Sağlık Araştırma ve Uygulama Merkezi Koleksiyonu
Permanent URI for this collectionhttps://hdl.handle.net/11499/46036
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Article Enhancing Hospital Drug and Medical Supply Request Processes through a Clinically Prioritized and Demand-Variability–Aware Adaptive Decision Support Framework(Elsevier Ireland Ltd, 2026-07) İşli, Devrim; Aydın, LemanBackground: Rule-based replenishment thresholds in hospital information systems (HIS) are feasible and auditable but may respond slowly to demand variability and clinical criticality. Objective: To evaluate a decision-support framework that preserves a three-level request structure (minimum/critical/maximum) while adapting thresholds using short-horizon demand forecasts and uncertainty, stratified by VEN clinical priority (Vital-Essential-Non-essential), and to benchmark its forecasting component against a na & iuml;ve rolling 180-day mean predictor (mu 180). Methods: A retrospective unit-item-day panel was constructed from routine hospital records and classified by VEN. XGBoost forecasted 14- and 30-day cumulative demand; uncertainty was modeled using a rolling 30-day consumption standard deviation scaled by VEN-specific coefficients. Adaptive targets were mapped to existing HIS request levels and backtested against the baseline rule (7 & times;/15 & times;/30 & times; the rolling 180-day mean daily consumption) on a 30-day ML-available panel (35,801 unit-item-day records; 1269 series; 2025-09-30-2026-01-22). Forecast accuracy was compared with mu 180 using RMSE and WAPE, supported by calibration and Diebold-Mariano testing. Policies were evaluated using paired Wilcoxon tests and lead-time sensitivity analyses. Results: The proposed policy reduced stock-out days (54 to 10; -81.5%), days below critical (11,612 to 6396; -44.9%), ordering days (1936 to 550; -71.6%), and ordered quantity (853,119 to 579,795; p < 0.001). Stock-outs were eliminated for Vital items. XGBoost reduced WAPE by 62%-71% versus mu 180 across horizons, with absolute-error superiority confirmed by Diebold-Mariano testing. Inventory exposure increased (366,406 to 802,049), indicating a measurable safety-inventory trade-off. Conclusions: VEN-prioritized, forecast- and volatility-aware threshold adaptation improved service continuity and ordering efficiency within an auditable HIS workflow while quantifying trade-offs under alternative lead-time assumptions.Article Medication Regimen Complexity and Patient-Reported Adherence: A Cross-Sectional Study in Internal Medicine Outpatients(Dove Medical Press Ltd, 2026-02) Ertuna, Elif; Guray, Irem; Inci, Veli; Bucuk, Pinar Sirmatel; Gencer, Nagihan Sozen; Arun, Mehmet Zuhuri; Kilavuz, Asli; Sirmatel Bucuk, Pinar; Sozen Gencer, NagihanPurpose: Medication non-adherence and regimen complexity are significant barriers to achieving therapeutic goals. This study aimed to determine the impact of medication regimen complexity, and clinical characteristics of patients on medication adherence in internal medicine outpatients. Patients and Methods: This prospective cross-sectional study was conducted in the internal medicine and geriatric outpatient clinics of a tertiary university hospital. Adherence was assessed with Medication Adherence Report Scale (MARS-5), and regimen complexity was quantified using the Medication Regimen Complexity Index (MRCI) in 150 patients. Results: The mean age of the participants was 57.53 +/- 1.26 years. Only 44% of the participants demonstrated perfect adherence to therapy. The MRCI scores of geriatric patients (median: 11 (3-44) vs 19 (5-65)) and those hospitalized within the last six months (median: 12.75 (3-47) vs 20 (6-65.5)) were significantly higher. Complexity scores related to dosing schedule and instructions for use were especially higher in patients with hypertension or diabetes. No statistically significant correlation was found between the total MRCI score and patient-reported adherence scores (P=0.32). However, geriatric patients and recently hospitalized patients were less likely to fully adhere to therapy (chi 2 (1, N=150) = 4.71, P=0.030 and 4.23, P=0.040, respectively). Conclusion: Although a direct correlation between total regimen complexity and self-reported adherence was not observed, complexity poses a significant challenge for specific high-risk groups, including geriatric patients and those with recent hospitalizations. These findings may suggest that providing targeted medication counseling and medication regimen review, particularly in the early post-discharge period, might be crucial for optimizing adherence and clinical outcomes.Article Rus Bilimkurgusunda Ekoeleştiri: Strugatski Kardeşlerin Eserleri Üzerine Bir İnceleme(2025-09-30) Söyler, SinemSovyet Dönemi Rus fantastik edebiyatının en önemli yazarlarından olan Arkadi ve Boris Strugatski, sadece bilimkurgu ve fantastik türlerine yenilikler getirmekle kalmayıp aynı zamanda eserlerinde derin felsefi ve toplumsal temaları da işleyerek edebiyatta fantastiğin güçlü bir tür olarak yerini bulmasını sağlamışlardır. Bilim ve insan deneyimi ile beslenen yazarlar, eserlerinde hem bilimin sağladığı verileri hem de fantastiği kullanarak insanın geçmişten günümüze ve gelecekte karşılaşabileceği veya karşılaştığı sorunları ve olayları anlatmışlardır. Bu çalışmada yazarların en bilinen Tanrı Olmak Zor İş (Трудно Быть Богом 1964), Uzayda Piknik (Пикник на Обочине 1972) gibi romanları üzerinden ekoeleştirel bir okuma yapılacaktır. Çevresel adalet anlayışı çerçevesinde, insanın doğal dünya ile kurduğu ilişkiyi sosyal, kültürel ve tarihsel bağlamlarıyla birlikte inceleyen ekoeleştiri, yazılan bu romanlarda Kardeşlerin tasavvur ettikleri gelecek yaşam ve onun getirileri, toplumun yarattığı karmaşanın sebep olduğu bozulmalar ve mutasyona uğrayan bir doğayı incelememize olanak sağlayacaktır. Çoğulcu yöntem kullanılan bu çalışmada eserler ve yazarlar hakkında literatür taraması yapılmış, yazarların eserleri, doğa ve ekoloji temalı yazıları ayrıntılı bir biçimde okunmuştur.Article Citation - WoS: 1Citation - Scopus: 2Trends and Methods in Intensive Care Unit (ICU) Research Using Machine Learning: Latent Dirichlet Allocation (lDA)-Based Thematic Literature Review(BMC, 2025-07-29) Topaloglu, Duygu; Polat, OlcayIntroductionThe use of machine learning (ML) in intensive care units (ICUs) has led to a large yet fragmented body of literature. It is imperative to conduct a systematic analysis and synthesis of this research to identify methodological trends, clinical applications, and knowledge deficits.MethodsA systematic literature review was conducted in accordance with the PRISMA guidelines, encompassing 2,507 ICU-focused ML publications from 2019 to 2024. Latent Dirichlet Allocation (LDA), an unsupervised topic modeling approach, was used with n-gram and no-n-gram tokenization strategies. Bayesian optimization approaches were used to increase model coherence and diversity.ResultsThe analysis demonstrated a substantial degree of methodological variability, emphasizing the predominance of studies on infection surveillance and complication prediction. N-gram tokenization efficiently identified clinically specific topics, but no-n-gram techniques produced larger interpretative groups. Underexplored fields include emerging research areas like drug response prediction, pediatric-specific modeling, and surgical risk classification.ConclusionIn conclusion, the study highlights the significance of methodological transparency and tokenization strategies while offering a thorough topic overview and identifying methodological trends in the literature on ICU - ML. Future research should prioritize neglected areas such as pediatric care modeling and therapy response, utilizing advanced ML techniques and multimodal data integration to enhance the outcomes of ICU patients.Article Pressure Injuries Related to the Positioning of Surgical Patients in the Operating Room and Identification of Associated Risk Factors: A Cross-Sectional Study(Wiley, 2025-06-26) Usul, Osman; Dizer, BernaSurgery represents a significant risk factor for the development of pressure injuries. However, risk factors related to positioning-induced pressure-injuries in surgical operating rooms have not been adequately investigated. Therefore, this study aimed to determine the presence of pressure injuries and associated risk factors related to patient positioning in the operating room. This prospective, descriptive, and cross-sectional study was conducted between November 2023 and July 2024 in operating rooms of a university hospital, including surgeries from various surgical departments, with a cohort of 140 patients determined using a G*Power analysis. Data collection tools included the 'Individual Characteristics Form', 'Risk Assessment Scale for Pressure Injuries Related to Surgical Positioning' and 'Postoperative Patient Evaluation Form', with data collected pre, intra and postoperatively. We found that 25.7% of patients developed Stage I pressure injuries post-surgery, with the supine position being the most prevalent risk factor (p = 0.023). Patients with diabetes, higher body mass index, advanced age, longer surgeries and certain anaesthesia types had significantly increased risks (p < 0.05). Furthermore, 17.9% of patients were classified as high-risk. These findings underscore the need for nurses to monitor high-risk patients closely, adjust positioning as needed and develop tailored care plans to mitigate risk.Article Turkish Validity and Reliability Study of the Children's Trust in General Nurses Scale(Dokuz Eylul Univ Inst Health Sciences, 2025-05-31) Gulcenbay, Gulsum; Turan, TurkanAmaç: Bu araştırma, Türkçe dilinde 'Çocukların Hemşirelere Güven Ölçeği (CTGÖ) 'nin geçerlik ve güvenirliğini kanıtlamayı amaçlayan bir metodolojik çalışmadır. Yöntem: Örnekleme, şehir merkezindeki 13 ilkokul ve ortaokuldan, 9 ile 12 yaş arasındaki 221öğrenciyi içermektedir. Veri toplama amacıyla, aydınlatılmış onam formu ve aile veri toplama formu tüm ailelere gönderilmiştir. Güven ölçeği Türkçe formu ve öğrenci veri toplama formu ise öğrenciler tarafından doldurulmuştur. İçerik geçerlik indeksi hesaplanmış, Kaiser-Meyer-Olkin değeri ve Bartlett testi incelenmiş ve yapı geçerliği için açımlayıcı ve doğrulayıcı faktör analizleri yapılmıştır. Güvenilirlik için iç tutarlılık analizinden Cronbach Alfa değeri (α) kontrol edilmiştir. Sonuçlar: Öğrencilerin ortalama yaşı 10.35 ± 0.97 yıl olarak bulunmuştur. Ölçeğin iç güvenilirlik Cronbach Alfa değeri 0.72 olarak bulunmuştur. Kaiser-Meyer-Olkin testi ve Bartlett testi sonuçları istatistiksel olarak anlamlı bulunmuştur. Açımlayıcı faktör analizinden sonra, ölçeğin toplam varyansın %56.76'sını 3 alt ölçekte açıkladığı tespit edilmiştir. Doğrulayıcı faktör analizi, ölçeğin uyum değerlerinin RMSEA=0.068, pArticle Determinants of Exclusive Breastfeeding in the Second Month after Birth in Turkey: The Role of Prenatal Breastfeeding Self-Efficacy(Ethiopian Public Health Association, 2024) E.U., Akça; H.U., HazarBackground: The decline in breastfeeding rates with exclusive breast milk in the second month postpartum is an important situation we have encountered. This requires consideration of the relationship with prenatal breastfeeding self-efficacy. Objective: The aim of the study was to determine the role of prenatal breastfeeding self-efficacy in exclusive breastfeeding in the second -month postpartum in Turkey. Methods: This is an analytical, cross-sectional study. The study sample comprised 312 women, who met the inclusion criteria of the study. The Descriptive Characteristics Form, Prenatal Breastfeeding Self-Efficacy Scale, and the Postnatal Interview Form were used. Data analysis was performed using descriptive statistics, Mann-Whitney U test, Kruskal-Wallis test, Chi-square test, and Bonferroni test for multiple comparisons (p<0.05). Results: The mean Prenatal Breastfeeding Self-Efficacy Scale total score of the women was 74, 11±12, 39 (minimum-maximum: 19, 00–95, 00). Among the subscale scores of the Prenatal Breastfeeding Self-Efficacy Scale, the highest was the “desire– subscale score, which was 39.05±5.85. In the 2nd month after birth, the rate of mothers who were exclusively breastfeeding their babies was 87.5% (n=273). There was no significant difference in terms of mean Prenatal Breastfeeding Self-Efficacy Scale scores between women who exclusive breastfeeding their babies in the second month and women who did non-exclusive breastfeeding (p=0, 14). The mean Prenatal Breastfeeding Self-Efficacy Scale score of women who exclusively breastfeed their babies in the second month was 71, 00±11, 63. The mean Prenatal Breastfeeding Self-Efficacy Scale scores of women who had previous breastfeeding experience (p=0.003) were significantly higher. Statistically significant differences were found in a type of infant nutrition between the age (p=0.023) and income (p=0.036) of women. Conclusion: The study showed that prenatal breastfeeding self-efficacy was not a decisive factor for exclusive breastfeeding in the second month after birth. Women who did not exclusively breastfeed their babies in the 2nd month postpartum had lower PBSS scores. In addition, women who already have experience with breastfeeding have higher breastfeeding self-efficacy. Therefore, midwives and nurses should encourage and support women to breastfeed. Further studies are needed to determine whether prenatal breastfeeding self-efficacy is related to breastfeeding behavior. © (2024), (Ethiopian Public Health Association). All rights reserved.Article Care burden and depression levels in the relatives of patients with bipolar disorder(Kare Publ, 2024) Yilmaz, Halis; Demirkiran, FatmaObjectives: Bipolar disorder (BD) is an affective disorder characterized by a chronic course and places a heavy financial and moral burden on caregivers. The study was carried out to identify care burden, depression, and related factors in the caregivers of bipolar patients. Methods: This descriptive and cross-sectional study was conducted on the relatives of 71 BD-diagnosed patients hospitalized in the psychiatry clinic of a tertiary hospital. Data were collected using the introductory information form, the Zarit Caregiver Burden Scale, and the Beck Depression Inventory (BDI). Results: The mean age of the caregivers was 47.55 +/- 9.03, and 52.1% of them were women. A significant difference was evident between the BDI scores of caregivers, being single, having a low education level, not working in any job, not having any social security, living in an extended family, needing a helper in caring for their patients, having a physical illness and increasing the number of children they have (p<0.05). The relationship between the Zarit Scale scores and the caregivers' lack of social security, closeness to their patients as a spouse, child, or sibling, and living in a different house from the patients also yielded a significant difference (p<0.05). Conclusion: Providing psychoeducation to caregivers concerning coping skills, stress management, and symptoms and episodes of the disease may bring benefits in alleviating their care burden and depression symptoms.Article Early and mid-term radiological results of isolated pembersal procedure in cases of developmental dislocation ofthe hip(2024-03-25) Gül, Orkun; Turanlı, Sacit; Ök, Nusret; Baymurat, Alim Can; Abdulaliyev, Ferid; Ahmadov, Asim; Osmanlı, ElshadAim: Early diagnosis and timely care is important in patients with Developmental Hip Dysplasia (DDH). Late presenting or neglected patients may require various osteotomy procedures. There is a limited number of articles in the literature on Pembersal osteotomy in DDH surgery. The aim of this study was to assess the outcomes of isolated Pembersal osteotomy in children over 18 months of age with DDH. Materials and Methods: A retrospective analysis was made of the outcomes of patients who underwent Pembersal osteotomy for DDH at our clinic from 2014 to 2021. The study included 9 children (7 girls, 2 boys) aged between 19 and 36 months with at least 2 years of follow-up who underwent isolated periacetabular Pembersal osteotomy with open reduction. Preoperative, early postoperative, 6 weeks postoperative and final follow-up radiographs were evaluated and Wiberg's centre-edge angle (CEA), the acetabular index (AI) and Tönnis grades were noted. Results: The mean age of the patients was 28.75 months and the follow-up period was 50.33 months. CEA and AI showed improvement in the early postoperative period and this improvement continued in the later periods. Tönnis staging showed postoperative improvement in all patients, and this improvement continued in the early postoperative period and on the 6-week follow-up radiographs. At the final follow-up examination, 3 hips had CEA <20º, AI >20º and Tönnis stage ≥2 and these 3 hips were considered as a radiologically poor outcome. Conclusion: This study demonstrated that isolated Pembersal osteotomy is an effective and safe option for the treatment of developmental dysplasia of the hip, with improvement in acetabular index and other radiological parameters.Article Citation - Scopus: 1Social media use in dermatology in Turkey: Challenges and tips for patient health(JMIR Publications Inc., 2024-03-28) A.S., Karadag; B., Kandi; B., Sanlı; H., Ulusal; H., Basusta; S., Sener; S., CalıkaSocial media has established its place in our daily lives, especially with the advent of the COVID-19 pandemic. It has become the leading source of information for dermatological literacy on various topics, ranging from skin diseases to everyday skincare and cosmetic purposes in the present digital era. Accumulated evidence indicates that accurate medical content constitutes only a tiny fraction of the exponentially growing dermatological information on digital platforms, highlighting an unmet patient need for access to evidence-based information on social media. However, there have been no recent local publications from Turkey analyzing and assessing the key elements in raising dermatological literacy and awareness in digital communication for patients. To the best of our knowledge, this study is the first collaborative work between health care professionals and a social media specialist in the medical literature. Furthermore, it represents the first author-initiated implementation science attempt focusing on the use of social media in addressing dermatological problems, with the primary end point of increasing health literacy and patient benefits. The multidisciplinary expert panel was formed by 4 dermatologists with academic credentials and significant influence in public health and among patients on digital platforms. A social media specialist, who serves as a guest lecturer on “How social media works” at Istanbul Technical University, Turkey, was invited to the panel as an expert on digital communication. The panel members had a kickoff meeting to establish the context for the discussion points. The context of the advisory board meeting was outlined under 5 headlines. Two weeks later, the panel members presented their social media account statistics, defined the main characteristics of dermatology patients on social media, and discussed their experiences with patients on digital platforms. These discussions were organized under the predefined headlines and in line with the current literature. We aimed to collect expert opinions on identifying the main characteristics of individuals interested in dermatological topics and to provide recommendations to help dermatologists increase evidence-based dermatological content on social media. Additionally, experts discussed paradigms for dermatological outreach and the role of dermatologists in reducing misleading information on digital platforms in Turkey. The main concluding remark of this study is that dermatologists should enhance their social media presence to increase evidence-based knowledge by applying the principles of patient-physician communication on digital platforms while maintaining a professional stance. To achieve this goal, dermatologists should share targeted scientific content after increasing their knowledge about the operational rules of digital channels. This includes correctly identifying the needs of those seeking information on social media and preparing a sustainable social media communication plan. This viewpoint reflects Turkish dermatologists’ experiences with individuals searching for dermatological information on local digital platforms; therefore, the applicability of recommendations may be limited and should be carefully considered. © 2024 JMIR Publications Inc.. All rights reserved.