Applicability Of Ecosystem Services Based Watershed Management Model In Istanbul –omerli Case

Tez (Doktora) -- İstanbul Teknik Üniversitesi, Fen Bilimleri Enstitüsü, 2012Thesis (PhD) -- İstanbul Technical University, Institute of Science and Technology, 2012Bu araştırmada kentsel alanlar ve ekosistem servisleri arasındaki ilişkileri rasyonel yöntemlerle analiz edilmiş ve Türkiye’deki mevcut planlama ve doğal kaynak yönetim sistemi içerisine entegre edilebilecek, ekosistem servislerine dayalı bir mekansal havza yönetim planının ana hatlarının tanımlanması için İstanbul’daki Ömerli Havzası araştırma alanı olarak seçilmiştir. Araştırma kapsamında Ömerli Havzası’ndaki ekolojik birimler, ekosistem servisleri, ekosistemleri değiştiren faktörler, idari sınırlar ve mülkiyet yapısı belirlenmiştir. Ekolojik birimlerin ürettiği potansiyel servisler tespit edilerek araştırmada analiz edilecek öncelikli ekosistem servisleri seçilmiştir. Seçilen öncelikli ekosistem servislerinin ekolojik, ekonomik, sosyo-kültürel değerleri ve toplam değeri Analitik Hiyerarşi Süreci yöntemi kullanılarak ayrı ayrı hesaplanmış ve ardından servis üreten alanlar çok işlevlilik yaklaşımı doğrultusunda, servis üretim miktarlarına göre CBS kullanılarak kategorize edilmiştir. Bununla birlikte gelecekteki planlama ve yönetim çalışmalarına altlık olabilecek bir bölgeleme şeması oluşturulmuştur. Araştırmada üretilen mekansal stratejiler kapsamında, korunması, ekolojik restorasyonu ve risk azaltma faaliyetlerinin yürütüleceği alanlar belirlenmiştir. Bölgeleme şemasında önerilen faaliyetlerin Türkiye deki mevcut planlama ve su kaynakları yönetim sistemine entegre edilebilmesi için yollar tarif edilmiştir.In this research the relations between urban areas and ecosystem services in Omerli were analyzed with rational methods and also the outline of ecosystem services based watershed planning and management framework is by emphasizing spatial content of the management plan. Within the research ecological units, drivers of change on ecosystems and priority ecosystem services in Omerli Watershed were described and mapped. The ecological, economic, socio-cultural values and total value of selected ecosystem services were calculated by using Analytic Hierarchy Process method. Then the services areas were categorized by the amount of ecosystem services production towards the approach of multi-functionality by using GIS. However a zonation scheme which can be support future planning and management activities was produced. Within the spatial strategies, the areas in which conservation, ecological restoration and hazard mitigation activities can be conducted were established. The ways to integrate the activities established in the proposal zonation scheme into existing land use planning and water resources management systems in Turkey were described.DoktoraPh

Urban Resilience and Ecosystem Services: How Can Be Integrated in the Case of Istanbul - Sultanbeyli District?

As estimated by UN, in 2030, 95 % of population growth will result from urban areas while a few metropolitan areas of rapidly growing developing countries will absorb much of this growth. Due to the accelerated urban growth and uncontrolled urban dispersion through naturally significant areas, sustainable urban growth management becomes a critical urban development policy for the global agenda. Istanbul has been attracting much of the internal migration with a dramatic urban growth process since 1950s and Istanbul Province, with over 12 million people, in 2010 is the most populated city of Turkey. Sultanbeyli, as a unique case for informal housing development in Istanbul, expanded like mushrooming after 1980’s and located itself on the largest drinking water source of Istanbul: the Omerli Watershed. The population of Sultanbeyli District grew from 82,298 (1990 census) to 272,758 people (2007 census) (TUIK, 1990;2007): more than threefold increase in less than two decades with consequent environmental degradation, uncontrolled ground water pumping, lack of drinking and waste water infrastructures. These endanger the well-being of the environment and of the society. On the other hand, the serious poverty problem is the main concern in Sultanbeyli for urban resilience (UR) which can be defined as the degree to which cities are able to tolerate alteration before reorganizing around a new set of structures and processes and which can be measured by how well a city can simultaneously balance ecosystem services (ES) and human functions (Resilience alliance, 2007). This paper aims to discuss how to integrate ecosystem services and resilience theory which will be essential to resolve the problems reflected by social, economic and administrative characteristics of Sultanbeyli District to enhance its urban resilience capacity in Istanbul

Comparison of the short-term results of single-dose intra-articular peptide with hyaluronic acid and platelet-rich plasma injections in knee osteoarthritis: a randomized study

Introduction/objectives Intra-articular injections may be useful in terms of pain and functional status, in knee osteoarthritis (OA). Besides hyaluronic acid (HA) and platelet-rich plasma (PRP), peptide molecules recently begin to be used. The aim of this study was to compare the efficacy of intra-articular peptide Prostrolane (R) (CAREGEN Co. Ltd.) injection with that of the HA and PRP in the persons with OA. Method Fifty-four patients with OA were included in this prospective, randomized study. Patients were randomized into three groups as intra-articular HA, peptide, and PRP groups. Paracetamol was permitted three times a day to all groups. All the patients were evaluated by the Western Ontario and McMaster Universities Arthritis Index (WOMAC), Health Assessment Questionnaire (HAQ), and visual analogue scale (VAS) at rest and during movements. Measurements performed at the baseline, after the first week of injection, and at the first and third months of follow-up. Results Mean age was 55.8 +/- 8.9 years. Forty-four (81.6%) were women. A week after the injections, rest and movement pain severity was measured by VAS decreased significantly in all the study groups (p 0.05). WOMAC pain, stiffness, function, and total scores were improved significantly in all the groups a week after the injections (p < 0.05). Improvement continued at the third month control; however, the improvement in the WOMAC pain score was significantly better in the peptide group at the third month control (p < 0.05). The decrease in the rest and movement pain was continued for 3 months except the HA group's rest pain. There were no differences among the groups for all measurements, except for the WOMAC pain score at 3 months after treatment, which was significantly lower in the peptide group. Conclusion As a result, pain relief and functional improvement were obtained after the intra-articular HA, peptide, and PRP injections in OA, and decrease in pain was better in the peptide group

The GUSS test as a good indicator to evaluate dysphagia in healthy older people: a multicenter reliability and validity study

Purpose Dysphagia is known to be a disorder of the swallowing function, and is a growing health problem in aging populations. Swallowing screening tests have mostly been studied in comorbidities such as stroke associated with old age. There is no simple, quick and easy screening test to best determine the risk of oropharyngeal dysphagia in geriatric guidelines. We aimed to evaluate whether the Gugging Swallowing Screen (GUSS) test is an effective method for evaluating swallowing difficulty in healthy older people. Methods This cross-sectional and multicenter study was conducted at 13 hospitals between September 2017 and February 2019. The study included 1163 participants aged >= 65 years and who had no secondary dysphagia. Reliability was evaluated for data quality, scaling assumptions, acceptability, reliability, and validity as well as cutoff points, specificity and sensitivity. Results The age distribution of 773 (66.5%) patients was between 65 and 74 years and 347 (29.8%) of them were male and 767 (66%) patients were female. The average total GUSS score was 18.57 +/- 1.41. The Cronbach's alpha was 0.968. There was a moderate statistically significant negative correlation between the total GUSS and 10-item Eating Assessment Tool scores as well as between the total GUSS score and quality of life. The cutoff point of the total GUSS score was 18.50, sensitivity was 95.5% and specificity was 94.4%. Conclusions The GUSS test is a valid and reliable test to identify possible oropharyngeal dysphagia risk in healthy older people who had no secondary dysphagia. It is suitable as a screen test for clinical practice

Prevalence, etiology, and biopsychosocial risk factors of cervicogenic dizziness in patients with neck pain: A multi-center, cross-sectional study

Objectives: This study aims to investigate the prevalence, etiology, and risk factors of cervicogenic dizziness in patients with neck pain. Patients and methods: Between June 2016 and April 2018, a total of 2,361 patients (526 males, 1,835 females; mean age: 45.0 +/- 13.3 years; range, 18 to 75 years) who presented with the complaint of neck pain lasting for at least one month were included in this prospective, cross-sectional study. Data including concomitant dizziness, severity, and quality of life (QoL) impact of vertigo (via Numeric Dizziness Scale [NDS]), QoL (via Dizziness Handicap Inventory [DHI]), mobility (via Timed Up-and-Go [TUG] test), balance performance [via Berg Balance Scale [BBS]), and emotional status (via Hospital Anxiety Depression Scale [HADS]) were recorded. Results: Dizziness was evident in 40.1% of the patients. Myofascial pain syndrome (MPS) was the most common etiology for neck pain (58.5%) and accompanied with cervicogenic dizziness in 59.7% of the patients. Female versus male sex (odds ratio [OR]: 1.641, 95% CI: 1.241 to 2.171, p=0.001), housewifery versus other occupations (OR: 1.285, 95% CI: 1.006 to 1.642, p=0.045), and lower versus higher education (OR: 1.649-2.564, p<0.001) significantly predicted the increased risk of dizziness in neck pain patients. Patient with dizziness due to MPS had lower dizziness severity scores (p=0.034) and milder impact of dizziness on QoL (p=0.005), lower DHI scores (p=0.004), shorter time to complete the TUG test (p=0.001) and higher BBS scores (p=0.001). Conclusion: Our findings suggest a significant impact of biopsychosocial factors on the likelihood and severity of dizziness and association of dizziness due to MPS with better clinical status

Best Practice Recommendations for Stroke Patients with Dysphagia: A Delphi-Based Consensus Study of Experts in Turkey-Part I: Management, Diagnosis, and Follow-up

Dysphagia is one of the most common and important complications of stroke. It is an independent marker of poor outcome after acute stroke and may become chronic after the acute period and continues to affect all aspects of the patient's life. Patients with stroke may encounter any of the medical branches in the emergency room or outpatient clinic, and as in our country, there may not be specialists specific for dysphagia, such as speech-language pathologists (SLP), in every hospital. This study aimed to raise awareness and create a common opinion of medical specialists for stroke patients with dysphagia. This recommendation paper has been written by a multidisciplinary team and offers 45 recommendations for stroke patients with dysphagia. It was created using the eight-step Delphi round via e-mail. This study is mostly specific to Turkey. However, since it contains detailed recommendations from the perspective of various disciplines associated with stroke, this consensus-based recommendation paper is not only a useful guide to address clinical questions in practice for the clinical management of dysphagia in terms of management, diagnosis, and follow-up, but also includes detailed comments for these topics

Best Practice Recommendations for Stroke Patients with Dysphagia: A Delphi-Based Consensus Study of Experts in Turkey-Part II: Rehabilitation.

Dysphagia is one of the most common and important complications of stroke. It is an independent marker of poor outcome after acute stroke and may become chronic after the acute period and continues to affect all aspects of the patient's life. Patients with stroke may encounter any of the medical branches in the emergency room or outpatient clinic, and as in our country, there may not be specialists specific for dysphagia, such as speech-language pathologists (SLP), in every hospital. This study aimed to raise awareness and create a common opinion of medical specialists for stroke patients with dysphagia. This recommendation paper has been written by a multidisciplinary team and offers 45 recommendations for stroke patients with dysphagia. It was created using the eight-step Delphi round via e-mail. This study is mostly specific to Turkey. However, since it contains detailed recommendations from the perspective of various disciplines associated with stroke, this consensus-based recommendation paper is not only a useful guide to address clinical questions in practice for the clinical management of dysphagia in terms of management, diagnosis, and follow-up, but also includes detailed comments for these topics