Mahalli İdare Birlikleri Bağlamında Sağlıklı Kentler Birliği Yerel Yönetimler İlişkileri: Bursa Örneği

Dünya genelinde gerçekleşen hızlı nüfus artışı ile kısıtlı olan doğal kaynakların modern yaşam tarzına yetmemesi, ya da yetmediği algısının olması kentlerin önde gelen sorunudur. Kentlerin sürdürülebilirliği geçmişten geleceğe uzanan koruma kullanma dengesinin sürdürülmesi ile mümkündür. Kentlerde meydana gelen ulaşım, trafik, iklim değişikliği, barınma, çarpık kentleşme, atık yönetimi vb. sorunların üstesinden gelinmesinde kullanılabilecek araçlardan birisi Sağlıklı Kentler Birliği kapsamında gerçekleştirilen bazı çalışmalardır.Bu çalışmada yöntem olarak eko kent, yavaş şehir, dirençli kentler, akıllı kent ve sağlıklı kentler gibi sürdürülebilirliği temel alan bazı kentsel gelişim yaklaşımları araştırılmıştır. Dünya Sağlık Örgütü, Sağlıklı Kentler ve Türkiye’deki durumuna ilişkin irdelemeler yapılarak, Bursa kenti ve sağlıklı kentler kapsamında yapılan bazı projelerin incelenmesi gerçekleştirilmiştir. Sonuçta Sağlıklı Kentler birliğine üye belediyelerinin, sağlıklı kentler birliği açısından bazı sorun/faydaları ortaya konularak bazı öneriler getirilmiştir

Türkiye’de evde sağlık bakım hizmetleri: Bolu örneği

Objective: This study was planned with the aim of determining the clinicalcharacteristics of patients served by the Bolu Home Health Care Services (HHCS),their reasons for making use of home health care services, and the distribution of care.Methods: The sample of this descriptive study consisted of 386 patients to whomservice was being provided by Bolu HHCS. A Patient Information Form created bythe researchers by examining the relevant literature was used to collect data. Numbers,percentages and mean were used in the analysis of data.Results: The mean age of the individuals receiving HHCS who participated in thestudy was 61.6±10.4 years; a majority were female; 50.8% were married and 78.0%lived with their families, and for 70%, their children had applied to HHCS. It wasfound that most of the patients (96.1%) were satisfied with the home care services,97.6% had no expectations beyond the current services, 80.1% had a chronic illness,with circulatory system diseases the most common; they most often made use ofphysical examination, blood collection and wound dressing services, and most wereold and dependent patients.Conclusions: It was seen in the light of the results of the study that it is important toplan home health care services especially for dependent and semi-dependent oldpeople, to develop protective health services relating to the risks of early stage strokeand cardiovascular disease, and to improve rehabilitation services.Amaç: Bu araştırma, Bolu Evde Sağlık Hizmetleri (ESH) biriminde, hizmet kapsamına alınan hastaların klinik özellikleri, evde bakım hizmetinden yararlanma nedenleri ve hizmet dağılımlarının belirlenmesi amacıyla planlanmıştır. Gereç ve Yöntem: Tanımlayıcı olarak planlanan bu araştırmanın örneklemini Bolu ESH biriminde hizmet verilen toplam 386 hasta oluşturmuştur. Veriler, araştırmacılar tarafından ilgili literatür incelenerek oluşturulan “Hasta Bilgi Formu” kullanılarak toplanmıştır. Verilerin analizinde sayı, yüzde ve ortalama dağılımları kullanılmıştır. Bulgular: Araştırmaya katılan ESH alan bireylerin yaş ortalamasının 61.6±10.4 yıl ve çoğunluğunun kadın olduğu, %50.8’inin evli ve %78.0’inin ailesi ile birlikte yaşadığı, %70’inin ESH’ne çocuklarının başvuru yaptığı saptanmıştır. Hastaların çoğunluğunun (%96.1) evde bakım hizmetlerinden memnun oldukları, mevcut hizmetlerin dışında beklentilerinin olmadığı (%97.6), çoğunluğunun kronik hastalığının olduğu (%80.1) ve dolaşım sistemi hastalıklarının ön planda olduğu, en fazla fizik muayene, kan alma ve pansuman hizmetinden yaralandıkları ve büyük çoğunluğunun yaşlı ve bağımlı hastalardan oluştuğu saptanmıştır. Sonuç: Araştırma sonuçları doğrultusunda ESH’nin özellikle bağımlı ve yarı bağımlı, yaşlı kişilere yönelik planlanması, erken dönemde inme ve kardiyovasküler hastalık risklerine ilişkin koruyucu sağlık hizmetlerinin geliştirilmesi ve rehabilitasyon hizmetlerinin geliştirilmesinin önemli olduğu götürülmüştü

Understanding Covid-19 Management Process in Health Care Facilities Using Functional Resonance Analysis Method

COVID-19 was identified in Wuhan, China, in December of 2019. Afterwards, it spreads all over the World and causes many difficulties in health management in many countries. Many risk analysis methods have been applied to control and minimize contamination risks.This study aims to understand the COVID-19 management process in health care facilities using the Functional Resonance Analysis Method (FRAM) to facilitate the safety analysis, taking account of the system response to different operating conditions and various risks.The hospital process of COVID-19 patient is examined in three public and one private hospital in Istanbul/Turkey. The information is taken with teleconference meetings over 34 hours with 16 doctors and 12 nurses during a month. The model is applied by "FRAM Model Visualizer" to determine potential couplings between the functions and their potential impact on the hospital process. Fourteen functions are identified to analyze the hospital process of a patient, and multiple scenarios are developed with consideration for the progress conditions of the system. It has been concluded that FRAM does not remain at the conceptual level with application studies, but it is very suitable for many complex systems such as case analyzes such as pandemic and disaster scenarios. Keywords: COVID-19, pandemic, Functional resonance analysis method, Health care facilities DOI: 10.7176/JHMN/80-13 Publication date:September 30th 202

Preseptal and orbital cellulitis

ABSTRACT Preseptal cellulitis (PC) is defined as an inflammation of the eyelid and surrounding skin, whereas orbital cellulitis (OC) is an inflammation of the posterior septum of the eyelid affecting the orbit and its contents. Periorbital tissues may become infected as a result of trauma (including insect bites) or primary bacteremia. Orbital cellulitis generally occurs as a complication of sinusitis. The most commonly isolated organisms are Staphylococcus aureus, Streptococcus pneumoniae, S. epidermidis, Haempphilus influenzae, Moraxella catarrhalis and S. pyogenes. The method for the diagnosis of OS and PS is computed tomography. Using effective antibiotics is a mainstay for the treatment of PC and OC. There is an agreement that surgical drainage should be performed in cases of complete ophthalmoplegia or significant visual impairment or large abscesses formation. This infections are also at a greater risk of acute visual loss, cavernous sinus thrombosis, meningitis, cerebritis, endophthalmitis, and brain abscess in children. Early diagnosis and appropriate treatment are crucial to control the infection. Bu enfeksiyonlar çocuklarda akut görme kaybı, kavernöz sinus trombozu, menenjit, serebrit, endoftalmi, beyin absesi gibi komplikasyonlara neden olabilir. Bu nedenle bu enfeksiyonların erken tanınması ve doğru tedavi edilmesi oluşabi-lecek ciddi enfeksiyonların önlenmesi açısından çok önemlidir. Bu yazıda PS ve OS'nin tanı, tedavi, yönetim ve komplikasyonları özetlendi

DEQ-MPI: A Deep Equilibrium Reconstruction with Learned Consistency for Magnetic Particle Imaging

Magnetic particle imaging (MPI) offers unparalleled contrast and resolution for tracing magnetic nanoparticles. A common imaging procedure calibrates a system matrix (SM) that is used to reconstruct data from subsequent scans. The ill-posed reconstruction problem can be solved by simultaneously enforcing data consistency based on the SM and regularizing the solution based on an image prior. Traditional hand-crafted priors cannot capture the complex attributes of MPI images, whereas recent MPI methods based on learned priors can suffer from extensive inference times or limited generalization performance. Here, we introduce a novel physics-driven method for MPI reconstruction based on a deep equilibrium model with learned data consistency (DEQ-MPI). DEQ-MPI reconstructs images by augmenting neural networks into an iterative optimization, as inspired by unrolling methods in deep learning. Yet, conventional unrolling methods are computationally restricted to few iterations resulting in non-convergent solutions, and they use hand-crafted consistency measures that can yield suboptimal capture of the data distribution. DEQ-MPI instead trains an implicit mapping to maximize the quality of a convergent solution, and it incorporates a learned consistency measure to better account for the data distribution. Demonstrations on simulated and experimental data indicate that DEQ-MPI achieves superior image quality and competitive inference time to state-of-the-art MPI reconstruction methods

TranSMS: Transformers for Super-Resolution Calibration in Magnetic Particle Imaging

Magnetic particle imaging (MPI) offers exceptional contrast for magnetic nanoparticles (MNP) at high spatio-temporal resolution. A common procedure in MPI starts with a calibration scan to measure the system matrix (SM), which is then used to set up an inverse problem to reconstruct images of the MNP distribution during subsequent scans. This calibration enables the reconstruction to sensitively account for various system imperfections. Yet time-consuming SM measurements have to be repeated under notable changes in system properties. Here, we introduce a novel deep learning approach for accelerated MPI calibration based on Transformers for SM super-resolution (TranSMS). Low-resolution SM measurements are performed using large MNP samples for improved signal-to-noise ratio efficiency, and the high-resolution SM is super-resolved via model-based deep learning. TranSMS leverages a vision transformer module to capture contextual relationships in low-resolution input images, a dense convolutional module for localizing high-resolution image features, and a data-consistency module to ensure measurement fidelity. Demonstrations on simulated and experimental data indicate that TranSMS significantly improves SM recovery and MPI reconstruction for up to 64-fold acceleration in two-dimensional imaging

The prevalence of drug-drug interactions and reported therapy related side-effects in oncology out-patients

Objective: The use of multiple medications in cancer patients is unavoidable; thus, adverse drug-drug interactions are frequent. This study aims to assess the prevalence of potential drug interactions in oncology patients visiting the outpatient chemotherapy unit. Method: Demographic and health-related information of patients visiting an outpatient chemotherapy unit was recorded using a pre-prepared form. A comprehensive list of all concurrently used medications was compiled and checked for interactions with the Micromedex online drug interaction tool.Results: A total of 179 adult patients were included. We recorded an average of 9.3 drugs per patient with 79 patients using more than 10 drugs. A total of 1671 drugs including 303 chemotherapeutic agents were assessed for drug-drug interactions. A total of 374 interactions, of which 203 were significant, were recorded in 118 (65.9%) patients with an average of 3.2 interactions per patient. Only 46 major interactions were recorded for anticancer agents. Cyclophosphamide (n=13) and cisplatin (n=12) were involved in most interactions. The number of interactions correlated with the number of drugs used (p=.001) and the presence of comorbidities (p=.002). The presence of comorbidities increased the risk of interaction by 1.21 (p=.04). Recorded side effects were not correlated to drug interactions. Conclusion: Medication review in cancer patients is essential in establishing all medications used by patients. Routine assessment in terms of potential drug interactions and evaluation of these interactions by a qualified pharmacist may help in optimizing patient outcomes

An ontology based approach in health information systems: Blood test ontology example

<span>Health domain is a complex and distributed research area, where different institutions and people take and provide service, at the same time. Therefore, the health data about a patient is completely distributed among doctors, clinics, hospitals, pharmacies and insurance companies. To share and reuse the distributed, well-structured and semantically rich clinical data with the appropriate permissions from anywhere is one of the major areas that the research of information systems focused in healthcare domain in recent years. The semantic web provides a technological infrastructure with representing the meaning of data and reasoning new information from the existing knowledge for the healthcare domain. The blood, as the life fluid, gives hints to the clinicians about a patient's general health status by analyzing the ingredients in. The results of blood tests contain lots of information that can be used by different clinics. In the diagnostic phase, analyzing the blood for the same tests repeatedly delays to start the treatment process and increases the cost. The Blood Test Ontology is developed to model the blood tests semantically that is done in the health field and also to define information related with the blood and the blood tests as well as the relationships between them. The ontology in this work is developed with the aim to be used in the health information system, which should provide the querying, sharing and reusing the personalized the blood test result of the patients, as a knowledge base. The Blood Test Ontology is supported by the medical information standards to be able to interoperable with the other medical ontologies that are developed in the health.</span

DISTRICT DESIGN AND ROUTE PLANNING FOR CUSTOMER-RELATED FIELD OPERATIONS OF NATURAL GAS DISTRIBUTION SYSTEMS: A CASE STUDY

Dünya enerji ihtiyacının yaklaşık % 24'ü doğalgazdan karşılanmaktadır. Bir şehirde, doğal gaz dağıtım sistemi, yapım, işletme, iç tesisat ve müşteri hizmetleri olmak üzere birbirine bağlı dört ana süreçten oluşur. Bu çalışmada, dağıtım sisteminin müşteri ile doğrudan ilişkili olan müşteri hizmetleri süreçleri ele alınmıştır. Bölgesel ayrım, rota planlaması ve mobil ekip iş yükü tahsisi gibi müşteri hizmetleri süreçleri için matematiksel modeller önerilmiş ve Konya'nın yetkili doğal gaz dağıtım şirketi olan Gaznet A.Ş.'de uygulanmıştır. Önerilen modellerin performansı, mobil ekip sayısı ve iş yükü miktarı açısından mevcut sistemle karşılaştırılmıştır. Deneysel çalışmalar, önerilen sistemin mobil ekip sayısının mevcut sistemden % 37 daha düşük olduğunu göstermektedir