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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PublicationOpen Access

State and trait anxiety among medical staff during the first month of COVID-19 pandemic: A sample from Turkey

2021-08-01T00:00:00Z, ŞAHAN, EBRU, TANGİLNTİZ, AİSE, ŞAHAN, EBRU, TANGİLNTİZ, AİSE

Objectives During the COVID-19 pandemic, excessive workload, a rapidly changing workplace environment, the danger of carrying the virus and transmitting the disease to their families, relatives and those they live with creates stress for the medical workers. In our study, we aimed to evaluate the state and trait anxiety levels of healthcare professionals who encounter patients with suspected COVID-19 infection and related factors. Method Data were collected from healthcare professionals working with patients diagnosed or suspected with COVID-19 via online self-report questionnaire between 9-19 April 2020. The state (STAI-S) and trait anxiety (STAI-T) scale was used to measure anxiety. Results A total of 291 healthcare professionals, 216 women and 75 men, participated in the study. Women-s state and trait anxiety were significantly higher than men-s. 11 participants without any lifetime psychiatric illness experienced psychiatric symptoms and consulted to a psychiatrist. The state anxiety of those who have children, nurses and those working in branches directly related to the pandemic (Infectious Diseases, Respiratory Diseases, Emergency Medicine, Internal Medicine, Radiology, Anesthesiology and Reanimation) was higher than others. The state anxiety of those who thought they were not protected with personal protective equipment and those who did not stay in their own home was higher than others. Conclusions At the forefront of the fight against COVID-19, there are medical personnel who pay a serious psychological cost. Especially in terms of anxiety, we should pay attention to women, workers with children, nurses and people working in branches that are directly related to pandemics.

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PublicationOpen Access

Global overview of health systems oversight and financing for kidney care

2018-02-01, Bello, Aminu K., Alrukhaimi, Mona, Ashuntantang, Gloria E., Bellorin-Font, Ezequiel, Gharbi, Mohammed Benghanem, Braam, Branko, Feehally, John, Harris, David C., Jha, Vivekanand, Jindal, Kailash, Johnson, David W., Kalantar-Zadeh, Kamyar, Kazancioglu, RÜMEYZA, Kerr, Peter G., Lunney, Meaghan, Olanrewaju, Timothy Olusegun, Osman, Mohamed A., Perl, Jeffrey, Rashid, Harun Ur, Rateb, Ahmed, Rondeau, Eric, Sakajiki, Aminu Muhammad, Samimi, Arian, Sola, Laura, Tchokhonelidze, Irma, Wiebe, Natasha, Yang, Chih-Wei, Ye, Feng, Zemchenkov, Alexander, Zhao, Ming-hui, Levin, Adeera, KAZANCIOĞLU, RÜMEYZA

Reliable governance and health financing are critical to the abilities of health systems in different countries to sustainably meet the health needs of their peoples, including those with kidney disease. A comprehensive understanding of existing systems and infrastructure is therefore necessary to globally identify gaps in kidney care and prioritize areas for improvement. This multinational, cross-sectional survey, conducted by the ISN as part of the Global Kidney Health Atlas, examined the oversight, financing, and perceived quality of infrastructure for kidney care across the world. Overall, 125 countries, comprising 93% of the world's population, responded to the entire survey, with 122 countries responding to questions pertaining to this domain. National oversight of kidney care was most common in high-income countries while individual hospital oversight was most common in low-income countries. Parts of Africa and the Middle East appeared to have no organized oversight system. The proportion of countries in which health care system coverage for people with kidney disease was publicly funded and free varied for AKI (56%), nondialysis chronic kidney disease (40%), dialysis (63%), and kidney transplantation (57%), but was much less common in lower income countries, particularly Africa and Southeast Asia, which relied more heavily on private funding with out-of-pocket expenses for patients. Early detection and management of kidney disease were least likely to be covered by funding models. The perceived quality of health infrastructure supporting AKI and chronic kidney disease care was rated poor to extremely poor in none of the high-income countries but was rated poor to extremely poor in over 40% of low-income countries, particularly Africa. This study demonstrated significant gaps in oversight, funding, and infrastructure supporting health services caring for patients with kidney disease, especially in low- and middle-income countries.

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PublicationOpen Access

Risk Factors for Cervical Cancer: Results from a Hospital-Based Case-Control Study

2011-01-01T00:00:00Z, Reis, Nesrin, Beji, Nezihe K., KILIÇ, Dilek

The aim of this study was to investigate risk factors for cervical cancer in Turkish women. In a hospital-based case-control study in Istanbul, 209 patients with histologically confirmed cervical cancer were compared with 1050 controls, who were admitted to the different departments of the same hospital. Odds ratios (OR) and 95% confidence intervals (Cl) were obtained from multivariate logistic regression analysis, fitted by the method of maximum likelihood.

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PublicationOpen Access

Recommendations for management of diabetic foot ulcers during COVID-19 outbreak.

2020-06-05T00:00:00Z, Kelahmetoglu, Osman, Camlı, Mf, Kirazoglu, A, Erbayat, Y, Guneren, E, Asgarzade, S, Durgun, U, Mehdizade, T, Yeniocak, A, Yildiz, K, Sonmez, Ergun, KELAHMETOĞLU, OSMAN, ERGÜN, SELMA, GÜNEREN, ETHEM

COVID-19 pandemia began in Wuhan, China, in December 2019. A total of 1 878 489 people were infected and 119 044 people were lost because of the disease and its complications by 15 April. Severe morbidity and mortality complications are mostly seen in elderly and patients having comorbidities. Diabetic foot ulcers (DFUs) are one of severe complications of diabetes mellitus and it may require urgent surgical interventions. In this paper, we aimed to create a management algorithm to prevent the unexpected complications that may occur in the patients and health care workers during the evaluation of COVID-19 in DFU patients who require urgent surgical intervention. We advise the use of thorax computerised tomography for preoperative screening in all DFU patients with severe signs of infection and especially those requiring urgent surgery for both the detection of the possible undiagnosed COVID-19 in the patient for the need for close follow-up and protection of the surgical and anaesthesiology team.

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PublicationOpen Access

Discordance between Serum Neutralizing Antibody Titers and the Recovery from COVID-19

2020-09-25T00:00:00Z, Koç, Mm, Kalkan, Yazıcı, Çetin, Nesibe Selma, Doymaz, Mz, Sümbül, B, Durdu, B, YAZICI, MERVE, MERİÇ KOÇ, MELİHA, ÇETİN, NESİBE SELMA, KARAASLAN, ELİF, OKAY, GÜLAY, DURDU, BÜLENT, SÜMBÜL, BİLGE, DOYMAZ, MEHMET ZIYA

The recent pandemic of COVID-19 has caused a tremendous alarm around the world. Details of the infection process in the host have significant bearings on both recovery from the disease and on the correlates of the protection from the future exposures. One of these factors is the presence and titers of neutralizing Abs (NAbs) in infected people. In the current study, we set out to investigate NAbs in the recovered subjects discharged from the hospital in full health. Serum samples from a total of 49 documented consecutive COVID-19 subjects were included in the study. All the subjects were adults, and serum samples collected during the discharge were tested in viral neutralization, enzyme immunoassay (EIA), and Western immunoblot tests against viral Ags. Even though a majority of the recovered subjects had raised significant NAb titers, there is a substantial number of recovered patients (10 out of 49) with no or low titers of NAbs against the virus. In these cohorts as well as in patients with high NAb titers, viral Ag binding Abs were detectable in EIA tests. Both NAb titers and EIA detectable Abs are increased in patients experiencing a severe form of the disease, and in older patients the Ab titers were heightened. The main conclusion is that the recovery from SARS-CoV-2 infection is not solely dependent on high NAb titers in affected subjects, and this recovery process is probably produced by a complex interplay between many factors, including immune response, age of the subjects, and viral pathology.

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PublicationOpen Access

Development and Validation of the Turkish Version of the Colorectal Anal Distress Scale-8

2017-01-01T00:00:00Z, Aydin, Serdar, Pasa, Tugce Irem, Bidak, Merve, Batmaz, Gonca, Dansuk, Ramazan

Objective: Pelvic floor disorders are common and include a wide spectrum of conditions such as pelvic organ prolapse, urinary incontinence, fecal incontinence, voiding and/or defecation dysfunction, sexual dysfunction, and several chronic pain syndromes. There is a need for a validated and reliable inventory to evaluate colorectal anal distress in women with pelvic floor disorders. The aim of this study was to investigate the reliability and validity of the Turkish version of the CRADI-8 for the evaluation of colorectal distress.

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PublicationOpen Access

Association between human leukocyte antigen gene polymorphisms and multiple EPIYA-C repeats in gastrointestinal disorders.

2020-08-28T00:00:00Z, Saribas, S, Demiryas, S, Uysal, O, Yilmaz, E, Kepil, N, Demirci, M, Caliskan, R, Dinc, HARİKA ÖYKÜ, Akkus, S, Gareayaghi, N, Kirmusaoglu, S, Ozbey, D, Tokman, HB, Koksal, SS, Tasci, I, Kocazeybek, B, UYSAL, ÖMER, DİNÇ, HARİKA ÖYKÜ

Background: Polymorphisms of human leukocyte antigen (HLA) genes are suggested to increase the risk of gastric cancer (GC). Aim: To investigate the HLA allele frequencies of patients with GC relative to a control group in terms of CagA+ multiple (≥ 2) EPIYA-C repeats. Methods: The patient group comprised 94 patients [44 GC and 50 duodenal ulcer (DU) patients], and the control group comprised 86 individuals [(50 non-ulcer dyspepsia patients and 36 people with asymptomatic Helicobacter pylori (H. pylori)]. Polymerase chain reaction was performed for the amplification of the H. pylori cagA gene and typing of EPIYA motifs. HLA sequence-specific oligonucleotide (SSO) typing was performed using Lifecodes SSO typing kits (HLA-A, HLA-B HLA-C, HLA-DRB1, and HLA-DQA1-B1 kits). Results: The comparison of GC cases in terms of CagA+ multiple (≥ 2) EPIYA-C repeats showed that only the HLA-DQB1*06 allele [odds ratio (OR): 0.37, P = 0.036] was significantly lower, but significance was lost after correction (Pc = 0.1845). The HLA-DQA1*01 allele had a high ratio in GC cases with multiple EPIYA-C repeats, but this was not significant in the univariate analysis. We compared allele frequencies in the DU cases alone and in GC and DU cases together using the same criterion, and none of the HLA alleles were significantly associated with GC or DU. Also, none of the alleles were detected as independent risk factors after the multivariate analysis. On the other hand, in a multivariate logistic regression with no discriminative criterion, HLA-DQA1*01 (OR = 1.848), HLA-DQB1*06 (OR = 1.821) and HLA-A*02 (OR = 1.579) alleles were detected as independent risk factors for GC and DU. Conclusion: None of the HLA alleles were detected as independent risk factors in terms of CagA+ multiple EPIYA-C repeats. However, HLA-DQA1*01, HLA-DQB1*0601, and HLA-A*2 were independent risk factors with no criterion in the multivariate analysis. We suggest that the association of these alleles with gastric malignancies is not specifically related to cagA and multiple EPIYA C repeats.

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PublicationOpen Access

Serum endocan levels in women with restless legs syndrome.

2015-11-19, CELIK, K, ÇıKRıKÇıOĞLU, MA, HALAC, G, KILIC, ERDEM, AYHAN, S, OZARAS, N, Karatoprak, CUMALİ, YILDIZ, KEMALETTİN, YILDIZ, RS, ZORLU, MEHMET, CAKIRCA, MUSTAFA, KıSKAÇ, MUHARREM, KILIÇ, ERDEM, YILDIZ, KEMALETTİN, ZORLU, MEHMET, KARATOPRAK, CUMALİ, ÇAKIRCA, MUSTAFA, KISKAÇ, MUHARREM

Background: Endocan is a recently introduced marker of endothelial dysfunction. The objective of this study was to compare serum endocan levels in patients with restless legs syndrome (RLS) and control subjects in order to elucidate whether RLS is associated with endothelial dysfunction. Methods: A total of 31 drug naïve female patients with RLS and 31 age- and BMI-matched women were included in the study. Patients with pathological or physiological conditions or with a history of medication use that could potentially influence endothelial functions were excluded, as well as those with alcohol or drug abuse history. The two groups were compared with routine blood tests and serum endocan levels. Results: Patients with RLS had lower serum endocan levels than the controls (P=0.037). There was a negative bivariate correlation between RLS severity score and serum endocan levels (r=-0.406, P=0.023). While white blood cell count was significantly higher in RLS group, 25-hydroxy vitamin D3, vitamin B12, transferrin saturation rate, and HDL-cholesterol were significantly lower. Creatininemia and diastolic blood pressure were also marginally insignificantly lower in RLS group. Due to the presence of differences between two groups in these variables, a linear regression analysis was performed that showed a positive association between endocan and creatininemia (β=0.310, P=0.022), and a negative association between endocan and RLS (β=-0.502, P,0.001). Conclusion: The results of this study seem to suggest that patients with RLS may have better endothelial functions when compared with the general population and that these patients may be better protected against atherosclerosis

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PublicationOpen Access

Orthostatic hypotension and health outcomes: an umbrella review of observational studies

2019-11-07, Veronese, Nicola, Smith, Lee, Torbahn, Gabriel, Jackson, Sarah E., Yang, Lin, SOYSAL, PINAR, Rivasi, Giulia, Rafanelli, Martina, Petrovic, Mirko, Maggi, Stefania, Isik, Ahmet Turan, Demurtas, Jacopo, SOYSAL, PINAR

Purpose Orthostatic hypotension (OH) is associated with older age and many negative clinical outcomes in geriatric practice. We aimed to capture the breadth of outcomes that have been associated with the presence of OH and systematically assess the quality, strength and credibility of these associations using an umbrella review with integrated meta-analyses. Methods We systematically searched several major databases from their commencements through to 16th May 2019 for meta-analyses of observational studies of OH and any health-related outcome. We used these metrics to categorize the strength of evidence of significant outcomes (p < 0.05) from class I (convincing) to class IV (weak), according to the pre-established criteria. Results From 975 abstracts, seven meta-analyses of 12 outcomes were included. For each outcome, the median number of studies was four, and the median number of participants was 46,493, with a median of 3630 incident cases. There was suggestive (class III) evidence that OH was associated with significantly higher risk of coronary heart disease (HR = 1.32, 95% CI 1.12-1.56), stroke (HR = 1.22, 95% CI 1.08-1.38), congestive heart failure (HR = 1.30, 95% CI 1.09-1.55), all-cause mortality (RR = 1.50, 95% CI 1.24-1.81), falls (OR = 1.84, 95% CI 1.39-2.44), and dementia (HR = 1.22, 95% CI 1.11-1.35). Conclusion The current evidence base indicates that OH is significantly associated with a range of adverse cardiovascular, cognitive, and mortality outcomes in older people, although the strength of this evidence remains only suggestive. Further research in larger samples and with lower risk of bias is required to build a fuller picture of the impact of OH on health.

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PublicationOpen Access

Chronotype anc Sleep Quality Assessment of Patients with Polycystic Ovary Syndrome

2021-01-01T00:00:00Z, GÖKMEN KARASU, AYŞE FİLİZ, Sahbaz, Cigdem Dilek, Dogu, Zeynep Filiz Eren, TAKMAZ, TAHA, ÇALI, HALİME, Tanoglu, Basak, GÖKMEN KARASU, AYŞE FİLİZ, ŞAHBAZ, ÇIĞDEM DILEK, TAKMAZ, TAHA, ÇALI, HALİME

Aim: Polycystic Ovary Syndrome (PCOS) is the most common endocrine disorder among women during the reproductive ages. The purpose of this study was to investigate the chronotype and sleep quality of PCOS patients.