Zonguldak Bulent Ecevit University Thesis of the Institute of Health Sciences

ZONGULDAK BULENT ECEVIT UNIVERSITY THESIS OF THE INSTITUTE OF HEALTH SCIENCES

ZONGULDAK-2019

Contents Contents ...... 2 MASTER OF SCIENCE THESIS ...... 8 Seyda Damatoglu Çakmak, Erythrocyte Na+-K+Atpase And Antioxıdant Enzyme Activity Changes And Lipid Peroxidation In Coal Miners ...... 9 Sinan Kurtman, Iron Metabolism Markers And Malondialdehyde Levels Which Indicates Of Oxidative Damage On Alcohol Abusers ...... 10 Cemil Yavuz, Smoking Prevalence and the Factors Affecting Smoking Habits in High School Students in Zonguldak ...... 11 Serpil Subasi Caglar, Effect Of Breathıng Teaching To Pulmonary Functıon Tests On Patıents Who Had Upper Abdominal Laparoscopy Surgery ...... 12 Feride Dursun, Evaluation Of Policlinic Applies And Hospıtalised Patients Between Years 2001-2003 In Zonguldak Karaelmas Unıversity Hospıtal By Tıme Serıes Analysis ...... 13 Zühtü Sahin, Evaluation Of Baby Follow-Ups Followed Between Years 2003-2004 at Karadeniz Eregli 2. Health Center District Zonguldak ...... 14 Hakan Kalyon, Comparison Of The Health Perception Of Disabled And Non-Disabled Individuals Working In Public Sector Within Zonguldak City Center By Means Of Sf 36 ...... 15 Hulya Kulakci, Health Perceptıon Of Elderly People Who Lıve At Elderly Resıdental House ...... 16 Nurhan Gurel, To Assess The Use Of Electrical Stimulation To The Quadriseps Muscle İn The Rehabilitation Of The Patients After Total Knee Artroplasty ...... 17 Nurdan Yalcin, Determining Of Clinical Nutrition Knowledge Of Nurses Who Are Working At Hospıtals Which Have Inpatient ...... 18 Banu Saltik, Life Expectancy At Zonguldak Province In The Year 2003 ...... 19 Kurtulus Cetin, The Protectıve Effects Of Melatonın Agaınst Formaldehyde Induced Cellular Damage In Frontal Cortex, Hippocampus And Cerebellum ...... 20 Betul Kaybolmaz, The Protectıve Effect Of Ebselen Agaınst Ethanol Induced Acute Gastrıc Mucosal Injury In Rats ...... 22 Halime Pulat, The Investigatıon Of The Effectiveness Of Varıous Nutritional Assessment Methods ...... 23 Pınar Demirel, Comparıson Of Hand Anthropometric Measurements And Grip Strength In Different Sports Branches ...... 24 Emine Fidan, The Influences Of Socıo-Economic State Of Chronic Wounded Patients On Wound Formation And Treatment Process ...... 25 Yurdagul Demiroglu, Microorganisms Isolated From Chronic Wounds ...... 27 Ozlem Ozturk, Evaluating The Emotion Of Guıltiness-Shame In The Adolescents Stayed In Istanbul H Type Prison ...... 28 Tulay Ayyildiz, Child Raising Attitude Of The Mothers Of 0-6 Years Old Children In The Centrum Of Zonguldak ...... 29 Aysel Kose, Study Of Eating Habits Except Meals On The High School Students Between 15-17 Age In The Centre Of Zonguldak ...... 31 Habibe Karaoglu, High Licence Thesis The Investigation, Complications Of Nutrition That Different Nutrition Discipline Tested Over Patients ...... 32

Mustafa Onder Sekeroglu, National Basketball Team Anthropometry Profıle Obvıous ...... 33 Cagla Ozyılmaz, The Loss Of Workforce And The Cost In The Patients Havıng Chronic Wounds ...... 34 Fatma Bola, Evaluation Of Malnutrution For The Patients Who Areunder Threatment Of Dıalysıs For Chronic Kidney Failure ...... 36 Mustafa Gumus, Determination Of Anthropometric Parameters Of Traditionally Oil Wrestlers...... 37 Emel Yigen, The Assessment Of Sister Or Brother Jealousy Among The Children At The Age Of 3-6 Who Go To Kindergarten In The City Center Of Zonguldak ...... 38 Atınc Kayınova, Evaluation Of Job Satısfactıon Level Of Laborersın a Pipe And Tube Factory ...... 39 Hulya Kabalak, The Effects Of Rem Sleep Deprivation On Corneal Thickness ...... 40 Dilek Konuk, A Comparison Of Psycho-Social Development Of Children Agıng 7-11 With And Without Hearing Loss In Zonguldak City ...... 41 Nihal Kalinci, Investigation Of The Behaviours With Respect To Hand-Hygiene Of The 5th Class-Students In Prımary School In Zonguldak City Centre ...... 42 Sukru Bozkurt, Effects Of Homocysteine On The Vascular Smooth Muscles Function ...... 43 Memnune Kahveci, The Effects Of Iron Suplemantation During Pergnancy In Which On The Mothers' Hematologic Parameters And The İnfants' Antropometric Scales ...... 45 Nilufer Tatoglu, The Effect Of Self-Esteem To Academıc Achievement On 15-17 Age General High School Students In Center Of Zonguldak ...... 46 Neriman Ozcan Sahin, Investigation Of Antiasthmatic Effect Of Thymoquinon In Experimental Asthma Model ...... 47 Ecehan Yenici, The Seroprevalence Of Hepatitis B And Hepatıtıs C Of Voluntary Blood Donors That Applıed To Zonguldak Red Crescent Blood Centre Between Years 2001-2004 ...... 48 Rahsan Kalafatoglu, The Comparison Of Physical Development Of Children Who Live In Zonguldak Nursery Centre With Those Who Live Wıth Their Family ...... 49 Funda Veren, Evaluation Of The Frequency Of Home Accidents In 15-49 Aged Housewives Living In Zonguldak City Centre ...... 50 Guliz Akin, The Effect Of Sibutramine On The Behavıour Of Rats ...... 51 Sukru Madenoglu, Effects Of Thorax Physıotherapy Methods On Arterıal Blood Gases And Pulmonary Functıon Test Values Applıed In Early Pre-Operatıve And Post Operatıve Perıods To Patıents Who Had Coronary By-Pass Surgery ...... 52 Kamil Guney, The Renovatıon Of Household Survey Cards And The Comparasıon Wıth The Ones In The Prımary Health Centers In A Sample Whıch Represents The Zonguldak Provınce Center ...... 53 Ozgur Sekreter, Evaluation Of Cold Chain And Knowledge Of Health Workers In Pri Mary Healt Care Centers Which Have Immunazation Services In The Center District Of Zonguldak City...... 54 Ayse Bezir, Localization Of Basic Fibroblast Growth Factor On Placenta And Umblical Cord ...... 55 Nezahat Ozturk, Evaluation Of Hypertensive Patients According To Obesity, In The Cardiology Outpatient Clinics Of Zonguldak Karaelmas University Hospital ...... 56 Songul Demirok, The Evaluation Of Caloric Needs And Caloric Intake Of Patients' Who Are Treated In Intensive Care Units ...... 57 Dilek Duzgun, Evaluation Of Trace Element Deficiency In Coronary İntensive Care Patients With Long Time Cardiac Medication ...... 58 3

Burcin Demirel, The Evaluation Of Malnutrition In Patients Of General Surgery And Orthopedic Surgery .... 59 Ayse Serbest, The Impact Comparison of The Use of Soybean Oil Based Lipid Solution And Olive Oil Based Lipid Solution On The Platelet Counts In Children Receiving Total Parenteral Nutrition (TPN) ...... 60 Sanem Yildirim, Chemotherapy Side Effects Linked To Chemotherapy In Patient Evaluation Before And After Nutrition Education ...... 61 Asuman Ugurlu Yildiz, Intervention in Patients With Chronic Kidney Disease Life Style Change Effects on Quality of Life (QoL) ...... 62 Neslihan Yilmaz, Determınants Of Smokıng Behavıor And Desıre To Quıt Of Smoker Students In Educatıon Faculty ...... 63 Aydan Ozbay, Intervention in Patients With Coronary Artery Disease Life Style Change Effects on Quality of Life (QoL) ...... 64 Turkan Akyol Guner, An Evaluation of Shift-work and Sleep Associated characteristics in Work Life ...... 65 Vildan Kalkan Akyuz, Evulation Of The Nutrionel Status Of Pregnant Women And The Effect On İnfant Birth Weight ...... 66 Funda Kasapoglu, Evaluation Of Acute Phase Response And Malnutrition In Hemodialysis Patients ...... 67 Selda Yildiz, The Influence Of Total Parenteral Nutrition On Blood Stream Infections In Intensive Care Unit Patients With Central Venous Catheter ...... 68 Mehmet Kıvanc Erdem, Effects of Anesthetics on Pulmonary Oedema Model Induced by ANTU (alpha- naphthtylthiourea) ...... 69 Kadriye Calıskan, The Nutritional Status of The Patients Who are going under Upper and/or Lower Gastrointestinal System Surgery due to Malignancy and to Measure the Quality of Life of These Patient .... 70 Berhude Baba, Evaluation Of Occupational Accidents Occured İn Blast Furnace, Cold Mill And Steel Making Plant Unites Of An Iron And Steel Factory İn 2006-2007 Years...... 71 Ahmet Burak Türkili, Role of Angiotensin and Endothelin on Ischemia Reperfusion Injury in Rats ...... 72 Meryem Aydin, The Effectiveness Of Menstrual Physiology And Hygiene Training Provided For The Secondary School Girls In Duzce Province Primary Schools ...... 73 Emel Ertugrul, Exhaustion and The Frequency of Depression on Nurses, Midwifes, Medical Officers and Emergency Medical Technicians Who Work at a University Hospital Karaelmas University ...... 74 Cigdem Samanci Tekin, The Role of Motivation on Smoking Cessation of Students In Health Sciences Faculty ...... 75 Ozge Bilge Atay, Non-Smokers Students of Education Faculty Attitudes Against Smoking and Factors Affecting ...... 76 Gulcan Kaynar, The Role of Peripheral Benzodiazepine Receptors on Acute Lung Injury ...... 77 Nergiz Kaya, Evaluation Of Working Life Quality Of Nurses Working In A University Hospital And The Affecting Factors ...... 78 Saadet Colak Ozdemir, The Effect Of Peer Education On Preventing Smoking In High Schools In The City Center Of Zonguldak ...... 79 Aslı Gokdemir Tekeli, Effects On Seminal Mast Cells And Leucocytes On The Sperm Motility And Morphology In Men With Abnormal Semen Parameters ...... 80 Sukriye Kuzoren. Evaluation of the Follow-up of the Pregnant-Puerperal Women at Two Health Centers in Rural and Urban Areas...... 81

Sayeste Gebedek, Evaluation of Respiratory Functions Among Workers Diagnosed With Coal Workers’ Pneumoconiosis ...... 82 Bayram Kamat, How The Profilactic Usage Of Curcumin Affects The PARP-1 Immunoreactivity And Spermatogenesis In Scrotal Radiotherapy? Bulent Ecevit University, Enstitute of Health Science, Department of Histology and Embryology, Master of Science Thesis, Zonguldak, 2013...... 83 Ibrahim Pala, Protective Effect of Curcumin on Folliculogenesis, and PARP-1 Expression Exposed Ionising Radiation In Rat Ovary ...... 84 Gulsah Yapici, The Assessment Of Frequency Of Diagnosed Sleep Disorders And Daytime Sleepiness In Workers Of A Mine Enterprise ...... 85 Arzum Celik Beklevic, The Evaluation of Social Gender Roles Attitude Scale and Perception of Social Gender Roles in Work Life in Residents of a University Hospital ...... 86 Sibel Demir, Teachers' Working Conditions And Health Status Assessment ...... 87 Medine Guzel, Zonguldak Maternity Hospital Who Presented To The Knowledge, Attitudes And Preferences Influence The Shape Of The Birth Experience ...... 88 Elnaz Bagherinabel, Evaluation of Traffic Accidents With Time Series Analysis ...... 89 Dilek Horuz, Hospitalized In The Chest Diseases Department Of Music Therapy In Patients With COPD Anxiety And Its Effects On Some Clinical Physical Findings ...... 90 Hicran Demirhan, Family Burden and Quality of Life Assesment in Families Whose Children and Adolescents Evaluated Mentally and Borderline Itellectual Functioning ...... 91 Gamze Orenli, Mothers Of Secondary School Female Students Knowledge Attitude Behaviours About Cervical Cancer And HPV Vaccine ...... 92 Nesibe Sogutlu, Fecal Carriage Of Extended Spectrum Beta-Lactamase (ESBL) Producing Escherichia Coli And Klebsiella Spp ...... 94 Seda Kaya Ozdemir, Bartin Province Health Vocational High School And General High School Students Eating Habits And Obesity Prevalence ...... 96 Elcin Sebahat Kasapoglu, Evaluation of Healthy Life Style Behaviours In Students of Vocational Colleges .... 97 Fatime Filiz Kapucubas Akpınar, Assessment Of Blood Heavy Metal Levels For Traffic Polices ...... 98 Koray Olgun, Comparison of Two Different Scales In Pain Evaluation of Patients Who Received Mechanıcal Ventilatıon Support ...... 100 Dilek Karaman, Effects of Virtual Reality Applications on Pain and Anxıety During Breast Biopsy...... 101 Nurten Arslan, Examination Of The Condition Of Influence Of Family Functions On Relationship Between Healtly Adolescents And Their Disabled Siblings ...... 102 Dilek Bayram, Children Peripheral Cannula Used During The Application Of The Cardiovascular Imaging Effects On Pain And Anxiety ...... 103 Dilek Yildirim Tank, The Effect of Using Nail Polish by Operatıng Room Nurses on Bacterial Colonization After Surgical Hand Washing ...... 104 Elif Erbay, Effect Of The Distraction Technique Which Is Done During Peripheral Venous Cannulation In The Children On Reducing Pain ...... 105 Ozgur Bahadir, The Effect of Music Therapy on Anxiety, Fear and Pain Management in 6-12 Year Old Children Undergoing Surgery ...... 106 Isin Alkan, Effect of Lullabies on Babies In The Neonatal Intensive Care Units ...... 108

Tulay Basoglu Namal, Evaluation of Work Accidents in Nurses who Work in State Hospital ...... 109 Ozden Kalayci, Evaluating the Information, Attitudes and Behaviors About Foot Care of Diabetic Patients and Diabetic Foot ...... 110 Neslihan Akman, Identifying The Psychosocial Adjustment Of Patients With Chronic Obstructive Pulmonary Disease And The Difficulties Experienced By The Caregivers ...... 112 Sibel Altıntas, The Effects of Shallow and Deep Endotracheal Suctioning Applied to Neurosurgery Intensive Care Patients on Hemodynamic Parameters and Pain ...... 114 Candan Dalkilic, Effects Of Amitriptyline On The Experimental Acute And Chronic Inflammation Models .. 115 Fatma Goksu, The Effect Of Virtual Reality Headset That Is Used During Blood Drawal On The Pain Felt By The Children ...... 116 Derya Sahin, Determination of Knowledge Levels of Pregnant Women about Breast Milking Techniques and Storage Conditions ...... 117 Selda Turkmen Coban, Determination Of Attitudes Of The Nurses Who Are Working In Children Clinics In Zonguldak City Center For The Participation Of Parents In Children Care ...... 118 Musa Kiran, Effect of Lecithin on Experimental Gastric Ulcer...... 119 Musa Ozsavran, An Evaluation Of The Impact Of Art Activity For Enhancing Emotional Resiliency In Adolescents: Mandala ...... 120 Ayla Gundogdu Karakaya, Evaluation Of The Effectiveness Of Presentation And Demonstration Assisted Baby Massage Training For Newborn Baby Mothers ...... 121 Serap Demirel, Evaluation Of Training Given For Decreasing The Fears Of Hospitalized Children For Medical Procedures ...... 122 Pelin Tuncer Coban, Evaluation Of Preoperative And Postoperative Survival Of Patients With Varicose Veins ...... 123 Sevda Doğru, The Effect Of Hospitalization Education Given To The Parents Of Premature Babies In Intensive Care Unit On Their Stress Levels...... 124 Necmi Keskin, Examination Of The Relationship Between The Upper Extremity Composıtıon And It's Functıons In Individuals With Different Hand Preferences ...... 125 Hulya Ertop, The Effect Of Workplace Environment Factors On Anxiety Level In Mining Workers In Private Sector ...... 126 Aylin Kurt, The Effect Of Distraction Techniques (Finger Puppet Plays) On The Postoperative Pain Relief In Children ...... 127 Meryem Ergenc, The Effect Of Melatonin On Depresive Like Behaviour And AGE Levels In Diabetic Rats .. 128 Gaye Erdogan, Evaluation Of Postoperative Pain By The Parent, Nurse And An Independent Observer Among 1-7 Year Old Children ...... 129 Feyza Tasdemir, The Effect Of Night Sleep Characteristics Before Breast Surgery On Postoperative Pain ... 131 Sercan Zor, Evaluation Of Patients Sleep Features With Actigraphy Method In First 24 Hours After Breast Surgery ...... 132 Bircan Tasci, Calming Effect Of The Smell Of Breastmilk On The Babies Born At Term ...... 133 Sumeyye Yasar Kivik, The Effect Of Early Skin To Skin Contact On Breastfeeding For The Primaparious Mothers Giving Birth Through Epidural Anesthesia ...... 134

Oznur Yilmaz, Evaluation Of The Effect Of Play Therapy On Separation Anxiety Among Preschool Children ...... 135 Tulin Kurt, Effect Of Nature Based Voice Therapy In The Separation From Mechanical Ventilation Process Of Intensive Care Patients ...... 136 Merve Yanik, Evaluation Of The Effectiveness Of Education Given With Toy Type Nebulizer In Children Between 3-6 Years Of Age Who Receive Nebulizer Treatment ...... 137 Damla Unal, Determination Of The Relationship Between The Humorous Styles And Burnout Levels Of Nurses Working In Pediatric Clinics ...... 138 Arzu Sen, The Use Of Elastic Pressure Socks And The Effect Of Training On Surgical Patients...... 139 Ayse (Oksuzoglu) Tali, TheEffect of Oral Care on BacterialColonization in Oral Mucosa Given by Two Different Methods to Patients Supported by Mechanical Ventilators ...... 140 Nigar Ak Turkis, The Effect of Preoperative Relaxation Exercises on Anxiety Level ...... 141 PHD THESIS ...... 142 Furuzan Kokturk, Comparing Classification Success of K-Nearest Neighbor, Artifical Neural Network and Decision Trees...... 143 Mustafa Cagatay Buyukuysal, Comparison of Normality tests with Different Sample Sizes ...... 144 Anvar Hamdiev, Pharmacological Modulation of Paw Edema and Pain Behaviors ...... 145 Shemsu Umer Hussen, Effects of Different Heparin Derivatives on Experimental Pain and Inflammation Models in Rats ...... 146 Aslihan Kulekci Ugur, Factors Affecting Infant Deaths And Evaluation Of The Quality Of Life In Mothers Of Dead And Alive Babies ...... 147 Gaye Saglam, Evaluation Of Marginal Adaptation And Fracture Strength Of Endocrowns Manufactured With Different Restorative Materials ...... 148 Ezgi Akdeniz, The Effects Of Rolipram, A Phosphodiesterase 4 Enzyme Inhibitor, On Testicular Ischemia Reperfusion Injury In Rats ...... 149 Ecehan Hazar, Evaluation Of The Efficacy Of Different Techniques In Removal Of Root Canal Filling During Retreatment Of Oval Shaped Root Canals ...... 150

INSTITUTE OF HEALTH SCIENCES MASTER OF SCIENCE THESIS

ABSTRACT

Seyda Damatoglu Çakmak, Erythrocyte Na+-K+Atpase And Antioxıdant Enzyme Activity Changes And Lipid Peroxidation In Coal Miners. Zonguldak Karaelmas University, Institute of Health Sciences, Department of Biochemistry, Master of Science Thesis, Zonguldak, 2003. In this study, it is aimed to investigate the correlation among the changes in Na+-K+ATPase enzyme and lipid peroxidation with antioxidant enzymes in erythrocytes. In this respect the blood samples are taken from 40 coal miners age between 27-48, worked 1-21 years and 34 healty control group of age 27-52. We have got erythroyte ghosts from the tubes of EDTA and serum from empty tubes than estimate Na+-K+ATPase enzyme activity and MDA level from the erythrocyte membrane. Besides these we estimate SOD, CAT activity from that erythrocyte membranes. In study group while Na+-K+ATPase enzyme levels are lower than the control group, membrane MDA levels are higher. There was no significant difference in antioxidant enzyme of CAT activity between two group but found lower SOD activity in study group. As a result , a role for rising amounts of ROT commited to coal dust has been considered in the account of reduced levels of enzyme activities and increased levels of lipid peroxidation in coal miners. Keywords: Na+-K+ATPase, coal miners,antioxidant enzymes

ABSTRACT

Sinan Kurtman, Iron Metabolism Markers And Malondialdehyde Levels Which Indicates Of Oxidative Damage On Alcohol Abusers. Zonguldak Karaelmas University, Institute of Health Sciences, Department of Biochemistry, Master of Science Thesis, Zonguldak, 2003. In this study, we collected blood specimens from 25 volunteer men who were alcohol abuser and 26 volunteer men then investigated relations between MDA which is one of the end product of lipid peroxidation and iron metabolism parameters like serum iron, ferritin and total iron binding capacity and GGT, ALT and AST enzyme levels. We determined serum iron, ferritin, iron binding capacity, GGT, ALT and AST enzyme levels using an autoanalyzer and we performed spectrophotometric methods for measuring MDA levels. The findings were statistical compared by applying Student-T test. The elevated MDA, GGT, serum iron and ferritin levels were obtained on the alcohol abuser group (p<0.001). However there is no considerable difference were observed between two groups when comparing iron binding capacity, ALT and AST enzyme levels. (p>0.05). In conclusion, we thought that there were increased body iron stores on alcohol abusers and induced lipid peroxidation which was contributed liver damage. Keywords: Alcohol, serum iron, ferritin, lipid peroxidation, malondialdehyd

ABSTRACT

Cemil Yavuz, Smoking Prevalence and the Factors Affecting Smoking Habits in High School Students in Zonguldak. Zonguldak Karaelmas University, Institute of Health Sciences, Department of Thoracic Surgery, Master of Science Thesis, Zonguldak, 2003. In recent years to begin smoking age is going down and being spreading is increasing among high school students. This research is done to determine the freguency and factors affecting smoking among zonguldak high school students in 2003. This research is planned as sectional. All of the research is composed of 515 high school second level students in 23 high school depend on ministry of education. The data were collected by a questionnaire and the statistical analyze is done by ki-square and %. Subjects were occurred in 51 % girl students, 49 % boy students. The age average was 15,9+-0,7.smoking frequency was found 15,9. Smoking frequency of the boys was higher than girls students. The students used cigarette once in their lives about 55%. First smoking age was found 11,06+-3,01. Average age to begin smoking was found as 12,97+-2,33. As they grow older the smoking frequency increased. İn this research to determined ,81 % students were to buy whatever cause , 76,8 % of the students werent to force. The rate smoking was higher found in the students divorcing family or, deading or separating parents or, using alcohol or smoking brothers, living to be separated from family, or working mothers or retiring fathers. When mothers educational status and allowance increased smoking frequency increased too. When fathers educationals status increased smoking frequency decreased. The most effective factor in smoking is found as curiosity. Determined in this research, 96,5 % of the students to believed smoking is harmful to,72 % were regretful and 91,5 % was thinking to stop smoking Keywords: smoking, frequency, high school students.

ABSTRACT

Serpil Subasi Caglar, Effect Of Breathıng Teaching To Pulmonary Functıon Tests On Patıents Who Had Upper Abdominal Laparoscopy Surgery. Zonguldak Karaelmas University, Graduate School of Health Sciences, Department of Thorax Surgery, Pulmonary Physiotherapy Master Of Science Thesis, Zonguldak, 2004. The purpose of this experimental study was to evaluate the patients breathing and the effect of breathing exercises on this values on patients who had laparoscopic cholecystectomy in Pre- operative and postoperative period. Of this study consisted 40 patients who were admited Z.K.Ü. Medical Faculty Hospital, General Surgery Departmant. Of 40 patients 20 were study group, while the remaining 20 were control group. The patients has given planned breathing exercises to the study group in preoperative period. Training has been gone on in postoperative period. All of the patients who were consisted of study , had pulmonary function test (FVC, PEF, FEV1/FVC, FEV1). The differnce was found meanful. As a result, patient who had laparoscopic cholecystectomy, planned breathing teaching exercise had possitive effect on pulmonary functions test results. Keywords: Laparoscopy Surgery, Breathing Teaching, Pulmonary Function Tests

ABSTRACT

Feride Dursun, Evaluation Of Policlinic Applies And Hospıtalised Patients Between Years 2001-2003 In Zonguldak Karaelmas Unıversity Hospıtal By Tıme Serıes Analysis. Zonguldak Karaelmas University, Institute of Health Sciences, Department of Public Health, Master of Sciences Thesis, Zonguldak, 2004. The statistics of health care services have great importance in evaluation of data while planning the health service. The analysis of data will enlight the health directors about priorities and necessities. In this retrospective, descriptive analysis, policlinic apllies and hospitalised patients between years 2001-2003 evaluated by correlation analysis and linee regretion analysis at Zonguldak Karaelmas University Hospital. There were great positive corelation of time and the number of policlinic apply at Endocrinology (r=0.789;p=0.001), Gastroenterology (r=0.809;p=0.001), Oncology (r=0.757;p=0.001) ve Psychiatry policlinics (r=0.786;p=0.001). When examine the formation of lineer regration formula for policlinic applies, Gastroenterology (9.8), Psychiatry (7.5), Endocrinology (6.8), Neurology (5.5) and Opthalmology policlinic (5.3) have been observed the highest regration coefficiency. There were great positive corelation of time and the number of hospitalised patients at Pregnancy (r=0.808;p=0.001), Pulmonary diseases (r=0.866,p=0.001), Nephrology (r=833;p=0.001), Neurology (r=0.786;p=0.001), Neurosurgery (r=0.770;p=0.001), Oncology (r=0.838;p=0.001) and Psychiatry clinics (r=0.799;p=0.001). When examine the formation of lineer regration formula for hospitalisation Pulmonary diseases (1.6), Oncology (1.3), Cardiology (1.1), Pregnancy (1.1) Pediatrics (0.6) and Neurosurgery (0.6) have been observed the highest regration coefficiency. Continuation of providing evaluation and observation is a necessity for adaptation of change and improvement in instutions such as Zonguldak Karaelmas University hospital. Keywords: Time Series Analysis, Policlinic Applies, Hospitalised Patients

ABSTRACT

Zühtü Sahin, Evaluation Of Baby Follow-Ups Followed Between Years 2003-2004 at Karadeniz Eregli 2. Health Center District Zonguldak. Zonguldak Karaelmas University, Institute of Health Sciences Department of Public Health, Master of Sciences Thesis, Zonguldak, 2004. Healthy infant follow-up has the basic importance in decreasing infant deaths. Utilisation of common quality points to evaluate infant follow-ups over Infant Card at Health Centers is valuable. In this cross-sectional study, the criterion of infant follow-up quality point (IFQP) used were as follows: recording birth date, weight and length data, kinship and Rh incompatibility history of parents, graphical data, weight, length and head perimeter data at the last follow-up to Card and adequate follow-ups according to age. The record rate of data boxes in the Cards of 648 infants is evaluated. The mean record rate of boxes were 78,3%. Of the mothers, 90,7% were between age 20-34, 33,0% educated higher than primary school, 73,0% SII for health insurance, 81,3% maximum 2 delivery. Of the infants 98,7% were born in hospital, 38,6% by caesarean. Caesarean rate increased with the mother's education level. Vaccination rate of DPT-Polio and Hepatitis B were lower, Measles and BCG higher than Turkey vaccination data. The frequency of IFQP criterion were 64,9%. Mean IFQP was 6,5±1,7. Of the infants; urban (6,8±1,4), male (6,7±1,7), had higher educated mothers than primary school (6,9±1,3), had Rh incompetent parents(7,2±1,3) and followed by nurses (6,9±1,3) were significantly high IFQPs. The mean follow-up number was 1,84. Adequate follow-ups according to age were in 30 Cards. Of the infants, 77,7% were followed at most 2 times and maximum follow- up number was 5. Education, motivation and equipment support is necessary for nurses and midwives. Birth data must be recorded in the hospitals and sent to Health Centers. Education and Research Districts of Universities must be reconstituted. Community participation must be provided and health councils must work. Keywords: Infant follow-up, primary health Services, quality point, form 006

ABSTRACT

Hakan Kalyon, Comparison Of The Health Perception Of Disabled And Non-Disabled Individuals Working In Public Sector Within Zonguldak City Center By Means Of Sf 36. Zonguldak Karaelmas University, Institute of Health Sciences Department of Public Health, Master of Sciences Thesis, Zonguldak, 2004. Disabled people have priorities in the communities because of their health problems and also they are special risk groups for preventing and improving health. In this cross-sectional and comperative study, the effect of socioeconomic properties on life quality of disabled and non disabled people working in public sector in Zonguldak City is researched. The population of this study was 161 disabled people working in public sector in Zonguldak City. Of the population, 148 have accepted to answer the questionnaire. The same questionnaire was answered with non disabled 148 employer, working at the same places with disabled people. Of the disabled people, 41,9% (n=62) was orthopedically disabled, 25,7% (n=38) blind, 16,9% (n=25) deaf, 15,5% (n=23) other disabilities. Of the disabled people, 81,8% (n=121) was male, 18,2% (n=27) female, of the nondisabled; 76,4% (n=113) male, 23,6% (n=35) female. While 6,1% (n=9) of the disabled people had University degree 17,6% (n=26) of nondisabled had University degree and there were a significant difference between groups (p=0,001). The mean PCS and MCS of disabled people were 47,2 and the mean PCS and MCS of non disabled people were 50,9. The mean PCS of disabled people were significantly low (p=0,001). While the mean MCS of disable people were 49,6, 48,2 of non disabled. There were no significant difference of mean MCS between groups (p=0,141). Keywords: Working in Puplic Sector, Disability, Life Quality, Health Perception, SF-36

ABSTRACT

Hulya Kulakci, Health Perceptıon Of Elderly People Who Lıve At Elderly Resıdental House. Zonguldak Karaelmas University, Institute of Health Sciences Department of Public Health, Master of Sciences Thesis, Zonguldak, 2004. Life begins at birth and continiues with babyhood, childhood, adolescense, young adulthood, adulthood and old age. Human health is the result of individual state and environmental interaction. Age is the most important variable of public health researches and epidemiological evaluations. During World Health Day activities, it is emphasized that life quality is more important than lifetime. Although the mean number of elderly people in Turkey is lower than Western Countries, it is certain to be increased. For this reason, there must be precautions to increase life quality of elderly people. In this study, health perceptions of elderly people that live in rest homes and others in Zonguldak City were evaluated. Of the 152 subjects who accepted the study, 50.0% (n=76) were selected from rest homes. Of the elderly people that live in rest homes, 84.2% (n=64) were 60-89 age group, 43.4% (n=33) were female, 64.5% (n=49) were widowed, 35.5% (n=27) had no literacy, 9.2% (n=7) had no income, 30.3% (n=23) had no social security, 26.3%(n=20) had no child. There were significant difference of having social security (p=0.001) and child (p=0.001) between two groups. It is found that 73.7% (n=56) of elderly people that live in rest homes used a continual drug and 80.2% (n=61) had a chronical disease. Mean FSD (p=0.746) and MSD (p=0.198) were not different between two groups. Of the elderly people that live in rest homes, mean FSD were significantly different in gender (p1=0.016), educational level (p1=0.005), and monthly income (p1=0.040) groups, besides mean MSD were significantly different in gender (p2=0.011) and monthly income (p2=0.015) groups. Keywords: Elderly, Residental House, Life Quality, Health Perception, SF 36

ABSTRACT

Nurhan Gurel, To Assess The Use Of Electrical Stimulation To The Quadriseps Muscle İn The Rehabilitation Of The Patients After Total Knee Artroplasty. Zonguldak Karaelmas Universty Institute of Healt Sciences, Department of Physical Medicine and Rehabilitation, Master of Sciences Thesis, Zonguldak, 2004. Purpose : To assess the use of electrical stimulation (ES) to the quadriceps muscle in the rehabilitation of the patients after total knee arthroplasty (TKA). Material and Method : Thirty women patients who have had TKA operation were included this study. The patients were randomly assigned to 1 of 2 groups (15 patients per group). Both groups received standard knee arthroplasty rehabilitation programme. The group 2 also received ES of the quadriceps femoris muscle. The muscle strenght was evaluated with manuel muscle testing and graded 0 to 5. Knee flexion and extension degrees of patients were measured with manuel goniometer. Pain assessment was performed using 0-10 mm Visual Analog Scale (VAS). Functional assessment of patients were performed by Lequesne index. All of the measurements were performed preoperatively (0) and postoperatively first (1), second (2) and sixth (6) weeks. Results : A significant decrease in Lequesne index in both groups were found for all postoperatively weeks. VAS was significantly decreased in both groups at postoperative second and sixth weeks. Measurement of knee flexion and extension of postoperative first week were significantly impaired in both groups. A statistically significant increase in extension and flexion degree were observed in the group 2 at both 2. week and 6. week. Comparison of the two groups, only knee extension was better in group 1 than group 2. Conclusion: In all the patients that were included in the rehabilitation programme after TKA operation, there was a significant decrease in pain and progress in the functional measurements, although the progress in knee extension was more apparently seen in ES practice. The use of ES to the quadriceps muscle after TKA operation effects the rehabilitation results in a positively, because there were weakness and extansor lag in the quadriceps muscle before the operation. Keywords: Total knee arthroplasty, Lequesne index, Electrical stimulation.

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Nurdan Yalcin, Determining Of Clinical Nutrition Knowledge Of Nurses Who Are Working At Hospıtals Which Have Inpatient. Zonguldak Karaelmas University, Institute of Health Sciences, Department of Clinical Nutrition, Master of Sciences Thesis, Zonguldak, 2004. Several researches have shown that when staff, who carries out nutrition support, has adequate knowledge about this subject, the success of the treatment increases and the complication risk decreases. This research has been done to determine the level of knowledge of nurses about clinical nutrition, and the adequacy of education about clinical nutrition. This study was carried out in April-July 2004 with 302 nurses working at tree different hospitals in Zonguldak (Hospital of University of Zonguldak Karaelmas, Hospital of Health Ministry and Social Insurance Hospital). The data of this study was collected with interview technique using a questionnaire. The curriculums of programs of nurse education colleges in Turkey were investigated. Pearson correlation analysis, student t-test, arithmetical means, ANOVA one way variance analysis were used for the analysis of data. According to findings of this study, the clinical nutrition knowledge of nurses was not at the expected level and information about clinical nutrition was restricted in the other lessons. Nurses with graduate degree had higher knowledge score than the others and the duration of occupational experience of nurses didn't affect knowledge scores. There was relation between nutrition knowledge and nutrition assessment practices. According to the findings of this study, the nurse education institutions should review their curriculums about clinical nutrition and systematic education program on nutrition should be organized for nurses who are on active practice. Keywords: Clinical Nutrition Knowledge, Nurse, Education

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Banu Saltik, Life Expectancy At Zonguldak Province In The Year 2003. Zonguldak Karaelmas University Institute of Health Sciences, Department of Public Health, Master of Sciences Thesis, Zonguldak, 2005. The necessities of determining the health needs of individual and communities, evaluating health services and comparing different communities, caused to develop too many health criteria in order to ascertain the state of health and unhealth. Life expectancy is one of the health criteria that is frequently used to evaluate health and sickly for individual and communities. In this descriptive study, life table method which is transmitted by Sumbuloglu is used; the data were evaluated in 7 main groups which are: Province center, Karadeniz Ereglisi, Devrek, Caycuma, Gokcebey, Alapli and totally province. In every group, life expectancies at birth, 1 year old, 5 and 65 years old for women, men and total population were calculated with model life tables. Life expectancy for women at the Zonguldak province were calculated as follows: 76.3 years at birth, 76.7 at 1 year old, 77.3 at 5 years old and 81.1 at 65 years old. Of the population, 92.1% expected to reach 65 years old. Life expectancy for men at the Zonguldak province were: 71.7 years at birth, 72.3 at 1 year old, 72.9 at 5 years old and 79.3 at 65 years old. Of the men population, 86.8% expected to reach 65 years old. For the total population, life expectancy at the Zonguldak province were: 73.7 years at birth, 74.2 at 1 year old, 74.9 at 5 years old and 80.2 at 65 years old. Besides, 89.6% of them expected to reach 65 years old. Keywords: life expectancy, model life table, health criteria

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Kurtulus Cetin, The Protectıve Effects Of Melatonın Agaınst Formaldehyde Induced Cellular Damage In Frontal Cortex, Hippocampus And Cerebellum. Zonguldak Karaelmas University Institute of Health Sciences, Department of Histology and Embryology, Master of Sciences Thesis, Zonguldak, 2005. Formaldehyde is widely used in industry and medicine. It reacts with proteins and nucleic acids which is a very toxic and reactive compound. Formaldehyde causes cellular damage on respiratory and digestive tracts, skin, central nervous system. Melatonin is the major product of the pineal gland. Recent studies report that melatonin exerts potent free radical scavenging, antioxidant, and neuroprotective properties. In this study, we aimed to investigate the possible protective effects of exogenous melatonin treatment against formaldehyde-induced cellular damage in frontal cortex, hippocampus and cerebellum in rats. Male Wistar albino rats, weighing 210-250 g used for this experiment. Animals were randomly divided into three groups, each containing 8 animals; Control group was given intraperitoneal (i.p.) distilled water. formaldehyde treated and formaldehyde + melatonin treated groups were given i.p. formaldehyde at a dose of 10 mg/kg. Formaldehyde + melatonin group was also received 15mg/kg i.p melatonin. All injections continued for 30 days. On 31st day, frontal cortex, hippocampus and cerebellum tissues of all groups harvested for histological and biochemical investigations. Statistical analyses were carried out using SPSS 11.0 computer programme. Differences in measured parameters among three groups were analyzed by Kruskal-Wallis test. Dual comparisons between groups that present significant values were evaluated with Mann-Whitney-U test. The differences were considered to be significant when the probability was less than 0.05. Formaldehyde, significantly increased tissue malondialdeyde (MDA) levels and decreased superoxide dismutase (SOD) enzyme activities compared to the control. Melatonin treatment decreased MDA level and also increased SOD enzyme activation. In the control group, the morphology of the neurons were normal. In the formaldehyde group, shrunken cytoplasm and dark picnotic nuclei were seen in neurons. In the formaldehyde + melatonin group, degenerative changes in neurons were less than those in the formaldehyde group. The number of neurons in formaldehyde group were also significantly less than formaldehyde + melatonin and control groups. This study has shown that formaldehyde administration for 30 days causes various biochemical and histopathological abnormalities in the frontal cortex, hippocampus and cerebellum. Melatonin treatment shows antioxidant and neuroprotective effects against formaldeyde intoxication in these tissues.

Keywords: Formaldehyde, melatonin, neurotoxication, antioxidant, frontal cortex, hippocampus, cerebellum, histology.

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Betul Kaybolmaz, The Protectıve Effect Of Ebselen Agaınst Ethanol Induced Acute Gastrıc Mucosal Injury In Rats. Zonguldak Karaelmas University, Institute of Health Sciences, Department of Histology and Embryology, Master of Science Thesis, Zonguldak, 2005. The exposure of gastric mucosa to damaging agents, such as ethanol, produces structural and functional changes in the organism: inflammatory process, hemorrhagic erosions, even acute ulcers. The epithelial cells of stomach are continuously exposed to various toxic agents that may cause mucosal injury. Alcohol usage is one of the most important problem of the modern society. Alcohol can be absorbed easily from stomach epithelial tissue of gastrointestinal system that was taken by orally. Absolute ethanol-induced oxidative stress play a pivotal role in the pathogenesis of gastric mucosal injury. The base of these changes is a impairment of protective mechanisms and consequently disrupture of gastric mucosal barrier. The changes of gastric mucosa in rat includes the generation of ROT and increasing of lipid peroxidation accompanied by impairment of antioxidative enzyme activity of cells. This study presents preventive effects of ebselen, a seleno-organic compound, which is known to possess GPx like activity, antioxidative and anti-inflammatory properties, on the development of acute gastric mucosal lesions administrated by 1 ml 100% ethanol. Pre-treatment with ebselen at a dose of 30 mg/kg significantly reduced gastric injury and lipid peroxidation. H2 receptor antagonist, famotidine, which is a commonly used to treat stomach and duodenal ulcers was used as a reference drug for comparison of ebselen efficacy. Ethanol administration casused hemorrhage and edema. Ebselen reduced these histological findings. In addition ebselen pretreatment decreased MDA levels and prevented inhibition of antioxidant enzyme activities in the tissues. The present results indicate that ebselen treatment before ethanol administration prevents the development of acute gastric mucosal lesions in rats, and suggest that this preventive effects of ebselen could be due to its GPx like activity, antioxidative and antiinflammatory properties. Keywords: Ebselen,ethanol, gastric mucosal damage, oxidative stress, glutathione peroxidase, lipid peroxidation.

ABSTRACT Halime Pulat, The Investigatıon Of The Effectiveness Of Varıous Nutritional Assessment Methods. University of Zonguldak Karaelmas, Institute of the Health Science, Department of Surgery, Master Thesis of the Clinic Nutrition, Zonguldak, 2005. Aim: Malnutrition is a major problem that can still be unrecognized in medical centers. Absence of a gold standard method to assess malnutrition and insufficient interest of clinicians on this issue are the main reasons for ignorance of nutritional support. The aim of this study is to compare various techniques to assess nutritional status of hospitalized patients and to establish their sensitivity and specificity. Materıals And Methods: The sample of this study is composed of 300 patients over 18 years of age or above, excluding pregnant and childbed women, whose laboratory tests were completed and to whom all 4 of Subjective Global Assessment (SGA), Nutritional Risk Screening (NRS-2002), Nutritional Risk Index (NRI) and Instant Nutritional Assessment (INA) tests were applied in the first 48 hours of hospitalization. The clinical data of the patients were obtained by interviewing with the patients and the laboratory data from the files. SGA, NRS-2002, NRI and INA tests results were grouped into ‘well-nourished' and ‘under malnutrition risk'. Further, a combined index was constructed to group the patients into a ‘well-nourished group' if at least 3 of this four tests were ranged as well-nourished and the rest into a ‘group with malnutrition or under malnutrition risk'. Results: With combined index 47.6 % of the patients were found to be ‘under malnutrition risk'. When the nutritional assessment methods were compared, the sensitivity of SGA and INA was 82 %, that of NRI was 81 % and that of NRS-2002 was 80 %. The specificity was found to be 97 % for SGA, 96 % for NRI, 90 % for NRS-2002 and 83 % for INA. Conclusion: Among the four nutritional assessment methods, SGA seems to have the highest sensitivity and specificity that is closest to those of the combined index. When experienced clinical staff applies the test, the confidency of SGA is getting improved. Hence, all of the hospitalized patients should be evaluated by an experienced staff. NRS-2002 that is applied without any laboratory data has lower sensitivity and specificity ratios than SGA. NRI has been found to be of similar accuracy as SGA, but the need for laboratory measurement makes it difficult to use as a surveillance test. With INA, the values were lower than with the combined index and with the other tests alone. This is because of its reliance only on laboratory parameters.SGA, with the highest specificity, can be applied routinely; NRS-2002 also can be used as a routine malnutrition surveillance test due to its easiness and quickness. Keywords: malnutrition, nutritional assessment

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Pınar Demirel, Comparıson Of Hand Anthropometric Measurements And Grip Strength In Different Sports Branches. Zonguldak Karaelmas University Institute of Health Sciences, Deparmant of Anatomy, Master Of Science Thesis, Zonguldak, 2005. The individual's genes and his (her) gene structure has part in the development and changing of the hand shape. Outer factors and the work dealt with effect the structure of the hand in the process of development. It is believed that the shape of the hand will change with the intendional training in different sport branches. This study is planned to determine the hand grip strength and anthropometric features of sportsmen playing basketball, volleyball and handball in which hands are used extensively. This study has been carried out on 374 sportsmen (236 male 138 female) who attended voluntarily. These sportsmen have been grouped as young, junior and adult. Eight different anthropometric measurements were implemented from sportsmen's both hands and grip strength has been measured. Ignoring the sexual difference when basketball and volleyball compared to handball the handball players' right and left hand parameters were higher than those of basketball and volleyball players'. Right and left hand width and palm length values were found to be highest in handball players and lowest in basketball players. When hand structure was considered, handball players have “square” shaped, coarse right and left hands which are broad and powerful whereas basketball players have “rectangle” shaped, delicate right and left hands which are highly capable of grasping. In all three sports branches it has been determined that, left hand has a narrower structure than the right hand. When hand gripping values were evaluated ignoring the sexual differences and age, it was evident that the right and the left hand gripping strength values for the handball players are higher than those of the volleyball and basketball players. It has been suggested that hand anthropometric measurements and the grip strength values are tought to be important for the guidance of sportsmen competing in sport branches in which the hands are important for the performance. Keywords: Hand, Anthropometrics, Grip Strength, Sports.

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Emine Fidan, The Influences Of Socıo-Economic State Of Chronic Wounded Patients On Wound Formation And Treatment Process. Zonguldak Karaelmas University Graduate School of Healt Sciences, Depaetment of Plastic and Reconstructive Surgery, Master Of Science Thesis, Zonguldak, 2005. Inspite of the developments in education of surgery nursery care and self - care, chronic wounds keep being an important source of morbidite and mortalite. Most of ulcers are chronic and repeatable. These chronic and repeatable ulcers accompanied with complications are one of the biggest reason for losing labour force. The mantanance of these patients changes from patient to patient and leads to lose the jobs of the patients and social isolation. The cornect diagnosis of phasing these wounds will facilitate the selection of a suitable treatment technigue. But surgery and medical treatment expenditures are burden to the economy of developing countries. Since the ideal multidiscipliner approach hasn' t formed yet, Ascertaining risk groups by using basic technigues before the problem starts would be an ideal solution at least for the people who look after the patients such as doctor, nurse and any otherhealth staff. This study has been planned and materialized as a clinic research in order to search the influences of socio-economic state of the chronic wounded patients on wound formaction and treatment progress. The model group consists of people who applied to the clinics of Zonguldak Karaelmas University Application and Searching Hospital and alsa the eighty chronic wounded patients who accepted to join this research. The survey which is featured, with the patient and the definition of the chronic wound is filled out by meeting the patients and their relatives who are involved in the survey. At the end of our study, ı t has been determined that the diagnosis of 38,8 % of chronic wounded patients (n=i31) is diabetes mellitus, the underside illness of 22,5 % of patients (n=18) is diabetes millitus, and that 55% of chronic wounded patients, wound localization (n=44) has lower degree, the 35% (n=44) has middle degree and the 28,8 % of the patients (n=23) has middle degree life comfort. Remarkable differences have been achieved between the patients body mass index and chronic wound's localization; bachelors and chronic wound period and treatment period; the underside illness and wound's localization, treatment periot and life comfort. And also remarkable differences have been achieved between the diagnosis of the patient and wound's localization, the seriousness of the wound and life comfort. It has been ascertained a remarkable difference between the wound localization of the patient and life comfort; chronic wound period, the seriousness of the wound and

treatment progress; the age group of the patients and life comfort; the hazardous habits and the underside illness. It's essential to approach to the patient totally in order to recover the wound. It should be paid attention to the physical, social and cultural needs of the patient. Taking all precautions which prevent illness from emerging forevery kind of illnesses is more cheaper and morale giving than treat the illness later. Ascertaining the risky patients early by the medical staff and giving the essential education to the patients and their relatives facilitates to eradicate the problem easily and cheaply. Keywords: Wound, chronic wound, socioeconomic state, wound treatment.

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Yurdagul Demiroglu, Microorganisms Isolated From Chronic Wounds. Zonguldak Karaelmas University, Graduate School of Health Sciences, Department of Plastic and Reconstructive Surgery, Master of Science Thesis, Zonguldak, 2005. This study was carried out to determine the microorganisms isolated from chronic wounds. The subjects included 100 patients who had chronic wound treatment in Zonguldak Karaelmas University Hospital. The data collection tool prepared by the researcher on the basis of literature data. SPSS 11.0 package software was used to analyse the collected data, and the percentage, Chi-Square tests were implemented to evaluate the collected data. One hundred and forty nine isolates were cultured from 100 patients. The results demonsrated that 15 species microorganisms and 34.9% Stafilococus (18.1% Koagülaz (+) Stafilococus 16.8% Koagülaz (-) Stafilococus), 22,9% Pseudomonas, 7,4% Acinetobacter, E. Coli, 6,7% Klebsiella, 5,4% Enterococus, 4,7% Enterobacter, 3,3% Proteus, 2,7% Streptococus, 2,0% Difteroid, 2,0% Candida, 0,6% Stenetrophomonas were isolated from chronic wounds. The difference between isolated microorganisms, wound localization and etiologic reasons of choronic wound was not statistically different ( p>0.05). When compared with nonintensive care units, MRSA was more frequently isolated from care unit patients (p< 0.05). Keywords: Chronic wound, microorganisms

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Ozlem Ozturk, Evaluating The Emotion Of Guıltiness-Shame In The Adolescents Stayed In Istanbul H Type Prison. Zonguldak Karaelmas University, Institute of Health Sciences, Department of Nursing of Children Health and Illness, Master of Science Thesis, Zonguldak, 2005. An indivudual who is the most important factor in society continues his development in a specific development such as childhood, adolescence, adulthood and oldness. Individual's acquiring sense of identity occurs in adolescence period. Adolescent acquires new systems of values steming from his parent and his society in which he grows up on basis but differs from with his own experiences and feautures in adolescence period. From time to time, adolescent tends to illegal works such as theft, usurpation that the cultural and moral values of the society adolescent belongs to, don't accept. Under these circumstances, as a consequance of acting the behaviour that the society or the parent don't approve, adolescent may have the emotion of guiltiness-shame with the trouble of not belonging and not accepted. Currently the number of guilty adolescents has been increasing according to number of commiting crime. Regaining guilty adolescents to the society effects the development level of the society positively. For this reason, the precautions in order to regain the adolescents staying in prison should be taken. This study has done to evaluate the emotion of guiltiness-shame in the adolescents who stay in İstanbul H Type Prison. This study has been carried out with the application of 380 adolescents accepted to involve in this study from 416 adolescents stayed in prison. It is reported that from all the adolescents staying in prison, 90.0% (n=342) are between 15 and 17 years old. When GP (Guiltiness Points) and SP (Shame Points) are examined, a significant difference has been found in terms of average GP and SP according to the numbers of entering prison (p1=0.001, p2=0.001), their belief about joining the society as a qualified person (p1=0.001, p2=0.001), their desires about what they want to do after they leave prison (p1=0.008, p2=0.020). Moreover, a significant difference has been found in terms of GP according to their father's education (p1=0.041), wealth condition (p1=0.036), their parent's using addictive drugs (p1=0.002), themselves important (p1=0.015). Also, a significant difference has been found in terms of average SP according to their ideas about the crime that they committed in the adolescents who involve in the investigation. Keywords: Adolescent, Prison, Nurse, Emotion Of Guiltiness-Shame

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Tulay Ayyildiz, Child Raising Attitude Of The Mothers Of 0-6 Years Old Children In The Centrum Of Zonguldak. Zonguldak Karaelmas University, Institute of Health Sciences, Department of Nursing of Children Health and Illness, Master of Science Thesis, Zonguldak, 2005. The child raising attitudes and conducts are important for the children in the course of socialization to develop a healthy personality, live in peace with themselves and the community, and become self- confident individuals that would make contribute to the community. This study was carried out to determine the child raising conducts and attitudes of the mothers of 0-6 years old children in the Centrum of Zonguldak, and evaluate the factors that affect such conducts and attitudes. The sampling group comprised of 382 mothers of 0-6 years old children living in the Centrum of Zonguldak. The data collection tools included a personal questionnaire and the family life and child raising conduct scale consisting of five subscales. Statistical analyses were performed using Student t Test, One-Way of Analysis Variance, Post Hoc Tukey Testi or Kruskall- Wallis Variance Analysis. It was determined that 64.1% of the mothers were between the ages of 25 and 34 years, 86% of them had no schooling, 83.8% of didn't have any job and 41.6% had two children. The study demonstrated significant differences in the average points of the mothers for protective conduct depending on the mother's age (p=0.012), education (p=0.001), employment (p=0.001), settlement unit where the mother lived for the longest time (p=0.025), number of children (p=0.001), knowledge on the child growing (p=0.001), having a baby readily (p=0.004), permanent health problems of the children (p=0.002), help and support of the spouse (p=0.004), the father's education (p=0.001) and employment (p=0.044). The difference was significant in the points for democratic conduct, depending on the mothers' education (p=0.004), conducts of their mothers (p=0.020), the father's education (p=0.005) and employment (p=0.001). The points for defiance of being a housewife were significantly different, depending on the mothers' age (p=0.013), education (p=0.001), employment (p=0.001), conduct of their mothers (p=0.001), available knowledge on the child growing (p=0.008), self-confidence on child growing (p=0.007), the father's education (p=0.001) and the number of children (p=0.009) . However, the points for conduct on conflict with spouse were significantly different in terms of the mothers' education (p=0.001), employment (p=0.001), having a baby readily (p=0.012) and the father's education (p=0.001) and spouse help and assistance (p=0.001). There were significant differences in the points for authoritative conduct, depending on the mother's age (p=0.007), education (p=0.001), employment (p=0.001), settlement unit where the mother lived for the longest time (p=0.001), ability to take care of children at a desired level (p=0.21), knowledge on child raising (p=0.001), having a baby readily

(p=0.019), permanent health problems of the children (p=0.011), spouse help and support (p=0.001), number of children (p=0.001), the father's education (p=0.001) and employment (p=0.010).

ABSTRACT

Aysel Kose, Study Of Eating Habits Except Meals On The High School Students Between 15-17 Age In The Centre Of Zonguldak. Zonguldak Karaelmas University Institute of Health Sciences, Department of Nursing of Children Health and Illnesses, Master of Science Thesis, Zonguldak, 2005. A very important part of first step in health services, which is described as at the nearest of the individuals and accessible, consists of protecting and developing health. The role of school nurses who protect and develop health is very important in developing and continuing protector health services. Insufficient and unbalanced eating habit especially has become the first health problem of adults in high schools. For this reason, education programs should be established about balanced eating habits for adults by school nurses. This survey has been done to search for both eating habits and also some characteristics in related to eating habits of adults except meals for middle adolence period in high schools. It has been determined that 39.1% of adults joined this survey are 17 years (n=190), 56.4% of them is girl (n=274), 26.2% is in 50th percentile (n=127), 59.7% has eating habit except meals (n=290), 90.3% of them realizes this eating characteristic while spending time with its friends (n=262), the most eaten male is chocolate-waffer with 33.1% (n=161). Comparing the groups, when it is investigated that the eating habit expect males according to sexuality (p=0.001) and incoming of family (p=0.036), an suitable difference has been observed. However, there is no difference comparing the eating habit except males and some characteristics like residensial area, working condition and education level of the parents, manner of family and geting pocket money. Keywords: Adults, eating habit except meal, school, school nursery

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Habibe Karaoglu, High Licence Thesis The Investigation, Complications Of Nutrition That Different Nutrition Discipline Tested Over Patients. Zonguldak Karaelmas University, Science of Health Institute, General Surcical Main Science Branch Consultant of Thesis, Zonguldak, 2005. Aim: this study practiced on patients took different nutrition discipline to invesitigate nutrition complications with aim. Material and Method: the results discussed to pretend not to see nutrition support cure protocols practiced and by patients's responsible clinics or nutrition unit that patinet's needing and clinic operators's offer at the Zonguldak Karaelmas University Practice and Research Hospital between in October 2003 March - 2004 periods. Study limited with 60 patients that comprise 20 patients with enteral, parenteral and both of them tested together. Findings: 24 % of patients are female (40%), 36 % of patients are male (60%). Patients's age averages determined as 62.8 (20-92)±17, patients's APACHE II scores totally are 16.8 (3.0-33.0)±7.5 and expecting average found 30.7 %. Nutrition complications which APECHE II seems over patients found that more seems in 1120 scores, but not observed a difference as statistically (p>0.05). 19 of nutrition complications that observed total 35 patient who has extra complication related with cause, 16 of 20 patients have not any complication not observed complication related with nutrition. Conclusion: 60 patients involved in our study observe who individually observed and treated by nutrition support team and clinic operators. Seems complications are just GIS complications, considered related with must not use route of GIS of patients in parenteral group. rare complications seems in enteral group which is related with primer cause and considered able to increase with nutrition complications and observed to stretche by nutrition modification Keywords: support nutrition, complication, APACHE II

ABSTRACT

Mustafa Onder Sekeroglu, National Basketball Team Anthropometry Profıle Obvıous. Zonguldak Karaelmas University, Institute of Health Sciences, Departman of Anatomy, Master Of Science Thesis, Zonguldak, 2005. Anthropometry which determines the physical characteristics of human body by using specific measurement methods helps people to accommodate with everyday life. Body composition determined by using antropometric data is also used to evaluate growth and nutrition state, to follow- up some diseases and to evaluate the performance of physical activity. It is considered that body composition affects success in different sports branches. This study aims to determine the antropometric characteristics and body composition of National Juniour Male Basketball Team. 16 sportsmen who were invited to National Team in 2003-2004 season participated in this study. Height, weight, skin fold thickness, length, body perimeter and diameter of the sportsmen participated the study were meausured. The somatotype of the sportsmen were determined by using Heath-Carter equation. As the result of the measurements, endomorphy is 2.06±0.92, mezomorphy is 3.12±1.54, and ectomorphy is 4.68±1.57 when whole group is considered. It has been determined that National Juniour Male Basketball Team is mezomorphic ectomorphy. In other words, sportsmen are tall, thin with low fat percentage and they have thin and dainty body. In this study, the antropomertic characteristics and body composition of elite sportsmen in this category have been displayed. It is important to determine sportsmen, compatibiltiy to the branch by comparing somatotype characteristics with elite sportsmen, as well as sportsmen aptitude to the branch in orientation to a specific branch. Keywords: Basketball, Anthropometry, Somatotype

ABSTRACT

Cagla Ozyılmaz, The Loss Of Workforce And The Cost In The Patients Havıng Chronic Wounds. Zonguldak Karaelmas University Institute of Health Sciences, Department of Plastic, Reconstructif and Aesthetic Surgery Master Of Science Thesis, Zonguldak, 2005. Chronic wounds are illnesses which are seen in all age groups, look on long- term illness situation, can decrease the life quality when they are not treated well, cause workforce loss and have a high cost. Determining the loss of workforce during the illness is important in terms of determinig the physical and emotional loss of the patient. Also, as the patient is in the condition of consumer instead of producer (thus, being paid without working), this situation causes the social insurance administration damage. Moreover, determining the costs of chronic wounds and the factors forming these costs is significant in terms of society's health. Being aware of the cost of illness and the factors forming it is the first element in order to start the efforts decreasing the cost of illness. So, it is possible to contribute to the health and economy of the country in a positive way with the cost- effective treatment. For this reason, this study has been done to assess the loss of workforce and the cost in the patients having chronic wounds being treated in Zonguldak Karaelmas Universty School of Medicine. This study has been carried out with the participation of 116 patients accepting to involve in this study. It is reported that from these patients , 31 % are between 58 and 49 years old, 84 % are male, 41 % graduated from high school, 34 % are occupied with business, 60 % have monthly income between 500 YTL and 700 YTL, 57 % have social insurance in pension fund.In the patients having chronic wounds, a significiant relationship between groups has been found according to hindering their life activities excessively or more excessively ( p1=0.064 , p2=0.407 ), according to not working or hindering their work ( p1=0.008 , p2= 0.040 ) in terms of average hospitalisation period ( A.S.P.) and average cost ( A.C. ). A significiant relationship has been found according to their dependency on another person during the treatment period in hospitals (p1=0.011), inability to work as in the past after the chronic wound appears (p1= 0.039), current chronic wounds (p1=0.025 ), quality of life ( p2= 0.018 ) in terms of A.S.P. average. A significant relationship has been found according to their having green card (Green Card is a card which is given to individuals having low wealth condition and not working in a government corporation or any other private corporation with their application in order to benefit from the health services) (p2=0.012 ) in terms of A.C. Consequently, chronic wounds cause patients whether not to carry out their daily activities in a regular and healthy way or to decrease their productivity in their occupational life. In addition,

repetitive chronic wounds make the treatment and the care be longer and make the cost-effective be higher. Keywords: Chronic Wounds, The Lost of Workforce, The Cost of Treatment

ABSTRACT

Fatma Bola, Evaluation Of Malnutrution For The Patients Who Areunder Threatment Of Dıalysıs For Chronic Kidney Failure. Zonguldak Karaelmas University, Institute of Health Science, Department of Clinical Nutrition, Master Of Science Thesis, Zonguldak, 2005. Malnutrition is one of the most common problems in patients who have chronic kidney failure. Various metabolic and nutritional anomalies can develop during chronic kidney failure. Studies showed that it is a bad prognostic sign of protein- energy malnutrition at the begining or during hemodialysis. Therefore suffıciency of hemodialysis and evaluation of nutrition at dialysis patients is very important in terms of prognosis of disease. Aims of this study are 1. investigating the correlation between hemodialysis periods and intensity of malnutrition, end techniques of nutritional evaluation for patients with chronic kidney failure and patients who are under dialysis 3 times in a week. This study consisted of 72 patients who get hemodialysis 3 days a week in Hemodialysis Unit of Ibni- Sina Hospital, Ankara University School of Medicine, Department of Nephrology, in November 2003. Data of the study is collected with interview technique using a questionnaire. Findings are evaluated using SPSS for Windows. Analysis methods are: one-way variance analysis, Bonforroni test, Kruskall-Wallis variance analysis and Ki-square test. In our study, it is found that patients are given sufficient amount of hemodialysis according to results of hemodialysis-suffıtiency tests. When evaluated in terms of extended duration of hemodialysis, decrease of CRP and normalization of transferlevel is observed. When scores of SGD (Subjective Global Survey) investigated according to duration of hemodialysis there is no important difference observed. However, decrease of rates of triceps skin curl thickness was observed. According to fmdings, we can conclude that chronic hemodialysis patients should be followed-up for risk of malnutrition and in terms of effects of dialysis. This study also shows that applying appropriate nutrition and effectiveness of hemodialysis prevents malnutrition in years. Keywords: Chronic Kidney Failure, Hemodialysis, Nutritional Evaluation.

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Mustafa Gumus, Determination Of Anthropometric Parameters Of Traditionally Oil Wrestlers. Zonguldak Karaelmas University, Institute of Health Sciences, Departman of Anatomy, Master Of Science Thesis, Zonguldak, 2005. Anthropometric parameters are important factors that effect the success and performance of sportsman and important in oil wresting sports. The aim of this study is to investigate anthropometric measurements and body compostions of traditional 52 oil wrestlers who attended 643 rd Kirkpinar Oil Wrestling Tournoment at 2004 at four diffrent categories. The height, weight, skinfolds, circumferences, diameters, lenghth parameters of wrestlers were measured. Somatotypes of wrestlers were determined using Heath-Carter formula. Evalatuation of parameters were performed using; Microsoft Excel Software, mean, standart deviation and equations were calculated. Anthropometric parameters of all wrestlers are measured as height 178±0.05 cm, weight 92,25±9.68 kg, triceps skinfold thickness 11.47±3.56 mm, subscapular skinfold thickness 13.80±3.23 mm, suprailiac skinfold thickness 8.26±2.45 mm, calf skinfold thickness 9.23±2.48 mm, shoulder-elbow length 34.4±3.4 cm, forearm length 27.96±1.68 cm, upper extremity length 79.84±3.81 cm, thigh length 50.50±4.37 cm, knee height 50.52±2.86, lower extremity length 101.88±5.40, head circumference 58.34±2.06 cm, shoulder circumference 133.30±6.95 cm, chest circumference 105.08±6.25 cm, biceps circumference 35.51±2.49 cm, biceps circumference at flexion 39.95 ±2.60 cm, forearm circumference 30.46 ±1.34 cm, ankle circumference 27.30 ±13.2 cm, calf circumference 39.98 ±2.56 cm, thigh circumference 58.02 ±3.82, hip circumference 106.09±4.98 cm, abdomen circumference 94.05 ±5.71 cm, wrist circumference 19.00 ±0.69 cm. The diameters measured were as wrist diameter 62.24±2.10 mm, humerus bicondylar diameter 74.90±3.88 mm, femur bicondylar diameter 103.69±9.85 mm, chest diameter 33.98±1.31 cm, chest depth follows 26.64±2.84 cm, biacromial diameter 45.96±3.10 cm, biiliac diameter 32.73±5.05 cm, bitraconteric diameter 34.28±1.79 cm. According to analysis of somatotypes the whale study group endomorphi was 3,65±0,58, mesomorphi were 7,45±0,45, ectomorphi was 1,17±0,09, as a general evaluation wrestlers endomorphic mesomorph. As a conclusion wrestlers were middle heighted, had slightly rounded appearance and had an extremely muscular body. Keywords: Oil Wrestlers, Anthropometry, Somatotype Science

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Emel Yigen, The Assessment Of Sister Or Brother Jealousy Among The Children At The Age Of 3-6 Who Go To Kindergarten In The City Center Of Zonguldak. Zonguldak Karaelmas University Institute of Health Sciences, Department of Nursing of Children Health and Ilnesses, Master of Science Thesis, Zonguldak, 2005. The first 5-6 years during which the basis of personality is established is child's period of socialization. At the begining of childhood jealousy includes mother and father. Because the child wants care and tenderness he usually finds himself in comparison with other children jealousy in children between the age of 3-6 years old begins with the arrival of a new baby. This defining study is done in order to evaluate the jealousy of sister or brother on children between 3-6 years old who have sisters or brothers who attend kindergarten and nursery schools belonging to M.E.B. and Social Service Organization in the centre of Zonguldak. The study includes families of 210 children between the ages of 3-6 and who have sisters or brothers and who attend kindergartens and nursery schools. Before the illustration done it is aimed to reach 210 children's mothers. 140 mothers (%66.6) who accepted to join the research are reached. In the research , having the ideas of 3 experts on the signs of brotherhood jealousy, a public survey prepared and applied. The data gathered is transfered to ‘‘SPSS for Windows 11.0''. It is found out that %41.4 (n=58) of the mothers were university graduates. It is also found out that %43.6 (n=61) of the children were the first child of the family, %55.0 (n=77) were the second child of the family, %65.7 (n=92) wanted to use his brother's belongings, %60.7 (n= 85) said their family behaved his brother differently, %56.4 (n=79) asked constanty if his parents love him or not, %52.9 (n=74) didn't share his toys with his brother, %51.4 (n=72) behaved in a very spoilt way. There is a three years difference between the children of the mothers' who joined the survey. Jealousy behaviours of the children under the research is much more obvious now than they first learned that they will have a brother and it is found out that during this time jealousy behaviours has developed (p=0.00).

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Atınc Kayınova, Evaluation Of Job Satısfactıon Level Of Laborersın a Pipe And Tube Factory. Zonguldak Karaelmas University, Institute of Health Sciences, Department of Public Health, Master of Sciences Thesis, Zonguldak, 2005. It is important to determine variables that affect health and causes job difficulties at work system in order to solve the problem. The issues such as; relation between workers, directors, the type of direction, the wage policy affects the workers job satisfaction and loyalty. Job satisfaction is effective on both physical and psycological health of the person. Therefore, it will be helpful to fînd out the job satisfaction level and factors effecting of heavy industry workers. In this cross sectional study, we used “Job Satisfaction Scale” which is created by Hackman and Oldham, and adapted to Turkish by Gödelek and Güler. Job satisfaction points are studied with sociodemographic survey and work life data. In this study, of the 130 employee, 109 had answered the “Job Satisfaction Scale” and sociodemographic survey. Ali the participants were male. Of the participants; 61,5% were working at product section, 93,6% were married and 89,4% had child. The mean age were 33,0±5,7 and, the mean work experience were 8,9±6,2 years. Of the participants; 38,5% had occupational accident. The mean job satisfaction point was 43,5± 11,7 and the median was 43,0. There were no significant association of job satisfaction point with duty at work, occupational experience, had/had not occupational accident, age, marital status, had/had not child, level of education as a result; there were no significant association with job satisfaction points of tube and pipe factory laborers with personal properties and work conditions. There must be a corporate policy and action plan that will perform the participation of heavy industry laborers in improving work conditions and institutional organization that will perform the continuousness. Keywords: Occupational health, job satisfaction, heavy industry.

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Hulya Kabalak, The Effects Of Rem Sleep Deprivation On Corneal Thickness. Zonguldak Karaelmas University, Institute of Health Sciences, Department of Physiology, Master Of Scıence Thesis, Zonguldak, 2005. In this study, we aimed to investigate the possible effects of REM sleep deprivation on corneal thickness in mice. For the investigation, 24 healthy male Swiss albino (25-30gr.) mice randomly alloted into three groups, each containing 8 mice. REM sleep deprivation group (RUY) was treated to 7 days of REM sleep deprivation by using flower pot technique. REM control group (RK) was treated to the same technique without REM sleep deprivation. Control group (KK) was not received any treatment. At the end of the 7th day, All animals were sacrified. Cornea and blood samples were harvested for histological and biochemical analyses. After routine histological tissue processes, corneal thickness of all groups measured on a light microscope by using an image analysis computer program. Also, plasma NOx levels measured biochemically. All the data of this study was expressed as arithmetic mean ± S.E.M. Statistical assessment was performed using one-way analysis of varience (ANOVA). Significance refers to results where p < 0.05 will be obtained. The results showed that there was no significant differences on the total and stromal cornea thickness between the groups. Also, REM sleep deprivation did not cause any histopatological abnormalities on the corneal tissues. Biochemical analysis indicated that plasma NOx levels of the groups were not statistically sigificant. Consequently, we suggest that there was no effect 7 days of REM sleep deprivation on corneal thickness in mice. Keywords: REM sleep deprivation, corneal thickness, ‘flower pot' tecnique, nitric oxide, mice.

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Dilek Konuk, A Comparison Of Psycho-Social Development Of Children Agıng 7-11 With And Without Hearing Loss In Zonguldak City. Zonguldak Karaelmas University, Institute of Health Sciences, Department of Nursing of Children Health and Illnesses, Master Of Science Thesis, Zonguldak, 2006. The sense of hearing, might affect communicative and behavioral skills, educational life and relations with other individuals of a child. Such problems might impair psycho-social development of deaf children. The aim of this study was to compare psycho-social development of children with and without hearing loss in a group aging 7-11. In this study, pscho-social development of 30 deaf children who had hearing loss before language acqusition and 61 children with normal hearing were assessed comparatively. In order to measure the level of psycho-social development of children, a psycho-social development scale composed 135 items, adapted to Turkish children by Yavuzer was used. The scale was completed for each child with the information given by the parents and evaluated according to scoring system of the scale. As comparing psycho-social development scale scores of normal hearing children and the children with hearing loss in 7-11 age group it is found that 7 years old children with normal hearing were got 69.1 and with hearing loss 53.6; 11 years old children with normal hearing were got 103.8 and with hearing loss 71.1 points. The difference between those mean values were found to be statistically significant. The subgroups of psycho-social development scale; economical independence, individual freedom, changing the place, spare time facilities, money, reading and book interest, social life issues, parental relations, relations with the same aged were also compared and evaluated between the groups. As a result of this evaluation it is found that 7-11 years old deaf children were having lower psycho-social development than normal hearing children. As evaluated to determine the relation between the age and the psycho-social development, its found that increasing age were increased strength of pyscho- social development. The mean scores of male children included the study were found to be higher than the mean scores for female children in both groups. In addition it was found that the scores of children in middle socio-economic level were higher than the scores of children in low socio-economic level. Keywords: deaf children, hearing loss, psycho-social development, pediatric nursery, pediatric development.

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Nihal Kalinci, Investigation Of The Behaviours With Respect To Hand-Hygiene Of The 5th Class-Students In Prımary School In Zonguldak City Centre. Zonguldak Karaelmas University, Institute of Health Sciences, Department of Nursing of Children Health and Illnesses, Master Of Science Thesis, Zonguldak, 2006. Children might learn easier during primary education, may improve behaviours concerning the health and carry these behaviours to their future lives. Hands which are used frequently in daily life get easily dirty and turn out a serious source of epidemic diseases. To aequire hand hygiene behaviuors that are easy and economic for all society starting with children will decrease the incidance and spreading of epidemic diseases and this will play an efficient role to improve health level of society. Our research was carried out through determining hand hygiene behaviours of primary education 5th class student in the central districts of Zonguldak city and it was aimed to investigate possible variables that influence hand hygiene behaviours. The study was accomplished by participance of 585 students studying at the 5th class of 27 primary school in Zonguldak city center. According to the result of study, 85.5 % of 5th class students in primary schools are 11 years old (N=500), 3.0 % (N=14) of students expressed that they got information concerning hand hygiene from health personnel. No significant difference was found concerning hand hygiene behaviour points of students comparing whether they were informed about hand hygiene (p=0.001), pre-school educational status (p=0.001) and whether they suffer health problems regarding their hands (p=0.001). Furthermore, significant differences of hand hygiene points were found out concerning sexuality (p=0.001), father' education (p=0.001), mother' education (p=0.001), order of birth (p=0.025) and economial in come level of students' families (p=0.001). Comparing the exitence of bathroom in students' house (p=0.002), and spring in front of their houses (p=0.015) significant difference was detemined among the groups. According to the results we obtained, in order to goin appropriate behaviours of hand hygiene for primary school education students, health education related to hand hygiene needs to be implemented in accordance with student' economical status. Suitable atmosphere should be created perform appropriate hand hygiene behaviours. Family education is also important awing to education starts in family. It is thought that education of stutdents and efficiancy of school health nursing services may influence students to advance hand hygiene behaviours and improve the health level of society. Keywords: Hygiene, hand hygiene, primary school student, school health nursing

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Sukru Bozkurt, Effects Of Homocysteine On The Vascular Smooth Muscles Function. Zonguldak Karaelmas University, Institute of Health Sciences, Department of Pharmacology, Master Of Science Thesis, Zonguldak, 2006.

Elevated plasma concentrations of total homocysteine are associated with increased risk of coronary artery disease, cerebrovascular disease, peripheral vascular disease, and thrombosis.

Epidemiological and experimental data have shown that homocysteine may provoke vascular lesions and that moderate homocysteinemia may constitute an independent risk factor for vascular disease. Although hyperhomocysteinemia has long been recognized as an independent risk factor for vascular disease, the mechanisms of the pathogenesis of homocysteine are largely unknown. The increased vascular risk associated with hyperhomocysteinemia has been linked to homocysteine- induced endothelial cell dysfunction. Indeed, homocysteine has been reported to alter the phenotype of endothelial cells by impairing the activation or production of mediators involving in coagulation, platelet aggregation, and fibrinolysis by modulating adhesion molecule expression, and by reducing the production or bioavailability of vasoactive mediators.

The aim of this study was to investigate the effects of homocysteine on vascular responses. The effect of short-term exposure to homocysteine on the contractile and dilator characteristics of rat aortic tissue was assessed in vitro.

Experiments were carried out on thoracic aorta rings isolated from rat of either sex. Isolated rat thoracic aorta rings were mounted in an organ bath. An initial tension of 1.0 g was applied and the contractility was recorded isometrically via a force-displacement transducer.

In a series of experiments the concentration-response curves of acetylcholine (10-9-10-5 M) and sodium nitroprusside (10-9-10-5 M) were assessed and repeated in the presence of homocysteine (10- 3 – 3x10-3 M). After a submaximal contraction (%70-80) was elicited with phenylephrine, cumulative concentration-response curves were made for acetylcholine and sodium nitroprusside.

In another series of experiments the contractile response curves to phenylephrine (10-9-10- 4M),angiotensin II (10-9-10-6 M) and noradrenalin (10-9-10-5 M) were performed in thoracic aorticrings and repeated in the presence of homocysteine (10-3 – 3x10-3 M).

Endothelium-dependent vasorelaxation (acetylcholine) was significantly reduced in rat aortic rings treated with homocysteine compared to controls. There were no differences in

endotheliumindependent vasorelaxation (sodium nitroprusside) between control and homocysteine- treated groups. The contractile effects of angiotensin II and noradrenalin in the aortic rings were reduced when the rings were preincubated with homocysteine. The contractile effect of phenylephrine was reduced except higher doses of phenylephrine (10-9-10-7 M).

The contractile effect of phenylephrine was increased higher doses of phenylephrine (10-5-10- 4M).These data demonstrated that homocysteine significantly decreased acetylcholine- endotheliumdependent (NO-related) vasorelaxation. The results also indicate an early detectable inhibitory effect of homocysteine on the in vitro contractile properties of vascular smooth muscle.

This study suggest that the changes of vascular characteristics by homocysteine may play important roles in vascular lesion formation and vascular disease such as atherosclerosis and hypertension in the hyperhomocysteinemic patient.

Keywords: Homocysteine, Endothelium, Vascular disease

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Memnune Kahveci, The Effects Of Iron Suplemantation During Pergnancy In Which On The Mothers' Hematologic Parameters And The İnfants' Antropometric Scales. Zonguldak Karaelmas University, Institute of Health Sciences, Department of General Surgery, Master Of Science Thesis, Zonguldak, 2006. Iron treatment is a polemical matter during pregnancy in which anemia is not detected. In the situations of pregnant women who don't use iron, the effects of decrease in the iron stores on the infant growth are not exactly defined. Our study's aim is to investigate the relationship between the mothers' hematologic parameters and the infants' antropometric scales. In this study, the Hb, hemotocrit serum iron, serum iron-binding capacity and serum ferritin level in mothers who use and don't use iron were determined just before the delivery of the baby. The relationship of mothers' parameters with infants' birth weight, length and head size were analyzed. The main finding of our study is; all parameters of mothers who don't use iron were affected negatively and anemia is detected rarely. When the two groups are compared -user and non-user of iron- from the point of age, gravida, parity and weight get on during pregnancy, the number of pregnant women who don't use iron is high. No difference is found in weight, length and head size of the two groups' infants. As long as the mother's serum ferritin isn't under the level of 12 ng/mL, which indicates depletion of maternal iron stores, and Hb isn't under level 7 gr/dL, infant's birth weight is thought to be developed in normal conditions. Due to the possible complications that the baby might be confronted with during and after the pregnancy, it seems necessary for the mother to have iron support during pregnancy. Keywords: Iron supplement, hematological parameters, anthropometric measures, iron deficiency anemia, pregnancy.

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Nilufer Tatoglu, The Effect Of Self-Esteem To Academıc Achievement On 15-17 Age General High School Students In Center Of Zonguldak. Zonguldak Karaelmas University, Institute of Health Sciences, Department of Nursing of Children Health And Illness, Master Of Science Thesis, Zonguldak, 2006. In almost every society individuals are required to adapt to the changes and improvements in the society and to find a place in the society coping with the difficult living conditions. It is necessary for the individuals to be equipped with adequate information and skill in order that this adaptation will be easy. It is the young population that suffers from the adaptation problem most. The adolescent resorts to illegal thoughts and behaviors that are not accepted by the society if he or she does not get over this crisis that is peculiar to this age period. In order to prevent these negativities, guidance and consulting services provided for the individuals in adolescence gain importance. School health services have a important place in the work field of preventive health services that are considered in fundamental health services. The concept of school health is the assessment and improvement of students' and school workers' health conditions, and the planning of the treatment. This research has been carried out on students aged between 15 and 17 in six high schools in the centre of Zonguldak city in order to study the effect of adolescents' self-esteem on academıc achievement within the framework of school health. The research group consists of 457 adolescents representing 5694 students. Of the students taking part in our research, 41.8 % is 15 years old, 58.0 % is female, and 42.0 % is male. 75.0 % of the students belong to middle- income classes, mothers of 92.6 % and fathers of 3.9 % have no jobs. According to the result of one-way variance analysis between self- esteem points and academıc marks, there is a considerable statistical difference in academıc marks among the groups getting high, middle and low self-esteem points (p=0.001). Keywords: Adolescent, self-esteem, academıc achievement, school health

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Neriman Ozcan Sahin, Investigation Of Antiasthmatic Effect Of Thymoquinon In Experimental Asthma Model. Zonguldak Karaelmas University, Institute of Health Sciences, Department of Pharmachology, Master Of Science Thesis, Zonguldak, 2006. Nigella Sativa seeds and it's oil have been used traditionally in overcame of asthma and inflammatory diseases for many years. Thymoquinon (TQ) is a major content from the volatile oil of this seeds. In this study, rats were sesitized and provoked by ovalbumin (OVA). TQ (3, 10 and 30 mg/kg ) administrated before provocation (at 48, 24 and 0.5 h) OVA has clearly increased the total cells in Broncho Alveolar Lavage Fluid (BALF) and eosinophile counts ( 1700 ± 129 and 298 ± 21, respectively). TQ (10 and 30 mg/kg) has significantly decreased the increased cell counts in BALF (for total cells; 775 ± 179 and 517 ± 104, for eosinophile; 55 ± 22 and 43 ± 8, respectively). Montelucast (6.6 mg/kg) has also inhibited the migration of inflammatory cells in BALF, as the similar to the dose of 10 mg/kg of TQ. In conclision, TQ is reducing, the dose manner, the migration of inflammatory cells in BALF after the OVA provocation in sensitized rats. Thus, TQ may be a choice in the treatment of asthma. TQ might be inhibited the 5-OH lipooxygenase enzyme in the pathway leukotriene of arachidonic acid and also the anthiasthmatic effect might be supported with the it's anthioxydant and anthihistaminic effect. Keywords: Thymoquinon (TQ), Experimantal Asthma Model, Ovalbumin (OVA), Bronkoalveolar Lavage Fluide( BALF), Rat

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Ecehan Yenici, The Seroprevalence Of Hepatitis B And Hepatıtıs C Of Voluntary Blood Donors That Applıed To Zonguldak Red Crescent Blood Centre Between Years 2001-2004. Zonguldak Karaelmas University, Institute of Health Sciences, Department of Public Health, Master of Sciences Thesis, Zonguldak, 2006. In this study, the distribution of seroprevalence of HBsAg and Anti-HCV is observed in voluntary blood donors that applied to Zonguldak Red Crescent Blood Centre between years 2001-2004 and had any of identification data, according to age group, gender, marital status, education, address and year. Of the donors; 392 (6.3%) were female, 5865 (93.7%) male and their ages were between 18-65 years old. It is observed that 68.8% of the donors was married, 31.1% single, 0.1% widow; 33.7% graduated from primary school, 18.7% junior high school, 31.6% high school, 16.0% university. It is found out that 4.1% of the donors resided out of province, 70.2% resided in Zonguldak city, and 25.7% resided in towns. The seroprevalence of HBsAg was 2.0% (n=123) and Anti-HCV was 0.6% (n=38) among 6261 voluntary blood donors. HBsAg frequency of men was 2.0%, women 1.5% and Anti-HCV frequency of men was 0.5%, women 1.8% (p=0.008) among 6204 cases. It is observed that; there was a decrease of HBsAg seroprevalence above 50 years old and an increase of Anti-HCV seroprevalence above 60 years old. HBsAg seroprevalence was 1.9% among married cases, 2.2% singles; Anti- HCV seroprevalence were both 0.7%. Of the 7 cases whom were widowed; neither HBsAg nor Anti-HCV positive. According to educational status HBsAg seroprevalence was as follows; 3.0% primary school, 1.2% junior high school, 1.7% high school and 1.6% university (p=0.004). Anti-HCV seroprevalence were; 0.9%, 0.4%, 0.6% and 0.7% respectively. HBsAg seroprevalence for years 2001-2004 was 2.9%, 1.1%, 2.1%, 1.7% and Anti-HCV seroprevalence 0.6%, 0.1%, 1.0%, 0.4% respectively. As a conclusion; HBsAg seroprevalence was found statistically different in educational status and Anti-HCV seroprevalence in gender. Lack of identification data in one third of the cases is conspicuous. Recording the data completely will encourage similar studies. Keywords: Voluntary blood donor, HbsAg, Anti-HCV, Seroprevalence

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Rahsan Kalafatoglu, The Comparison Of Physical Development Of Children Who Live In Zonguldak Nursery Centre With Those Who Live Wıth Their Family. Zonguldak Karaelmas University, Institute of Health Sciences, Department of Public Health, Master of Sciences Thesis, Zonguldak, 2006. This study is done for the comparison of physical development of children who live in Zonguldak Nursery Centre with those who live with their family and evaluate variables that effect physical development. It is performed by 88 children from Zonguldak Nursery Centre and 176 from the district of 4. Health Centre, totally 264 children. Of the children; 22.7% was female and 77.3% was male. Their ages were between 7-15. There were significant difference between groups for length according to age (p=0.003) and for weight according to age (p=0.001). The development of children who live in nursery was lower than those who live with their family. The mean Body Mass Index (p=0.007), the mean percentile of height (p=0.007) and the mean percentile of weight (p=0.001) were significally different. Number of meals (p=0541), sleeping period (p=0.489), eating something between meals (p=0.954) was not different between groups. Having breakfast (p=0.009), drinking milk, (p=0.001), making sports (p=0.002) and hospitalizing (p=0.001) were significally different between two groups. Despite of similar nutrition style and daily activities, it was conspicuous that the development of children who live in nursery falled behind the children live with their family. Studies must be done that will also evaluate the psycho-social charactheristics which explain the development of children who live in nursery falled behind despite the same nursing and habits. Keywords: Nursery, family, persentil, body mass index

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Funda Veren, Evaluation Of The Frequency Of Home Accidents In 15-49 Aged Housewives Living In Zonguldak City Centre. Zonguldak Karaelmas University, Institute of Health Sciences, Department of Public Health, Master of Sciences Thesis, Zonguldak, 2006. Accidents, preventable and have negative effects on health, productive power, life quality and financial, are one of the most important issue in public health. Home accidents defined as any kind of accidents which occur in home or its backyard, garden, garage etc. People who spend most of time at home are at risk about home accidents. This study was planned and carried out to determine the frequency of home accidents in 15-49 aged housewives living in Zonguldak City Centre and to evaluate the characteristics of home accidents. The sampling group comprised of 15-49 aged 380 housewives living in Zonguldak City Centre. To collect the data a questionnaire used by interviewing face to face. Statistical analyses were performed using mean average, percentage and Chi-Square test. Some findings of the study, the frequency of home accidents in housewives was 54.2%. The mean number of occured home accidents was 2.6±2.6. It was found that 28.7% (n=105) of the housewives was injured by a sharp-penetrative tool, 20.0% (n=72) of the housewives had burning, 19.8% (n=71) of the housewives had falling, 10.8% (n=37) of the housewives had insect bitting, 10.0% (n=34) of the housewives had electric shock, 6.4% (n=20) had poisoning, 4.3% (n=12) of the housewives had foreign body aspiration. The applications, that the housewives had, about home accident injuries were, 23.9% (n=49) of the housewives consulted a health centre, 34.2% (n=70) of the housewives had first aid at home, 18.5% (n=38) of the housewives had wrong practices, 23.4% (n=48) did nothing for the injuries. Finally most of the housewives in this study had home accidents. In this issue, Public Health Nurses should take measures to prevent from home accidents in the community and educate public about home accidents. Keywords: Accidents, Home Accidents, Public Health, Public Health Nursing

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Guliz Akin, The Effect Of Sibutramine On The Behavıour Of Rats. Zonguldak Karaelmas University, Institute of Health Sciences, Department of Pharmacology, Master of Sciences Thesis, Zonguldak, 2007. We used 50 female rats to compare the effects of sibutramine and antidepressants which inhibit the uptake of several neuromediators. We fulfilled this research by applying 3 different methods related with behaviour such as open field, forced swimming test and rotarod. As antidepressants enhance the stereotypic effects that amphetamine form, we formed a test model by using an amphetamine-like substance, phenylethylamine (FEA). By investigating the effects of antidepressants and sibutramine on this test model, we studied the prevision that the antidepressant effect of sibutramine could play a role in the mechanism of effect in obesity treatment. In this study we formed acute stereotypi by using FEA (100 mg/kg) and we compared the effects of sibutramine (10 mg/kg) and antidepressants, which effect different mediators, like fluoksetine (20 mg/kg), milnasipran (50 mg/kg) and mirtazapine (15 mg/kg). Sibutramine, when used alone or with FEA, did not increase the locomotor activity and stereotypic behaviours, on the contrary it caused a decrease. The 3 antidepressants used, mobility increased slightly when applied alone. Fluoksetine potentialized the FEA's effect and caused a significant increase in stereotypic behaviour whereas mirtazapine and milnasipran decreased the effecet of FEA. This decrease was noticable with milnasipran. The effect of sibutramine on the behavioral model formed by FEA was different from other antidepressants. We found that sibutramine decreased this effect like mirtazapin but in compaired low. FEA decreased the remaining time on rota rod remarkably and the either 3 antidepressants caused a decrease as well but not as significant as FEA. Sibutramine increased the time in the first period in comparison with the control, nevertheless in the second period sibutramine decreased the time as well as antidepressants. FEA decreased the immobile remaining time in swimming test, remarkably. Mirtazapine when applied with FEA, caused a decrease in immobile remainig time more than FEA. The other antidepressants decreased the immobile remaining time, but this decrease was not statistically significant. Sibutramine caused a decrease in immobile remaining time more than other antidepressants, and increased the swimming time remarkably. This result show that sibutramine has antidepressant effect. Keywords: sibutramine, open field test, rota rod, porsolt swimming test, fluoksetin, mirtazapine, milnacipran

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Sukru Madenoglu, Effects Of Thorax Physıotherapy Methods On Arterıal Blood Gases And Pulmonary Functıon Test Values Applıed In Early Pre-Operatıve And Post Operatıve Perıods To Patıents Who Had Coronary By-Pass Surgery. Zonguldak Karaelmas University Institute of Health Sciences, Department of Thorax Surgery, Master of Sciences Thesis, Zonguldak, 2007. Patients which were applied to Cardio Vascular Surgery Clinic to have a coronary by-pass operation were randomly divided into two groups as the study group and the control group, each group containing 20 patients. The patients in study group were taught for breathing exercises in preoperative period and they were also given thorax physiotherapy in post-operative period. The values of pulmonary functions test and arterial blood gases of all the patients included in this study were controlled before and after the surgical operation. No significant difference was exposed for the pulmonary functions test values of both patient groups. While no meaningful difference was found for the arterial blood gases values measured in pre-operative period, statistically significant differences were obtained at arterial blood gases (PaO2, PaCO2, and SaO2) values for the study group after postoperative period's 4. seance thorax physiotherapy treatment. As a result, it has shown that the breathe exercise training and applications have positive effects on arterial blood gas values. Keywords: Coronary By-pass Surgery, pulmonary functions test, thorax physiotherapy.

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Kamil Guney, The Renovatıon Of Household Survey Cards And The Comparasıon Wıth The Ones In The Prımary Health Centers In A Sample Whıch Represents The Zonguldak Provınce Center. Zonguldak Karaelmas University, Institute of Health Sciences, Department of Public Health, Master of Sciences Thesis, Zonguldak 2008. The health centers, which are the basic component of health system in Zonguldak province center, are serving as “multipurposed health service in a close district” according to the Socialization of Health Services Act (Act No 224). It is important to take records for planning, executing and evaluating the health services of health centers. The basic of other records at the health center is Household Survey Card (HSC). It is determinative to record Household Survey Cards correctly and completely when it is considered that it is the source of other forms in planning and executing of basic health services. This study is done to evaluate the state of HSCs which are supposed to be updated regularly and define the malfunctions in order to get a new point of view for service. In this cross sectional study, the HSCs of 363 houses in Zonguldak Province Center which are determined by Turkish Statistical Institute and recorded by us according to the Guide of Ministry of Health for form 001, compared with the HSCs which are recorded in Health Centers. Of the HSC records of houses, 32.8% could not be found at Health Center records. HSCs of health centers did not include 4.8% of household. Education and social sevanty data from the household were the comimonent mistaken or outdated data. Despite the error and deficiencies of practice, HSC is an indispensable form in planning and executing the health services because it gives the possibility for evaluating person with together his living place and family, and it is the source for determining the sociodemographic properties of district. HSC is the most workable and most auditable record choice for the basic health services that is planned to configured on, which gives the possibility of executing the health system with protective and preventive approaches. Keywords: Primary Health Center, Household Survey Card, Basic Health Services

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Ozgur Sekreter, Evaluation Of Cold Chain And Knowledge Of Health Workers In Pri Mary Healt Care Centers Which Have Immunazation Services In The Center District Of Zonguldak City. Zonguldak Karaelmas University, Institude of Health Sciences, Department of Public Health, Master of Sciences Thesis, Zonguldak, 2008. Immunization services are used for eradication and elimination of infectious diseases which are the main topics of Public Health and these services have important role among individual preventive medicine. The disabilities and deaths caused by infectious diseasesare prevented by ımmunization and also some infectious diseases are eradicated. Adherence to cold chain rules, is the basic principle of effective ımmunization. Cold chain is a system made of human and equipments. A continious cold chain maintains the preservation of effectiveness of vaccines from production to usage. In this cross sectional study, the data was obtained by means of a questionnaire, from 125 health workers of 22 health care centers in Center City Health Group Directorate of Zonguldak and all the centers were evaluated on site. The refrigerators temperatures were between +2 ile +8°C at all health care centers. Measles and Oral Polio Vaccines were placed properly. There were thermometers in the refrigerators of all health care centers. All health care centers have got home type refrigerators. Of the health care centers 20 of them had guide pictures on the refrigerators. The follow up records of refrigerators temperature were regulated 19 health care centers. All of health care centers had a person in charge of the control of the cold chain and deputy. When the in service training of the staff was more frequent, knowledge score of the personel about cold chain increased. Keywords: Cold chain, Vaccine, Primary Health Center

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Ayse Bezir, Localization Of Basic Fibroblast Growth Factor On Placenta And Umblical Cord. Zonguldak Karaelmas University, Institute of Health Sciences, Department of Histology and Embryology, Master of Sciences Thesis, Zonguldak, 2008. Placenta is the temporary organ that provide connection between mother and fetus and physiological exchange throught gestation. Umblical cord provides relationship between placenta and fetus. Basic fibroblast growth factor (bFGF) is the member of fibroblast growth factor family and has strong anjiogenic molecule. bFGF has effect on different tissues and organ systems. In some studies, localization of bFGF was found with different techniques at different term of placenta and umblical cord. In this study, it is aimed to present localization of bFGF on term placenta and umblical cord at different regions with immunohistochemistry. This study differ; than other studies with this property. 13 pieces of normal placenta and umblical cord from 13 woman between 18-37 years that were all at 34-41. gestation weeks were studied. Samples were collected from normal vaginal or sectio delivery between January-February 2006 at Zonguldak Karaelmas University Faculty of Medicine Department of Jinecology Clinic and Zonguldak Goverment Hospital Department of Gynecology Clinic. Placenta was sampled at two region that zone of near the umblical cord (P0) and 5 cm distant from this point (P5) and umblical cord was sampled at two region that point of near the placenta (U0) and 10 cm distant from this point. They were estimated histomorphological with hematoxylin&eosin (H&E) stain. bFGF protein expression were examined by immunohistochemical methods at microscopic level. At the end of this study, different bFGF immunreaction was determined at different region of placenta. Immunoreaction of bFGF was decreased at P5 compared to P0. This result show that angiogenesis of villus formation of placenta is supported by bFGF. Immunoreaction of bFGF wasn't differed between the two region of umblical cord. This result was concluded effect of bFGF on umblical kord vascularization and cord formation. Constant structure of umblical cord was concluded with bFGF immunoreaction.

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Nezahat Ozturk, Evaluation Of Hypertensive Patients According To Obesity, In The Cardiology Outpatient Clinics Of Zonguldak Karaelmas University Hospital. Zonguldak Karaelmas University, Institute of Health Sciences, Department of General Surgery, Master of Science Thesis, Zonguldak, 2008. Obesity is a growing public health problem that is known to cause hypertension, insulin resistance, dyslipidemia, and cardiovascular diseases. As body mass index (BMI) increases so does hypertension occurence. This study was designed to determine obesity prevalence and relationship between BMI and fasting blood glucose and lipid levels, and blood pressure in our university hospital cardiology outpatient clinics. The sample of this descriptive and cross-sectional study was 226 cardiology outpatients with blood pressures equal to or greater than 140/90 mmHg. A BMI of 30 or over was accepted as obesity. Fasting blood glucose, cholesterol, HDL, LDL, triglyceride levels were measured. These parameters were than analysed for any relationship. Obesity prevalance of these 226 hypertensive patients was 38.5%. A positive correlation was found between a high BMI and a high fasting glucose level, presence of diabetes, and presence of hyperlipidemia. There was a significant difference between obese and nonobese patients in terms of presence of diabetes, hyperlipidemia (hypercholesterolemia). In this study of 226 cardiology outpatients of Zonguldak Karaelmas University Hospital, 46% was overweight and 38.5% was obese. This makes a sense that to decrease the complications of hypertensive patients, obesity has to be detected and treated as well. Keywords: Cardiac heart, hypertension, obesity

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Songul Demirok, The Evaluation Of Caloric Needs And Caloric Intake Of Patients' Who Are Treated In Intensive Care Units. Zonguldak Karaelmas University, Institute of Health Sciences, Department of General Surgery, Master of Science Thesis, Zonguldak, 2008. The aim of this retrospective research is to ascertain caloric needs of intensive care unit (ICU) patients and their actual caloric intake. The sample of the study is 99 patients, who were managed during seven days in ICU of Zonguldak Karaelmas University Teaching Hospital between the 1st of October, 2006 and the 31 st of February, 2007. Data were collected from computerized records and order files. The energy need for each patient was calculated according to Schofield formula and energy intake was appointed according to daily diet or enteral nutrition or parenteral nutrition as well as intravenous glucose solutions infused or a combination in seven days. It has been found that the energy that was supplied each day to the patients was statistically lower than that was actually they needed. The effects of age, gender, clinical department on caloric supply were examined also. Women patients' caloric needs were significantly lower than men patients. There was no statistically significant difference among caloric needs of patients and patients' age and departments that they are treated. Energy provided to ICU patients was significantly less than energy needed, even for each day during seven days period of the study. Because of this, appropriate follow up policy should be constructed for actual energy supplement for ICU patients. Keywords: Intensive care unit, nutrition, caloric intake

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Dilek Duzgun, Evaluation Of Trace Element Deficiency In Coronary İntensive Care Patients With Long Time Cardiac Medication. Zonguldak Karaelmas University, Institude of Health Sciences, Department of General Surgery, Master of Sciences Thesis, Zonguldak, 2008. Nutrition is one of the basic requirements to protect and improve the quality of life of the population. Adequate, balanced, healthy nutrition and appropriate nutritional habits of the individuals ensure the decrease in nutritional deficiencies, hypertension, coronary arterial diseases, protein-energy malnutrition and vitamin- mineral deficiencies. Inadequate and over in take of nutrients is defined as malnutrition. Intensive care patients are especially inclined to have malnutrition that make them susceptible to nosocomial infections, increased morbidities and mortality, delayed wound healing and lenghtening of intensive care hospitalization. Trace elements are becoming a more important factor for malnutrition. Literature report the essential properties of trace elements and relation with diseases and medications. There are many studies concerning the relation of trace lement deficiencies with hypertension and coronary heart diseases. This thesis is planned to check the levels of trace elements iron, copper, zinc, cobalt and vanadium in coronary intensive care patients with and without malnutrition and interraction with long time antihypertensive medication. Patients receiving antihypertensives for more than 6 months are found to have a decreased serum iron concentration and significantly high serum copper levels regardless of nutritional condition. Serum zinc levels are decreasing with increasing age and cobalt levels are low in patients with body mass index less than 20. No significant difference is observed for vanadium. Keywords: Trace Elements, Antihypertensive, Malnutrition

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Burcin Demirel, The Evaluation Of Malnutrition In Patients Of General Surgery And Orthopedic Surgery. Zonguldak Karaelmas University, Institude of Health Sciences, Department of General Srugery, Master of Science Thesis, Zonguldak, 2009 The aim of this study is to evaluate nutritional status of the patients planned to undergo for elective orthopedic and general surgery operations with Subjective Global Assessment (SGA) and compare the malnutrition determined according to the clinics and accompanying diseases. The SGA scores and antropometric measurements of 150 adult patients planned to undergo for elective operations in Department of General Surgery and Orthopedic Surgery were performed preoperatively and during discharge and the recorded data were compared. The mean age of the patients was 54.25 ± 18.19 years and 76 of them were females (%50.7) and 74 of them were males (%49.3). When the SGA scores were evaluated 113 of them were in class A (%75.3), 30 of them were in Class B (%20.0), and 7 of them were in Class C (%4.7). According to SGA classification, 37 of the patients were malnourished (%24.7). The patients of general surgery were more malnourished due to cancer. However, extremity fractures were determined to have no significant difference in sense of malnutrition levels. Especially the patients of general surgery are concluded to be evaluated and supported for nutrition during preoperative period. Keywords: Nutritional evaluation, Subjective Global Assessment, Malnutrition, BMI, TSF, MACM

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Ayse Serbest, The Impact Comparison of The Use of Soybean Oil Based Lipid Solution And Olive Oil Based Lipid Solution On The Platelet Counts In Children Receiving Total Parenteral Nutrition (TPN). Zonguldak Karaelmas University, Institute of Health Sciences, Departman of General Surgery, Master of Science Thesis, Zonguldak, 2009. This research is retrospective study investigates the effect of soybean oil and olive oil based lipid solutions on platelet counts in child patients receiving total parenteral nutrition (TPN). In this study, from January 1, 2004 through December 31, 2007, 65 child patients receiving TPN in Zonguldak Karaelmas University Application and Research Hospital neonatal care and pediatric surgery units were studied. 24 of these patients received Soybean oil based lipid solution and the other 41 received olive oil based lipid solution. The values of the platelet counts before beginning the infusion of the solutions, during first week of infusion, and after the first, second, third, fourth, fifth and sixth week of infusion were recorded. The values of platelet counts recorded just before the patients were discharged from the hospital are also included in the study. Twenty patients, 8 of whom were given soybean oil based lipid solution and the other 12 given olive oil based lipid solution, diagnosed as idiyopathic thrombocytopenic purpura (ITP), liver disease or thrombocytopenia and given plateled suspension, were excluded from the study so as not to affect the results of the study. The data was collected by using the computer records and the archive files of the patients. As a result of this study, no significant difference between platelet counts of the patients depending on the use of either lipid solutions was detected. Keywords: Total parenteral nutrition, olive oil, soybean oil, intravenous fat solution, platelet

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Sanem Yildirim, Chemotherapy Side Effects Linked To Chemotherapy In Patient Evaluation Before And After Nutrition Education. Zonguldak Karaelmas University, Institute of Healt Sciences, Department of General Surgery, Master of Science Thesis, Zonguldak, 2009. Despite the impotant developments in the treatment, cancer is still the most important and up to date problem of the human beings and contempoary medicine and the most frightening disease evver. Either the disese itself or the treatment alternatives and medications causes different problems and side effects, particularly on gastointestinal system during the treatment and follow up of cancer patients. This study is designed to assing the side effects of chemotherapy affecting the nutrition of patients, determine the effect of nutritional education on various side effects and the model of educational. This research study is performed on 50 outpatient and hospitalized patients under chemotherapy treatment in clinical oncology department of Zonguldak Karaelmas Universty accepted to participate with a written approval. 42% of the patient were female and 58% male with an age distrubution of 36% within 50-59, 34% within 60-69 and 18% within 40-49 years old. The freguency and types of tumors in decreasing order were lung cance (38%), gastrointestinal system cancers (26%), breast cancer (20%) and genitourinary system cancer (10%). The analysis of the results yielded a statistically significant difference in the degree of side effects before and after nutritional educational in anorexia (p=0.000), taste poblem (p=0.000), weakness and exhaustion (p=0.000), nausea (p=0.000), constipation (p=0.031), dryness of the mouth (p=0.012). There was no difference in vomiting (p=0.063). Keywords: Cancer, chemotherapy, side effects, cachexia, nutrition.

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Asuman Ugurlu Yildiz, Intervention in Patients With Chronic Kidney Disease Life Style Change Effects on Quality of Life (QoL). Zonguldak Karaelmas University, Institude of Health Sciences, Department of Public Health, Master of Science Thesis, Zonguldak, 2010. Chronic kidney disease (CKD) treatment cause significant changes in daily lives of the patients, and effect the self-perceived quality of life (QoL) of the patients. In the present study, aim is to investigate the effects of Patient Education success on quality of life (QoL) in chronic kidney disease (CKD). In Sample of this study are composed 39 patients on haemodialysis (HD), 45 patients, total 84 patients on continuous ambulatory peritoneal dialysis. QoL was measured by means of the Short Form-36 (SF-36) and than subscale scores were calculated in before getting the education. Two months later, Short Form-36 and than subscale scores were administered. Data were evaluated a statistical pocket program (SPSS), All variables were summarised as mean ± standard deviation. CKD, HD and CAPD Statistical significance was assigned to p-values of <0.05. All dimensions of QoL of patients were better in the after education and counseling which include life style change about exercise, smoking cessation, diet compliance education and counseling and elimination of alcohol intake, as compared with the before intervention in this study. After education and counseling, exercise duration mean and patient with well adjusted diet programmed ratio also increased, Kt/V urea and serum albumin means increased, Serum Urea and Serum Creatinine and systolic tension arterial means decreased. But number of cigarette in a day and glass of alcohol in a week means and diastolic tension arterial variables were not significantly changed after education and counseling. Keywords: Quality Of Life, Patients with Chronic Kidney Disease, Life Style Change, SF-36, Education And Counseling

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Neslihan Yilmaz, Determınants Of Smokıng Behavıor And Desıre To Quıt Of Smoker Students In Educatıon Faculty. Zonguldak Karaelmas University, Institute of Health Sciences, Master of Science Thesis, Zonguldak, 2010. Tobacco use among University students increased substantially in last years. Better understanding of University student smokers is warranted to develop interventions specific to the needs of this population. In this study aimed to investigate of smoking prevalance, sociodemographic and tobacco-use characteristics associated with self-identification as a regular smoker and intentions to quit smoking among Karaelmas University Education Faculty students who smoke cigarettes. In this study, 209 smoker students of total 1078 students were administered a questionary which include sociodemographic and tobacco-use characteristics associated with self-identification and intentions to quit smoking in Karaelmas University Education Faculty by face to face technique. Data were evaluated a statistical pocket program (SPSS). All variables were summarised as mean ± standard deviation. Statistical significance was a signed to p- values of <0.05.Variables which grouped was analysed chi square, ANOVA and logistic regression tests. Student smoking prevalance was 19.4%. Mean of Fagerstrom points was 3.1 ±2.62. student who thinking quit smoking at next six months was %46.9. and %19.1 was seeking specialist for quit. Students who thinking quit smoking were their family or friends who oppasite smoking, occassionally smokers, smoker more than 5 years, smokers with low level nicotine addictive, smoker who try and begin smoking on late ages. Keywords: Smoking, desire to quit smoking, tobacco-use characteristics, university students, education faculty

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Aydan Ozbay, Intervention in Patients With Coronary Artery Disease Life Style Change Effects on Quality of Life (QoL). Zonguldak Karaelmas University, Institude of Health Sciences, Department of Public Health, Master of Science Thesis Zonguldak, 2010. Coronary artery disease (CAD) is a significant cause of morbidity and mortality in Turkey. CAD usually impacts negatively on an individual's physical functioning and activities of daily living and thus their quality of life (QoL).In the present study, aim is to investigate the effects of patient education success on QoL in patients with coronary artery disease. In Sample of this study are 82 patients with coronary artery disease in Cardiology and Heart and Vascular Surgery Departments, Zonguldak Karaelmas Universty. QoL was measured by means of the Short Form-36 (SF-36) and than subscale scores were calculated in before getting the education and education administered about Healthy nutrition, pysical activity, maintain of healthy body weight, smoking and alcohol quit. Two months later, Short Form-36 was repeated. Data were evaluated a statistical pocket program (SPSS). All variables were summarised as mean ± standard deviation. Statistical significance was a signed to p- values of <0.05.Variables which grouped was analysed chi square, Variables which continue were analysed repeated measure t test an done way analyses of varriance(ANOVA). All dimensions of QoL of patients were better in the after education and counseling which include life style change about exercise, smoking cessation, diet compliance education and counseling and elimination of alcohol intake, as compared with the before intervention in this study. After education and counseling , SF 36 points were evaluated. Exercize duration mean and patient with well adjusted diet programme ratio also increased, and diastolic tension arteriel means decreased. But number of cigarette in a day and glass of alcohol in a week means, systolic tension arteriel, collesterol HDL and LDL variables were not significantly changed after education and counseling. Keywords: Quality of life, SF-36, Patients With Coronary Artery Disease, Life Style Change, Education and Counseling.

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Turkan Akyol Guner, An Evaluation of Shift-work and Sleep Associated characteristics in Work Life. Zonguldak Karaelmas University, Institute of Health Sciences, Department of Public Health, Master of Science Thesis, Zonguldak, 2010. Shift-work is a common practice in work-life and thus, the numbers of shift-workers and shift-work have been on the rise. In shift-work set-up, the biorhythms of workers change, which increases the frequency of health and sleep-related problems among these workers. In this cross sectional study, shift-work has been evaluated in terms of the characteristics of work- life, and its impact on the sleep related status has been determined. Using these characteristics, workers of regular daytime, double-shift, and triple-shift systems were compared. The data were collected through a questionnaire determining the socio-demographic characteristics and shift working, a characteristic of work-life, and Epworth Sleepiness Scale. In the workplace where the study was conducted, 431 people are employed, and of those, 354 (81.7%) could be contacted. Of the 354 workers, 13.3% were on double- shift; 42.1%, on triple-shift, and 4.6%, on regular daytime. Of the participants, 98.3% were male. The mean age of the participants was 44.8±6.0 years. The mean time at work (seniority) was 20.0±6.96 years. Nineteen percent of the regular daytime workers, 11.0 % of the double-shift workers and 70.0 % of the triple-shift workers had an Epworth Sleepiness score of 10 or higher. Keywords: Work-life, Shift-work, Sleep, Occupational health, Epworth Sleepiness Scale

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Vildan Kalkan Akyuz, Evulation Of The Nutrionel Status Of Pregnant Women And The Effect On İnfant Birth Weight. Zonguldak Karaelmas University, Institute Of Health Sciences, Department Of General Surgery, Master Of Science Theises, Zonguldak 2010. This sectional and retrospective study is designed to assessment of nutritional status of pregnant women and newborn infants in order to investigate the effect of birth weight which admitted to department of obstetrics. The survey sample in this study is constituted with 100 pregnant women which admitted Zonguldak Karaelmas University Research Hospital, Gynecology and Obstetrics unit between 01/05/2009 and 31/09/2009. Data were generated with the pregnant questionnaire and hospital medical records for the postnatal andropometric measurements of the newborns. Questionnaire were consisted of with pregnant women and their families about their general knowledge, general health status, eating habits, nutrition information, food consumption frequency and daily food consumption situation sections. Body weight, height, head circumference and chest circumference measurements of newborns are collected for andropometric measurements. SPSS 13 software was used for data analysis. The average age of the pregnant women 27.6 ± 4.8, mean height 161.0 ± 5.6, mean weight 75.1 ± 14.2 have been found. Mean ponderal index of babies have been found to be 2.33 ± 0.46. According to the results of data analysis: a significant difference was found (p = 0.022) between mother's educational status and the baby's birth weight. As a result of bilateral comparisons of educational levels between groups were found to create differences. Mother's work situation was found no significant difference between the baby's birth weight (p = 0.955). The duration of marriage was found significant difference between infant birth weight (p = 0.041). As a result of bilateral comparisons between less than 1 year with 6-10 years and less than 1 year of marriage as between more than 11 years of marriage has created a significant difference between the duration groups were identified. There were no statistically significant difference among father's educational status (p = 0.633), family incomes (p = 0.987), nausea and vomiting (p = 0.178), protein consumption, consumption of vegetables and fruits, milk and dairy products consumption (p = 0.255, p = 0.396, p = 0.180 respectively) and infants birth weights. The preservation of maternal health during pregnancy and fetal development of mothers to ensure regular and adequate weight gain, calories, protein, vitamin, mineral intake should be evaluated. In addition, before and during pregnancy, mothers may endanger the fetus should be investigated in terms of nutritional risk Keywords: Pregnancy, Nutrition, Newborn

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Funda Kasapoglu, Evaluation Of Acute Phase Response And Malnutrition In Hemodialysis Patients. Zonguldak Karaelmas University, Health Science Institute, Department of General Surgery, Master of Science Thesis, Zonguldak, 2010. Despite the current advancements in dialysis treatment, chronic renal failure proceeds with high mortality rates. Malnutrition is an important risk factor for morbidity and mortality in these patients. The present study is designed as a descriptive analysis, aiming to evaluate the parameters of inflammation and malnutrition in 20 patients having hemodialysis 3 times a week in Zonguldak Karaelmas University Hospital. The correlation between malnutrition and inflammation was determined by means of procalcitonin (PCT) levels, in addition to routine biochemical examination of patients before hemodialysis. Anthropometric measurements (triceps skin fold thickness, body mass index) with subjective global assessment (SGA) were also conducted. The mean age of patients, the time from initial diagnosis and the period of dialysis induction were found to be 54.7±16.4 years, 6±5.2 years, and 44±43.1 months, respectively. According to the SGA, 55% (n:11) of patients were determined to be in good nutritional status, whereas 45% (n:9) was demonstrated to have moderate or severe malnutrition. The association between malnutrition and the inflammation parameters including prealbumin and PCT were determined to possess a limited statistical significance (p=0,050). Nevertheless, there were no statistically significant association between PCT and SGA groups (p=0,566). The distribution of parathormon (PTH) levels in terms of SGA groups was found to be statistically significant (p=0.026). A patient with a previous history of parathyroidectomy was excluded from the analysis and the patient number was calculated as 19. There were no statistically significant correlation between diet information level and SGA groups (p=1.000). A detailed diet education was given to the patients at the end of the study. In conclusion; malnutrition and the parameters analyzed within the present study demonstrated no significant correlation in chronic renal failure patients. This data might be interpreted as there is no gold standard test or method to evaluate malnutrition in chronic diseases; nevertheless further studies with greater number of cases are thus called for. Keywords: malnutrition, hemodialysis, procalcitonin, subjective global assessment

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Selda Yildiz, The Influence Of Total Parenteral Nutrition On Blood Stream Infections In Intensive Care Unit Patients With Central Venous Catheter. Zonguldak Karaelmas University, Institute of Health Sciences, Department of General Surgery, Master of Science Thesis, Zonguldak, 2010. Total parenteral nutritional (TPN) support is an important aspect of intensive care unit (ICU) treatment. TPN is usually given from central venous catheters (CVC). Blood stream infections (BSI) are infectious complication of TPN. BSI is one of the most common nasocomial infections in intensive care unit patients. Lenghtened hospitalisation leads to higher treatment expenses and responsible for higher mortality rates in intensive care unit patients. 64 adult patients over 16 years old with CVC and BSI that developed during internalisation included in this retrospective study. None of the patients had received any blood transfusion or received hemodialysis and had been hospitalized over 48 hours. Patients were seperated into two groups according to TPN receivement as 34 patients with BSI and 30 patients without BSI. Both groups were compared according to age, gender, hospitalisation duration, extra-blood stream related infections existence at admission, comorbidities, invasive procedures and enstruments existence, isolated microorganisms and antibiotic resistence in order to determine the influence of TPN on BSI development. 21 female and 43 male patients were enrolled and mean age were 65 ± 15.92. Malignancy (p<0.05), enteral nutrition (p<0.05), nasogastric catheter (p<0.05), gram positive microorganism (p<0.05), candida spp. (p<0.05) and ampicilin/sulbactam resistence (p<0.05) were found statistically significant in BSI that developed after TPN supplementation. Those data enable us to compare blood stream infections in TPN received patients with non-receivers and shows us how TPN infussion influence BSI. Keywords: Total parenteral nutritions, blood stream infections, intensive care units,

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Mehmet Kıvanc Erdem, Effects of Anesthetics on Pulmonary Oedema Model Induced by ANTU (alpha-naphthtylthiourea). Zonguldak Karaelmas University, Health Science Institute, Department of Pharmacology, Master of Science Thesis, Zonguldak, 2010. This study was designed to investigate the effects of ketamine, midazolam, and xylazine on acute lung injury induced by a-naphthylthiourea (ANTU). Injection of ANTU (10 mg/kg i.p.) produced pulmonary oedema as indicated by an increase in lung weight/body weight ratio (LW/BW) and pleural effusion (PE) reaching a maximum within 4 h in rat. Ketamine (7.5, 15 and 50 mg/kg, i.p.), midazolam (2 and 4 mg/kg, i.p.), and ketamine/xylazine (50/10 mg/kg, i.p.) carried out to rats 30 min prior to ANTU. The thorax was opened and pleural effusion was carefully collected by suction and measure volumetrically. The lungs were removed and all surrounding tissues were dissected and weighed with an analytical balance. Ketamine, midazolam and xylazine did not affect lung weight/body weight ratio, but significantly reduced pleural effusion (PE/BW). Ketamine, midazolam and xylazine have prevented effect on ANTU-induced pleural effusion. These result suggested that anesthetic agents may affect the pathophysiological mechanisms which are important in lung tissue damage. Because of this, the effects of anesthetics on biological systems keep in mind in experimental and clinical applications. Keywords: a-naphthylthiourea; ketamine; midazolam; xylazine; acute lung injury; pleural effusion

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Kadriye Calıskan, The Nutritional Status of The Patients Who are going under Upper and/or Lower Gastrointestinal System Surgery due to Malignancy and to Measure the Quality of Life of These Patient. Zonguldak Karaelmas University, Health Science Thesis, Deparment of General Surgery, Master's Thesis, Zonguldak, 2010. The aim of this research is to assess the nutritional status of the patients who are going under upper and/or lower gastrointestinal system surgery due to malignancy and to measure the quality of life of these patients. This study was carried out on patients treated in Zonguldak Karaelmas University Research and Practice Hospital, General Surgery Clinic. Between 21/03/2008-20/10/2009, 43 of whom are gastrointestinal system patients, 44 of whom are upper gastrointestinal system cancer patients, 17 of whom are colelitiasis, 17 of whom are hernia, 3 of whom are interval apendectomy, 4 of whom are goitre, 7 of whom have a mass in the breast and 5 of whom have other reasons (surgical patients apart from cancer) totally 140 patients, were included in the research. Anthropometric measures ( weight, height ), albumin levels and life quality of the patients during the pre-operative period were compared with those of the contol group. While assessing the nutritional status, SGA (Subjective Global Assessment) form was used. According to the SGA scores, 17 patients were found well-nutritioned-normal, 40 were found medium level malnutrition, 30 were found serious malnutrition, whereas in the control group 47 were well-nutritioned-normal, 5 were medium level malnutrition and 1 was suffering from serious malnutrition. Considering the bio-chemical scores, the albumin levels of cancer suffering patients were lower than those of control group's. Cancer and nutritional status are among the reasons which affect the quality of life. As for the gastrointestinal system cancer patients the situation is the same. In the research, it was found that the nutritional status in gastrointestinal system cancer patients in the preoperative period was low. This sets the importance of nutritional assessment during the pre-operative period. Keywords: Quality of life, Cancer, Nutrition, SF-36, SGA

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Berhude Baba, Evaluation Of Occupational Accidents Occured İn Blast Furnace, Cold Mill And Steel Making Plant Unites Of An Iron And Steel Factory İn 2006-2007 Years. Zonguldak Karaelmas University, Institute of Health Science, Department of Public Health, Master Thesis, Zonguldak, 2010. Occupational health is one of the important and priority research area for the health sciences, especially in Public Health sciences. Occupational accidents are not only important causes of morbidity and mortality but also important cause of economical loss. Iron and steel production is one of the well known dangerous working area. Aim of this study is to evaluate of occupational accidents occured blast furnace, cold mill and steel making plant unites od an iron and steel factory in 2006 and 2007. Study includes all of the 85 occupational accidents occured in these unites and was planned as a descriptive study. Descriptive characteristics of occupational accidents were obtained from workplace health unite records. Average values were shown with standart deviation.Average age of injured workers were 35.8±6.2 (median 36, minimum 23, maximum 55) and most frequently observed age group was 35-39 years group. most frequently accidents occured on Monday with 27%. mean workday loss due to occupational accidents was 9.5±2.1 (median 2, minimum 0, maximum 151). Most frequently observed causes of occupational accidents were accidents due to sharp piercing device with 22.4% and pressing of the body or members between two objects with 22.4%, most frequently injured body part was upper extremity with 43.5%. Occupational accidents freguently occured between 14:00 and 14:59. Of the all occupational accidents, 47.05% were occured in second shift and 29.4% were the third quarter of shift. Keywords: Public health, occupational health, occupational accident, epidemiology, iron and steel production.

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Ahmet Burak Türkili, Role of Angiotensin and Endothelin on Ischemia Reperfusion Injury in Rats. Zonguldak Karaelmas University, Health Science Institute, Department of Pharmacology, Master of Science Thesis, Zonguldak, 2009. This study was designed to determine whether angiotensin and endothelin have a role in testicular IR injury. Rats were anesthetized with thiopental sodium (50 mg/kg i.p.) before the operation. Left testicular artery and vein of rats was occluded for 1 hour, before the bilateral orchiectomy the organ was allowed to reperfuse 3 or 24 hour. Enalapril (20 mg/kg, i.p.), losartan (30 mg/kg, i.p.), bosentan (10 mg/kg, i.p.) or vehicle (saline) was administrated at 30 min prior reperfusion. Malondialdehyde (MDA) level and myeloperoxidase (MPO) activity were measured in testicular tissue after 3 hours of reperfusion. Histologic examination was made after 24 hours of reperfusion. IR caused a significant increase in MDA level of ipsilateral testis, but did not change the MPO activity. Enalapril, losartan and bosentan treatments decreased MDA levels without any change in MPO activities. Only, bosentan treatment ameloriated IR induced histopathologic alterations. These results shown that endothelin may play more important role in pathogenesis of testicular IR injury than angiotensin. Keywords: Enalapril, losartan, bosentan, ischemia, reperfusion, malondialdehyde, testis, rats

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Meryem Aydin, The Effectiveness Of Menstrual Physiology And Hygiene Training Provided For The Secondary School Girls In Duzce Province Primary Schools. Zonguldak Karaelmas University, Institute of Health Sciences, Department of Public Health, Master of Science Thesis, Zonguldak, 2010. As long as half of a woman’s life is taken up wih menstrual period and problems following the physical, behavioral and emotional changes pertaining to this period. The aim of this study is to evaluate the effectiveness of menstrual physiology and hygiene training provided for the secondary school girls in Düzce province primary schools. This study is reflected of 34 primary schools in Düzce Province in which 3392 female students are trained. The sample group is composed of 340 female students studying in 6 schools selected through cluster sampling. 304 students, the written parental consent of whom has been obtained and who agreed to participate in our study have been incorporated into the study. 152 of those 304 students make up our intervention group while the other 152 make up the control group. A pre-test has been administered to the students in the intervention group and two months after menstrual physiology and hygiene training were given, a post-test was administered while the subjects in the control group were administered a pre-test and a post-test two months later without training. The data obtained are used to evaluate statistical tests, SPSS 16 program with the averages, standard deviations, percentages were calculated and chi square was used for categorical variables, continuous variables were assessed using the t test for repeated measures. p< 0.05 has been decided as the significance level in statistical evaluations. In this study, it has been established that while there has been significant increase in the knowledge scores of the intervention group (p=0.0001), there has been no change in the control group(p=0.543). It has been established through this study that the menstrual hygiene behaviors of the intervention group have significantly changed, with the well-planned education provided, the students’ level of knowledge about menstruation has been increased and their menstrual hygiene behaviors have been affected favorably. Keywords: Menstruation, Menstruation hygiene, Health education, Adolescent.

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Emel Ertugrul, Exhaustion and The Frequency of Depression on Nurses, Midwifes, Medical Officers and Emergency Medical Technicians Who Work at a University Hospital Karaelmas University. Zonguldak Karaelmas University, Insitute of Health Sciences, Department of Public Health, Master of Science Thesis, Zonguldak, 2010. Burnout and depression are common and important health problems of the health workers. As a descriptive and cross-sectional study, the aim is to evaluate the exhaustion and the frequency of depression on nurses, midwifes, sanitary servant and emergency medical technicians who work at a university hospital. In the study the data was collected with questionnaire form the 270 participants and assessed by SPSS programme. Anova variance, Kruskal-Wallis variance analyses, student, Mann-Whitney U and Bonferroni tests, and corelation analysis are used in statistical analysis, all analysis results considered with a 95% confidence interval and mean values shown as “arithmetic mean±standard deviation”. The Burnout and depression degree (condition) of the participants has been evaluated with Maslach Bunout Scoring and Beck Depression Inventory. Four scoring were statiscally different in who often/always feel depression, with need psycological assistance but not taken any, unhappy in their work life, unappreciated by their chief and think their career not suitable for them. Emotional Burnout was found higher in women, graduate and postgraduate students, suffering from sleep disorder, who have been working for 6 to 10 years, who have had their positions assigned by administration, who always have the night shift, who work over 50 hours per week, who attend to social activies inadequately, who chosen profession reluctantly, who want to resign and work somewhere else, desensitization was higher in who want to resign and want not to work, non- members of any association, depression was higher in high school graduates, tenants, suffering from sleep disorder, who attend to social activies inadequately, who want to resign and want not to work, smokers and who think not supported sufficiently. Perceptions of personal accomplishment was lower in women, who attend to social activies inadequately, who want to resign and want not to work and who use public transportation. Burnout and depression are health problems of the health workers, improvement in the working conditions and trainig workers to cope with burnout and depression would be helpful to protect against these problems. Keywords: Burnout Syndrome, Maslach Tunout Scoring, Depression, Beck Depression Inventory, Occupational health, Health care workers

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Cigdem Samanci Tekin, The Role of Motivation on Smoking Cessation of Students In Health Sciences Faculty. Zonguldak Karaelmas University, Institute of Health Science, Department of Public Health, Master Thesis, Zonguldak, 2010. Tobacco use substantially increased among university students in last years. Better understanding of university student smokers is warranted to develop interventions specific to the needs of this population. In this study aimed to investigate of smoking prevalance, sociodemographic and tobacco-use characteristics associated with self-identification and the role of motivation in smoking cessation of Ankara University Health Sciences Faculty students. In this study, 300 students of total 352 students were administered a questionary which include sociodemographic and tobacco-use characteristics associated with self-identification and the role of motivation in smoking cessation by face to face technique in Ankara University Health Sciences Faculty. Data were evaluated a statistical pocket program (SPSS). All variables were summarised as mean ± standard deviation. Statistical significance was a signed to p-values of <0.05. Variables were analysed chi square, ANOVA and logistic regression tests. Smoking prevalance was 28.6%. Students who thinking quit smoking at next six months were 33.3% and Students who thinking quit smoking at next one month were 22.5%. 24.4% of Students were trying to quit smoking at last one mouth or less. When students' smoking cessation motivation role of evaluation, It was found that “self-efficacy” and “self feel strong desire” affects the smoking cessation trial and quitting smoking the time. Keywords: Smoking, Desire To Quit Smoking, Tobacco-Use Characteristics, Motivation, University Students, Health Sciences Faculty.

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Ozge Bilge Atay, Non-Smokers Students of Education Faculty Attitudes Against Smoking and Factors Affecting. Zonguldak Karaelmas University, Enstitute of Health Science, Master of Science Thesis, Zonguldak, 2010. Since the fact that university students do not smoke and struggle against smoking set an example for the students who will be attending universities after themselves is of importance, which will make it possible to spread this struggle. In this study, it is aimed to determine the reasons for which Ereğli Education Faculty students do not smoke, the elements contributing to the sustainability of non-smoking habit and their attitudes towards being non-smoker. In this study which has been planned cross sectionally an inquiry was applied to the students who are non-smokers out of the 1078 students at Zonguldak Karaelmas University Ereğli Education Faculty between April 1st and May 1st under observation. 869 ( %80.4) non-smoker students out of 1078 students attending Ereğli Education Faculty form the sample of this study. 656 (75.4) students of these students took part in this study. Statistical tests used to evaluate the obtained data: the averages and standard deviation were calculated through SPSS 11.5 programme, categorical data such as square and continous variable were assessed by means of ANOVA and logistical regression. The meaningfulness level at statistical evaluation was granted as p<0.05. The students of non smoking is % 80.6. Being male has been determined as a crucial factor at attempting to smoke. Family support and the support of spouse, lover, fiance, strong willpower, being determined to protect health have been categorized into meaningful level in terms of facilitating not to smoke (p<00.5). The attitude points of the student who have never tried smoking towards the smoker students are significantly higher than the students who have tried smoking. As for the students who have tried smoking, their attitude points towards the cigarette itself and the struggle against smoking are higher than the students who have never tried smoking. In the sense of attitude points towards smoking there is no significant difference between the students. Keywords: Non-smoking behavior, to continue to avoid smoking, university student, education faculty

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Gulcan Kaynar, The Role of Peripheral Benzodiazepine Receptors on Acute Lung Injury. Zonguldak Karaelmas University, Health Science Institute, Department of Medical Pharmacology, Master of Science Thesis, Zonguldak, 2011. This study was designed to investigate the effects of selective peripheral benzodiazepine receptor agonist 4’-chlorodiazepam (Ro 5-4864) on acute lung injury induced by α-naphthylthiourea (ANTU). Injection of ANTU (10 mg/kg i.p.) produced pulmonary edema as indicated by an increase in lung weight/body weight ratio (LW/BW) and pleural effusion (PE) reaching a maximum within 4 h in rat. 4’-chlorodiazepam (0.1, 0.5, 2 and 4 mg/kg, i.p.) carried out to rats 30 min prior to ANTU. In another group, NMDA receptor antagonist, MK-801 (0.3 and 3 mg/kg) carried out to rats 30 min prior to ANTU. The thorax was opened and pleural effusion was carefully collected by suction and measure volumetrically. The lungs were removed and all surrounding tissues were dissected and weighed with an analytical balance. 4’-chlorodiazepam at the doses of 2 and 4 mg/kg, had a prophylactic effect on ANTU-induced pulmonary edema (LW/BW). 4’-chlorodiazepam had a prophylactic effect on ANTU-induced PE formation at all doses and significantly reduced PE and PE/BW ratio. NMDA receptor antagonist, MK-801 had no effect on lung edema, but significantly reduced pleural effusion. These result suggested that peripheral benzodiazepine receptors play an important role in modulation of acute lung injury induced by ANTU. These results demonstrated that peripheral benzodiazepine receptor agonists may be a novel therapeutic target for the lung diseases including acute lung injury. Keywords: Acute lung injury, α-naphthylthiourea; peripheral benzodiazepine receptor, 4’- chlorodiazepam, pulmonary edema, pleural effusion, MK-801

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Nergiz Kaya, Evaluation Of Working Life Quality Of Nurses Working In A University Hospital And The Affecting Factors. Zonguldak Karaelmas University, Institution of Health Sciences, Department of Public Health, Master of Science Thesis, Zonguldak, 2011. Working life quality is a psychosocial factor affecting the health of the employee and a basic determinant for the efficiency of working life. It is known to be a significant factor for nurses, having direct and indirect effects for giving highly qualified patient care during health services. Identifying the factors affecting working life quality of nurses and eliminating the unfavorable components will improve both work organization and the efficiency at workplace. The aim of this cross-sectional study was to determine the level of working life quality of nurses working in a university hospital. The population of the research consists of 161 nurses working in Zonguldak Karaelmas University (ZKU) Application and Research Hospital. Questionnaire form prepared in accordance to working life characteristics and socio-demographic variables was applied; additionally, working life quality scale for the health workers was also implemented. 142 (%88.20) nurses were reached in total, including 96 working in daytime period and in services and 46 working by shifts in intensive care unit. The mean age of nurses was 29.22 ± 3.32. The mean score of their working life quality was 79.54 ± 15.65. When working life properties were examined, working life quality between groups was found to be different. The mean score of the working life quality of nurses working in daytime period was 80.44 ± 15.00 and the mean score of the working life quality of nurses working by shifts in intensive care unit was 77.61 ± 16.98. Mean score of the working life quality of nurses working overtime (76.59±14.41), was also lower than those not working overtime (81.86±16.38), (p= 0.042). Keywords: occupational health, health of health worker, working life quality, nursing, shift work

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Saadet Colak Ozdemir, The Effect Of Peer Education On Preventing Smoking In High Schools In The City Center Of Zonguldak. Zonguldak Karaelmas University, Institution of Health Sciences, Department of Public Health, Master of Science Thesis, Zonguldak, 2011. Although a decrease in cigarette smoking among adults is observed in developed societies, the frequency of smoking among young people increases. Young people are the target of tobacco industry because of their characteristics such as being easily persuaded and being easily affected. Peer education is planned education which is realized by the young and their peers, and the aim of which is to make young people conscious about protecting health, gaining information, changing their attitudesandbehaviors. The aim of this crossectional experimental research is to evaluate the effect of peer education at Zonguldak Kozlu Anatolian High School and Kozlu High School on young peoples level of knowledge about smoking and on their smoking behavior. The population of this research is the students at 1st, 2nd and 3rd classes of high schools at Zonguldak City Center. Kozlu High School and Kozlu Anatolian High School, which are at Zonguldak City Center, are in the sample of the research. 1st, 2nd and 3rd classes of these two schools are determined according to the total number of students as experiment and control classes via drawing lots. It is aimed to reach 487, which is the total number of students. The attainability is 91.6 %. Data is evaluated via SPSS for Windows 13.0 statistics package program and percentage, average, chi-square test are used in analyses and analysis of variance is used in repeated measurements. 32.3% of 99 students who stated that they had tried smoking before peer education still continues smoking. 67.7% of them states that they gave up smoking. After peer education, the number of students who tried smoking increased, and the number of students who stated that they didnt try smoking increased. The difference between the number of trying smoking before and after peer education is not significant. Smoking behaviour and knowledge about smoking increased in both experiment and control groups. Although there was no difference between control and experiment groups, taking education about smoking before intervention and being a student of Anatolian High School were the basic determinative variables on the increase in the points of knowledge of smoking. In order to prevent smoking, school-based experiment programs should be developed and in applications, multidisciplinary approach should be used with peer education. Keywords: Peer Education, Preventing Smoking, Health Promotion, Health Education, Health of School, Social Learning

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Aslı Gokdemir Tekeli, Effects On Seminal Mast Cells And Leucocytes On The Sperm Motility And Morphology In Men With Abnormal Semen Parameters. Zonguldak Karaelmas Unıversity, Enstitute Of Health Scıence, Deparment Of Histology And Embryology Master Of Science Thesis, Zonguldak, 2011. Infertility is the failure in acquiring pregnancy despite the couples having sexual intercourse regularly in one year. Semen analysis is one of the fertilization potential indicators in men. According to World Health Organization (WHO: 1999), standard semen analysis contains sperm count, sperm motility and sperm morphology. Ninety-five patients with sperm motility disorders who were admitted to Ankara University Andrology Clinic were included in the study. This work aimed to assess the possible association between the presence of seminal mast cells, leukocytes and Teratozoospermia(n=16),Asthenoteratozoospermia(n=23) Oligoasthenoteratozoospermia (n=30), Azospermia (n=26). Two smear slides were prepared for each semen sample to be stained with wright to detect leukocytes and one smear slide was prepared to be stained with toluidine blue to detect mast cells. Groups were examined for the presence of mast cells; four groups found to be different from each other (p = 0.002). Here, it was observed that the azoospermia caused the difference. When the Azoospermia group was excluded from the analysis there was no significant difference among the 3 groups. When the groups were examined for the presence of leukocytes, no significant difference between groups (p = 0.048) were found. Again, it was observed that the azoospermia group was the cause of difference. The studies made state various opinions on the report about mast cells and leukocytes in the presence or absence of seminal studies of sperm motility, and morphology. In our study, we haven’t observed a significant difference when three groups; Teratozoospermia, Astenoteratozoospermi, Oligoastenoteratozoospermi were compared in terms of the presence of mast cells and leukocyte- absence of the head, neck, tail, and multiple anomalies. As a result, more detailed studies are required to determine how mast cell presence or absence affect sperm quality (regarding the parameters morphology, count, motility,etc.) Keywords: Infertility, Semen analysis, Mast cell, Leucocyte, Sperm Morphology

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Sukriye Kuzoren. Evaluation of the Follow-up of the Pregnant-Puerperal Women at Two Health Centers in Rural and Urban Areas. Zonguldak Karaelmas University, Institute of Medical Sciences, Master of Science Thesis, Zonguldak, 2012. The aim of this study was to determine the qualitative and the frequency of filling-up of the pregnant- puerperal women follow-up cards at two health centers in rural and urban areas. This study was a cross-sectional study. Population of this study was the pregnant-puerperal women follow-up cards of 683 women who delivered live birth in 2009 at Karadeniz Ereğli Central Health Center Nr. 2 and Süleymanbeyler Health Center. It was aimed to reach all sheets without sampling. The accessibility was 92%. The data was evaluated by SPSS for Windows and chi-squared test, student t test, Mann-Whitney U test and ANOVA were used. The occupancy rate of the pregnant-puerperal women follow-up cards was 78.3% at urban health center and 77.5% at rural health center. The 49.8% of the pregnants were detected in the first 14 weeks and the 56.9% of those had antenatal care four times and more at rural health center. The 48.1% of the pregnants were detected in the first 14 weeks, 48.9% of had medical care four times and more at urban health center. Every follow-up at the rural health center, filling up of the measurements of weight and blood pressure, oedema and varicosis check-up, pulse count were significantly higher than rural health center. The measurement of haemoglobin, the protein analysis in urine and baby heartbeat had been filled up less at both health centers. The pregnant follow-up quality score was 7.2±1.5 at rural health center, 8±1.5 (p=0.001) at urban health center. Although the pregnant follow-up quality score of the pregnant women who were high school graduates and more, under the age of 20 and had first pregnancy at rural health center was significantly high, at the urban health center the pregnant follow-up quality score of the pregnant women who were unemployed, under the age of 20 and had first pregnancy was significantly high. As a result, there was no difference in the frequency of filling-up the pregnant-puerperal women follow-up cards between two health centers, but the pregnant follow-up quality score at rural health center was significantly lesser than urban health center. Keywords: Primary health care, reproductice health, Form 005, antenatal care, quality point.

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Sayeste Gebedek, Evaluation of Respiratory Functions Among Workers Diagnosed With Coal Workers’ Pneumoconiosis. Zonguldak Karaelmas University, The Institute of Health Science, Master of Sciences Thesis, Zonguldak, 2012. The aim of this retrospective and cross-sectional study is to evaluate the respiratory function tests among coal mine workers who applied to Zonguldak Uzunmehmet Chest and Occupational Diseases Hospital in 2008 and diagnosed with coal workers’ pneumoconiosis. Study sample includes hospital records of 469 coal mine workers who started working in 1971 and after, applied to Zonguldak Uzunmehmet Chest and Occupational Diseases Hospital in 2008 and diagnosed with coal workers’ pneumoconiosis. In this study, hospital records of 12 workers, which were forwarded to Ankara Occupational Diseases Hospital and not taken back, were excluded, the rest of 457 records and files of patients are planned to be reached without sampling and all of them are succeeded to be avaliable. The data was analysed with SPSS for Windows, mean values were shown as “arithmetical mean±standart deviation, Chi-square test, ANOVA, independent samples t test and pearson correlation analysis were used for comparisons of groups and result of analysis were eveluated within 95% confidence interval. While the significant correlation was not determined between underground working day of workers and three respiratory parameters (FEV1, FVC, FEV1/FVC), negative and middle significant correlation between age of worker and FEV1 (r=-0.341, p=0.001), negative and middle significant correlation between age of worker and FVC (r=-0.324, p=0.001), negative and poor significant correlation between age of worker and FEV1/FVC (r=-0.122, p=0.009,) were recorded. It was observed that respiratory function was not effected by tuberculosis history and smoking status. Evaluation of respiratory functions must be considered as an important collateral assessment in diagnosis of occupational lung diseases. Occupational safety practice about prevention and control of dust exposure and periodical follow up of respiratory functions have a vital importance for prevention and control of coal workers’ pneumociniosis. Keywords: Occupational health, coal mine worker, coal workers’ pneumoconiosis, respiratory function test, occupational disease.

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Bayram Kamat, How The Profilactic Usage Of Curcumin Affects The PARP-1 Immunoreactivity And Spermatogenesis In Scrotal Radiotherapy? Bulent Ecevit University, Enstitute of Health Science, Department of Histology and Embryology, Master of Science Thesis, Zonguldak, 2013. The lethal effects of acute doses of radiation on fertility are well known. Germ cells are killed or damaged within a short time of exposure to radiation. In recent years, radiotherapy of patients with cancer has led to an increased number of sustained remissions. However, among the long-term side effects of radiation, injury to the reproductive system is of particular concern. Many papers have been reported so far on the antioxidant effect of curcumin. The present study, we hypothesized that curcumin can minimize germ-cell depletion and morphological features of late cell damage in the rat testis following X-irradiation. The animals were divided into 4 groups: the first group was the control and the other three were the experimental groups. 6 Gy X ray in a single fraction was applied into the scrotal areas of the subjects except the control and curcumin groups in order to form radiation damage. The rats in the second and forth groups were given curcumin (a dose of 100 mg/kg body weight) orally three times a week during a seven-week period, beginning the week before radiation therapy. The rats in the first and third groups received serum physiologic in the same way. Testis biopsy samples from the all groups were taken on the 7th week. All samples were processed and observed at the light microscopic levels. In the present study, radiation exposure caused severe degenerative changes in testes. Spermatogenesis had arrested in seminiferous tubules and the majority of the tubules were found to be atrophic, absent of germ cells. It was identified that curcumin hadn’t been effective in the prevention of all damages caused by radiation. Keywords: Ionizing-radiation, Curcumin, PARP-1, Spermatogenesis, Rat.

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Ibrahim Pala, Protective Effect of Curcumin on Folliculogenesis, and PARP-1 Expression Exposed Ionising Radiation In Rat Ovary. Bulent Ecevit University, Enstitute of Health Science, Department of Histology and Embryology, Master of Science Thesis, Zonguldak, 2013. Radiation is known to be one of the agents intensifying follicular atresia in the ovarium as a stimulant of atretogenic. Curcumin is discussed to have a positive impact on radiation- induced damage. It has a strong antioxidant agent against oxidative stress. The aim of our study was to show the effects of ionising radiation on ovarium follicular atresia so that the protective effect of curcumin on the resulting damage could be determined, and in addition to immunohistochemically determining to level of expression of PARP-1 enzyme is responsible for DNA repair in the nucleus of the cells protected from radiation or irradiated the cells. The female rats were divided into 4 groups. The whole body of the rats in the experimental groups were exposed to a single dosage of ionising radiation (8.3 Gy) with a view to causing radiation- induced damage. The animals in the curcumin and in the irradiated with treated curcumin had been fed a daily 100 mg/kg of curcumin for seven days in a row before the radiation process was launched. Ovarium tissues sample were collected for the microscopic examinations. The ovarium tissues showed that there were the number of follicles showing atresic features was significantly high in the irradiated group. On the other hand, in the irradiated with treated curcumin group showed that the number of atretic follicles was lower than that in the irradiated group. The irradiated group given curcumin were observed to prevent the follicular damage caused by radiation. Beside our results demonstrate that PARP-1 especially was expressed in the nuclei of oocytes throughout follicular development from the primordial to the secondary follicle stages and some in granulosa cells. It was identified that effects of radiation on ovarian morphology and was speculated that curcumin may help prevent infertility caused by radiation and thus be of benefit to clinical practice. Keywords: Ionizing-radiation, Curcumin, PARP-1, Folliculogenesis, Rat.

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Gulsah Yapici, The Assessment Of Frequency Of Diagnosed Sleep Disorders And Daytime Sleepiness In Workers Of A Mine Enterprise. Bulent Ecevit University, The Institute of Health Science, Master of Sciences Thesis, Zonguldak, 2013. Sleeping, which constitutes about 1/3 of human life time, is an important requirement for health. During sleeping, brain performs various physiological, electro-physiological and cognitive activities. Sleep disorders are disturbances in the duration, pattern and quality of sleep. It's known that there are 85 types of sleep disorders. This cross-sectional study aims to explore the frequency of diagnosed sleep disorders and the daytime sleepiness, known to be related to sleep disorders (using Epworth Sleepiness Scale) in miners. Other investigated variables are socio-demographic characteristics, working life and conditions, habits and the history of other diseases. In the study, a questionnaire developed by the investigator in accordance to the variables and Epworth Sleepiness Scale to measure daytime sleepiness were used. Target population of the study was 1520 miners and the calculated "smallest representative sample size" was 307. Thirty percent of replacement has been used and out of a total of 409 target people, selected by using a random numbers table in accordance with their working characteristics, 378 people (92.4%) were reached. Achieved sample represents its own universe. The mean age of the study group was 34.5±5.1. The average working year of the employees was 8.3±5.1.While sleep disorder diagnoses were not reported by the workers, the frequency of daytime sleepiness detected by Epworth Sleepiness Scale was found to be 29.4%. Keywords: Sleep disorders, Miners, Epworth Sleepiness Scale, Occupational Health, daytime sleepiness

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Arzum Celik Beklevic, The Evaluation of Social Gender Roles Attitude Scale and Perception of Social Gender Roles in Work Life in Residents of a University Hospital. Bulent Ecevit University, Institute of Health Sciences, Department of Public Health, Master's Degree Thesis, 2013. The aim of this descriptive study is to evaluate the reflections of social gender role attitudes of resident doctors in a university hospital on gender perception in work life. The target population of the study cosists of 159 resident doctors working in a university hospital. All of the residents were included, but 128 people (80.5%) accepted to participate. Variables of the study were socio-demographic characteristics, "Social Gender Roles Attitude Scale" (SGRAS) developed by Zeyneloélu and answers to statements related to perception of social gender roles in work life. Data was collected via a self reported questionnaire prepared in accordance to relevant variables. 45.3% of the participants were female and 54.7% were male. While 52% of the residents worked in departments of medical sciences, 38.4% worked in departments of surgical sciences and 9.6% worked in departments of basic sciences. When Agreement to the statement of "Gender does not affect choices in work life" was higher in female and the difference between female and male subjects was significant. When sub-dimensions of perception of social gender roles in work life and sub-dimensions of SGRAS were evaluated, there was a moderate positive correlation between the perception of "Utilization of job opportunities is free of gender" and "Equitable gender role" (r=0.49 p=0.000) . While there was a moderate negative correlation between the perception of "males are more favored in the working unit" and "Equitable gender role" (r=-0.41 p=0.000), there was a moderate positive correlation between the perception of "Males are more favored in the working unit" and "Gender role in marriage" (r=0.52 p=0.000). The reflections of social gender role perceptions to gender perceptions in work life has been investigated in this study. Awareness in this regard and improving social gender role behaviours with educations would be expected to support improvements in unfavorable conditions related to gender in work life. Key Words: Social Gender, Work Life, Status of Woman, Social Gender and Attitudes, Social Gender Equality

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Sibel Demir, Teachers' Working Conditions And Health Status Assessment. Bulent Ecevit University, Institute of Health Science, Master of Science Thesis, Zonguldak, 2013. The aim of this descriptive study is to evaluate the characteristics of work and current health condition of the teachers’ who work at the schools in the city center which are affiliated to Zonguldak Provincial Directorate for National Education. The sample size to represent the total number of 2212 teachers was calculated to be 720. Simple random sampling was used. The data of this survey, of which accessibility was 91.4% (n:658), was collected via the self-administered questionnaire prepared by the researcher. While 54% of the teachers included in the study was female. Among 658 teachers, 93.9% worked as permanent staff, while 6.1% were contracted. 23.4% was found to be regularly working overtime and 4.7% had extra jobs. The mean working hours of the teachers were 34.0±10.9. The mean score of their perception of the worthiness of their job in the community was 4.5±2.1, where 10 represented the best deserved status. The mean score of their satisfaction from job was 7.3±2.3, where 10 represented the most satisfied. 39.4% of teachers had at least one disease diagnosed by a doctor. While otolaryngologic diseases were most frequent (15.8%), gastrointestinal diseases had a frequency of 13.7%. The three most frequent health complaints were backache (15.0%), headache (14.9%) and sore throat (13.7%). 17% of the teachers were using medicine on regular basis. Being a role model and having the ability to reach to whole community, the teachers have a key status for health promotion and prevention. Considering their potential of reflecting their knowledge and perceptions to the community, it is essential to integrate the health of teachers into school health services or cover them in occupational health services. With the new legislation, TSM based occupational health services can be carried out with the support of occupational health nurses. Key Words: Teacher, Health status, Occupational health, Working conditions

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Medine Guzel, Zonguldak Maternity Hospital Who Presented To The Knowledge, Attitudes And Preferences Influence The Shape Of The Birth Experience. Bulent Ecevit University, Institute of Health Science, Department of Public Health, Master of Science Thesis, Zonguldak, 2014. Cesarean rates increasing fast at the World and our country. All health personel act an important part to decrease cesarean rates. The purpose of this research is pregnant’s knowledge, attitude and experiments effects an barn modality design.This research is descriptive, has sone at Zonguldak Women and Child Diases Hospital. The research include 512 pregnants, that applied pregnancy Polyclinic between the dates 23 January- 16 February 2012. Obtained datas were evawated via SPSS 15.0 Windows pocket program. Datas have shown by the calculated mean± standart deviationi importance test of chi-square was applied. %67,6 of pregnants have chosen vaginal birty, %30,7 have chose cesarean, %1,8 been double minded. The main reasons the choose vaginal birty are healty (%67,3), makes body fit earlier (%28,1) and have doubts about cesarean (%7,4). Case of mother is under 20 years old, hasn’t got a baby, got pregnant willingly, to choose born modality own or with her husband, has a chronic illneus, has a dead born tale (uzamış travay öyküsü olmaması), had vaginal birty before, not have problems on previous born are the significant reasons the choose vaginal birty. Anything big party of mothers coose vaginal delivery, doctor choose cesarean predominantly. This case reguires to give importance to mother choose by evoluate cesarean indications fussily by the doctors. Key Words: Delivery Mode, Caesarean, Vaginal Delivery, Pregnant, Socio- economic status

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Elnaz Bagherinabel, Evaluation of Traffic Accidents With Time Series Analysis. Bulent Ecevit University, Institute of Health Science, Department of Public Health, Master of Science Thesis, Zonguldak, 2014. Traffic accidents are an important public health problem due to mortality, morbidity and economical loss caused by accidents. The aim of this study is evaluation of traffic accidents in Turkey accrued between 1966 and 2012 with time series analysis. In this study, data were obtained from governmental statistics and analyzed with a linear model that includes national income, population, road structure, and number of motor vehicle. In analysis, the effects of changing were evaluated between these parameters and number of accident, death and injury. There were a positive relationship between number of accident and national income, between number of death and number of accident, injury, truck, mini bus, bus, and between number of injury and number of accident, death, bus and national income, although there was a negative relationship between total road length and number of death and injury. Increasing of national income has an expanding effect on carrying trade and passenger transport. Heavy traffic due to intensive carrying trade and passenger transport negatively effects to traffic accidents. Encourage of balanced distribution of carrying trade and passenger transport between different transportation systems can support positively to control of traffic accidents. Keywords: Traffic accidents, death, injury, time series, Turkey.

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Dilek Horuz, Hospitalized In The Chest Diseases Department Of Music Therapy In Patients With COPD Anxiety And Its Effects On Some Clinical Physical Findings. Bulent Ecevit University Institute of Health Sciences Department of Public Health, Master of Science Thesis Zonguldak, 2014. Some physcological symptoms, such as agitation, anxiety, depression, disorientation and delirium, appear in hospitalized patients related to the factors as little information about heals and application, limited movement that monitorization, infusion sets, urine scrotum form, isolation, painful enterprise, unusual place and people, illnesses. In this study, observing the effects of musical theraphy to the anxiety and some physical findings on patients of Chronic Obstructive Pulmonary Disease (COPD). The patients with COPD staying in Bülent Ecevit University (BEU) Health Application and research center of Chest Disease Clinic have formed the universe of the research. 114 patients who applied between 10th of November, 2013 and 10th of March, 2014 of thèse patients have formed the sample of the research. Two experimental group of 32 people and one control group form the desing of the research. Bach compositions for the one group and some chosen Turkish Art Music compositions of Farabi to the other group have been listened by Mp3 player every morning totally for one hour. Also, a questionnaire, developed by researchers, including sociodemographic characteristics and the clinical features of patients was carried out on the first day of the study. Beck anxiety scale was repeated on the 0-5th and 10th dayof the musical theraphy. SPSS 11.5 was used to analyse the obtained data. pt 0.05 was accepted as meaningfulness level in statistical evaluations. Abnormal dispersions were determined by Kolmogorov Smirnov test. for the reason Kmskal-Wallis test was used to show the difference between the group median. Keywords : COPD, anxiety, music therapy.

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Hicran Demirhan, Family Burden and Quality of Life Assesment in Families Whose Children and Adolescents Evaluated Mentally and Borderline Itellectual Functioning. Bulent Ecevit University, Institute of Health Science, Department of Public Health, Master’s Degree Thesis, Zonguldak, 2014. This research aims to investigate family burden and quality of life in families who have mentally handicapped children and borderline intellectual functioning children the age between 6-16. Socio- demografic characteristics, psychological support and psychiatric medicine need in families, income support and home care support from goverment have also been evaluated in this study. WISC-R test has been applied to the children of aged 6-16 to verify the diagnosis of mental handicap. Family Burden Evaluation Scale, WHOQOL-BREF and Socio- demografic form have been applied to accompanying family members. In this study, 131 children, attented to the Bülent Ecevit University Health Practise and Research Center, psychiatric department of children and adolescents, requested a mental evaluation test (WISC-R) and IQ score between 35-79 and their mothers were included. The mothers who have mentally handicapped children were the age between 24-56. In those, 93.1% were married and 69.5% were lived in a nuclear family. Most of the mothers were housewife and the average montly income of the families were 1237,44±971,39 TL. In those, 25.2% were having psychological support and 26.7% were taking psychiatric medicine. In this study, quality of life were in mid-scale in mothers who have an mental handicapped children. The lowest score has been detected in “environmental” relation to social oppression where the highest score has been detected in “physical domain”. From the results obtain from family burden evaluation data, the most important concern of the mothers were that their mentally handicapped children would never be self-sufficient and they would fall behind from their pers. Key Words: Family Burden, Mental Retardation, Quality of Life, Mental Handicapped, Borderline Intellectual Functioning.

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Gamze Orenli, Mothers Of Secondary School Female Students Knowledge Attitude Behaviours About Cervical Cancer And HPV Vaccine. Bulent Ecevit University, Institute of Health Science, Department of Public Health, Master’s Degree Thesis, Zonguldak, 2014. This cross-sectional study was performed with aim to determine the knowledge, attitude, behaviors of mothers of female students in secondary schools in Kozlu about cervical cancer and HPV vaccination. The population of there search consists of 769 mothers of female students in all secondary schools in the district of Kozlu. Female students were determined Kozlu Secondary School (441 student’ s mother), Kozlu 19 Mayıs 100.Yıl Secondary School (114 student’ s mother), Kozlu Alparslan Secondary School (194 student’ s mother), Kozlu Imam Hatip Secondary School (20 student’ s mother). As a the sample size had been take all universe, mothers who agreed to participate in there search and who full filled the questionnaire form 633 (82.3%). Questionnaire form was prepared by there searcher examined the literature on related topics, after preparing the questionnaire form has been an expert opinion from the public health field. Female students were asked to transport the mother giving the questionnaire form. Data were analyzed. Data obtained from the study by researchers. And these transferred to Statistical Package for Social Sciences (SPSS) 18.0 on computer. Frequency distribution, Chi-square test, analysis of variance, t test and Kolmogorov- Smirnov test was used. Data are expressed in numbers and percentages in the tables. Mean ± Standard deviation are given by. According to the findings; age range was 28-63. The mothers' mean age was 38.3±4.42. When we look at the distribution of the sociodemographic characteristics of mothers, primary school graduates were 61.6%, housewives were 87.8%, married was 94.0%, and health insurance was74.6%, marriage average was16.2 ± 5.73 years. 73.3% of the mothers had not heard HPV and 62.1% of the mothers had not heard HPV vaccine before. 94.8% of women had heard the cervical cancer. But only 51.6% of the mothers know that HPV causes cervical cancer. 60.2% of mothers had heard papsmear test and 26.9% of mothers hadn’t make pap smear test. 58.1% of the mothers know that taking the HPV vaccine to girls, 15.6% of the mothers know that taking the HPV vaccine both male and female children. Only 0.8% of the mothers know that taking the HPV vaccine to boys.

87.5% of the mothers want to learn about there liability of the vaccine. They want to learn other topics were side effects (71.6%), level of protection (69.8%), duration of protection (67.3%) and effect of vaccine (64.3%). In conclusion, the mother don’t aware cervical cancer, HPV and HPV vaccine and they did not have enough information. It was found that taking levels of pap smear test of mothers was insufficient. Therefore the maternal education should be planned programs which related to cervical cancer, pap smear test, HPV and HPV vaccine and dissemination of education programs should be ensured. Keywords: Human Papilloma Virüs (HPV), The Pap Smear Test, Cervical Cancer, Cervical Cancer Risk Factors, HPV Vaccination.

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Nesibe Sogutlu, Fecal Carriage Of Extended Spectrum Beta-Lactamase (ESBL) Producing Escherichia Coli And Klebsiella Spp. In Zonguldak Children. Bulent Ecevit University, Health Sciences Institute, Master's Thesis. Zonguldak, 2015. Background: The recent studies about fecal carriage of ESBL producing bacteria in the community are reported to be significantly increased. Over-use of antibiotics is the main cause of it. The presence of ESBL- producing bacteria in the gut, makes it difficult to treat infections caused by these bacteria and facilitates spreading transportation of resistance genes to other bacteria in the intestine flora. In our country, although the incidence of upper respiratory tract infections are mostly by viral agent in childhood, use of antibiotics is also common. The purpose of this study, to investigate the prevalence of intestinal carriage of ESBL-producing E. coli and Klebsiella spp in childhood and to determine the type of ESBL enzymes. Methods: Children (ages 0-15 ) who applied to pediatric outpatient clinics for any complaint were evaluated between November 2012 and May 2013. The demographic characteristics of the patients was collected by survey and stool samples were requested. Patient samples were seeded EMB agar containing 2μg/ml cefotaxime and 2μg/ml ceftazidime + 2μg/ml cefotaxime. After one day incubation, the bacterias were inoculated to blood agar. Bacteria were identified by conventional methods. Antibiotic susceptibility tests were performed by CLSI recommendations. ESBL were detected by double-disk synergy test, agar gradient method is used when it is necessary. Enzymes types of isolated bacteria were determined by PCR. Results: 454 patients (51.8% male, 48.2% female) were admitted to the laboratory within the time specified. The prevelance of the fecal carriage of ESBL producing E. coli and Klebsiella spp is 33% (150/454). ESBL -producing bacteria was found more than one in four patients. Two different ESBL- producing E. coli was found in one patient. One hundred and forty-two of 154 ESBL- producing bacteria were identified as E. coli ( 92.2%), 11 of them were K. pneumoniae (7.1%) and 1 of them were K. oxytoca (0.6%). Age, gender, education status, receipt of antimicrobial therapy during previous 3 months, history of urinary infection in recent 6 months, history of hospitalization and surgery, having any cronic disease, the number of the room in the house and household members, having a pet in the house or garden, weekly consumption of chicken meat were questioned by the survey but none of these factors were statistically significant relationship between fecal carriage of ESBL- producing bacteria. One hundred and forty-three of 154 ESBL-producing bacteria (92.8%) were positive for CTX-M group enzymes. 94.4% of these bacterias (135/143) had CTX-M-3, 81.1%

of them (116/143) had CTX-M-15 enzymes. One hundred and sixteen isolates had more than one CTX-M enzymes (CTX-M-3 and CTX-M-15). Seventy seven of 154 (50%) ESBL-producing bacterias had TEM group enzyme and 12 of them (7.8%) had SHV group enzyme. Conclusions: In our study, the fecal carriage rate of ESBL in childhood is 33 % (150/454). This rate is significantly high according to the previous reverences. After it could not be found a significant relationship between the risk factors and fecal carriage of ESBL, It was thought that, this high carriage rate of ESBL poducing bacteria could be related with horizontal sharing like seen among the adults. CTX-M group enzyme was found to be the dominant enzyme group in carriers. The most fequent enzyme type of CTX-M group was found to be CTX-M -3. Keywords: Extended spectrum beta-lactamase, Escherichia coli, Klebsiella spp., carriage

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Seda Kaya Ozdemir, Bartin Province Health Vocational High School And General High School Students Eating Habits And Obesity Prevalence. Bulent Ecevit University, The Institute of Health Science, Master of Sciences Thesis, Zonguldak, 2015. This research was carried out to comparatively investigate the eating habits and the prevalence of obesity between the students of the vocational high school of health and the general high school. A questionnaire was prepared in this purpose and was administered to a total of 586 high school students studying in the vocational high school of health and general high schools in 2012-2013 academic year in Bartın.The data obtained from the survey were assessed using SPSS 22.0 statistical software package on the computer. The main conclusions reached in the study are as follows: There are no significant differences in obesity prevalence between the students of the vocational high school of health and the students of the general high school. It was determined that they resemble each other in terms of the eating form of the dishes, eating habits in a day, the slices of bread consumed in the meals, and the number of meals of the students in a day. The status of skipping meals among the students of the vocational high school of health were found to be more often than the general high school students. Furthermore, while the overall eating habits of the general high school and the vocational school of health students were similar to each other, it is more common among the students of the general high school than the students of the vocational high school of health to rarely consume beef, mutton and the salami, sujuk and sausage etc. made from them, and to eat hamburgers, French fries and döner kebab menus. Keywords: Nutrition, obesity, vocational school of health, general high school, adolescents.

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Elcin Sebahat Kasapoglu, Evaluation of Healthy Life Style Behaviours In Students of Vocational Colleges. Bulent Ecevit University, Institute of Health Science, Department of Public Health, Master of Science Thesis, Zonguldak, 2015. The purpose of the study is to determine healthy life style behaviours and related factors between students of vocational college. The study was carried out in the Bartın University for 2014-2015 academic year. The study design is cross-sectional. The data were collected from students using Descriptive Characteristics Form and Healthy Lifestyle Behaviors Scale. The data obtained were analyzed by SPSS (Statistical Package for Social Sciences) 22.0. The quantitative data between two independent groups were compared by t-test and the quantitative data among more than two independent groups were compared by One Way ANOVA test. Following ANOVA test, Scheffe test was used as a complementary post-hoc analysis to determine differences. The study was carried out on 711 students. % 60.3 of students were women. The mean score achieved by students from the Healthy Life Style Behaviour Scale was 122.201±20.412 It was found that the highest scores were obtained from “self actualisation” and “health responsibility” sub-groups while the lowest scores were obtained from the “exercise” and “nutrition” sub-groups of the scale. It was found that healthy life style behaviours of students were related to age, income level, family type, education status of mother, the frequency of inspection by doctor, Hepatitis B immunization, mood, exercising regularly and participating in social activities (p<0.05). Keywords: Health promotion, healthy life style behaviours, vocational college students.

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Fatime Filiz Kapucubas Akpınar, Assessment Of Blood Heavy Metal Levels For Traffic Polices. Bulent Ecevit University, Institute of Health Science, Department of Public Health, Master of Science Thesis, Zonguldak, 2016. Traffic polices are the ones who usually work at the major intersections of the downtowns where the traffic run in rush and the ones fall into engine fumes the most which is one of the factors cause air pollution, get into many of health and security problems due to working conditions.the traffic polices on duty especially in civic center are directly subjected to lots of pollutants including chemical, physical and biologic harm.Primarily, engine fumes and heavy metals allowed to environment by other sources can influence the health negatively due to entering the body in different ways. Traffic polices are in the risk group in heavy metal exposuring. In this study, It is aimed the assessment of blood and serum heavy metal levels of traffic polices. Sectional typical participants of research are chosen from actively working 47 traffic and 50 office polices in Zonguldak police headquarters and Area Traffic supervision suboffice headship. In survey, It has been searched the levels of As75, Cd111, Hg202, Pb208, Al27, Cr52, Mn55, Co59, Ni60, Cu63, Zn66, Se82 in blood and serum. The heavy metal levels of polices have been evaluated by ARUP Laboratories in determinated reference range. One of 97 participants got result for cupric on reference range and two of them got it for zinc. When the polices are evaluated as field and office personel, It has not been assigned a meaningful difference among the groups in view of serum selenium and manganate, blood, cadmium, cupric and plumbo rates. When the arsenic and cobalt concentration of the field personels significantly higher than office personels, Aluminum, cupric, zinc, chromium and Nickel concentration of the office personels significantly higher than the field personels. As to gender, cupric average of men is significantly higher than women. Aluminum and Nickel average of women is significantly higher than men. When the metal levels of polices evaluated as to age, cupric level between the group (age 30-39 and above 40) is significantly higher than the age group (20-29). For traffic polices , those whose daily working time is 12 hours or more have higher aluminum levels than those whose daily working time is 11 hours and less.. For Office personels, those whose daily working time is 12 hours or more have higher zinc and selenium levels but lower manganate level than those whose daily working time is 11 hours and less.. When the relation evaluated between working time and blood metal levels of polices, It has been detected average significant correlation between working time on traffic and plumbo level. It has been detected average significant correlation between working time at office and chromium and nickel levels. It has been detected average

significant correlation and in negative way between Office working time and cobalt level. It has been detected average significant correlation between total working time and cupric level. In literature, as there are studies shown that some heavy metals primarily plumbo and cadmium increase due to engine fumes exposing, there are also some studies not detected any difference. In our country, the studies about this subject are limited. It needs to keep on studying aimed at exposing of traffic polices. Keywords: Heavy Metal, Traffic Police, Environmental Pollution, Air Pollution, Engine Fumes

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Koray Olgun, Comparison of Two Different Scales In Pain Evaluation of Patients Who Received Mechanıcal Ventilatıon Support. Bulent Ecevit University, Institute of Health Sciences, Department of Nursing Surgical Nursing Program, Master of Sciences Thesis, Zonguldak, 2016. The fact that nursing practices are based on relaxation of the person, and that nurses are together with the patients for long hours and are watching them closely, give great responsibility to intensive care nurses in determining and relieving the pain. This research conducted as a definer in order to define whether “Behavioral Pain Scale” or “Intensive Care Unit Observation Scale” evaluating the pain of the patients who stay in hospital and get mechanical ventilation support, is the best way to evaluate the pain of the patients in the university hospital. Research stages, 15.09.2015 - 31.15.2015, were created with 101 patients who have treatment and have suitable conditions to be in this research. Findings in this study have been gathered with Data Collection Form, Behavioral Pain Scale and Intensive Care Unit Observation Scale which have been designed according to the revelant literature. Data obtained at the research has been analyzed by using SPSS. Findings have been evaluated at the level of % 95 confidence interval and 0,05 meaning level. Research; in the case of both scale and rest before the procedure revealed no longer mean score of pain during the procedure (p = 0,000). The mean pain score in both scale according to introductory variables was statistically no difference. Two scales were compared and CPOT BPS based on mechanical ventilation in the intensive care unit in support of evaluation of pain patients was found to be significantly more effective (p = 0,000). Key Words: Intensive Care Unit, mechanical ventilation, pain assessment, nursing, pain scales

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Dilek Karaman, Effects of Virtual Reality Applications on Pain and Anxıety During Breast Biopsy. Bulent Ecevit University, Institute of Health Sciences, Department of Nursing Surgical Nursing Program, Master of Sciences Thesis, Zonguldak, 2016. Fine needle aspiration biopsy in the diagnosis of breast cancer is used as a method simple, fast, economical, reliable at the cellular level diagnostics. Although the small diameter of the catheter in this method because of it is an invasive procedure, pain and anxiety is described as an important factor. Virtual reality applications developing with the advancement of technology is an application reduced the perception of pain and anxiety using people's attention and cognitive processes. Applications involving the music in the background, the imagery winning multidimensional through binoculars glasses and obtained by special camera systems are moving, individuals away from thinking of medical procedures. Pain and anxiety management with non-pharmacological methods such as virtual reality is among the main objectives of nursing practice. This study was carried out as experimental research with patients who received breast biopsy samples in the department of general surgery a university hospital to determine the effect on pain and anxiety levels of virtual reality applications during the process. The research population were created patients who admitted to breast and endocrine clinic of the concerned institution between 15.02.2016- 15.05.2016, the sample patients who 60 women volunteers patients taken breast biopsy samples with method fine-needle aspiration biopsy and have suitable conditions to be in this research. Findings in this study have been gathered with State and Trait Anxiety Inventory, Visual Analogue Scale, Data Collection Form prepared taking into account the review of the literature and expert opinion. Data obtained at the research has been analyzed by using SPSS 17.0 Statically Packed Program. Findings have been evaluated 0,05 meaning level. At the end of the research, The mean age of the patients aged between 18-69 years of age is 44.0 ± 12.3 years mean age, between cases and control groups differences in features not descriptor and spread as groups homogeneously (p> 0.05), patients of cases average score of pain and the state anxiety after the procedure, according to the average score of patients in the control It was found to be significantly lower (p <0.001). Virtual reality application during breast biopsy is effective on pain and anxiety. Keywords: Breast biopsy, Virtual reality, Pain, Anxiety

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Nurten Arslan, Examination Of The Condition Of Influence Of Family Functions On Relationship Between Healtly Adolescents And Their Disabled Siblings. Bulent Ecevit University, Institute of Health Sciences, Department of Pediatric Nursing, Master’s Thesis, Zonguldak, 2016. The variables like parent-child relatıonship of disabled children, the attitude and expectation of healthy adolescents, family functionality of parents and characteristics of the children may affect emotional/behavioral responses and harmony between healthy adolescents and disabled siblings. In this descriptive study that was conducted at four special education centers located in Zonguldak province between April 14th and May 14th with 125 disabled children, 125 their parents and 125 healthy developing siblings. İt was aimed to evaluate family functionality and its influence on sibling relations and sibling problems. The data for the study was gathered through General Information Form, Sibling Problems Questionnarre (SPQ), Schaeffer Sibling Behavior Rating Scale (SSBRS)- Sibling’s Form and Family Assesment Device (FAD). 57.5% of healtly adolescents were female and in 10-14 age group. 60.0 % of diisabled siblings were male. 47.5% mental disabled and 53.3% have the educationlevel through secondary school. 65.8% of mathers were in 35-44 age group. 66.7% graduated from primary school and 94.2% were housewives. 54.2% of fathers were 35-44 age group, 39.2% were primary school graduate and 50.0 % of them were workers. In comparasion of FAD-SPQ total point of SPQ had been decrease in the subscales point of FAD increase; except maternal/paternal dimension of behaviour control subscales. İn comparasion of SSBRS-SPQ sobscale point of SSBRS on being kind, synergy-being connected and empathy had been increased as well as SPQ total point increase, on the other hand abstienence-restraint subscale point of SSBRS had been increased as weel as total point of SPQ increase. In comparasion of FAD- SSBRS statistically significant relationship was found. Keywords: Disability, Disabled Children, Healtly Adolescent, Sibling Relationship, Family Functionality.

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Dilek Bayram, Children Peripheral Cannula Used During The Application Of The Cardiovascular Imaging Effects On Pain And Anxiety. Bulent Ecevit University, Institute of Health Sciences, Department of Pediatric Nursing, Master’s Thesis, Zonguldak, 2016. Children’s vascular structures being small and lack of subcutaneous fat tissue makes peripheral cannula applications difficult and may cause lots of attempt to be made. This study was made with the aim of determining the effects of using vascular imaging device in 9-12 years age group of children on children’s pain and anxiety. The research is a semi-empirical study with pre-test - past- test control groups.1156 children 9 to 12 age group who were treated at Zonguldak Bulent Ecevit University Health Research Center and Pediatrics constitute the research’s universe.The sample that was calculated based on Power analysis is made of a total of 80 pediatric patients including 40 in the control group and 40 in the experimental group. 80 children that make up the sample are randomized in the experimental and control groups. Personal information form, faces rating scale,state anxiety scale, vascular imaging device and a peripheral cannula are used in the collection of the data. Before the procedure the experimental and the control groups are applied to the state anxiety scale, the procedure was carried out with vascular imaging device in the experimental group and with the routine application in the control group. Both groups were applied to the facial expressions rating scale during the procedure. After the procedure both groups were applied to the state anxiety scale. In terms of children’s pain feeling status during the peripheral cannula application (p=0.003<0.05), the processing time (p=0.000<0.05), the transaction number of attempts (p=0.04<0.05) and facial expressions rating scale score averages (p=0.000<0.05) statistically significant difference was found between experimental and control groups in the statistical analysis that was made (p<0.05).While there wasn’t any difference in terms of the state anxiety scales average points of children who constitutes experimental and control groups before the procedure (p=0.766<0.05); a statistically significant difference between experimental and control groups was found to be at an advanced level in terms of post processing state anxiety levels (p=0.000<0.05). The state anxiety scale score of the children in the experimental groups after the procedure (33.250±4.01) is found to be lower than the state anxiety scale averange scrore of the children in the control group after the procedure (37.420±4.51). As a result; it is determined that using vascular imaging device in children living pain and anxiety during peripheral cannula application reduces this pain and anxiety and shortens the durations of the initiative. Keywords: School child, vascular imaging device, pain, anxiety

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Dilek Yildirim Tank, The Effect of Using Nail Polish by Operatıng Room Nurses on Bacterial Colonization After Surgical Hand Washing. Bulent Ecevit University Institute of Health Sciences Department of Nursing Surgical Nursing Program, Master of Sciences Thesis, Zonguldak, 2016. Surgical site infections are very important and serious problem on morbidity, mortality, increasing the length of stay hospital and hospital costs.It is known to be very important handwashing practices of health care workers of operating room in the prevention of surgical site infections. In the literature there is no definitive judgement about the effect of using nail polish by operating room nurses on surgical hand washing. This study was carried out as experimental research with 33 nurses working at Zonguldak Atatürk Devlet Hastanesi Operating Unit and that over 18 years between 09.01.2015 - 15.07.2016. Nurses were excluded if they had skin irritation, latex allergy or eczema, if they had taken antibiotics during the previous 2 weeks or had performed surgical hand disinfection during the preceeding 24 hours. Glove juice method were used to measure the bacterial colonization on the flora of the participants.The data obtained analyzed in SPSS 16.0 with descriptive statical methods, Man Whitney U test and Kruskal Wallis test. Findings have been evaluated 0.05 meaning level. As a result, surgical nurses were no statistically significant difference between the number of bacteria in samples taken when after hand-washing natural nails and applying nail polish.The demographic characteristics of the nurses were no evident significant difference between the number of bacteria but in the youngest age group, license degree, 1-10 years in the profession and 1-10 years working in the operating room, smaller than 2 mm nail length, the use of regular moisturizer was found to be higher than the average bacteria count in their hands. Findings have been evaluated 0.05 meaning level. Keywords: hospital infection, hand contamination, surgical hand washing, operating room nurse, nail polish.

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Elif Erbay, Effect Of The Distraction Technique Which Is Done During Peripheral Venous Cannulation In The Children On Reducing Pain. Bulent Ecevit University Institute of Health Sciences, Department of Nursing of Children Health and Illnesses Master of Science Thesis, Zonguldak, 2016. This study is a randomized controlled experimental design which was done to determine effect of the distraction technique watching cartoon on pain during peripheral venous access in the children aged 2-7. 61 children and parents (30 control group, 31 study group) consisted the sample. Data was collected with identification data form which was prepared by the researcher, FLACC Pain Assessment Scale and Satisfaction with Nursing Care Scale. The data is evoluated with SPSS 19.0 programme and chi-square test, Studen t test, Mann Whitney U test, Paired Samples t test, Kruskall- Wallis Variance Analysis and Correlation Analysis to examine relation between numeric variables are used in analysis. When point averages taken by children from FLACC pain scale before prosedure and post prosedure was matched, post prosedure in fovor of the experimental group, statistically significant difference was found (p<0.05). During prosedure it was found that children in study gruop demonstrated less reaction than children in control group (p=0.000). According to satisfaction scale results, satisfaction level of parents in study group was higher than parents in control group significantly (p=0.042). Between children age and FLACC scores, negatively and significant relationship was found. During peripheral venous access, detected pain by children in study group who watched cartoon is less than control group. Keywords; Child, Venous access, Pain, Distraction

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Ozgur Bahadir, The Effect of Music Therapy on Anxiety, Fear and Pain Management in 6-12 Year Old Children Undergoing Surgery. Bülent Ecevit University, Graduate School of Health Sciences, Department of Pediatrics Nursing, Master’s Thesis, Zonguldak, 2016. The study was designed as quasi-experimental and conducted to determine the effect of music therapy on anxiety, fear and pain management in 6-12 year old children undergoing surgery. The present study was carried out between 01.01.2016 and 19.08.2016 in BEU Application and Research Center. The children aged 6 -12 who applied for surgery between the mentioned dates constituted the universe of the study. In the quasi-experimental study that was conducted in the clinics where children received operational treatment, two groups were formed: experimental group (the children who received musical therapy before the surgery) and control group (the children who were administered surveys and the surgery service routines only). Each group consisted of 30 children and the participants of the study were 60 children in total. Necessary permissions were obtained from the parents of the children hospitalized before the beginning of the implementation. The data was collected through Child Anxiety Sensitivity Index (CASI), “Fear In Medical Treatment Scale”, Face, Legs, Activity, Cry, Consolability Scale (FLACC), Visual Analog Scale (VAS) and Participant Information Form. In the analysis of the data, Kolmogorov-Smirnov distribution scale was used to examine the normality of the distribution along with descriptive statistics methods (Frequency, Percentage, Mean, Standard Deviation). Data was presented in the tables in numbers and percentages. Means were demonstrated along with the standard deviations. The research compared children received; case and control groups include sociodemographic perspective, non-significant difference statistically among similar groups are intertwined. General level of fear regarding the medical processes before returning to service after the operation and 30 minutes before getting discharged was found to be significantly low in experimental group compared to control group (p<0.05). No statistically significant difference was found between experimental and control groups in terms of general level of fear regarding the medical processes before the operation, during the operation day and in the recovery room after the operation (p>0.05). Total CASI AD (anxiety sensitivity) levels before the operation, day of the operation and 30 minutes before the discharge for patients in experimental group was found to be significantly higher than the control group (p>0.05). There was no statistically significant difference between the experimental

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and control groups in the total CASI AD levels for the post-operative recovery room and for returning to the service room after the operation (p>0.05). VAS levels for patients in the experimental group in the post-operative recovery room was significantly higher than the control group (p>0.05). There was no statistically significant difference between the groups in terms of VAS findings in returning to service room after the operation and in 30 minutes before the discharge (p>0.05). As a result of the research; applied children music therapy in the experimental group anxiety, fear, and pain of the scales, their scores average, is lower than the control group children in this situation an increase in the satisfaction of children and parents was observed. In line with this, music therapy preoperative anxiety, fear, and can be used as an effective method of decreasing postoperative pain clinics is suggested. Keywords: Children, Operative process, Anxiety, Fear, Pain, Music Therapy

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Isin Alkan, Effect of Lullabies on Babies In The Neonatal Intensive Care Units. Bulent Ecevit University, Institute of Health Sciences, Department of Peadiatric Nursing, Master of Science Thesis, Zonguldak, 2016. This study was carried out with an experimental design in order to determine whether the lullaby, which was listened from mother’s voice and a stranger’s voice to the babies born at term and hospitalized in neonatal intensive care unit, had an effect on saturation values, peak heart rate, respiration, fever, stress symptoms, growth development and hospitalization time of the newborn. Data of the study were obtained from 90 newborn babies who were hospitalized in Neonatal Intensive Care Unit of Zonguldak Maternity And Children Hospital between September 2015-January 2016 and who met the eligibility criteria. Before treatment, families were verbally informed; and they filled “written consent form” and “baby identifier information form”. Routine treatments were carried out at every threehours in Neonatal Intensive care unit; and lullaby concert was performed by choosing one of the suitable treatment hours. Stress symptoms, PHR, respiration, saturation and fever were recorded by therese archer on “Newborn response follow-up form” at pre-treatment and post-treatment (lullaby concert). Data were evaluated by SPSS 18 package program. When the babies in the study groups were examined; no statistically significant differences were found in the mean values of growth (weight, height, head circumference) between experimental (groups that were listening to lullaby from mother’s voice and stranger’svoice) and control groups (p>0,05). When hospitalization times of experimental and control groups in the study were examined, it was found that hospitalization times of the babies who listened to a lullaby from mother’s voice were significantly lower than the babies who listened from a stranger’svoice (p<0,05). While PHR, respiration and fever values were observed within normal limits (p>0,05), significant differences were observed in stress and relaxation levels (p<0,05). In conclusion, it was determined that lullaby which was listened to the newborns in intensive care unit from mother’s and stranger’s voices were effective in decreasing stress symptoms of the babies and it had positive effects on keeping peak heart rate, saturation, respiration and fever values within normal values. Besides, hospitalization times were reduced in the group which was listened from mother’s voice but it did not have an effect on their growth and development. Keywords: Mother’s voice, Lullaby, Stress, Newborn

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Tulay Basoglu Namal, Evaluation of Work Accidents in Nurses who Work in State Hospital. Bulent Ecevit University, Institute of Health Science, Department of Public Health, Master’s Thesis, Zonguldak, 2016. Hospitals are the institutions where the work accidents occur relatively frequently regarding their risk factors due to both number of employees and working environment conditions. There is not sufficient data related to the work accidents which the healthcare employees face with in Turkey. Nurses form a signifıcant healthcare employee group and are in much risk to be subjected to work accidents due to working conditions. It is aimed to evaluate the work accidents in nurses who work in all units of Zonguldak Atatürk State Hospital. It was tried to be reached to all nurses (322) who worked in the hospital without sampling in the research, but 81.6% of population participated in (n=263). The questionnaire form, consisting of 20 questions, was applied to the participants with face-to-face interview technique. In the study, 41.8% of nurses were subjected to the work accident; 34.8% needlestick injuries, 33.3% ampoule cut, 16.4% contaminated blood and body fluids. It was found that the services, where the accidents occurred, were 23.8% emergency and 20.8% internal diseases service. Rate of using the personal protective equipment in the accidents was 64.6%. The most frequent injury zones were the hand and fingers, and the accidents occurred most frequently on Monday and Friday. The accidents occurred most frequently at 08:00-09: 59, 10:00-11: 59, 18:00- 19: 59. Increasing the work years, decreasing the number of accident in nurses. Nurses are in the risky group regarding the work accident. The nurses are frequently subjected to the work accidents and do not report them. Keywords: Nurse, Hospital, Occupational Health and Safety, Work Accident

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Ozden Kalayci, Evaluating the Information, Attitudes and Behaviors About Foot Care of Diabetic Patients and Diabetic Foot. Bülent Ecevit University, Public Health Postgraduate Thesis , Zonguldak, 2016. Diabetes is a chronic metabolic disease in which organism can’t make use of carbohydrate, fat and protein because of lack of the insulin or the impact of defects in insulin and it requıres constant medical care. In approximetely fifty percent of the reasons for hospitalization of diabetic patients are chronic complications and this situation result to high treatment costs and increasing loss of labor force. Diabetic foot ulsers which is one of the factors determining the life span and the quality of life are the most common reasons for hospitalization and surgical interventions of diabetic patients. Diabetic foot is an important complication which influence morbidity of diabetes, have expensive treatment, can only be prevented by patient education. Educating the patiens about foot care plays an important role on preventing the lower extremity problems. This study was carried out to detect the informaton, attitude and behaviour of diabetic patients about foot care and diabetic- foot and to put forth the educational needs for patients. The participants of the cross sectional study consists of 150 voluntary patients who applied for Bülent Ecevit University Health Practise and Research Center Endocrinology Clinic between the dates 20.07.2015 and 08.09.2015 and being treated in the bed unit of centre in the same date. 143 of the participant (%95,3) have had diabetic coma. It’s found that 75 of the participants (%50,0) think that foot care is important. 106 of the participants (%70,7) express that they wash their foot frequently or everyday; 85 of the participant (%56,7) express that they dry their foot frequently or after each washing ; 9 of the patients (%6,0)express that they use foot care cream frequently or every day. The type of the socks and shoes the patients use (56 percent of them) use cotton socks, 76 percent of them wear flat-soled shoes) is generally comply with the standarts but their nail cutting forms are incompatible (38,7 percent of them have round oval cut) and almost half of the patients (46 percent of them) reported to have foot infection . In addition to having infections,it’s identified that 48,7 percent of the patients always have burning sensation and 36,7 percent of them generally have cracks and dryness on their feet. It’s found that 78 percent of the patients consult a health institution when they have a problem. It’ seen that men have more ulceration on foot than women. It’s found that the group who have higher education level and have had information about the importance of foot care from any source before,are more conscious than the ones who haven’t (68 of the patients (%45,3) have had information about foot care). Also, the group who get educated about foot care had higher

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percentage on washing, drying up and creaming their feet frequently (10,3 percent of them cream their feet frequently) At the same time,the group who have higher education level had less foot ulceration.(100 percent of gradutes from high school/university or postgradutes don’t have ulceration) It’s been seen that the ones who smoke have the discomfort of foot ulceration and loss of sensation more than the ones who don’t smoke. To prevent the complications of diabetes, patient compliance, regular treatment and education are important parameters. In order to reduce the risk of having diabetic foot which is the most common complication of diabetes, there is need for centers monitoring, evaluating and educating the patients to make them have positive behaviour change in this sense, caring about philosophy of preventive health. Keywords: Diabetes, Foot Care, Diabetic Foot, Information and Behaviour.

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Neslihan Akman, Identifying The Psychosocial Adjustment Of Patients With Chronic Obstructive Pulmonary Disease And The Difficulties Experienced By The Caregivers. Bulent Ecevit University, Public Health Department, Master Thesis, Zonguldak, 2016 The main purpose of this study is to identify the psychosocial adjustment of patients with chronic obstructive pulmonary disease and the difficulties experienced by the caregivers. This study was conducted with 204 patients and with their relatives who were diagnosed as chronic obstructive pulmonary disease and received a treatment in the Bülent Ecevit University Health Research Center the department of chest diseases during March 03 2014 and August 03 2014. The data were collected through survey form, Psychosocial Adjustment to Illness Scale-Self-Report (PAIS-SR) and a Burden Scale. In the evaluation process of the obtained data, number and percent values, Shapiro-Wilk test, Kruskal-Wallis test, Mann-Whitney U test and Student T test were used. The relation among the measurements were evaluated with correlation analysis. The mean of the participants’ age was 67.0±11.7. It was found out that 80.4% of the participants are married, 47.5% of them was graduated from primary school; 62.3% was retired from mine; 70.1%’ income was lower than their expense; 70.6% have been smoking for 21-40 years; 44.6% had diagnosis of chronic obstructive palmonary disease for 11 years and for more than 11 years and 39.2% had two more chronic diseases in addition to chronic obstructive palmonary disease; 88.2% had their routine checks; 52.9% perceived their health as “bad –very bad”; 85.8% had the history of hospitilization due to chronic obstructive palmonary disease; 36.3% used extra tools and 36.3% could do their daily life activities with the help of others. It was determined that 90.7% of the patients had poor complience with the disease and their pschosocial adjustment was negative in general. The mean of the caregivers’ age was 43.5±7.9. It was found out that 52% of them was male; 91.2% was married; 60.8% of them graduated from primary school or had education level under primary school; 46.6% perceived their health conditions as good; 63.2% had cronic disease; 38.2% had been caregivers of the patiens for 11 and more than 11 years; 99% provided this care as for family responsibility; 53.9% did not take help during the care; 68.6% of the caregivers’ life was affected from this care and 29.4% had difficulty in providing care. When the relationship between the psychosocial adaptations of the patients to the disease and the care load of the caregivers was evaluated, it was found that the burden of the caregivers decreased as the psychosocial adjustment of the patients increased (p<0.05). Considering the findings of the research, it is suggested that the life quality of both patients with chronic diseases and caregivers should be detected in a realistic manner, their independence in daily

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life should be supported and increased, data collection should be continued at regular intervals, and regular visits to the patients and to their families should be made. Keywords: Chronic Disease, Chronic Obstructive Pulmonary Disease (COPD), Psycho social Adjustment, Caregiver, Burden of Caregiving.

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Sibel Altıntas, The Effects of Shallow and Deep Endotracheal Suctioning Applied to Neurosurgery Intensive Care Patients on Hemodynamic Parameters and Pain. Bulent Ecevit University Graduate School of Health Sciences, The Department of Nursing, Surgical Nursing Master’s Program, Master’s Thesis, Zonguldak, 2016. In spite of being therapeutic, postoperative endotracheal intubation and mechanical ventilation applied to neurosurgery patients increase complication risk. Of nursing services applied to ventilated neurosurgery patients, especially patient positioning and deep endotracheal suctioning may lead intracranial pressure(ICP) in patients to increase. Therefore, during and after shallow and deep endotracheal suctioning, probable changes in patients hemodynamic symptoms must be examined closely and results must be evaluated comparingly. This research was conducted as a randomized controlled experimental trial to determine the effects of postoperative shallow and deep endotracheal suctioning applied to ventilated neurosurgery patients on arterial blood pressure, pulse rate, body temperature, respiration rate, oxygen saturation level and pain. In the research, between the dates of 01/09/2015 and 01/11/2016 with the method of open system suctioning shallow endotracheal suctioning was performed in 37 patients and deep endotracheal suctioning was also performed in 37 patients. At the 1st, 5th and 30th minutes of pre and post endotracheal suctioning arterial blood pressure, pulse rate, body temperature, respiration rate, SpO2 levels and pain status of patients were compared evaluatingly. Findings were evaluated with SPSS 16.0 program in addition to t-test for independent variables and two way ANOVA for repeated measurements. The results obtained were interpreted in accordance with 0.05 significance level. In the research, there wasn’t detected any clinically and statistically significant difference between performed shallow and deep endotracheal suctioning methods. Yet, when patients’ 30 minutes pre and post endotracheal suctioning values were compared, it was found that shallow endotracheal suctioning slightly causes less changes in patients’ systolic and diastolic arterial blood pressures and pulse rates, has more postive impact on oxygenation level, is less traumatic and causes less pain in patients compared to deep endotracheal suctioning. Furthermore, at the 1st minute after deep endotracheal suctioning, it was observed that patients’ systolic and diastolic arterial blood pressures, pulse rates, respiration rates and the pain experienced increased more. Keywords: Endotracheal suctioning, neurosurgery, intensive care, hemodynamic parameters, nurse

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Candan Dalkilic, Effects Of Amitriptyline On The Experimental Acute And Chronic Inflammation Models. Bulent Ecevit University, Health Sciences Institude, Department of Medical Pharmacology Master’s Thesis, Zonguldak, 2017. Amitriptyline is a tricyclic antidepressant, antagonizes serotonergic, adrenergic, histaminergic and some cholinergic receptors and blocks sodium, calcium and potassium channels which have affects on inflammmation pathophysiology. Aim of our study is to examine the anti-inflammatory effect (AIE) of amitriptyline on acute and chronic inflammation models in rats. In our study acute inflammation was created with carrageenan and histamine. After measuring the basal right hind paw volumes of rats, distilled water for control group, diclofenac sodium and amitriptyline (5-10-20mg/kg carrageenan model, 10mg/kg histamine model) for other groups were injected intraperitoneally. After 30 minutes, inflammation was induced by injection of %1 carrageenan or %0.1 histamine solutions into the same paws. Paw volumes were measured 5 times at 1 hour intervals after carrageenan injection and 6 times at 30 minutes intervals after histamine injection. The AIE of amitriptyline were calculated according to paw volumes of control group. Chronic AIE of amitriptyline was tested with Cotton- Pellet granuloma method. Amitriptyline (10mg/kg) showed AIE at 1 and 2 hours (%52.56 and 46.43) in carrageenan-induced (p<0.05), and at 30, 60, 90, 120 and 150 minutes (%46.23, 40.05, 43.34, 47.67 and 52.94 respectively) in histamine-induced (p<0.05) paw edema models. In Cotton-Pellet granuloma model, amitriptyline showed antiproliferative effect according to wet (%26.62) and dry (%31.09) cotton pellets weights (p<0.05). Amitriptyline showed both acute ve chronic AIE. Acute AIE of amitriptyline may be due to the inhibition of some neuromediators (especially histamine) on early phase of inflammation. Chronic AIE may be usefull for the treatment of some chronic inflammatory diseases accompanied with depression. Keywords: Amitriptyline, inflammation, histamine, carrageenan, cotton-pellet, rats.

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Fatma Goksu, The Effect Of Virtual Reality Headset That Is Used During Blood Drawal On The Pain Felt By The Children. Bulent Ecevit University Institute of Health Sciences, Department of Children Health and Diseases Nursing, Master thesis, Zonguldak, 2017. This was a randomized, controlled experimental study that was performed to determine the effect of distraction technique which was applied by a virtual reality headset for decreasing the pain of the child during blood drawal. The universe of the study was composed of children between the ages of 6-10 years old who admitted to blood drawal service in Zonguldak Bulent Ecevit University Health Practice and Research Center between May 2016-September 2016. A total of 80 children, 40 in the control group and 40 in the experimental group, were taken. Descriptive Information Form was used to determine sociodemographic characteristics of the children and their families, and Faces Comparative Pain Scale and Visual Comparative Pain Scale were used to determine the pain level experienced by the children during the procedure. Children in the experimental group were made to watch a video by a virtual reality headset during the blood drawal procedure. Data were assessed by SPSS 19.0 package program. It was found that mean score of the children in the experimental group from “Faces Pain Scale” was 1.02±1.12 following the procedure and their mean score from “Visual Comparative Pain Scale” was 1.87±1.97. For the children in control group, mean score from “Faces Comparative Pain Scale was 2.47±1.83 and mean score from “Visual Comparative Pain Scale” was 4.17±3.16; and also, a statistically significant difference was found between two groups (p=0.0001 and p=0.001). In conclusion, virtual reality headset was found to be an effective method in decreasing pain in children during blood drawal. Keywords: Pain, Distraction, Blood drawal, Child, Virtual reality

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Derya Sahin, Determination of Knowledge Levels of Pregnant Women about Breast Milking Techniques and Storage Conditions. Bulent Ecevit University, Institute Of Health Sciences, Department of Children Health and Disease Nursing, Master Thesis, Zonguldak, 2017. This was a descriptive study that was performed to determine knowledge levels of pregnant women about breast milking techniques and storage conditions. The universe of the study was composed of pregnant women who admitted to high risk pregnancy outpatient clinic of Ankara Dr Zekai Tahir Burak Women Health Education and Research Hospital between March 2016-July 2016. Sample included 390 pregnant women who met the inclusion criteria and who approved to participate in the study. “Descriptive Information Form” was used in the collection of data, and assessment of data was performed by SPSS 19.0 program. 74.6% of the women in the study stated that they heard about breast milking techniques but 74.1% did not; and 87.9% of these women told that they knew how to store milked breast milk. The ratio of women who have taken education about feeding with breastmilk was found to be significantly higheramong the mothers who started working within the first six months following childbirth compared to unemployed mothers (p=0.042). A statistically significant difference was found between the state of getting information about feeding with breast milk and the education level of pregnant women (p=0.024). It was detected that mothers with a high education level less preferred to feed with breast milk; but they got more information about feeding with breast milk. In conclusion In nursing approaches implemented, pregnant women should be informed about feeding with breast milk, breast milking techniques and mother milk storage conditions; and some interventions should be done to encourage the use of breast milk. Key Words: Breast milk, Pregnant, Breast milk storage conditions, Breast milking technique, Knowledge level

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Selda Turkmen Coban, Determination Of Attitudes Of The Nurses Who Are Working In Children Clinics In Zonguldak City Center For The Participation Of Parents In Children Care. Bulent Ecevit University Institute of Healt Sciences, Department of Nursing of Children Healt and Illnesses Master of Science Thesis, Zonguldak, 2017. This is a descriptive study that was performed to determine the thoughts of nurses about the participation of parents to the care of their hospitalized children. It was performed in Children Health Clinics of Zonguldak Bulent Ecevit University Health Practice and Research Center and Zonguldak Maternity and Children Hospital which are located in Zonguldak City center between October 2015 - January 2016. No sample selection was done in the study; and 130 nurses were included in the sample group. Data were collected by a Descriptive Information Form for sociodemographic characteristics of the nurses and “Parent Participation Attitude Scale” (PPAS). Data obtained from the study were assessed by SPSS 19.0 program. The differences between two groups were analyzed by Mann-Whitney U test and Kruskal-Wallis variance analysis. Dual comparisons of subgroups in Kruskal-Wallis variance analysis was performed by Mann-Whitney U tests with Bonferroni correction. When mean PPAS scores of the nurses in the study were evaluated based on their working life characteristics, it was determined that there were significant differences between the hospital, clinic, position in the clinic and the status of getting information for family-centered care (p<0.05). Keywords: Parent participation in children care, Family-centered care, Nurse opinions.

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Musa Kiran, Effect of Lecithin on Experimental Gastric Ulcer. Bulent Ecevit University, Institute of Health Sciences, Department of Medical Pharmacology, Master Thesis, Zonguldak, 2017. Lecithin is a substance used in medicine and food industry, located in all body cell membranes and gives elasticity to cell membrane. In our study, we investigated the effect of lecithin on indomethacin- induced gastric ulcer in rats. For the study, rats were divided into 5 groups. To 1st group distilled water (10 ml/kg), 2nd group lecithin (1200 mg/kg), 3rd group lecithin (2400 mg/kg), 4th group famotidine (40 mg/kg) and 5th group pantoprazole (40 mg/kg) were given orally, 30 minutes later indomethacin (25 mg/kg-oral) was given to all groups. After 6 hours, all rats were sacrificed with thiopental sodium (50 mg/kg), stomaches were removed, ulcer indexes and ulcer inhibition rates of the groups were calculated. Stomach tissues were also histopathologically examined. Stomach tissues were evaluated and ulcerated areas were observed in all rats in low dose lecithin (1200 mg/kg) group, in 7 rats in high dose lecithin (2400 mg/kg) group and in only 2 of the rats in famotidine group. None of the rats in pantoprazole group had ulcerated areas. Ulcer index of control group was 6.75±0.81% and according to this, ulcer inhibition rates of the groups (lecithin-I, lecithin- II, famotidine and pantoprazole) were calculated as 45%, 57%, 98% and 100% respectively and these ratios were statistically significant. While both doses of lecithin decreased mucosal hyperemia (p<0.05), positive effects on gastric erosion were observed in the high dose only (p<0.05). The decrease in PMNL and MNL infiltration caused by lecithin were statistically insignificant. Pantoprazole and famotidine significantly reduced mucosal hyperemia, erosion, PMNL and MNL infiltration. In conclusion, in indomethacin-induced gastric lesion in rats, compared to the control group, lecithin showed gastroprotective effects both macroscopically and histopathologically (hyperemia, gastric erosion). Keywords: Lecithin, Indomethacin, Stomach ulcers, Rat.

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Musa Ozsavran, An Evaluation Of The Impact Of Art Activity For Enhancing Emotional Resiliency In Adolescents: Mandala. Bulent Ecevit University, Institute of Health Sciences, Department of Pediatric Nursing, Master’s Theises, Zonguldak, 2017. Art activities are enhancing emotional flexibility and helping to live positive emotions in adolecents, who exprience feelings such as anxiety, stress, conflict and worthlessness, by attracting attention elsewhere. The purpose of this research is to evaluate the effect of mandala drawing and painting as an art activity method on the enhancement of emotional flexibility. The study was designed as an interventional experimental study and it was performed between 1 January and 31 May 2017, at the 9., 10. and 11. grades of a high school connected to the Ministry of National Education in Zonguldak. 586 students attending to 9., 10. and to the 11. grade have formed the universe. Student Information Form, Child and Youth Resilience Measure (CYRM-12), Scale of Positive-Negative Experiences (SPANE) and Self-Efficacy Questionaire for Children (SEQ-C) were applied for adolescents in the 586 person population. After the first findings obtained, 41 experimental groups and 41 control groups were assigned to the low scores and the interventional part of the research was realized. According to research findings; it was determined that the (CYRM- 12) scores increased significantly after each mandala session (before intervention: 35,92±4.2; fourth mandala session: 43.17±7.7; p=0.000). It was determined that at the end of fourth mandala session; according to (CYRM-12) scores, social self efficancy score (r=0.402; p=0.09), total self efficancy score (r=0.354; p=0.02), SPANE positive experiences sub score (r=0.275; p=0.09) and SPANE total score (r=0.323; p=0.04) were increased. This finding has led to the conclusion that as an art activity, mandala practice is an effective way to increase the emotional resiliency (psychological integrity) of adolescents. Keywords: Adolescence, Emotional Resiliency, Mandala, Self-Efficacy

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Ayla Gundogdu Karakaya, Evaluation Of The Effectiveness Of Presentation And Demonstration Assisted Baby Massage Training For Newborn Baby Mothers. Bülent Ecevit University Health Sciences Institute, Child Health and Diseases Nursing Department, Postgraduate Thesis, Zonguldak, 2016. The newborn recognizes the environment by communicating with the outside world through touch. Therapeutic application of touch is the massage. Baby massage is especially applied to infants, and it is useful for mother-father-infant. This study was conducted as a quasi-experimental pre-test - post- test study to evaluate the effectiveness of the baby massage training given to the primipara mothers using different teaching methods. The target population of the study was formed by 400 primipara mothers who were in Karadeniz Ereğli State Hospital, Gynecology and Newborn Intensive Care Unit. 192 primipara mothers were determined as target population and sample selection criteria were met. Personal information form and massage knowledge evaluation pre-test - post-test form were used to collect the data. Personal information form and pre-test were applied to the mothers, video demonstration and massage application on the model were done by the researcher. Afterwards, massage application on the model was practiced to mothers, and the knowledge of massage phases and the correct application status were recorded by the researcher on the post-test form. It was determined that 41% (n = 79) of the mothers could massage their baby before baby massage training, and 93.8% (n = 180) of them did not feel competent enough about making a baby massage. After the training, it was determined that the mothers' pre-massage preparation (p = 0.000), the massage with right technique during the massage (p = 0.000) and the level of knowing how to comfort the baby properly after the massage were significantly higher than those of the level of being able to do it (p = 0.000). As a result, it has been determined that the training given to the mothers to increase the massage knowledge was effective and the effectiveness of the training was improved by using different teaching techniques. Keywords: Mother, Baby Massage, Training, Newborn

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Serap Demirel, Evaluation Of Training Given For Decreasing The Fears Of Hospitalized Children For Medical Procedures. Bulent Ecevit University Institute of Health Sciences, Department of Children’s Health and Diseases, Master Thesis, Zonguldak, 2017. During hospitalization of the children, rejection of treatment process, introversion, thinking to be punished, extension of hospitalization period and fears that also continue during adulthood may be observed. The aim of this study was to evaluate the effect of training given for decreasing the fears of 7-14 year old children, who were treated in children services, for medical procedures. This was a semi-experimental study including pre test-post test and control group. The universe of the study was composed of 2289 children who were between 7-14 years old and treated in Afyonkarahisar state hospital children services. Sample size, that was calculated based on power analysis, was 90 children including 45 in the experimental group and 45 in control group. Descriptive Information Form (DIF), Child Medical Fear Scale (CMFS), training videos, training brochure and training model were used to collect data. During implementation of the study, training program was performed to the experimental group and control group was given routine hospitalization training. It was found that 68.9% of the children included in the study were between 7-10 years old. A statistically significant difference was found between children in experimental and control groups in terms of their mean total scores from Child Medical Fear Scale (p<0.001). In addition, statistically significant differences were found between both groups in terms of mean scores from the subscales of Medical Fear Scale such as procedural items, environmental items, personal items and interpersonal items following training (p<0.001). In conclusion; it was determined that training program given to hospitalized children decreased their fears at an advanced level. Keywords: Medical fear, School child, Hospital, Nurse

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Pelin Tuncer Coban, Evaluation Of Preoperative And Postoperative Survival Of Patients With Varicose Veins. Bulent Ecevit University Institute of Health Sciences, Department of Nursing, Department of Nursing Surgical Diseases, Graduate Thesis, Zonguldak, 2017. The problem of varicose veins, as well as creating visual problems for individuals, It also impedes the fulfillment of individuals' daily life activities and affects their quality of life negatively. Nowadays, minimally invasive procedures are frequently used in variceal therapy and affect the quality of life of the individual positively. Research to determine the change in quality of life before and after minimally invasive procedures in patients with varicose veins problems, was conducted as a cross sectional study. The study of 150 patients with preoperative surgery with minimally invasive procedures, and quality of life after the date between 16.05.2016- 30.03.2017 were evaluated and compared. The data used the SPSS 22.0 program to examine the socio-demographic and clinical characteristics of the patients (Frequency, Percentage, Mean, Standard deviation) as well as normal distribution in the Kolmogorov-Smirnov distribution test Kolmogorov-Smirnov distribution test. Both of groups, the Mann Whitney U test was used for comparison of quantitative data. The Kruskal Wallis test was used to compare the parameters with no normal distribution, and the Mann Whitney U test was used to determine the group that caused the difference. Wilcoxon signed rank test was used for comparison between two groups of parameters. The findings were evaluated at the 0.05 significance level. In the study, it was determined that women, individuals aged 51-60 years, the ones with BKI> 30, and individuals with pregnancy stories had a higher prevalence of variceal disease and lower quality of life. In addition, for patients with minimally invasive procedures, the clinical severity of the illness decreased and the quality of life improved in the positive direction during the post operation period. Keywords: Venous insufficiency, Quality of life, Varicose veins, Nursing care, Compression stockings

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Sevda Doğru, The Effect Of Hospitalization Education Given To The Parents Of Premature Babies In Intensive Care Unit On Their Stress Levels. Bulent Ecevit University Institute of Health Sciences, Department of Children Health and Diseases Nursing, Master Thesis, Zonguldak, 2017. This study was planned as a semi-experimental type in order to evaluate the efficacy of hospitalization education given for decreasing stress levels of the parents whose babies were hospitalized in NICU; and performed as a study including pre test (before education) and post test (after education) single group. Parents were made to see their babies for the first time before the education after getting informed consent from them; and they underwent “Parent Stress Scale-NICU”. Parents were given education with the guidance of “Booklet for Hospitalization Education for Parents- NICU” during the treatment, and the booklets were delivered to the parents at the end of the education. When mean scores of the parents from Parent Stress Scale and its subscales were examined, it was detected that there was a statistically significant difference in total mean Parent Stress Scale scores before and after the education at 1st and 2nd evaluations (p<0.05). It was also observed that there was a statistically significant difference between the subscales of “Appearance and Behaviors of the Baby” and “Relationship with the Baby and Parenting Role” before and after the education at 1st and 2nd evaluations (p<0.05). However; no significant difference was found in the subscale of “Images and Sounds” before and after the education at 1st and 2nd evaluations (p>0.05). As a result; it was concluded that the hospitalization education given to decrease stress levels of the parents whose babies were hospitalized in NICU decreased the stress of the parents. Keywords: Premature baby, Neonatal intensive care, Hospitalization education, Parent, Stress

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Necmi Keskin, Examination Of The Relationship Between The Upper Extremity Composıtıon And It's Functıons In Individuals With Different Hand Preferences. Bulent Ecevit University, Institute of Health Sciences, Departmant of Anatomy, Master of Science Thesis, Zonguldak 2017. Human use either their left or right hand dominantly in their hand preferences. Hand preference is a general evaluation method while determining side preference and it reflects the asymmetrical hand usage. Evaluation of hand preference is the standard procedure in most neuropsychological research and the research on the effects of asymmetry on human behavior. In this study, we aimed to look in to the possible structural and functional difference between the preferred and dominant hands and the others by comparing the grip forces between fingers and hands. In our study, 172 students from Bülent Ecevit University Faculty of Medicine, Faculty of Dentistry, Physiotherapy and Rehabilitation Departman and The Nursery Department who are between the ages of 18-25 (68 left handed and 104 right handed) were evaluated on their dominant and other hands. Antropometric readings, hand and pinch grip measurements and body mass indexes were taken by applying bioelectrical impendence analysis method. As a result of these studies, we were able to make comparisons on the structural and functional properties of the group. We discovered that the grip force, key pinch and the tip pinch declines as the fat level in the arm rises and the mentioned grip forces rise as the fat level in the arm declines. We found a noticeable difference in tweezer pinch grip forces between the dominant and nondominant hands of right handed people (p>0,05). However we did not run into this difference in left handed people. Furthermore, unlike the similar studies, we found no difference between the hand grip forces of dominant and nondominant hands of right handed people (p>0,05). In this study, Bioelektrical Impedansce Analyses Method and the relation between hand grip force, pinch grip force and hand preference has been examined and it is thought that our data can be a guide for future researches. Key words: Body composition, Hand grip, Key pinch, Tip pinch, Upper Extremity

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Hulya Ertop, The Effect Of Workplace Environment Factors On Anxiety Level In Mining Workers In Private Sector. Bulent Ecevit University Public Health Master’s Thesis, Zonguldak 2017. The mining industry has many risk factors inherent in its nature. For this reason, it is a business with heavy conditions that require knowledge, experience, expertise and continuous supervision. It should be kept in mind that risks may arise when the mining sector is carried out through the private sector. Workers are faced with many problems caused by the working environment. This cross-sectional study was carried out in order to determine the effect of workplace environmental factors on the anxiety level of workers in Private Akkurt Mine operation. Anxiety over minimal was found in 13.8% of workers. The anxiety level is affected by the environmental factors such as lighting, the humidity level, the unsafe and unhealthy working environment, the lack of adequate health and safety measures, the excessive workload in the physical and mental sense, the livelihood problems, not to work in a way that suits their education and abilities, to have a fear of making mistakes. On the other hand, the environmental factors like vibration, noise, heat, thought to be accidents at any moment, thought to have irreversible influences on health, dust level, ventilation adequacy, ergonomic factors, thinking about getting out of work, making changes about the work without the opinions of the workers, not to receive the right fee for the work done do not affect the anxiety level and it has also been determined that there is no meaningful effect on the level of anxiety of the people who have problems with their private life, relations with their managers and colleagues, legal regulations and social security concerns. Keywords: Coal mining, Workplace environment factors, Workers health

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Aylin Kurt, The Effect Of Distraction Techniques (Finger Puppet Plays) On The Postoperative Pain Relief In Children. Bulent Ecevit University, Institute of Health Sciences, Department of Pediatric Nursing, Master’s Theises, Zonguldak, 2017. Play provides an autraumatic care to cope with stressfull situations and connect between home and hospital. This research was conducted to determine the effect of other techniques of pulling attention (finger puppet plays) on the postoperative pain relief in children and study Turkish adapiton of Children's Hospital of Eastern Ontario Pain Scale (CHEOPS) in Young Children. In the first step, the validity and reliability study of CHEOPS in Young Children was conducted Zonguldak Women's Obstetrics and Gynecology Hospital between AprilJune 2016. 20 children for pre-application and 60 children for the appliaction of the scale were included in the study. For reliability, high correlation rates were obtained by observing independence between observers (researcher-nurse) and reliability of parallel form (CHEOPS-Wong Baker Scale) (%98.6,%94.8) (%94.4,%94.1). The Cronbach's alpha value was found 0.912, and the reliability and validity of the CHEOPS was established. In the second step, an intervention with puppets was made to reduce the pain of a child underwent day-to-day surgery and determine the levels satisfaction of the parents about this situation. This step was conducted with 90 children who underwent surgery between June-August 2016 in the same hospital. Children assigned to control (routine care), experiment 1 (nurse playing puppet play) and experiment 2 (parent playing puppet play) groups as randomize. After the intervention the pain of the children by CHEOPS and the satisfaction of the parents by PedsQL Health Care Satisfaction Scale were examined. The children's pain in the control group was found higher than the children's pain in the experimental group 1 and the experimental group 2 (p=0.00<0.05). The parents' satisfaction in the control group was found lower than the parent's satisfaction in experiment 1 and 2 groups (p=0.00<0.05). These findings show that finger puppet plays are effective in postoperative pain relief in children. Keywords: Child surgery, Postoperative pain, Pain managment, Distraction, Puppet play

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Meryem Ergenc, The Effect Of Melatonin On Depresive Like Behaviour And AGE Levels In Diabetic Rats. Bulent Ecevit University, Institute of Health Sciences, Department of Physiology, Master of Science Thesis, Zonguldak, 2018. Neuropsychiatric diseases such as depression and anxiety are frequently observed in diabetes. Several studies have shown increased levels of AGE in hippocampus and prefrontal cortex, which are brain areas and associated with depression and anxiety. Our aim is to investigate the effects of melatonin, which is known with its antioxidant and anti-inflammatory effects, on anxiety and depression-like behavior and AGE and S100 calcium binding B protein (S100B) levels in hippocampus and prefrontal cortex (PFC) in diabetic rats. In our study, 36 male Wistar-Albino rats were used and after they were made diabetic by using streptozotocin (STZ) (60 mg / kg), for a period of four weeks melatonin (10 mg / kg) was administered. Animals are divided in four groups; 1) the group which are administered diabetes+ melatonin (n:10), 2) diabetic control group (n:10), 3) normoglycemic control group (n:8), 4) normoglycemic + melatonin treated group (n:8). By applying an elevated plus maze (EPM) test and a forced swimming test (FST) anxiety and depression-like behaviors were tested in all groups. AGE and S100B levels were measured from the samples taken from the hippocampus and PFC. Differences between groups were evaluated with Kruskal-Wallis followed by a post-hoc Bonferroni test to evaluate the differences with in the groups. The results of the behavioral tests have shown that in diabetic rats, anxiety and depression-like behaviors increased however in diabetic rats which are administered melatonin both behaviors decreased. In our study, prefrontal cortexes and hypocampal AGE levels increased, while S100B content decreased with diabetes. It was determined that melatonin administration decreased the levels of AGE in these areas and the S100B levels were kept protected. As a result, behavioral changes associated with diabetes could be prevented by melatonin. We have shown for the first time that antidepressive and anxiolytic effects of melatonin occur by reducing brain tissue AGE levels and maintaining S100B levels. Keywords: Diabetes, AGE, S100B, Depression-like behavior, Anxiety-like behavior, Melatonin

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Gaye Erdogan, Evaluation Of Postoperative Pain By The Parent, Nurse And An Independent Observer Among 1-7 Year Old Children. Bulent Ecevit University, Institute of Health Sciences, Department of Surgical Nursing, Master Thesis, Zonguldak, 2018. Gaye Erdoğan, Evaluation of Postoperative Pain by the Parent, Nurse and an Independent Observer among 1-7 year old Children. Bulent Ecevit University, Institute of Health Sciences, Department of Surgical Nursing, Master Thesis, Zonguldak, 2018. This study was performed as descriptive and cross sectional in order to compare the differences in the evaluations of postoperative pain by the parent, nurse and an independent observer among 1-7 year old children in Pediatric Surgery Clinic of Ankara Children Health and Diseases, Hematology and Oncology Training and Research Hospital. The sample of the study was composed of 236 pediatric patients. Data were collected between 04.01.2016 and 10.01.2016 by "Pediatric Information Form", "Parent Information Form", "Nurse Information Form"; and "NRS=Numeric Rating Scale" and "Wong-Baker Faces Pain Scale" that are used to determine the severity of pain. Written permission was obtained from Bulent Ecevit University Clinical Research Ethics Committee and Ankara Children Health and Diseases, Hematology and Oncology Training and Research Hospital in order to conduct the study. Doctors and nurses who were working in Pediatric Surgery Clinic were informed about the content of the study and their consents were taken. Parents of the children who were included in the study were instructed about the aim and implementation of the study, about that they could withdraw from the study whenever they wanted and the study would not give any harm to them; and their consents were also taken. SPSS 18.0 statistical package program was used to evaluate data in the study. Data were assessed by standard deviation, t test in the comparison of two independent groups, one-way ANOVA in the comparison of pain scores of three and more independent groups, Kruskal Wallis test and intraclass correlation coefficient besides descriptive statistical methods. Based on Numeric Rating Scale at operated pediatric patients' first admission to the service following the operation, it was found that pain rating scores of the parent, nurse and independent observer was incompatible with intraclass correlation coefficient of 0.676 in the study (p<0.05). Pain rating scores of the parent, nurse and independent observer at two hours after the admission of pediatric patient to the service following the operation were found to be compatible with intraclass correlation coefficient of 0.702 at a significant level (p<0.05). Based on Wong-Baker Faces Pain Scale in the study, pain rating scores which were given at first admission to the service (intraclass correlation coefficient of 0.696) and at two hours after the admission to the service (intraclass correlation coefficient of 0.684) were found to be incompatible (p<0.05). In conclusion, it was detected that parents found postoperative pain level

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among pediatric patients higher than the nurse and independent observer. With this study, it was determined that knowledge of the parents, nurses and independent observer should be strengthened by trainings about pain and pain management. Key Words: Postoperative pain, Pediatric patient, pain rating, Nurse, Parent.

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Feyza Tasdemir, The Effect Of Night Sleep Characteristics Before Breast Surgery On Postoperative Pain. Bulent Ecevit University, Institute of Health Sciences, Department of Nursing Surgical Nursing Program, Master of Sciences Thesis, Zonguldak, 2017. This research was conducted examine the relationship between the sleep characteristics of patients prior night before breast surgery. The research was carried out between May 2016 and May 2017 at Bulent Ecevit University Health Research and Application Centre general surgery clinic. The sample, it comprised randomly selected 30 patients who had been having breast surgery, who could maintain communication and who agreed to participate to the study. Prior to the implementation, written consent of Bulent Ecevit University Clinic Research Ethics Committee and Bulent Ecevit University Health Research and Application Centre’s Management was obtained. The data were collected via face-to-face interviews and by means of Data Collection Form Pittsburgh Sleep Quality Index and Brief Pain Inventory. Data related to sleep colected by actigraphy method. Evaluation of the data is presented frequencies and percentages, continuous variables with mean and standard deviation in descriptive statistics for categorical variables. The relationship between continuous variables with not normal distribution examined, partial correlation analysis and Spearman Correlation analysis. The patients' Pittsburgh Sleep Quality Index mean score was found 3.70±1.57, sleep efficiency (%) average was found 87.97±3.35, bed time average was found 228±89.05 minutes (3 hour 48 minutes±1 hour 29 minutes), sleep time average was found 199± 85.36 minutes (3 hour 19 minutes±1 hour 25 minutes) the night before surgery. There was not statistically significant relationship between patients’ sleep efficiency, bed time, sleep time and postoperative pain scores. As a result, it was found that there is not relationship between the level of postoperative pain and sleep characteristics the night before breast surgery. Keywords: Sleep, Postoperative pain, Breast surgery

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Sercan Zor, Evaluation Of Patients Sleep Features With Actigraphy Method In First 24 Hours After Breast Surgery. Bulent Ecevit University, Institute of Health Sciences, Department of Nursing Surgical Nursing Program, Master of Sciences Thesis, Zonguldak, 2017. This research was conducted with the aim of evaluate patients' sleep features with actigraphy method in first 24 hours after breast surgery. The research was carried out between May 2016 and May 2017 at Bulent Ecevit University Health Research and Application Centre general surgery clinic. The sample, it comprised randomly selected 30 patients who had been having breast surgey, who could maintain communication and who agreed to participate to the study. Prior to the implementation, written consent of Bulent Ecevit University Clinic Research Ethics Committee and Bulent Ecevit University Health Research and Application Centre's Management was obtained. The data were collected via face-to-face interviews and by means of Data Collection Form Pittsburgh Sleep Quality Index and Form of Factors Affecting Sleep Pattern. Data related to postoperative sleep colected by actigraphy method. Evaluation of the data is presented frequencies and percentages, continuous variables with mean and standard deviation in descriptive statistics for categorical variables. The relationship between continuous variables with not normal distribution examined, partial correlation analysis and Spearman Correlation analysis. The patients' Pittsburgh Sleep Quality Index mean score was found 3.82±1.74, and postoperative sleep efficiency (%) average was found 88.59±3.84, bed time average was found 201.60±80.71 minutes, sleep time average was found 183.00±70.43 minutes. Patients had 88.74±7.81mean score from the Form of Factors Affecting Sleep Pattern, the lower score was 77 and the highest score was 119. As a result, it was found that patients sleep characteristics was affected and sleep time decrase after breast surgery. Keywords: Sleep, Postoperative, Nursing

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Bircan Tasci, Calming Effect Of The Smell Of Breastmilk On The Babies Born At Term. Bulent Ecevit University, Institute of Health Sciences, Department of Peadiatric Nursing, Master’s Degree Thesis, 2018. The research was conducted experimentally to evaluate the effects of breast milk and formula milk smells on reducing acute pain due to heel blood removal in newborns and to investigate the effects of these smells on heart rate, oxygen saturation, crying time and cortisol level. The research data were obtained from 84 newborn babies in ‘Baby Room’ Obstetrics and Pediatric Hospital in Zonguldak between March 2017 and December 2017, which met the case selection criteria. All newborns in the study were divided into two groups: those who were fed with breast milk, those who were fed with breast milk and formula milk. Twenty one of the newborns fed only breast milk were smelled of breast milk (Group 1) and twenty one of them were smelled formula milk (Group 2). Twenty one of the newborns fed with breast milk and formula milk were smelled of breast milk (Group 3) and twenty one of them were smelled of formula milk (Group 4). Before, during, and after the procedure of heel blood, pain levels were assessed by NIPS (Newborn Pain Scale), heart rate and oxygen saturation were measured by pulse oximetry. Cortisol levels the newborns were measured by taking saliva samples from newborns before and after the procedure. The crying times of the newborns were recorded with a stopwatch. The data were evaluated using the SPSS 18 package program. It was determined that newborns who smelled breast milk during the heel blood procedure had less pain during and after the procedure, less rise in stress hormones and less increase in heart rate, and less decrease in oxygen saturation compared to the newborns smearing formula. It was determined that even though the newborns who were fed with breast milk with formula milk were familiar with both smells, the mother's milk smell was more effective than the formula milk smell in relieving the pain. As a result; this study suggests that mothers' smells are an effective method of reducing intervental pain. Keywords: Pain, Breast milk, Smell, Newborn

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Sumeyye Yasar Kivik, The Effect Of Early Skin To Skin Contact On Breastfeeding For The Primaparious Mothers Giving Birth Through Epidural Anesthesia. Bulent Ecevit University, Graduate School of Health Sciences, Department of Pediatrics Nursing, Master’s Thesis, Zonguldak, 2018. This study is planned as an experimental study whose aim is to determine the effect of early skin to skin contact on breastfeeding for primiparous mothers giving vaginal birth through epidural anesthesia. The study was conducted Zonguldak Maternity and Pediatric Hospital with 60 primiparous mothers who gave vaginal birth through epidural anesthesia; 30 of them were in experimental group and 30 were in control group. LATCH Breastfeeding Scale and data collection form prepared by researchers were used to collect the data. Experimental group was treated with skin to skin contact immediately after baby was born whereas control group was applied hospital protocols. Data evaluated by SPSS 16 package program. The percentage of housewives in control group proved to be higher than that of experimental group (p=0.005), it was also found that there was a statistically significant difference between the mothers in control and experimental groups in terms of education received about breastfeeding during pregnancy (p=0.028). The percentage of breastfeeding in 30 minutes following birth was higher in experimental group (p=0.012). It is considered that the babies of mothers who received prior education about breastfeeding and who had skin to skin contact had a greater percentage of breastfeeding in 30 minutes following the birth. The mothers in the experimental group could breastfeed spontaneously and with assistance and the percentage of spontaneous breastfeeding proved to be higher in experimental group than the control group. In the percentage of spontaneous and assisted breastfeeding during skin to skin contact was significantly higher in experimental group compared to control group (p=0.048). In the experimental and control group the total score of the 1 hour LATCH score did not statistically significant difference (p=0.349; p>0.05). However, a statistically significant difference was found between the total scores of the 24 hour LATCH scale (p=0.009; p <0.01). The total scores of the LATCH scale of the experimental group were found to be higher than the control group. Keywords: Epidural anesthesia, vaginal birth, skin to skin contact, breastfeeding

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Oznur Yilmaz, Evaluation Of The Effect Of Play Therapy On Separation Anxiety Among Preschool Children. Bulent Ecevit University Institute of Health Sciences, Department of Children's Health and Diseases Nursing, Master Thesis, Zonguldak, 2018. Preschool, that follows playing period, is a period during which children socialize a little more and carry out group and symbolic games commonly. One of the reason that postpones socialization of children among this age group is separation anxiety. Play therapy using playing effectively has a significant role in the resolution of this problem among these children. The aim of this study which was performed was to evaluate the effect of play therapy on separation anxiety among these children. This was an experimental study including pre test-post test control group. The universe of the study was composed of 292 preschool children of 3-5 years old who were studying in Kozlu Central Kindergarten and Kozlu Fatih Kindergarten. Sample size, that was calculated based on power analysis, included a total of 60 preschool children including 30 in experimental group and 30 in control group. Demographic information form, revised Preschool Anxiety Scale and The Separation Anxiety Scale for Preschool Children (teacher form) were used for data collection. When the change in total mean score of the preschool children from The Separation Anxiety Scale before and after the training was evaluated, it was observed that there was a higher decrease in the separation anxiety of the children in experimental group following training compared to the control group. The decreases in separation anxiety in both groups were found to be statistically significant (p<0.000). When total mean score from revised Preschool Anxiety Scale and the changes in subitems before and after the training were assessed, the decrease in separation anxiety that occurred among the children in experimental group following the training was found to be statistically significant (p<0.000). In control group, the decrease occurred following the training was not found to be statistically significant (p>0.05). In conclusion; it was determined that play therapy program, that was applied to preschool children studying in kindergarten, reduced separation anxiety substantially. Keywords: Preschool children, Separation anxiety, Game, Play therapy

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Tulin Kurt, Effect Of Nature Based Voice Therapy In The Separation From Mechanical Ventilation Process Of Intensive Care Patients. Zonguldak Bülent Ecevit University Graduate School of Health Sciences, The Department of Nursing, Surgical Nursing Master’s Program, Master’s Thesis, Zonguldak, 2018.

There are harmful physiological and psychological effects besides beneficial effects of mechanical ventilation for patients receiving mechanical ventilation support in intensive care units after surgery. Therefore, it is very important to ensure the stability of the patient's hemodynamic parameters, pain and anxiety level in order to reliably remove the patient from the mechanical ventilator in time and increase the success of the procedure. The research was conducted as a randomized controlled experimental study to investigate the effect of nature-based sound therapy on patients during the separation from mechanical ventilator in a surgical intensive care unit. In the study, 34 patients were separated from the ventilator by closing their eyes for 30 minutes accompanied by nature-based sound therapy between 01/06/2016 - 01/07/2017. The eyes of the other 34 patients were closed without listening to nature-based voice therapy and headphones. Patients' arterial systolic and diastolic blood pressures, heart rate, respiratory counts, oxygen saturation values, pain at both 0th and 30th minutes before and after each ainterventions and the 0th, 10th, 20th and 30th minutes of seperation from the ventilator, and anxiety levels were compared. Data were analyzed by descriptive statistical methods, t test for comparison of parameters between groups, and two way ANOVA for repeated measurements in the SPSS 24.0 program. Findings were interpreted at a significance level of 0.05. In the study; clinical and statistically significant differences were found in the patients in the experimental and control groups for mean systolic and diastolic blood pressures, heart and respiration rates, administration methods and measurement times (p<0.001), their mean oxygen saturations weren't significantly different (p>0.05). Pain, agitation and anxiety levels of the experimental group were found clinically and significantly lower than the control group (p<0.001), there was a statistically significant difference in types of application methods and measurement times (p<0.001).

Keywords: Intensive care patient, Postoperative period, Extubation, Nature based voice therapy, Nurse

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Merve Yanik, Evaluation Of The Effectiveness Of Education Given With Toy Type Nebulizer In Children Between 3-6 Years Of Age Who Receive Nebulizer Treatment. Zonguldak Bulent Ecevit University, Institute of Health Sciences, Department of Pediatric Nursing, Master Thesis, 2018. The study was a randomized controlled study designed to assess the effect of application training with a toy type nebulizer on the mothers of receiving treatment with nebulizer in the age group 3 to 6. The study's universe consisted of 3-6 year old children and their mothers who had nebulized treatment between September 2016 and January 2018 in the Istanbul Okmeydanı Education and Research Hospital children's clinics. 60 children for the validity of the scale and 60 children and their mothers for the thesis study were taken suitable for sampling criteria. Children and their mothers who were included in the study were randomly divided into two groups for 30 people (Experiment and Control group). The Descriptive Information Form was used to determine the sociodemographic characteristics of the children and their mothers, and the Children's Emotional Manifestation Scale was used to assess the anxiety experienced by children before the procedure. Mothers ' nebulizer drug using skills were assessed by means of a scale and their anxieties were assessed by STAI. The mothers in the control group were given a routine training procedure and the mothers in the experimental group were given a practical training with a toy type nebulizer and hand brochure. The data were evaluated using the SPSS 18 packet program. The validity and reliability of the scale to be used as a tool to evaluate anxiety of the children to be included before the research was investigated and the scale was found to be usable. It has been observed that the treatment of toy type nebulizer has a positive effect on the anxiety of children (p<0.05). It was determined that the education given to mothers with toy type nebulizer had a positive effect on their using skills (p<0.05), but it was not effective at anxiety level (p>0.05). As a result, this study shows that the education given to mothers with a toy-type nebulizer reduces the anxiety of the child and increases the mother's ability to practice. Keywords: Nebulizer, Child, Anxiety

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Damla Unal, Determination Of The Relationship Between The Humorous Styles And Burnout Levels Of Nurses Working In Pediatric Clinics. Bülent Ecevit University Health Sciences Institute Child Health and Disease Nursing Program, Graduate Thesis, Zonguldak, 2018 The research was carried out to determine in a descriptive form the relationship between the humor styles and burnout levels of nurses working in pediatric clinics. The scope of the research included 135 nurses working in Zonguldak Bülent Ecevit University (BEU) Application and Research Center and Zonguldak Public Hospitals Association (ZKHB) Child Diseases and Obstetrics and Gynecology Hospital, located at the central district of the Zonguldak. Survey forms, Maslach Burnout Scale and Humor Styles Scale were used to determine the socio-demographic and occupational characteristics of the nurses participating in the study. SPSS 24.0 package program was used to evaluate the findings obtained in the study. The 44.4% of the nurses felt that they have occupational burnout because of their profession. The distribution of the subscale scores of the Maslach Burnout Scale, shows that the "emotional burnout" level is (9.180 ± 4.444); the "desensitization" level is moderate (2.960 ± 2.313); and the "low self-efficacy feeling" level is (20,150 ± 4,134). It was found that the nurses "participatory humor" level is (4.482 ± 0.743); the "Self-improving humor" level is (4.044 ± 0.865); the "aggressive humor" level is (3.121 ± 0.812); and the "self-destructive humor" level is (3.607 ± 0.888). During the analysis of the influence of humor on the prevention of burnout, it was found that the nurses, who think that the humor affects the burnout, feel their selves more successful (p<0.05). The positive humor style and the participant and self-improving humor scores of such nurses were found to be higher than nurses who think that the humor is not effective in the prevention of burnout (p<0.05).The average aggressive humor point scores of nurses with negative humor were higher in nurses who thought that humor is not effective in the prevention of burnout. Furthermore, it was observed that the emotional exhaustion desensitization score increases as the aggressive humor score increases. As the self-enhancement humor sub-scale score increases, the low self-efficacy sub-scale score also decreases (p<0.05). Keyworlds: Pediatric nursing, Burnout, Humorous styles

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Arzu Sen, The Use Of Elastic Pressure Socks And The Effect Of Training On Surgical Patients. Zonguldak Bulent Ecevit University Institute of Health Sciences, Department of Nursing, Department of Nursing Surgical Diseases, Graduate Thesis, Zonguldak, 2018. This search aims to the effects of usage elastic pressure socks and its evaluation of education on surgial patients. It’s a planned segmental study. This search was applied at Zonguldak Bülent Ecevit Unıversity Medical Faculty, the Hospital of Research and Practise, General Surgery, Brain Surgery, Urology Surgery between February 2017 and 2018. It includes 166 patients who are from gastroenterology surgery, breast endocrin, brain surgery, urology oncology. Patients are divided into two groups randomly. Patients receiving deep vein thrombosis in Group I, and patients receiving routine care in Group II were included. Before operation, to the patients in Group I, were given elastic pressure socks by taking their leg measurements. They take courses by giving a brochure about preventation the development of deep vein thrombosis. In Group II, the patients were given some clinical applications by measuring both of their legs’ sizes. After 24-48 hours, the elastic pressure socks were taken off and controlled their skin. The problems of the patients regarding the use of socks or the problems expressed by the patient and their applications during the use of elastic pressure socks were evaluated. SPSS 19.0 packet program was used to evaluate the datas. Identifler tests, Kolmogorov tests, Smirnov tests, t test, Mann Whitney test, U test, Wilcoxon test, Pearson test, Yates test, Fisher exact test, chi-square test and McNemar test have been used to make statistically analyse. In all studies, comprasions which are under 0.05 are accepted as meaningful statistically. As a result, it was found that the training given by the nurses in the patients who underwent surgical intervention had an effect on compliance with the use of ECS, and the mean satisfaction score of the patients for the use of ECS was found to be significantly higher in Group I. Keywords: Deep vein thrombosis, Elastic pressure stockings, Patient education, Nursing care

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Ayse (Oksuzoglu) Tali, TheEffect of Oral Care on BacterialColonization in Oral Mucosa Given by Two Different Methods to Patients Supported by Mechanical Ventilators. Zonguldak Bulent Ecevit University, Institute of Health Sciences, Department of Nursing, Surgical Nursing Master Program, M.Sc. Thesis, Zonguldak, 2018. This study was carried out experimentally in order to examine the effect of oral care given by two different methods in mechanical ventilator support patients. The research was carried out in the Anesthesia-Reanimation Intensive Care Unit and General Intensive Care Unit between 26.03.2017- 20.02.2018 at Bülent Ecevit University Research and Application Center. The sample of the study consisted of 30 patients who had started to receive mechanical ventilator support but had not yet passed through 24 hours. In the collection of data; Patient Information Form, Patient Follow-up Form, Oral Evaluation Assessment Form, Oral Assessment Scaleand Microbiological Evaluation Form were used. Patients were divided into 2 groups, and patients in the experimental group has received physiological saline solution and toothbrush and in the control group has received oral care 4 times a day for 4 days with an abeslang which wrapped in sodium bicarbonat esponge. Forthe microbiological examination, the results of oral swaps taken on the 1st and 4th days were evaluated. In order to carry out the study, ethical consent from Kocaeli University Non-invasive Clinical Research Ethics Committee, written permission from the institution and informed consent were obtained from the relatives of the patient. In the evaluation of data had been used Pearson's chi-square test, t test, Mann Whitney test and Fisher Exact test; McNemar test. The results wereevaluated at 95% confidence interval and p <0.05 significance level. The power of sample size was calculated as 70%. After four days of application, there was a decrease in dental plaque in the experimental group. There was nostatistically significant difference between the groups in the comparison of the culture results obtained on the 1st and 4th day of the bacteria in the oral mucosa as a result of microbiological examination; toothbrushes and abeslang methods used in oral care were found to be effective and were not been found to have advantage so verea chother. Keywords: Oral care, Mechanical ventilator, Oral mucosa, Toothbrush, Intensive care

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Nigar Ak Turkis, The Effect of Preoperative Relaxation Exercises on Anxiety Level. Zonguldak Bulent Ecevit University Graduate School of Health Sciences, The Department of Nursing, Surgical Nursing Master’s Program, Master’s Thesis, Zonguldak, 2019. Surgery affects patients regardless of their size, physiologically, behaviorally and psychologically and causes anxiety in patients. If anxiety is not taken under control, it causes problems in patients at every stage of surgery. This study was performed before buried dental surgery to investigate the effect of relaxation exercises on anxiety level and physiological parameters (systolic and diastolic blood pressure, heart rate and respiratory rate). This study was conducted randomly controlled and quasi-experimental between 02.03.2017 and 01.02.2018. The sample of the study consisted of 130 patients who were accepted to participate in the study. In the preoperative period, 65 patients in the experimental group were allowed to perform the prograssive relaxation exercises by listening 30 minutes. Control group 65 patients waited for 30 minutes in the same environment. Systolic and diastolic blood pressures, heart rate, respiration rate, anxiety levels and post-treatment satisfaction levels were evaluated at before and after application. The findings were interpreted at a level of 0.05 significance level of 95% confidence interval. In the study, the mean anxiety scores of the patients in the experimental group were significantly lower than the control group (p<0.001). Systolic and diastolic blood pressure, heart rate and respiratory rate were statistically significant differences in the experimental and control groups (p<0.001). Pre-operative relaxation exercises were found to be effective on physiological parameters such as anxiety level, systolic and diastolic blood pressure, heart rate and respiratory rate. It was concluded that satisfaction was higher in the experimental group. Keywords: Anxiety, relaxation exercises, surgical patient, preoperative period, embedded teeth

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INSTITUTE OF HEALTH SCIENCE

PHD THESIS

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ABSTRACT

Furuzan Kokturk, Comparing Classification Success of K-Nearest Neighbor, Artifical Neural Network and Decision Trees. Bulent Ecevit University, Institute of Health Science, Department of Biostatistics, PhD Thesis, Zonguldak 2012. The amount of medical data is huge and vital. It is possible to obtain more benefit from these data by data mining techniques. Although the data mining has been becoming a very important subject and being used in almost all fields in recent years, it has no widely use in the health sector in our country. In this thesis study, it was aimed to compare of the classification success of the knearest neighbor, artifical neural network and the decision trees techniques. For this purpose, these three techniques were applied and the classification success was measured on the pregnants those gave preterm birth and those gave birth in time in Departments of Obstetrics and Gynecology of Bulent Ecevit University. After the analysis of the results, the correct classification ratios found to be 78.3 % for knearest neighbor method, 90.8 % for artifical neural network, 82.5 % for decision trees method and it was concluded that the artifical neural network is more successful than the other two methods. Keywords: Data mining, k-nearest neighbor, artifical neural network, decision trees, correct classification ratio

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ABSTRACT

Mustafa Cagatay Buyukuysal, Comparison of Normality tests with Different Sample Sizes. Bulent Ecevit University, Institute of Health Science, Department of Biostatistics, PhD Thesis, Zonguldak 2014. One of the most important assumption for parametric tests is normality of a distribution. Many normality tests are available in the literature. In our study we compare 5 normality tests which are most popular and available in statistical softwares. Usage of normality tests differs due to samples size or nature of data. For that purpose distributions are generated from different theoretical distributions and sample sizes by Monte-Carlo simulation. Type-I error and power used for comparison of normality tests. According to simulation results, Shapiro-Wilk test has the best results, when the sample size decreases, Anderson-Darling has also good results as Shapiro- Wilk test. All normality tests‟ power getting lower with a decrease of sample sizes. At that situation we suggest to provide normality test results with graphical techniques. Keywords: Normal distribution, Normality tests, Type-I error, Power, Monte-Carlo Simulation

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ABSTRACT

Anvar Hamdiev, Pharmacological Modulation of Paw Edema and Pain Behaviors. Bulent Ecevit University, Institute of Health Sciences, Deparpartment of Medical Pharmacology, Doctoral Thesis, Zonguldak, 2016. Formalin model of natural inflammation caused inflammation in humans has been identified as the closest model. The ratformalin test, which causes a local tissue injury of the paw, has been used as a model for tonic pain and localized inflammatory pain. Acute inflammation lasts a relatively shortduration; only for minutes or a several hours, and its main characteristics are the exudation of fluid and plasma proteins and the emigration of leukocytes, predominantly neutrophils. Saeveral studies have shown that, after an injection of formalin, of the injected paw develop sedema rapidly. Formalin-inducedpain is caused primarily by peripheral tissue inflammation. Depending on the edema and paincaused by the formalin test in rats it has been shown that two characteristic behavior occurs. These paw licking (Licking) and abstinence (myfeettouch the ground, holding high). When we look at the effects of anti-inflammatory drugs, the ranking was obtained as prednisolone >diclofenac > carbamazepine > diazepam >mirtazepin> morphine HCl in term of reduce inflammation due to decreased volumes of animal paw. It was found that morphine HCl and/or diclofenac have a protective effect due to their analgesic effect in the event of characteristic behaviors of animals such as paw licking and avoidance. This protective effect was mediated by mirtazapine which is the anti-depressant drug. The lowest values was obtained on diazepam due to its sedative and anxiolytic effects in the event of other behavioral movements like the rising on its hind legs, walk forward, combing and embellishing. It is followed by morphine HCl and diclofenac owing to their analgesic effect and prednisolone due to its anti-inflammatory effect. It was found that edema is releated positive direction with combing behavior in formaldehyde and diclofenac groups and also negative direction with paw licking behavior in diclofenac Na groupa result of correlation analysis. It was found that edema is releated positive direction with rise on hindlegs behavior in carbamazepine group and negative direction with rise on hindlegs behavior prednisolone group. These results allow to further studies on the relationship between edema and animal movement behavior. Keywords: Formalin test, Experimental pain model, Anti-inflammatory effects, Acute inflammation.

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Shemsu Umer Hussen, Effects of Different Heparin Derivatives on Experimental Pain and Inflammation Models in Rats. Bulent Ecevit University, Institute of Health Sciences, Department of Medical Pharmacology, Doctorate Thesis, Zonguldak, 2017. In our study, we investigated whether different heparin derivatives (heparin, enoxaparin and bemiparin) have acute and chronic anti-inflammatory and analgesic effects in rats. In our study, acute inflammation in carrageenan model, chronic inflammation in cotton-pellet granuloma test and analgesic effect by hot-plate pain model were evaluated. In acute inflammation and pain studies, heparin (100-500-1000 U/kg), enoxaparin (100-200-400 U/kg) and bemiparin (125- 250-500 U/kg) doses were used. In carrageenan induced paw edema model in rats, heparin (100-1000 Ü/kg) showed significant anti-inflammatory effect compared to the control group based on paw volumes, weight differences between the two feet and histopathologic evaluations. Bemiparin reduced inflammation at 2nd and 3rd h only at low doses (125 U / kg), but the weight difference between the two feet and histopathological results did not support this. Enoxaparin did not show significant anti-inflammatory effect. Heparin (1000 U/kg) and bemiparin (125 U / kg) showed significant antiproliferative effects in the coton-pellet granuloma test. In the hot-plate test, enoxaparin (100, 200 and 400 U / kg) showed significant antinociceptive effects in all measurements, whereas heparin (at all doses) and bemiparin (125 U / kg) showed significant antinociceptive effect only at the 30th minute. In conclusion, heparin and bemiparin showed acute and chronic antiinflammatory and early phase antinociceptive effects. We think that acute antiinflammatory effects may be due to the inhibition of some neuromediators (histamine, serotonin, prostaglandin, etc) and active coagulation factors, while their chronic antiinflammatory effects may be a favorable feature for some chronic inflammatory diseases. In our study, enoxaparin showed only antinociceptive effect and this may be through a different mechanisms. Keywords: Heparin, Enoxaparin, Bemiparin, Hot-Plate, carragenin, Inflammation, Koton-pellet granuloma test, Rats.

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ABSTRACT

Aslihan Kulekci Ugur, Factors Affecting Infant Deaths And Evaluation Of The Quality Of Life In Mothers Of Dead And Alive Babies. Bulent Ecevit University, Institute of Health Sciences, Department of Public Health, PhD Thesis, Zonguldak, 2017. In this case control study, it is aimed to evaluate the relationship between the quality of life, pregnancy, infant follow-up and infant mortality of the mothers between 2010-2011 in Zonguldak. WHOQOL quality of life scale and sociodemographic characteristics developed by the researchers and data collection forms which included information on mother and baby follow up were used. The data were evaluated with SPSS package program and nonparametric tests were used in the comparison. The surviving infants were found to have a significant difference than dead infants regarding being at 38th and above gestation weeks during birth, borning with birth weight over 2500 g, borning with cesarean section, and borning in state hospital. Mothers with risk factors for pregnancy have a higher infant mortality rate. The father being under 24 years of age and father unemployment has also been found to be factors that increase infant mortality. The quality of life score does not affect the likelihood of the baby survival while the working mothers, being at least primary school graduate, having pregnancy follow-up in the primary health care, and having USG performed are the factors increase the survival of the baby. As a result; no relationship was found between quality of life and infant mortality. Among living and dying babies; that the monthly income of the families is high and that the educational status of the mother is above the primary school, the quality of life scores are increased, the number of infant follow-ups, the number of pregnancy follow-ups, USG that the mother made during pregnancy, and maternal urinary tract infections during pregnancy were found to be factors affecting infant mortality. Keywords: Baby, Infant deaths, Death, Affecting factors, Quality of life.

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ABSTRACT

Gaye Saglam, Evaluation Of Marginal Adaptation And Fracture Strength Of Endocrowns Manufactured With Different Restorative Materials. Bulent Ecevit University, Institute of Health Sciences, Department of Prosthodontics, PhD Thesis, Zonguldak, 2017. Endocrowns, that can be applied to endodontically treated teeth with excessive material loss, are a kind of restoration that have a central retention cavity inside pulp chamber and adhesively bond to tooth tissues. With the development of computer assisted design/computer aided manufacturing (CAD/CAM) and the use of new materials in dentistry the interest in adhesive restorations is increasing. In this study, marginal adaptation and fracture strength of endocrowns manufactured with different materials by CAD/CAM and heat-pressure technique are evaluated. For this purpose, mandibular first molar teeth (N =50) were endodontically treated and the teeth were divided into five groups (n = 10). Endocrowns were obtained from lithium disilicate glass ceramic ingots (GEP) by hot-press technique and feldspathic blocks (GC), polymer infiltrated ceramic network blocks (GE), lithium disilicate glass ceramic blocks (GEC), zirconia reinforced glass ceramic blocks (GS) by CAD/CAM technique. Restorations were semented with dual polymerized resin cement and then subjected to thermocycling (5-55 °C, 6000 cycles). Marginal adaptation evaluated under scanning electron microscope at 200x magnification. Fracture stength test of specimens were done at a Universal Test Machine with a speed of 1 mm/min. Fracture types evaluated under stereomicroscope. Statistical analyzes of the data were performed. Kruskal-Wallis test was used to determine for differences between groups for marginal adaptation and fracture strength. Dunn’s test was used for post-hoc test after Kruskal-Wallis test. A statistically significant difference was observed between groups in terms of marginal adaptation (p=0.001). The highest marginal discrepancy values were found in the GEP. There was no significant difference between the other four groups (p> 0.05). A statistically significant difference was observed between groups in terms of fracture strength (p=0.019). Among the five groups, the higher fracture strength values were obtained from GEC, the lowest fracture strength values were obtained from GC. It is concluded that endocrowns manufactured with CAD/CAM show better marginal adaptation and lithium disilicate endocrowns have higher fracture strength values. Keywords: Endocrown, CAD/CAM, Marginal adaptation, Fracture strength, Feldspathic ceramic, Glass ceramic, Polymer infiltrated ceramic network

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ABSTRACT

Ezgi Akdeniz, The Effects Of Rolipram, A Phosphodiesterase 4 Enzyme Inhibitor, On Testicular Ischemia Reperfusion Injury In Rats. Bulent Ecevit University, Health Sciences Institute, Department of Medical Pharmacology, Doctoral Thesis, Zonguldak, 2018. In this study, the effects of phosphodiesterase 4 (PDE 4) enzyme inhibitor rolipram on sperm count, motility and histopathological damages in rat testes after testicular torsion/detorsion (T/D) in rats were investigated through apoptotic pathways and proinflammatory cytokines which are thought to have contributions to the damage. Rats were divided into 4 groups as Sham, rolipram (ROL), T/D and ROL+T/D. Torsion was formed by rotating the spermatic cord of the right testes of anesthetized rats 7200 clockwise and fixing it to abdomen for 3 hours. Fifteen minutes before detorsion, rolipram (single dose 10 mg/kg) or vehicle was administered intraperitoneally (i.p.) to the rats. Tumor necrosis factor alpha (TNF-α) and interleukin-1 beta (IL-1β) levels and spectrophotometric caspase-3 activity in testicular tissues were measured 4 and 24 hours after detorsion. Twenty four hours after detorsion, histopathologic tissue damages and activities of caspase-3, 8 and 9 using immunohistochemical staining method were evaluated. On the 65th day of detorsion, sperm count and motility were evaluated. T/D caused significant increase in caspase-3 activity at 4th and 24th hours of detorsion, significant histopathologic damage and strong immunostaining for caspase-3 and caspase-9 in spermatogonia at 24th hours of detorsion, significant decrease in sperm count and motility at 65th day of detorsion in ipsilateral testes. Rolipram treatment significantly increased TNF-α and IL-1β levels in the T/D group. Rolipram didn’t restore increased caspase-3 tissue activity, caspase-3 and caspase-9 immunostaining in germ cells, histological damage, sperm count and motility reductions associated with T/D. In conclusion, rolipram treatment increased the levels of proinflammatory cytokines in T/D injury, didn’t inhibit the active intrinsic apoptotic pathway and showed no protective effects on histopathological damages and sperm count and motility. Keywords: Testicular torsion/detorsion, Phosphodiesterase 4, Rolipram, TNF-α, IL-1β, Caspase-3, Caspase-8, Caspase-9.

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ABSTRACT

Ecehan Hazar, Evaluation Of The Efficacy Of Different Techniques In Removal Of Root Canal Filling During Retreatment Of Oval Shaped Root Canals. Bulent Ecevit University, Institute of Health Sciences, Department of Endodontics, PhD Thesis, Zonguldak, 2018. When initial root canal treatment fails, non-surgical treatment is prefered as the first treatment option. Studies showed that filling material can not be completely removed from the root canal system. The aim of this study is compare the efficacy of different irrigation activation methods to remove root canal obturation material from oval shaped root canals by use 3 different evaluation methods. Forty oval shaped distal canals from mandibular first molars were filled. Each distal canals were retreated with rotary retreatment files. Then all specimens were randomly assigned to one control and three experimental groups according to the activation procedures: Passive Ultrasonik Irrigation (PUI), Self Adjusting File (SAF) and XP Endo Finisher (XPF). The percentage of removed filling material was assessed by means of micro computed tomograpy and digital radiographic imaging. Root canal walls were examined and scored in three regions, apical, middle and coronal by using SEM. PUI, SAF and XPF activation in assessed micro-CT analyses improved root canal cleanliness when compared to control group (p<0.05). There was no significant difference between the PUI, SAF and XPF groups in both micro-CT analysis and digital radiographic analysis (p>0.05). When compared to control group, XPF activation technique removed more residual filling in all evaluation methods (p<0.05). There was no difference between the SAF and PUI groups in any of the evaluation methods (p>0.05). SEM evaluation showed higher scores in apical region in all groups (p<0.05). None of the activation techniques removed root canal remnants completely (p<0.05). Micro-CT provided more detailed data than digital radiography. The use of activation methods reduces the amounth of residual filling material. When XPF activation method was used, cleaner root canal walls were observed than other activation methods. Keywords: Retreatment, Passive ultrasonic irrigation, Self Adjusting File, XP Endo finisher, Micro- CT, Digital radiography, Scanning electron microscopy.

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