"Belonging” in the gentrified Golden Horn/Halic neighbourhoods of Istanbul

Mainstream gentrification research predominantly examines experiences and motivations of the middle-class gentrifier groups, while overlooking experiences of non-gentrifying groups including the impact of in situ local processes on gentrification itself. In this paper, I discuss gentrification, neighbourhood belonging and spatial distribution of class in Istanbul by examining patterns of belonging both of gentrifiers and non-gentrifying groups in historic neighbourhoods of the Golden Horn/Halic. I use multiple correspondence analysis (MCA), a methodology rarely used in gentrification research, to explore social and symbolic borders between these two groups. I show how gentrification leads to spatial clustering by creating exclusionary practices and eroding social cohesion, and illuminate divisions that are inscribed into the physical space of the neighbourhood

Epidemiology of surgery associated acute kidney injury (EPIS-AKI): a prospective international observational multi-center clinical study

Purpose: The incidence, patient features, risk factors and outcomes of surgery-associated postoperative acute kidney injury (PO-AKI) across different countries and health care systems is unclear. Methods: We conducted an international prospective, observational, multi-center study in 30 countries in patients undergoing major surgery (> 2-h duration and postoperative intensive care unit (ICU) or high dependency unit admission). The primary endpoint was the occurrence of PO-AKI within 72 h of surgery defined by the Kidney Disease: Improving Global Outcomes (KDIGO) criteria. Secondary endpoints included PO-AKI severity and duration, use of renal replacement therapy (RRT), mortality, and ICU and hospital length of stay. Results: We studied 10,568 patients and 1945 (18.4%) developed PO-AKI (1236 (63.5%) KDIGO stage 1500 (25.7%) KDIGO stage 2209 (10.7%) KDIGO stage 3). In 33.8% PO-AKI was persistent, and 170/1945 (8.7%) of patients with PO-AKI received RRT in the ICU. Patients with PO-AKI had greater ICU (6.3% vs. 0.7%) and hospital (8.6% vs. 1.4%) mortality, and longer ICU (median 2 (Q1-Q3, 1-3) days vs. 3 (Q1-Q3, 1-6) days) and hospital length of stay (median 14 (Q1-Q3, 9-24) days vs. 10 (Q1-Q3, 7-17) days). Risk factors for PO-AKI included older age, comorbidities (hypertension, diabetes, chronic kidney disease), type, duration and urgency of surgery as well as intraoperative vasopressors, and aminoglycosides administration. Conclusion: In a comprehensive multinational study, approximately one in five patients develop PO-AKI after major surgery. Increasing severity of PO-AKI is associated with a progressive increase in adverse outcomes. Our findings indicate that PO-AKI represents a significant burden for health care worldwide

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

Early mobilisation in critically ill COVID-19 patients: a subanalysis of the ESICM-initiated UNITE-COVID observational study

Background Early mobilisation (EM) is an intervention that may improve the outcome of critically ill patients. There is limited data on EM in COVID-19 patients and its use during the first pandemic wave. Methods This is a pre-planned subanalysis of the ESICM UNITE-COVID, an international multicenter observational study involving critically ill COVID-19 patients in the ICU between February 15th and May 15th, 2020. We analysed variables associated with the initiation of EM (within 72 h of ICU admission) and explored the impact of EM on mortality, ICU and hospital length of stay, as well as discharge location. Statistical analyses were done using (generalised) linear mixed-effect models and ANOVAs. Results Mobilisation data from 4190 patients from 280 ICUs in 45 countries were analysed. 1114 (26.6%) of these patients received mobilisation within 72 h after ICU admission; 3076 (73.4%) did not. In our analysis of factors associated with EM, mechanical ventilation at admission (OR 0.29; 95% CI 0.25, 0.35; p = 0.001), higher age (OR 0.99; 95% CI 0.98, 1.00; p ≤ 0.001), pre-existing asthma (OR 0.84; 95% CI 0.73, 0.98; p = 0.028), and pre-existing kidney disease (OR 0.84; 95% CI 0.71, 0.99; p = 0.036) were negatively associated with the initiation of EM. EM was associated with a higher chance of being discharged home (OR 1.31; 95% CI 1.08, 1.58; p = 0.007) but was not associated with length of stay in ICU (adj. difference 0.91 days; 95% CI − 0.47, 1.37, p = 0.34) and hospital (adj. difference 1.4 days; 95% CI − 0.62, 2.35, p = 0.24) or mortality (OR 0.88; 95% CI 0.7, 1.09, p = 0.24) when adjusted for covariates. Conclusions Our findings demonstrate that a quarter of COVID-19 patients received EM. There was no association found between EM in COVID-19 patients' ICU and hospital length of stay or mortality. However, EM in COVID-19 patients was associated with increased odds of being discharged home rather than to a care facility. Trial registration ClinicalTrials.gov: NCT04836065 (retrospectively registered April 8th 2021)

On the dual nature of intra-urban borders: the case of a Romani neighborhood in Istanbul

This essay questions the nature of intra-urban borders from a politico-ethical point of view. Namely: to what extent are intra-urban borders acceptable at a time of proliferating discourses about a borderless world, and open cities? We discuss this through a case study of Sulukule – a historic neighborhood home to a millennium old Roma community located within the historic city center of Istanbul – in the context of the urban renewal project launched by the local municipality. The often cited “humanitarian” pretext for the renewal project is “incorporating” the Sulukule’s poor Roma community into the city and tearing down the borders demarcating their ghetto. Eventually, this discourse of incorporation served to instigate a rapid episode of gentrification in the area. Offering a critical perspective on the municipality’s renewal project, and through a discussion of the often conflicting premises of the discourses of the “right to the city” and the “group right to difference,” this essay argues that intra-urban borders are “undecided” separators and calls for policy tools that are responsive to the enabling aspects of bordering processes

Enhancing STEM Education by Integrating Research and Teaching in Photochemistry: An Undergraduate Chemistry Laboratory in Spectroscopy and Photochemistry

Molecular spectroscopy and photochemistry constitute an integral field in modern chemistry. However, undergraduate level classes provide limited opportunities for hands-on experimentation of photochemistry and photophysics. For this reason, a simple laboratory experiment was designed that may be easily implemented into undergraduate teaching laboratories with the aim of introducing undergraduate students to UV/visible spectroscopy and photochemistry/photophysics and its possible applications. Samples of three unknown sunscreen formulations are given to students and they are asked to use a set of techniques to identify their molecular composition and to test their efficacy using basic laboratory equipment available to them. In particular, the students are asked to complete the following tasks: (i) sample preparation using solvent extraction to extract active ingredients from the sunscreen lotion, (ii) identify the extracted molecular sunscreen constituents by Thin Layer Chromatography (TLC) and UV/visible spectroscopy, and finally (iii) study their photostability by means of steady state irradiation coupled with UV/visible spectroscopy. The students were provided with the following tools for data collection: silica-backed TLC plates, a short-wave lamp (254 nm, for TLC analysis), a UV-Vis spectrophotometer with an associated computer and software, and an LED lamp (315 nm) to irradiate the samples. Combined TLC and UV-Vis spectroscopy allowed the students to identify the extracted ingredients. UV irradiation confirmed the photostability of sunscreens