Molecular characterization of human and animal isolates of echinococcus granulosus in the thrace region, Turkey

Amaç: Echinococcus granulosus insanlarda ve birçok evcil hayvanda kistik ekinokokkozisin etkenidir ve dünya çapında önemli bir halk sağlığı sorunudur. Bu çalışmanın amacı Türkiye’nin Trakya bölgesinde insanlardan ve hayvanlardan elde edilen E. granulosus izolatlarının genotipini belirlemektir. Gereç ve Yöntemler: Edirne ilinde çeşitli hastanelerde opere edilen insanlardan ve kesimhanedeki hayvanlardan toplam 58 izolat elde edildi. E. granulosus’un insan ve hayvan izolatlarını karakterize etmek için; ribozomal birinci internal transcribed spacer fragmanının analizi için PCR-RFLP (polimeraz zincir reaksiyonu - restriksiyon fragman uzunluğu polimorfizmi) yöntemi ve parsiyel mitokondriyal NADH dehidrogenaz subunit 1 geninin analizi için PCR-SSCP (polimeraz zincir reaksiyonu - tek sarmal konformasyon polimorfizmi) yöntemi kullanıldı. İzolatların genetik özelliklerinin ileri incelemeleri için mitokondriyal sitokrom oksidaz c subunit 1 (CO1) ve NADH dehidrogenaz subunit 1 (ND1) gen bölgelerinin DNA (deoksiribonükleik asit) dizi analizi yapıldı. Bulgular: Kırk iki insan, 13 sığır ve 3 koyun kökenli olan 58 E. granulosus izolatı analiz edildi. Sonuçlar G1 (evcil koyun suşu) ve G7 (domuz suşu) olmak üzere iki farklı genotip bulunduğunu gösterdi. İnsan, koyun ve sığırları etkileyen E. granulosus’un en yaygın genotipinin koyun suşu olduğu gösterildi. Parsiyel mitokondriyal CO1 ve ND1 verileri birlikte değerlendirildiğinde mevcut çalışmadaki E. granulosus izolatlarında 8 haplotip tanımlandı. Sonuç: Bu çalışma; Trakya bölgesindeki insanlarda E. granulosus’un domuz suşunun varlığını gösteren ilk rapordur. Türkiye’de E. granulosus’un kontrol programları için yeni stratejiler oluşturulmasını önermekteyiz.Objective: Echinococcus granulosus is the causative agent of cystic echinococcosis in humans and many domestic animals, and remains an important global health problem. The aim of this study was to genotype E. granulosus isolates obtained from humans and animals in the Thrace Region of Turkey. Material and Methods: A total of 58 isolates were obtained from patients who underwent surgery at several hospitals and from animals at a slaughterhouse in the province of Edirne. Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) analysis of ribosomal internal transcribed spacer 1 fragments, and polymerase chain reaction-single strand conformation polymorphism (PCR-SSCP) of the partial mitochondrial NADH dehydrogenase subunit 1 (ND1) gene, was used to characterize human and animal E. granulosus isolates. To investigate the genetic characteristics of isolates, deoxyribonucleic acid (DNA) sequencing of the mitochondrial cytochrome c oxidase subunit 1 (CO1) and ND1 genes was performed. Results: Fifty-eight E. granulosus isolates, including 42 from human, 13 from cattle and 3 from sheep were, analyzed. The results indicated two distinct genotypes: the G1 (sheep strain) and G7 (pig strain) genotypes. The sheep strain was shown to be the most common genotype of E. granulosus affecting humans, sheep and cattle. Among the concatenated partial CO1 and ND1 sequence data, eight haplotypes of Echinococcus species were identified in the present study. Conclusion: This is the first report indicating that the E. granulosus pig strain is present in humans in this region. We suggest that new strategies be designed for E. granulosus control programs in Turkey

Resistance Rates of Mycobacterium Tuberculosis Complex Isolates Obtained From Clinical Samples to Major Antituberculous Drugs: a Study in Edirne, Turkey

DergiPark: 439208tmsjAims: The aim of this study is to reveal the rates of the Mycobacterium tuberculosis complex resistance to major antituberculous drugs (streptomycin, isoniazid, rifampicin, ethambutol) by the evaluation of the specimens that are sent to Trakya University Hospital Microbiology Laboratory. Methods:In this study, laboratory data of the cases that were pre-diagnosed with tuberculosis between 11/02/2016 and 31/12/2017 were scanned retrospectively. To compare the annual data descriptive statistics as arithmetic mean, numbers and percentages were used. Results: Out of 4752 samples, 133 (2.79%) were culture positive. 120 isolates were identified as Mycobacterium tuberculosis complex, while other 13 were defined as Mycobacterium other than tuberculosis. Antimycobacterial susceptibility tests showed that 9 (7.5%) isolates were resistant to streptomycin, 10 (8.33%) isolates to isoniazid, 4 (3.33%) isolates to rifampicin, 4 (3.33) isolates to ethambutol. 5 (4.16%) isolates were multidrug resistant. Conclusion: Antituberculous drug resistance is still a threat for an effective treatment of tuberculosis and streptomycin resistance has increased. However, it is also pointed out that presence of Mycobacterium other than tuberculosis in isolates has increase

Antifungal susceptibilities of aspergillus SPP. strains isolated from invasive aspergillosis cases

Çevrede ve hastane ortamında yaygın olarak bulunan Aspergillus türleri, özellikle bağışıklık sistemi yetersiz ya da baskılanmış hastalarda ciddi morbidite ve mortalite etkenidir. Bu retrospektif çalışmada, hastanede yatan hastaların klinik örneklerinden etken olarak izole edilen Aspergillus spp. suşlarının antifungal duyarlılıklarının araştırılması amaçlanmıştır. Çalışmaya, Ocak 2002-Ekim 2007 tarihleri arasında mantar enfeksiyonu şüphesi ile laboratuvarımıza gönderilen 569 hastaya ait toplam 678 örnek (420 solunum yolu örneği, 202 steril vücut sıvısı örneği, 56 biyopsi/doku örneği) dahil edilmiştir. Örnekler, beyin kalp infüzyonlu kanlı agar ve Sabouraud dekstroz agara ekilerek 25°C ve 35°C’de inkübe edilmiş; ayrıca tüm örneklerden hazırlanan Gram ve Giemsa boyalı preparatlar direkt mikroskobik olarak incelenmiştir. Küf mantarı üreyen örneklerde tanımlama konvansiyonel yöntemlerle yapılmış; olgularda “invazif aspergilloz” tanımı ise, Avrupa Kanser Araştırma ve Tedavi Kuruluşu, İnvazif Fungal Enfeksiyon Çalışma Grubunun aspergilloz tanı kriterlerine göre yapılmıştır. Çalışmada, tümünde malignite gibi altta yatan bir faktör olan 12 (%2.1) olgunun klinik örneklerinden (9 alt solunum yolu, birer asit, beyin biyopsisi ve plevral sıvı örneği) Aspergillus spp. izole edilmiş ve bu suşlar A.fumigatus (n= 8), A.flavus (n= 2) ve A.niger (n= 2) olarak tanımlanmıştır. İzolatların, kaspofungin, vorikonazol, itrakonazol ve amfoterisin B’ye karşı duyarlılıkları buyyon mikrodilüsyon yöntemiyle, posakonazole karşı duyarlılıkları ise E-test (AB Biodisk, İsveç) yöntemi ile araştırılmıştır. Aspergillus spp. suşlarında en düşük minimum inhibitör konsantrasyonu (MİK) değerleri kaspofungin ve posakonazol için (≤ 0.125 µg/ml); en yüksek MİK değerleri ise amfoterisin B için (≥ 1 µg/ml) tespit edilmiştir. Vorikonazol ve itrakonazol için, biri hariç tüm suşlarda MİK değerleri ≤ 0.5 µg/ml saptanırken, sadece bir A.niger suşunda itrakonazol için 2 µg/ml değeri elde edilmiştir. Diğer türlerin sayısının az olması nedeniyle, MİK50 değerleri sadece A.fumigatus için hesaplanmış ve A.fumigatus için en yüksek MİK50 değeri amfoterisin B (2 µg/ml) için saptanırken, en düşük MİK50 değerleri sırasıyla; posakonazol (0.064 µg/ml), kaspofungin (0.064 µg/ml), itrakonazol (0.25 µg/ml) ve vorikonazol (0.25 µg/ml) için belirlenmiştir. Sonuç olarak, suş sayımızın az olmasına rağmen, kaspofungin ve posakonazol için en düşük MİK değerlerinin tespit edilmiş olması, bu yeni antifungallerin hastanemizde aspergillozlu olguların tedavisinde akılda tutulması gereken seçenekler olduğunu vurgulamaktadır.Aspergillus species found abundantly in the outer environment and hospital setting may lead to serious morbidity and mortality particularly in patients with suppressed immunity This retrospective study was aimed to investigate the antifungal susceptibilities of Aspergillus spp isolated from aspergillosis cases being hospitalized Aspergillus spp. isolated from samples of the patients with suspected fungal infections between January of 2002 and October of 2007, were investigated A total of 678 samples (420 lower respiratory tract, 202 sterile body fluids, and 56 biopsy/tissue specimens) from 569 patients were included in the study. The samples were incubated in 25 degrees C and 35 degrees C on brain-heart-infusion agar supplemented with blood and on Sabouraud dextrose agar Gram and Giemsa stained samples were also examined by microscopy Mold type of fungi were identified by conventional techniques "Invasive aspergillosis" was described according to criteria of Invasive Fungal Infections Cooperative Group of the European Organization for Research and Treatment of Cancer. A.fumigatus (n= 8), A.flavus (n= 2) and A niger (n= 2) were isolated from 12 patients' samples (2.1%), 9 of them were lower respiratory tract and one of each was ascid, brain biopsy and pleural fluid specimens. All of those patients have had an underlying diseases such as malignancy The susceptibility of the isolates to caspofungin, voriconazole, itraconazole and amphotericin B was tested by broth microdilution susceptibility testing and to posaconazole by E-test (AB Biodisk, Sweden). The lowest minimum inhibitory concentration (MIC) ( 1 mu g/ml) MIC values of the all strains except one, were detected as <= 0 5 mu g/ml for voriconazole and itraconazole In one A niger strain itraconazole MIC value was 2 mu g/ml Since the number of other species was low, MIC(50) value was determined only for A fumigatus strains and it was found that the highest MIC(50) value was for amphotericin B (2 mu g/ml) and the lowest MIC(50) values were for posaconazole (0.064 mu g/ml), caspofungin (0 064 mu g/ml), itraconazol (0 25 mu g/ml) and voriconazol (0.25 mu g/ml). Since caspofungin and posaconazole revealed the lowest MIC values, they should be taken into consideration in choice of therapy of aspergillosis cases in our hospital

Genotyping of Echinococcus granulosus isolates

Tıpta Uzmanlık TeziEchinococcus granulosus insanlarda ve birçok evcil hayvanda kistik ekinokokkozis etkenidir ve dünyada geniş bir dağılıma sahiptir. Kistik ekinokokkozis Türkiye'de hala önemli bir sağlık sorunudur. Bu çalışmanın amacı; Türkiye'de Trakya bölgesindeki insanlardan ve çiftlik hayvanlarından elde edilen E. granulosus izolatlarının genotiplendirilmesidir. Ocak 2009 ? Aralık 2009 tarihleri arasında Edirne'de bulunan çeşitli hastanelerde cerrahi operasyon uygulanan ve kesimhanedeki hayvanlardan toplam 58 izolat elde edildi. E. granulosus'un insan ve hayvan izolatlarını karakterize etmek için ribozomal birinci ``internal transcribed spacer'' fragmanının polimeraz zincir reaksiyonu - restriksiyon fragman uzunluğu polimorfizmi analizi ve parsiyel mitokondriyal NADH dehidrogenaz subunit 1 geninin polimeraz zincir reaksiyonu - tek sarmal konformasyon polimorfizmi yöntemi kullanıldı. Yapılan analizler E. granulosus izolatları içinde üç farklı genotip olabileceğini gösterdi. İzolatların genetik karakteristiklerinin ileri incelemeleri için mitokondriyal sitokrom oksidaz c subunit 1 ve NADH dehidrogenaz subunit 1 gen bölgelerinin dizi analizi kullanıldı. Sonuçlar G1 (evcil koyun suşu) ve G7 (domuz suşu) olmak üzere iki farklı genotip bulunduğunu gösterdi. Mevcut çalışma Türkiye'nin Trakya bölgesinde E. granulosus'un evcil koyun suşunun baskın genotip olduğunu göstermektedir. Yapılan çalışma bu bölgede domuz suşunun bulunduğunu gösteren ilk rapordur. Bu bilgi bu bölge ve çevre ülkelerde hayvanlardaki parazitlerin epidemiyolojisi ve ekolojisi ile ilgili ileri çalışmalar açısından oldukça önemlidir.AbstractEchinococcus granulosus is the causative agent of cystic echinococcosis in human and many domestic animals, and has a widely distribution in the world. Cystic echinococcosis is still an important health problem in Turkey. The aim of this study is genotyping the isolates of E. granulosus obtained from human and livestock animals in Thrace region of Turkey. A total of 58 isolates were obtained from the patients who underwent surgery at several hospitals and from the animals in slaughterhouse in Edirne, between January 2009 and December 2009. Polymerase chain reaction - restriction fragment length polymorphism analysis of ribosomal internal transcribed spacer 1 fragment and polymerase chain reaction -based single strand conformation polymorphism of partial mitochondrial NADH dehydrogenase subunit 1 gene were used to characterize E. granulosus in human and animal isolates. The analysis revealed that there are three possible genotypes within E. granulosus isolates. To investigate the further genetic characteristics of isolates, deoxyribonucleic acid sequencing of mitochondrial cytochrome c oxidase subunit 1 and NADH dehydrogenase subunit 1 genes were used. The results indicated that there are two distinct genotypes, G1 (domestic sheep strain) and G7 (pig strain) in isolates. The present study revealed that domestic sheep strain is the most common genotype in Thrace region of Turkey. This is the first report indicating that E. granulosus pig strain is present in human in this region. This knowledge is quite important for future studies on the epidemiology and ecology of the parasites in animals and humans in this region and surrounding countries

Ekolojik mimarlıkla Çevreci Kentler Mümkün

Binaların güneşle ısınması, soğuması, aydınlanması, suyunu kendi içinde sağlaması katı ve sıvı atık vermeyerek çevreyi kirletmemesi; üstelik böylece inanılmaz paralar kazanılmasının önünde hiçbir teknik ve verim sorunu kalmayalı çok oldu

Poverty Reduction strategies On National And Local Level: Social Assistance Implementation On Istanbul

Tez (Yüksek Lisans) -- İstanbul Teknik Üniversitesi, Fen Bilimleri Enstitüsü, 2015Thesis (M.Sc.) -- İstanbul Technical University, Institute of Science and Technology, 2015ÖZET Yoksulluğun mutlak bir tanımı olmamasına rağmen yoksulluğu algılama ve tanımlama tarzı, ona karşı tavrımızı belirlemektedir. Yoksulluk özetle eşitsizlik anlamına gelmektedir ama nasıl bir eşitsizlikten bahsettiğimizin yanıtı önemlidir. Gelir dağılımında eşitsizlik, kaynakların dağılımında eşitsizlik, hizmetlerin kalitesinde ve erişilebilirliğinde eşitsizlik, neticede bireyin kendini yeniden üretmesinde yaşanılan eşitsizliktir. Yoksulluk ölçümleri yapılırken önce gelir ve tüketim harcamalarına bakılsa dahi bugün bunun yeterli olmadığı, bazı sosyal ve siyasal gelişmişlik kriterlerinin de hesaplamaya katılması gerektiği görülmüştür. Yoksulluğun kısacası  eşitsizliğin etkilerini hafifletmek, toplumsal kriz oluşmasının önüne geçmek ve yönetilebilir kılmak için özellikle gelişmekte olan ülkelere uluslararası kuruluşlarında yönlendirmesiyle devletlerin uyguladığı yöntem isesosyal politikadır. Sosyal politikanın yöntemsel olarak uygulanması sosyal koruma araçlarıyla olmaktadır. Sosyal sigorta, sosyal hizmetler ve sosyal yardımlar sosyal korumanın bileşenleridir. Yoksulluğu azaltma aracı olarak sosyal yardımlar bu bileşenlerin içinde son başvurulan, diğer bileşenlerin çözemediği sorunlarda destek alınması gereken bir araçtır. Günümüzde merkezi yönetimden yerel yönetime inen bir hiyerarşide sosyal yardımlara verilen önemin arttığı ve can simidi işlevi gördüğünü düşünülmektedir. Bu sebeple tez kapsamında, 2000’li yıllardan sonra uluslararası kuruluşların gelişmekte olan ülkelere bilgi üretimi ve yönlendirme anlamında en önemli kuruluşlardan biri olan Dünya Bankası’nın sosyal yardımlara dair uygulama ve söylemelerinden başlanarak,  ulusal düzeyde ve yerel yönetimlerin sosyal yardım anlayışı incelenmiştir. Yapılan incelemede söylem bazlı Dünya Bankası’nın çizdiği çerçeve ile merkezi yönetimin çizdiği çerçeve arasında fark bulunmamaktadır. Çalışmanın kuramsal arka planında yoksulluk, yoksulluğa değişen yaklaşımlar, yoksulluk ölçüm yöntemleri, büyüme ve gelir dağılımı arasındaki ilişkiye bakılmıştır. Kuramsal arka planının ardından bu tez kapsamında incelenen sosyal devlet, sosyal politika, sosyal koruma ve sosyal yardım kavramlarına yaklaşım netleştirilmeye çalışılmış bununla beraber Dünya Bankası’nın yoksulluğu azaltma araçları üretmede, yönlendirmede ve uygulamada nasıl bir yaklaşım içinde olduğu, özellikle gelişmekte olan ülkelerin karar alıcıları içinde nasıl bir konuma sahip olduğu belirtilmiştir. Sosyal yardım uygulama sürecinde hiyerarşik olarak üstten alta inecek şekilde tüm aktörlerin konumları ve rolleri ortaya konulmuştur. Çalışmanın saha kısmında merkezi yönetimin sosyal politika uygulamaları ve merkezi yönetimin kararlarının yerel yönetimleri nasıl etkilediğine değinilerek İstanbul Bölgesi’nde yerel yönetimlerin değişen sosyal yardım uygulamaları incelenmiştir. İstanbul Büyükşehir Beldiyesi’nin uygulamalarından başlanmış daha sonra, merkezde yer alan iktidar ve muhalefet parti yönetiminde iki belediye (Beyoğlu ve Şişli Belediyesi) ve çeperde yer alan iktidar ve muhalefet parti yönetiminde (Beylikdüzü ve Bağcılar Belediyesi) alınan istatistiki veriler ve derinlemesine uzman görüşmeleri kullanılmıştır. Merkezi yönetim faydalanıcıları belirlerken her ne kadar ilk aşamada nesnel yöntemleri kullansalarda nihai karar mütevelli heyetine bırakılmaktadır.Yerel yönetimler ise nesnel hiçbir yöntem kullanmamakla beraber yararlanıcıları belirlerken merkezi yönetimle biçim olarak aynı süreçlere sahiptir. Erişilen bilgiler ve yapılan hesaplamalarda belediyelerin yaptıkları sosyal yardım faaliyetlerin sadece nüfusun en muhtaç kesimini karşılayacak şekilde yapıldığı görülmüştür.In this study that is starting from the social assistance policies developed in the national scale and reaching to the local scale, the role of the social assistances as a social policy instrument within the poverty reduction strategies was examined through the case study of Istanbul. The sample of Istanbul was analyzed by way of the implications of central and local administrations. In this framework, which actors have taken a part and what kind of roles they have had sought in the manner of showing the hierarchy from the internatonal level to the national and local levels. How the neoliberal policies after 2000 and the changing approaches of international institutions to the concept of social policy have affected the national and local scale policy making processes was examined. Hereby, the increasing importance of developing an appropriate social policy in an atmosphere that income inequality is continously increasing was argued. For this aim, by providing some samples from certain municipalities of Istanbul, the social policy development methods and implications were examined in the urban scale. How the social assistances as an instrument have contributed to the poverty reduction was investigated. The necessity of tackling poverty multidimensionally and whether the approach of giving the main role to the social assistances in the poverty reduction strategies has been effective or not was revealed.  Within the scope of this study, the concepts of poverty, social policy, social protection and social assistance were elaborated conceptually. The relationship between the World Bank Reports and the Development Plans was revealed and the changing implications of central and local administrations were examined. The social policies determined by the World Bank for the developing countries, especially Turkey, were semtinized and the effects of this on the applications in Turkey was revealed. The qualification and function of the social policies in Turkey after 2000 was mentioned. In the theoretical background of the study, poverty, different approaches to the poverty, methods of poverty measurement, the relationship between growth and income distribution were searched. Subsequent to the theoretical background, the approach to the concepts of social policy, social protection and social assistance was clarified. In addition, what kind of an approach the World Bank has used in the production, direction and implication processes of the poverty reduction instruments and; what kind of an influence the World Bank has had in the decision-making processes of the developing countries were indicated. In the social assistance implication process, the roles and influences of all actors from top to bottom were revealed. Although there is not any certain definition of poverty, the way of perception and definition of poverty shows our attitude against it. Poverty does not mean inequality in brief but the answer of what kind of an inequality we are talking about is important in this point. In equality in the income distribution, inequality in the resource allocation, inquality in the quality and accessibility of services and eventually inequality in the reproduction of individuals. Even if the income and consumption expenditures are surveyed in the first instance, it is seen that this is not enough today and some social and political development criterions also must be considered at the same time. The method which is used for diminishing the effetcs of poverty or inequality in brief, preventing and controlling the social crisis and; which is applied by the states through the guidance of the international instituons is the social policy. The measurement of the poverty is important in order to develop social policy but measuring poverty by using one-way or only quantitative measurements has been inadequate. Class differences must be analyzed in detail; heterogenious structure of the poor (the poverty of woman, child, old, migrant etc) must be taken into consideration and; spatial and social disintegration must be revealed and; more clearly the view of the poverty in the social life must be drawn transparently.  Istanbul, when we look to the ratio of poverty, is not a region that has the biggest poverty but because of the population density it is accepted as a region having the biggest poverty. Because of this, examining the case of Istanbul matters. Generally, the view seeing poverty as a problem that cannot be destroyed but decreased is common. It is seen that poverty keep up –to-date as an important problem and it is not possible to sort poverty and income distribution out through economic growth. The view accepting that decreasing the poverty in the shortest term is only possible through the straight-forward approach instruments, the production of appropriate social policies is common in international and national levels. In the years when the concept of social policy first emerged, it was used for making the life of workers better (compulsorily) but today evolved into a different objectivity. Social policy still involves workers’ rights but the policies produced towards especially disdavantaged groups predominate. The procedural implementation of the social policy has been via social protection (security) instruments. Social insurance, social services and social asssistance are the components of the social protection. Indeed, social asssistance as an instrument of the poverty reduction are less frequently used instrument among these elements that involved in the problems which other elements could not overcome. At the present time it is thought that the importance given to the social asssistance have increased in a hierarchy from the centre to the local and worked as a flotation ring. It is thought that social exclusion and division decrease in a society which has appropriate social policies. When we examined the public social protection expenses since 2006, it is seen that Turkey ranges below OECD countries. Although Turkey is 17th in G-20, social protection expenses remains quite low. Full employment target is important in terms of social policy. Although it is seen that social assistances work for decresing poverty, it has been weak and inadequate in terms of targeting the poorest in the society and missing the complementary effects of other social protection elements. On the other hand, although we see that only a small proportion is left for the social assistances, it is important to emphasize that the amount of the assistance has been accelerated per year. Besides, for distributing the social assistances to the poor in the highest rate, it is necessary to determine the poverty profile of the poor correctly and to apply different programmes towards different poor groups. For this reason, within the scope of the thesis, the social benefit understanding of the local governments in Turkey after the 2000s will be examined by starting from the implications and discourses of the Wold Bank as one the most important international organisations in the information production and policy-direction for the developing countries.   The World Bank is one of the institutions producing policies in the international system and world economy. The World Bank determines the content of the concepts and sets the agenda. It is seen that the World Bank is not only an economic institution but also a political, ideological and cultural formation. Together with giving loans to the developing countries, the World Bank also makes the information production. The main attempts of the World Bank about the poverty reduction are mitigating the social risk, governing, preventing and decreasing. On the one hand the World Bank predicts a market-driven economic growth; on the other hand it makes an emphasize on the enhancement of the social capital. It emphasizes creating opportunities for the poor,  strengthening them and increasing the security of them. When we look to the social assistance policies of the central government, there are first the Ministry of Family and Social Policy (MFSP) and under its administration General Directorate of Social Assistance and Solidarity (GDSA) and Foundation of Social Help and Solidarity (FSHS). The discourse arguing that one of the advantages of organisation of the FSHS as a foundation is its conformity to the principle of governance took place in the World Bank reports firstly and then the target aiming at the cooperation between central and locak administrations and NGOs writing in the Development plans shows that these plans started to be implemented. In addition, although the income of the FSHS is generated mostly from the public funds, it was also received supoort from benefactors. By establishing a foundations-network organised in the country level, the FSHS gives support with the social assistance programmes. Even though the interventions in the economic realm have been made by the state, the FSHS, which is acting as an NGO via charity activities, has provided the political continuity of the central government with the localities at the same time. The share of the MFSP taken from the general budget has increased each year and in 2014 it reached to 3,97 %. Even in the current situation, for a ministry producing social assistance and service, a low amount has been budgeted. The GDSA contained within the MFSP has had 60% more budget than the MFSP and this is an important data for understanding the increasing importance of the social assistances.  The World Bank emphasizes that health and especially education is important for increasing the social capital and the World Bank policies have evolved into the increase in the social capital rather than the assistance to the disadvantaged groups. The World Bank opened a credit to the Social Risk Mitigating Project for decreasing the effects of the 2001 crisis. The conditional cash transfer has constituted the biggest part of this project. The still ongoing conditional cash transfer implementation has been realised not via the World Bank loans but the budget of FSHS. Within this scope, conditional cash transfer programme is in the field of education and health, although the share of the education is higher.   When we look to the statictics of the institutions distributing social assistances in the national level, as we mentioned before, the main institution is the MFSP and the total ratio of the local governments is 3,9 %. Although this ratio shows that the role of the local governments in the social assistances, the increasing rate of the municipalities among the institutions providing social assistance also shows the will for increasing the responsibilities of the localities in the social assistance provision.  In the fieldwork of the study, the changing social assistance implementations of the local governments in Istanbul were examined by referring to how the central administration has affected the social policy implementations and the local governments. For this, statistical data collected from two municipalities in the center (Beyoğlu ve Şişli Municipalities) and two municipalities in the periphery (Beylikdüzü ve Bağcılar Municipalities) and in-depth interviews with the authorities were used. When we look to the social assistance provided by the local governments, it is noticed that the assistances were concentrated on the public relief rather than the financial aid. The information exchange between the local governments themselves or with the central administration is quite limited.  Although the central administration has used the objective methods firstly in the determination of the beneficiaries, the last decision was taken by the boards of trustees. On the other hand, local governments have not used any objective method but had the same processes with the central administration in the determination of the beneficiaries. According to the reached information and calculations, it is seen that the social assistance facilities of the municipalities involves only the most needy part of the population. While it is noticed that the AKP municipalities are more experienced than the CHP municipalities in terms of the social assistance (they started the social assistance earlier; they have more experienced data set and; they are more quantitatively), the CHP municipalities have concentrated on social services and socio-cultural activities more but started to increase and develop the social assistance implications by feeling the pressure of the increasing importance of the social assistance. IYüksek LisansM.Sc

Kriz yönetiminde doğru karar alma: “Agrega İşletmeleri Örneği”

06.03.2018 tarihli ve 30352 sayılı Resmi Gazetede yayımlanan “Yükseköğretim Kanunu İle Bazı Kanun Ve Kanun Hükmünde Kararnamelerde Değişiklik Yapılması Hakkında Kanun” ile 18.06.2018 tarihli “Lisansüstü Tezlerin Elektronik Ortamda Toplanması, Düzenlenmesi ve Erişime Açılmasına İlişkin Yönerge” gereğince tam metin erişime açılmıştır.21. yüzyılın beraberinde getirdiği küreselleşme süreci, hem bireyler ve hem de örgütler için degişim hızına ayak uydurmayı gerekli kılan önemli bir olgu olarak kabul edilmektedir. Sosyo-politik yaşam ve ekonomik - ticari faaliyetler esnasında oluşan küresel etkileşime bağlı olarak, kriz kavramı değişik sektörler içerisinde faaliyet gösteren her firma için sürekli dikkat gerektiren bir fenomendir.Hızlı küreselleşme sonucu yaşanan bir ekonomik kriz, ekonomik Küreselleşen dünya ekonomisinde, bir ülke içinde yaşanan kriz, diğer ülkeleri de farklı boyutlarda etkileyebilmektedir. Değeri ve faaliyet alanı ne olursan olsun her tür işletmeyi etkiler hale gelmiş ve bu durum örgütlerin kendi varlıklarını her an tehdit altında hissetmelerine yol açmaktadır. Kriz sinyallerini önceden algılayabilen örgütler, krize karşı önlemler almakta, bu da onların krizden daha az zararla ve hatta zararsız çıkmalarını sağlamaktadır.Bu çalışmanın temel amacı, krizle karşı karşıya kalan örgütlerin bu durumdan, aldıkları doğru kararlarla nasıl kurtulabileceklerini belirlemektir. Bu nedenle birinci bölümde krizin tanımı, evreleri, kaynakları, türleri, ikinci bölümde; Kriz yönetimi aşamaları, farklı yaklaşımlar, kriz yönetim türleri, krizde etkin yönetimin boyutları, karar kavramı, krizde kullanılacak karar yöntemleri, kriz döneminden insan kaynakları ve ülkemizde kriz hakkında ayrıntılı bilgiler verilmiş olup, Üçüncü ve son bölümde ise çalışmanın araştırma problemi ortaya konulmuş ve aynı sektörde farklı firmalara, kriz döneminin özelliklerini belirlemek üzere yapılmış bir anket uygulaması yer almaktadır.Görüşme sonrası toplanan bilgilerle, gerekli istatistiksel analizleri yapmak ve araştırma hipotezlerini test etmek için SPSS programı kullanılmıştır. Çalışmada frekans, ortalama, gibi tanımlayıcı istatistiklerin yanısıra, gruplar arası ortalamaların farkı için t-testi ve ki-kare analizleri kullanılmıştır.Anahtar Kelimeler: Kriz, Agrega, Karar Alma, Kriz YönetimiThe globalization process, brought by the 21th century has accepted as a phenomenon that is necessary for the organizations and individuals to abreast with its speed of change. Belong to the global interferences through economic activities and socio-politic life, the concept of crisis is now necessitating a consistent attention for every company operates in various sectors. Within the globalized world economy, crisis happened in one country can affect the other countries through multiple dimensions.An economic crisis, occurred by the effect of the globalization, has a remarkable influence on every single company no matter what its economical value or activity type and it causes the organizations reduce to feel their selves in high risk. The organizations that can perceive the signs of the crisis are able to take precautions and not or less effected from the crisis.Main purpose of this work is to determine how organizations can prevent their selves from the effects of the crisis by examining the influential and correct decisions of the organizations. In this respect, in the first part the definition, phases, resources of the crisis are tried to be given. The second part gives detailed information about, the crisis management phases, various theories, crisis management types, the dimensions of efficient crisis management, decision concept, the decision methods that are used during the crisis, human resources samples from the crisis and crisis in our country; in the third and the last part, the research problem of our study is revealed and results of a survey study aim to determine the particularities of the crisis on various companies in the same sector, is interpreted.The data gathered by the survey is tested and analyzed through the SPSS statistical analysis program. During the analysis, the definitive statistical techniques as Frequency, average calculations are used and also the t-test and chi-square tests are also used to calculate the differences between the averages within the groups.Keywords: Crisis, Aggregate, Decision Making, Crisis Management

Clinical Features of Cerebral Venous Sinus Thrombosis

Objective: To investigate the predisposing factors for cerebral venous sinus thrombosis (CVST), presenting patterns of the disease, imaging characteristics, types of treatment, and outcomes of patients. Materials and Methods: Retrospectively, between April 2011 and September 2016 at Eskisehir Osmangazi Stroke Center, the demographic data, symptoms and findings, neuroimaging and laboratory findings of patients with CVST were collected. Additionally, predisposing factors for the disease, treatment strategies, and the neurologic functions of patients at discharge were examined. Results: Thirty-one patients with CVST were included in the study, 25 of whom were female. The mean age of the patients was 43.7 years (standard deviation: 16.4; range, 22-78 years). The most common symptom was headache and the most common predisposing factors were pregnancy and puerperium. Also, transverse sinus was the most common thrombosed sinus. In the majority of patients (29/31, 93.6%), anticoagulation was applied and the Modified Rankin Scale score was 2 or below. Conclusion: In this study, we detailed the characteristics of patients with CVST at our stroke center and contrary to previous knowledge, we showed that the outcomes of patients were good. However, to achieve more accurate conclusions about treatment strategies and outcomes, we need prospective studies with larger cohort

Efficiency of Intravenous Thrombolytic Therapy in Isolated Middle Cerebral Artery Occlusions: A Computed Tomography Angiography Study

Objective: We aimed to evaluate the outcomes of two groups of patients with acute ischemic stroke who were treated with intravenous recombinant tissueplasminogen activator (IV rt-PA); those with isolated middle cerebral artery (MCA) occlusion and those without any large vessel occlusion. Materials and Methods: Data of patients treated with IV rt-PA within 4.5 hours of symptom onset between March 2015 and January 2017 were retrospectively analyzed. Patients were divided into two groups; those with isolated MCA occlusion and those with no large vessel occlusion. Large vessel occlusion was detected with contrast-enhanced computed tomography angiography performed before IV rt-PA. Additionally, demographic and clinical data of the patients were analyzed. The clinical outcomes of the patients were determined using the modified Rankin Scale (mRS) score at 3 months after treatment. Results: A total of 69 patients were included in the study. Isolated MCA occlusion was observed in 28 (40.6%) patients. The rate of very good outcome (mRS 0-1) was 46.4%, whereas the rate of poor outcome (mRS 3-6) was 42.9% in the group with isolated MCA occlusion. Moreover, in the other group, the rate of very good outcome and poor outcome were 65.9% and 26.8%, respectively. Conclusion: In acute ischemic stroke with isolated MCA occlusion, due to the favorable outcomes of the patients, IV rt-PA continues to be the best treatment option in cases where endovascular treatment options cannot be performed and it should be applied by physicians in appropriate cases without dela