Navigating exodus: understanding the migration dynamics of health care professionals from Turkey

Objectives: We aimed to determine the reasons for the emigration of health workers who left Turkey and the difficulties experienced before and after the migration. Methods: This is an exploratory qualitative study of open-text fields focusing on migrant health workers from Turkey. Answers given to five open-ended questions directed to the participants in our survey, with 513 participants between April and June 2022, were used. Data were analyzed following content analysis. Results: A total of 506 responses were analyzed. The mean age of the participants was 39.9 ± 8.8 years (54.2% men, 77.5% medical doctors). Almost all participants reported that the political atmosphere in Turkey forced them to migrate. Some participants were unable to do their jobs due to the increasing violence in the health system in recent years. Most participants saw migration as the only way out, as they did not feel free and safe. Comparatively, they were in a better economic situation in Turkey and had a higher standard of living. Conclusion: Migration creates a sense of security while at the same time accepting a lower standard of living. To organize the sustainable migration of professionals, it is beneficial to ask what framework conditions need to be created and to access the labor market in particular

The effect of heavy metals on the anthracene-Me-beta-cyclodextrin host-guest inclusion complexes

Anthracene was used to form an inclusion complex with methylated--cyclodextrin (Me-beta-CD) in water. In aqueous Me--CD solution, typical fluorescence emission of anthracene was observed. Benesi-Hildebrand's method was used to obtain the stoichiometry of the anthracene-Me--CD complex. The Stern-Volmer quenching constants, K-sv, and fluorescence quantum yields were calculated according to changes in the fluorescence emission intensity of anthracene-Me-beta-CD inclusion complexes by adding various amounts of Pb2+ and Cd2+ salts in water. The K-sv values and fluorescence quantum yields indicate that Pb2+ salts quench the anthracene-Me-beta-CD inclusion complexes more efficiently than Cd2+ salts

The effect of mulching on water consumption, yield and some parameters in apple orchards grafted onto dwarf rootstock

This study was conducted to determine the effect of different mulch materials on plant water consumption, yield, fruit quality, vegetative growth, and weed control and soil temperature of Braeburn apple variety grafted onto M9 rootstock in Eğirdir Fruit Growing Research Station in 2010-2011. The experimental design was a randomized block design with three replications. Three different treatments were determined as two different mulch materials (white fabric, black plastic covering) and control (without any mulching). Irrigation water was applied by using drip irrigation system in 7 days intervals. Amount of irrigation water to be applied in the each irrigation was determined as water amount needed for raising the soil moisture to the field capacity in 0-60 cm soil depth. As a result, substantial water saving has been provided from both of the mulch materials (%< 22-28) in comparison with the control treatment. The yield results showed statistically significant difference (p<0.05) among the treatments only in the second year. The highest red colour density value, which is an important criterion in apple marketing, was obtained from mulching with white fabric for both years. It was determined that mulch applications with these two materials were positive effects on vegetative growth and they were very effective on weed control. Soil temperature measured in the treatment used white fabric was found 1-2°C lower in comparison with control treatment, while it was found 3-4°C lower in comparison with the black plastic covering

Bodur anaçlı elma bahçelerinde malç kullanımının su tüketimi, verim ve bazı parametreler üzerine etkileri

This study was conducted to determine the effect of different mulch materials on plant water consumption, yield, fruit quality, vegetative growth, and weed control and soil temperature of Braeburn apple variety grafted onto M9 rootstock in Eğirdir Fruit Growing Research Station in 2010-2011. the experimental design was a randomized block design with three replications. Three different treatments were determined as two different mulch materials (white fabric, black plastic covering) and control (without any mulching). Irrigation water was applied by using drip irrigation system in 7 days intervals. Amount of irrigation water to be applied in the each irrigation was determined as water amount needed for raising the soil moisture to the field capacity in 0-60 cm soil depth. As a result, substantial water saving has been provided from both of the mulch materials (%;lt; 22-28) in comparison with the control treatment. the yield results showed statistically significant difference (p;lt;0.05) among the treatments only in the second year. the highest red colour density value, which is an important criterion in apple marketing, was obtained from mulching with white fabric for both years. It was determined that mulch applications with these two materials were positive effects on vegetative growth and they were very effective on weed control. Soil temperature measured in the treatment used white fabric was found 1-2°C lower in comparison with control treatment, while it was found 3-4°C lower in comparison with the black plastic covering.Bu çalışma, tam bodur anaç (M9) üzerine aşılı Braeburn elma çeşidinde farklı malç materyallerinin bitki su tüketimi, verim, meyve kalitesi, vejetatif gelişim, yabancı ot kontrolü ve toprak sıcaklığına etkilerini belirlemek amacıyla Eğirdir Meyvecilik Araştırma İstasyonu’nda 2010-2011 yıllarında yürütülmüştür. Tesadüf blokları deneme desenine göre 3 tekerrürlü kurulan denemede 2 farklı malç materyali (BKÖ ve SP) ve kontrol (K) olmak üzere 3 farklı konu yer almıştır. Sulama suyu tüm konulara 7 günlük aralıklarla damla sulama sistemi ile uygulanmıştır. Her sulamada 0-60 cm toprak derinliğinde eksik nemi tarla kapasitesine getirmek için gerekli miktar kadar sulama suyu uygulanmıştır. Malç uygulanan konularda kontrol konusuna göre sulama suyundan büyük oranda (% 22-28) tasarruf sağlanmıştır. Verim bakımından sadece ikinci yıl kontrol ve malç konuları arasında % 5 düzeyinde farklılık bulunmuştur. Pazarlama için önemli bir kriter olan elmanın kırmızı renk yoğunluğu yönünden ise beyaz kumaş örtü ile her iki yılda da en yüksek değerler elde edilmiştir. Her iki malç materyalinin de vejetatif gelişimi olumlu etkilediği ve yabancı ot gelişimi kontrolünde çok etkili oldukları belirlenmiştir. Toprak sıcaklığı beyaz kumaş örtü kullanılan konuda kontrol konusuna göre 1-2 °C daha düşük, siyah plastik örtü kullanılan konuya göre ise 3-4oC daha düşük saptanmıştır

Gastrostomy in hospitalized patients with acute stroke: "NoroTek" Turkey point prevalence study subgroup analysis

Objective: Nutritional status assessment, dysphagia evaluation and enteral feeding decision are important determinants of prognosis in acute neurovascular diseases. Materials and Methods: NöroTek is a point prevalence study conducted with the participation of 87 hospitals spread across all health sub regions of Turkey conducted on 10-May-2018 (World Stroke Awareness Day). A total of 972 hospitalized neurovascular patients [female: 53%, age: 69±14; acute ischemic stroke in 845; intracerebral hematoma (ICH) in 119 and post-resuscitation encephalopathy (PRE) in 8] with complete data were included in this sub-study. Results: Gastrostomy was inserted in 10.7% of the patients with ischemic stroke, 10.1% of the patients with ICH and in 50% of the patients with PRE. Independent predictors of percutaneous endoscopic gastrostomy (PEG) administration were The National Institutes of Health Stroke Scale score at admission [exp (β): 1.09 95% confidence interval (CI): 1.05-1.14, per point] in ischemic stroke; and mechanical ventilation in ischemic [exp (β): 6.18 (95% CI: 3.16-12.09)] and hemorrhagic strokes [exp (β): 26.48 (95% CI: 1.36-515.8)]. PEG was found to be a significant negative indicator of favorable (modified Rankin’s scale score 0-2) functional outcome [exp (β): 0.032 (95% CI: 0.004-0.251)] but not of in-hospital mortality [exp (β): 1.731 (95% CI: 0.785-3.829)]. Nutritional and swallowing assessments were performed in approximately two-thirds of patients. Of the nutritional assessments 69% and 76% of dysphagia assessments were completed within the first 2 days. Tube feeding was performed in 39% of the patients. In 83.5% of them, tube was inserted in the first 2 days; 28% of the patients with feeding tube had PEG later. Conclusion: The NöroTek study provided the first reliable and large-scale data on key quality metrics of nutrition practice in acute stroke in Turkey. In terms of being economical and accurate it makes sense to use the point prevalence method.Amaç: Akut nörovasküler hastalıklarda nütrisyonel durum ve disfaji değerlendirmesi ve enteral beslenme kararı önemli prognoz belirleyicilerindendir. Gereç ve Yöntem: NöroTek, 10 Mayıs 2018’de (Dünya İnme Farkındalık Günü) Türkiye’nin tüm sağlık alt bölgelerine yayılmış 87 hastanenin katılımıyla gerçekleştirilen bir nokta prevalans çalışmasıdır. Hastanede yatan ve bu alt çalışma için toplanan verisi tam olan toplam 972 nörovasküler hasta (kadın: %53, yaş: 69±14 yıl; 845’i akut iskemik inme; 119’u intraserebral hematom ve 8’i post-resüsitasyon ensefalopatisi) analiz edildi. Bulgular: Gastrostomi iskemik inmeli hastaların %10,7, intraserebral kanamalıların %10,1 ve post-resusitasyon ensefalopatisi olanların %50’sine uygulanmıştır. Perkütan endoskopik gastrostomi (PEG) gereksiniminin bağımsız belirleyicileri, iskemik inme grubunda kabul NIHSS [exp (β): 1,09, %95 güven aralığı (GA): 1,05-1,14, puan başına] ile hem iskemik hem de hemorajik inmelerde mekanik ventilasyon uygulanmış olmasıdır [iskemik için: exp (β): 6,18, %95 GA: 3,16- 12,09] ve hemorajik inme için: [exp (β): 26,48, 95% GA: 1,36-515,8]. İnme olgularında PEG uygulaması hastane içi mortalite için bağımsız belirleyici değildi [exp (β): 1,731, 95% GA: 0,785-3,829]. Ancak, PEG uygulanmış olması taburculuk esnasında iyi prognoza (modifiye Rankin skoru 0-2) sahip olabilme için anlamlı bir negatif etmen olarak bulundu [exp (β): 0,032, %95 GA: 0,004-0,251]. Hastanede yatan nörovasküler hastaların yaklaşık üçte ikisinde malnütrisyon ve yutma bozukluğu açısından değerlendirme yapılmıştı. Nutrisyonel status değerlendirmesinin %69’u ve disfaji değerlendirmesinin %76’sı ilk 48 saat içinde gerçekleştirilmişti. Tüple enteral nütrisyon uygulama oranı %39’du. Beslenme tüplerinin %83,5’i ilk 2 gün içinde yerleştirilirken beslenme tüpü olan hastaların %28’ine daha sonra PEG açılmıştı. Sonuç: NöroTek çalışması ile Türkiye’de hastanede yatan akut inme hastalarında nutrisyonel uygulamaların temel kalite ölçütlerine ilişkin ilk güvenilir ve büyük ölçekli veri sağlanmıştır. Ekonomik olması ve doğruluğu açısından nokta yaygınlık yönteminin bu tip verilerin temini için daha fazla kullanılması mantıklıdır