The Predictive Effect of the Level of Psychological Resilience on the Level of Readiness for Discharge in Patients Undergoing Orthopaedic Surgery

ABSTRACT Aim The aim of this study is to establish the correlation between the degree of psychological resilience and readiness for discharge in patients undergoing orthopaedic surgery. Design This study is of a descriptive correlational type. Material and Method This study comprised a cohort of 190 patients who were admitted to the orthopaedics and traumatology department and had surgical procedures performed between November 2023 and April 2024. The study data were gathered via completion of the Introductory Information Form, the Psychological Resilience Scale and the Hospital Discharge Readiness Scale. IBM SPSS 25 package program was used to analyse the research data. Results In this study, 34.2% of the participants stated that they did not feel ready for discharge. Predictors of Readiness for Hospital Discharge were identified as being male ( β  = 0.118, p  = 0.003), living alone ( β  = 0.222, p  < 0.001), having undergone prosthesis, fracture or amputation surgery ( β  = 0.161, p  < 0.001), not having received discharge training ( β  = 0.122, p  = 0.001), not feeling ready for discharge ( β  = 0.442, p  < 0.001) and resilience ( β  = 0.246, p  < 0.001). These variables were found to explain 88.7% of Readiness for Hospital Discharge (adjusted R 2  = 0.773). Conclusion The findings of this study emphasise that including patients in their healthcare and creating comprehensive discharge plans tailored to their specific care requirements have a beneficial impact on their readiness for discharge. Additionally, the study demonstrates that enhancing psychological resilience plays a mediating role in facilitating discharge readiness. Implications for the Patient Care Patients who feel ready for discharge are less likely to be hospitalised and their recovery may be faster. Including the patient in the discharge plan, taking individual needs into consideration and disseminating programmes to increase resilience should be an integral part of holistic care. Reporting Method The STROBE checklist was applied in the reporting of the finding.

Which Factors Affect Functional Outcomes and Survival in Metastatic Humeral Fractures Treated With Nails?

ABSTRACT Objective Intramedullary nailing is a treatment method for metastatic humerus fractures that stabilizes a large area while minimizing damage to the surrounding soft tissues. However, the results of this treatment may vary depending on certain factors. This study aimed to investigate the factors influencing functional outcomes and survival in patients with pathological humeral fractures treated using humeral nails. Methods This retrospective study included 41 patients who underwent humeral nailing for metastatic pathological humerus fractures between 2009 and 2024. Functional outcomes were compared based on factors such as gender, age, cancer type, another pathological fracture surgery, visceral metastases, cancer diagnosis prior to fracture, fracture type and location, and cement use, using VAS improvement, MSTS, KPS scores, and ROM measurement. Survival analysis was performed considering these same factors. Statistical analyses included the Mann–Whitney U test, Kruskal‐Wallis test, Chi‐square test, and Kaplan–Meier survival curves. Cox regression analyses were used to identify factors associated with mortality. Results In younger patients, better VAS improvement( p  = 0.001), MSTS( p  = 0.038), KPS( p  = 0.028), and ROM( p  = 0.045) were observed compared to those 65 and older. Cancer type and visceral metastases negatively impacted MSTS( p  = 0.007, p  = 0.049) and KPS( p  = 0.002, p  = 0.022). Actual fractures showed greater VAS improvement than impending fractures( p  = 0.002), and shaft fractures had greater VAS improvement than proximal fractures( p  = 0.037). Unknown cancer diagnosis prior to fracture led to better VAS improvement( p  = 0.008), MSTS( p  = 0.018), KPS( p  = 0.023), and ROM( p  = 0.006). Rapid growth tumor( p  < 0.001) and visceral metastasis( p  = 0.007) were independently associated with poor survival. No significant effects were seen for gender or cement use on functional outcomes and mortality. Conclusion Although intramedullary nails are feasible implants for humeral pathological fractures, there are significant factors that affect their functional outcomes and survival. Actual fractures and shaft fractures showed better pain relief. Patients with a known cancer diagnosis prior to fracture and older patients had poor functional outcomes. Rapid cancer type and visceral metastasis negatively affect both functional outcomes and survival. Although cement use carries a risk of thrombosis, no significant changes in mortality and functional outcomes were observed with cement use. Level of Evidence IV.

Navigating financial cycles: Economic growth, bureaucratic autonomy, and regulatory governance in emerging markets

Abstract Political decisions over economic growth policies influence the degree of bureaucratic autonomy and regulatory governance dynamics. Yet, our understanding of these processes in the Global South is somewhat limited. The article studies the post‐Global Financial Crisis period and relies on elite interviews and secondary sources from Turkey. It problematizes how an economic growth model dependent on foreign capital inflows, which are contingent on global financial cycles, influences the trajectory of bureaucratic autonomy. Specifically, we argue that dependence on foreign capital flows for economic growth creates an unstable macroeconomic policy environment: while the expansionary episode of the global financial cycle masks conflicts between the incumbent and bureaucracy, the contractionary episode threatens the political survival of the incumbent. In the case of Turkey, this has incentivized the ruling coalition to resort to executive aggrandizement to control monetary policy and banking regulation, which resulted in a dramatic decay of the autonomy of the regulatory agencies since 2013.

The experience of the Turkish Red Crescent blood banks in the 2023 Türkiye earthquake

Abstract Aim This cross‐sectional study aimed to determine the impact of a severe earthquake on blood donation as per blood safety and donation behaviour. Materials and Methods This retrospective cross‐sectional study included a total of 263 779 whole‐blood donors at the Turkish Red Crescent during two periods: before (25 January 2023 – 5 February 2023) and after (6 February 2023 – 17 February 2023) the earthquake that occurred on 6 February 2023. Demographic data describing the donors, donor types, the number of blood donations by province, blood donations by blood groups, hospital demand, and transfusion transmissible infection (TTI) rates according to donor type were evaluated. Results There was a 129% increase in blood donations after the earthquake. his increase was significant among female donors, younger age groups, and first‐time donors. However, a significant increase in TTI rates was not detected in either first time donors or repeat donors. Conclusion Our study focuses on blood banking activities of the Turkish Red Crescent during the 2023 Türkiye earthquake. While previous disasters have shown excess blood collection, we emphasise the need for a balanced approach to avoid wastage and shortages. Our study emphasises the importance of efficient blood utilisation and the necessity of regular, voluntary blood donations to ensure a stable supply, especially for high‐demand blood groups like O Rh (−).

Several features of newborns following intrauterine intravascular blood transfusion for fetal hemolytic disease caused by anti‐D alloimmunization

Abstract Background Early detection and intervention for fetal hemolytic disease are essential to prevent severe complications. This study evaluates the antenatal and postnatal clinical and laboratory characteristics of newborns who underwent intrauterine intravascular transfusion due to anti‐D‐induced hemolytic disease. Study Design and Methods Twenty newborns who received intrauterine transfusions between 18 and 35 weeks of gestation were included. Data on maternal history, transfusion frequency, birth anthropometrics, ABO blood group, D typing, laboratory findings, morbidities, and hospitalization duration were analyzed. Results Thirteen cases (65%) had anti‐D antibody titers ≥1:1024. Intrauterine transfusions were administered once in 55% of cases, twice in 15%, and three or more times in 30%, with a mean gestational age of 29.6 ± 2.3 weeks. The mean birth weight and gestational age were 2478.7 ± 222.03 g and 35.6 ± 2.08 weeks, respectively. Severe hyperbilirubinemia requiring treatment was present in 50% of newborns, while 50% exhibited anemia‐related complications. Hypoxic–ischemic encephalopathy and intracranial hemorrhage were observed in 55% and 45% of cases, respectively. Exchange transfusions were required in 65% (once) and 10% (twice) of cases. All newborns received standard hemolytic disease treatments, including high‐intensity phototherapy (94.3 ± 22.4 h), infusion therapy (packed red cell transfusions, 10 mL/kg, 8 ± 2 times), and intravenous immunoglobulin (0.5–1 g/kg, 6 ± 1 times). Conclusion Newborns with anti‐D‐alloimmunization‐induced hemolytic disease requiring intrauterine transfusion demand intensive neonatal care to manage anemia, hyperbilirubinemia, hypoxic–ischemic encephalopathy, and intracranial hemorrhage.

Assessment of urban seismic resilience of a town in Eastern Turkiye: Turkoglu, Kahramanmaras before and after 6 February 2023 M 7.8 Kahramanmaras earthquake

On 6 February 2023, two earthquakes occurred approximately 9 h apart, with Mw 7.8 and 7.5, and epicenters located in Pazarcık and Elbistan districts of Kahramanmaras province, respectively. As part of a national project team which was funded by the Disaster and Emergency Management Presidency of Turkiye (AFAD) between June 2021 and June 2023, the authors of this article had proposed a framework to assess the seismic resilience of an urban region. The pilot area of this national project was a small‐scale industrial town named Turkoglu located to the south of Kahramanmaras, at the intersection of Amanos and Pazarcik segments of the East Anatolian Fault zone. The proposed framework encompasses the assessment of active faults in the region, construction of regional velocity models, ground motion simulations of potential earthquakes, structural vulnerability, and study of seismic resilience indicators. The Pazarcik earthquake occurred 4 months before the end of the project on the exact fault system, which was modeled in ground motion simulations within the project in 2022. The objective of this article is multifold: first, to present our findings before the earthquake (2021–2022) in the region, including regional velocity models, ground motion simulations, street survey‐based building classifications, and vulnerability classes; and second, to compare the after‐event modeling of damage distributions in comparison with the observed damages as well as resilience evaluations of the region from multiple perspectives. A third objective is to assess the seismic resilience framework used in the project, as there are multiple seismically active areas in Turkiye and the world where similar large events are anticipated. This study constitutes a significant case study in the Turkoglu region, which involves critical evaluations of seismic resilience from before and after event data.

Respiratory infections after elexacaftor/tezacaftor/ivacaftor treatment in people with cystic fibrosis: analysis of the European Cystic Fibrosis Society Patient Registry

The response of rare CFTR mutations to specific modulator combinations

Association between periprocedural cerebral desaturation during transcatheter aortic valve implantation and postprocedural delirium: a prospective observational study

Evaluating the Turkish Red Crescent’s (Türk Kızılay) disaster response: insights from the 2023 Kahramanmaraş earthquakes