Goal: 16 - Barış, Adalet ve Güçlü Kurumlar
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Barış, Adalet ve Güçlü Kurumlar
Sürdürülebilir kalkınma için barışçıl ve kapsayıcı toplumlar tesis etmek, herkes için adalete erişimi sağlamak ve her düzeyde etkili, hesap verebilir ve kapsayıcı kurumlar oluşturmak.
Barış, istikrar, insan hakları ve hukukun üstünlüğüne dayalı etkin yönetim olmadan, sürdürülebilir kalkınma olmasını bekleyemeyiz. Gittikçe artan ölçüde bölünmüş bir dünyada yaşıyoruz. Bazı bölgelerde barış, güvenlik ve refah sürekli iken, diğer bazı bölgelerde ise bitmek bilmeyen çatışma ve şiddet sarmalı var. Ancak bu, hiçbir şekilde kaçınılmaz sonuç değildir ve mutlaka çözümlenmelidir.
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Publication Metadata only Indirect Effect Of A Dentistry And Medical School Hospital Before And After Covid-19 On The Environment(2021-03-20T00:00:00Z) Ekinci, Esma; Armagan, Sara; KILIÇ, BANUDünya Sağlık Örgütü (WHO)’ne göre küresel ısınma tüm dünyada insanların karşılaştığı ciddi sorunlardan biridir.(WHO 2011) Gelecek nesiller için dünyanın uzun bir süre daha var olması önem taşımaktadır. Dolayısıyla bir diş hekimi olarak çevre dostu bir yöntem kullanarak doğanın ko runmasına yönelik katkı sağlamak bizim sorumluluğumuzdur. Küresel ısınmanın en önemli sebeplerinden biri de çevresel kirliliktir. Yapılan çeşitli araştırmalara göre, diş hekimliğinin çevreye etkisi değerlendirilmiştir. Birleşik Krallık Ulusal Sağlık Sistemi (NHS)’ne göre karbon ayakizine en büyük katkıyı dental servislere yapılan giriş çıkışlar ve tedarik süreci oluşturmaktadır. Diş hekimliği klinikleri, diğer sağlık kuruluşlarına kıyasla daha az atık üretiyor olsa da, son on yılda dental atıklarda önemli bir artış gözlenmektedir. Çeşitli ülkelerde yapılan akademik araştırmalarda, Covid-19 sürecinden bağımsız olarak değerlendirilen kliniklerden esinlenerek Bezmialem Vakıf Üniversitesi Diş Hekimliği ve Tıp Fakültesi Hastanelerinde bir çalışma yapılmıştır. Bu çalışma, Covid-19 öncesi ve sonrası bir diş hekimliği ve tıp fakültesi hastanesinin kullandığı ve harcadığı materyallerin (2019-2020 yıllarının Haziran-Aralık ayları arasındaki dezen-fektan, sabun, kağıt, hasta sayısı, doğalgaz, elektrik ve geri dönüşüm atıkları) derlenmesiyle sağlık sektörünün karbon ayakizinin bu süreçte hangi yönlerde değişime uğradığını belirtmektedir. Matery-allerin belirlenen süreçlerdeki hem yıllık değişimi hem de hasta başına düşen birim değişimi dikkate alınmıştır. Sağlık sektöründeki bireyler olarak bu süreci nasıl değerlendirmiş olduğumuzu gösteren bu çalışma, gelecekte benzer pandemilerin yaşanması durumunda öngörülecek durumları ve dikkat edilmesi gereken noktaları göz önüne sermiştirPublication Metadata only Are Students Using Pharmacological Cognitive Enhancement More Successful?(2021-09-08T00:00:00Z) Sümbül Şekerci, Betül; Bektay, Muhammed Yunus; Bildik, Özlem; İzzettin, Fikret Vehbi; SÜMBÜL ŞEKERCİ, BETÜL; BEKTAY, MUHAMMED YUNUS; BİLDİK, ÖZLEM; İZZETTİN, FIKRET VEHBIIntroduction: The use of psychostimulant drugs to increase academic success is common among young people, especially medical students. However, the effect of psychostimulants on academic success not clear in the current literature. Materials and Methods: A structured online survey was carried out with 431 undergraduate students in different faculties of Medicine in Turkey. Comparisons between groups, correlation and regression analysis about associated variables were made. The academic performance of the students was evaluated with grade point average (GPA) score. Also, academic success, academic anxiety, study performance, sleep quality and pharmacological knowledge levels were questioned with the scale based on self-evaluations. Results: 23 (5.4%) healthy students reported using psychostimulants to improve academic success. There was no significant difference in age, gender, semester, objective (GPA score) and subjective (self-report) assessment of success between users and non-users. But most of the users evaluated that the psychostimulants are useful. Smoking and increased knowledge level of pharmacology are risk factors for psychostimulant use. Conclusion: We could not find a relationship between academic success and pharmacological cognitive enhancement. Psychostimulant use had an positive effect on self-assessment of students. It can support the hypothesis that the psychostimulants has a motivational contribution rather than a purely pharmacological effect. The relationship of psychostimulants with alcohol and smoking should be examined in detail, and users should be questioned in terms of susceptibility to risky behaviors and addiction.Publication Metadata only MENOPOZ DÖNEMİNDE BESLENMENİN KEMİK SAĞLIĞI ÜZERİNE ETKİLERİ(2021-04-11T00:00:00Z) Coşkun, Venüs; Mendeş, Beyza; MENDEŞ, BEYZAMENOPOZ DÖNEMİNDE BESLENMENİN KEMİK SAĞLIĞI ÜZERİNE ETKİLERİEffects of Nutrition on Bone Health During Menopause PeriodVenüs COŞKUN1*, Öğr. Gör. Beyza MENDEŞ21*Bezmialem Vakıf Üniversitesi, Sağlık Bilimleri Fakültesi, Beslenme ve Diyetetik Bölümü, İstanbul,Eyüpsultan, Türkiye. ORCID ID: 0000-0002-2986-0050. E-mail: 170405005@bavu.edu.trTelefon: +905350237727 2Bezmialem Vakıf Üniversitesi, Sağlık Bilimleri Fakültesi, Beslenme ve Diyetetik Bölümü, İstanbul,Eyüpsultan, Türkiye. ORCID ID: 0000-0002-4182-1273. E-mail: bmendes@bezmialem.edu.trTelefon: +905535022093ÖZ: Kadınların cinsel olgunluk dönemlerinden sonra ovaryumların aktivitelerini kaybetmeye başlamasıyla birlikte menstrual siklusun kalıcı olarak sonlanmasıyla girilen döneme menopoz dönemi denilmektedir. Menopoz döneminde başta hormonsal olmak üzere birçok fiziksel ve psikolojik değişimler meydana gelmektedir. Ovaryumların işlevlerinin bozulmasına paralel olarak östrojen hormonu seviyesi azalmaktadır. Kemik hücrelerinde de östrojen hormon reseptörleri yer aldığından, östrojen hormonu eksikliğine bağlı olarak kemik kayıpları bu dönemde artış göstermektedir. Kalsiyumun yeterli olarak vücutta emiliminin yapılamaması, idrarla atılan kalsiyum miktarındaki artış ve kalsiyum açısından fakir bir beslenme bu dönemdeki kemik kayıplarının diğer sebepleridir. Menopoz döneminde basit karbonhidratlar yerine kompleks karbonhidratların tercih edilmesi, kuru baklagiller, süt ve süt ürünleri, sebze ve meyveyi yeterli ve dengeli beslenme programının uygulanması kemik hastalıkları riskini düşürebilir. Kemik mineral yoğunluğunu olumsuz etkileyen aşırı tuz, kafein ve alkol tüketiminden kaçınılmalı ve sigara kullanımı bırakılmalıdır. Ayrıca menopoz döneminde yapılan düzenli fiziksel aktivite, kas ve kemikleri güçlendirmekle birlikte kilo kontrolünü de sağlamaktadır. Sonuç olarak, menopoz dönemindeki kadınlarda yeterli ve dengeli bir beslenme programıyla birlikte yapılan düzenli fiziksel aktiviteler, bu dönemde artış gösteren kemik hastalıkları riskini düşürebilmektedir. Bu çalışmada, menopoz döneminde artan kemik hastalıkları riskinin azaltılmasını sağlayan yeterli ve dengeli beslenmede dikkat edilmesi gerekenler tartışılacaktır.Anahtar Kelimeler: menopoz, östrojen, kemik sağlığı, beslenmeABSTRACT: The period entered by the permanent termination of the menstrual cycle as the ovaries begin to lose their activity after the sexual maturity of women is called the menopause period. During the menopause period, many physical and psychological changes occur, especially hormonal. The level of estrogen hormone decreases in parallel with the deterioration of the ovarian functions. Since there are estrogen hormone receptors in bone cells, bone loss increases during this period due to estrogen hormone deficiency. Inadequate absorption of calcium in the body, an increase in the amount of calcium excreted in the urine and a diet poor in calcium are other reasons for bone loss in this period. Choosing complex carbohydrates instead of simple carbohydrates during menopause, applying an adequate and balanced diet program for legumes, milk and dairy products, vegetables and fruits can reduce the risk of bone diseases. Due to their negative effects on bone mineral density, excessive salt, caffeine and alcohol consumption should be avoided and smoking should be stopped. In addition, regular physical activity during menopause; besides strengthening muscles and bones, it also provides weight control. As a result, regular physical activities combined with an adequate and balanced nutrition program in menopausal women can reduce the risk of bone diseases that increase during this period. In this study, the points to be considered in adequate and balanced nutrition that reduce the incidence of bone diseases that increase during menopause will be discussed. Keywords: menopause, estrogen, bone health, nutritionPublication Metadata only ANALYSIS OF THE RELATIONSHIP BETWEEN NURSING STUDENTS’ PERCEPTIONS OF THEIR PROFESSION AND THEIR ATTITUDES TOWARDS THEIR PROFESSION DURING THE COVID-19 PANDEMIC(2021-10-11T00:00:00Z) Meşedüzü, Merve; Ayaz, Selin; Onar, Melike; Şeker, Simge; Tellioğlu, Hilal; BAYRAKTAR, SEMAABSTRACT Introduction: It is known that nursing education, attitudes towards the profession are questioned and perceptions and attitudes of the nursing profession are evaluated. It may also have an impact on the Covid-19 pandemic. Purpose: It aimed to analysis of the relationship between nursing students- perceptions of their profession and their attitudes towards their profession during the Covid-19 pandemic. Method: The study, which was conducted as a descriptive, cross-sectional and relationship-seeking study, was applied to a total of 191 students in February 2021 through the survey form of BVU Nursing Department students. In the study, Sociodemographic Characteristics Data Form, Questionnaire Form for students- opinions about the nursing profession during the COVID-19 pandemic period and Attitude towards Nursing Profession Scale (HMYTÖ). These are HMÖ*, HMTED**, HMGD***. Statistical significance was calculated by using the p<0.05 value in the SPSS 22 program. Results: 58.1% are targeted to work in the field due to the Covid-19 pandemic process, and 41.9% are working in this field. Changing the mind at the point of designing the movement of Covid-19 is to change the dream of 11.5% of those who think and 88.5% of those who change the direction of thought. Here is one, it is significantly higher in terms of HMI (p=0.028) and HMGD (p=0.028) points compared to those who received it. Those who think that those who are in the Covid-19 pandemic process do not get the real value, HMGD average score is 042, compared to those who are thought to be entitled (p=0. HMYTÖ is significant compared to those who are self-sacrificing and self-sacrificing because of Covid 19 pandemics (p=0.042). Covid-19 pandemic Those who think that it does not have a negative effect on the nurse-s image, the HMGD is different on average compared to those who are considered in terms of score (p=0.031). Covid-19, regarding directing the gaze of the people who are directed according to the referrals, and the rotation of the changed people compared to the referrals, the HMGD scores are significantly higher than those who change the referral (p= 0.018) HMTED scores were small (p=0.018) Conclusion and suggestions: Although the students thought that nurses could not get the value they deserved even though they worked devotedly, it was revealed that their general attitudes towards their profession were positive. However, this situation has negatively affected their views on practicing the profession in the future and their outlook on the future. In addition, it has been revealed that nursing students- understanding of the importance of their profession in the Covid-19 period and realizing thesatisfying aspects of the profession affect their attitudes towards the profession positively, as well as they think that it also affects the image of the profession in a positive way. In this process, it was seen that the attitudes of the students working in any job were positive towards the profession. As a result, it is thought that for the positive development of nursing students- attitudes towards the profession, nurses should improve their working conditions and see the value they deserve in crisis situations. Keywords: Covid-19, attitude, nursing student, nursing professionPublication Metadata only AN ALTERNATIVE APPROACH TO COVID-19: GINGER(2020-12-25T00:00:00Z) Emirhüseyinoğlu, Ayşenur; Mendeş, Beyza; MENDEŞ, BEYZASARS-CoV-2 emerged in Wuhan, China in 2019, and has taken hold in entire world in a short time. This virus, identified -Coronavirus Disease-19 (COVID-19)- by the World Health Organization (WHO), causes severe acute respiratory distress syndrome. The number of people infected with the virus increases day by day and this situation is the reason for people-s deaths. COVID-19 binding to angiotensin-converting enzyme 2 (ACE2) and spreads through the respiratory tract. COVID-19 is an RNA virus and this virus shows cough, fever and flu-like symptoms similar to other coronaviruses. These symptoms might be seen in entire age groups, but the elderly and the individuals who have chronic disease history are defined as a high-risk group. After severe pneumonia, the virus can lead to acute respiratory distress syndrome and multiple organ failure, causing death in infected individuals. There is no specific medicine or vaccine to treat COVID-19. In order to protect against this virus, it is necessary to wear a mask, pay attention to hand hygiene and social distance. Because of the fact that there is no medical treatment or protection procedure, people can tend to utilize herbal remedies by acquiring immunity to viruses. Ginger (Zingiber officinale) is one of these medicinal plants. Ginger has been utilized due to various treatments of diseases for a long time in alternative medicine. These properties should be provided by an ideal anti-COVID-19 agent; being safe for patients, ensuring antiviral immunity, increasing repair of tissue and demonstrating strong antiviral effects. It is known that the ginger that ensures whole these criteria, additionally, contains tumor necrosis factor-a (TNF-a) which defined as cytokine of anti-influenza. It has been reported that the ginger which not only increases the immun response, but also decreases viral replication. Ginger has the property of inhibiting prostaglandin, leukotriene biosynthesis and cyclooxygenase, lipoxygenase activities. in-silico studies conducted according with these known effects have also shown that the active ingredients of ginger have encouraging effects against COVID-19. It has been observed that the use of ginger in various mixtures has positive effects on COVID-19 patients. This study, will discuss the impacts on the course of the disease the ginger and the mixture which contains ginger, used in the treatment COVID-19.Publication Metadata only Bezmialem Vakıf Üniversitesi Hastanesi Acil Servisine Başvuran Adli Nitelikli Olguların ve Adli Raporların Değerlendirilmesi(2021-12-12T00:00:00Z) Kara, Kerem; Taşlıdere, Bahadır; TAŞLIDERE, BAHADIREvaluation of Forensic Cases and Forensic Reports Appealing to Bezmialem Vakıf University Emergency DepartmentIntroductionForensic cases are all events caused by intent, negligence, recklessness or carelessness that cause a person to be physically or mentally victimized (1, 2). Firearm injuries, stab injuries, traffic accidents, falls, beatings, work accidents, poisonings, burns, electric shocks, sexual assaults, all kinds of suicide attempts, torture allegations, suspicious or unexpected deaths can be considered as forensic cases. The first place where these cases are evaluated is usually the emergency departments. Therefore, physicians working in emergency departments have a great responsibility (3, 4). We retrospectively evaluated the forensic reports written in the emergency department of our hospital with this study, which we intend to do in order to write more accurate forensic reports. With this study, it is aimed to increase the awareness of newly graduated medical students and emergency physicians about forensic reports and thus to keep their knowledge about the subject up-to-date.MethodsOur study was carried out retrospectively in Bezmialem Vakıf University Faculty of Medicine Emergency Service after approval of the Ethics Committee. The study was completed by examining the forensic reports written between 01.09.2020 and 30.09.2020.ResultsThe ratio of forensic cases admitted to the total number of patients within a one-month period was approximately 2.6%. The decrease in the number of emergency services due to COVID-19 and other restrictive measures may have decreased the rate of forensic cases admitted (4, 5). In our study, 78.9% (157 people) of forensic cases were men and the mean age was 34.26 ± 11.89. The proportion of women was 21.1% and the mean age was 37.21 ± 12.54. Men are more present in traffic than women. They work in high-risk jobs and have higher rates of alcohol use and substance abuse. For this reason, men are more involved in forensic cases (6). Among the forensic case reasons, 32.2% (64 people) of traffic accidents were the first. In other studies examined, traffic accidents were in the first place as well (7). The second most common reason for men was abuse (19 people), and poisoning for women (10 people) (Table 1). The area with the most frequent injuries was the upper extremity with a rate of 56.3% (112 people), followed by lower extremity (33.2%- 66 people), head- neck (23.1%- 46 people), thorax- back (22.6%- 45 people), abdomen (10.1%- 20 people), pelvis (8.5%- 17 people) and genital area (0.5%- 1 person) (Table 2). 35.2% (70 people) of the reports were prepared due to work related accidents. 87.1% of these cases were men. While the most common cause of work related accidents in males was cuts (49%), it was blunt trauma in females (44%). Only 12.1% of the reports written in the emergency department were written as definitive reports. Temporary forensic reports were prepared for the remaining 175 cases. One of the common problems with forensic reports is that the physician gives a temporary report when he/she is able to give a definitive report (5). It was seen that 50.8% of the reports mentioned if the injury was life-threatening or not. It was stated at a rate of 60.3% whether the injury could be relieved by a simple medical intervention or not. These ratios show that information should be given about the reason for the preparation of the report and its legal dimension. In forensic reports, the answers that are generally expected from the emergency physician are whether the person is life-threatening and whether he/she will recover with simple medical intervention. The deficiencies observed in the preparation of the forensic report can be seen as a neglect of duty for the physician. Emergency physicians should know how to write a forensic report and what their responsibilities are in this regard. Forensic reports must be filled in carefully, detailed and accurately.Student: Kerem Kara 160101066Mentor: Dr.Öğr.Üyesi Bahadır TAŞLIDEREReferences1. Aktas N, Gulacti U, Lok U, Aydin İ, Borta T, Celik M. Characteristics of the Traumatic Forensic Cases Admitted To Emergency Department and Errors in the Forensic Report Writing. Bull Emerg Trauma. 2018 Jan;6(1):64-702 . Bozkurt S, Daraoğlu V, Okumuş M, Savrun A, Karanfil R, Gök AA. Acil Serviste Düzenlenen Adli Raporların Uygunluğunun Değerlendirilmesi ve Tespit Edilen Eksiklikler. Journal of Clinical and Analytical Medicine, 2015;6: 331-43. Küçük E, Günel C. Demographic characteristics of forensic ınvestigation in emergency service. Sakarya Medical Journal. 2016;6(2):100-105. 4. Kukul Güven FM, Bütün C, Yücel Beyaztaş F, Eren Ş, Korkmaz İ. Cumhuriyet üniversitesi tıp fakültesi hastanesine başvuran adli olguların değerlendirilmesi. ADÜ Tıp Fakültesi Dergisi. 2009;10(3):23-28. 5. Korkmaz T, Kahramansoy N, Erkol Z, Sarıçil F, Kılıç A. Evaluation of the forensic patients presenting to the emergency department and legal reports. Haseki Tip Bulteni. 2019;50:14-20.6. Crane CA, Godleski SA, Przybyla SM, Schlauch RC, Testa M. The Proximal Effects of Acute Alcohol Consumption on Male-to-Female Aggression: A Meta-Analytic Review of the Experimental Literature. Trauma Violence Abuse. 2016 Dec;17(5):520-531 7. Serinken M, Turkcuer İ, Acar K, Ozen M. Evaluation of medicolegal reports written by physicians in the emergency unit with regard to deficiencies and mistakes. Ulus Travma Acil Cerrahi Derg 2011;17:23-8.Publication Metadata only Adli Bilim Uzmanları ve Teknikerlerinin SARS CoV2 Pandemisi Hakkındaki Bilgi ve Anksiyete Düzeylerinin Değerlendirilmesi(2021-12-04T00:00:00Z) Arslan, Mustafa; Melez, İpek Esen; MELEZ, İPEK ESENPublication Open Access Evaluating compliance to stimulants in adults with attention deficit and hyperactivity disorder(2021-12-03T00:00:00Z) Kılıç, Özge; Boylu, Muhammed Emin; KILIÇ, ÖZGE; BOYLU, MUHAMMED EMİNObjective: Attention deficit hyperactivity disorder (ADHD) has several negative psychosocial outcomes including poor work performance, academic failure, problems in social relationships, and criminality. However, it is among the most treatable mental disorders given the safety and efficacy of stimulants. We aimed to explore compliance levels to methylphenidate and associated sociodemographic factors in adults with ADHD.Methods: Patients with ADHD who have been following up in a single-center outpatient psychiatry clinic of a university hospital were included in the study. Diagnoses were established according to the Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (DSM-5) during a face-to-face clinical interview. Sociodemographic data form and Morisky medication adherence scale were utilized.Results: Among 64 patients (36 males, 28 females) (mean age ± SD = 25.2 ± 6.8) with ADHD, 19 (29.7 %) and 29 (45.3%) patients showed high and medium adherence to methylphenidate respectively. However, 16 (25 %) had low adherence. Men and women did not significantly differ in compliance levels to stimulants (X2 (2) = 1.639, p = 0.441). Compliance was not found to be related to education, marital and economic status, living conditions, smoking. The number of patients who consume alcohol tends to be higher in the low adherent group although not reaching statistical significance.Discussion: One-fourth of adult patients with ADHD had low adherence to methylphenidate. Men and women did not differ in adherence levels. No significant difference has been observed in the mean ages between the three adherence groups. Our results were in line with some earlier studies on treatment adherence in ADHD but not with others that showed adherence was higher in females and younger patients. The reason for these discrepancies could be that the studies with contrary results have recruited both children and adolescents. Longitudinal multicenter studies are needed to draw conclusions on the factors affecting compliance in ADHD.Keywords: attention deficit and hyperactivity disorder, drugs/medication, pharmacology, treatment compliance, treatment adherence, demographicPublication Metadata only Covid-19 Pandemisinde Bir Risk Faktörü: Yaşlılarda Kırılganlık(2021-05-25T00:00:00Z) Adıgüzel, Yasemin; İlhan, Nesrin; ADIGÜZEL, YASEMINCovid-19 Pandemisinde Bir Risk Faktörü: Yaşlılarda Kırılganlık Yasemin ADIGÜZEL1, Nesrin İLHAN2 1 Arş. Gör., Bezmialem Vakıf Üniversitesi Sağlık Bilimleri Fakültesi Hemşirelik Bölümü, yadiguzel1@bezmialem.edu.tr. 2 Doç. Dr., İstanbul Medeniyet Üniversitesi Sağlık Bilimleri Fakültesi Hemşirelik Bölümü Halk Sağlığı Hemşireliği Anabilim Dalı, nesrin.ilhan@medeniyet.edu.tr. Koronavirüs hastalığı (Covid-19), tüm dünyaya yayılarak 11 Mart 2020 tarihinde DSÖ tarafından pandemi ilan edilmiştir(1). Covid-19, herkesi enfekte edebilmekle birlikte en çok orta yaşlı ve yaşlı yetişkinleri etkilemektedir(2,3). Yapılan çalışmalarda yaşlıların Covid-19’a karşı daha savunmasız olduğu ve enfeksiyon ile ölüm oranlarının yaşlılarda daha yüksek olduğu bulunmuştur(2,4,5). Covid-19 pandemisinde yaşlı bireylerde ölüm oranlarının artmasıyla yaşlılar için sokağa çıkma kısıtlamaları yapılmıştır (3,6). Bu durum, azalmış işlevsel yetenek ve ilerleyici geriatrik kırılganlık oluşum riskiyle mücadele eden yaşlıların başa çıkmaları gereken başka sorunlar doğurmuştur(7). Bu sorunlar; uzun süre evde hareketsiz kalma, sosyal ilişkilerin azalması, stres, anksiyete ile kendileri ve yakınları için hastalık ve ölüm korkusudur(7,8,9,10). Özellikle bu bireylerin kısıtlamada olası düşme ve yaralanma durumlarını ve kronik hastalıkları yönetememe sebebiyle yaşadıkları rahatsızlıkları Covid-19 ile enfekte olma korkusuyla göz ardı etmeleri muhtemeldir. Bu durum, onları kırılganlık riskine karşı daha savunmasız hale getirmektedir(7).Kırılganlık; yaşa bağlı olarak fizyolojik rezervlerin azalması, çoklu organ veya sistemlerde fonksiyonel kayıp ve stresörlere karşı savunmasızlığın artması olarak tanımlanan geriatrik bir sendrom olmakla birlikte dünyada ve ülkemizde giderek artarak küresel bir sağlık yükü oluşturmaktadır(11,12). Kırılganlığın etiyolojisi bilinmemekle birlikte, kronik inflamasyon ile kas- iskelet ve endokrin sistemde değişiklikler, hücresel yaşlanma, apopitozis, kardiyovasküler sistem hastalıkları, kadın cinsiyet, komorbiditeler, genetik, çevresel faktörler (stres, malnütrisyon vb.), ırk, eğitim, sosyoekonomik durum, depresyon, sigara, alkol kullanımı ve polifarmasi kırılganlığın patogenezinde rol oynamaktadır(11,13,14). Kırılganlığın oluşumunda rol oynayan bu faktörler Covid-19 pandemisinde de devam etmektedir. Bu durum mevcutta kırılgan olan yaşlıların şiddetli kırılganlık dönemine girmesine sebep olabileceği gibi kırılgan olmayan yaşlılar için de risk oluşturmaktadır(10). İngilitere’deki ve İtalya-daki hastaneleri kapsayan gözlemsel bir kohort çalışmasında Covid-19-un, kırılgan yaşlılar için daha şiddetli sürebileceği ve prognozunun kötü ilerleyebileceği tespit edilmiştir(15). Türkiye-deki tüm hastanelerde ulusal çapta yürütülen bir kohort çalışmasında ise 18.234 Covid-19 hastasının % 67,4’ünün kırılgan, % 15,4’ünün ise şiddetli kırılganlık döneminde olduğu tespit edilmiştir(16). Kısıtlamaların bir sonucu olarak, toplumda yaşayan beş yaşlı yetişkinden dördünün yaşam alanı hareketliliğinde önemli bir azalma yaşanmaktadır ve bu durum kırılganlık, sarkopeni ve kronik hastalık riskini artırmaktadır(10). Bu süreçte yaşlı bireyin fonksiyonel bağımsızlığının ve işlevselliğinin korunması için kronik hastalıklarını yönetme, farmakolojik tedavilerine uyumu sağlama, fiziksel güç ve direnci artıran egzersizler yapma, beslenmenin düzenlenmesi, kilo kontrolü ve bakım verenlerin dijital ortamlarla bakımı desteklemesi gibi alanlarda yapılacak girişimlerle kırılganlığın önlenmesi sağlanabilir(11,17). Kırılganlığın önlenmesi için Covid-19 pandemisinde ve getirdiği kısıtlamalarda yaşlı bireylerin gerek fiziksel gerekse ruhsal açıdan takip edilmesi, telefon ve diğer dijital ortamlarda temaslarının desteklenmesi, çevirim içi sosyal destek, ruhsal destek faaliyetlerinin yürütülmesi önemlidir. Tele-Sağlık ve Tele-hemşirelik uygulamalarının yaygınlaştırılmasıyla pandemi döneminde yaşlıların günlük yaşam aktivitelerinde bağımsızlıkları desteklenebilmektedir(18). Yaşlıların telefon, bilgisayar ve internete erişememeleri, sınırlı dakika kullanımları onların yakınlarıyla etkileşim kurmasını ve online alışveriş imkanlarını kullanmalarını zorlaştırabilir. Bunlar ve benzeri durumların devlet kurumları ve yerel yönetimler aracılığıyla destelenmesiyle yaşlıların sosyal fonksiyonelliği desteklenebilir(17,19). Yaşlılarda kırılganlığın değerlendirilmesi ve semptomların belirlenerek önlenmesi önemlidir. Kırılganlığın değerlendirilmesinde; Fried Kırılganlık Ölçeği, Edmonton Kırılganlık Ölçeği, FRAIL İndeksi, CSHA Kırılganlık Ölçeği ve Tilburg Kırılganlık Ölçeği gibi araçlar kullanılmaktadır. Bu araçlar sayesinde kırılganlık erken evrede belirlenebilmektedir(11,13). Covid-19 pandemisinde de yaşlıların kırılganlıktan korunması, kırılganlığın değerlendirilmesi ve Covid-19 ile enfekte olduklarında kırılgan yaşlıya özgü girişimleri alabilmeleri için hemşirelerin kırılganlığın farkında olmaları önemlidir.Anahtar Kelimeler: Yaşlılık, Kırılganlık, Kırılgan Yaşlı, Covid-19, Hemşire.Publication Metadata only INVESTIGATION OF PERSONAL PROTECTION KNOWLEDGE LEVEL OF PERSONNEL WORKING IN RISKY UNITS OF THE HOSPITAL AGAINST CBRN HAZARD(2021-07-04T00:00:00Z) Taşlıdere, Bahadır; TAŞLIDERE, BAHADIRIn this study, it was aimed to determine the use of personal protective equipment and the level of knowledge of healthcare professionals working in hospitals, especially in risky areas, in a possible chemical, biological, radiological, or nuclear incident. In this way, it is aimed to ensure that the healthcare personnel who intervene in the CBRN incident are ready consciously and effectively. A total of 270 people, 150 women, and 120 men, participated in the study. In the study, it was observed that whether the participants were male or female, their knowledge level of protection against CBRN danger did not significantly affect. 40 of these participants (14.8%) are healthcare technicians, 161 (59.6%) are nurses and 69 (25.6%) are doctors. Considering the occupational difference, the knowledge level of the participants who are nurses against CBRN danger was found to be significantly lower than the participants who were healthcare technicians and doctors. Considering the geopolitical position of our country, it is essential to know CBRN issues well and to intervene appropriately. Health personnel who will perform such an important intervention must first ensure their safety. In the study, it was found that the knowledge levels of the participants who knew the expansion of the CBRN expression were significantly higher than the participants who did not know the expression of CBRN against the risk of CBRN. The spectrum of CBRN threats is wide. There may be deaths, injuries, psychosocial impacts, damage to economic assets, environmental damage, and submissive and threatening approaches to political issues. To be protected against various threats such as chemical threats, bacteria that cause disease, viruses that cause pandemics, radiological threats, nuclear weapons, radiation spreading around, it is necessary to obtain detailed information about the subject first. In the study, it was determined that the protection knowledge level of the participants who received CBRN training against CBRN danger was significantly higher than the participants who did not receive CBRN training. First things to do in a CBRN event; to protect oneself and the injured from the harmful effects of CBRN agents, to be able to perform appropriate triage, to apply first aid and decontamination methods, to identify and diagnose the agent used, to carry out advanced diagnosis and treatment procedures. Comprehensive knowledge of CBRN agents is required to be prepared against CBRN agents at all times and to be able to manage the situation correctly when the event occurs.