Culture shock among international students in Turkey: an analysis of the effects of self-efficacy, life satisfaction and socio-cultural adaptation on culture shock.

In this study, we investigated whether the interaction effects of self-efficacy, life satisfaction, and sociocultural adjustment have significant negative effects on culture shock. The data were collected from 323 international students in Turkey, and the sample comprised 197 undergraduates (61%) and 126 graduates (39%). We administered the "Culture Shock Questionnaire," "General Self-Efficacy Scale", "The Satisfaction with Life Scale", and "Sociocultural Adaptation Scale" through an online survey. Of the participants, 86 were female (26.6%), and 237 were male (73.4%). The ages of the participants ranged from 18 to 32 (M = 22.11; SD = 4.23). In this study, we identified three structural models to test the relationships between culture shock, self-efficacy, life satisfaction, and sociocultural adjustment. The results supported our hypothesis (H1) that there would be a significant negative relationship between self-efficacy and culture shock. One-way MANOVA revealed that students with lower self-efficacy scores experienced greater culture shock. Conversely, students with higher self-efficacy scores experienced lower culture shock and interpersonal stress. Additionally, a multigroup analysis was conducted to test the assumed relationships in structural models for Muslim (such as Turkey, where the research was conducted, which is 90% Muslim) and Christian students. The results indicated that self-efficacy has a significantly greater negative impact on culture shock for Christian students than for Muslim students. Our study confirmed the hypothesis (H4) that life satisfaction and sociocultural adjustment serve as mediating variables between self-efficacy and culture shock. Both life satisfaction and sociocultural adjustment were found to have significant direct impacts on culture shock, and a meaningful mediating effect on the relationship between self-efficacy and culture shock was identified. Based on these findings, we concluded that self-efficacy may be particularly beneficial for coping with culture shock for people who do not embrace dominant religious beliefs in a local culture.

The Effect of Prewarming on Perioperative Hypothermia: A Systematic Review and Meta-analysis of Randomized Controlled Studies.

PURPOSE: One of the methods for maintaining perioperative normothermia is prewarming. This study was conducted to investigate the effect of a preoperative prewarming intervention on perioperative body temperature. DESIGN: Systematic review and meta-analysis. METHODS: A literature review was conducted using PubMed, CINAHL, Cochrane Central, Science Direct, Springer Link, Scopus, Web of Science, and Ovid databases. Randomized controlled trials that investigate the effect of prewarming on body temperature in the prevention of perioperative hypothermia were included. The review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement guidelines. Methodological quality was assessed using the Cochrane Collaboration "risk of bias" tool. Meta-analysis was performed with Comprehensive Meta-Analysis, version 2. Moderator analysis and publication bias assessment were performed. Funnel plots were analyzed using Orwin's fail-safe N, Trim, and Fill test method to investigate the source of heterogeneity. FINDINGS: A total of 907 studies were found. The systematic review included 27 studies. Of these, 23 were included in the intraoperative meta-analysis, and 16 were included in the postoperative meta-analysis. According to the meta-analysis results, the prewarming intervention was effective in maintaining normothermia in the intraoperative (Hedge's g = 0.972, 95% confidence intervaI = 0.674 to 1.270) and postoperative (Hedge's g = 0.818, 95% confidence intervaI = 0.520 to 1.114) periods. CONCLUSIONS: The findings of this systematic review and meta-analysis showed that preoperative prewarming played a significant role in providing and maintaining perioperative normothermia.

The effectiveness of aromatherapy in the management of labor pain: A meta-analysis.

One non-pharmacological method that can be used to safely and without negative side effects is aromatherapy. This meta-analysis study was carried out to assess the effectiveness of aromatherapy in the treatment of labor pain. The analysis included 14 randomized controlled trials of aromatherapy interventions for labor pain. In the studies, it was observed that aromatherapy was applied through massage and inhalation using oils such as lavender, jasmine, rose, chamomile, bitter orange, and boswellia. In the meta-analysis, it was discovered that aromatherapy had a beneficial effect on the management of labor pain and reduced labor pain in the intervention group in 11 studies; it was found that there was no effect in 3 studies. According to analysis findings, aromatherapy significantly lessened the intensity of labor pain. The study's findings support the notion that aromatherapy can lessen labor pain.

Why research productivity of some scientists is higher? Effects of social, economic and cultural capital on research productivity.

In the past decades, the awareness about the concept of research productivity at higher education institutions has improved which led to an increase in the number of studies dealing with the subject. Such studies mostly deal with correlations between research productivity and organizational elements, gender, age, professional experience, and alma mater characteristics. To provide an innovative dimension to the existing studies this study focuses on the interaction between the research productivity of the scientists and their childhood period and childhood setting. In this context, the aim of our study is to examine the effects of cultural, economic, and social capitals on research productivity of both scientists' current status and their parents' during their childhood. The data were collected from 9499 faculty members through a survey questionnaire which included items on cultural, economic, and social capital. The data on research productivity of the participants were taken from the Web of Science. The major findings of the study are as follows: (a) Turkish scientists both have lower levels of parents' level of-during childhood- and their current level of cultural capital, and they mostly come from families with the lower-middle economic level; (b) they have medium level social capital; (c) cultural and social capitals together can account for 69% of research productivity, and the order of the related items are found to be childhood objectified cultural capital, current embodied cultural capital and parents' embodied cultural capital during childhood; (d) among social capital structures, relational social capital is the strongest predictor of research productivity and (e) economic capital is not a significant predictor of research productivity. We believe that our current findings contribute to the studies on higher education research by uncovering the new relationships between structures.

The effects of parental's cultural and economic capital and parental support on being an elite scientists.

Despite the rapid increase in the number of scientists all over the world in recent years, very few scientists can achieve to be part of elite scientist's category. Although there are many studies focusing on elite scientists, these studies generally do not focus on their childhood and parental background. In this study, which attempts to fill this gap, we focus on the cultural and economic capital of the families of elite scientists in Turkey and their parental support in childhood to analyze the roles of these variables in their being elite scientists. First, we assess the impact of cultural capital (institutional, objectified, and embodied), economic capital, parental support, and perceived academic success in basic education on the probability of becoming an elite scientist. Second, we analyze the differences among elite scientists to shed light on the gender gap in academia. We collected the data from 1,966 scientists working at 87 universities in Turkey through an online survey. Some of our main findings are as follows: (a) cultural capital, parental support, and academic success in basic education all have a strong positive effect on becoming an elite scientist; (b) objectified cultural capital has the highest impact in that an increase in this capital increases the probability of becoming elite scientists by 19%; (c) economic capital has no significant effect on elite scientists. Elite scholars have certain common characteristics, but significantly they are different from their average peers in terms of cultural capital and parental support and (d) elite female scientists have higher of cultural capital, economic capital, parental support, and academic success than elite male scientists. This finding supports the existence of the academic inequality and suggests that female scientists need higher cultural capital, economic capital, parental support, and perceived academic success to become elite scientists than their male counterparts.

Acceptance and use of the distance education systems of Turkish medical educators during COVID-19 pandemic: an analysis of contextual factors with the UTAUT2.

The aim of this study was to analyze the factors that has affected the use and approval of distance education systems during the COVID-19 pandemic in Turkey according to the extended Unified Theory of Acceptance and Use of Technology (UTAUT2). The study provided valuable insights on factors affecting the acceptance and use of distance education systems, which have become vital media of instruction since 2020. A total of 708 medical educators volunteered to participate in the study. The data were collected with a scale that was developed according to the UTAUT2 model. The scale consists of the variables of the UTAUT2 model as a ten-point Likert type questionnaire, including twenty-five items and seven dimensions: performance expectancy, effort expectancy, social influence, hedonic motivation, habits, facilitating conditions and behavioral intentions. The data were processed through correlation analysis, simple and multiple linear regression, and the structural equation model. The findings of the study indicated that performance expectancy, effort expectancy, social influence, hedonic motivation, habit, facilitating conditions and behavioral intentions all had positive effects on medical educators using distance education systems.

The effectiveness of educational interventions aimed at agricultural workers' knowledge, behaviour, and risk perception for reducing the risk of pesticide exposure: a systematic review and meta-analysis.

AIM: The aim of this study was to determine the effectiveness of educational interventions aimed at agricultural workers' knowledge, behaviour, and risk perception for reducing the risk of pesticide exposure. METHOD: All studies published in the English language between the years 2000 and 2020 were screened on relevant databases. The study protocol was registered on PROSPERO. Randomised controlled studies (RCTs) and quasi-experimental studies meeting the inclusion and exclusion criteria according to the PICOS criteria were included. In line with the PRISMA flow diagram, 38 studies were included in the systematic review and meta-analysis. Risk of bias was assessed with the Cochrane risk-of-bias assessment tool. A random-effects model was applied and Hedge's g was used to calculate effect size. FINDINGS: Five of the included studies are RCTs, two are cluster RCTs, 17 are quasi-experimental studies with experimental and control groups, and 14 have single-group pretest-posttest study designs. Educational interventions had a large effect on knowledge level (Hedge's g = 0.890), a medium effect on behaviour level (Hedge's g = 0.707), and a small effect on risk perception (Hedge's g = 0.377). No publication bias was detected. The largest effect of educational interventions on both knowledge and behaviour levels belonged to studies grounded on a theoretical basis and carried out between the years 2011 and 2020. CONCLUSION: It was determined that educational interventions are an appropriate method for reducing the pesticide exposure risks of agricultural workers. To increase the effectiveness of these interventions, it is recommended that consideration is given to a theoretical basis, the use of multiple education components, and evidence-based practices.

Validity and reliability evidence for the scale of distance education satisfaction of medical students based on item response theory (IRT).

BACKGROUND: The objective of this study is to reveal on the basis of the item response theory (IRT) the validity and reliability evidence for the data obtained from the scale prepared to determine the satisfaction with distance education in students studying in medical schools. METHODS: This is a quantitative study exploring IRT and measurement invariance evidence in developing a scale. The scale whose IRT evidence was explored was the Distance Education Satisfaction Scale (DESS). The data were obtained from 1332 medical school students who were studying at various universities. The data were analysed using the confirmatory factor analysis (CFA), multidimensional and unidimensional IRT, and measurement invariance. RESULTS: A 20-item construct with 3 sub-factors was found for DESS. This construct was unable to pass the iteration limit in the multidimensional IRT analysis. A unidimensional IRT was used assuming that the 3 sub-factors were locally independent. CONCLUSIONS: The least informative items were item 23, 24 and 25 in Factor 1, item 3 in Factor 2, and items 13 and 18 in Factor 3. The most informative items of DESS were those that had adaptive, useful expressions that had meaningful content and were able to provide educator support, which are the properties emphasized in the literature with respect to satisfaction with distance education. A measurement invariance test made based on gender revealed that DESS satisfied measurement invariance by meeting the compliance indexes required for configural, metric, scalar and strict invariance as recommended in the literature. The results showed that it is possible to make comparisons on the basis of gender using DESS.

Effect of Telehealth Interventions on Blood Pressure Control: A Meta-analysis.

The aim of this study was to find out the effects of telehealth interventions on blood pressure control by conducting a meta-analysis. Six databases were used. The literature review covered the period between December 1, 2020, and January 26, 2021. The meta-analysis was conducted by comprehensive Meta-Analysis Software version 2.2. Categorical variables were analyzed by odds ratios at a confidence interval of 95%. In data formatting and analysis, independent groups (sample size, P value); independent groups (mean, SD); Cohen's d, SE; and paired groups (N, P value) were used. The bias risk was assessed based on the Revised Cochrane Risk-of-Bias Tool for Randomized Trials. Total sample size including 22 studies was 11 120. It was determined that interventions performed through telehealth applications had a significant effect on blood pressure control (odds ratio = -0.14; 95% confidence interval = -0.20 to -0.08; P < .001). In telehealth applications, blood pressure values decreased more when the application was performed through a Web site (-0.31; 95% confidence interval = -0.49 to -0.13), duration of the intervention was 12 months or shorter (-0.18; 95% confidence interval = -0.28 to -0.010), stroke developed in case of hypertension (-0.31, 95% confidence interval = -0.76 to 0.12), and the study was conducted in the Far East countries (-0.24; 95% confidence interval = 0.40 to -0.07). Interventions with telehealth applications are effective in blood pressure management. PROSPERO ID: CRD42021228536.

Multi-level analyses of distance education capacity, faculty members' adaptation, and indicators of student satisfaction in higher education during COVID-19 pandemic.

COVID-19 pandemic triggered distance education in higher education. Decisions such as isolation, social distancing and quarantine made by countries unexpectedly and suddenly forced face-to-face education to change to distance education within days. All academics around the world had to move online overnight. All the educational and academic activities in higher education (courses, exams, meetings, etc.) had to be conducted online in a few days. Based on these changes, this study aimed to analyze the relationships among student, faculty (adaptations of faculty members to distance education) and institutional (distance learning capacities of the universities) variables that affected satisfaction of the students related to distance education in higher education institutions in Turkey during COVID-19 pandemic using hierarchical linear modeling (HLM). The study group included 14,962 students and 3631 academics from 30 universities. The results showed that universities with higher distance education capacities got higher satisfaction scores. HLM analysis showed that 43% of the variation in satisfaction scores resulted from universities. The second HLM analysis showed that 44% of the overall satisfaction score variance of the students could be explained by the factors of university features (Level 2: distance education capacity and acceptance and use of distance education systems of faculty members). Thus, it was determined that 44% of the university factor calculated as 43% in Model 1 (which is calculated within students' general satisfaction scores) resulted from the distance education capacity and the acceptance and use of distance education systems of faculty members. The findings of this study provide insights to improve distance education by stakeholders of higher education institutions.

Effect of COVID-19 pandemic on grade inflation in higher education in Turkey.

This study analyzes the effects of the COVID-19 pandemic on grade inflation in higher education. Data were collected from five universities in Turkey, including grades of 152,352 students who attended 2,841 courses conducted by 903 instructors before the COVID-19 pandemic and grades of 149,936 students who attended 2,841 courses conducted by 847 instructors during the COVID-19 pandemic. The results of this study demonstrate that the COVID-19 pandemic causes a marginal increase in grades in higher education when the other factors that might explain the differences are controlled. Grade inflation of 9.21% is the highest ever reported in literature. Compared with a year ago, DD and DC grades decreased 55%; FD and FF grades decreased 31%; and the highest-grade AA increased 41% for courses taken during the pandemic. Additionally, classroom population, academic history of the instructor, class level, field, university entrance scores, and course execution and evaluation (grading) forms of course notes are important determinants. This increase can be explained by the effort of instructors who are accustomed to face-to-face settings. When they suddenly switch to distant education, they might try to grade higher to compensate for the unforeseen negative circumstances.

Pre-graduation grade inflation in medical training in Turkey: a longitudinal study from 2005 to 2020.

BACKGROUND: Grade inflation which is known as the awarding of higher grades than students deserve in higher education has been observed since the 1960s. There is comprehensive evidence that document the allegations, prevalence, and severity of grade inflation in higher education in universities around the world for the past 10 years. METHODS: This study analyzes the change in the ratio of graduates with a "very good (>2.99)" degree in medical education in Turkey within a 15-year-long period in terms of the grade inflation (when all other factors are constant), and factors that affect the overall achievement grades. The analyses were carried out using the grade point average (GPA) of 9,618 students who graduated from the medical schools of 25 Turkish universities, and grades of 288,540 students for 7,597 courses. In doing so, the "real" university random effects estimator modelling considering the differences in universities with correlation, ANOVA, t-test and ANCOVA analyses were carried out. RESULTS: The results revealed that there was a marginal increase in grades in medical training before graduation. Twenty-nine percent grade inflation was detected in line with the relevant findings in literature and this figure is one of the highest that has been reported so far. It was also detected that the ratio of graduates with a "very good (>2.99)" degree was 17% in 2005 and it increased to 46% in 2020. Additionally, the class size, academic rank of the instructors, grades, course contents, types of the universities (public & non-profit private), accreditation of the program, and the age of the medical schools were considered as important determinants of the difference in course grades. CONCLUSION: These results show that both the uncontrolled expansion of medical schools in Turkey and the decrease in quality cause a significant increase in grades. Moreover, an important finding is that accreditation slows down the grade inflation. Both the course grades following the accreditation process and the inflation in the graduation grades (grade inflation) slowed down significantly in the accredited medical schools. This finding is an important example for the necessity of accreditation for universities, which is referred to as the "gold standard" to improve the quality of medical education.

Measurement invariance of the Phubbing Scale across 20 countries.

Mobile phone addiction is a robust phenomenon observed throughout the world. The social aspect of mobile phone use is crucial; therefore, phubbing is a part of the mobile phone addiction phenomenon. Phubbing is defined as ignoring an interlocutor by glancing at one's mobile phone during a face-to-face conversation. The main aim of this study was to investigate how the Phubbing Scale (containing 10 items) might vary across countries, and between genders. Data were collected in 20 countries: Belarus, Brazil, China, Croatia, Ecuador, India, Israel, Italy, Netherlands, Pakistan, Poland, Portugal, Serbia, Slovakia, Slovenia, Spain, Turkey, UK, Ukraine and USA. The mean age across the sample (N = 7696, 65.8% women, 34.2% men) was 25.32 years (SD = 9.50). The cross-cultural invariance of the scale was investigated using multigroup confirmatory factor analyses (MGCFA) as well as the invariance analyses. Additionally, data from each country were assessed individually via confirmatory factor analyses (CFAs). We obtained two factors, based on only eight of the items: (a) communication disturbances and (b) phone obsession. The 8 items Phubbing Scale.

Increase in COVID-19 cases and case-fatality and case-recovery rates in Europe: A cross-temporal meta-analysis.

The new coronavirus (COVID-19) infection reported in China in December 2019 has become a pandemic in a few weeks, affecting the entire world. In this respect, it is crucial to determine the case-increase, case-fatality, and case-recovery rates to control COVID-19. In this study, the case-increase, case-fatality, and case-recovery rates of COVID-19 in 36 European countries were analyzed with the meta-analysis method using data released by the health organizations and WHO. The data were obtained from the website of health organizations of 36 European countries and the website of WHO until 11 May 2020. The analyses were carried out on 1 744 704 COVID-19-diagnosed cases in 36 European countries. The case-increase, case-fatality and case-recovery rates of COVID-19 were calculated using 95% confidence intervals (95% CI), single-arm meta-analysis, cross-temporal meta-analysis, and meta-regression random-effects model. The standardized case-increase rate of COVID-19 is 5% (95% CI [0.040, 0.063]) and the average case-increase rate in European countries has started to decline by around 3% (95% CI [0.047, 0.083]) weekly. The countries with the highest rate of case increase are Belgium, Sweden, Russia, the Netherlands and the United Kingdom. Although the case-fatality rate of COVID-19 patients was 4.5% as of May 11 (95% CI [0.037-0.055]), this rate is 6.3% (95% CI [0.047, 0.083]) in standardized time (6th week). The case-recovery rates of patients are 46% (95% CI [0.376-0.547]). This study presents important results regarding the COVID-19 pandemic in Europe. Although the rate of increase in new COVID-19 cases has dropped, there is not much decline in the case-fatality rates and no increase in case-recovery rates. The case-fatality rate of COVID-19 in Europe was estimated to be in the range of 4% to 4.5% and a minimum of 4 weeks (as of 11 May) is expected to have the figure below 1% in a country with an average case-increase rate. Monitoring case fatalities in Belgium, the Netherlands and Sweden, and treatment successes in Germany and Austria play a role of utmost importance.

Developing a scale of social attitude towards childhood epilepsies: a validity and reliability study.

AIM: There is no scale of social attitude towards childhood epilepsies. In this research study, it was aimed to develop a valid and reliable scale based on three-component attitude model to measure society's attitudes towards childhood epilepsy. MATERIAL AND METHODS: This study was conducted in a province in Central Anatolia with 314 participants (150 males and 164 emales) aged between 18 and 68 years. The data in the study were obtained by applying a draft scale consisting of 52 items. Correlation analysis was performed to determine item discrimination of the items included in the draft scale; exploratory and confirmatory factor analyses were performed to determine the scale's structure validity and Cronbach alpha internal-consistency coefficients were used to determine the scale's measurement reliability. RESULTS: In the study, a two-factor structure with an eigenvalue above 1, which explained 52.39% of the variance, was obtained as a result of principal component analysis and Horn's parallel analysis. Following confirmatory factor analysis, the factor structure modeled in exploratory factor analysis was confirmed within the context of standard fit values. The Cronbach alpha internal consistency coefficient (measurement reliability of the scale) was between 0.75 and 0.85. The Childhood Epilepsy Attitude Scale consists of 12 items included in two factors: (i) Affective and Behavioral Attitude and (ii) Cognitive Attitude. The scale is a 5-point Likert-type scale. CONCLUSION: According to the data obtained in the study, the scale is a valid and reliable data collection tool that can be used for measuring individuals' attitudes towards childhood epilepsy. It is thought that this scale can be used in studies related to childhood epilepsy.

Turkish medical educators' TPACK components and characters: an analysis within the framework of simulation-based medical education.

BACKGROUND: Nowadays, a comprehensive approach is needed to describe the current status of the technology integration process and the identification of the factors that affect it, because the description and frame of the existing situation will be the starting point in the organization of the roadmap to the realization of an effective integration process. The purpose of this study is to identify the differences in technology integration of the medical educators working in Turkey and analyze these according to various variables on the basis of technological pedagogical content knowledge. METHOD: Data used in the study were collected from 301 medical educators using the TPACK-Practical Scale and Attitude towards Technology Scale. The data were analyzed using Ward's minimum variance hierarchical clustering analysis, discriminant function analysis and multinomial logistic regression analysis. RESULTS: According to the results of the study, medical educators' technology integration was grouped in the following clusters, according to their TPACK: (i) activity-based, (ii) student- based and (iii) topic-based. It was found that the developed model explains 79% of the variance of technology integration. The implementation of simulation-based medical education in medical school and the department where they work affect the clusters to which the medical educators were assigned, whereas the gender variable didn't have an effect. The findings showed that attitudes towards technology, simulation education and working in the field of basic medical sciences increased medical educators' activity-based presence. CONCLUSIONS: The review of the clusters and their characteristics showed that there are similarities between the items used in the designing stage of the education programs and the relationships of these items among them. Learner centered approaches are based on the assumption that students are located at the center of the program. In these designs, teaching mostly focuses on the learner, rather than program, learning or administrative body. Individuals and their identities are crucial.

Development of an Attitude Scale for Home Care.

The aim of this study was to evaluate the attitudes about home care services and to develop a reliable and valid measurement tool. This methodological study was carried out on 290 students studying at a school of health. Mary Albrecht's nursing model for home health care, Jean Watson's theory of human caring, and Leslie Jean Neal's theory of home health nursing practice constituted the theoretical framework of the study. According to the results of the confirmatory factor analysis, obtained fit indices (Χ2/df = 1.91, root mean square error of approximation [RMSEA] = .057, normed fit index [NFI] = .80, comparative fit index [CFI] = .89, goodness-of-fit index [GFI] = .85) showed that the proposed model is appropriate for the scale. The Attitude Scale for Home Care (ASHC) consists of 3 subdimensions and 29 items. Cronbach's alpha of the questionnaire was .93. Therefore, ASHC is a valid and reliable instrument for measuring attitudes about home care and can be used in selecting personnel to work in home care services.

Determinants of phubbing, which is the sum of many virtual addictions: a structural equation model.

BACKGROUND AND AIMS: Phubbing can be described as an individual looking at his or her mobile phone during a conversation with other individuals, dealing with the mobile phone and escaping from interpersonal communication. In this research, determinants of phubbing behavior were investigated; in addition, the effects of gender, smart phone ownership and social media membership were tested as moderators. METHODS: To examine the cause-effect relations among the variables of the theoretical model, the research employs a correlational design. Participants were 409 university students who were selected via random sampling. Phubbing was obtained via the scales featuring mobile phone addiction, SMS addiction, internet addiction, social media addiction and game addiction. The obtained data were analyzed using a correlation analysis, multiple linear regression analysis and structural equation model. RESULTS: The results showed that the most important determinants of phubbing behavior are mobile phone, SMS, social media and internet addictions. DISCUSSION: Although the findings show that the highest correlation value explaining phubbing is a mobile phone addiction, the other correlation values reflect a dependency on the phone. CONCLUSIONS: There is an increasing tendency towards mobile phone use, and this tendency prepares the basis of phubbing.