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17 - Amaçlar için Ortaklıklar

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Amaçlar için Ortaklıklar Uygulama araçlarını güçlendirmek ve sürdürülebilir kalkınma için küresel ortaklığı canlandırmak. Hedefler, tüm hedefleri başarmak üzere ulusal planları desteklemek suretiyle Kuzey-Güney ve Güney-Güney işbirliğini artırma amacını güdüyor. Uluslararası ticaretin geliştirilmesi ve gelişmekte olan ülkelerin ihracatını artırmalarına destek verilmesi, adil ve açık, herkesin yararına olan, evrensel kurallara dayalı ve hakkaniyetli bir ticaret sistemini oluşturmanın unsurlarıdır.

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    PublicationOpen Access
    Acute kidney injury in Turkey: epidemiological characteristics, etiology, clinical course, and prognosis
    (2022-10-01T00:00:00Z) GÜRSU, Meltem; Yegenaga, Itir; TUĞLULAR, ZÜBEYDE SERHAN; DURSUN, BELDA; GÖKÇAY BEK, SİBEL; Bardak, Simge; ONAN, ENGİN; Demir, Serap; DERİCİ, ÜLVER; DOĞUKAN, AYHAN; Sevinc, Mustafa; KOÇYİĞİT, İSMAİL; Altun, Eda; Haras, Ali Burak; ALTIPARMAK, Mehmet Rıza; TONBUL, HALİL ZEKİ; GÜRSU, MELTEM
    Background: This study aimed to evaluate the etiologies, comorbidities, and outcomes of acute kidney injury (AKI) in Turkey and determine any potential differences among different geographical parts of the country. Methods: This prospective observational study was conducted by the Acute Kidney Injury Working Group of the Turkish Society of Nephrology. Demographical and clinical data of patients with AKI at the time of diagnosis and at the 1st week and 1st, 3rd, and 6th months of diagnosis were evaluated to determine patient and renal survival and factors associated with patient prognosis. Results: A total of 776 patients were included (54.7% male, median age: 67 years). Prerenal etiologies, including dehydration, heart failure, and sepsis, were more frequent than other etiologies. 58.9% of the patients had at least one renal etiology, with nephrotoxic agent exposure as the most common etiology. The etiologic factors were mostly similar throughout the country. 33.6% of the patients needed kidney replacement therapy. At the 6th month of diagnosis, 29.5% of the patients had complete recovery; 34.1% had partial recovery; 9.5% developed end-stage kidney disease; and 24.1% died. The mortality rate was higher in the patients from the Eastern Anatolian region; those admitted to the intensive care unit; those with prerenal, renal, and postrenal etiologies together, stage 3 AKI, sepsis, cirrhosis, heart failure, and malignancy; those who need kidney replacement therapy; and those without chronic kidney disease than in the other patients. Conclusion: Physicians managing patients with AKI should be alert against dehydration, heart failure, sepsis, and nephrotoxic agent exposure. Understanding the characteristics and outcomes of patients with AKI in their countries would help prevent AKI and improve treatment strategies.
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    PublicationOpen Access
    Gene Hunting Approaches through the Combination of Linkage Analysis with Whole-Exome Sequencing in Mendelian Diseases: From Darwin to the Present Day
    (2021-07-08T00:00:00Z) Susgun, Seda; Kasan, Koray; Yucesan, Emrah; SÜSGÜN, SEDA; YÜCESAN, EMRAH
    Background: In the context of medical genetics, gene hunting is the process of identifying and functionally characterizing genes or genetic variations that contribute to disease phenotypes. In this review, we would like to summarize gene hunting process in terms of historical aspects from Darwin to now. For this purpose, different approaches and recent developments will be detailed. Summary: Linkage analysis and association studies are the most common methods in use for explaining the genetic background of hereditary diseases and disorders. Although linkage analysis is a relatively old approach, it is still a powerful method to detect disease-causing rare variants using family-based data, particularly for consanguineous marriages. As is known that, consanguineous marriages or endogamy poses a social problem in developing countries, however, this same condition also provides a unique opportunity for scientists to identify and characterize pathogenic variants. The rapid advancements in sequencing technologies and their parallel implementation together with linkage analyses now allow us to identify the candidate variants related to diseases in a relatively short time. Furthermore, we can now go one step further and functionally characterize the causative variant through in vitro and in vivo studies and unveil the variant-phenotype relationships on a molecular level more robustly. Key Messages: Herein, we suggest that the combined analysis of linkage and exome analysis is a powerful and precise tool to diagnose clinically rare and recessively inherited conditions.
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    PublicationOpen Access
    Global capacity for clinical research in nephrology: a survey by the International Society of Nephrology
    (2018-02-01) Okpechi, Ikechi G.; 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; Levin, Adeera; Lunney, Meaghan; Olanrewaju, Timothy Olusegun; Perkovic, Vlado; Perl, Jeffrey; Rashid, Harun Ur; Rondeau, Eric; Salako, Babatunde lawal; Samimi, Arian; Sola, Laura; Tchokhonelidze, Irma; Wiebe, Natasha; Yang, Chih-Wei; Ye, Feng; Zemchenkov, Alexander; Zhao, Ming-hui; Bello, Aminu K.; KAZANCIOĞLU, RÜMEYZA
    Due to the worldwide rising prevalence of chronic kidney disease (CKD), there is a need to develop strategies through well-designed clinical studies to guide decision making and improve delivery of care to CKD patients. A cross-sectional survey was conducted based on the International Society of Nephrology Global Kidney Health Atlas data. For this study, the survey assessed the capacity of various countries and world regions in participating in and conducting kidney research. Availability of national funding for clinical trials was low (27%, n = 31), with the lowest figures obtained from Africa (7%, n = 2) and South Asia (0%), whereas high-income countries in North America and Europe had the highest participation in clinical trials. Overall, formal training to conduct clinical trials was inadequate for physicians (46%, n = 53) and even lower for nonphysicians, research assistants, and associates in clinical trials (34%, n = 39). There was also diminished availability of workforce and funding to conduct observational cohort studies in nephrology, and participation in highly specialized transplant trials was low in many regions. Overall, the availability of infrastructure (bio-banking and facilities for storage of clinical trial medications) was low, and it was lowest in low-income and lower-middle-income countries. Ethics approval for study conduct was mandatory in 91% (n = 106) of countries and regions, and 62% (n = 66) were reported to have institutional committees. Challenges with obtaining timely approval for a study were reported in 53% (n = 61) of regions but the challenges were similar across these regions. A potential limitation is the possibility of over-reporting or under-reporting due to social desirability bias. This study highlights some of the major challenges for participating in and conducting kidney research and offers suggestions for improving global kidney research.
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    Synthesis and Comprehensive in Vivo Activity Profiling of Olean-12-en-28-ol, 3β-Pentacosanoate in Experimental Autoimmune Encephalomyelitis: A Natural Remyelinating and Anti-Inflammatory Agent
    (2023-01-01) Şenol H.; Özgün Acar Ö.; Dağ A.; Eken A.; Güner H.; Aykut Z. G.; Topçu G.; Şen A.; ŞENOL, HALIL; DAĞ, AYDAN; TOPÇU, GÜLAÇTI
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    SAĞLIK TURİZMİNDE HİZMET VEREN SAĞLIK PROFESYONELLERİNDE KÜLTÜRLERE DUYARLILIK
    (2021-09-24T00:00:00Z) Kıyak, Yasemin; Adıgüzel, Yasemin; Erdoğan, Özcan; KIYAK, YASEMIN; ADIGÜZEL, YASEMIN; ERDOĞAN, ÖZCAN
    Sağlık, şüphesiz dünyanın her yerinde en çok önemsenen ve değer verilen kavramlardan biridir. DSÖ’YE göre sağlık -yalnızca hastalık ve sakatlığın olmayışı değil, fiziksel, ruhsal ve sosyal yönden tam bir iyilik halidir. Hastalık ise sağlığın tanımıyla anlam kazanmakta ve vücut fonksiyonlarının bozulmasını ifade etmektedir. Field’a (1993) göre hastalık, toplumsal ve kültürel içerikli bir kavram olarak da ele alınmalıdır. Kültürel faktörler, bireyin sağlığı ve hastalığı nasıl algıladıklarını etkiler. Aynı zamanda birey sağlığını nasıl koruyacağını, nasıl yükselteceğini, hastalık ortaya çıktığında nasıl tedavi edileceğini kültürüne göre seçmek ister. Günümüzde gelişen teknoloji, tıbbi ve sağlık bilimlerindeki ilerlemeler aracılığıyla mortalite ve morbidite oranlarını artıran hastalıklara çözümler bulunmaya başlanmıştır. Ayrıca eğitim düzeyinin yükselmesiyle bireyler, sağlıklı yaşam biçimi davranışlarını benimsemeye başlamış ve yaşam süresi uzamıştır. Bu durum toplum yaşlanmasını ve beraberinde kronik hastalıkların artışını doğurmuştur. Tüm bu değişimler sağlık hizmetlerinin sunumunda farklılıkları ortaya çıkarmıştır. Bu farklılıklardan biri olan ‘Sağlık Turizmi’ tüm dünyada ve ülkemizde gelişim göstermektedir. Ülkemiz de sağlık turizminde en çok tercih edilen ilk 10 ülkeden biridir. TÜİK’İN 2020 yılı verilerinde 388.150 hasta sağlık hizmeti almak için Türkiye’yi tercih etmiştir. Sağlık turizminin amacı; bireylerin sağlığının korunması, iyileştirilmesi ve rehabilite edilmesi için yaşadıkları ülke dışından başka bir ülkeye yaptıkları ziyaretleri içermektedir. Sağlık turizmi, medikal ve termal turizm; yaşlı ve engelli turizmi olarak dörde ayrılmaktadır. Bunlardan en çok medikal ve termal turizm rağbet görmektedir. Medikal tedavi işlemleri içerisinde en çok kemoterapi uygulaması ile estetik , kalp ve damar ve diş cerrahisi operasyonları tercih edilmekteyken termal turizmde ise termomineral su banyosu, inhalasyon, iklim kürü gibi tamamlayıcı tedaviler daha fazla tercih edilmektedir. Sağlık turizmi her ne kadar bireylere sağlık eşitliği ve imkanlara erişim sağlasa da sağlık profesyonelleri için önemli etik, eşitlik ve güvenlik sorunlarına yol açmaktadır. Farklı kültürlerden gelen bireylerin etnik yapıları, dinsel farklılıkları, kültürel geçmişleri, hastalıklara bakış açıları ve beklentileri durum ve olaylara göre farklılık göstermektedir. Bu kapsamda sağlık turizmi yapılan ülkelerde hizmet veren sağlık profesyonellerinin; bireylerin kültürel ihtiyaçlarının farkında olmaları, kültürel ve geleneksel beklentilerine saygı duymaları ve bireyleri yargılamamaları büyük önem taşımaktadır. Özellikle sağlık profesyonellerinden hastalık odaklı bakım yerine bireye özgü tedavi ve bakım hizmetlerini sunmaları beklenmektedir. -Bireyin kültürel farklılıkların tanımlanmasında ve anlaşılmasında uygun ve etkili davranış biçimini teşvik eden ve kültürlerarası iletişim IWACT’21 140 yönünden pozitif duygu geliştirebilme kabiliyeti- olarak tanımlanan kültürel duyarlılık kavramının sağlık turizminde hizmet veren tüm sağlık profesyonellerinde olması gereklidir. Sağlık profesyonellerinin içerisinde yer alan hekimler ve hemşireler, hastalıkların tıbbi tedavisinin uygulanması ve bakımında hastalarla birebir temas halinde olan gruplardır Tedavi ve bakım hizmetlerinin sunumunda bireylerin kültürel uygulamalarını daha fazla gözlemleme imkanına sahiptirler. Bu uygulamalar; beslenme, giyinme, hijyen, ailenin yapısı, cinsiyet rolleri ve cinsel davranışlar, evlilik örüntüleri, gebeliğe yönelik uygulamalar, boş zamanları değerlendirme, stres kaynakları ve baş etme yöntemleridir. Günümüz dünyasında sağlık turizminin artmasıyla insanlar arasındaki kültürel farklılıklar ve etkileri daha görünür olmuştur. Bu derleme çalışmasının amacı sağlık turizminde hizmet veren sağlık profesyonellerinin kültürlere duyarlılık davranışlarının önemini vurgulamaktır. Anahtar Sözcükler: Sağlık Turizmi, Kültür, Kültürel Duyarlılık, Sağlık Profesyonelleri, Sağlıkta Eşitlik
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    PublicationOpen Access
    Global nephrology workforce: gaps and opportunities toward a sustainable kidney care system
    (2018-02-01) Osman, Mohamed A.; Alrukhaimi, Mona; Ashuntantang, Gloria E.; Bellorin-Font, Ezequiel; Gharbi, Mohammed Benghanem; Braam, Branko; Courtney, Mark; Feehally, John; Harris, David C.; Jha, Vivekanand; Jindal, Kailash; Johnson, David W.; Kalantar-Zadeh, Kamyar; Kazancioglu, RÜMEYZA; Klarenbach, Scott; Levin, Adeera; Lunney, Meaghan; Okpechi, Ikechi G.; Olanrewaju, Timothy Olusegun; Perl, Jeffrey; Rashid, Harun Ur; Rondeau, Eric; Salako, Babatunde lawal; Samimi, Arian; Sola, Laura; Tchokhonelidze, Irma; Wiebe, Natasha; Yang, Chih-Wei; Ye, Feng; Zemchenkov, Alexander; Zhao, Ming-hui; Bello, Aminu K.; KAZANCIOĞLU, RÜMEYZA
    The health workforce is the cornerstone of any health care system. An adequately trained and sufficiently staffed workforce is essential to reach universal health coverage. In particular, a nephrology workforce is critical to meet the growing worldwide burden of kidney disease. Despite some attempts, the global nephrology workforce and training capacity remains widely unknown. This multinational cross-sectional survey was part of the Global Kidney Health Atlas project, a new initiative administered by the International Society of Nephrology (ISN). The objective of this study was to address the existing global nephrology workforce and training capacity. The questionnaire was administered online, and all data were analyzed and presented by ISN regions and World Bank country classification. Overall, 125 United Nations member states responded to the entire survey, with 121 countries responding to survey questions pertaining to the nephrology workforce. The global nephrologist density was 8.83 per million population (PMP); high-income countries reported a nephrologist density of 28.52 PMP compared with 0.31 PMP in low-income countries. Similarly, the global nephrologist trainee density was 1.87 PMP; high-income countries reported a 30 times greater nephrology trainee density than low-income countries (6.03 PMP vs. 0.18 PMP). Countries reported a shortage in all care providers in nephrology. A nephrology training program existed in 79% of countries, ranging from 97% in high-income countries to 41% in low-income countries. In countries with a training program, the majority (86%) of programs were 2 to 4 years, and the most common training structure (56%) was following general internal medicine. We found significant variation in the global density of nephrologists and nephrology trainees and shortages in all care providers in nephrology; the gap was more prominent in low-income countries, particularly in African and South Asian ISN regions. These findings point to significant gaps in the current nephrology workforce and opportunities for countries and regions to develop and maintain a sustainable workforce.
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    PublicationOpen Access
    Global coverage of health information systems for kidney disease: availability, challenges, and opportunities for development
    (2018-02-01) See , Emily J.; Alrukhaimi , Mona; Ashuntantang, Gloria E.; Bello, Aminu K.; Bellorin-Font, Ezequiel; Gharbi, Mohammed Benghanem; Braam, Branko; Feehally, John; Harris, David C.; Jha, Vivekanand; Jindal, Kailash; Kalantar-Zadeh , Kamyar; Kazancioglu, RÜMEYZA; Levin, Adeera; Lunney, Meaghan; Okpechi, Ikechi G.; Olanrewaju , Timothy Olusegun; Osman, Mohamed A.; Perl, Jeffrey; Qarni, Bilal; Rashid, Harun Ur; Rateb, Ahmed; Rondeau, Eric; Samimi, Arian; Sikosana, Majid L. N.; Sola, Laura; Tchokhonelidze, Irma; Wiebe, Natasha; Yang, Chih-Wei; Ye, Feng; Zemchenkov, Alexander; Zhao, Ming-hui; Johnson, David W.; KAZANCIOĞLU, RÜMEYZA
    Development and planning of health care services requires robust health information systems to define the burden of disease, inform policy development, and identify opportunities to improve service provision. The global coverage of kidney disease health information systems has not been well reported, despite their potential to enhance care. As part of the Global Kidney Health Atlas, a cross-sectional survey conducted by the International Society of Nephrology, data were collected from 117 United Nations member states on the coverage and scope of kidney disease health information systems and surveillance practices. Dialysis and transplant registries were more common in high-income countries. Few countries reported having nondialysis chronic kidney disease and acute kidney injury registries. Although 62% of countries overall could estimate their prevalence of chronic kidney disease, less than 24% of low-income countries had access to the same data. Almost all countries offered chronic kidney disease testing to patients with diabetes and hypertension, but few to high-risk ethnic groups. Two-thirds of countries were unable to determine their burden of acute kidney injury. Given the substantial heterogeneity in the availability of health information systems, especially in low-income countries and across nondialysis chronic kidney disease and acute kidney injury, a global framework for prioritizing development of these systems in areas of greatest need is warranted.
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    Akıllı Depolama Sistemleri
    (Paradigma Yayınları, 2022-11-01) Toker K.; Görener A.; TOKER, KEREM
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