Selin Kalender

In the pharmaceutical industry, the strategic importance of biotechnological products is steadily increasing globally. Countries are accelerating efforts to enhance R&D capabilities and positioning production capacity expansion as a strategic priority. Although there have been developments in biosimilar drug production in Türkiye’s pharmaceutical sector, a similar momentum is not observed in the manufacturing of original biotechnological drugs and active pharmaceutical ingredients (APIs). This study aims to identify the challenges encountered in the production of biopharmaceuticals and original APIs in Türkiye and to prioritize these challenges based on their relative importance using the Analytic Hierarchy Process (AHP) method. A structured AHP-based survey was conducted with 11 pharmaceutical industry executives. Based on a literature review and expert opinions, three main criteria (financial; infrastructure, human resources, and market; bureaucratic/legal processes) and 13 related sub-criteria were defined. According to the pairwise comparison results, “infrastructure, human resources, and market” was determined as the highest-priority area with a weight of 68.2%, followed by “financial” (18.3%) and “bureaucratic/legal” (13.6%) difficulties. Based on global weights, the most critical challenge was “insufficiency of qualified human resources” (28.8%), followed by “lack of pharmaceutical/biotechnology enterprise ecosystem” (16.7%) and “insufficiency of technoparks” (9.8%). Sensitivity analysis showed that the highest-ranked challenge remained unchanged across all tested scenarios, supporting the robustness of the main prioritization result. This study reveals that Türkiye’s pharmaceutical sector faces not only operational but also complex structural and systemic challenges requiring a holistic approach. The findings highlight the need for a strategic governance framework to boost predictability, strengthen institutional capacity, and ensure long-term financial sustainability. Prioritization results from the AHP method offer decision-makers a practical, sustainable roadmap, contributing to Türkiye’s global competitiveness in biopharmaceutical and original API production.

Background: Healthcare workers face challenges such as intense work tempo, irregular working hours and high patient expectations. This situation may affect the happiness and performance of employees, as well as the quality of health services. Objective: The aim of this study is to reveal the relationship between organizational health perceptions, happiness and job performance of health personnel working in a university hospital. Method: The data were collected from 350 healthcare workers between December 2023 and January 2024 by face-to-face survey method. Organizational Health Scale, Oxford Happiness Scale and Employee Performance Scale were used as measurement tools. Data were analyzed with SPSS 22.0 and AMOS 26.0 programs; descriptive statistics, correlation analysis and Structural Equation Modeling (SEM) were applied. Results: According to the correlation analysis, there was a positive and low level relationship between organizational health and happiness (r = .359) and a very weak but significant relationship with performance (r = .136). A moderately significant relationship was found between happiness and performance (r = .252). According to SEM findings, organizational health significantly predicted happiness (β = 0.98, p < .001), while happiness predicted performance (β = 0.14, p = .002). The direct effect of organizational health on performance was not significant (β = 0.23, p = .077). In subgroup analyses, differences were observed according to occupational groups and length of experience. Conclusions: Organizational health is a determinant of employee happiness, and happiness increases job performance. Therefore, it is recommended that healthcare organizations develop strategies that focus on employee well-being.

Mental health disorders, particularly depression and anxiety, represent a growing global public health concern. Although population-level nutrient intake may be associated with mental health burden, ecological evidence across income groups remains limited. This study examined the association between nutrient intake and mental health burden across 120 countries from 1990 to 2018, stratified by income levels. A cross-sectional ecological analysis was conducted using country-level data from the Global Dietary Database and the Global Burden of Disease study. Nutrients were categorised as potentially beneficial (omega-6 fats, folate, protein) or unhealthy (sugar-sweetened beverages, refined grains, processed meats). Mental health burden was measured using prevalence and disability-adjusted life years. Pearson correlations and multivariable linear regression analyses were employed. Unhealthy nutrient consumption increased globally, particularly in low- and middle-income countries. Omega-6 fats and processed meats were positively associated with depressive (β = 1554.04, p = 0.03) and anxiety disorders (β = 1976.09, p = 0.01). Protein intake was associated only with anxiety (β = 17.51, p = 0.02). Upper-middle-income countries exhibited the largest increase in mental health burden. Public health strategies should prioritise nutrient-dense diets, especially in transitioning economies, to mitigate the rising mental health burden. Future research should explore causal mechanisms and longitudinal effects.

Geleneksel sağlık teknolojisi değerlendirme (STD) yaklaşımları çoğunlukla klinik ve ekonomik kriterlere odaklanırken, çevresel sürdürülebilirlik unsurlarını göz ardı etmektedir. Çevresel etkilerin, özellikle karbon salımının STD süreçlerine entegrasyonu hem yöntem hem de etik, politik ve yönetim açısından çok katmanlı bir değerlendirme gerektirmektedir. Bu çalışma, mevcut yöntemlerin sınırlılıklarını ve uygulanabilirliğini analiz ederek, karbon salımının STD’de nasıl dikkate alınabileceğini tartışmaktadır. Karbon salımının STD’ye dahil edilmesi için, karbonun sosyal maliyeti doğrudan maliyet-etkililik hesaplarına dahil edilebilir ya da karbon salımı bilgisi maliyet-etkililik dışında ek bir ölçüt olarak ele alınabilir. Araştırmalar bu yöntemlerin önündeki temel engelleri ortaya koymaktadır; veri eksiklikleri, standartlaştırma sorunları ve uygulanabilirlik zorlukları. Ancak bu zorluklar aşılabilir niteliktedir. Çevresel etkilerin STD süreçlerine dahil edilmesi, artık sağlık sistemlerinin sürdürülebilirliği için bir zorunluluktur. Uluslararası düzeyde NICE, ICER ve HAS gibi kurumların çevresel etkileri değerlendirme süreçlerine dahil etmeye başlasa da bu çabaların henüz kurumsal standartlara dönüşmediği gözlemlenmektedir. Türkiye özelinde ise, çevresel etkilerin STD politikalarına sistematik biçimde dahil edilmediği, ancak 2053 Net Sıfır Emisyon hedefi ve Avrupa Yeşil Mutabakatı çerçevesinde bu yönde bir dönüşüm olanağı bulunduğu belirtilmektedir. Sonuç olarak, çevresel etkilerin STD süreçlerine dahil edilmesi, sağlık sistemlerinin sürdürülebilirliği açısından stratejik bir gereklilik olarak ortaya çıkmakta; bunun sağlanabilmesi için standart yöntemlerin geliştirilmesi, veri altyapısının güçlendirilmesi ve karar vericiler arasında farkındalık oluşturulması gerektiği ifade edilmektedir.

Anemia remains a major global health concern with multifactorial causes and consequences across income levels. Evidence linking environmental factors, such as particulate matter (PM_2.5) air pollution, to anemia is limited. This study examined longitudinal associations between PM_2.5 air pollution and anemia prevalence across 185 countries from 1990 to 2021, focusing on sex and income-level differences. Secondary data on PM_2.5 exposure, anemia prevalence, socio-economic indices (SDI, HAQ, SDGs), and health-related factors (iron, vitamin A, calcium, zinc deficiencies, and kidney dysfunction) were analyzed using Joinpoint regression and generalized estimating equations (GEE). Globally, anemia prevalence rose by 8% in males and 9% in females over 32 years, with substantial variation by income group. Upper-middle-income countries achieved the greatest reductions in anemia disability-adjusted life years (DALYs), while low-income countries showed the largest PM_2.5 declines (5%). GEE analysis found significant associations between anemia prevalence and PM_2.5 pollution (β = 2.18, P = 0.002), income level (β = 1.25, P = 0.025), and female sex (β = 1.14, P = 0.033). PM_2.5 exposure rose most steeply in lower-middle-income countries (2008–2012) but declined in high-income countries (2015–2019). Despite declining PM_2.5 exposure, global anemia prevalence has increased. Addressing air pollution alongside other health-related factors is essential, particularly in low-income countries.

Climate change and environmental sustainability are increasingly recognized as critical issues within healthcare systems. However, there is limited understanding of how healthcare professionals perceive and experience these challenges in their daily practice. This study aims to explore healthcare professionals’ perceptions, experiences, and attitudes toward environmental sustainability and climate change within public hospitals. Designed as a descriptive phenomenological study, the research was based on Giorgi’s phenomenological approach. Data were collected through semi-structured, in-depth interviews with 10 healthcare professionals (physicians, nurses, and technicians) working in public hospitals. The interview form was developed by the researchers through a comprehensive literature review and expert validation. Interviews were audio-recorded and analyzed in five stages using Giorgi’s descriptive phenomenological method: holistic reading, identification of meaning units, transformation into psychological expressions, construction of the essential structure, and thematic coding. The findings revealed common themes related to environmental awareness, institutional practices, perceived barriers, and proposed solutions for climate-resilient healthcare. Participants’ statements converged around themes such as environmental sustainability awareness, institutional practices, encountered barriers, and proposed solutions. Understanding healthcare professionals’ lived experiences provides a foundation for promoting climate-resilient healthcare practices. The findings can inform institutional policies, training programs, and future research aimed at strengthening environmental sustainability in healthcare settings.

This study aims to identify and prioritise the key criteria that affect decision-making processes in hospital medication management. For this purpose, the Analytic Hierarchy Process (AHP), a multi-criteria decision-making method, was employed. Data were collected through a survey conducted with 21 expert pharmacists working in public and private hospitals. The criteria were determined through a systematic literature review and expert consultations. Five main criteria—safety, medication preparation and distribution, storage and inventory management, personnel training and competence, and technology and information systems—were evaluated using pairwise comparisons. As a result of the analysis, safety (0.34686) was identified as the highest priority criterion, followed by technology and information systems (0.27019), while storage and inventory management (0.07290) had the lowest priority. At the sub-criteria level, patient safety (0.17004) and data security (0.11909) emerged as the most significant factors. The study's limitation is that it reflects only the perspectives of pharmacists, which may restrict the inclusion of viewpoints from other healthcare professionals. Nevertheless, the study offers original and quantitative findings for pharmaceutical risk management. The results may contribute to hospital administrators in prioritising investments in digital technologies, safety protocols, and personnel development. This study is among the pioneering research that systematically prioritises hospital medication management criteria using the AHP method.

The COVID-19 pandemic has significantly impacted health systems and economies worldwide, creating a global crisis that necessitates international cooperation. The aim of this study is to explore research areas and thematic trends in publications related to COVID-19 and economic crises using co-word analysis. A total of 5094 publications, published between 2020 and 2024, related to the keywords "economic crisis" and "COVID-19" were examined using the Web of Science (WoS) database. The publications were analyzed using R Studio and the Bibliometrix package. The annual growth rate of publications related to COVID-19, and economic crises peaked in 2022. The initial publications in 2020 focused on the epidemiological definition of the pandemic, while from 2021 onwards, studies on economic impacts and crises gained more attention. Co-word analysis revealed an increase in research addressing the relationship between the pandemic and economic crises. The thematic map analysis identified key themes such as "COVID-19" and "financial crisis," which showed a high degree of centrality and formed the research focus, with these terms appearing in most of the publications. Additionally, niche themes such as "connectedness" and "stock market" pointed to specific studies examining financial connections and market dynamics. This clearly demonstrates how the interaction between COVID-19 and economic crises has evolved over time and how research focus areas have shifted. The study concludes that research addressing the relationship between the pandemic and economic crises plays a critical role in filling gaps in literature and in developing strategies for future pandemics. Future research problems could be structured to enhance the ability of countries and international organizations to cope with economic crises and develop strategies to prepare for future pandemics.

Bu çalışmanın amacı Sürdürülebilir Kalkınma Amaçları (SKA) kapsamında gezegensel sağlık konusunda yapılan çalışmaların yapısını bibliyometrik haritalama tekniğiyle incelemektir. Bu amaçla Web of Science (WoS) veri tabanında zaman kısıtlaması olmadan bir tarama yapılmıştır. Tarama "planetary health" ve "health*" anahtar kelimeleri kullanılarak "topic" seçeneğiyle yapılmıştır ve 1726 veriye erişilmiştir. Erişilen veriler belirlen hariç tutma ve dahil etme kriterlerine göre filtrelenmiş ve 546 yayın çalışma kapsamına alınmıştır. Veriler, VOSviewer programı ve R-Stüdyo programı Bibliometrix paketi kullanılarak analiz edilmiştir. Analiz sonucunda sürdürülebilir kalkınma amaçları kapsamında gezegensel sağlık konusunun yayın ve atıf eğilimlerinde düzenli artış olduğu tespit edilmiştir. Ayrıca yayın eğilimi açısından en etkili yılın 127 yayınla 2023 yılı olduğu belirlenmiştir. Her iki programla yapılan analizde de anahtar kelimelerin yoğun olarak gezegensel sağlık kümesi etrafında toplandığı saptanmıştır. Anahtar kelimelerin tematik haritası incelendiğinde “iklim değişikliği”, “gezegensel sağlık” ve “eğitim” anahtar kelimelerinin temel temalarda yer aldığı görülmüştür. Ayrıca bu alanda en fazla atıf alan ülkenin Amerika Birleşik Devletleri (ABD) ve en fazla atıf alan derginin Lancet Planetary Health olduğu tespit edilmiştir. Çalışma sonuçlarının bibliyometrik verilerle gezegensel sağlık alanının bilim haritasını ortaya koyma açısından önemli olduğu düşünülmektedir. Gezegensel sağlık alanında çalışmak isteyen araştırmacıların çalışmalarında hem temel temalarda hem de motor temalar da yer alan “gıda politikaları” ve “sürdürülebilir beslenme” konularına ağırlık vermeleri önerilmektedir.

Hastanelerde yatarak tedavi gören hastaların en yaygın zarar görme nedeni ilaç hatalarıdır. İlaç hataları tıbbi hataların en yaygın nedenidir. İlaç hataları olumsuz ilaç olaylarının (advers drug events-ADE) yaşanmasına neden olabilir. ADE’lerin ölüm ve kalıcı engellilik gibi geri dönüşü olmayan sonuçları bulunmaktadır. Bununla birlikte bu durum genellikle önlenebilir niteliktedir. ADE’lere neden olan ilaç hataları en sık reçete yazma aşamasında meydana gelmektedir. Bir ilacın yanlış reçete edilmesi ya da yanlış yolla verilmesi nedeni ile her yıl binlerce kişi hayatını kaybetmektedir. Bu gibi sonuçlarla karşılaşılmaması için reçete yazma süreçlerinin elektronik olarak kontrol altına alınması gerekmektedir. Bu süreçte meydana gelebilecek ilaç hatalarının engellemesi, azaltılması ve ortadan kaldırılması amacıyla elektronik reçete (e-reçete) sistemleri yaygın olarak kullanılmaktadır. Bu çalışmanın amacı e-reçete konusu detaylı olarak ele almaktır. Çalışmada e-reçetenin tanımına, e-reçete sisteminin kullanıldığı ülkelere, potansiyel faydalarına, olası zararlarına, zorluklarına ve literatürde e-reçete konusuna ilişkin yapılan çalışmalara yer verilmiştir. Çalışmada e-reçete sistemlerinin mevcut ve potansiyel çok sayıda faydasının olduğu tespit edilmiştir. Bununla birlikte sistemlerin kullanımının çeşitli riskleri olduğu belirlenmiştir. E-reçetelerin hastanelerde ilaç ve hasta güvenliği başta olmak üzere iş akış süreçlerini nasıl etkilediğine dair kapsamlı bir anlayış geliştirilmesine ihtiyaç olduğu düşünülmektedir.