Search

Ulaşım faaliyetleri bir ülkenin gelişmişlik derecesini belirleyen önemli göstergelerden birisidir. Ülke içindeki ticari faaliyetlerin devamı, ülkenin her noktasına olabilecek iletişim hareketliliği ve bireysel faaliyetler gibi birçok unsurun da odak noktasında yer alan ulaşım aynı zamanda ülkeler arasındaki ilişkileri de belirleyen başat aktörlerdendir. Kara yolu ile her noktaya ulaşım imkânının bulunması ve ulaşımda kullanılabilen araç çeşitliliğinin fazlalığı nedeniyle tüm dünya gibi Türkiye’de de kara yolu ulaşımının geliştirilmesine yönelik politikalar benimsenmiştir. Bu politikaların bir sonucu olan ve etki düzeyi ile hem ulusal hem de uluslararası bir niteliği bulunan İstanbul - İzmir Otoyolu 2009 yılında ihale edilmiş ve 2019 yılı itibariyle tamamen hizmete açılmıştır. Bu çalışma söz konusu otoyolun tarım alanları üzerindeki etkisini Manisa örneğinde incelemeyi amaçlamıştır. Manisa’nın ulusal ve uluslararası düzeyde bir tarım bölgesi olması örneklem seçiminde etkili olmuş ve bu kapsamda Google Earth, OpenStreetMap, Coordination of Information on the Environment (CORINE, 2018), Harita Genel Müdürlüğü ve Köy Hizmetleri Genel Müdürlüğü’nden elde edilen veriler kullanılmıştır. Çalışma sonucunda otoyol projesi neticesinde Manisa genelindeki karmaşık ekim modelleri, kuru tarım alanı, zeytin alanı, sulu tarım alanı ve üzüm bağları kategorisinde toplam 842 ha’lık tarım alanının kaybedildiği sonucuna varılmıştır. Çalışma ile gıda üretim alanı olan tarım alanlarını koruyucu önlemler ile entegre ulaşım politikalarının temel alınmasının zorunluluğu vurgulanmıştır.

This study aims to determine the rural gentrification process in Yunt Mountain, which is located in a between İzmir and Manisa provinces and is an important geographical value with its physical and human geography elements. Within the scope of the study, the phenomenon of gentrification was examined by revealing the change in the rural landscape in the case of 11 villages on Yunt Mountain. In the study, where fieldwork was used as the main research method, field surveys were carried out in various periods between 2019 and 2024. The data obtained were transferred to the map with ArcGis 10.8.1 software and the study was visualised with a rich photo archive. After the study, it was determined that the land and housing prices in the neighbourhoods taken as a sample have risen to a level to compete with the city centre, the newly built houses are built with additions that are not suitable for the structure of the rural area and there are visible problems in land use. It is concluded that this situation, even if not in a total manner in the field, especially in some villages (Bağyurdu, Gülbahçe, Üçpınar), the process of gentrification has progressed rapidly

Abstract Background In patients presenting to the emergency department (ED) with acute respiratory failure, non-invasive mechanical ventilation (NIMV) is applied when conventional oxygen support is not sufficient. Patients who are agitated often have very low NIMV compliance and a transition to invasive mechanical ventilation (IMV) is often required. To avoid IMV, a suitable sedative agent can be utilized. The aim of this research is to investigate the relationship between ketamine administration to patients who are non-compliant with NIMV due to agitation and the outcome of their intubation. Methods This retrospective study included patients with acute respiratory failure who were admitted to the ED from 2021 to 2022 and used Richmond Agitation Sedation Scale (RASS) to identify agitation level of patients. The relationship between ketamine administration in this patient group and NIMV compliance and intubation rate was evaluated. Results A total of 81 patients, including 35 (43.2%) men and 46 (56.8%) women, were included in the study. Of these patients, 46 (56.8%) were intubated despite ketamine administration, while 35 (43.2%) were compliant with NIMV and were not intubated. When evaluating the RASS, which shows the agitation levels of the patients, the non-intubated group was found to be 2.17 ± 0.68, while the intubated group was 2.66 ± 0.73, and it was statistically significant that the NIMV intubated group was higher (p = 0.003). Conclusion This study showed that agitation can impair NIMV compliance in patients with acute respiratory failure. However, a significant proportion of this patient group can be avoided through IMV with proper sedative agents.

Objective: This study was designed to determine the reasons for vaccine rejection in patients who applied for the coronavirus disease-2019 (COVID-19) polymerase chain reaction (PCR) test but did not receive the vaccine. Methods: The study was conducted prospectively in the emergency department of a tertiary hospital between 31.01.2022 and 31.05.2022. 1000 patients who applied for the COVID-19 PCR test and refused to be vaccinated were included. The COVID-19 status of the participants, reasons for their application, number of PCR tests, methods of obtaining information about the vaccine, and reasons for the rejection of the vaccine were questioned. Results: 54.6% of the participants were male and 45.4% were female. 60.7% of the patients applied for testing due to symptoms, 25.4% due to contact with people with symptoms, and 23.9% due to travel. 43.3% of the cases had COVID-19 infection; 53.6% of them had tested an average of 2-5 times in the last year. Most of the information about the vaccine was taken from social media, television, medical publications, and people around, respectively. Of the participants, 62.0% believed that COVID-19 vaccines had side effects, 47.3% believed that it had no protection, and 30.9% believed that there was not enough study on the subject. As the age grew, the rate of learning information from social media increased. Conclusions: The most common reasons for COVID-19 vaccine rejection were vaccine side effects, doubtful vaccine protection, and concerns about the lack of sufficient studies on the vaccine. The higher the education level, the higher the vaccine rejection rate.

Abstract Background Secondary bacterial infections are an important cause of mortality in patients with coronavirus disease 2019 (COVID-19). All healthcare providers acted with utmost care with the reflex of protecting themselves during the COVID-19 period. We aimed to compare the rates of ventilator-associated pneumonia (VAP) and bloodstream infections (BSIs) in our intensive care units (ICUs) before and during the COVID-19 outbreak surges. Methods This multicenter, retrospective, cross-sectional study was performed in six centers in Turkey. We collected the patient demographic characteristics, comorbidities, reasons for ICU admission, mortality and morbidity scores at ICU admission, and laboratory test data. Results A total of 558 patients who required intensive care from six centers were included in the study. Four hundred twenty-two of these patients (males (62%), whose mean age was 70 [IQR, 58–79] years) were followed up in the COVID period, and 136 (males (57%), whose mean age was 73 [IQR, 61–82] years) were followed up in the pre-COVID period. BSI and VAP rates were 20.7 (19 events in 916 patient days) and 17 (74 events in 4361 patient days) with a −3.8 difference (P = 0.463), and 33.7 (31 events in 919 patient days) and 34.6 (93 events in 2685 patient days) with a 0.9 difference (P = 0.897), respectively. The mortality rates were 71 (52%) in pre-COVID and 291 (69%) in COVID periods. Conclusion Protective measures that prioritize healthcare workers rather than patients and exceed standard measures made no difference in terms of reducing mortality.