Bircan Kara

Earthquake preparedness in Türkiye is widely promoted through national awareness campaigns; however, household-level preparedness remains limited. Drawing on Maslow's hierarchy of needs and the Risk Perception Paradox, this study examines how socioeconomic inequalities are associated with earthquake preparedness self-efficacy, preparedness behaviors, and perceived barriers and motivations at the household level. The research universe was defined using the Türkiye Earthquake Hazard Map by identifying 325 districts located in high-hazard zones (≥ 0.4 g at DD-2 design value, 475-year return period). A 19-item structured questionnaire was developed and administered online between May and September 2025, yielding responses from 1,193 households across high-risk districts. Data were analyzed using descriptive statistics, cross-tabulations, and chi-square tests (p < 0.05). The findings indicate high earthquake salience: 80.9% of respondents reported prior earthquake experience and 93.1% perceived local earthquake risk. However, only 19.3% considered themselves sufficiently prepared, while 47.9% reported being partially prepared. Perceived constraints were substantial: 89.7% reported insufficient financial resources, 83.8% insufficient time, and 69.2% concerns about sustaining daily life. Preparedness self-efficacy was significantly associated with gender, age, and monthly household income. Training participation was also significantly associated with higher self-perceived preparedness, while homeownership was associated with greater knowledge of building earthquake resistance. Household earthquake preparedness in Türkiye appears to be constrained not only by awareness deficits but also by socioeconomic inequalities related to time, financial resources, and housing security. These findings suggest that awareness campaigns should be complemented by targeted education, financial support mechanisms, tenant-inclusive housing safety measures, and community-based preparedness practices.

This study aims to develop a mathematical model to estimate the number of emergency nurses required to ensure the continuity of healthcare services in the

This study aims to develop and validate a mathematical model for estimating the number of emergency physicians required in post-earthquake scenarios, using

In the globalizing world, significant advances have been made in health services with the development of technology. These advances have led to an increase

Objectives: Despite advancements in medical science, existing methodologies for predicting placental invasion in patients with previa remain insufficient. Systemic inflammatory markers have emerged as potential prognostic indicators in oncology. This study aims to explore whether systemic inflammatory parameters can predict placenta accreta spectrum (PAS) in patients with previa, given the analogous mechanisms between PAS and cancer cell invasion. Methods: This retrospective case-control study encompassed patients diagnosed with placenta previa who underwent cesarean section procedures between 2010 and 2024. The case group (PAS+) comprised patients who underwent hysterectomy, segmental resection (with histopathologically confirmed PAS), or had in situ placenta. Conversely, the control group (PAS-) included other patients. The systemic immune-inflammatory index (SII), platelet-to-lymphocyte ratio (PLR), and neutrophil-to-lymphocyte ratio (NLR) were calculated from the most recent preoperative complete blood count. A comparative analysis of demographic data, clinical findings, and systemic inflammatory markers was conducted between the groups. Results: A total of 487 patients were analyzed, with 146 (30%) classified as PAS (+) and 341 (70%) as PAS (-). The PAS (+) group exhibited significantly higher values in terms of age, gravidity, parity, and the number of prior cesarean sections (P=0.004, P<0.001, P=0.018, and P<0.001; respectively). However, no significant correlation was identified between the two groups concerning systemic inflammatory markers. Conclusions: Systemic inflammatory markers do not appear to be reliable for predicting placental invasion in previa patients.

Economic development is influenced by GDP, educational attainment, production capacity, and health service indicators. The sustainability of human capital and production capacity depends on high-quality healthcare services supported by efficient governance. This study aims to construct a health governance index by analyzing the relationship between health indicators and the Human Development Index (HDI) in Türkiye. This study utilizes a logarithmic differencing model to analyze quarterly data from Q1 2002 to Q4 2020. Annual health expenditure data is transformed into quarterly data. The methodology includes assessing data properties, testing for nonlinearity using the BDS (Brock, Dechert, and Scheinkman) test, and exploring quantile-based relationships using Quantile-on-Quantile Regression (QQR). To further confirm the results, Quantile Regression (QR) is applied to analyze the differential effects across various quantiles. Key variables include the Medical Service Quality Index (MDSQI), the Medical Service Capacity Index (MDSCI), and the Human Development Index (HDI). The study also considers the Health Economic Performance Capacity (HEPC) as an additional indicator to assess the broader health governance impact. The analysis reveals that the majority of data exhibits non-normal distribution characteristics. Significant improvements in the MDSQI and MDSCI positively influence both the HDI and HEPC in Türkiye. The findings suggest that better management of healthcare services correlates with higher human development outcomes. Robustness checks confirm the consistency and reliability of the results. Efficient management of healthcare services and capacity significantly impacts HDI and HEPC in Türkiye. Increased healthcare expenditures enhance service quality and capacity, contributing to overall human development. Policy recommendations include investment in preventive healthcare, ensuring equal access, integrating health technology, enhancing human resource training, implementing inclusive health insurance, and securing sustainable funding to improve healthcare quality and ensure comprehensive coverage.

Introduction: Toolbox training or toolbox talks is short‐term training to improve occupational health and safety practices in various sectors. These on‐the‐job trainings provide employees with opportunities to ask questions and share experiences, facilitating the enhancement of workplace safety practices. The aim of this study is to determine the impact of toolbox trainings provided to nurses on nursing‐sensitive quality indicators (pain management, pressure ulcer, patient falls, peripheral venous catheter complications, and adverse event reporting) in the workplace.Design: Randomized controlled, pre‐test, post‐test, and control group design.Methods: Before the toolbox training, pretest measurement instruments were used for the nurses in both the experimental and control groups, and the nursing‐sensitive quality indicators were monitored by two independent observers. Toolbox training was provided to nurses in the intervention group on their shift in the respective units. Both groups were followed up at the 8th and 12th weeks after the training. Descriptive tests, independent sample t‐tests for intergroup comparisons, and repeated and mixed ANOVA for intragroup comparisons were utilized in data analysis.Results: Significant differences were found between pre‐test and post‐test scores of the nurses in the group who received toolbox training in terms of falls, pressure ulcers, pain management, peripheral venous catheter, and adverse event reporting (p < 0.01). It was observed that the application scores significantly differed among all nurses who received toolbox training according to the findings of both observers, generally increasing in the second follow‐up compared to the first, but decreasing in the third follow‐up (p < 0.05). Evaluated according to unit quality indicators, it was determined that the number of patient falls (mean 4.04, 2.32, and 1.95 respectively), pressure ulcer occurrences (mean 4.48, 2.69, and 2.45 respectively), and the number of patients experiencing peripheral venous catheter complications decreased (mean 26.79, 16.46, and 15.42 respectively) in the units where nurses who received toolbox training worked. The average number of correctly managed pain patients (mean 37.82, 71.61, 69.07 respectively) and the number of reported adverse events (mean 2.79, 6.60, 6.42 respectively) were observed to increase in the second follow‐up but decrease in the third follow‐up.Conclusions: As a result, it was determined that on‐the‐job trainings increased nurses' knowledge level regarding nursing‐sensitive quality indicators, improved their practices, and enhanced unit quality indicators. According to the findings of this study, on‐the‐job trainings provided to nurses were found to be an effective method, and it is recommended to use them in addition to traditional training methods in nurses' in‐service education.Clinical Relevance: There is a growing demand for shorter and different training methods in nurses' education. In addition to classical in‐service training methods, this training method, which was applied for the first time in the field of nursing, contributed to the improvement of quality indicators sensitive to nursing. Our findings emphasize that it will be useful to use this training method in future studies on improving and developing nursing‐sensitive quality indicators.Trail Registration: The study has been registered with ClinicalTrials.gov (NCT05853588)

Objective: The increasing population and changing demographic structure, scientific advancements, and the growing expectations and need for healthcare specialists are enhancing the importance of higher education in the nursing profession. Understanding the perspectives of service-responsible nurses on postgraduate education is crucial for improving healthcare outcomes. This study aims to determine the views of service-responsible nurses on postgraduate education. Materials and Methods: The research was designed as a phenomenological qualitative study and was conducted with 13 service charge nurses. Data were collected through in-depth individual interviews using a semi-structured interview form and were analyzed using Colaizzi's seven-stage analysis. Results: Four main themes with eight categories were identified as follows: (i) "necessity of postgraduate education," (ii) "effects of postgraduate education," (iii) "contributions of postgraduate education," and (iv) "barriers to continuing postgraduate education." It was found that service-responsible nurses generally consider postgraduate education necessary, believe that it enhances professionalism and specialization among nurses, increases professional respect, accelerates the integration of practice and academia, and provides quality patient care. Conclusions: As a result, responsible nurses see not receiving support from senior management as an obstacle during their postgraduate education process. Based on these findings, it is recommended that upper management support nurses who wish to pursue postgraduate education, that responsible nurses collaborate with universities to facilitate postgraduate education and adopt encouraging policies, and that postgraduate education programs in nursing be integrated with clinical practice.

Aim:The objective of this study was to investigate the frequency of neuropathic pain (NeP) in patients with rheumatoid arthritis (RA) who are receivers and non-receivers of biological treatment. The secondary objective of our study was to identify NeP-related factors in RA. Material and Methods:This was a sectional case–control study that measured the frequency of NeP using painDETECT (pDETECT) in patients with RA being monitored in our rheumatology outpatient clinic and in the control group. In addition, along with the demographic data of the patients, the disease activity score in 28 joints calculated with C‐reactive protein (DAS28-CRP), visual analog scale (VAS) pain, VAS fatigue, Beck depression index, Beck anxiety index, health assessment questionnaire, and RA quality of life index were used. Results:A total of 105 patients with RA (60 biological, 45 conventional treatment) and 106 healthy controls were enrolled in the study. According to pDETECT, NeP was n=15 (7.1%), n=9 (4.3%), and n=13 (6.2%) in the Biological disease-modifying antirheumatic drugs (bDMARD), non-receivers, and control groups, respectively. There was no statistical difference between groups who were bDMARD receivers and non-receivers (p>0.05). There was a moderate positive correlation between pDETECT and RA duration (r=0.363), VAS pain score (r=0.594), VAS fatigue score (r=0.589), DAS28-CRP score (r=0.489), Beck depression index (r=0.402), Beck anxiety index (r=0.606), erythrocyte sedimentation rate (ESR) value (r=0.226), and tender joint count (TJC) (r=0.367) (p<0.05). Conclusion:NeP is commonly observed in patients with RA, and treatment with bDMARDs did not change the frequency of NeP. A positive correlation was observed between NeP and RA disease duration, DAS28-CRP, VAS pain, VAS fatigue, Beck depression index, Beck anxiety index, ESR, and TJC. When measuring disease activity in patients with RA, NeP should not be ignored.

Objective: Our aim in this study is to reveal to what extent hospital efficiency indicators changed in a University Hospital between the period before the Covid 19 pandemic (2018-2019) and the period when the pandemic started and continued (2020-2021). Method: The study planned as a retrospective and descriptive type, data belongs to a 4-year period (2018-2021). The number of personnel for the years examined in the study, the number of applications to the outpatient clinic and emergency department calculated monthly and the number of deceased patients. Bed occupancy rate, inpatient rate, average patient stay days, bed turnover rate and bed turnover interval were used as hospital bed utilization efficiency indicators. Result: Among all years, April 2020 had the lowest number of emergency applications (n=1287) and total number of outpatient clinic applications (n=7530). The year with the highest bed occupancy rate was 2020 with 77.2±6.7. The highest inpatient rate was in 2020 with 6.7±2.1, the highest average day of stay was in 2021 with 10.8±2.2, the highest bed turnover rate was in 2018 and 2019 with 4.7±0.3 and the highest bed turnover interval was observed in 2021 with 5.2±2.2. April 2020 was the month with the highest inpatient rate at 11.8% and the highest bed turnover interval at 16.8. Conclusion: The number of patients applying to emergency departments and outpatient clinics decreased, the inpatient rate increased, the bed turnover rate decreased, the bed turnover interval extended and the average day of stay increased during the pandemic period.