Afet yönetiminde kritik başarı faktörlerini belirlemek için analitik hiyerarşi prosesi ve metin madenciliği destekli bir model önerisi

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.Afetler tarih boyunca kayda değer miktarda can kaybına ve maddi hasara sebep olan büyük yıkımlara yol açmıştır. Bu nedenle yıllar içerisinde afet ile mücadele hem akade-mik hem de uygulamanın temel odak noktası olmuştur. Günümüz yüksek teknolojisi ile dâhi doğal afetleri önlemek mümkün olmadığından, bu mücadele afetleri önlemekten ziyade, afet öncesi, sırası ve sonrasındaki zarar azaltma ve yeniden yapılandırma çalışmalarında olmaktadır. Fakat çok sayıda paydaşı barındıran, afet yönetimi olarak adlandırılan bu sürece etki eden oldukça fazla faktör söz konusudur. Bu faktörlerin hangisinin daha kritik olduğunu belirleyebilmek, özellikle pratikte çok önemli faydalar sağlayabilir. Çalışmamızda afet yönetimi literatürü üzerinde kapsamlı bir sistematik inceleme gerçekleştirilerek bu alanın paydaşlarından olan alan uzmanları ve akademik uzmanların bakış açılarını yansıtacak ortak bir kritik başarı faktörleri modeli oluşturmak amaçlanmıştır. Bu bağlamda akademisyen ve uzmanların bakış açılarının entegre edilebileceği metin madenciliği ile destekli yeni bir Analitik Hiyerarşi Süreci (AHP) modeli çalışmada önerilmiştir. Bu modelle kritik başarı faktörlerini belirleyebilecek bir önceliklendirme yaklaşımı sunulmuştur. Modelin uygulanmasında 20 uzmana ait görüşler ile 2000-2016 yılları arasında yayınlanmış 773 tam metin makaleden elde edilen metin madenciliği çıktıları kullanılmıştır. Analiz sonuçlarına göre entegre modelde sosyo-kültürel faktörler ön plana çıkarken; akademik yayınların odağının büyük oranda teknolojik alana kaydığı ve bu alanın akademik uzmanlarca afet yönetiminde oldukça önemli olduğu tespit edilmiştir. AHP analiz sonuçlarında yasal faktörler, alan uzmanlarının görüşleri doğrultusunda önemli olarak değerlendirilmiştir. Bu iki bakış açısının ise örgütsel alanda büyük ölçüde; ekonomik, sosyo-kültürel, çevresel ve yasal alanlarda ise nispeten örtüştüğü ortaya çıkmıştır.Throughout history, disasters have led to massive destruction which has caused considerable loss of life and financial damage. For this reason, dealing with the disaster has been the main focus of both academic literature and practice over the years. Since it is not pos-sible to prevent natural disasters even with today's high technology, main focus takes place in the works of mitigation and restructuring before, during and after the disaster rather than preventing disasters. But there are a lot of factors affecting this process, also called disaster management, which has a large number of stakeholders. To determine which of these factors is more critical can also provide significant benefits in practice. In our study, a comprehensive systematic review of the disaster management literature was conducted to create a model of critical success factors that would reflect the perspectives of field experts and academicians. In this context, a new model of Analytical Hierarchy Process supported by text mining, in which the perspectives of academics and experts can be integrated, has been proposed. With this model, a prioritization approach that can determine the critical success factors is presented. In the implementation of the model, the opinions of 20 experts and the text mining outputs obtained from 773 full text articles published between 2000-2016 were used. According to the results of the analysis, socio-cultural factors come to the forefront in the integrated model; It has been determined that the focus of academic publications has shifted to a great extent in the field of technology and this field is very important in the management of disaster by academic experts. In the results of Analytical Hierarchy Process analysis, legal factors were evaluated as important according to the opinions of field experts. These two perspectives were overlapped in economic, socio-cultural, environ-mental and legal fields, especially in the organizational field

Evde Bakım Hastalarında Görülen Yeni Ürolojik Problemler: Çıkmayan Sondalar

Amaç: Evde sağlık hizmeti alan hastalardaki ürolojik problemlerin ve çözüm önerilerinin değerlendirilmesi amaçlanmıştır. Gereç-Yöntem: Çalışmaya, Ocak 2017- Şubat 2019 yılları arasında evde sağlık hizmeti alan ve her ay düzenli takibi yapılan 1950 hasta içerisinden kronik üretral kateter kullanımı olan 99 hasta alındı. Hastaların ve sağlık personelinin karşılaştığı problemler, bu problemler ile baş edilme yöntemleri ve üroloji uzmanına başvuru nedenleri kaydedildi. Bulgular: Çalışmaya alınan hastaların ortalama yaşları 77,3 (48-96) idi. Hastaların 55’i (%55,5) erkek idi. Evde bakım hastalarının birincil hastalıkları arasında en çok görülen 58 (%58,5) ile nörolojik sorunlardı. Karşılaşılan ürolojik sorunlar ise sırası ile %18,1 hastada üriner enfeksiyon, %18,1 hastada sondanın çıkmaması, %15,1 hastada kronik irritasyona bağlı üretral erozyon ve %8 hastada hematüri görüldü. Üriner enfeksiyonu olan hastalara antibiyoterapi uygulandı. Hematüri, irrigasyon yapılarak ve antikoagülan kullanımı kesilebiliyorsa ara verilerek yerinde tedavi edildi. Üretromeatal erozyonu olan hastalarda prezervatif sondaya geçildi yada temiz aralıklı kateterizasyon yapılıp lokal pomad kullanılarak tedavi edildi. Sondası çıkartılamayan hastalar üroloji uzmanına danışılmak üzere hastaneye getirildi ve sonda girişimsel işlemler uygulanarak (üretral veya suprapubik) çıkarıldı. Sonuç: Evde bakım hastalarının karşılaştığı sorunlar içerisinde ürolojik problemler yaklaşık %60 oranında görülmekte olup, bu problemlerin düşük bir oranı üroloji uzman desteği gerektirmektedir

Factors Affecting the Attitudes of Women toward Family Planning

Everyone has the right to decide on the number and timing of children without discrimination, violence and oppression, to have the necessary information and facilities for it, to access sexual and reproductive health services at the highest standard. Deficient or incorrect family planning methods, wrong attitudes and behaviors toward the methods and consequent unplanned pregnancies, increased maternal and infant mortality rates are the main health problems in most countries. Individuals’ learning modern family planning methods and having positive attitude for these methods may increase the usage of these methods and contributes the formation of healthy communities. It is considered important to examine the current attitudes and determinants in order to spread the choice of effective method

Endoscopic Excision of Cribriform Plate Schwannoma: A Case Report

Although 25-45% of all schwannomas occur in the head and neck, nasal and paranasal sinus presentations are rare in the literature. Here we report the case of a 67-year-old woman with a nasal schwannoma. Computerized tomography (CT) showed the mass completely occluding the nasal passage with evidence of a secondary maxillary sinusitis. A preoperative biopsy suggested the presence of a benign schwannoma. She underwent a complete endoscopic sinus surgery to remove the mass arising from the cribriform plate. Six years after surgery, the patient remains asymptomatic and without endoscopic evidence of recurrence. This case demonstrates that it is possible to achieve a complete excision of a nasal schwannoma endoscopically, which is similar to results observed for other benign nasal tumors

Adenoid Vegetation in Children with Allergic Rhinitis

Objective:Pediatric patients with nasal obstruction due to adenoid vegetation (AV) can also encounter allergic rhinitis (AR) as a comorbidity. The aim of the study was to estimate the incidence of mite sensitization and its effect on adenoid size in children who underwent adenoidectomy.Methods:This prospective randomized study conducted between August and September 2014 included 84 children. Skin Prick Test (SPT) for inhalant allergens was preoperatively applied to all children who underwent adenoidectomy for nasal obstruction. Children were divided into two study groups: AV only (Group I) (n=52) and AV with Dermatophagoides Pteronyssinus and/or D. farinae allergy (Group II) (n=32). Postoperative specimen volumes, visual analogue scale (VAS) scores, and adenoid volumes measured using flexible fiberoptic nasopharyngolaryngoscopy were compared between the two groups.Results:Postoperative specimen volume measures were higher in Group II compared with those in Group I (p<0.05). Furthermore, in preoperative endoscopic examination, adenoid volume measures were higher in Group II compared with those in Group I (p<0.05). Pre and postoperative VAS scores in SPT+ group were higher in the Group II (p<0.05) than those in Group I.Conclusion:We observed that children with AR tend to have an early onset of symptoms of adenoid hypertrophy. We believe that focusing on the management of role of allergy regarding these early symptoms will reduce the need for surgery in a large number of cases. We suggest that SPT must be performed in all children with AV and adenoid examination should not be neglected in children with AR

Occupational Allergic Diseases in Kitchen and Health Care Workers: An Underestimated Health Issue

Objective. This study evaluated the frequencies of allergic symptoms and rate of upper respiratory infections during the past year in the general population, kitchen workers (KW) and health care workers (HCW). Methods. The European Community Respiratory Health Survey (ECRHS) was used to inquire retrospectively about asthma and asthma-like symptoms and the number of treatments required for previous upper respiratory tract infections (URTI: acute pharyngitis, acute sinusitis, etc.) during the past year for health care workers, kitchen workers, and members of the general population. Adjusted odds ratios by gender, age, and smoking status were calculated. Results. 579 subjects (186 from the general population, 205 KW, and 188 HCW; 263 females, 316 males) participated in the study. Noninfectious (allergic) rhinitis was significantly higher in the HCW and KW groups than in the general population (P < 0.001). Cumulative asthma was significantly higher only in the HCW group (P < 0.05). In addition, the HCW and KW groups had significantly higher risks of ≥2/year URTI (OR: 1.59, 95% CI: 1.07–2.38 versus OR: 1.57, 95% CI: 1.05–2.38) than the general population. Conclusion. Occupational allergic respiratory diseases are an important and growing health issue. Health care providers should become familiar with workplace environments and environmental causes of occupational rhinitis and asthma

Clinical Study Gastric Decompression Decreases Postoperative Nausea and Vomiting in ENT Surgery

There is a passive blood flow to the stomach during oral and nasal surgery. It may cause postoperative nausea and vomiting (PONV). We researched the relationship between gastric decompression (GD) and severity of PONV in ear, nose, and throat (ENT) surgery. 137 patients who have been into ENT surgery were included in the study. In Group I ( = 70), patients received GD after surgery before extubation; patients in Group II ( = 67) did not receive GD. In postoperative 2nd, 4th, 8th, and 12th hours, the number and ratio of patients demonstrating PONV were detected to be significantly more in Group II as compared to Group I. PONV was also significantly more severe in Group II as compared to Group I. In Group I, the PONV ratio in the 2nd hour was significantly more for those whose amounts of stomach content aspired were more than 10 mL as compared to those whose stomach content aspired was less than 10 mL. In the 4th, 8th, and 24th hours, there is no statistically significant difference between the stomach content aspired and PONV ratio. GD reduces the incidence and severity of PONV in ENT surgery

Assessment of knowledge, attitudes, and behaviors regarding breast and cervical cancer among women in western Turkey.

Objective We aimed to assess knowledge, attitudes, and practices regarding breast and cervical cancer and screening methods among women living western Turkey. Methods A questionnaire survey was administered to women aged ≥21 years. Data were collected using a 12-item questionnaire measuring women's knowledge, attitudes, and practice levels, including among participants who were health workers. Results A total 668 women were included in the study. The average age was 37.48 ± 11.85 years. Most women had a primary-level education (43.4%) and most (50.3%) were homemakers; 27.1% of participants were health care workers. The differences in age, education, and occupation among participants were evaluated according to whether participants perform breast self-examination and have undergone Pap testing. The distribution of women according to age group showed that with increased age, the frequency of performing these two behaviors decreased, with women over 55 years old accounting for a significantly higher proportion than other age groups. Conclusions In our study, the level of knowledge and attitudes regarding breast and cervical cancers among women was similar to that in previous studies and was higher than expected, especially among women who were health workers. However, all women had inadequate frequency of performing screening tests