Hacettepe Üniversitesi Açık Erişim Sistemi (HÜAES)
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OKUL ÖNCESİ ÖĞRETMENLERİNİN OKUL DIŞI ÖĞRENME ORTAMLARINI KULLANMA ÖZYETERLİKLERİNİN GÜÇLENDİRİLMESİ: MÜZE EĞİTİMİ PROGRAMI
(Eğitim Bilimleri Enstitüsü, 2026) Cansu Bozer; Okul Öncesi Öğretmenliği
This research aims to strengthen preschool teachers' self efficacy in using out-of-school learning environments (OSLE) through a museum education program. Therefore, it is planned to increase preschool teachers' self efficacy beliefs regarding the use of OSLE, to support their usage skills by increasing their knowledge level in this area, and to encourage their frequent use of OSLE. In the first stage, a museum education program was developed, and in the second stage, efforts were made to support the teachers' skills in using out-of-school learning environments. The research method is a quasi-experimental design using a convergent mixed model. Participants in this research were determined using purposive criterion sampling. Quantitative data were collected through pre-test-post-test measurements using the OSE Self Efficacy Scale, while qualitative data were collected through semi-structured interviews, teacher journals, and researcher observation. Quantitative data were analyzed using mixed ANOVA. Quantitative findings revealed that the program had a statistically significant effect with a large effect size on teachers' self-efficacy beliefs in OSLE, F(1,58)=119.506, p<.001, η²p=.673. Self-efficacy scores in the experimental group increased from 61.36±21.91 in the pre-test measurement to 118.70±8.60 in the post-test measurement; no significant change was observed in the control group. Qualitative findings revealed that teachers experienced four main problems before the program: insufficient preparation, difficulties in implementation and evaluation, limitations in supporting learning, and lack of knowledge and experience. After the program, comprehensive and positive changes were observed in the themes of preparation transformation, implementation-evaluation transformation, learning support transformation, knowledge-experience transformation, and the overall effect of the program. The mixed methods findings support each other and confirm the effectiveness of the program at both statistical and experiential levels. In conclusion, this museum education program, developed with both theoretical and practical content, is considered an effective professional development intervention for increasing preschool teachers' competencies in using out-of-school learning environments.
Okul Çağının Ötesindeki Çocuklarda Atopik Dermatit, Prognoz Ve Persistan Hastalık İçin Risk Faktörleri
(Tıp Fakültesi, 2026-04-06) Numan Fırat Ekici; Çocuk Sağlığı ve Hastalıkları
Background and Aim: Atopic dermatitis (AD) is a common chronic inflammatory skin disease of childhood with a heterogeneous clinical course. This study aimed to evaluate the persistence of AD beyond early childhood and to identify clinical, demographic, and environmental risk factors associated with disease persistence in patients with symptom onset within the first year of life.
Materials and Methods: This retrospective cross-sectional study included 496 pediatric patients diagnosed with AD between January 1, 2020 and December 31, 2023, whose symptoms began within the first 12 months of life. Diagnosis was based on the Hanifin–Rajka criteria. Demographic, clinical, laboratory, and environmental data were obtained from medical records. Comparisons were made according to AD persistence at ages 3 and 5 years. Logistic regression analyses were performed to identify independent risk factors, and Kaplan–Meier survival analysis was used to evaluate symptom duration.
Results: While most patients showed spontaneous remission over time, AD persisted in 20.7% of patients at age 3 and in 8.1% at age 5. The median age at last symptom was 16 months. Kaplan–Meier analysis demonstrated significantly longer symptom duration in patients with asthma symptoms, allergic rhinitis, higher disease severity (objective SCORAD), parental atopy, and early-life exposure to tobacco smoke. In multivariate analysis, age at symptom onset, parental atopy, asthma symptoms, and objective SCORAD were identified as independent predictors of persistence at both time points. No significant associations were found between persistence and sex, mode of delivery, prematurity, breastfeeding duration, total IgE levels, or eosinophil counts.
Conclusion: Although early-onset AD is generally self-limiting, a clinically relevant subgroup of patients exhibits persistent disease. Disease severity, parental atopy, and concomitant atopic conditions are key determinants of persistence. Early identification of high-risk patients may facilitate individualized management and long-term follow-up strategies.
Keywords: Atopic dermatitis, persistence, childhood, risk factors, SCORAD, asthma, allergic rhinitis.
UYKU SAĞLIĞI OKURYAZARLIĞI ÖLÇEĞİNİN TÜRKÇE GEÇERLİK GÜVENİRLİK ÇALIŞMASI
(Tıp Fakültesi, 2026) Muhammed Şenocak; Aile Hekimliği
Şenocak M., Validity and Reliability Study of the Turkish Version of the Sleep Health Literacy Scale, Hacettepe University Faculty of Medicine Department of Family Medicine, Master's Thesis, Ankara, 2026. The aim of this study was to evaluate the Turkish validity and reliability of the Sleep Health Literacy Scale (SHLS) developed by Feldman and Slavish (2024). This methodological study included 364 individuals aged 18 years or older. The scale was adapted into Turkish using the forward–backward translation technique. Content validity was assessed through expert opinions from 10 specialists, and the content validity index (CVI) was calculated. Construct validity was evaluated using exploratory and confirmatory factor analyses (EFA, CFA). Internal consistency was assessed with Cronbach’s alpha, while test–retest reliability was evaluated 1–2 weeks apart in 40 participants. Relationships between sociodemographic variables and scale scores were analyzed using independent samples t-test, one-way analysis of variance (ANOVA), and Pearson correlation analysis. The mean age of 364 participants was 32.97±11.09 years, with 56.9% being female and 43.1% male. The content validity index exceeded 0.90 for all items. The Kaiser-Meyer-Olkin (KMO) sampling adequacy value was 0.892, and Bartlett's Test of Sphericity was significant (p<0.001). Exploratory factor analysis confirmed the two-factor structure of the original scale (Sleep Health Communication and Sleep Health Knowledge). Confirmatory factor analysis goodness-of-fit indices were within acceptable limits (RMSEA=0.063, CFI=0.902, TLI=0.895, GFI=0.802). Internal consistency analysis revealed Cronbach's alpha values of 0.884 for Factor 1, 0.648 for Factor 2, and 0.795 for the total scale. Test-retest reliability analysis showed no significant differences in scores for both factors (p>0.05). Weak positive correlations were found between age and scale subscales. Education level, willingness to learn new information about sleep, and level of knowing whom to consult significantly affected scale scores. The Turkish version of the Sleep Health Literacy Scale is a valid and reliable tool for assessing sleep health literacy in the Turkish-speaking adult population. The scale can be used to evaluate individuals' knowledge of sleep health and their ability to navigate the healthcare system. Determining sleep health literacy will help identify at-risk groups and plan interventions to improve sleep health. Future research should test the scale in different populations and examine its relationship with sleep quality.
PERKÜTAN KORONER GİRİŞİMİN GERİATRİK HASTALARDA FONKSİYONEL PERFORMANS, KIRILGANLIK VE GERİATRİK SENDROMLAR ÜZERİNE ETKİSİ
(Tıp Fakültesi, 2026-07-03) Mustafa Utku Uğur; İç Hastalıkları
Uğur, M.U., The Impact of Percutaneous Coronary Intervention on Functional Performance, Frailty, and Geriatric Syndromes in Older Adults. Hacettepe University Faculty of Medicine, Thesis in Internal Medicine. Ankara, 2026.
Objective: This study aimed to evaluate the changes in functional performance, frailty, and geriatric syndromes before and after percutaneous coronary intervention (PCI) in older adults with chronic coronary syndrome (CCS).
Materials and Methods: In this retrospective, single-center study, 103 patients aged ≥65 years who underwent elective PCI and had comprehensive geriatric assessment data before and 6–12 months after the procedure were included. Patients were evaluated in terms of frailty (Clinical Frailty Scale, CFS), sarcopenia risk (SARC-F), nutritional status (Mini Nutritional Assessment–Short Form, MNA-SF), functional status (ADL/IADL), physical performance tests (4-meter gait speed, Timed Up and Go test, five times sit-to-stand test), and cognitive assessments(S-MMSE ,CDT). Subgroup analyses were performed according to treatment strategy (optimal medical therapy vs. revascularization).
Results: Following PCI, a significant reduction in LDL levels and an increase in vitamin D levels were observed in the overall cohort. However, a general trend toward worsening in functional performance and frailty parameters was noted. An increase in CFS scores and a decline in ADL scores were more pronounced in male patients, whereas changes in muscle strength and mobility were more evident in females. Although revascularized patients showed greater improvement in certain metabolic parameters, functional gains remained limited. Patients with malnutrition demonstrated a weaker metabolic and functional response. The development of post-PCI acute kidney injury was associated with poorer clinical and functional outcomes.
Conclusion: While PCI improves metabolic parameters in geriatric patients, its impact on functional status and frailty is heterogeneous and often limited. Geriatric parameters such as nutritional status, sarcopenia, and frailty are key determinants of post-PCI outcomes. Therefore, decision-making for revascularization in older adults should incorporate comprehensive geriatric assessment alongside cardiovascular parameters to enable individualized patient-centered care.
Tiroid Göz Hastalığında Hastalık Şiddetinin Oftalmolojik ve Ortoptik Klinik Bulgular ile Korelasyonu: Klinik Belirteç Olarak Mikroperimetri ve Derin Öğrenme Tabanlı Program Kullanımının Değerlendirilmesi
(Tıp Fakültesi, 2026) Beyzanur KARACA; Göz Hastalıkları
Karaca B. Correlation of Disease Severity with Ophthalmological and Orthoptic Clinical Findings in Thyroid Eye Disease: Evaluation of Microperimetry and Deep Learning-Based Software as Clinical Biomarkers. Hacettepe University Faculty of Medicine, Department of Ophthalmology, Specialty Thesis, Ankara, 2026.
Objective: Thyroid eye disease (TED) is the most common extrathyroidal manifestation of Graves' disease. The present study aimed to (i) evaluate whether macular sensitivity and fixation stability abnormalities measured by MAIA™ microperimetry are already present in Graves' disease patients without overt orbitopathy, (ii) test whether the wide bivariate contour ellipse area (BCEA) values observed in these patients represent retinal dysfunction or an adaptive strategy operating within the Panum fusion area, and (iii) assess the diagnostic performance of TED Detector, an artificial intelligence-based photograph analysis pipeline.
Methods: This cross-sectional observational study enrolled 180 participants: 90 healthy controls, 48 Graves' disease patients without clinical orbitopathy (Graves w/o GO), and 42 Graves' orbitopathy patients (Graves w/ GO). Disease severity was graded by EUGOGO classification. All participants underwent MAIA™ microperimetry, yielding average threshold (AT, dB), fixation stability (FS) at P1/P2 probability levels and 63%/95% BCEA. Primary position facial photographs were analyzed with the TED Detector for macOS v2.3 pipeline. Three-group comparisons were performed with the Kruskal–Wallis test with Bonferroni-corrected Dunn post-hoc testing. Age effects were controlled with Quade's nonparametric ANCOVA. Logistic regression models were fitted using Firth's penalized maximum likelihood to handle quasi-complete separation caused by near-zero lid retraction values in controls.
Results: Macular sensitivity was significantly reduced in both disease groups compared with controls (AT (Average Threshold) OD (oculus dexter)) median: controls 27.1 dB; Graves w/o GO 25.6 dB; Graves w/ GO 25.2 dB; H = 40.98, ε² = 0.229, p < 0.001). After Bonferroni correction, no MAIA™ microperimetry parameter differed significantly between the Graves w/o GO and Graves w/ GO subgroups (all p > 0.05). Fixation stability P1 OD decreased across both disease groups (96.0% vs 90.0% vs 77.5%; p < 0.001). The majority of wide BCEA values remained within the Panum foveal fusion area bounds (≈ 0.1–1 deg²). All group differences persisted after age adjustment. The TED Detector pipeline achieved 87.8% sensitivity, 85.6% specificity and 86.7% accuracy (κ = 0.733). Firth Model 1 (controls vs all Graves) had AUC = 0.902; Model 2 (Graves w/o GO vs w/ GO) had AUC = 0.901. In Model 2, no MAIA™ microperimetry parameter was a significant discriminator; only pipeline Hertel (OR = 2.05; 95% CI 1.20–3.49, p = 0.008) and pipeline CAS (Clinical Activity Score) (OR = 5.69; 95% CI 1.10–29.57, p = 0.039) reached significance.
Conclusion: In Graves' disease the principal macular functional deterioration appears to emerge before overt orbitopathy develops, suggesting that objective retinal involvement may be present at the subclinical stage. The observation that wide BCEA values largely remain within Panum foveal fusion limits supports the hypothesis that this "enlarged" fixation distribution may reflect an adaptive compensatory strategy preserving binocular vision rather than a pure motor disturbance. The TED Detector pipeline demonstrated high diagnostic accuracy for both general TED detection and the orbitopathy subgroup distinction, and may serve as an adjunct to photograph-based screening.
Keywords: Thyroid eye disease, Graves' orbitopathy, microperimetry, BCEA, Panum fusion area, subclinical orbitopathy, artificial intelligence, deep learning.