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Sili U, Tekin A, Bilgin H, Khan SA, Domecq JP, Vadgaonkar G, Segu SS, Rijhwani P, Raju U, Surapaneni KM, Zabolotskikh I, Gomaa D, Goodspeed VM, Ay P. Early empiric antibiotic use in COVID-19 patients: results from the international VIRUS registry. Int J Infect Dis 2024; 140:39-48. [PMID: 38128643 PMCID: PMC10939992 DOI: 10.1016/j.ijid.2023.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Revised: 12/11/2023] [Accepted: 12/15/2023] [Indexed: 12/23/2023] Open
Abstract
OBJECTIVES COVID-19 escalated inappropriate antibiotic use. We determined the distribution of pathogens causing community-acquired co-infections, the rate, and factors associated with early empiric antibiotic (EEAB) treatment among hospitalized COVID-19 patients. METHODS The Society of Critical Care Medicine Discovery Viral Infection and Respiratory Illness Universal Study (VIRUS) COVID-19 Registry including 68,428 patients from 28 countries enrolled between January 2020 and October 2021 were screened. After exclusions, 7830 patients were included in the analysis. Azithromycin and/or other antibiotic treatment given within the first 3 days of hospitalization was investigated. Univariate and multivariate analyses were performed to determine factors associated with EEAB use. RESULTS The majority (6214, 79.4%) of patients received EEAB, with azithromycin combination being the most frequent (3146, 40.2%). As the pandemic advanced, the proportion of patients receiving EEAB regressed from 84.4% (786/931) in January-March 2020 to 65.2% (30/46) in April-June 2021 (P < 0.001). Beta-lactams, especially ceftriaxone was the most commonly used antibiotic. Staphylococcus aureus was the most commonly isolated pathogen. Multivariate analysis showed geographical location and pandemic timeline as the strongest independent predictors of EEAB use. CONCLUSIONS EEAB administration decreased as pandemic advanced, which may be the result of intensified antimicrobial stewardship efforts. Our study provides worldwide goals for antimicrobial stewardship programs in the post-COVID-19 era.
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Affiliation(s)
- Uluhan Sili
- Department of Infectious Diseases and Clinical Microbiology, School of Medicine, Marmara University, Istanbul, Türkiye.
| | - Aysun Tekin
- Division of Nephrology and Hypertension, Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota, United States
| | - Huseyin Bilgin
- Department of Infectious Diseases and Clinical Microbiology, School of Medicine, Marmara University, Istanbul, Türkiye
| | - Syed Anjum Khan
- Division of Critical Care Medicine, Mayo Clinic Health System, Mankato, Minnesota, United States
| | - Juan Pablo Domecq
- Division of Nephrology and Hypertension, Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota, United States
| | | | - Smitha S Segu
- Bangalore Medical College and Research Institute, Bengaluru, Karnataka, India
| | - Puneet Rijhwani
- Department of Medicine, Mahatma Gandhi University of Medical Sciences & Technology, Jaipur, Rajasthan, India
| | | | - Krishna Mohan Surapaneni
- Departments of Biochemistry, Molecular Virology, Research and Clinical Skills & Simulation, Panimalar Medical College Hospital & Research Institute, Varadharajapuram, Poonamallee, Chennai, Tamil Nadu, India
| | - Igor Zabolotskikh
- Department of Anesthesiology, Intensive Care Medicine and Transfusiology, Kuban State Medical University with affiliation Territorial Hospital #2, Krasnodar, Russia
| | - Dina Gomaa
- Department of Surgery Division of Trauma and Critical Care- Trauma Research University of Cincinnati, Cincinnati, Ohio, United States
| | - Valerie M Goodspeed
- Department of Anesthesiology, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, United States
| | - Pinar Ay
- Department of Public Health, School of Medicine, Marmara University, Istanbul, Türkiye
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Ergun T, Hosgoren Tekin S, Apti Sengun O, Akin Cakici O, Seckin D, Adiay C, Enul H, Yilmaz S, Ay P, Haklar G, Sili U. Immunogenicity, efficacy, and safety of CoronaVac and Pfizer/BioNTech mRNA vaccines in patients with psoriasis receiving systemic therapies: A prospective cohort study. Vaccine 2023:S0264-410X(23)00615-1. [PMID: 37277251 DOI: 10.1016/j.vaccine.2023.05.052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Revised: 05/08/2023] [Accepted: 05/18/2023] [Indexed: 06/07/2023]
Abstract
BACKGROUND AND OBJECTIVES Evidence of immune response to COVID-19 vaccine in psoriasis patients on biological agents is lacking. This study aimed to evaluate SARS-CoV-2 antibody levels following vaccination with CoronaVac or Pfizer/BioNTech mRNA in patients using biological agents or methotrexate, high-titer antibody levels achievement rate, and impact of medications on immunogenicity. METHODS This noninterventional, prospective cohort study included 89 patients and 40 controls vaccinated with two doses of inactivated (CoronaVac) or Pfizer/BioNTech mRNA vaccines. Anti-spike and neutralising antibodies were analysed before and three to six weeks after the second dose. Adverse effects and symptomatic COVID-19 were assessed. RESULTS Median anti-spike and neutralising antibody titers after CoronaVac were significantly lower in patients than controls (57.92 U/mL vs 125.4 U/mL, and 1/6 vs 1/32, respectively, p < 0.05). Patients were less likely to achieve high-titer anti-spike antibody levels (25.6 % vs 50 %). Infliximab was associated with attenuated vaccine response. Pfizer/BioNTech vaccine induced comparable median anti-spike (2,080 U/mL vs 2,976.5 U/mL,) and neutralising antibody levels (1/96 vs 1/160) in patients and controls, respectively (p > 0.05). High-titer anti-spike and neutralising antibodies development rates were comparable among patients and controls (95.2 % vs 100 %, and 30.4 % vs 50.0 %, respectively, p > 0.05). Nine (10.1 %) COVID-19 cases- all mild - were identified. Psoriasis flare was seen in 6.74 %, mostly after Pfizer/BioNTech vaccine. CONCLUSION Psoriasis patients treated with biological agents and methotrexate developed similar response to mRNA vaccine but weaker response to inactivated vaccine. Infliximab reduced response to the inactivated vaccine. Adverse effects were more frequent with mRNA vaccine, but none was severe.
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Affiliation(s)
- Tulin Ergun
- Marmara University, School of Medicine, Department of Dermatology, Istanbul, Turkey.
| | | | - Ozlem Apti Sengun
- Marmara University, School of Medicine, Department of Dermatology, Istanbul, Turkey
| | - Ozlem Akin Cakici
- Marmara University, School of Medicine, Department of Dermatology, Istanbul, Turkey
| | - Dilek Seckin
- Marmara University, School of Medicine, Department of Dermatology, Istanbul, Turkey
| | - Cumhur Adiay
- Pendik Veterinary Control Institute, Istanbul, Turkey
| | - Hakan Enul
- Pendik Veterinary Control Institute, Istanbul, Turkey
| | - Seval Yilmaz
- Marmara University, School of Medicine, Department of Biochemistry, Istanbul, Turkey
| | - Pinar Ay
- Marmara University, School of Medicine, Department of Public Health, Istanbul, Turkey
| | - Goncagul Haklar
- Marmara University, School of Medicine, Department of Biochemistry, Istanbul, Turkey
| | - Uluhan Sili
- Marmara University, School of Medicine, Department of Infectious Diseases and Clinical Microbiology, Istanbul, Turkey
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Yilmaz Yegit C, Erdem Eralp E, Gokdemir Y, Ergenekon P, Sabancı M, Ay P, Karadag B, Ersu R. Night-to-night variability of polygraphy in children with sleep disordered breathing symptoms. Pediatr Pulmonol 2023. [PMID: 37014151 DOI: 10.1002/ppul.26404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2022] [Revised: 12/07/2022] [Accepted: 03/23/2023] [Indexed: 04/05/2023]
Abstract
INTRODUCTION Polygraphy (PG) can be used as an alternative test for the diagnosis of obstructive sleep apnea syndrome (OSAS) in children. Night-to-night variability of PG in children is not known. Our aim was to determine whether a single night PG was reliable for OSAS diagnosis in children with symptoms of sleep-disordered breathing (SDB). MATERIALS AND METHODS Otherwise healthy children who had been evaluated for symptoms of SDB were included. Two nocturnal PGs were performed 2-7 days apart. Demographic and clinical characteristics, Pediatric Sleep Questionnaire, and modified Epworth Sleepiness Scale were recorded. OSAS was diagnosed if obstructive apnea-hypopnea index was (oAHI) ⩾ 1/h and classified as mild (oAHI: 1-4.9/h), moderate (oAHI: 5-9.9/h), and severe (oAHI ⩾ 10/h). RESULTS Forty-eight patients were included (37.5% female, age 10.8 ± 3.9 years) to the study. There were no significant differences in oAHI values and other respiratory parameters between the two PGs (p > 0.05). Thirty-nine children were diagnosed with OSAS if the highest oAHI over any single night was used for diagnosis. Thirty-three of the 39 children (84.6%) were diagnosed with OSAS with the first PG while 35 of 39 (89.7%) children were diagnosed with OSAS with the second PG. There was an agreement for identifying OSAS and its severity between the two PGs in our study even though there were few individual intra-subject differences in oAHI. CONCLUSION There was no significant first-night effect for PG in this study which suggests that a single night PG is adequate for diagnosis of OSAS in children with SDB- related symptoms.
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Affiliation(s)
- Cansu Yilmaz Yegit
- Division of Pediatric Pulmonology, Marmara University, School of Medicine, Istanbul, Turkey
| | - Ela Erdem Eralp
- Division of Pediatric Pulmonology, Marmara University, School of Medicine, Istanbul, Turkey
| | - Yasemin Gokdemir
- Division of Pediatric Pulmonology, Marmara University, School of Medicine, Istanbul, Turkey
| | - Pinar Ergenekon
- Division of Pediatric Pulmonology, Marmara University, School of Medicine, Istanbul, Turkey
| | - Meltem Sabancı
- Sleep Center, Marmara University, School of Medicine, Istanbul, Turkey
| | - Pinar Ay
- Division of Public Health, Marmara University, School of Medicine, Istanbul, Turkey
| | - Bulent Karadag
- Division of Pediatric Pulmonology, Marmara University, School of Medicine, Istanbul, Turkey
| | - Refika Ersu
- Division of Respirology, Children's Hospital of Eastern Ontario, University of Ottawa, Ottawa, Canada
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Ay P, Yasin Y, Elbek O, Guner M, Gezer T, Pece Sonmez U, Ceyhan M, Yildiz F, Dagli E. Will plain packaging of cigarettes achieve the expected?
Perceptions among medical students. Tob Induc Dis 2022; 20:92. [DOI: 10.18332/tid/154056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 11/20/2021] [Accepted: 09/14/2022] [Indexed: 11/06/2022] Open
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Teker AG, Ay P. Has the cancer-related death trend been changing in Turkey? An evaluation of the period between 2009 and 2019. Cancer Epidemiol 2022; 80:102228. [PMID: 35930982 DOI: 10.1016/j.canep.2022.102228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 06/29/2022] [Accepted: 07/17/2022] [Indexed: 12/03/2022]
Abstract
BACKGROUND The objective of this study was to determine the trend of cancer-related death rates between 2009 and 2019 in Turkey for all cancers combined and the five cancer types with the highest mortality: lung, stomach, pancreas, breast, and colon cancers. METHODS Cancer mortality data were obtained from the Turkish Statistical Institute (TURKSTAT) and standardized by age using the World Health Organization (WHO) standard population ratios. The change in cancer-related mortality over the years was evaluated using Joinpoint Regression Analysis (JRA). RESULTS Total cancer-related deaths increased by 2.2% annually between 2009 and 2014 and decreased by 2.9% annually between 2014 and 2019 (p < 0.05). Among men; lung cancer-related deaths increased by 2.4% annually between 2009 and 2014 and decreased by 3.4% annually between 2014 and 2019 (p < 0.05), stomach cancer-related deaths decreased by 5.1% annually between 2014 and 2019 (p < 0.05), colon cancer-related deaths increased by 5.8% annually between 2009 and 2015 and decreased by 3.3% annually between 2015 and 2019 (p < 0.05), pancreatic cancer-related deaths increased annually by 5.6% in 2009-2013 (p < 0.05). Among women; lung cancer-related deaths increased by 2.5% annually between 2009 and 2016 (p < 0.05), stomach cancer-related deaths increased annually by 2.3% between 2009 and 2014 and decreased annually by 4.5% between 2014 and 2019 (p < 0.05), colon cancer-related deaths increased by 2.5% annually between 2009 and 2017 (p < 0.05), pancreatic cancer-related deaths increased by 7.4% annually between 2009 and 2013 (p < 0.05) and breast cancer-related deaths increased by 2.2% annually between 2009 and 2019 (p < 0.05). CONCLUSION Mortality data in Turkey are collected only by TURKSTAT, which raises concern regarding the incompletion of the data. While this might lead to underestimation, the trend shows that there has been a decrease in total cancer-related deaths in Turkey. Pancreatic cancer, on the other hand, gains a higher proportion in cancer-related deaths in Turkey as in the world. Increasing deaths from lung and breast cancer in women remind of the importance of tobacco control interventions and cancer screening programs.
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Affiliation(s)
- Ayse Gulsen Teker
- Marmara University School of Medicine, Public Health Department, 34854 Istanbul, Turkey.
| | - Pinar Ay
- Marmara University School of Medicine, Public Health Department, 34854 Istanbul, Turkey.
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Uyan ZS, Atag E, Ergenekon AP, Gokdemir Y, Gokler O, Ay P, Bas İkizoglu N, Cenk M, Erdem Eralp E, Sivrikaya GU, Girit S, Cakir E, Kilic AA, Yazan H, Can Oksay S, Hepkaya E, Kiyan G, Karadag B, Karakoc F, Oktem S. Efficacy of standardized tracheostomy training with a simulation model for healthcare providers: A study by ISPAT team. Pediatr Pulmonol 2022; 57:418-426. [PMID: 34821480 DOI: 10.1002/ppul.25772] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 10/30/2021] [Accepted: 11/18/2021] [Indexed: 12/15/2022]
Abstract
INTRODUCTION Tracheostomy care in children may be challenging, due to lack of knowledge of healthcare providers (HCPs). The aim of this study was to determine the level of knowledge of HCP who follow patients with tracheostomy and to increase this level with theoretical training and training in a simulation laboratory. MATERIALS AND METHODS ISPAT (IStanbul PAediatric Tracheostomy), a multidisciplinary team for tracheostomy care was established and a training program was prepared. Participants were subjected to theoretical and practical pretests which evaluated their knowledge levels and skills for care, follow-up, and treatment of a patient with tracheostomy. After the theoretical and practical training given to the participants with a simulation model, theoretical and practical posttests were applied. RESULTS Fifty-one HCP from nine tertiary pediatric clinics in Istanbul were enrolled in the training program. Only six (11.8%) of them had received standardized training programs previously. Regarding the theoretical tests, seven of the 33 questions were indicated as essential. The knowledge level of the participants based on the essential questions significantly increased after the training (p < 0.05 for all of the essential questions). The total number of correct answers and correct answers of three subheadings also significantly increased after the practical training (p < 0.001 for all). Ninety-five percent of the participants assessed the course as good or excellent in general. CONCLUSION Training in a simulation laboratory in combination with theoretical education can improve the knowledge and skills of the HCP enabling improved care of children with a tracheostomy.
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Affiliation(s)
- Zeynep S Uyan
- Division of Pediatric Pulmonology, Faculty of Medicine, Koc University, Istanbul, Turkey
| | - Emine Atag
- Division of Pediatric Pulmonology, Faculty of Medicine, Medipol University, Istanbul, Turkey
| | - Almala P Ergenekon
- Division of Pediatric Pulmonology, Faculty of Medicine, Marmara University, Istanbul, Turkey
| | - Yasemin Gokdemir
- Division of Pediatric Pulmonology, Faculty of Medicine, Marmara University, Istanbul, Turkey
| | - Ozan Gokler
- Department of Otorhinolaryngology, Faculty of Medicine, Koc University, Istanbul, Turkey
| | - Pinar Ay
- Department of Public Health, Faculty of Medicine, Marmara University, Istanbul, Turkey
| | - Nilay Bas İkizoglu
- Division of Pediatric Pulmonology, Sureyyapasa Chest Diseases and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey
| | - Muruvvet Cenk
- Division of Pediatric Pulmonology, Faculty of Medicine, Marmara University, Istanbul, Turkey
| | - Ela Erdem Eralp
- Division of Pediatric Pulmonology, Faculty of Medicine, Marmara University, Istanbul, Turkey
| | - G Ulufer Sivrikaya
- Rahmi M. Koc Academy of Interventional Medicine, Education and Simulation (RMK AIMES), Istanbul, Turkey
| | - Saniye Girit
- Division of Pediatric Pulmonology, Faculty of Medicine, Medeniyet University, Istanbul, Turkey
| | - Erkan Cakir
- Division of Pediatric Pulmonology, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey
| | - Ayse A Kilic
- Division of Pediatric Pulmonology, Faculty of Medicine, Cerrahpasa University, Istanbul, Turkey
| | - Hakan Yazan
- Division of Pediatric Pulmonology, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey
| | - Sinem Can Oksay
- Division of Pediatric Pulmonology, Faculty of Medicine, Medeniyet University, Istanbul, Turkey
| | - Evrim Hepkaya
- Division of Pediatric Pulmonology, Faculty of Medicine, Cerrahpasa University, Istanbul, Turkey
| | - Gursu Kiyan
- Department of Pediatric Surgery, Faculty of Medicine, Marmara University, Istanbul, Turkey
| | - Bulent Karadag
- Division of Pediatric Pulmonology, Faculty of Medicine, Marmara University, Istanbul, Turkey
| | - Fazilet Karakoc
- Division of Pediatric Pulmonology, Faculty of Medicine, Marmara University, Istanbul, Turkey
| | - Sedat Oktem
- Division of Pediatric Pulmonology, Faculty of Medicine, Medipol University, Istanbul, Turkey
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Yilmaz Yegit C, Kilinc AA, Can Oksay S, Unal F, Yazan H, Köstereli E, Gulieva A, Arslan H, Uzuner S, Onay ZR, Kilic Baskan A, Collak A, Atag E, Ergenekon AP, Bas Ikizoğlu N, Ay P, Oktem S, Gokdemir Y, Girit S, Cakir E, Uyan ZS, Cokugras H, Karadag B, Karakoc F, Erdem Eralp E. The ISPAT project: Implementation of a standardized training program for caregivers of children with tracheostomy. Pediatr Pulmonol 2022; 57:176-184. [PMID: 34562057 DOI: 10.1002/ppul.25704] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2021] [Revised: 08/15/2021] [Accepted: 09/15/2021] [Indexed: 11/09/2022]
Abstract
BACKGROUND Tracheostomy-related morbidity and mortality mainly occur due to decannulation, misplacement, or obstruction of the tube. A standardized training can improve the skills and confidence of the caregivers in tracheostomy care (TC). OBJECTIVE Our primary aim was to evaluate the efficiency of standardized training program on the knowledge and skills (changing-suctioning the tracheostomy tube) of the participants regarding TC. MATERIALS AND METHODS Sixty-five caregivers of children with tracheostomy were included. First, participants were evaluated with written test about TC and participated in the practical tests. Then, they were asked to participate in a standardized training session, including theoretical and practical parts. Baseline and postintervention assessments were compared through written and practical tests conducted on the same day. RESULTS A significant improvement was observed in the written test score after the training. The median number of correct answers of the written test including 23 questions increased 26%, from 12 to 18 (p < .001). The median number of correct steps in tracheostomy tube change (from 9 to 16 correct steps out of 16 steps, 44% increase) and suctioning the tracheostomy tube (from 9 to 17 correct steps out of 18 steps, 44% increase) also improved significantly after the training (p < .001, for both). CONCLUSION Theoretical courses and practical hands-on-training (HOT) courses are highly effective in improving the practices in TC. A standardized training program including HOT should be implemented before discharge from the hospital. Still there is a need to assess the impact of the program on tracheostomy-related complications, morbidity, and mortality in the long term.
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Affiliation(s)
- Cansu Yilmaz Yegit
- Division of Pediatric Pulmonology, Marmara University, School of Medicine, Istanbul, Turkey
| | - Ayse Ayzit Kilinc
- Division of Pediatric Pulmonology, İstanbul University-Cerrahpaşa, Cerrahpaşa School of Medicine, İstanbul, Turkey
| | - Sinem Can Oksay
- Division of Pediatric Pulmonology, Istanbul Medeniyet University, Faculty of Health Sciences, Istanbul, Turkey
| | - Fusun Unal
- Division of Pediatric Pulmonology, Istanbul Medipol University, School of Medicine, Istanbul, Turkey
| | - Hakan Yazan
- Division of Pediatric Pulmonology, Istanbul Bezmialem University, School of Medicine, Istanbul, Turkey
| | - Ebru Köstereli
- Division of Pediatric Pulmonology, Koc University, School of Medicine, Istanbul, Turkey
| | - Aynur Gulieva
- Division of Pediatric Pulmonology, Marmara University, School of Medicine, Istanbul, Turkey
| | - Hüseyin Arslan
- Division of Pediatric Pulmonology, Istanbul Medipol University, School of Medicine, Istanbul, Turkey
| | - Selçuk Uzuner
- Division of Pediatrics, Istanbul Bezmialem University, School of Medicine, Istanbul, Turkey
| | - Zeynep Reyhan Onay
- Division of Pediatric Pulmonology, Istanbul Medeniyet University, Faculty of Health Sciences, Istanbul, Turkey
| | - Azer Kilic Baskan
- Division of Pediatric Pulmonology, İstanbul University-Cerrahpaşa, Cerrahpaşa School of Medicine, İstanbul, Turkey
| | - Abdulhamit Collak
- Division of Pediatrics, Istanbul Bezmialem University, School of Medicine, Istanbul, Turkey
| | - Emine Atag
- Division of Pediatric Pulmonology, Istanbul Medipol University, School of Medicine, Istanbul, Turkey
| | - Almala Pinar Ergenekon
- Division of Pediatric Pulmonology, Marmara University, School of Medicine, Istanbul, Turkey
| | - Nilay Bas Ikizoğlu
- Division of Pediatric Pulmonology, Sureyyapasa Chest Diseases and Thoracic Surgery Training Hospital
| | - Pinar Ay
- Division of Public Health, Marmara University, School of Medicine, Istanbul, Turkey
| | - Sedat Oktem
- Division of Pediatric Pulmonology, Istanbul Medipol University, School of Medicine, Istanbul, Turkey
| | - Yasemin Gokdemir
- Division of Pediatric Pulmonology, Marmara University, School of Medicine, Istanbul, Turkey
| | - Saniye Girit
- Division of Pediatric Pulmonology, Istanbul Medeniyet University, Faculty of Health Sciences, Istanbul, Turkey
| | - Erkan Cakir
- Division of Pediatric Pulmonology, Istanbul Bezmialem University, School of Medicine, Istanbul, Turkey
| | - Zeynep Seda Uyan
- Division of Pediatric Pulmonology, Koc University, School of Medicine, Istanbul, Turkey
| | - Haluk Cokugras
- Division of Pediatric Pulmonology, İstanbul University-Cerrahpaşa, Cerrahpaşa School of Medicine, İstanbul, Turkey
| | - Bulent Karadag
- Division of Pediatric Pulmonology, Marmara University, School of Medicine, Istanbul, Turkey
| | - Fazilet Karakoc
- Division of Pediatric Pulmonology, Marmara University, School of Medicine, Istanbul, Turkey
| | - Ela Erdem Eralp
- Division of Pediatric Pulmonology, Marmara University, School of Medicine, Istanbul, Turkey
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Musellim B, Kul S, Ay P, Uyanusta C, Dagli E, Itil O, Bayram H. Excess Mortailty during Covid-19 pandemic in Istanbul. Epidemiology 2021. [DOI: 10.1183/13993003.congress-2021.pa925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Yilmaz O, Yasar A, Caliskan Polat A, Ay P, Alkin T, Taneli F, Odabasi Cingoz F, Hasdemir PS, Simsek Y, Yuksel H. Maternal psychiatric status and infant wheezing: The role of maternal hormones and cord blood cytokines. Pediatr Pulmonol 2021; 56:1573-1582. [PMID: 33587823 DOI: 10.1002/ppul.25302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 12/07/2020] [Accepted: 01/22/2021] [Indexed: 11/09/2022]
Abstract
RATIONALE Maternal psychosocial stress might be associated with development of allergic diseases in the offspring. OBJECTIVES To evaluate the association of maternal depression and anxiety with ever wheezing and recurrent wheezing among infants and to assess the role of maternal hypothalamo-pituatary-adrenal axis changes and fetal immune response in this association. METHODS This study encompasses two designs; cohort design was developed to evaluate the association of prenatal depression with development of wheezing in infants while nested case-control design was used to assess the role of maternal cortisol and tetranectin and cord blood interleukin 13 and interferon γ. RESULTS We enrolled 697 pregnant women. Elementary school graduate mother (odds ratio [OR] = 1.5, p = .06), maternal smoking during pregnancy (OR = 3.4, p = .001), familial history of asthma (OR = 2.7, p < .001) increased the risk of ever wheezing. Elementary school graduate mother (OR = 2.6, p = .002), maternal smoking during pregnancy (OR = 4.8, p < .001) and familial history of asthma (OR = 1.7, p = .01) increased the risk of recurrent wheezing. Maternal previous psychiatric disease, or Edinburgh Postnatal Depression Scale or Spielberger State-Trait Anxiety Inventory scores were not associated with wheezing. Maternal tetranectin levels were significantly higher among never wheezers compared to the ever wheezers (264.3 ± 274.8 vs. 201.6 ± 299.7, p = .04). CONCLUSIONS In conclusion, the major risk factors for ever wheezing and recurrent wheezing were maternal smoking, level of education and family history of asthma. However, maternal depression and anxiety were not determined as risk factors for wheezing. Maternal tetranectin carries potential as a biomarker for wheezing in the infant.
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Affiliation(s)
- Ozge Yilmaz
- Department of Pediatric Allergy and Pulmonology, Celal Bayar University Medical Faculty, Manisa, Turkey
| | - Adem Yasar
- Department of Pediatric Allergy and Pulmonology, Celal Bayar University Medical Faculty, Manisa, Turkey
| | - Arzu Caliskan Polat
- Department of Pediatric Allergy and Pulmonology, Celal Bayar University Medical Faculty, Manisa, Turkey
| | - Pinar Ay
- Department of Public Health, Marmara University Medical Faculty, Istanbul, Turkey
| | - Tunc Alkin
- Department of Psychiatry, Dokuz Eylül University Medical Faculty, Izmir, Turkey
| | - Fatma Taneli
- Department of Biochemistry, Celal Bayar University Medical Faculty, Manisa, Turkey
| | - Ferhan Odabasi Cingoz
- Department of Pediatric Allergy and Pulmonology, Celal Bayar University Medical Faculty, Manisa, Turkey
| | - Pinar S Hasdemir
- Department of Obstetrics and Gynecology, Celal Bayar University Medical Faculty, Manisa, Turkey
| | - Yurda Simsek
- Department of Pediatric Allergy and Pulmonology, Celal Bayar University Medical Faculty, Manisa, Turkey
| | - Hasan Yuksel
- Department of Pediatric Allergy and Pulmonology, Celal Bayar University Medical Faculty, Manisa, Turkey
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Balcan B, Thunström E, Yucel-Lindberg T, Lindberg K, Ay P, Peker Y. Impact of CPAP treatment on leptin and adiponectin in adults with coronary artery disease and nonsleepy obstructive sleep apnoea in the RICCADSA trial. Sleep Med 2019; 67:7-14. [PMID: 31884309 DOI: 10.1016/j.sleep.2019.10.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Revised: 09/26/2019] [Accepted: 10/19/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND Increased leptin and decreased adiponectin levels are reported in coronary artery disease (CAD) as well as in obstructive sleep apnoea (OSA). Less is known regarding the impact of continuous positive airway pressure (CPAP) on these biomarkers. We aimed to determine variables associated with leptin and adiponectin in adults with CAD and nonsleepy OSA, and evaluate the effect of CPAP adjusted for confounding factors. METHODS This was one of the secondary outcomes of the RICCADSA trial, conducted in Sweden between 2005 and 2013. From 244 revascularized CAD and OSA patients (apnoea-hypopnoea index >15/h) without excessive daytime sleepiness (Epworth Sleepiness Scale score <10), 196 with blood samples at baseline, after 3, and 12 months were included in the randomized controlled trial arm; of those, 98 were allocated to auto-titrating CPAP, and 98 to no-CPAP. RESULTS No significant changes in leptin and adiponectin levels were observed during follow-up, whereas Body-Mass-Index and waist circumference increased in both CPAP and no-CPAP groups with no significant between-group differences. Alterations in plasma leptin were determined by changes in waist circumference (beta coefficient 2.47; 95% confidence interval 0.77-4.40), whereas none of the analyzed parameters was predictive for changes in adiponectin levels. No association was found with CPAP adherence. CONCLUSIONS CPAP had no significant effect on leptin and adiponectin in this cohort of nonsleepy OSA patients. An increase in waist circumference predicted an increase in plasma levels of leptin after 12 months, suggesting that lifestyle modifications should be given priority in adults with CAD and OSA regardless of CPAP treatment.
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Affiliation(s)
- Baran Balcan
- Dept. of Pulmonary Medicine, Marmara University, School of Medicine, Istanbul, Turkey
| | | | - Tülay Yucel-Lindberg
- Division of Periodontology, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
| | - Kristin Lindberg
- Division of Periodontology, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
| | - Pinar Ay
- Dept. of Public Health, Marmara University, School of Medicine, Istanbul, Turkey
| | - Yüksel Peker
- Sahlgrenska Academy, University of Gothenburg, Sweden; Dept. of Pulmonary Medicine, Koc University, School of Medicine, Istanbul, Turkey; Division of Pulmonary, Allergy, and Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
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11
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Kaya G, Ay P, Hidiroglu S. Are neighbourhood characteristics associated with physical activity levels in schoolchildren? Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz187.189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Moderate-vigorous physical activity (MVPA) is an essential determinant of health for children. However 82% of children aged 11-17 years in Turkey are physically inactive. The objective of this study was to determine the prevalence of physical inactivity (PI) and sociodemographic and neighbourhood characteristics associated with PI among children aged 9-13 years.
Methods
The population of this cross-sectional study was 5-7th grade students attending schools in a district of Istanbul. Two schools from urban and two from semi-urban localities were selected in order to capture different neighbourhood characteristics. Sample size was calculated as 344 assuming a difference of PI prevalence of 15% between neighbourhoods, an alpha error of 0.05, a power of 80%. Data were collected by child and parent questionnaires. PI was defined as < 60 minutes MVPA per day within the previous week. Neighbourhood characteristics were evaluated as physical (walkability levels, structure of sidewalks, presence of yards/parks, traffic density) and social (characteristics of social networks, trust among neighbours). Factors associated with PI were analysed by logistic regression.
Results
A total of 334 students participated with a response rate 96%. The median age was 11 years and 52.9% were girls. The prevalence of PI was 79.3% (95%CI: 75.0-83.7%). Neighbourhood characteristics were not associated with PI (p > 0.05). PI was associated with ownership of mobile phones (OR: 1.96, 95%CI: 1.01-3.78), not being a member of a sports team (OR: 2.83, 95%CI: 1.21-6.58) and having ≤1 day of physical education classes at school (OR: 2.10, 95%CI: 1.08-4.09).
Conclusions
The prevalence of PI is very high among schoolchildren. School-based interventions as motivating children to participate in sports teams and having physical education classes >1 times per week could be achievable strategies to combat PI. There is a need to adapt objective methods for assessment of neighbourhood characteristics.
Key messages
PI is a prevalent public health problem among school children in urban and semi-urban environments. The effectiveness of increasing structured physical activity levels at schools by utilizing sports teams and physical education classes should be evaluated in future studies.
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Affiliation(s)
- Gulin Kaya
- Department of Public Health, Marmara University School of Medicine, Istanbul, Turkey
| | - Pinar Ay
- Department of Public Health, Marmara University School of Medicine, Istanbul, Turkey
| | - Seyhan Hidiroglu
- Department of Public Health, Marmara University School of Medicine, Istanbul, Turkey
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12
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Surmen A, Ay P, Hidiroglu S, Karavus M. Physical Activity Patterns of Primary School Teachers in a District in Istanbul, Turkey. Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz186.472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Physical inactivity (PI) is determined as the fourth leading risk factor for global mortality. Insufficient physical activity is prevalent in Turkey; approximately 4 in 10 adults are physically inactive and have less than 150 minutes of moderate activity per week. The objective of this study was to assess the prevalence of PI and the factors associated with it among primary school teachers in a district in Istanbul, Turkey.
Methods
This was a cross-sectional study conducted in a district in Istanbul, Turkey. Sample size was calculated as 434 assuming a PI prevalence of 70% with a 95% confidence level, margin of error of 0.05 and a design effect of 2. Twenty out of 39 schools were selected randomly. PI was assessed through using International Physical Activity Questionnaire short form. Logistic regression analysis was used to determine the variables associated with PI.
Results
A total of 345 teachers participated in the study (response rate: 79.5%). Among the participants the mean age was 45.6± 8.3 and %74.1 were women. PI prevalence was 49.2% (95%CI: 43.6%-54.7%). PI was significantly associated with having chronic disease (OR: 1.8, 95%CI:1.0-3.0), having children (OR: 2.9, 95%CI:1.5-5.7), using motor vehicles for transportation (OR:4.1, 95%CI:1.5-11.0) and using elevators (OR:4.4, 95%CI:1.7-11.4). Among women, PI was significantly associated with having children (OR: 10.3, %95CI:1.2-87.1) and using elevators (OR: 8.4, 95%CI: 2.3-30.8).
Conclusions
Approximately half of the teachers were physically inactive. As having children is an important determinant of PI, we need to adopt appropriate conditions so that parents, particularly women can engage in physical activity together with their children. Active transportation and use of elevators should be encouraged. Special attention should be paid to adults having chronic diseases.
Key messages
PI is highly prevalent among school teachers, particularly among the ones who have chronic diseases. Strategies supporting parents especially women to engage in physical activity together with their children, encouraging active transportation and use of elevators should be implemented.
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Affiliation(s)
- A Surmen
- Noncommunicable Disease, Ministry of Health, Yozgat, Turkey
| | - P Ay
- Public Health Department, Marmara University,School of Medicine, Istanbul, Turkey
| | - S Hidiroglu
- Public Health Department, Marmara University,School of Medicine, Istanbul, Turkey
| | - M Karavus
- Public Health Department, Marmara University,School of Medicine, Istanbul, Turkey
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13
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Erden Cengiz C, Ay P, Aigbovbiosa M, Yıldırım K, Guder S. Smoking habits among 5th and 6th degree medical students. Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz186.714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Smoking is the most common cause of preventable mortality and morbidity worldwide. In the fight against tobacco physicians take active role. The objective of this study is to determine the rate and patterns of tobacco use among students of Marmara University School of Medicine (MUSM). This is a cross sectional study carried out in MUSM. The study population were all students studying in the 5th and 6th grades. Data were collected through questionnaires. The questionnaire form included sociodemographics, tobacco usepatterns, quitting attitudes and experiences. Among 410 students, 328 participated. Among all 56.1% were 5th year and 43.9% were 6th year students. The median age was 24 and 55.8% were female. 22.6% of the participants were current smoker. 33.8% of males and 13.7% of females are smoking (p:0,001). Common reasons for starting to smoke were the influence of close friends (11.3%), curosity (8.2%), stress (4.6%). Of the participants, 8.5% had smoked waterpipe. 28.4% of the current smokers still smoke waterpipe, 46.2% had tried to quit more than once and 13.5% wished to quit but had never tried to quit. 40.2% of the participants whose close friend smokes and %44.4 whose partner smokes are current smokers (p:0.001). %70 of current smokers tried at least one time electronic cigarette (p:0.001).
Approximately one fourt of the students are current smokers, higher in men. Those who smoked cigarettes had high affinity for waterpipe, electronic cigarettes. Electronic cigarette is fast rising trend daily. Starting smoking and quitting is influenced by close friends and partners.
Key messages
The primary goal should be to stop the smokers and prevent the start of the smokers. Information should be made on the harms of electronic cigarettes and the community should be informed.
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Affiliation(s)
- C Erden Cengiz
- Public Health, Marmara University School of Medicine, Istanbul, Turkey
| | - P Ay
- Public Health, Marmara University School of Medicine, Istanbul, Turkey
| | - M Aigbovbiosa
- Public Health, Marmara University School of Medicine, Istanbul, Turkey
| | - K Yıldırım
- Public Health, Marmara University School of Medicine, Istanbul, Turkey
| | - S Guder
- Public Health, Marmara University School of Medicine, Istanbul, Turkey
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14
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Ikizoglu NB, Kiyan E, Polat B, Ay P, Karadag B, Ersu R. Are home sleep studies useful in diagnosing obstructive sleep apnea in children with down syndrome? Pediatr Pulmonol 2019; 54:1541-1546. [PMID: 31290291 DOI: 10.1002/ppul.24440] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2018] [Accepted: 06/06/2019] [Indexed: 01/11/2023]
Abstract
INTRODUCTION AND AIM Obstructive sleep apnea syndrome (OSAS) is frequent in children with Down syndrome (DS) and polysomnography (PSG) is recommended for all children with DS. However PSG is not always available and alternative diagnostic methods are needed. The aim of the study was to evaluate the feasibility and validity of home polygraphy (HPG) in children with DS. METHODS A national DS association was contacted and children aged 6 to 18 years who accepted to participate were recruited. Otorhinolaryngologic evaluation, in-lab PSG and HPG were performed. OSAS was diagnosed by PSG with an apnea-hypopnea index (AHI) more than or equal to 1. OSAS severity was classified as moderate-to-severe if AHI was more than or equal to 5. Receiver operating characteristic curves were calculated for HPG using PSG as the gold standard. RESULTS Nineteen children (12 girls) completed the study. Median age was 11.3 years. Demographic and clinical characteristics were similar in children with and without OSAS. Eighty-nine percent of HPG studies were technically acceptable at the initial night and the success rate was 100% when two failed studies were repeated. PSG revealed OSAS in six (32%) children, two had mild and four had moderate-to-severe OSAS. All four patients with moderate-to-severe OSAS diagnosed with PSG have been diagnosed with the same severity on HPG. HPG had 100% sensitivity and 83% specificity when AHI ≥ 3 was set as diagnostic criteria. CONCLUSION HPG is a feasible and reliable test of OSAS in children with DS and may be useful in diagnosis and treatment of patients with moderate-to-severe OSAS in this patient group.
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Affiliation(s)
- Nilay Bas Ikizoglu
- Department of Pediatric Pulmonology, Marmara University Medical Faculty, Istanbul, Turkey
| | - Esen Kiyan
- Department of Pulmonology, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey
| | - Beldan Polat
- Department of Otorhinolaryngology, Head and Neck Surgery, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey
| | - Pinar Ay
- Department of Public Health, Marmara University Medical Faculty, Istanbul, Turkey
| | - Bulent Karadag
- Department of Pediatric Pulmonology, Marmara University Medical Faculty, Istanbul, Turkey
| | - Refika Ersu
- Department of Pediatric Pulmonology, Marmara University Medical Faculty, Istanbul, Turkey
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15
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Sili U, Ay P, Bilgin H, Hidiroglu S, Korten V. Hand hygiene knowledge, perception and practice of healthcare workers in a Turkish university hospital intensive care unit. J Infect Dev Ctries 2019; 13:744-747. [PMID: 32069259 DOI: 10.3855/jidc.10916] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2018] [Accepted: 07/15/2019] [Indexed: 10/31/2022] Open
Abstract
INTRODUCTION While improvement of hand hygiene (HH) compliance is considered as the best approach to reduce healthcare-associated infections, the instructional interventions in HH among healthcare workers of intensive care unit (ICU) of our hospital was not successful enough. The following study was conducted to evaluate HH knowledge, perception, practice and effectiveness of the trainings among healthcare workers of ICU in our hospital. METHODOLOGY A cross-sectional study was conducted in the ICU containing 8 medical and 16 surgical beds with 284 filled questionnaires about HH knowledge and 1187 observed opportunities for HH compliance. RESULTS Overall observed HH compliance rate was 40.6%; lowest compliance was 21.7% for "before clean/aseptic procedure" indication and highest compliance was 68.6% for "after touching a patient" indication. Although > 90% healthcare workers correctly identified the World Health Organization's five indications for HH, 82 - 85% failed to recognize non-indications, i.e. when it was not necessary to perform HH. Our study showed that 15.1% of healthcare workers neither received nor felt the need for HH training. CONCLUSIONS Despite regular HH trainings, healthcare workers could not differentiate when HH was not required which suggested failure to understand HH rationale. This may explain poor HH compliance rates. A systematic study is needed in order to find out the reasons behind of this noncompliance and improve HH training methods for educating healthcare workers.
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Affiliation(s)
- Uluhan Sili
- Department of Infectious Diseases and Clinical Microbiology, School of Medicine, Marmara University, Istanbul, Turkey.
| | - Pinar Ay
- Department of Public Health, School of Medicine, Marmara University, Istanbul, Turkey.
| | - Huseyin Bilgin
- Department of Infectious Diseases and Clinical Microbiology, School of Medicine, Marmara University, Istanbul, Turkey.
| | - Seyhan Hidiroglu
- Department of Public Health, School of Medicine, Marmara University, Istanbul, Turkey.
| | - Volkan Korten
- Department of Infectious Diseases and Clinical Microbiology, School of Medicine, Marmara University, Istanbul, Turkey.
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16
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Dagli E, Güner M, Elbek O, Yildiz F, Gezer T, Ay P, Ceyhan M. Tobacco industry activities in Turkey: through media monitoring. Tob Prev Cessat 2019. [DOI: 10.18332/tpc/105162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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17
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Ay P, Teker AG, Hidiroglu S, Tepe P, Surmen A, Sili U, Korten V, Karavus M. A qualitative study of hand hygiene compliance among health care workers in intensive care units. J Infect Dev Ctries 2019; 13:111-117. [PMID: 32036345 DOI: 10.3855/jidc.10926] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2018] [Accepted: 01/10/2019] [Indexed: 10/31/2022] Open
Abstract
INTRODUCTION Studies indicate that adherence to hand hygiene guidelines is at suboptimal levels. We aimed to explore the reasons for poor hand hygiene compliance. METHODOLOGY A qualitative study based on the Theory of Planned Behavior as a framework in explaining compliance, consisting four focus group discussions and six in-depth interviews. RESULTS Participants mostly practiced hand hygiene depending on the sense of "dirtiness" and "cleanliness". Some of the participants indicated that on-job training delivered by the infection control team changed their perception of "emotionally" based hand hygiene to "indication" based. Direct observations and individual feedback on one-to-one basis were the core of this training. There was low social cohesiveness and a deep polarization between the professional groups that led one group accusing the other for not being compliant. CONCLUSIONS The infection control team should continue delivering one-to-one trainings based on observation and immediate feedback. But there is need to base this training model on a structured behavioral modification program and test its efficacy through a quasi-experimental design. Increasing social cohesiveness and transforming the blaming culture to a collaborative safety culture is also crucial to improve compliance. High workload, problems related to work-flow and turnover should be addressed.
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Affiliation(s)
- Pinar Ay
- Department of Public Health, School of Medicine, Marmara University, Istanbul, Turkey.
| | - Ayse Gulsen Teker
- Department of Public Health, School of Medicine, Marmara University, Istanbul, Turkey.
| | - Seyhan Hidiroglu
- Department of Public Health, School of Medicine, Marmara University, Istanbul, Turkey.
| | - Pinar Tepe
- Department of Public Health, School of Medicine, Marmara University, Istanbul, Turkey.
| | - Aysen Surmen
- Department of Public Health, School of Medicine, Marmara University, Istanbul, Turkey.
| | - Uluhan Sili
- Department of Infectious Diseases and Clinical Microbiology, School of Medicine, Marmara University, Istanbul, Turkey.
| | - Volkan Korten
- Department of Infectious Diseases and Clinical Microbiology, School of Medicine, Marmara University, Istanbul, Turkey.
| | - Melda Karavus
- Department of Public Health, School of Medicine, Marmara University, Istanbul, Turkey.
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18
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Cagman Z, Bingol Ozakpinar O, Cirakli Z, Gedikbasi A, Ay P, Colantonio D, Uras AR, Adeli K, Uras F. Reference intervals for growth arrest-specific 6 protein in adults. Scand J Clin Lab Invest 2017; 77:109-114. [PMID: 28150505 DOI: 10.1080/00365513.2016.1275768] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
The objective of this study was to establish reference intervals for growth arrest-specific 6 (GAS6), a vitamin K-dependent protein, in human adult plasma according to the Guideline of Clinical and Laboratory Standards Institute (CLSI) C28-A3. Blood samples were collected from 308 healthy volunteers aged 18-72 (157 female, 151 male). A non-parametric approach was used to calculate the reference interval. The plasma GAS6 reference interval was determined, with 90% confidence interval: the lower limit (2.5 percentile) was 2.5 (1.9-3.1) μg/L and the upper limit (97.5 percentile) = 18.8 (18.0-22.3) μg/L. Harris-Boyd's test did not suggest partitioning by age or gender: medians for males [7.8 (5.8-10.7) μg/L] and females [9.9 (7.1-13.5) μg/L]. Three age-subgroups were tested: 18-29 years (n = 168); 30-44 years (n = 73); 45-72 years (n = 67). The intra- and inter-assay variations were 12.6% (mean, 5.2 ± 0.7 μg/L) and 14.0% (mean, 9.2 ± 1.3 μg/L), respectively. The mean recovery was 104%. This study reports plasma GAS6 reference intervals established first according to the guideline of CLSI C28-A3.
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Affiliation(s)
- Zeynep Cagman
- a Marmara University School of Pharmacy , Department of Biochemistry , Istanbul , Turkey
| | - Ozlem Bingol Ozakpinar
- a Marmara University School of Pharmacy , Department of Biochemistry , Istanbul , Turkey
| | - Zeynep Cirakli
- b Department of Biochemistry , Bakirkoy Dr. Sadi Konuk Training and Research Hospital , Istanbul , Turkey
| | - Asuman Gedikbasi
- b Department of Biochemistry , Bakirkoy Dr. Sadi Konuk Training and Research Hospital , Istanbul , Turkey
| | - Pinar Ay
- c Marmara University School of Medicine, Department of Public Health , Istanbul , Turkey
| | - David Colantonio
- d Clinical Biochemistry, Department of Paediatric Laboratory Medicine , The Hospital for Sick Children, University of Toronto , Toronto , ON , Canada
| | - Ahmet Riza Uras
- e Department of Biochemistry , Haydarpasa Numune Training and Research Hospital , Istanbul , Turkey
| | - Khosrow Adeli
- d Clinical Biochemistry, Department of Paediatric Laboratory Medicine , The Hospital for Sick Children, University of Toronto , Toronto , ON , Canada
| | - Fikriye Uras
- a Marmara University School of Pharmacy , Department of Biochemistry , Istanbul , Turkey
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Okuyan B, Hucum H, Sancar M, Ay P, Izzettin FV. Turkish Validation of Patient Satisfaction Towards Patient Oriented Pharmacy Services Questionnaire in Patients with Chronic Disease. Clin Exp Health Sci 2016. [DOI: 10.5152/clinexphealthsci.2016.05] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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20
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Okuyan B, Sancar M, Ay P, Demirkan K, Apikoglu-Rabus S, Vehbi Izzettin F. Translation and psychometric evaluation of the Turkish version of the pharmacy students' perceptions of preparedness to provide pharmaceutical care scale. Pharmazie 2016; 71:613-616. [PMID: 29441932 DOI: 10.1691/ph.2016.6716] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
The aim of the study is to conduct the psychometric evaluation of the Turkish version of the Pharmacy Students' Perceptions of Preparedness to Provide Pharmaceutical Care (PREP) scale. The present study was conducted at three faculties of pharmacy among fifth-year students during a three-month period in 2015. After the translation process, the Turkish version was developed. Psychometric evaluation consisted of the calculation of inter-rater and test-retest reliability and factor analysis. The mean age of 184 students (71.2% of female) was 23.74±1.07. The mean score of the Pharmacy Students' PREP scale was 4.54±1.00 and the Cronbach's alpha was 0.971. Inter-rater and test-retest reliability and factor analysis were also in concordance with the literature. In the present study, the Turkish version of Pharmacy Students' Perceptions of Preparedness to Provide Pharmaceutical Care Scale has been determined to be a reliable and validated tool to assess students' perceptions of preparedness to provide pharmaceutical care.
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Ay P, Evrengil E, Guner M, Dagli E. Noncompliance to smoke-free law: which hospitality premises are more prone? Public Health 2016; 141:1-6. [PMID: 27931983 DOI: 10.1016/j.puhe.2016.08.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2016] [Revised: 08/01/2016] [Accepted: 08/08/2016] [Indexed: 11/30/2022]
Abstract
OBJECTIVES In Turkey, smoking has been banned in hospitality establishments since July 2009. The objective of this study was to determine noncompliance to the smoke-free law and its change in 2 consecutive years in enclosed spaces of hospitality venues and also to evaluate the factors associated with noncompliance. STUDY DESIGN This is an observational study. METHODS Hospitality venues in Istanbul were visited, and data were collected through direct observation and interviews. Observation of smoking, cigarette butts or existence of ashtrays were defined as noncompliance. The survey was repeated in 2 consecutive years; the venues were visited both in 2013 and 2014. Logistic regression was used to evaluate factors associated with noncompliance. RESULTS In 2013, 450 establishments were visited, and in the next year, 367 (81.6%) were revisited. Noncompliance for 2013 and 2014 were 49.0% and 29.7%, respectively. The highest violation was observed in bars and traditional coffeehouses. There was a significant decrease in noncompliance from 2013 to 2014 among restaurants and cafés, while such a change was not observed among bars and traditional coffeehouses. In the multivariate analysis, venues other than restaurants, venues that did not have no-smoking signs and venues which had been issued fines previously had increased probability of noncompliance. CONCLUSIONS While compliance to smoke-free law had increased significantly within 1 year, almost one third of the venues were still violating the law in 2014. The venues which were issued fines continued to violate the law. There is a need to strengthen enforcement efforts and revise the methods of enforcement and penalties in hospitality establishments.
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Affiliation(s)
- P Ay
- School of Medicine, Department of Public Health, Istanbul, Turkey.
| | - E Evrengil
- Health Institute Association, Istanbul, Turkey.
| | - M Guner
- Health Institute Association, Istanbul, Turkey.
| | - E Dagli
- Marmara University, School of Medicine, Department of Paediatrics, Istanbul, Turkey; School of Medicine and Health Institute Association, Istanbul, Turkey.
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22
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Kraus L, Hay G, Richardson C, Yargic I, Ilhan MN, Ay P, Karasahin F, Pinarci M, Tuncoglu T, Piontek D, Schulte B. Estimating high-risk cannabis and opiate use in Ankara, Istanbul and Izmir. Drug Alcohol Rev 2016; 36:626-632. [DOI: 10.1111/dar.12447] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2016] [Revised: 05/17/2016] [Accepted: 05/19/2016] [Indexed: 11/28/2022]
Affiliation(s)
- Ludwig Kraus
- IFT Institute for Therapy Research; Munich Germany
- Centre for Social Research on Alcohol and Drugs; Stockholm University; Stockholm Sweden
| | - Gordon Hay
- Centre for Public Health; Liverpool John Moores University; Liverpool UK
| | - Clive Richardson
- Department of Economic and Regional Development; Panteion University of Social and Political Sciences; Athens Greece
| | - Ilhan Yargic
- Faculty of Medicine, Department of Psychiatry; İstanbul University; Istanbul Turkey
| | - Mustafa Necmi Ilhan
- Faculty of Medicine, Department of Public Health; Gazi University; Ankara Turkey
| | - Pinar Ay
- Faculty of Medicine, Department of Public Health; Marmara University; Istanbul Turkey
| | - Füsun Karasahin
- Faculty of Medicine, Department of Public Health; Gazi University; Ankara Turkey
| | - Mustafa Pinarci
- Turkish National Police; Turkish Monitoring Centre for Drugs and Drug Addiction; Ankara Turkey
| | - Tolga Tuncoglu
- Turkish National Police; Turkish Monitoring Centre for Drugs and Drug Addiction; Ankara Turkey
| | | | - Bernd Schulte
- Centre for Interdisciplinary Addiction Research; Hamburg University; Hamburg Germany
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Uyan ZS, Turan I, Ay P, Cakir E, Ozturk E, Gedik AH, Gokdemir Y, Erdem E, Şen V, Karadag B, Karakoc F, Ersu R. Sleep disordered breathing and sleep quality in children with bronchiolitis obliterans. Pediatr Pulmonol 2016; 51:308-15. [PMID: 26129911 DOI: 10.1002/ppul.23246] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2015] [Revised: 05/17/2015] [Accepted: 05/28/2015] [Indexed: 01/13/2023]
Abstract
The incidence of sleep-disordered breathing (SDB) increases in chronic lung diseases. Our aim was to evaluate SDB and sleep quality in children with postinfectious bronchiolitis obliterans (BO) and assess associated risk factors. We hypothesized that children with BO are at increased risk for SDB and have impaired sleep quality. We also hypothesized that severity of SDB and impairment of sleep quality is related to the severity of lung disease. Sleep Related Breathing Disorder (SRBD) subscale of the Pediatric Sleep Questionnaire (PSQ) and Pittsburgh Sleep Quality Index (PSQI) questionnaires; spirometry, impulse oscillometry (IOS), and overnight polysomnography (PSG) were performed. Twenty-one patients (14 male, median age: 8.3 years) were enrolled. Five patients (25%) had a PSQ score of >0.33, predictive of a SDB. Ten patients (48%) had poor sleep quality. Four patients (19%) had an OAHI of >1/hr. Nineteen patients (90%) had a high desaturation index. Four patients (19%) had a mean oxygen saturation of <93%. Median central apnea time was 7.5 (IQR: 6.9-9.1) seconds. Central apnea index of the patients correlated positively with R5, R10, R15, R20, Z5, and negatively with X10 and X15 at IOS. There was a positive correlation between the lowest oxygen saturation and FVC, FEV1 , X5, X10, X15, X20 while there was a negative correlation between lowest saturation and the central apnea index at PSG, R5, R10, and Z5 at IOS. Mean oxygen saturation during PSG correlated positively with FVC, FEV1, FEF(25-75), X5, X10, X15, X20 results. The risk of nocturnal hypoxia is increased in patients with BO and correlated to the severity of lung disease determined by pulmonary function tests. Although BO patients have a shorter duration of central apneas, they are more prone to desaturate.
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Affiliation(s)
- Zeynep S Uyan
- Division of Pediatric Pulmonology, Kocaeli University, Kocaeli, Turkey
| | - Ihsan Turan
- Department of Pediatrics, Marmara University, Istanbul, Turkey
| | - Pinar Ay
- Department of Public Health, Marmara University, Istanbul, Turkey
| | - Erkan Cakir
- Division of Pediatric Pulmonology, Bezmi Alem Vakif University, Istanbul, Turkey
| | - Ersin Ozturk
- Department of Pediatrics, Kocaeli University, Kocaeli, Turkey
| | - Ahmet H Gedik
- Division of Pediatric Pulmonology, Bezmi Alem Vakif University, Istanbul, Turkey
| | - Yasemin Gokdemir
- Division of Pediatric Pulmonology, Marmara University, Istanbul, Turkey
| | - Ela Erdem
- Division of Pediatric Pulmonology, Marmara University, Istanbul, Turkey
| | - Velat Şen
- Division of Pediatric Pulmonology, Marmara University, Istanbul, Turkey
| | - Bulent Karadag
- Division of Pediatric Pulmonology, Marmara University, Istanbul, Turkey
| | - Fazilet Karakoc
- Division of Pediatric Pulmonology, Marmara University, Istanbul, Turkey
| | - Refika Ersu
- Division of Pediatric Pulmonology, Marmara University, Istanbul, Turkey
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Sili U, Tekin A, Karadag H, Altinkanat G, Gul F, Bilgili B, Arslantas MK, Ay P, Soyletir G, Cinel I, Korten V. An Outbreak With Colistin- and Carbapenem-Resistant Klebsiella pneumoniae in an Intensive Care Unit. Open Forum Infect Dis 2015. [DOI: 10.1093/ofid/ofv133.1344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Hidiroglu S, Tanriover O, Ay P, Karavus M. A qualitative study on menopause described from the man's perspective. J PAK MED ASSOC 2014; 64:1031-1036. [PMID: 25823183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
OBJECTIVE To look at menopause from men's point of view and to provide a better understanding of this phase to improve the care delivered to menopausal women. METHODS The study was conducted at the health centre of a single district of Istanbul, from April 2013 to June 2013, which serves as the research and training area of the Marmara University and which receives migrations from mainly southern and eastern regions of Turkey.The study sample included 33 married men. Qualitative in-depth interviews were performed individually and main themes were noted down for analysis. RESULTS The age range of the study population was 40-77 years. The subjects lacked basic knowledge about both menstruation and menopause. Most of the participants defined menopause as loss of fecundity, increased weight, and loss of beauty.The most important concern voiced was men's own sexual life. None of the men had heard about treatment modalities available for menopause. CONCLUSION Interventions are needed to increase men's awareness regarding menopause in order to help these men to be able to better support their spouses so that they can both have a smooth transition into postmenopausal years.
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Tanriover O, Hidiroglu S, Akan H, Ay P, Erdogan Y, Karavus M, Vitrinel A, Hayran O. A Qualitative Study on Factors that Influence Turkish Medical Students' Decisions to Become Family Physicians After the Health Transformation Programme. N Am J Med Sci 2014; 6:278-83. [PMID: 25006564 PMCID: PMC4083530 DOI: 10.4103/1947-2714.134374] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND In Turkey, general practitioners were authorized to work as family physicians without specialization, within the scope of the Health Transformation Programme, due to inadequate number of family medicine specialists since 2004. With this new implementation Family Medicine specialty became a less preferable option for medical students. AIMS The study was to investigate the perspectives of medical students and understand the issues to choose Family Medicine specialty as a career option. MATERIALS AND METHODS This qualitative study was performed with 48 final year medical students using a convenience sample from two medical universities. RESULTS Three main categories emerged from the data viewing Family Medicine 'as a specialty', 'as an employment', and finally 'as a system'. Very few students stated that Family Medicine would be their choice for specialty. CONCLUSIONS Family Medicine does not seem to be an attractive option in career planning by medical students. Several factors that may constrain students from choosing Family Medicine include: not perceiving Family Medicine as a field of expertise, and the adverse conditions at work which may originate from duality in the system.
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Affiliation(s)
- Ozlem Tanriover
- Department of Family Medicine, Yeditepe University, Istanbul, Turkey
| | - Seyhan Hidiroglu
- Department of Public Health, Marmara University, Istanbul, Turkey
| | - Hulya Akan
- Department of Family Medicine, Yeditepe University, Istanbul, Turkey
| | - Pinar Ay
- Department of Public Health, Marmara University, Istanbul, Turkey
| | - Yalcin Erdogan
- Department of Family Medicine, Bilim University, Istanbul, Turkey
| | - Melda Karavus
- Department of Family Medicine, Yeditepe University, Istanbul, Turkey
| | - Ayca Vitrinel
- Department of Pediatrics, Yeditepe University, Istanbul, Turkey
| | - Osman Hayran
- Department of Public Health, Medipol University, Istanbul, Turkey
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Rahu M, Vlassov VV, Pega F, Andreeva T, Ay P, Baburin A, Bencko V, Csépe P, Gebska-Kuczerowska A, Ondrusová M, Ribak J. Population health and status of epidemiology: WHO European Region I. Int J Epidemiol 2014; 42:870-85. [PMID: 23918855 DOI: 10.1093/ije/dyt054] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND This article of the International Epidemiological Association commissioned paper series stocktakes the population health and status of epidemiology in 21 of the 53 countries of the WHO European Region. By United Nations geographical classification, these countries belong to Eastern Europe, Western Asia and South-Central Asia. METHODS Published data were used to describe population health indicators and risk factors. Epidemiological training and research was assessed based on author knowledge, information searches and E-mail survey of experts. Bibliometric analyses determined epidemiological publication outputs. RESULTS Between-country differences in life expectancy, amount and profile of disease burden and prevalence of risk factors are marked. Epidemiological training is affected by ongoing structural reforms of educational systems. Training is advanced in Israel and several Eastern European countries. Epidemiological research is mainly university-based in most countries, but predominantly conducted by governmental research institutes in several countries of the former Soviet Union. Funding is generally external and limited, partially due to competition from and prioritization of biomedical research. Multiple relevant professional societies exist, especially in Poland, the Czech Republic and Hungary. Few of the region's 39 epidemiological academic journals have international currency. The number of epidemiological publications per population is highest for Israel and lowest for South-Central Asian countries. CONCLUSIONS Epidemiological capacity will continue to be heterogeneous across the region and depend more on countries' individual historical, social, political and economic conditions and contexts than their epidemiologists' successive efforts. National and international research funding, and within- and between-country collaborations should be enhanced, especially for South-Central Asian countries.
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Affiliation(s)
- Mati Rahu
- Department of Epidemiology and Biostatistics, National Institute for Health Development, Tallinn, Estonia.
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Abstract
Turkey is a country with intermediate endemicity for hepatitis B, and approximately 4% of the population are HBsAg-positive. A number of measures have been implemented to prevent hepatitis B infection. In 1998, hepatitis B antigen was included in the national immunisation programme, and infants have since been vaccinated with three doses. Catch-up strategies, vaccination for high risk groups and screening measures were also adopted. The aim of this study was to evaluate the impact of the prevention and control strategies on hepatitis B notification rates in Turkey in the period from 1990 to 2012, using data from the national surveillance system. Secular trends revealed that rates showed an initial increasing trend, followed by a steady decline from 2005. The most dramatic decline occurred among children younger than 15 years, highlighting the benefits of vaccination and catch-up strategies. However, vaccination cannot fully explain the decrease in this age group. Socioeconomic development, through interrupting the horizontal transmission may also have contributed. After 2005, a steady decline was achieved also among those 15 years and older. The rates in adults were higher, which indicates that stronger prevention measures are needed to target this group, particularly men.
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Affiliation(s)
- P Ay
- Marmara University, School of Medicine, Department of Public Health, Istanbul, Turkey
| | - M A Torunoglu
- Turkish Public Health Institution, Ministry of Health, Ankara, Turkey
| | - S Com
- Provincial Health Directorate, Ministry of Health, Ankara, Turkey
| | - Z Çipil
- Turkish Public Health Institution, Ministry of Health, Ankara, Turkey
| | | | - Y Erkoç
- Ministry of Health, Ankara, Turkey
| | - U Dilmen
- General Directorate of Health Research, Ministry of Health, Ankara, Turkey
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Dasgupta S, Ay P, Kommolk R, Xu S. Kinetics of Melt Crystallization of a Sunflower Oil-Based Polyunsaturated Fatty Acid Mixture. Chem Eng Technol 2013. [DOI: 10.1002/ceat.201200524] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Karabekiroglu K, Uslu R, Kapci-Seyitoglu EG, Özbaran B, Öztop DB, Özel-Özcan Ö, Dogangün B, Gülen-Sismanlar S, Görker I, Fidan T, Bahali KM, Barut Y, Gürkan K, Kilic BG, Ay P, Taskin B, Bilgin N, Cengel-Kültür ES. A nationwide study of social–emotional problems in young children in Turkey. Infant Behav Dev 2013; 36:162-70. [DOI: 10.1016/j.infbeh.2012.11.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2012] [Revised: 10/03/2012] [Accepted: 11/30/2012] [Indexed: 11/24/2022]
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Senol A, Yücelten AD, Ay P. Development of a Quality of Life Scale for Vitiligo. Dermatology 2013; 226:185-90. [DOI: 10.1159/000348466] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2012] [Accepted: 01/23/2013] [Indexed: 11/19/2022] Open
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Jurischka C, Stollberg C, Smieszek M, Ay P, Kay M, Gerath H. Isolation of Highly Pure Substances from Essential Oils: Efficiency Improvement by Combination of Different Thermal Separation Processes. CHEM-ING-TECH 2012. [DOI: 10.1002/cite.201250462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Karadag-Saygi E, Akyuz G, Bizargity P, Ay P. The effect of risedronate treatment on serum osteoprotegerin and bone marker levels in postmenopausal women with osteoporosis. Gynecol Endocrinol 2011; 27:1033-6. [PMID: 21627558 DOI: 10.3109/09513590.2011.579657] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND To evaluate the effect of risedronate treatment on osteoprotegerin (OPG), C-terminal cross-linking telopeptide of type 1 collagen (CTX), osteocalcin (OC), and deoxypyridinoline (DPD). METHODS Eighty postmenopausal osteoporotic patients were randomized into two groups. In first group, patients received 35?mg of risedronate once a week and calcium with vitamin D per day. In second group, patients received only calcium with vitamin D per day. Bone turnover markers were measured at baseline, 1st, 3rd and 6th month. RESULTS OPG levels were significantly reduced at 1st and 6th month of treatment in both groups, but no statistically significant difference was detected between groups. In the group treated with risedronate, difference in CTX level was observed at 3rd month of treatment, while a difference in DPD and OC levels were observed at 6th month of treatment. The baseline OPG levels correlated with age, menopause duration, and CTX levels. There was no correlation between OPG levels and the levels of the other markers during treatment. CONCLUSION The present study showed that using risedronate in treatment of postmenopausal osteoporosis causes no specific changes in OPG levels; therefore, in contrast to some of the studies in the literature OPG may not be useful marker in monitoring of bisphosphonate.
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Affiliation(s)
- Evrim Karadag-Saygi
- Department of Physical Medicine and Rehabilitation, Marmara University School of Medicine, Istanbul, Turkey.
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Erdem E, Ersu R, Karadag B, Karakoc F, Gokdemir Y, Ay P, Akpinar IN, Dagli E. Effect of night symptoms and disease severity on subjective sleep quality in children with non-cystic-fibrosis bronchiectasis. Pediatr Pulmonol 2011; 46:919-26. [PMID: 21462360 DOI: 10.1002/ppul.21454] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2010] [Revised: 01/07/2011] [Accepted: 01/12/2011] [Indexed: 11/11/2022]
Abstract
BACKGROUND Night-time symptoms and hypoxemia during sleep may affect sleep quality in children with chronic lung disease such as bronchiectasis. Poor sleep quality may impair growth, learning, and emotional development of children. Our aim was to assess the sleep quality and associated factors in children with non-cystic fibrosis bronchiectasis. METHODS Fifty-four patients with bronchiectasis and age-matched controls were included to the study. Pittsburgh Sleep Quality Index (PSQI) and Pediatric Sleep Questionnaire (PSQ) were used to evaluate sleep quality and presence of sleep disordered breathing. A global sum of 5 or more according to PSQI indicated a poor sleep quality. A cut-off value of 0.33 in PSQ was used to identify pediatric sleep disordered breathing. Association between PSQI, pulmonary function tests, symptoms and HRCT scores were evaluated. RESULTS Thirty-seven percent of patients with bronchiectasis and 17% of patients in the control group had poor sleep quality (P < 0.05). Patients with sputum and wheezing had poorer sleep scores (P = 0.003 and P = 0.005). The association of wheezing and breathlessness during night time with sleep quality tended to be significant (P = 0.05). Twenty-two percent of patients with bronchiectasis and 9% of controls had sleep disordered breathing (P = 0.003). Bronchiectasis patients who snored had poorer sleep quality (P < 0.001) and patients with wheezing had significantly higher rate of snoring (P = 0.04). Children with worse HRCT scores also had worse sleep quality (r = 0.28, P = 0.04). CONCLUSIONS Patients with bronchiectasis have disturbed sleep associated with severity of disease. Night symptoms increase the risk of poor sleep quality. Sleep disordered breathing and sleep quality should be assessed in these patients.
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Affiliation(s)
- Ela Erdem
- Division of Pediatric Pulmonology, Marmara University, School of Medicine, Istanbul, Turkey.
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Abstract
AIM In this population-based study, we aimed to determine the total sleep duration (TSD), its association with socio-economic status (SES) and behavioural symptoms among schoolchildren. METHODS A cross-sectional study was performed among schoolchildren in Istanbul. A structured questionnaire evaluating the sleep schedule variables was filled out by their parents. SES was determined according to the Turkish SES scale. RESULTS The mean age of 2669 children was 8.2 ± 2.4 years, and 51% of the students were girls. The mean TSD was 10.20 ± 1.04, and the mean bedtime was 21.57 ± 0.56 (both in hours, minutes ± SD). Boys tended to go bed later (p = 0.004) and slept less than girls (p = 0.02). The duration of sleep disruptions increased (p < 0.001), whereas TSD decreased with age (p < 0.001). Multiple linear regression revealed that waking time and TSD decreased significantly (p < 0.05) with higher SES among both girls and boys. Sleep fragmentation was associated with habitual snoring, parasomnias, daytime sleepiness and conduct symptoms. CONCLUSION Decreased total sleep duration is more prominent in boys, older children and children among higher socio-economic status. Insufficient sleep attributed to shortened total sleep duration by age and higher socio-economic status might have a negative effect on both sleep hygiene and psychological well-being in schoolchildren.
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Affiliation(s)
- Ayse Rodopman Arman
- Department of Child and Adolescent Psychiatry, Marmara University Hospital, Istanbul, Turkey.
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Hidiroglu S, Ay P, Topuzoglu A, Kalafat C, Karavus M. Resistance to vaccination: The attitudes and practices of primary healthcare workers confronting the H1N1 pandemic. Vaccine 2010; 28:8120-4. [DOI: 10.1016/j.vaccine.2010.09.104] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2010] [Revised: 09/23/2010] [Accepted: 09/29/2010] [Indexed: 02/04/2023]
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Ay P, Hayran O, Topuzoglu A, Hidiroglu S, Coskun A, Save D, Nalbant H, Ozdemir E, Eker L. The influence of gender roles on health seeking behaviour during pregnancy in Turkey. EUR J CONTRACEP REPR 2009; 14:290-300. [DOI: 10.1080/13625180902925211] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Ay P, Hidiroglu S, Topuzoglu A, Ucar MS, Kose OO, Save D. Do perceived health risks outweigh the benefits of modern contraceptives? A qualitative study in a suburban population in Istanbul, Turkey. EUR J CONTRACEP REPR 2009; 12:154-61. [PMID: 17559014 DOI: 10.1080/13625180701300822] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVES To evaluate the health concerns and the perceived non-contraceptive benefits of modern contraceptive methods through utilizing qualitative methods. METHODS Six focus group discussions were carried out with a total of 53 married women in a socio-economically disadvantaged community in Istanbul, Turkey. RESULTS Women had a vague knowledge of the mechanism of menstruation. Some women believed that the uterus was filled with blood -- termed 'dirty blood' -- which should be eliminated during menstruation in order to stay healthy. For this reason, amenorrhoea was recognized as the important disadvantage of the progestin-only injectable contraceptives. While the participants mentioned fallacious and exaggerated side effects related to modern methods they did not recognize their non-contraceptive benefits. Most women gained the information concerning side effects through their social networks. Sometimes the information acquired was based on rumours that biased women against the modern contraceptives. CONCLUSIONS Women outweighed the risks, some of which were fallacious and exaggerated, against the benefits of modern contraceptives. It is crucial to address health concerns of women and what they 'heard' from their peers during counselling sessions. Also the non-contraceptive health benefits of modern methods should be well emphasized. Since informal sources are prevalent, the effectiveness of peer education should be studied in this community.
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Affiliation(s)
- P Ay
- Department of Public Health, School of Medicine, Marmara University, Istanbul, Turkey.
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Cakir E, Uyan ZS, Varol N, Ay P, Ozen A, Karadag B, Ersu R, Karakoc F, Dagli E. Effect of occupation and smoking on respiratory symptoms in working children. Am J Ind Med 2009; 52:471-8. [PMID: 19283789 DOI: 10.1002/ajim.20696] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVES To compare the respiratory symptoms and the lung function of children who work in different occupational groups. METHODS The study was performed among children attending vocational training centers. The participants were evaluated in six different occupation groups. Chronic cough, wheezing and shortness of breath were evaluated by questionnaire. The association of independent variables with the respiratory symptoms was investigated through both univariate and multivariate methods. RESULTS Among 642 children, 534 were males; the mean age was 17.7 +/- 1.0 years. Using an internal reference group, the odds ratios of chronic cough were significantly higher in the lathe (OR: 2.0, 95%CI: 1.07-3.74), coiffure (OR: 1.94. 95%CI: 1.01-3.70), and electricity-construction (OR: 2.63, 95%CI: 1.06-6.54) groups after adjustment for smoking, age, gender, and work characteristics. There were no significant differences in spirometric values between occupational groups in either smoking or non-smoking males. In non-smoking females, median values of FEV(1) (P: 0.046), PEF (P: 0.005) and FEF(25-75%) (P: 0.019) were lower in the textile compared to the coiffure group. There was no significant association between the total working time and spirometric values. There was no statistically significant relationship between the work-related factors and the smoking status. CONCLUSIONS The prevalence of chronic cough was higher in the lathe, coiffure, and electricity-construction groups and pulmonary function tests were lower in the non-smoking textile female group. Working children should be screened for respiratory symptoms and disease.
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Affiliation(s)
- Erkan Cakir
- Division of Pediatric Pulmonology, Marmara University, Istanbul, Turkey.
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Karabekiroglu K, Rodopman-Arman A, Ay P, Ozkesen M, Akbas S, Tasdemir GN, Boke O, Peksen Y. The reliability and validity of the Turkish version of the brief infant-toddler social emotional assessment (BITSEA). Infant Behav Dev 2009; 32:291-7. [PMID: 19411111 DOI: 10.1016/j.infbeh.2009.03.003] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2008] [Revised: 03/04/2009] [Accepted: 03/30/2009] [Indexed: 10/20/2022]
Abstract
In this study the reliability and validity of the Turkish version of the brief infant-toddler social emotional assessment (BITSEA) were investigated in a community sample. The sample consisted of 462 children (mean age: 24.60+/-7.93 [12-42] months) who had applied to Turkish health centers for immunization. Both parents completed the BITSEA; mothers completed the child behavior checklist 2/3 (CBCL). Internal consistencies of the BITSEA-problem (P) and competence (C) scales were good to excellent (Cronbach's alpha=0.82 and 0.72, respectively). Interrater reliability between parents and test-retest reliability were good. BITSEA/P scores were significantly correlated with CBCL internalizing, externalizing and total problem scores (p<0.001). Maternal BITSEA/P cutpoint scores revealed that 30.6% of male toddlers and 28.6% of females were in the subclinical range and 13.1% of males and 17.6% of females were in clinical range. Results reveal that the Turkish version of BITSEA is a reliable, valid and simply applicable instrument for screening social, emotional and behavioral problems among toddlers. Clinical validation of the BITSEA/C and BITSEA/P is warranted.
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Affiliation(s)
- Koray Karabekiroglu
- Child & Adolescent Psychiatry Department, Ondokuz Mayis University, School of Medicine, Samsun, Turkey.
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Taskin H, Karavus M, Ay P, Topuzoglu A, Hidiroglu S, Karahan G. Radionuclide concentrations in soil and lifetime cancer risk due to gamma radioactivity in Kirklareli, Turkey. J Environ Radioact 2009; 100:49-53. [PMID: 19038480 DOI: 10.1016/j.jenvrad.2008.10.012] [Citation(s) in RCA: 112] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/08/2008] [Revised: 10/08/2008] [Accepted: 10/15/2008] [Indexed: 05/27/2023]
Abstract
The objective of this study is to evaluate and map soil radionuclides' activity concentrations and environmental outdoor gamma dose rates (terrestrial and cosmic) in Kirklareli, Turkey. The excess lifetime cancer risks are also calculated. Outdoor gamma dose rates were determined in 230 sampling stations and soil samples were taken from 177 locations. The coordinates of the readings were determined by the Global Positioning System (GPS). The outdoor gamma dose rates were determined by Eberline smart portable device (ESP-2) and measurements were taken in air for two minutes at 1m from the ground. The average outdoor gamma dose rate was 118+/-34nGyh(-1). Annual effective gamma dose of Kirklareli was 144microSv and the excess lifetime cancer risk of 5.0x10(-4). Soil samples were analyzed by gamma spectroscopy. The average 226Ra, 238U, 232Th, 137Cs, and 40K activities were 37+/-18Bqkg(-1), 28+/-13Bqkg(-1), 40+/-18Bqkg(-1), 8+/-5Bqkg(-1) and 667+/-281Bqkg(-1), respectively. The average soil radionuclides' concentrations of Kirklareli were within the worldwide range although some extreme values had been determined. Annual effective gamma doses and the excess lifetime risks of cancer were higher than the world's average.
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Affiliation(s)
- H Taskin
- Cekmece Nuclear Researches and Training Center (CNAEM), Department of Health Physics, Istanbul, Turkey
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Cam C, Sakalli M, Ay P, Aran T, Cam M, Karateke A. Validation of the prolapse quality of life questionnaire (P-QOL) in a Turkish population. Eur J Obstet Gynecol Reprod Biol 2007; 135:132-5. [PMID: 17693011 DOI: 10.1016/j.ejogrb.2007.06.009] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2006] [Revised: 04/15/2007] [Accepted: 06/19/2007] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To validate the Turkish translated version of the prolapse quality of life questionnaire (P-QOL). STUDY DESIGN After establishing the test-retest reliability and internal consistency in a pilot study, 310 patients were enrolled in the study and general and subscale scores of the questionnaires were calculated. All participants underwent the International Continence Society (ICS) prolapse score (POP-Q). RESULTS One hundred and forty-five (49.7%) women were symptomatic and 147 (50.3%) were asymptomatic. The level of missing data ranged from 0 to 2.2%. For the test-retest reliability, Spearman's rho was from 0.91 to 1.00 for all domains (p<0.001). The severity of P-QOL was strongly correlated with the vaginal examination findings among the symptomatic group (p<0.001). Items correlated with the objective vaginal examination findings. The total and domain scores for P-QOL of symptomatic and asymptomatic women were found to be statistically significant (p<0.001). CONCLUSION The Turkish translated version of the P-QOL is reliable, consistent and valid instrument for assessing symptom severity, impact on quality of life in women with uterovaginal prolapse. It is easy to understand may be easily administered and self-completed by the women.
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Affiliation(s)
- Cetin Cam
- Zeynep Kamil Training Hospital, Department of Gynecology and Obstetrics, Istanbul, Turkey.
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Topuzoğlu A, Ay P, Hidiroglu S, Gurbuz Y. The barriers against childhood immunizations: a qualitative research among socio-economically disadvantaged mothers. Eur J Public Health 2007; 17:348-52. [PMID: 17090559 DOI: 10.1093/eurpub/ckl250] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND The socio-economically disadvantaged populations are among the most vulnerable groups that are under-vaccinated. Therefore, the aim of this qualitative study was to understand the behaviours of mothers concerning the immunization of their children, the decision-making process, the perceived barriers, and the enabling factors to access the services in a suburban population in Istanbul. METHOD Eight focus group discussions and two in-depth interviews were carried out with the mothers who have children younger than five years. RESULTS While the responsibility of immunization was left totally to the mother, the socially subordinate role of women did not provide the means of getting the immunization services. The women were dependent mostly on social networks for getting the immunization services. Another important barrier to the services was related to the economical constraints and accessibility of the services. In addition, the lack of effective communication and information transfer between the health personnel and the mothers formed an important obstacle. CONCLUSION This study underlines a need for an effective counselling tailored to the immunization session, which will maintain a positive relationship between the personnel and the mother.
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Affiliation(s)
- Ahmet Topuzoğlu
- Department of Public Health, School of Medicine, Marmara University, Istanbul, Turkey.
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Cam C, Sakalli M, Ay P, Cam M, Karateke A. Validation of the short forms of the incontinence impact questionnaire (IIQ-7) and the urogenital distress inventory (UDI-6) in a Turkish population. Neurourol Urodyn 2007; 26:129-33. [PMID: 17083117 DOI: 10.1002/nau.20292] [Citation(s) in RCA: 136] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AIM To validate the Turkish versions of the IIQ-7 and UDI-6 for use in Turkish-speaking populations. METHODS After establishing the test-retest reliability and internal consistency in a pilot study, 302 patients were enrolled in the study and general and subscale scores of the questionnaires were calculated. All participants underwent an urodynamic assessment. RESULTS Both instruments showed a high internal consistency (Cronbach's alpha for the IIQ-7 and UDI-6 was 0.87 and 0.74, respectively) and test-retest reliability (Spearman's rho was 0.99 for both of the scales (P < 0.001). 55.6% of the participants showed urodynamic abnormality and/or leakage. 39.7% had urodynamic stress incontinence (USI) and 15.9% had detrussor overactivity (DOA) +/- USI. The mean scores of each IIQ-7 and UDI-6 were significantly higher in the USI, and DOA +/- USI groups compared with normal women. Women with DOA +/- USI scored highest in the IIQ-7 and UDI-6. The irritative subscale scores of the 1st and 2nd items of the UDI-6 were significantly higher in the DOA +/- USI group. The stress subscale scores of 3rd and 4th items of UDI-6 were significantly higher in the USI group. Women with postvoid residual (PVR) urine values greater than 50 ml had significantly higher obstructive subscale scores compared to the ones who had less residual volumes. CONCLUSIONS The Turkish translated versions of the IIQ-7 and UDI-6 are reliable, consistent and valid instruments for assessing symptom severity and the impact on QOL in Turkish speaking women with urinary incontinence.
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Affiliation(s)
- Cetin Cam
- Department of Urogynecology, Zeynep Kamil Women's Hospital, Istanbul, Turkey.
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Isik U, Ersu RH, Ay P, Save D, Arman AR, Karakoc F, Dagli E. Prevalence of headache and its association with sleep disorders in children. Pediatr Neurol 2007; 36:146-51. [PMID: 17352946 DOI: 10.1016/j.pediatrneurol.2006.11.006] [Citation(s) in RCA: 75] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2006] [Revised: 08/21/2006] [Accepted: 11/22/2006] [Indexed: 11/26/2022]
Abstract
An association between headache and sleep disturbances has been reported in previous studies, but there is a lack of research examining this relationship in a community sample of children in order to reveal the magnitude of the problem. Among 32 District Educational Directorates in Istanbul, nine school districts and within each district eight schools were randomly selected. A questionnaire consisting of sociodemographic variables and evaluating headache and sleep disturbances was sent to students' homes to be completed by their parents. The prevalence of headache was 31.4% (95% confidence interval: 29.5-33.4%). Migraine prevalence was 3.3%, whereas nonmigraine headache prevalence was 28.1%. The prevalence of headache was similar between males and females (29.6% vs 33.3%, P > 0.05). The frequency of headache increased with age for both sexes. Snoring, parasomnias, sweating during sleep, and daytime sleepiness were more common among children with migraine compared with nonmigraine and no headache groups. Headaches are common among schoolchildren. Because children with migraine headaches have a high prevalence of sleep disturbances, they should always be evaluated for the presence of sleep problems.
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Affiliation(s)
- Ugur Isik
- Division of Pediatric Neurology, Acibadem Institute of Neurological Sciences, Istanbul, Turkey.
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Demir F, Ay P, Erbaş M, Ozdil M, Yaşar E. [The prevalence of depression and its associated factors among resident doctors working in a training hospital in Istanbul]. Turk Psikiyatri Derg 2007; 18:31-7. [PMID: 17364266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
OBJECTIVES The objectives of this study were to determine the prevalence of depression and to evaluate the association of sociodemographic factors, as well as aspects of the work environment, with depression among resident doctors working in a training hospital in Istanbul. METHODS This cross-sectional study was conducted in a teaching hospital which has 332 residents in Istanbul. The required sample size was determined to be 207. The study population was stratified proportionally according to hospital departments and a random sampling method was used. Data were collected with a questionnaire consisting of sociodemographic variables, the Beck Depression Inventory (BDI), and the Minnesota Job Satisfaction Questionnaire (MJSQ). The associations were studied through univariate and multivariate analyses. FINDINGS The study included 156 residents who agreed to participate (response rate: 75.3%). The prevalence rate of probable depression was 16.0% (95% CI: 10.7-22.7). In the multivariate analysis, the rate of depression was significantly higher among women compared to men (OR: 5.16, 95% CI: 1.51-17.68, p<0.01). Age, marital status, hospital department, duration of residency, number of night shifts, and duration of exposure to daylight in the work environment were not associated with depression. Among the participants, 90.4% did not want to get a feedback concerning their BDI scores. A negative correlation was determined between depression and job satisfaction scores. CONCLUSION Among resident doctors, women in particular should be evaluated as an important at-risk group for depression. Prevention and control programs that also include components for reducing stigma should be implemented.
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Affiliation(s)
- Figen Demir
- Araş Gör., Uzm., Marmara U Tip Fak., Halk Sağliği, Istanbul, Turkey.
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Ay P, Topuzoglu A, Korukluoglu G, Cali S. Rubella seroprevalence among first-grade primary school students in a district in Istanbul, Turkey. Public Health 2006; 120:267-73. [PMID: 16364385 DOI: 10.1016/j.puhe.2005.09.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2005] [Revised: 06/29/2005] [Accepted: 09/20/2005] [Indexed: 11/23/2022]
Abstract
OBJECTIVES Rubella vaccination is not included in the national immunization programme of Turkey. However, it is on the market and is recommended, mainly by the private sector, at the age of 12-15 months. Introduction of the rubella vaccine without achieving high coverage has the risk of shifting the mean age of rubella infection among the unvaccinated population to reproductive ages. The aim of this study was to evaluate the seroprevalance of rubella and the factors associated with seropositivity among primary school students in Umraniye, a district of Istanbul. METHODS Blood samples were collected from 489 students in 70 primary schools of Umraniye. Parents completed a concise questionnaire assessing sociodemographic characteristics and measles, mumps and rubella vaccination status. RESULTS Among the students screened, 163 (33.3%, 95% confidence intervals 29.2-37.7%) were susceptible to rubella. When sociodemographic variables were evaluated, paternal education was the only variable associated with seronegativity. As the level of paternal education increased, seronegativity rates decreased. This finding may suggest that rubella vaccination is practiced more commonly among children whose fathers are better educated. CONCLUSIONS Surveillance and control of rubella and congenital rubella syndrome must be set as public health priorities in Turkey, particularly given that rubella vaccination is practiced partially in the country.
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Affiliation(s)
- P Ay
- Department of Public Health, School of Medicine, Marmara University, Haydarpasa, Istanbul, Turkey.
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Gaydardzhiev S, Karthikeyan J, Ay P. Colour removal from model solutions by coagulation--surface charge and floc characterisation aspects. Environ Technol 2006; 27:193-9. [PMID: 16506515 DOI: 10.1080/09593332708618633] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
Chemical coagulation applied for colour removal from dye bearing solutions has been investigated from the point of view of surface charge progression. Two commercially used dyes, i.e. CI Acid Blue 113 and CI Disperse Blue 26 have been tested, employing three common coagulants: alum, aluminium chloride and ferric chloride. Coagulant type and dose level and pH of the dye solution have been studied as process parameters affecting surface charge and degree of colour removal after filtration of coagulated dye. It has been found, that both dyes could be almost completely removed with the tested coagulants, when supplied however at different dosages. From one side, the correlation between surface charge and colour removal suggests that destabilization of colour colloids occurs as a result of charge neutralization followed by removal by filtration. From other side, the lack of re-stabilization and continued high colour removal even at increased coagulant dosages implies enmeshment of destabilized dye colloids into the hydroxy flocs/precipitates of metal coagulant by "sweep coagulation". Finally, flocs from selected sludge samples have been examined for particle size and shape by image analysis and their key characteristics summarised.
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Affiliation(s)
- S Gaydardzhiev
- Lehrstuhl Aufbereitungstechnik, Brandenburg Technical University, Siemens-Halske-Ring 8, 03046 Cottbus, Germany
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Ay P, Save D, Fidanoglu O. Does stigma concerning mental disorders differ through medical education? A survey among medical students in Istanbul. Soc Psychiatry Psychiatr Epidemiol 2006; 41:63-7. [PMID: 16328750 DOI: 10.1007/s00127-005-0994-y] [Citation(s) in RCA: 69] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/25/2005] [Indexed: 10/25/2022]
Abstract
BACKGROUND Stigma and discrimination toward mentally disabled persons might exist within the medical environment and may form a barrier for patients to receive appropriate care. The aim of this study is to determine the attitudes of medical students toward mentally disabled people and to understand the impact of schooling on attitude difference by evaluating second and sixth year medical students. METHOD The study was carried out among 452 students from the all the three public medical schools located in Istanbul, Turkey. Attitudes were assessed through a Likert scale by presenting vignettes for depression and schizophrenia. RESULTS In both men and women, the scores of last year students for depression and schizophrenia scales were better compared with those of the second graders, and the differences were statistically significant (p<0.05). However, the proportion of students who did not perceive schizophrenia as "temporary" and "curable" and the perceived likelihood of dangerousness for schizophrenia were higher among the last year students compared with the second graders. CONCLUSION As a result of this study, it was determined that last year students had improved attitudes toward the mentally ill; however, they still had striking stigmatizing opinions and judgments. The improvement in the attitude score between the second and the sixth graders is considered a result of the students' contact and interaction with persons having mental disorders throughout their medical education. The challenge is to maintain a social environment that aims to reduce the distance between the patient and the medical staff through introducing a holistic approach in medical schools.
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Affiliation(s)
- Pinar Ay
- Dept. of Public Health, School of Medicine, Marmara University, Istanbul, Turkey.
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Ertugrul BM, Yildirim A, Ay P, Oncu S, Cagatay A, Cakar N, Ertekin C, Ozsut H, Eraksoy H, Calangu S. Ventilator-associated pneumonia in surgical emergency intensive care unit. Saudi Med J 2006; 27:52-7. [PMID: 16432594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/06/2023] Open
Abstract
OBJECTIVE To investigate the incidence, risk factors and the etiology of ventilator-associated pneumonia (VAP) in surgical emergency intensive care unit (ICU) patients. METHODS We conducted this prospective cohort study in the surgical emergency ICU of Istanbul Medical Faculty between December 1999 and May 2001. We included 100 mechanically ventilated patients in this study. We diagnosed VAP according to the current diagnostic criteria. We identified the etiology of VAP cases by both quantitative cultures of endotracheal aspiration and blood cultures. To analyze the predisposing factors for the development of VAP, we recorded the following variables: age, gender, acute physiology and chronic health evaluation (APACHE) II score, Glasgow coma scale (GCS), sequential organ failure assessment (SOFA) score, serum albumin level, duration of mechanical ventilation (MV) prior to the development of VAP, and underlying diseases. RESULTS We determined the VAP incidence rate as 28%. We found the APACHE II score and the duration of MV to be statistically significant variables for the development of VAP. There were no significant differences regarding age, gender, GCS, SOFA score, albumin level, or underlying diseases for the development of VAP. The isolated bacteria among VAP cases were as follows: Staphylococcus aureus (n=12, 43%), Acinetobacter spp. (n=6, 21%), coagulase-negative Staphylococci (n=4, 15%), Pseudomonas aeruginosa (n=3, 10.7%) and Klebsiella pneumoniae (n=3, 10.7%). CONCLUSION Ventilator-associated pneumonia is a common infection, and certain interventions might affect the incidence of VAP. The ICU clinicians should be aware of the risk factors for VAP, which could prove useful in identifying patients at high risk for VAP, and modifying patient care to minimize the risk of VAP.
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Affiliation(s)
- Bulent M Ertugrul
- Department of Infectious Diseases and Clinical Microbiology, Adnan Menderes University Medical Faculty, Aydin 09100, Turkey.
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