Evaluation of Metropolitan Government Act adopted in July 2004 in Act No 5216 in terms of strategic spatial planning approach

Türkiye’de metropoliten bölge ölçeğinde stratejik mekânsal planlamada önemli problemlerin yaşandığı bu konuda yapılan araştırmalardan ve uygulama sürecindeki anlaşmazlıkları çözmek üzere ortaya konan yargı kararlarından bilinmektedir. Bu çalışmada, metropoliten yönetimlerin yasal statüsünü belirleyen 5216 sayılı yeni Büyükşehir Belediyesi Yasası ile getirilen yeni düzenlemelerin, mevcut yönetim ve planlama sorunlarına ne ölçüde yanıt getirdiği tartışılmaktadır. Bu doğrultuda, 5216 sayılı yasa, Avrupa’da metropoliten bölge ölçeğinde stratejik mekânsal planlama konusundaki gelişmeler ve bu konuda geliştirilen kriterler göz önüne alınarak değerlendirilmektedir. Anahtar Kelimeler: Stratejik mekânsal planlama, metropoliten bölge ölçeği, kurumsal kapasitenin geliştirilmesi.The current planning regulations in Turkey have not defined explicitly the legal and administrative procedures and institutional arrangements for strategic spatial planning at the metropolitan region level. Furthermore, previous research concerned with the subject pointed out that there is no basic model for strategic spatial planning and it is the aspect which is dealt with in this thesis. The main objective of the thesis is to evaluate strategic spatial planning at the metropolitan region level in Turkey within European spatial planning system in terms of institutional capacity building. As a result of this evaluation based on the new directions in the practice of strategic spatial planning and institutional approach in Europe and the practice benchmark of effective metropolitan spatial planning in European metropolitan regions and areas, a conceptual system model is proposed for strategic spatial planning at the metropolitan region level in Turkey. This article is primarily concerned with the evaluation of the regulation was enacted newly in 2004 (the so-called Metropolitan Government Act) related to metropolitan government and strategic spatial planning at the metropolitan region level in terms of institutional capacity building. Keywords: Strategic spatial planning, metropolitan region level, institutional capacity buildin

How are alcohol related problems prevented? Brief intervention approach in the treatment of alcohol use disorders

Excessive alcohol consumption and alcohol related problems are significant public health problems worldwide. Many factors contribute to the development alcohol related problems. Lack of knowledge about low-risk consumption levels and risks of excessive alcohol use is the most important factor. Men who are drinking more than four standard drinks per day and 14 standard drinks per week, women and men older than age 65 who are drinking more than three drinks a day and seven standard drinks per week have an increased risk for alcohol related problems. Screening and early brief intervention for alcohol consumption among patients in primary health care provides an opportunity to educate them about low-risk consumption levels and risks of excessive alcohol use. Alcohol Use Disorders Identification Test (AUDIT) has been established as a screening scale to identify risky and harmful alcohol use. "Brief intervention" is a time-limited and patient centered counseling method focuses to change the patient's behavior and increase the treatment compliance. It includes four stages; 1. Ask alcohol use, 2. Assess alcohol use disorders, 3. Advice and support, 4. Arrange follow-up. Brief intervention has been shown as an effective secondary prevention method in the studies and meta-analysis. Alcohol use problems as a major public health problem should be intervened in the primary health care as a secondary prevention. Early identification and intervention will prevent the growth of the problem. (Anatolian Journal of Psychiatry 2010; 11:51-59

Alkol kullanım sorunları nasıl önlenir? Alkol kullanım bozukluklarının tanı ve tedavisinde kısa müdahale yaklaşımı

Aşırı alkol tüketimi ve alkolle ilişkili sorunlar tüm dünyada önemli bir halk sağlığı sorunudur. İçme sınırlarının ve aşırı alkol tüketimiyle ilişkili risklerin bilinmemesi alkolle ilişkili sorunların gelişmesinde en önemli etkendir. Günde dört standart içkiden fazla ve haftada 14 standart içkiden fazla içen erkekler, günde üç standart içkiden fazla ve haftada yedi standart içkiden fazla içen kadınların ve 65 yaş üstü erkeklerin alkolle ilişkili sorun yaşama riski artmıştır. Sağlık ocaklarına başvurular alkol sorunlarına erken dönemde müdahale etme olanağı yaratır. Birinci basamak sağlık hizmetlerine başvuran hastalarda alkol tüketiminin taranması ve erken kısa müdahale hastaları düşük-riskli tüketim düzeyleri ve aşırı alkol kullanımının riskleri konusunda eğitmek için fırsat sağlar. Alkol Kullanım Bozuklukları Tanıma Testi (AUDIT) riskli ve zararlı alkol kullanımını tanımlamak üzere geliştirilen tarama ölçeğidir. ‘Kısa müdahale’ hastanın davranışını değiştirmeye ve hastanın tedavi uyumunu artırmaya odaklanan, süresi sınırlı, hasta merkezli danışmanlık yöntemidir. Dört basamaktan oluşmaktadır: 1. Alkol kullanımını sormak, 2. Alkol kullanım bozukluklarını değerlendirmek, 3. Uygun davranışı önermek ve yardımcı olmak, 4. Hastanın gelişimini izlemek, desteği sürdürmek. Alkol kullanım bozukluklarında kısa müdahalenin ikincil koruma yöntemi olarak etkili olduğu çalışmalarda ve meta analizlerde gösterilmiştir. Önemli bir halk sağlığı sorunu olarak alkol kullanım sorunlarına birinci basamak sağlık hizmetlerinde ikincil koruma olarak müdahale edilmelidir. Erken tanı ve müdahale sorunun büyümesini önleyecektir.Excessive alcohol consumption and alcohol related problems are significant public health problems worldwide. Many factors contribute to the development alcohol related problems. Lack of knowledge about low-risk consumption levels and risks of excessive alcohol use is the most important factor. Men who are drinking more than four standard drinks per day and 14 standard drinks per week, women and men older than age 65 who are drinking more than three drinks a day and seven standard drinks per week have an increased risk for alcohol related problems. Screening and early brief intervention for alcohol consumption among patients in primary health care provides an opportunity to educate them about low-risk consumption levels and risks of excessive alcohol use. Alcohol Use Disorders Identification Test (AUDIT) has been established as a screening scale to identify risky and harmful alcohol use. “Brief intervention” is a time-limited and patient centered counseling method focuses to change the patient’s behavior and increase the treatment compliance. It includes four stages; 1. Ask alcohol use, 2. Assess alcohol use disorders, 3. Advice and support, 4. Arrange follow-up. Brief intervention has been shown as an effective secondary prevention method in the studies and meta-analysis. Alcohol use problems as a major public health problem should be intervened in the primary health care as a secondary prevention. Early identification and intervention will prevent the growth of the problem

The Planning and Management in the Sustainability of Protected Areas: Kayseri Sultan Sazligi

The conservation of biodiversity on which the processes of rapid urbanization and industrialisation creating pressure is concerned as an important issue that might be handled with international efforts. The conservation of biodiversity that consists of ecosystems, species diversity and genetic diversity, principally uses the "in-situ" and "ex-situ" conservation methods. This paper aims to evaluate the planning and management process of protected areas (natural sites, national parks, wetlands and protected areas) in Turkey through the Sultan Sazligi (Kayseri) case and to argue the opportunities for effective conservation of biodiversity and probability of sustainable targets for Turkish natural heritage. The RAPPAM (Rapid Assessment and Prioritization of Protected Area Management) and METT (Management Effectiveness Tracking Tool Method) methods are used in the study to determine the problems related to the aims and the targets in planning and management of protected areas, institutional structure, planning authority, legal framework, sustainable development strategies, participatory planning approaches and conservation practices. At the final evaluation, the main problems are observed as the disruption of natural water cycle in wetland ecosystem, the ecological pollution caused by the unplanned developments and touristic activities, the fragmented and partial institutional structure on the management and planning of the protected areas, the lack of the common sense among the different sectors to achieve the integrated conservation aims, insufficient economic subsidies, the deficiency in experience and technology transfer, inef-ficient personnel and technical opportunity for monitoring and controlling the process and activities

Granulomatous polyangitis (Wegener granulomatosis): Clinical findings and results of long-term follow-up

Introduction: To evaluate long-term outcome of patients with granulomatous polyangitis (GPA) followed up in a tertiary university hospital. Patients and Methods: We reviewed medical records of 22 patients with GPA diagnosis confirmed by tissue biopsies between 2004 and 2014. Results: The mean time from the onset of symptoms to diagnosis was 7.8 +/- 12.3 months [interquartile range (IR)= 4.0]. The most commonly involved organs were the upper respiratory tract (URT) (72.7%), lower respiratory tract (81.8%) and kidneys (72.7%). URT involvement indicated good prognosis (p= 0.046). Survival in the patients with and without URT involvement was 124.6 +/- 6.9 months and 59.7 +/- 22.9 months, respectively. End-stage renal failure (ESRF) requiring dilaysis and cardiac involvement were associated with mortality (p= 0.022 and p= 0.026, respectively). Of the 12 dialysis-dependent patients at diagnosis, 11 survived > 3 months and seven regained renal function permanently. Dialysis dependency was significantly lower in patients who received plasmapheresis (p= 0.047). Overall mortality rate was 18% (4/22). Mean survival was 55.9 +/- 42.8 months (IR= 84.0). Conclusion: Diagnosis of GPA may be delayed by the nonspecific nature of its symptoms. URT involvement was associated with good prognosis, whereas cardiac involvement and ESRF requiring dialysis were associated with poor outcome. Plasmapheresis may increase the rate of renal recovery in the patients with ESRF requiring dialysis