Education and reproductive health: evidence from schooling expansion in Turkey

We investigate the role of additional years of schooling mandated by a compulsory schooling expansion law in affecting reproductive preferences and safe reproductive health behaviors in Turkey-a middle-to-high-income country with gender inequity in education but overall high levels of safe reproductive health practices at the time of passing the law. Using a fuzzy regression discontinuity design, we find that the additional schooling improved several health behaviors. However, the effects on some outcomes commonly analyzed in the existing literature, such as contraceptive use or fertility, were either weak or insignificant. Overall, our findings complement the current literature on the marginal health benefits of schooling expansion and suggest that policymakers consider the institutional and cultural factors while evaluating the scope and potential non-educational benefits of such expansions.

Contamination acts as a genotype-dependent barrier to gene flow, causing genetic erosion and fine-grained population subdivision in Mussels from the Strait of Istanbul

This study provides evidence of fine-grained genetic structuring in Mediterranean mussels (Mytilus galloprovincialis) from the Strait of Istanbul, caused by barriers to gene flow via contaminant-mediated selection. In this study, mitochondrial D-loop sequences were analyzed in mussels from 8 localities, all less than 30 kilometers apart, with differing contaminant loads. The results were: 1) Intra-population genetic differentiation (ΦST) between sites with high and low contaminant loads was high (up to 0.459), even at distances of only a few kilometers. 2) Genetic diversity was negatively correlated with the contaminant load ("genetic erosion"). 3) There was evidence of selection, based on haplotype frequencies and neutrality tests (Tajima's D), with purifying selection at the most contaminated site and balancing selection at the least contaminated. 4) Genetic distance was not correlated with geographic distance (no isolation-by-distance), but was correlated with contaminant load at each site. 5) Population dendrograms and Bayesian estimators of migration indicated that gene flow between sites was affected by contamination. For the dendrograms of the sampling sites, the clades clustered according to contaminant load more than geographic distance. Overall, these results suggest that 1) contamination may serve as a genotype-dependent dispersal barrier (i.e., contamination may not affect total number of migrants, just the relative proportions of the haplotypes in the established immigrants), leading strong population differentiation over short distances, and 2) genetic erosion may occur by a combination of selection and altered patterns of haplotype-specific gene flow. These effects may be more pronounced in the Strait of Istanbul than in other locations because of the riverine nature and strong, uni-directional current of the strait.

The prevalence and associated factors of fear of childbirth among Turkish pregnant women

OBJECTIVE

This study was conducted to determine the prevalence of fear of childbirth and affecting factors in pregnant women in Turkey.

MATERIALS AND METHODS

This was a cross-sectional study and included a total of 2025.    Pregnant Women Assessment, some variables related to previous and current perinatal processes and Wijma Delivery Expectancy/Experience Questionnaire (version A) were used for data collection.

FINDINGS

In this sample, 42.4% of the women reported fear of childbirth. What the women were afraid of most was the development of unwanted conditions at childbirth, obscurity/uncertainty, and negative attitudes of health professionals. The factors causing fear of childbirth were the low education level, unemployment status, low financial status, stillbirth, unplanned pregnancy, indecisiveness about the type of delivery, not attending prenatal education programs, negative effects of other people, insufficient social support, confiding in the healthcare centre and health professional, negative, and indecisive birth perceptions, prior negative birth experiences and not feeling ready for childbirth (p < 0.001).

CONCLUSIONS

The prevalence of fear of childbirth in this Turkish sample, especially in the multipara is higher than in Western countries. Causes of fear of childbirth can vary with countries and even with each region of a country.

On the nexus between CO2 emissions and the air transportation sector in the European Union and Turkey: accessing evidence from wavelet coherence analysis

The coronavirus disease has had a devastating impact on the airline industry worldwide. However, the cancellation of flights has also enormously reduced CO2 emissions in the air. The present study empirically explores the environmental impact of the sectoral lockdown within the EU28 and Turkey by leveraging the wavelet coherence transform (WCT) technique. The results revealed that there is a positive correlation between the number of passengers carried and CO2 emissions. In the short run, during the pandemic, there is a strong positive linkage between the number of passengers carried and CO2 emissions, while in the long run, there are also positive and meaningful relationships between the number of passengers carried and CO2 emissions between 2014 and 2022. The result also indicates that, on a quarterly basis, there was a sharp decline in CO2 emissions caused by the airline industry during the period of 2020-2021. The reverse effect was also detected, which has empirically validated the hypothesis that, during the pandemic, pollution in the atmosphere has declined because of the cancellation of flights. This confirms the hypothesis that there is positive feedback causality between passengers carried and CO2 emissions. This finding has also been supported in the existing energy literature. These outcomes have implications for environmental sustainability targets in the EU and Turkey, as the recovery of international passenger traffic will proceed at a very close pace. More policy caveats are elucidated in the conclusion section.

Slatted floor reduces the welfare and increases the foot pad dermatitis and growth performance of Turkeys under Egyptian conditions

Background

When Turkeys' legscome in contact with their dropping during the growing stage results in footpad dermatitis condition which affects the poult's welfare and productivity.

Aim

Our experiment aimed to detect the impact of various bedding substrates on the wellbeing, and performance of growing Turkey under Egyptian conditions.

Methods

180-day-old Turkey poults were allocated into three treatments. In treatment I, the poults [60 each with three replicates (n = 20 birds)] were kept on wood shavings (WS); in the second treatment, the poults were housed on chopped wheat straw (CWS). However, in the third treatment, they kept on a plastic slatted floor (PSF).

Results

The greater feed intake and body weight were recorded in poults reared in PSF compared with those kept in other treatments (WS and CWS). Feed conversion ratio did not show any significant difference. The mortality percentage was higher in the PSF group than in the WS one. The frequency of feeding and drinking behavior was higher in poults reared on WS treatment compared with other treatments CWS and PSF. On the other hand, resting behavior showed the highest frequency in poults kept in PSF. Contrary, the lowest frequency of walking behavior was recorded in poults reared in PSF treatment. In addition, the poults kept in WS had a longer tonic immobility reaction period followed by those kept in PSF and CWS. Concerning foot-pad dermatitis, the highest score of 0 was observed in the CWS group, while the highest score of 1 was recorded among poults kept in the WS group. On the other side, the highest score 2, 3, and 4 was observed in the poults reared in the PSF group. Heterophil/Lymphocyte ratio of Turkey poults was higher in PSF. While T3 and T4 concentrations in blood were not affected by using different bedding materials.

Conclusion

It is concluded that the slatted floor was good for Turkey producers from the point of performance but, it is the worst from the point of welfare.

Molecular Characterization of Giardia intestinalis and Cryptosporidium spp. Detected in Humans in Ağrı, Türkiye

Background

We aimed to determine the prevalence of Giardia intestinalis and Cryptosporidium spp. in patients who admitted hospital with diarrhea and to gain information about the transmission of these parasites in Ağrı, Türkiye.

Methods

This study included 184 patients who applied to Ağrı-Diyadin State Hospital, Türkiye in 2022. The immunochromatographic card test was used for detection of the G. intestinalis and Cryptosporidium spp. Nested PCR-RFLP analysis of the COWP gene and sequence analysis of the gp60 gene were used to genotype and subtype Cryptosporidium spp., whereas Nested PCR and sequence analyses of β-giardin gene were used genotype G. intestinalis.

Results

Of the 184 stool specimens examined, 12 (14.29%) and 7 (3.80%) were positive for G. intestinalis and Cryptosporidium spp., respectively. The Cryptosporidium species were identified as C. parvum belonging to the IId sub-type family. The G. intestinalis were identified assemblages A.

Conclusion

Assemblage A, which is associated with diarrhea, is responsible for giardiasis and C. parvum IId subtype, often found in sheep, goats and cattle, is responsible for cryptosporidiosis in Ağrı, Türkiye.

The role of large-scale atmospheric circulations on long-term variations of PM10 concentrations over Turkey

PM10 is widely identified as an important atmospheric pollutant posing a serious threat to human health and environment as well as it influences the climate system. To unearth the mechanism involved in its sources and circulation behavior in environment, this study focuses on the role of large-scale atmospheric circulation on the long-term variability of PM10 over Turkey by applying rotated empirical orthogonal functions (REOF) analysis. As a result of the implementation of REOF to the daily PM10 data for 80 air quality stations throughout the period 2010-2020, first REOF mode (REOF1 44.9% in winter, 43.2% in spring, 39.5% in summer and 31.6% in fall) for all the four seasons indicated the role of local emission sources on the variations of PM10, which show high PM10 values in different geographical regions. The results of the second mode (REOF2, 17.9% in winter, 14.0% in spring, 14.0% in summer and 16.3% in fall) indicate the role of large-scale atmospheric circulations on the values of PM10. From the REOF2 analysis and extracted synoptic composite maps, the strength of southerly winds and the presence of southwesterly winds at low levels are very important in transporting of dust pollutants from the Arabian Peninsula and Northern Africa, respectively, to the eastern (EAR) and southeastern (SEAR) regions of Turkey during winter. In spring, sand particles in the interior terrestrial part of the country are carried to the northern regions by the effect of large-scale southerly winds, which cause above-normal PM10 concentrations in the Black Sea region of Turkey. In summer, dust particles together with warm dry air intrusion to the eastern region of Turkey by strong easterly winds are sourced by Caspian Sea and result in high PM10 values. Our findings emphasize that the long-term variations in air quality over Turkey are affected secondary by the variations in the large-scale atmospheric circulations with primary contributions from the changes in local emission sources.

Multiple sclerosis prevalence and its relationship with economic status in Afyonkarahisar, Turkey

BACKGROUND

Over the past decade, the prevalence of Multiple Sclerosis (MS) has increased in Turkey. However, the prevalence of MS in Middle Anatolia, specifically Afyonkarahisar, remains unknown. Additionally, the potential link between economic status and MS has not yet been explored in Turkey.

METHODS

A stratified sampling method was employed to select samples from the population residing in Afyonkarahisar City Center, taking into account demographic factors such as income level, sex, and age. The sample size was calculated using the formula N = p.q.Zα2/d2, where an average prevalence rate of 70/100,000 was considered based on previous studies. The minimum sample size was 29,858. Considering incomplete, inaccurate, and low-reliability data, data were collected from 30,500 individuals and 30,408 individuals were evaluated.

RESULTS

The prevalence of Multiple Sclerosis in the center of Afyonkarahisar was 105.2 per 100,000 individuals. Upon investigating the association between economic status and MS prevalence, the findings revealed rates of 193.6 per 100,000 in individuals with high income, contrasting with 80.2 per 100,000 in those with low income. Notably, a heightened prevalence of MS is evident among individuals with higher income levels.

CONCLUSION

This study revealed a significantly elevated prevalence of MS in Afyonkarahisar, the highest in Turkey. The inverse correlation between the prevalence of MS and socioeconomic status is intriguing. Possible reasons for the high prevalence include the relatively new and specific geologic and environmental conditions in the area.

The effect of theoretical and student-centered interactive education on intern nursing students' knowledge and consideration regarding human papillomavirus and its vaccine in Turkey: A repeated measures design

Background

Intern nursing students not only belong to the high-risk group for human papillomavirus (HPV) infection and its associated complications but also represent the future healthcare workforce. Therefore, they constitute a significant group that should comprehensively understand HPV and its vaccine.

Objective

This study aimed to assess the impact of educational interventions on intern nursing students' knowledge and considerations related to HPV and its vaccine.

Methods

A repeated measures design with pretest/posttest measures was employed. The study involved 88 students at a university in Turkey and was conducted between November 2021 and February 2022. Data were collected using a Personal Information Form and the HPV Information Scale. All participants received theoretical and student-centered interactive education, and data were analyzed using numerical data, percentage distributions, Bonferroni correction, and one-way repeated measures ANOVA.

Results

The total score of the scale and the scores of all four sub-dimensions obtained in the first and third months after the education were significantly higher than those obtained before the education (p <0.001). Additionally, the proportion of students considering getting an HPV vaccine increased following the education (p <0.001).Conclusions: The education on HPV and its vaccine potentially improved students' knowledge levels and increased consideration for vaccination. Implementing interventions that equip nursing students with sufficient knowledge about HPV and its vaccine can contribute to reducing HPV-related cancer rates. Therefore, it is recommended to implement educational programs focused on the prevention of HPV-related cancers.

Complete genome sequence analysis and genome organization of Dasychira pudibunda nucleopolyhedrovirus (DapuNPV-T1) from Turkey

The economically important pale tussock moth Dasychira pudibunda L. (Lepidoptera: Lymantriidae), known as a beech pest in Europe, primarily inflicts damage on beech leaves. In the present study, we aim to reveal the genome characteristics of Dasychira pudibunda nucleopolyhedrovirus (DapuNPV-T1), which was detected for the first time in Turkey and compare it with the reference genome and other baculovirus genomes. The DapuNPV-T1 genome was determined to be a circular, double-stranded DNA molecule with 136,920 bp and a nucleotide distribution of 54.4% G + C. Bioinformatics analysis showed that the DapuNPV-T1 genome contains 163 open reading frames with more than 150 nucleotides. Fifty-four ORFs of unknown function, 6 homologous regions (hrs), 1 AC-rich region, and 3 bro genes (bro-a, bro-b, and bro-c) were determined in the genome sequence. Comparative analysis with other baculovirus strains revealed distinctions in the DapuNPV-T1 genome based on ORF. The gene parity plot and phylogenetic analysis confirmed that DapuNPV-T1 belongs to the alphabaculovirus group Ib. In addition, the DapuNPV-T1 isolate was found to be close to the nucleopolyhedrovirus Poland isolate in Dasychira pudibunda and Orgyia pseudotsugata multiple nucleopolyhedrovirus. With this study, the first genome analysis of DapuNPV from Turkey became the second in the world to enter the literature. Comprehensive information on a wide range of isolates will provide a more detailed overview of baculoviruses and help overcome their shortcomings as biocontrol agents.

Validity and reliability evaluation of the Turkish version of the Clinical Interpersonal Reactivity Index

AIM

This study was conducted to evaluate the validity and reliability of the Turkish version of the Clinical Interpersonal Reactivity Index, an instrument to assess nurses' empathy.

BACKGROUND

A practical empathic approach is valuable for planning nursing interventions suitable for the patient's conditions and needs and increasing patient satisfaction.

DESIGN

This is a methodological study.

METHODS

The study was carried out at Muğla Sıtkı Koçman University Training and Research Hospital, recruiting a total of 358 nurses between January and February 2023. Exploratory and confirmatory factor analyses were used to determine and validate the factor structure of the Clinical Interpersonal Reactivity Index.

RESULTS

The exploratory factor analysis extracted three factors. According to the confirmatory factor analysis, all goodness of fit measures were within acceptable limits. Cronbach's α values were 0.89 for the total scale with 17 items and between 0.73 and 0.81 for the factors. In test-retest analyses, all intra-class correlation coefficients were higher than 0.7, and the correlations between the first and second applications of the scale were between 0.61 and 0.73.

CONCLUSION

The Turkish version of the Clinical Interpersonal Reactivity Index can be applied as a valid and reliable measurement tool to evaluate empathy in Turkish nurses.

Dietary proteins modulate high-density lipoprotein characteristics in a sex-specific way in Apoe-deficient mice

OBJECTIVES

The type and amount of dietary protein have become a topic of renewed interest, considering their involvement in several diseases. However, little attention has been devoted to the effect of avian proteins despite their wide human consumption. In a previous study, we saw that compared with soybean protein, the consumption of avian proteins, depending on sex, resulted in similar or lower atherosclerosis with a higher paraoxonase 1 activity, an antioxidant enzyme carried by high-density lipoproteins (HDL). This suggests that under these conditions, the HDL lipoproteins may undergo important changes. The aim of this research was to study the influence of soybean, chicken, and turkey proteins on the characteristics of HDL.

METHODS

Male and female Apoe-deficient mice were fed purified Western diets based on the AIN-93 diet, differing only in the protein source, for 12 wk. After this period, blood and liver samples were taken for analysis of HDL composition and hepatic expression of genes related to HDL metabolism (Abca1, Lcat, Pltp, Pon1, and Scarb1). Depending on sex, these genes define a different network of interactions. Females consuming the turkey protein-containing diet showed decreased atherosclerotic foci, which can be due to larger very-low-density lipoproteins (VLDLs) calculated by molar ratio triacylglycerols/VLDL cholesterol and higher expression of Lcat. In contrast, in males, a higher ratio of paraoxonase1 to apolipoprotein A1 decreased the oxidative status of the different lipoproteins, and augmented Abca1 expression was observed.

CONCLUSIONS

The source of protein has an effect on the development of atherosclerosis depending on sex by modifying HDL characteristics and the expression of genes involved in their properties.

Perceptions of vaccine trust and conspiracy among those with COVID-19 vaccine hesitancy and resistance: a cross-sectional study

BACKGROUND

Individuals' beliefs in conspiracy theories and anti-vaccination defense play a role in the rates of COVID-19 spread.

PURPOSE

This study aims to determine the perception of trust in, and the perception of conspiracy theories regarding vaccines among those with COVID-19 vaccine hesitancy and resistance in a province in Turkey.

METHODS

This study was conducted with 1244 individuals who agreed to participate in the study in the province with the lowest vaccination rate in Turkey. The 'Personal Information Form' and the 'COVID-19 Vaccine Perception and Attitude Scale' were used to collect data.

FINDINGS

Those who were resistant to vaccines had a low mean score on the Perception of Trust and a high mean score on the Perception of Conspiracy. The variable of conspiracy perception had a significantly negative and high effect on the perception of trust.

CONCLUSION

The participants were highly resistant to COVID-19 vaccines. Their perception level of trust in COVID-19 vaccines was moderate and their perception level of conspiracy was high.

Evaluation of the attitude and knowledge level of dentistry undergraduate and specialist students towards epilepsy patients

OBJECTIVE

The objective of this research, which was carried out at a faculty of Dentistry situated in Turkey, was to assess the differences in awareness, knowledge, and attitudes about epilepsy among preclinical and clinical undergraduate students as well as speciality students. Moreover, this study seeks to ascertain the adequacy of the curriculum and clinical training provided to dental students in the context of managing patients with epilepsy. The aim is to ensure a full grasp of the subject matter and the development of practical skills.

MATERIAL-METHOD

At order to facilitate the research done at the Faculty of Dentistry at Afyonkarahisar Health Sciences University, Turkey, a comprehensive questionnaire including eight sections and a total of 60 questions was distributed to students at various stages of their dental education, including preclinical, clinical, and speciality students.

RESULT

The present study used a descriptive, cross-sectional methodology, including a total of 477 participants from various sections (preclinical, clinical, and speciality) within the Faculty of Dentistry at Afyonkarahisar Health Sciences University. When examining the overall understanding of epilepsy, a statistically significant difference was discovered across the various groups. It is noteworthy that a substantial proportion (68.4 %) of students specializing in a particular field displayed a high level of knowledge, which is in stark contrast to the percentages of clinical (40.5 %) and preclinical (29.4 %) students who exhibited similar levels of understanding.

CONCLUSION

This study conducted at a dental college in Turkey revealed a discernible gradient of knowledge, with speciality students exhibiting the greatest degree of knowledge, followed by clinical students, and subsequently preclinical students. In clinical settings, it was observed that students generally had a favorable disposition while interacting with individuals afflicted with epilepsy. Nevertheless, there was a prevailing sentiment of insufficient preparation and instruction. Hence, it is feasible to augment instructional lectures via the use of problem-based or simulation-based learning frameworks.

Women in Neurosurgery: Turkey's Yıldız Yalçınlar

BACKGROUND

Severalreports have been published on the history of pioneering women pursuing neurosurgery. Women in Turkey started receiving neurosurgery specialty training later than men, as was the case in other parts of the world. However, compared to other countries, Turkey saw the admission of women in neurosurgery sooner, with Aysima Altınok who obtained her specialization in 1959. Nevertheless, Yıldız Yalçınlar, one of the pioneers, remains relatively unknown.

METHODS & RESULTS

In this paper, we witness Yıldız Yalçınlar's journey, from her graduation from Ankara Medical Faculty in 1954 and her subsequent specialization in general surgery to her arrival in Iğdır as a young surgeon in the early 1960s, where she faced cultural challenges. We explored her transition into neurosurgery, becoming the second neurosurgeon in Turkey in 1965. We examine her complex career progression from receiving her specialization in neurosurgery to her academic journey toward becoming a department chief and her role as one of the founding members of the Turkish Neurosurgery Association.

CONCLUSIONS

In Turkey, the number of women practicing as neurosurgeons has increased consistently. Despite this upward trend, the representation of women in the field of neurosurgery remains disproportionately low. We hope that Yıldız Yalçınlar's achievements, which began in the early 60s, will encourage women today and contribute to the continuing growth of neurosurgery.

The Association Between Personal, Affective, and Cognitive Factors and Suicide Risk Among Muslims in Turkey

This study was conducted to examine the association of various personal, affective, and cognitive factors with suicide risk. The study group consisted of a total of 423 individuals, including 341 (74%) females and 82 (26%) males, who lived in Turkey and declared that they were Muslims. The data of the study, in which a cross-sectional design was employed, were collected between October and December 2022. The mean age of the participants was 26.84 years (SD = 9.88, min-max = 18-64). The data collection measures included the Psychological Distress Scale, the Perception of God Scale, the Two-Dimensional Self-Esteem Scale, the Suicide Probability Scale, and a personal information form. Pearson correlation analysis and Hierarchical Multiple Linear Regression analysis were employed in the analysis of the data obtained from the research. In the study, it was found that gender, age, suicide attempt, communication with the mother, communication with the father, psychological distress, self-esteem, and perception of God explained 58% of the variance in suicide risk. Psychological distress had the strongest positive association with suicide risk (β = 0.136, p < 0.001), while self-esteem had the strongest negative relation (β = - 0.454, p < 0.001). In conclusion, it was determined that the female gender, suicide attempt, and psychological distress increased the risk of suicide, but that age, positive communication with parents, self-esteem, and positive perception of God decreased it. The findings of the research were discussed in light of the literature.

Comparison of patients with hepatitis B virus-associated hepatocellular carcinoma: Data from two hospitals from Turkey and China

Aims

There are many studies on the incidence of hepatitis B virus (HBV)-associated hepatocellular carcinoma (HCC), but very little is known about the HCC features in different populations. The study aimed to compare characteristics in two cohorts of patients with HBV-associated hepatocellular carcinoma, from Turkey and China.

Methods

Data on patients with HBV-associated HCC diagnosed by imaging or liver biopsy were retrospectively collected from Shandong Provincial Hospital (n = 578) and Inonu University Hospital (n = 359) between January 2002 and December 2020, and the liver function and HCC characteristics were compared. Continuous variables were compared using Student's t-test or Mann-Whitney U test and categorical variables were compared using the χ2 test or Fisher's exact test.

Results

The patients in the Turkish cohort had significantly worse Child-Pugh scores (Child-Pugh A: 38.3% vs. 87.9%; Child-Pugh B: 40.3% vs. 11.1%; Child-Pugh A: 24.1% vs. 1.0%; p < 0.001) and significantly higher levels of aspartate aminotransferase (66.5 vs. 36.0; p < 0.001), alanine aminotransferase (47.5 vs. 33.0; p < 0.001), total bilirubin (20.8 vs. 17.9; p < 0.001), and lower albumin levels (32.0 vs. 40.0; p < 0.001) than patients in Chinese cohort. The tumor characteristics showed the Barcelona Clinic Liver Cancer (BCLC) score (BCLC 1: 5.1% vs. 71.8%; BCLC 2: 48.7% vs. 24.4%; BCLC 3: 24.4% vs. 3.8%; BCLC 4: 21.8% vs. 0; all p < 0.001), maximum tumor diameter (5.0 vs. 3.5; p < 0.001), alpha-fetoprotein values (27.7 vs. 13.2; p < 0.001), and percentage of patients with portal vein tumor thrombus (33% vs. 6.1%; p < 0.001) were all significantly worse in the Turkish cohort compared with Chinese cohort.

Conclusions

HBV-associated HCC from the Turkish cohort had worse liver function and more aggressive clinical characteristics than patients from the Chinese cohort.

The Effects of Daylight Saving Time (DST) Transition Cancelation on Work Accidents of Turkey

Objectives. Turkey canceled the daylight saving time (DST) transition and started permanent clock application. Considering the effect of this new regulation on working hours, this study examines whether there is a relationship with the increase in the number of work accidents in shifts. Methods. Data on work accidents were obtained from the Republic of Turkey Social Security Institution (SSI), filed between 2011 and 2020. We estimate accident rates using Poisson regression and log-linear models as a function of a variety of date-based factors. Results. The results show that DST transition is effective (ineffective in terms of gender) on changes in the number of work accidents. With statistical analyses, the hourly distribution of work accidents was determined, indicating at which hour the most work accidents occurred, using the work accident frequency rate. The number of prevented work accidents was calculated as 286,793 for Turkey. Conclusion. The findings from these studies suggest that cancellation of the DST transition does not have a negative effect on the incidence of work accidents in Turkey; on the contrary, this practice also serves the purpose of preventing work accidents.

Spiritual Well-Being and Psychological Well-Being Among Hemodialysis Patients in Turkey: A Descriptive and Correlational Study

This study aimed to determine the psychological and spiritual well-being of hemodialysis patients in Turkey. This descriptive and correlational study included 86 hemodialysis patients. Data were collected using the Spiritual Well-Being Scale and Psychological Well-Being Scale. There was a positive correlation between spiritual and psychological well-being (r = 0.315, p = 0.003). Psychological well-being and age explained 39% of total variance (F = 7.593, p = 0.001). In conclusion, there should be provided individualized spiritual care and counseling to improve the psychological well-being of hemodialysis patients.

Verbal violence and missed nursing care: A phenomenological study

AIM

To define the missed care experiences of nurses exposed to verbal violence from patients.

BACKGROUND

Verbal violence takes the first place among the types of violence that nurses face in healthcare settings. This can cause negative emotional and physical responses in nurses and issues in patient and nurse interaction. As a result, it may lead to missed nursing care, defined as skipped, postponed or incomplete care during the patient's care.

METHODS

This is a phenomenological study. The study sample included 16 nurses working in inpatient clinics who reported experiencing verbal violence at least once in Turkey. The study was conducted between January and February 2022 with institutional permission and ethics committee approval (09/12/2021-2021/357). A semi-structured interview method was used to collect data. The information gathered from the interviews underwent thematic analysis using an inductive approach. The 'Consolidated Criteria for Reporting Qualitative Research (COREQ)' was used to report this qualitative study based on a comprehensive protocol.

RESULTS

The types of verbal violence most frequently faced by nurses were determined as swearing, insulting, shouting and threats. Study findings were classified into three main themes: (i) response to verbal violence, (ii) missed nursing care experiences and (iii) suggestions to cope with verbal violence. The most felt emotions in the face of verbal violence were feeling sad, unsafe and worthless. Nurses common behaviours, in response to verbal abuse were ignoring, getting used to, and wishing to get away. The examples of missed care included using non-therapeutic communication, postponing care or withdrawing from care.

CONCLUSION

Verbal violence caused negative emotional and behavioural responses in nurses, which, in turn, negatively affected the nurse-patient interaction. These findings mean that verbal violence may pave the way for missed nursing care.

IMPLICATIONS FOR NURSING POLICY

According to these findings, an uninterrupted nursing care process needs to focus on preventive measures against verbal violence and increase the administrative and legal support offered to nurses.

Utility of glutaraldehyde-fixed turkey red blood cells for influenza virus detection after 18 months of storage

Turkey red blood cells (tRBCs) are an essential reagent used in the laboratory diagnosis of influenza viruses. Fresh tRBCs when stored at 4 °C have a shelf life of less than a week. Previous studies have shown the utility of glutaraldehyde-fixed tRBCs, with an increased shelf life, for use in hemagglutination (HA) assays. In the present study, we report their functionality after storage for 18 months, at -80 °C. Three influenza A subtypes, namely, H3N2, H1N1 and H5N1, were used in the study. Hemagglutination assay was performed using freshly prepared 0.5 % tRBCs suspension and stored 1 % glutaraldehyde-fixed tRBCs. There was no significant difference in the HA titers obtained using fresh and stored tRBCs. The validation of the HA assay was carried out, to determine the specificity, linearity, precision, accuracy, and robustness of the assay. All of the titers were within the acceptable range, indicating the validity of the HA assay using stored tRBCs. Hemagglutination inhibition assay was also performed to compare the antibody titers obtained using stored and fresh tRBCs. The stored RBCs also gave equivalent antibody titers, as compared to the fresh tRBCs. Thus, the present study demonstrates the utility of glutaraldehyde-fixed tRBCs after one and a half years of storage.

The prevalence of mental distress changes before and during the COVID-19 pandemic: a study on physicians in Turkey

BACKGROUND

The emergence of the COVID-19 pandemic may adversely affect the physicians' mental health differently.

AIMS

This study aimed to investigate the degree of changes in mental distress in physicians through two cross-sectional studies before and during the COVID-19 pandemic and explore factors associated with the change of mental distress status of participants between two-time periods.

METHODS

This cross-sectional, web-based survey collected demographic data and mental health measurements with the 12-item General Health Questionnaire from 416 and 522 physicians before and during COVID-19, respectively. Mixed-effects ordinal logistic regression analyses were performed to assess the factors associated with the change of mental distress status.

RESULTS

During the outbreak, a total of 319 of the 522 participants reported a clinically significant level of mental distress compared with 123 of 416 participants before COVID-19. Higher levels of mental distress were observed in all socio-demographic groups during COVID-19 compared with before, with more than two-fold higher prevalence of mental health deterioration in general.

CONCLUSIONS

This study suggests a significant deterioration in mental health status after the occurrence of COVID-19 compared with before. The mental health of physicians working in all medical specialty groups, especially those in internal and surgical specialties, may require special attention.

What non-pharmacological and non-invasive pain management interventions are available for individuals from Turkish-speaking ethnic groups with non-malignant chronic pain? A scoping review of published literature

Objectives

A scoping review was selected to explore what non-pharmacological and non-invasive pain management interventions are available for individuals from Turkish-speaking ethnic groups with chronic pain and what represents the most appropriate intervention.

Inclusion Criteria

Adults with non-malignant chronic pain from Turkish-speaking ethnic groups residing in or outside of Turkey. All non-pharmacological and non-invasive pain management interventions were considered. No limits were placed on geographic location, gender, sex or healthcare setting.

Methods

The MEDLINE database was searched for published literature in April 2022. An English language filter was applied. No limits were placed on study design or date of publication. Data was charted from eligible studies into a data extraction table. Key concepts were identified during data extraction by DN.

Results

Eleven studies were included in the final review. All were conducted within a quantitative research paradigm. The studies were completed in Turkey (7), Belgium (1), Sweden (1) and Switzerland (1). One was a multi-country review. No studies were conducted in the UK. The primary interventions were heterogenous and included: pain science education (2), cognitive behavioural therapy (2), transcranial magnetic stimulation (1), balneotherapy (1), extracorporeal shockwave therapy (1), transcutaneous electrical nerve stimulation (1), wool therapy (1), exercise and patient dialogues (1) and aromatherapy massage and reflexology (1). Location of pain, outcome measures and timings of follow-ups were heterogeneous.

Conclusions

Intervention heterogeneity, exclusively quantitative methodology and absence of studies completed in the UK meant no conclusions could be made on what represents the most appropriate non-pharmacological and non-invasive interventions intervention for individuals from Turkish speaking ethnic groups with non-malignant chronic pain.

Genetic, serological and clinical evaluation of childhood myasthenia syndromes- single center subgroup analysis experience in Turkey

BACKGROUND

Congenital myasthenic syndrome is a disease that occurs due to several types such as mutations in different pre-synaptic, synaptic, post-synaptic proteins and, glycosylation defects associated with congenital myopathy. Juvenile myasthenia gravis is an autoimmune condition usually caused by antibodies targeting the acetylcholine receptor.

AIMS

Our objective is to conduct an analysis on the subgroup traits exhibited by patients who have been diagnosed with congenital myasthenic syndrome and juvenile myasthenia gravis, with a focus on their long-term monitoring and management.

METHODS

This study was conducted on children diagnosed with myasthenia gravis, who were under the care of Dokuz Eylul University's Department of Pediatric Neurology for a period of ten years.

RESULTS

A total of 22 (12 congenital myasthenic syndrome, 10 juvenile myasthenia gravis) patients were identified. Defects in the acetylcholine receptor (6/12) were the most common type in the congenital myasthenic syndrome group. Basal-lamina-related defects (5/12) were the second most prevalent. One patient had a GFPT1 gene mutation (1/12). Patients with ocular myasthenia gravis (n = 6) exhibited milder symptoms. In the generalized myasthenia gravis group (n = 4), specifically in postpubertal girls, a more severe clinical progression was observed, leading to the implementation of more aggressive treatment strategies.

CONCLUSION

This study highlights that clinical recognition of congenital myasthenic syndrome and knowledge of related genes will aid the rapid diagnosis and treatment of these rare neuromuscular disorders. Findings in the juvenile myasthenia gravis group demonstrate the impact of pubertal development and the need for timely and appropriate active therapy, including thymectomy, to improve prognosis.

Obstetric Violence Questionnaire: Adaptation of a Turkish Self-Report Tool

Obstetric violence has started to attract attention as a form of violence against women. This study aimed to determine and analyze the psychometric properties of a Turkish version of the Obstetric Violence Questionnaire (OVQ).  Four hundred sixty-eight women from 19 to 59 years of age (M  =  35.28, SD  =  7.22) participated. The confirmatory factor analysis confirmed a multifactorial structure of two factors. The Cronbach's α internal consistency coefficients were .72, .70, and .73 obtained for the total scale, abuse and violence, and non-consented care subscale, respectively. The OVQ consisted of 11 items, proving to be a reliable and brief measure.

Accuracy of Syrain Refugee Mothers' Perceptions of Newborn's Birth Size: Insights from a National Survey in Turkey

This study aims to assess the accuracy of maternally perceived birth size and its associated factors among the Syrian refugees in Turkey, using the data from 2018 Turkey Demographic and Health Survey Syrian Migrant Sample (TDHS-SM-18). The study includes information on the last-born child, singleton pregnancies, births in healthcare facilities, children under 5 living with their mothers, with recorded birth weight (n = 969). The study categorizes the mother's perception of size into three groups : compatible, overestimated, and underestimated. Various factors, including sociodemographic characteristics, financial aspects, maternal characteristics, and child characteristics, are considered as explanatory variables. The analysis employs a complex sample multiple logistic regression model. The findings reveal that the majority of mothers accurately perceive the birth size, but 17.1% of them do not. Maternal factors such as region of residence, literacy, occupation, age at birth, and child factors such as birth order, birth interval, gender, and birth weight are identified as associated factors with maternal misperception. This study provides valuable insights into the accuracy of maternally perceived birth size and sheds light on the factors influencing this perception among Syrian refugee mothers in Turkey.

Identification of maternal attitudes and knowledge about newborn screenings: a Turkey sample

This study was planned to determine maternal attitudes and knowledge about newborn screening. The universe of the descriptive study consisted of postpartum mothers living in the centers of three provinces in the north and east of Turkey. The sample included mothers who were older than 18 years of age, who could read and write Turkish, whose babies were in the 24th and 72nd hour after birth, and who volunteered to take part in the study. The study was completed with 407 mothers. The data were collected with the face-to-face interview method by the researchers using the "Descriptive Information Form" and the "Maternal Attitudes and Knowledge Survey about Newborn Screening." The results showed that 40.3% of the mothers were between the ages of 25 and 30 years, 52.8% received information about newborn screening, 61.1% received this information during pregnancy (27.3% in the first trimester and 33.8% in the last trimester), and most of the information was provided by a healthcare professional (77.8%). Mothers with only one child (p = .001) and those with nuclear families (p = .024) were found to have lower maternal attitudes and knowledge about newborn screening. The study showed that the level of knowledge of Turkish mothers about newborn screening is inadequate in general. In particular, the knowledge and attitudes of mothers with nuclear families, those with one child, and those not having regular check-ups during pregnancy are inadequate. Improving mothers' understanding of screening tests will lead to more successful screening program implementation and earlier detection and care of newborns with a disease.

The genome evolution of Marek's disease viruses in chickens and turkeys in China

The virus that causes Marek's disease (MD) is globally ubiquitous in chickens, continuously evolving, and poses a significant threat to the poultry industry. Although vaccines are extensively used, MD still occurs frequently and the virus has evolved increased virulence in China. Here, we report an outbreak of MD in vaccinated chickens and unvaccinated turkeys in a backyard farm in Guangdong province, China, in 2018. Phylogenetic analysis revealed two lineages of MDVs at this farm, with one lineage, containing isolates from two turkeys and five chickens, clustering with virulent Chinese strains and displays a relatively high genetic divergence from the vaccine strains. These new isolates appear to have broken through vaccine immunity, yielding this outbreak of MD in chickens and turkeys. The second lineage included four chicken isolates that clustered with the CVI988 and 814 vaccine strains. The large diversity of MDVs in this single outbreak reveals a complex circulation of MDVs in China. Poor breeding conditions and the weak application of disease prevention and control measures make backyard farms a hotbed for the evolution of viruses that cause infectious diseases. This is especially important in MDV as the MD vaccines do not provide sterilizing immunity, which allows the replication and shedding of virulent field viruses by vaccinated individuals and supporting the continuous evolution of MDVs. Hence, constant monitoring of the evolution of MDVs is necessary to understand the evolution of these field viruses and potential expansions of their host range.

Causal effect of obesity on the probability of employment in women in Turkey

This study aims to investigate the causal effect of obesity on the employment probability of women in Turkey via the instrumental variable approach by using data from the 2018 Turkey and Demographic Health Survey. Obesity prevalence in the area of living and the overweight status of the oldest child, which are the most common types of instruments seen in the literature, are used as instruments. Consistent with the OLS result, the 2SLS estimate indicates that obese women are statistically significantly less likely to be employed when the overweight status of the child is used as an instrument. On the other hand, the statistically significant effect of obesity disappears when the area level obesity prevalence is used as the instrument. In addition, obesity in women decreases the likelihood of employment in the services sector and full-time jobs and employment with social security. Although the results of this study do not indicate the source of the effect found, the presence of a causal relationship for women should not be ignored when the economic burden of obesity for Turkey is considered.

The effects of climate change awareness on mental health: Comparison of climate anxiety and hopelessness levels in Turkish youth

BACKGROUND

Climate anxiety, one of the negative emotions created by climate change, is particularly prevalent among climate activists and young individuals who hold a more serious concern for environmental issues.

AIM

This study aims to determine the effects of climate change awareness on the mental health of young people in Turkey.

METHODS

Designed as a descriptive and two-group comparative study, the target population of this study comprises young individuals aged 15 to 24 who are climate activists and those who are not. The study data was collected through e-questionnaires administered between March 15 and May 10, 2023, using a demographic characteristics form, a climate change anxiety scale and the Beck Hopelessness Scale. The study was completed with a total of 306 participants, including 103 young individuals who are climate activists and 203 young individuals who are not climate activists.

RESULTS

We determined that young individuals who are climate activists have a high level of climate change anxiety, while those who are not climate activists have a moderate level of climate change anxiety. We found that the levels of hopelessness in both groups are at a mild level. Additionally, within the group of climate activists, we observed that individuals with a higher level of knowledge about climate change tend to exhibit greater levels of hopelessness.

CONCLUSIONS

We identified that as awareness and knowledge about climate change increase, climate change anxiety, and hopelessness also increase. There is a need for studies to determine youth-specific mental health interventions to address mental health issues related to climate change awareness.

COVID-19 vaccine hesitancy in Turkey: A systematic review and meta-analysis

This systematic review and meta-analysis aims to estimate the prevalence of coronavirus disease 2019 (COVID-19) vaccine hesitancy in Turkey, which can aid future health policies and strategies. A comprehensive search was conducted on various databases using keywords related to COVID-19 vaccine hesitancy in Turkey. Quality assessment was performed using Joanna Briggs Institute (JBI) checklist for prevalence studies. Data extraction was conducted. The random effect model (DerSimonian and Laird method) was used in pooled prevalence data analysis (95% confidence interval [CI]). A total of 1,072 articles were identified. After removing duplicates and excluding articles, 61 articles remained for bias assessment. Among these, 19 articles with low risk of bias were included in the review and meta-analysis. Total population included in the analysis was 15,164, vaccine hesitancy was 30.5% (95% Cl: 24.3-36.8%). Prevalence of the vaccine hesitancy was found to be 39.8% (95% Cl: 31.4-48.2%) in studies conducted before the initiation of vaccination, while in studies conducted after the commencement of vaccination, hesitancy was 20.4% (95% Cl: 12.9-28%). We suggest conducting high-quality studies in different populations to understand the level of vaccine hesitancy, as many of the previous studies have mainly focused on healthcare workers and students, and rest were community-based studies, which have generally shown high bias. Also, we suggest that early vaccination can reduce vaccine hesitancy.

Assessment of the water quality using multivariate statistics and the water quality index: a case study of the Yağlıdere Stream (Giresun) in the Eastern Black Sea region, Turkey

In this study, the water quality of the Yağlıdere Stream passing through Espiye (Giresun-NE Turkey) and Yağlıdere districts, where old and new mining activities are present, was evaluated, and characterized by using the water quality index (WQI), multivariate statistical, and GIS techniques. The downstream aquifer of the Yağlıdere Stream, which originates from Erimez Mountains and reaches the sea from the west of Espiye district, meets the domestic and drinking water needs of Yağlıdere and Espiye districts. In addition, activities such as energy production and fish farming are carried out along the stream. Therefore, it is of great importance to investigate the water quality of the stream. In order to evaluate the water quality, 50 water samples were taken from 10 sampling points (5 periods) along the flow direction of the stream. Parameters other than T, DO, Mg, F, NH3, CN, and HS show significant spatial variations indicating the influence of geogenic and anthropogenic activities. Some of the investigated parameters (T, DO, Ca2+, Mg2+, SO42-, NH3, CN, Fe, Se) exhibit important seasonal variations due to high seasonality in water temperature and water flow. Principal component analysis/factor analysis reveals that the parameters responsible for water quality changes in the Yağlıdere Stream are mainly related to the geogenic structure, mining wastes, agricultural activities, and domestic wastes. According to the WQI values, the water samples taken from the upstream and middle part of the stream are in the water quality between "Excellent" and "Good", on the other hand, in the downstream regions where anthropogenic and geogenic effects are dominant, the water samples are in the quality of "Poor water" and "Unsuitable for drinking". The most effective water quality parameters on WQI are Al, Fe, and Mn and the water quality in the basin is negatively affected by geogenic and anthropogenic effects.

The positioning of nursing in Turkish mass media: Before and after the COVID-19 outbreak

AIM

To explore the way the nursing profession was portrayed in online news coverage before and after the COVID-19 pandemic.

BACKGROUND

The power of the media can be used as a tool to introduce nursing services to society, make nursing visible, and influence the public perception of nursing.

INTRODUCTION

Analyzing the image of nursing as portrayed in the news can be a guide for more effective management of the media as a tool for positioning nursing in the future and presenting the right message.

METHODS

A qualitative design was applied. Three online newspapers published in the Turkish language-the most widely read newspapers in Turkey-were analyzed. The sample for this research consisted of 505 news articles containing the keywords "nurse" and "nursing" published before and after the COVID-19 outbreak. The MAXQDA2022 software was used for data management.

RESULTS

The articles selected were themed as news reflecting the nursing profession negatively, positively, and neutrally. When the negative and positive themes were compared, the two most repeated subthemes included (1) working conditions and being unprofessionalism; (2) impact on health, social recognition, and neutral included only subtheme that happens to you as a citizen/individual.

CONCLUSION

Compared with the pre-COVID-19 period, there was an increase in news coverage reflecting portrayed nursing positively on the nursing profession in the post-COVID-19 period. Mass media, which are indispensable in social communication, can be used as an effective tool to improve the image of nursing in society.

IMPLICATIONS FOR NURSING

From nursing students to policymakers, all professionals must act in a planned and purposeful manner to present nursing professionals positively as leaders in public healthcare.

Can highway tunnel constructıon change the habitat selection of roe deer (Capreolus capreolus Linnaeus, 1758)?

One of the main things wildlife does for survival is movement. Wild animals need movement to meet their needs, such as reproduction, breeding, foraging, and dispersal. Although wildlife species use roads for various purposes, they also use them when moving from one habitat to another. In recent years, especially when it comes to habitat fragmentation brought about by urbanization, wild animals frequently use highways. Highways have a wide range of effects on factors such as biodiversity, wildlife, and ecology. Roads can cause habitat loss, habitat fragmentation, and habitat degradation; alter the composition of vegetation; act as barriers to the flow of genes and movement; increase human access to pristine areas; and even increase the risk of extinction for many threatened species. Species belonging to the family Cervidae also include the species most affected by road networks. Roe deer (Capreolus capreolus Linnaeus, 1758) is the smallest of the 3 Cervid species living in Turkey. Roe deer are often injured or die in road accidents, and they are one of the most important species affected by the adverse effects of roads in Turkey. For this reason, it was investigated whether the road tunnel construction affected the distribution of roe deer in the region. In the study, the general distribution of roe deer in the Ilgaz Mountain, and the factors affecting their possible distribution were determined by ecological niche modeling. Data were taken between before (2012-2015) and after the highway tunnel built (2020-2022) in Ilgaz Mountain, which connects the Western Black Sea and Central Anatolia and is located in the middle of Kastamonu and Çankırı provinces. As a result of the modeling, it was found that before the construction of the tunnel, the most influential factor in the distribution of the deer was road density. After the tunnel construction, roads ceased to be the main factor affecting the distribution of the species. This study showed that roe deer are disturbed by the density of vehicles on the road passing through the middle of their habitat. With the decrease in the number of vehicles, they are more willing to cross the road and tend to use the areas close to the road as they are less disturbed.

Turkey's quest to become a regional energy hub: Challenges and opportunities

Despite its relatively modest domestic energy resources, Turkey plays a central role in the global geopolitics of energy. Situated between energy-rich areas of the Middle East and energy-consuming Europe, it is no surprise that Turkey has become a crucial transit route for fossil fuels, especially natural gas. Furthermore, in recent decades, Turkey's leadership has pursued an ambitious plan to transform the country into a regional energy hub. This vision encompasses Turkey as a place where energy resources are not only transited but also sold and bought by international sellers and buyers. The study offers a historical overview of major transboundary oil and natural gas energy projects in Turkey, including both successful and failed endeavors and those in prospect. It delves into Turkey's aspirations to establish itself as a regional energy trade spot, a crucial component of its foreign policy agenda aimed at bolstering its influence on the regional and global stage. The paper also assesses the strengths and weaknesses of Turkey's ambition to become a regional energy nexus and its feasibility. The study highlights Turkey's potentially significant role in enhancing energy security for Europe, especially in the wake of the Russia-Ukraine conflict and the European Union's efforts to reduce its dependence on energy from Russia.

Continuous Lactation Support Provided Through the WhatsApp Messaging Application: A Randomized Controlled Trial

BACKGROUND

Although WhatsApp can be used to provide continuous lactation support, there are few studies on this subject.

RESEARCH AIMS

To determine the influence of lactation support provided through WhatsApp on the duration and exclusivity of breastfeeding, initiation of complementary feeding, breastfeeding problems, breastfeeding difficulties score, and the use of bottles and pacifiers.

METHODS

We conducted a randomized controlled trial assessing the efficacy of education and support provided through the cell phone based WhatsApp application. There were 129 primiparous participants recruited while attending a Baby-Friendly Hospital in Istanbul, Turkey. Participants were randomized to intervention (n = 64) and control (n = 65) groups. All participants received the same routine postpartum breastfeeding education in the hospital, and the intervention group received additional continuous breastfeeding education for 6 months. For both groups, data was collected by telephone interview on Days 7 and 15, and Months 1, 2, 4, and 6 months. T-tests were used to assess inter-group differences in duration of exclusivity of breastfeeding. Mixed-model ANOVA was used to compare breastfeeding difficulties scores. Chi-square tests were used to compare breastfeeding problems, feeding practices, and the proportion of the use of bottles and pacifiers.

RESULTS

The mean duration of exclusive breastfeeding for groups receiving breastfeeding support was higher (4.75, SD = 1.72) than that of the control group (2.21, SD = 1.98; p = 0.001). The change in the mean breastfeeding difficulties severity score between the initial and final measurements (17.03, SD = 8.66) was more in the intervention group than the control group (11.42, SD = 10.34, F = 4.081, p = 0.001). The proportion of exclusive breastfeeding in the 6th month was higher in the intervention group (62.5%) than in the control group (10.8%; p = 0.001).

CONCLUSIONS

The use of cellphone applications are accessible to both patients and health workers and offer a low-cost alternative for providing uninterrupted breastfeeding support.

Examining the effect of moral resilience on moral distress

AIMS

The study aims to test the Turkish validity and reliability of the Rushton Moral Resilience Scale (RMRS) and examine the effect of moral resilience on moral distress.

BACKGROUND

Moral distress is a phenomenon that negatively affects health workers, health institutions, and the person receiving care. In order to eliminate or minimize the negative effects of moral distress, it is necessary to increase the moral resilience of nurses. Moral resilience involves developing systems that support a culture of ethical practice in healthcare and aim to increase an individual's capacity to cope with moral challenges.

METHODS

A methodological and descriptive-predictive study design was adopted. Sociodemographic Information Form, Measure of Moral Distress - Healthcare Professionals (MMD-HP), and Rushton Moral Resilience Scale were used to collect data from the nurses. A total of 255 clinical nurses were recruited.

ETHICAL CONSIDERATIONS

Hacettepe University's non-interventional ethics committee approved the study's protocol and informed consent was obtained from the participants.

RESULTS

The original four-factor structure of the scale was tested with confirmatory factor analysis, and the index values were evaluated and found at an acceptable level. The Cronbach Alpha coefficient of the scale was found to be 0.826. Moral resilience predicted moral distress total, intensity, and frequency levels. A moderate and weak relationship was found in the negative between all sub-dimensions of moral distress and moral resilience.

CONCLUSIONS

The Rushton Moral Resilience Scale Turkish version showed good psychometric properties. Moral resilience has a reducing effect on moral distress. Young nurses who have less experience are at risk because they have lower moral resilience levels, while nurses working in intensive care units are at risk because of their high moral distress levels. A healthy workplace can be created by developing specific approaches to improve moral resilience in reducing the impact of moral distress in the healthcare environment.

What do children aged 12-18 think about COVID-19 vaccines?

OBJECTIVES

Vaccines are crucial for preventing the spread of the coronavirus pandemic and controlling its effects. We aimed to determine the desire of children aged 12-18 to be vaccinated with the current vaccines, the reasons for wanting or not wanting to be vaccinated, where they had learned about the vaccine, how many of the children with a history of chronic disease want to be vaccinated, and which factors affect them.

METHODS

A questionnaire form was completed for children aged 12-18 years who applied to Gazi University Pediatric Emergency Department and the Child Health and Diseases Polyclinic between April 1, 2022, and September 30, 2022.

RESULTS

A total of 924 children participated in the study. The mean age of the participants was 14.64±1.77 years. The willingness to be vaccinated was 83.1%. Being older, living in the city, having a mother, father, or sibling who was vaccinated, information about vaccines obtained from health personnel, a completed national vaccination program, and the presence of a first-degree relative in the healthcare field significantly increased the probability of the child being vaccinated. The most important factors affecting the desire to be vaccinated in children were the vaccination status of the mother, father, or sibling and the completed national vaccination program.

CONCLUSION

We found that the immunization status of the parents is the most important factor guiding the child's desire to be vaccinated and that the most common reason for vaccine hesitancy is the side effects of the vaccine.

Heavy metal contamination and health risk evaluation of chestnut (Castanea sativa Miller) consumed in Turkey

This study was performed to determine heavy metals and metalloids in twenty-eight chestnut (Castanea sativa Miller) samples consumed in Turkey by inductively coupled plasma optical emission spectrometry and evaluate health risks for humans through the consumption of chestnut samples. The concentrations of Cd, Cr, Co, Cu, Fe, Pb, Mn, Ni and Zn analyzed in chestnut samples varied from 537 to 635, 608 to 5333, 347 to 972, 207 to 8619, 12,739 to 86,310, 278 to 7549, 8676 to 67,622, 1068 to 18,661 and 3625 to 12,876 µg/kg (dry weight), respectively. The concentrations of Cd and Pb were above the maximum limits determined by the Turkish Food Codex. Healthy risks caused by the heavy metals in the consumed chestnut samples were evaluated by estimating the average daily intake of metal, health risk index (HRI), and total HRI. These results revealed that there is no possible health risk to consumers due to the intake of chestnut samples studied under the current consumption rate.

Different periods, similar challenges, opposing paths: Exploring the social structure of popular science magazines in Turkey

This study questions the social relations behind the challenges that popular science magazines in Turkey have faced from their onset, by focusing on the peculiarities of different historical periods and prevailing relations of production. The history of popular science magazines from the Ottoman Empire to the present day is also the history of the transition from artisan-like relations of production to factory-like relations of production and more. In this long historical period, premodern social relations and market conditions come to the fore as the main source of the challenges these magazines face. In recent years, big capital's interest in popular science and the enthusiastic struggle of "zero capital" magazines on the other hand reveal two different sides of the picture. Similar challenges and divergent experiences across different periods indicate that popularizing science goes far beyond bringing science to lay people. This study shows that it is possible to trace a frustrated story of modernization, as well as economic and political turmoil, in these magazines' survival struggle in a country which has not been closely studied in this respect.

Deaths associated with electric shock injuries in children and adults: A 10-year retrospective examination in Şanlıurfa, Southeast Turkey (2012-2022)

Electric shock injuries (EIs) have high rates of morbidity and mortality in both children and adults. The aim of this study was to examine autopsy cases resulting from EIs and to compare pediatric and adult groups with respect to sociodemographic data, clinical characteristics, location of the incident, electricity entry-exit wound characteristics, current direction, pathological effects of the electric shocks on the body, and cause of death. A total of 8075 autopsies conducted between 2012 and 2022 were retrospectively examined. Şanliurfa is a city in the southeast of Turkey with the highest birth rate in the country. Of 123 cases of death resulting from EIs in Şanliurfa, 58 (47.2%) were children (age < 18 years). In the majority of children (81%), a low-voltage injury resulted from a domestic appliance while the children were playing at home in a rural area. In the vast majority of adults, a high-voltage injury (HVI) resulted from a workplace accident due to working with HVI materials in an area outside the home. The manner of death was accidental in all the electric shock injuries. The electricity entry and exit wounds formed as a result of EIs had similar characteristics in both children and adults, with no significant difference identified. In the province of Şanliurfa, Turkey, which borders Syria and where the main occupation is agricultural activities, there is a need to increase electrical safety precautions within the home, educate parents, and increase electrical safety conditions and worker education in the workplace.

Anthropometric indexes for predicting high blood pressure in Turkish adults

Purpose

It is controversial which anthropometric indexes are the best in predicting the risk of hypertension and how anthropometric measurements are related to blood pressure (BP). This study aimed to evaluate the relationship between BP and anthropometric indexes and to determine the best predictors for hypertension risk.

Methods

This cross-sectional study was conducted with 415 consecutive participants (161 men, mean age: 33.4 years) aged 18-88 years in Istanbul, Turkey. Weight, height, waist circumference (WC), and neck circumference (NC) and BP were measured by well-trained personnel. Waist-to-height ratio (WHtR) and body mass index (BMI) were calculated. Pearson correlation, linear regression, and multivariate analyses were used to assess the relationship between anthropometric measurements and SBP, DBP, using the Statistical Package for the Social Sciences version 23.0.

Results

The systolic BP (SBP) and diastolic BP (DBP) were related to weight, WC, NC, BMI, and WHtR (P < 0.05). Linear regression analyses showed BMI and WC as independent risk factors for SBP with an increase by 1.11 mmHg in men (P = 0.036) and 1.59 mmHg in women (P = 0.001) in SBP when BMI increased 1 unit, while SBP increases by 0.2 mmHg when WC increases by 1 unit regardless of gender (P = 0.013).

Conclusion

Our results showed that BMI and WC are related to BP and important predictors of hypertension risk. Therefore, the uses of BMI and WC are recommended as screening tools for the prediction of hypertension risk among Turkish adults.

The relationship between PM10 and SO2 exposure and Covid-19 infection rates in Turkey using nomenclature of territorial units for statistics level 1 regions

The Covid-19 pandemic, which has been affecting the world since December 2019, has become one of the biggest problems of the 21st century. There are studies stating that the contagiousness of the Covid-19 pandemic, which is transmitted from person to person, increases more with environmental factors such as air pollution, and accordingly, there is an increase in the number of cases. In this study, a panel regression model to investigate the effect of air pollution concentrations such as PM10 and SO2 as environmental factors and population density on the monthly mean number of Covid-19 cases for 12 regions at the nomenclature of territorial units for statistics (NUTS) level 1 in Turkey between June 2020 and November 2020, and a linear regression model to investigate the effect at the regional level. we used. Based on the model results, we concluded that a small increase in air pollution indicators led to an increase in the number of Covid-19 cases in Turkey and its regions. It is very important to identify preventable environmental factors in order to prevent and minimize the effects of respiratory tract diseases and rapidly spreading pandemic diseases such as Covid-19. Accordingly, we can conclude that countries should take some measures, especially on air pollution, in order to develop public health and pandemic/disease management strategies and to reduce the risk of respiratory diseases.

The Relationship Between the Health Transformation Program and Health Expenditures: Evidence From an Autoregressive Distributed Lag Testing Approach

OBJECTIVES

As health expenditure increases every year, countries try to provide accessible health services to society and try to protect individuals from the expenses they cannot overcome by investigating the reason for this increase. Especially with the arrangements made in the health systems in developing countries such as Turkey, it has been tried to take the control of dramatic increases in health expenditure. Based on this issue, in this study, we aimed to evaluate the effect of income per capita, annual inflation, and health reform called as Health Transformation Program on the health expenditure per capita in Turkey.

METHODS

This study reflected the effects of income, inflation, and the reform on the total health expenditure through the autoregressive distributed lag. This study covered the years between 1985 and 2016 for Turkey.

RESULTS

As a result of this study, there was a positive relationship between health expenditure and income and a negative relationship with the reform (P < .05).

CONCLUSION

According to the results of this study, it is suggested that health expenditures can be kept under control with improvements such as encouraging individuals to use more primary healthcare services than curative health services and increasing the quality of service without compromising the equity in financing.

Prevalence of musculoskeletal system problems in children working in Turkey's automotive industry

OBJECTIVE

This epidemiology study was conducted to determine the musculoskeletal system problems of children working in the automotive industry and related factors affecting them in the province of Şanlıurfa, the Turkish province where the child population is the highest at 44.9%.

DESIGN AND METHODS

A cross-sectional descriptive type study of 256 children aged 7-17 years working in Şanlıurfa Evren Auto Industry Site and Birecik Fırat Auto Industry Site was carried out between April and September 2021.

RESULTS

The majority (55.9%) of the children spent most of their time afoot while working and had musculoskeletal symptoms, with a duration of more than one year. The body areas with the most symptoms were the waist, feet, and hands, respectively. These symptoms had not occurred before a child started working and were affected by the posture they worked in, and their daily working and sleep hours.

CONCLUSION

Public health nurses are in a position to ensure that tetanus vaccination of working children, employment examinations, routine health checks, and necessary personal protective equipment are available. They can also work to ensure that children work for legal periods, get paid their wages, have health insurance, receive apprenticeship training, and only start working when they reach the age of being an apprentice or apprentice candidate.

Knock, knock, knocking on Europes door: Threat of leishmaniasis in Europe with a focus on Turkey

Leishmaniasis epidemiology is currently undergoing substantial transformations in both Turkey and Europe, signifying potential implications for public health. This review analyzes the evolving patterns within Turkey and their potential ramifications for Europe. Within Turkey, the dynamics of leishmaniasis are undergoing noteworthy alterations, manifesting in a rise in cutaneous leishmaniasis (CL) cases and the emergence of Leishmania major and Leishmania donovani. These transformations are predominantly driven by factors such as the distribution of vectors, human activities, climate fluctuations, and migration. Across Europe, particularly in countries within the Mediterranean basin, leishmaniasis is endemic, primarily attributed to Leishmania infantum. Recent evidence suggests a resurgence of the disease even in previously non-endemic areas, propelled by climate change, urbanization, and migration. The changing landscape of leishmaniasis in Turkey carries direct implications for Europe. The presence and distribution of Leishmania tropica, L. major, and L. donovani raise concerns regarding cross-border transmission. Turkey's strategic position along migration routes further compounds the risk, alongside the facilitative effects of climate change and host mobility. Embracing a One Health approach with public awareness campaigns should be a priority. To ensure the protection of public health in Europe, it is imperative to adopt a proactive approach by establishing robust surveillance mechanisms, implementing preventive measures, and cultivating collaboration with Turkey. The invaluable experience, strategic geographical location, and well-established infrastructure of Turkey make this collaboration crucial in effectively addressing the evolving dynamics of leishmaniasis and its potential impacts on Europe.

Peer education model in Trakya university faculty of medicine

BACKGROUND

Peer education is an education model applied to change knowledge, behavior, and attitude in groups equal to each other regarding age, education, and status. This model is preferred in universities to improve teaching skills and reduce the stress level of students. This study aims to apply the peer education model at Trakya University Faculty of Medicine to receive feedback from students and to examine its effect on exam results.

METHODS

This cross-sectional, descriptive, and analytical study was conducted with second-year medical students in parasitology laboratory lessons. Eighteen out of a total of 264 students were selected as peer educators. Peer educators have reached the level of providing education to students by taking the training before the laboratory lessons. At the end of the study, questionnaires were applied to peer educators and students. The students' of 2021-2022 exam results were compared with the 2018-2019 academic year results.

RESULTS

A total of 233 students were surveyed, and 78.5% (183/233) of them believe peer education is helpful, 69.9% (163/233) think it can help them reinforce what they have learned in theoretical lessons, 54.5% (127/233) think it should be used in other practical lessons, and 64.3% think it should be used in the coming years. While there was no significant difference between the exam results of the students in 2021-2022 and the 2018-2019 period (p: 0.462), a significant difference was found between the exam results of peer educators and students (p < 0.05).

CONCLUSIONS

It is known that with the peer education model, student stress will decrease, and interest and participation in the lesson will increase. Continuing this education model in the coming years and expanding it to other laboratory courses will benefit medical education.

Survey of Military Physician Receptivity to Telemedicine and Perceived Telemedicine-Amenable Conditions in Turkey

BACKGROUND

Today, asymmetric conflict and terrorism pose a threat to not only soldiers but also civilians, forcing the North Atlantic Treaty Organization (NATO) to confront new threats and rethink its strategy. Various studies have shown that telemedicine is one of these advancements and that it can eventually bring expert advice to the field. Telemedicine, on the other hand, is new in Turkey and has yet to be implemented in the field. The aim of this study is to evaluate the support of health personnel with telemedicine from the perspective of military physicians.

METHODS

This study was carried out between 20 August 2021 and 5 October 2021 with the participation of 47 military physicians working as research assistants in a training and research hospital. A questionnaire consisting of 17 questions was used to evaluate military physicians' perspectives on telemedicine and their expectations from it.

RESULTS

Forty-six of the participants stated that they wanted a healthcare provider/expert opinion to consult about the patient/injured while they were on field and that telemedicine could be used within the scope of field medicine (4.51 ± 0.62). They also stated that telemedicine centers should employ emergency medicine specialists in particular (n = 40, 85.1%). The participants agreed that these centers would be quite useful, particularly for medical evacuations (n = 42, 89.4%).

CONCLUSION

Telemedicine's long-term viability in our country is thought to be contingent upon it covering medical conditions that are practical, require fewer technical intricacies, and appeal to emergency health services. The openness of the personnel to innovation and change is expected to improve harmony and cooperation.

Are Turkish doctors in deep water? The role of professional ethics and factors affecting the medical brain drain: A qualitative study from Turkey

With the increased rate of the Turkish medical brain drain (MDB) in recent years, there is a need for more comprehensive studies to elucidate its vague migratory factors. The aim of this paper is to try to narrow that gap by analyzing present impacts of the MDB in Turkey and to evaluate if these aspects were driven by professional ethical values, and if so, what ethical principles they were based on. In-depth interviews were conducted with 19 doctors from various backgrounds, followed by a thematic analysis. The MDB in Turkey demonstrated a multifactorial structure, with prominent push factors that are intertwined at macro-meso-micro levels. The effort to maintain the principles of beneficence, non-maleficence, and protecting professional autonomy were the most important in the context of professional ethics. Only deep-rooted regulations might ensure the prevention of the MDB in Turkey and the prospect of doctors returning in the future. Conclusively, the recent criticisms the MDB has been garnering may inspire improvements in deteriorating human and health rights in Turkey.