09 - Sanayi, Yenilikçilik ve Altyapı

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09 - Sanayi, Yenilikçilik ve Altyapı

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Sanayi, Yenilikçilik ve Altyapı Dayanıklı altyapılar tesis etmek, kapsayıcı ve sürdürülebilir sanayileşmeyi desteklemek ve yenilikçiliği güçlendirmek

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Open Access
COVID-19 Pandemic and Surge Capacity
(2020-08-01T00:00:00Z) Karakoç, Miraç Nevzat; Erdoğan, Özcan; ERDOĞAN, ÖZCAN
Disasters and pandemics experienced in recent years have shown the importance of emergency preparedness. Effectively responding to events leading to a large influx of patients that disrupt daily operations requires increased capacity. Not much resources may be available to recover losses in the current healthcare system. Therefore, plans should be made for the overflow capacity to accommodate a large number of patients before the disaster. In the face of a complex emergency epidemic, it is very important to identify and verify resources from the beginning of the outbreak in order to scale and use efficiently. It is necessary to make alternative plans and produce solutions against the worst possible scenario. In Coronavirus disease-2019 pandemics, as in all disasters and pandemics, trying to reduce the number of cases for overflow capacity, establishing alternative health facilities, minimizing the resource consumption of patients and increasing the bed capacity should be basic strategies. The need for excess resources arising in the overflow capacity experienced in a pandemic should be evaluated correctly and planning should be done accordingly. Therefore, it is necessary to create alternative areas. Projecting the underground car parks of the hospitals as underground hospitals in case of a nature-related disaster, and evaluating other closed areas within this scope; Again, the parks and reserve areas in the cities should be planned for the establishment of field hospitals against different scenarios against each natural disaster situation. With these plans, physical area demands that will occur in response to the overflow capacity can be supplied.
Open 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.
Open 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.
Open Access
Medical Education in Epidemic and Disaster Situations
(2020-11-01T00:00:00Z) Özçelik, Semra; Küçük, Özlem Su; Çakır, Erkan; Kazancıoğlu, Rümeyza; ÖZÇELİK, SEMRA; SU KÜÇÜK, ÖZLEM; ÇAKIR, ERKAN; KAZANCIOĞLU, RÜMEYZA
There is no standard practice for the sustainability of medical education in epidemics such as Covid-19 and disasters affecting society. Synchronous or asynchronous trainings have been carried out in some of universities and colleges that have distance education technical infrastructure, during the Covid-19 pandemic. If every student has access to information technologies and the skills of the instructors who will prepare and deliver the training increase their ability to use information technologies, there is no problem in the implementation and maintenance of theoretical lessons. During the Covid-19 pandemic, we had to go to distance education, which we had not yet implemented at Bezmialem Vakıf University Faculty of Medicine. During this period, we applied asynchronous and synchronous education models (mixed model) for theoretical lessons. However, the fact that practical and internship applications were carried out by distance education - although videos about skills and practices were shot and uploaded to the system - it was not possible to replace the formal education. Distance education is inevitable for the continuity of education in epidemic and disaster situations. However, after the epidemic and disaster situations have passed, practical and internship practices should be carried out as much as possible in addition to distance education in medical education. In normal times, distance education can only be used to support formal education in medical education. As a result of all these evaluations and experiences we gained in the Covid 19 pandemic, we think that synchronous/synchronous distance education applications will improve over time and contribute to medical education.
Open Access
A Comprehensive Review: Molecular and Genetic Background of Indirect Inguinal Hernias
(2021-04-01T00:00:00Z) SOMUNCU, SALİH; Somuncu, Ozge Sezin; SOMUNCU, SALİH
Background: The occurrence of indirect inguinal hernias (IIH) is 5 times more prevalent than that of direct inguinal hernias (IH) and it is 7 times more common in males, owing to the attendance of the processus vaginalis (PV) throughout testicular descent. Summary: In children, the immense mainstream of IH is indirect. The progress of IIH development in children is instigated with a patent PV, which is mostly treated by simple herniorrhaphy. Syndromes of the collagen, microfibril, elastin, and glycosaminoglycan constituents of the extracellular matrix may attend to the development of IH. Our recent research showed that the lack of epithelial-mesenchymal transition (EMT) in children contributes to the development of IIH, while the scenario is defined as the opposite in adults. However, there is still a lack of knowledge on all of the genetic and molecular causes of the disease. Key Messages: Here we aimed to review the published genetic background of IH, the deficiencies of connective tissue causing the disease, recently defined molecular pathways involved including EMT, and possible recurrence reasons. This comprehensive study can deliver an analytic outline aiding to define patients with IH combined with fundamental genetic diseases.
Open 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.
Open Access
Community Pharmacy Cognitive Services During the COVID-19 Pandemic: A Descriptive Study of Practices, Precautions Taken, Perceived Enablers and Barriers, and Burnout.
(2021-09-12T00:00:00Z) Okuyan, Betul; Bektay, Yunus Muhammed; Kingir, Zehra Betul; Save, Dilsad; Sancar, Mesut; BEKTAY, MUHAMMED YUNUS
Objective: The objectives of this study were to identify community pharmacist (CP)-led cognitive services and CPs' precautions taken related to COVID-19, perceived enablers and barriers related to pharmaceutical services and burnout levels during the COVID-19 pandemic. Method: In this descriptive study, the survey was administered online to CPs in all regions of Turkey. The frequency of their provision of patient counselling, provision of medication information and practices towards precautions during the pandemic were evaluated based on CP self-reports. The Turkish version of the Burnout Measure Short Form was used, and a 30-item questionnaire based on the 12-domain Theoretical Domains Framework was developed to determine CPs' perceived enablers of and barriers to pharmaceutical service delivery during the COVID-19 pandemic. Data were collected using convenience sampling methods. Besides internal consistency reliability, principal component analysis, and correlation analysis, Mann-Whitney U-test was conducted in group comparisons. Results: A total of 1098 complete responses were received, for a response rate of 4.11% among 26 747 CPs. The CPs' median burnout score was 3.3 (2.5-4.2). More than half of the CPs (54.5%) referred probable patients with COVID-19 to the hospital. Commonly delivered cognitive CP-led services included preventive health services (89.5%) and medication information services (86.3%). Perceived barriers to delivering pharmaceutical services were a lack of environmental resources and support and a lack of innovation in pharmaceutical services. Perceived enablers were CPs' knowledge, skills, self-confidence, actions, impacts, emotions and perceived behavioural control. Conclusion: To increase the preparedness of pharmacists for future pandemics or disasters, this study highlighted CP-led cognitive services, precautions taken related to COVID-19, perceived enablers and barriers and burnout during the COVID-19 pandemic. Pharmaceutical services guidelines that could be followed during a pandemic or other disaster should be designed by addressing these findings.
Open Access
Transforming a US scholarly concentrations program internationally: lessons learned
(2019-04-25) Koc, Meliha Meric; Kazancioglu, RÜMEYZA; KÜÇÜKDURMAZ, FATİH; Arici, DİLEK SEMA; DiBiase, Rebecca M.; Greene, Jeremy A.; Beach, Mary Catherine; KAZANCIOĞLU, RÜMEYZA; MERİÇ KOÇ, MELİHA; ARICI, DILEK SEMA
BackgroundScholarly Concentrations programs in U.S. medical schools aim to instill passion for critical thinking and promote careers in academic medicine. The rise of these programs has seen variable goals, structure, and outcomes. Transformation of these programs internationally is in its infancy.MethodsWe describe implementation of the Johns Hopkins School of Medicine Scholarly Concentrations program, offering Basic Science, Clinical Science, Medical Ethics/Healing Arts, History of Medicine, and Public Health/Community Service, at Bezmialem Vakif University in Istanbul, Turkey. Over six modules in the preclinical years, students develop a faculty-mentored experience which encourages the acquisition of attitudes and skills for self-directed, lifelong learning and scholarship. This culminates in abstract and project presentation. We report program characteristics (context and logistics) and outcomes (student engagement and experiences).ResultsThe Scholarly Concentrations program at Bezmialem began in 2014, with nearly two completed cohorts of students. In comparison to Johns Hopkins, students at Bezmialem begin at an earlier age (thus do not have as much prior research experience) and are subsequently evaluated for residency in terms of test scores rather than scholarship and publications, but have a similar level of intellectual curiosity and desire to take ownership of their project. Eighty-two percent of Bezmialem students stated the project they pursued was either their own idea or was an idea they formed after meeting with their mentor. Students at Bezmialem were more likely to choose Clinical Science projects (p=0.009). Only 5% of Bezmialem students in end-of-course survey felt dissatisfied with the level of ownership they experienced with their project, a frequency similar to that seen by Johns Hopkins students (2%).ConclusionsScholarly Concentrations programs play an important role in U.S. medical schools, and these programs can be successfully implemented internationally. The Scholarly Concentrations program at Johns Hopkins has been transformed to a program at Bezmialem in Istanbul, the first program outside North America or the European Union. When designing these programs, one must consider the context, logistics, student engagement, and outcomes. While long-term outcomes are needed, this can serve as a model for implementation elsewhere.
Open Access
The pioneer use of a modified PRGF–Endoret® technique for wound healing in a hemodialyzed diabetic patient in a terminal stage of renal disease
(2021-04-01T00:00:00Z) Raţiu, Ioana Adela; Raţiu, Cristian Adrian; Miclăuş, Viorel; Boşca, Adina Bianca; KAZANCIOĞLU, Rümeyza; Constantin, Anne Marie; Bako, Gabriel Cristian; Şovrea, Alina Simona; KAZANCIOĞLU, RÜMEYZA
© 2021, Publishing House of the Romanian Academy. All rights reserved.In the literature, this paper is the first to describe the use of plasma rich in growth factors (PRGF)–Endoret® in hemodialyzed diabetic patients, to promote the healing of after amputation wounds. The PRGF–Endoret® was primarily conceived to be used in maxillofacial surgery, oral implantology, etc., the innovation residing in the blood collection technique (quantity, moment of the week, rhythmicity), which was adapted to the specific conditions of the hemodialyzed patient. Moreover, in the initial phases, the two PRGF fractions were innovatively applied as single alternating layers on the wound surface. Only after the surface of the wound decreased, the two PRGF fractions were applied as overlapping layers. Nevertheless, the paper presents the optimal method to assess the clinical evolution of the wound. Histopathological examination of the biopsy performed during wound preparation for PRGF application brought additional, essential data for orienting the therapeutic approach. The exclusion of calciphylaxis, a disease with high mortality risk, encouraged the application of this method, and also demonstrated the microscopic features in hemodialyzed diabetic patients.
Open Access
Current status of health systems financing and oversight for end-stage kidney disease care: a cross-sectional global survey.
(2021-07-09T00:00:00Z) Yeung, Emily; Bello, A K; Levin, Adeera; Lunney, Meaghan; Osman, Mohamed A; Ye, Feng; Ashuntantang, Gloria; Bellorin-Font, Ezequiel; Benghanem Gharbi, Mohammed; Davison, Sara; Ghnaimat, Mohammad; Harden, Paul; Jha, Vivekanand; Kalantar-Zadeh, Kamyar; Kerr, Peter; Klarenbach, Scott; Kovesdy, Csaba; Luyckx, Valerie; Neuen, Brendon; O'Donoghue, Donal; Ossareh, Shahrzad; Perl, Jeffrey; Ur Rashid, Harun; Rondeau, Eric; See, Emily; Saad, Syed; Sola, Laura; Tchokhonelidze, Irma; Tesar, Vladimir; Tungsanga, Kriang; Turan Kazancioglu, Rümeyza; Wang, Angela Yee-Moon; Wiebe, Natasha; Yang, Chih-Wei; Zemchenkov, Alexander; Zhao, Minhui; Jager, Kitty J; Caskey, Fergus; Perkovic, Vlado; Jindal, Kailash; Okpechi, Ikechi G; Tonelli, Marcello; Feehally, John; Harris, David Ch; Johnson, David; KAZANCIOĞLU, RÜMEYZA