored 1-point) versus 69% of guideline questions (p =0.001; OR=5.48, 95% CI=2.29-13.11). Conclusion: Artificial intelligence is widely used in the medical field by both healthcare professionals and patients. Although ChatGPT answers questions from social media platforms quite properly, we recommend that healthcare professionals be conscientious when using it.

Objective: Contact tracing aids epidemic control by enabling early detection and isolation without overburdening healthcare systems despite potential challenges. This study aimed to evaluate the practical application of contact and risk assessment-based models in predicting SARS-CoV-2 infection following exposure among healthcare workers in a large tertiary public university hospital in Türkiye. Material and Methods: The study was designed as a retrospective cohort study, including contact tracing data from 3389 exposed healthcare workers from March 23, 2020, to October 22, 2021. Contact-based (mask use, contact duration and distance) and exposure risk-assessment-based (low, medium, high-risk) models with and without having symptoms were generated using logistic regression. SARS-CoV-2 infection was defined as having a positive SARS-CoV-2 RT-PCR test result. Adjustments were made to the models for demographic and occupational variables, previous infection, and vaccination. Model parameters were compared. Results: Of 3389 exposed healthcare workers, 2451 underwent RT-PCR testing. Among those tested, RT-PCR positivity was 5.9% (144/2451). Lack of personal protective equipment use (odds ratio [OR]=1.64, 95% confidence interval [CI]=1.03-2.66) and ≥15 minutes of contact duration (1.89, 1.21-3.09) were significantly associated with RT-PCR positivity. In the risk-assessment model, being a high-risk contact increased the odds of RT-PCR positivity (OR=2.76, 95% CI=1.61-5.03). Adding the presence of symptoms to contact-based and risk assessment models improved model parameters (Akaike information criterion [AIC]: from 1086.1 to 1083.1; Tjur’s R2: from 0.016 to 0.019, respectively). Conclusion: The inclusion of being symptomatic improved the contact-based and risk assessment-based models. Institutions should be encouraged to incorporate symptom inquiries into risk assessment protocols in response to newly emerging respiratory virus epidemics. Institutions lacking the capacity for extensive contact tracing are recommended, at minimum, to track symptomatic exposed workers for epidemic control.

Objective: Patients with COVID-19 accompanying cancer have been reported to have higher morbidity and mortality. In this study, we aimed to evaluate the high-dose high intravenous anakinra treatment response and outcome in patients with COVID-19-associated cytokine storm accompanying cancer. Methods: This retrospective observational study was carried out at a tertiary referral center between September 01, 2021, and February 01, 2022, in Turkey. The study population consisted of two groups: patients receiving high-dose intravenous anakinra and patients treated with standard care. Results: Data from 146 patients in the anakinra group and 114 patients in the control group were analyzed. Malignancy frequency was 11% (n=16) in the anakinra group and 7% (n=8) in the control group. In survival analysis, a significantly lower survival rate was observed in patients with malignancy than those without in the control group (log-rank: p=0.002) and patients with malignancy in the control group compared to the anakinra group (log-rank: p=0.013). However, it did not differ between patients with and without malignancy in the anakinra group (log-rank: p=0.9). Conclusion: In the control group, mortality was higher in patients with malignancy compared to those without malignancy, but not in the anakinra group. Also, mortality was higher in patients receiving SoC compared to anakinra. Intravenous high-dose anakinra treatment is safe and effective in patients with COVID-19 accompanying cancer.

Objective: This study aimed to determine the predictors for significant hepatic abnormality (SHA), a treatment indication, by assessing demographic, laboratory, and radiological results of chronic hepatitis B (CHB) patients who underwent liver biopsy. Materials and Methods: In this retrospective study, individuals with untreated hepatitis B e-antigen (HBeAg)-negative CHB infection were enrolled. Multivariate analysis modeling was conducted with parameters identified as predictors for SHA in univariate analysis. Optimal threshold levels for variables to predict SHA in patients with chronic hepatitis B were determined based on receiver operating characteristic (ROC) curve analysis. Results: A total of 566 patients with untreated chronic hepatitis B were included in the cohort; 61% (345/566) were male, and the median age was 41 years (interquartile range [IQR]=34-50). Notably, 36.9% (209/566) had SHA. In the multivariate analysis, utilizing different models, age, gender, HBV-DNA, LDL, ALT, and platelet count were identified as the most reliable predictors for SHA in CHB patients. For predicting SHA, the area under the ROC curve values of HBV-DNA, AST, and ALT were 0.704 (sensitivity=62.8%, specificity=76.2%; p<0.0001), 0.747 (sensitivity=51.9%, specificity=88.9%; p<0.0001), and 0.737 (sensitivity=68.6%, specificity=68.4%; p<0.0001), respectively. Conclusion: In our study, age, male gender, ALT, AST, HBV-DNA, LDL cholesterol, platelet count, and FIB-4 score were independent predictors of SHA in HBeAg-negative chronic hepatitis B. The most sensitive parameters for SHA were LDL and ALT. The most specific param- eters were age, AST, and APRI score. SHA may occur in patients with high HBV-DNA levels, even if ALT values are normal in HBeAg-negative patients.

Objective: Antimicrobial resistance can lead to morbidity and mortality in serious infections. Therefore, this study aimed to evaluate the knowledge and attitudes of patients admitted to the outpatient clinics of our hospital about the rational use of antibiotics. Materials and Methods: Patients who applied to Infectious Diseases and Internal Diseases Polyclinics between August 01, 2021 and February 01, 2022 were included. After obtaining written consent from those who agreed to participate in the study, a face-to-face questionnaire was applied to evaluate their knowledge and attitudes about antibiotic use. Results: A total of 735 patients were included in the study; 64.1% were women, and the mean age was 40±15 years. The median of the total correct score on the scale measuring the patients’ knowledge level in the study was 5. It was determined that individuals who scored 5 or less did not have sufficient knowledge, and those who scored above 5 had sufficient knowledge. Female gender, being single, being a university graduate, and hav- ing a middle income were associated with sufficient knowledge level (p<0.05). The rates of self-starting or using antibiotics until the complaints subsided were higher in the group with insufficient knowledge (p<0.05). Conclusions: The knowledge level of our patients regarding antibiotic use provided better results in all parameters, such as the number of visits to the doctor, self-starting antibiotics, using the antibiotic in the appropriate indication, and complying with the duration. The knowledge level was found to be associated with the appropriate antibiotic use.

Objective: Reuse of medical devices poses risks concerning technical issues and patient safety. In this study, we aimed to examine the structural changes in catheters that occur due to the reuse with the aid of electron microscopy. Materials and Methods: The effects of hydrogen peroxide (HP) and ethylene oxide (EO) sterilization on four percutaneous transluminal coronary angioplasty (PTCA) catheters and control PTCA catheters were examined by scanning electron microscope (SEM). Each catheter sample was divided into four parts during the SEM examination, and a total of 20 pieces were examined. Catheters were reprocessed through every regular sterilization step and used solely for the study, not in patients. Statistical evaluations of histological scoring made on images obtained from scanning electron microscopic images were made using the GraphPad Prism 8 program. Results: Electron microscopical examination showed that HP sterilization caused more robust and deeper lines compared to EO. These distortions increased directly with the increase in the reprocessing cycle. In EO, no significant damage was detected within five cycles in contrast to HP; however, the harmful effects of EO were seen over five cycles. Unprocessed samples had no damage. Outer and inner deterioration was significantly higher in the EO>5 group and HP>5 group than in the control group. However, the bacterial contamination score in the EO>5 group was higher than the control group. Conclusion: Our findings showed that HP and EO sterilizations caused some deterioration in the inner and outer surfaces of PTCA catheter samples. We recommend reprocessing using EO, the least damaging method, when necessary, and paying attention not to exceed five cycles when necessary.

During the last years, infant and toddler practice is receiving increased attention at the policy level. Yet, little is known about what infant/toddler practice entails and how educators working with children of this age group view their role and professional identity. The present mixed methods study aims at filling the research gap on what the professional identity and the work of infant and toddler educators entails, what are the characteristics that constitute an infant/toddler educator professionally and on the extent to which they are well prepared to perform their multi-dimensional role. 51 Greek infant/toddler educators responded to an online questionnaire which included close and open-ended questions. Results reveal that the role of infant/toddler educators is complex and multi-faceted and that infant/toddler educators spent most of their time in education and care practices rather than managerial practices. In addition, results highlight that care moves beyond narrow definitions that include routines, to a broader image of care which involves educational and relational aspects. Divergences between practices adopted in infant and toddler classrooms have also been revealed. The results highlight the need to further explore infant and toddler educators’ voices about their role, professional identity and work.

e public education policy of an individual country determines, among other things, the ways of documenting the educational process and children’s outcomes. This paper explores the opinion of preschool teachers about documenting children’s development. The sample included preschool teachers from two systems, or two different curricular approaches. One exists in the Republic of Croatia (curriculum based on the competence framework) and other in Bosnia and Herzegovina (curriculum based on normative outcomes). The measuring instrument Questionnaire of Preschool Teachers’ Opinions on Monitoring the Psycho-physical Status of Children (α= .847), was constructed for research purposes. The Questionnaire was based on relevant literature and insights into existing educational practices. On a dichotomously structured 4-level scale, preschool teachers estimated that the most important purpose of documenting children’s development is the planning of developmental incentives (M=3.63; SD= 0.495). They agree that monitoring should be continuous throughout the entire academic year (M=3.53; SD= 0.666). Likewise, preschool teachers are less inclined to one-time assessments of a children’s psycho-physical status, considering “a testing” unlikely to provide a realistic image of their development (M=1.88; SD=0.797). No correlation was found between preschool teachers’ age, length of service, and level of education. Using the t-test of independent samples, a mild/weak, but statistically significant difference in the preschool teachers’ assessment between the subsamples was determined.

Reading comprehension enables each child to make meaning of the world. Therefore, it is important to develop this during the child’s primary years in school. Using ex post facto design, this study investigated the effects of reading methods on English reading comprehension of randomly selected 75 Grade 2 pupils in a private school in the Philippines. The scores of pupils who read two comparable narrative passages in oral and silent were compared. Paired t-test results revealed a significant difference between oral reading and silent reading. Silent reading had a greater positive effect on the comprehension of the pupils. Likewise, it was the most preferred reading method among the respondents. Focus group discussion with English teachers results suggested that silent reading was preferred specifically because it helps in understanding the story better, remembering words, and concentrating given its quiet and peaceful nature. It is recommended that teachers employ sustained silent reading classroom practices such as: Silent Reading Activity (SRA) Reading Laboratory, Genuine Love for Reading activities through the Four-pronged approach and Drop Everything and Read time. These methods will help to support the reading needs and preference of the generation alpha pupils and to further strengthen the positive effects of silent reading on improving their reading comprehension.

Families are the ultimate recipients of the effects of policy, but seldom get a seat at the policymaking table. This study investigated how parents perceive the impacts of unequal teacher compensation policies on New York City’s (NYC) Universal Pre-K (UPK) expansion. Utilizing Bronfenbrenner's (1979) ecological systems theory and Schneider and Ingram’s (1993) theory of social construction and policy design to create a rich conceptual framework, this qualitative study analyzed parents' voices through document and social media discourse analysis expanding from 2014 to 2021, and semi- structured interviews (n=15). Participants reflected the demographic diversity found in NYC, the largest school system in the country. The data analysis occurred in three sequential stages: (a) content analysis of documents, (b) thematic analysis of interview data, and (c) compilation of findings from these analyses to draw comprehensive conclusions. Findings revealed that while parents had limited engagement with policy, they were able to articulate the detrimental effects of compensation policies—particularly the effect of teacher turnover on their daily lives—with a disproportional effect on parents of racially minoritized backgrounds or living in low-income neighborhoods. The rich interviews unearthed the dissonance between the policy’s intent and its effect on perpetuating racial and socio-economic biases. Recommendations for advocacy and engagement are provided.

Early childhood (EC) directors played a critical role in the successful operation of childcare centers during the COVID-19 Pandemic. Directors were responsible for adhering to health and safety protocols and caring for the well-being of their staff, children, and families. Due to the need to remain open for other first responders’ families, Directors were challenged with fluctuating numbers of staff and children, and in other cases, they were tasked with transitioning their programs online to serve children. This study examines 10 US EC Directors’ perspectives and leadership experiences during the Pandemic. From interviews with the participants, themes emerged to illustrate how EC Directors utilized adaptive leadership skills and strengths-based leadership. Findings from this study are beneficial not only to understand how EC Directors led during the Pandemic, but also which skills, resources, and supports are necessary for future times of crises and challenging times. This article offers recommendations for researchers, policymakers, and other decision-makers on how best to support EC Directors in future times of uncertainty.

The global health crisis, COVID-19, swiftly enveloped people all around the world. Upon the World Health Organization declared the COVID-19 as a pandemic, numerous countries have determined their own road maps. The main purpose of this study was to understand the effect of the COVID-19 pandemic on the life balance of parents with children aged 0-6 years in Türkiye. This study was a cross-sectional design. The data was collected from 514 parents who have at least one child at the age of 6 or less. Results showed that there were several direct and indirect relationships between demographic measures (gender, age, educational status, number of children in home and employment status of parents), mediating variables (self-rated measures such as support from distance learning, support from others), and endogenous variables (life balance variables). The findings of the study showed that “new normal” has entailed potential job losses for some individuals and changed perspectives and delivery methods of education. The findings also highlighted the importance of parents’ engagement into education for understanding and helping children’s development.

Swedish school-age educare has, in the last 25 years, undergone extensive reforms with revised goals for work in practice and new working conditions. The reforms and changing conditions seem to have challenged practice in terms of quality. Since 2010, instead of programme evaluation for generating knowledge about the expected benefits for children of attending school-age educare, quality and evaluation have been regulated in the Education Act 2010:800(2010) as decentralised, continuous, ongoing systematic quality work led by school leaders and teachers themselves. The aim of this study was to examine the norms and the social order forming evaluation in school-age educare practice, including how staff think institutionally about evaluation, how evaluation is classified and categorised and identifying institutional shadows. The article is built on interviews with 53 staff members in twelve different centres. The interviews were analysed using Mary Douglas’ (1986) theory about how institutions think. The analysis contains a careful reading of interviews through a theoretically informed institutional lens and has resulted in different categories of evaluation in SAEC, as well as the identification of an institutional shadow. Children’s experiences is discussed as the institutional grip and shadowing goals and results in evaluation. Finally, it argues for institutional change.

e Jolly Phonics Lessons application is a digital tool that is designed to enhance the preschoolers’ reading and writing skills through synthetic phonics approach. This study examined the impact of integrating Jolly Phonics Lessons application into literacy lessons on the emergent reading and writing skills among kindergarten students, ages 4 -6, in the United Arab Emirates through a comparative study between pupils (Group-A), whose literacy classes were integrated with the application, and pupils (Group-B) who were taught using the traditional method of teaching literacy. Mixed methods research design was followed to analyze the effects of integrating the application. The Phonemic Awareness Assessment Inventory (PAAI) tool, field notes, and artifacts were utilized to measure the development of students’ letter-sound identification, letter formation, phoneme blending and segmenting abilities. In addition, the paper compared the growth on phonics skills between students in Groups A and B. The results showed that students in Group-A outperformed pupils who received literacy instruction through traditional methods. The findings from the PAAI scores exhibited dramatic growth in letter-sound recognition and letter formation, and substantial increase in phoneme blending and segmenting abilities of Group-A. The T-statistic for differences between two means at 95% confidence revealed that there is a significant difference between the performance of students in Groups-A and B. Implications from this study highlight the positive impact of incorporating Jolly Phonics Lessons application into literacy classes on low-achieving students. On this bases, future research of Jolly Phonics Lesson application to support mixed-ability classes or students with dyslexia.

Outdoor free play encompasses unstructured, self-directed play in the outdoors and has been shown to support children’s health and development. Accurate and reliable measures are required to conduct research on children’s outdoor free play and examine cross-sectional and longitudinal variation. This study systematically reviews and evaluates measurement approaches for children’s outdoor free play used in existing literature. A scoping review was conducted to identify English-language peer-reviewed and grey literature that included measurements of the occurrence, frequency or duration of outdoor free play with children aged 2 to 17 years old. Studies were excluded if the outdoor free play measure included structured settings or activities, or focused on a specific location or play activity. Quantitative and qualitative content analysis was used to consider outdoor free play terminology, definition, and operationalization; positioning in relation to other variables and the topic of interest; and data collection context. A total of 4,860 unique studies were identified. After screening and full-text review, 184 papers were taken forward for analysis. Parent-recall questionnaires were used in 70.1% of included studies to measure outdoor free play, often using a single question to capture the variable. A lack of differentiation between outdoor play emanating from structured and unstructured settings was common, as was limited consideration of contextual factors such as season, school or non-school days, and time of day. The implications of existing approaches to measuring children’s outdoor free play and the need for valid and reliable measures to further research examining children’s outdoor free play are discussed.

Out-of-school mathematics education is a relatively new domain. This paper examines learning environments in out-of-school mathematics education, where teachers play a role. These environments fall into three major categories: (a) real- life settings (working places, outdoor environments, daily life settings like home), (b) designed learning enviro nments (e.g., museums, libraries, zoos), and (c) outside classroom settings in schools (e.g., school gymnasiums, art studios). This study highlights interchangeable use of “non-formal” and “informal” education by researchers and raises concerns regarding potential conflicts between informal education programs that employ formal approaches and the inherent nature of informal mathematics education. As a solution, this paper proposes using La Belle’s matrix (1982) to analyze current out —of-school mathematics education programs and identify their educational approaches. This contribution will broaden the conceptualization of out-of-school mathematics education and guide future research by examining critical issues.

1990’lı yıllarla birlikte çocukluk çalışmalarının sosyal bilimlerde kendine disiplinler arası bir yer edinmesiyle çocukluğa ve çocuğa dair ilgi giderek artmaktadır. Makalede, temel çocukluk çalışmaları kavramlarının Türkiye bağlamında irdelenerek kavramsal bakış açılarının özellikle eğitim merceğinden genişletilmesi rasyoneliyle Türkiye’deki çocukluk çalışmaları literatürüne katkı sağlamak amacıyla çocuk failliği, çocuk yetkinliği ve çocuk katılımı kavramları ele alınmıştır. Bu kavramların birbirleriyle ve çocukluk çalışmalarının diğer tartışmalarıyla etkileşimlerini göz önünde bulundurarak Türkiye'den akademik ve pratik örnekler global tartışmalarla bağdaştırılmış ve bu kavramsallaştırmalardan inşa edilen çocukluk imajları üzerine tartışmalar yapılmıştır. İçinde yaşadığımız çağın belirsizlikler çağı, ilişkilerin ise daha karmaşık ve birbirine bağlı ya da bağımlı olduğunu varsaydığımızda, bu çalışma çocukluğu tartışmak için başvurulan kavramların değişken ve dinamik yapısını daha anlaşılır kılmaktadır. Bu anlamda, çalışmamız faillik, yetkinlik ve katılım kavramları üzerinden çocuğun gündelik ilişkiler ağı içerisindeki ve toplumdaki konumunu irdeleyerek, bu alanda genişletilmesi ve geliştirilmesi gerektiği düşünülen akademik ve pratik uygulamalar için önerilerde bulunmaktadır.