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BACKGROUND: Coronary care units are sophisticated clinics established to reduce deaths due to acute cardiovascular events. Current data on coronary care unit mortality rates and predictors of mortality in Turkey are very limited. The MORtality predictors in CORonary care units in TURKey (MORCOR-TURK) trial was designed to provide information on the mortality rates and predictors in patients followed in coronary care units in Turkey. METHODS: The MORCOR-TURK trial will be a national, observational, multicenter, and noninterventional study conducted in Turkey. The study population will include coronary care unit patients from 50 centers selected from all regions in Turkey. All consecutive patients admitted to coronary care units with cardiovascular diagnoses between 1 and 30 September 2022 will be prospectively enrolled. All data will be collected at one point in time, and the current clinical practice will be evaluated (ClinicalTrials.gov number NCT05296694). In the first step of the study, admission diagnoses, demographic characteristics, basic clinical and laboratory data, and in-hospital management will be assessed. At the end of the first step, the predictors and rates of in-hospital mortality will be documented. The second step will be in cohort design, and discharged patients will be followed up till 1 year. Predictors of short- and long-term mortality will be assessed. Moreover, a new coronary care unit mortality score will be generated with data acquired from this cohort. RESULTS: The short-term outcomes of the study are planned to be shared by early 2023. CONCLUSION: The MORCOR-TURK trial will be the largest and most comprehensive study in Turkey evaluating the rates and predictors of in-hospital mortality of patients admitted to coronary care units.

We test a conjecture to explain Turkey’s decades long underachievement in early child mortality improvements. We argue that it is largely a consequence of cultural barriers to embrace available modern medical technology and health care practices. The empirical test rests on a reformulation of Coale’s Ready-Willing-Able (RWA) framework (1973) to explain fertility changes making it suitable to understand mortality changes. We employ a Structural Equation Model (SEM) and Demographic and Health Surveys (DHS) spanning 1993 to 2013, and estimate basic parameters of the reformulated framework. These are then used to classify mothers into four categories representing subgroups with different configurations of RWA dimensions and different probabilities of adopting modern medical practices. We find that observed behaviors in these subgroups are consistent with RWA expectations. In addition, we find that an important contributor to Turkey’s lagging mortality decline is a population distribution biased toward groups more reticent to adopt modern health care, not to their availability or accessibility.

Objective: To evaluate the serotype distribution and antibiotic resistance in pneumococcal infections in adults and to provide a perspective regarding serotype coverage of both current and future pneumococcal vaccines. Patients and methods: This passive surveillance study was conducted with the Streptococcus pneumoniae strains isolated from the specimens of patients with pneumonia (materials isolated from bronchoalveolar lavage), bacteraemia, meningitis, pleuritis and peritonitis between 2015 and 2018. Serogrouping and serotyping were performed by latex particle agglutination and by conventional Quellung reaction using commercial type-specific antisera, respectively. The strains were analysed for penicillin, cefotaxime, erythromycin and moxifloxacin susceptibilities by E-test. Results: In the whole study group (410 samples from adults aged ≥18 years), the most frequent serotypes were 3 (14.1%), 19 F (12%) and 1 (9.3%). The vaccine coverage for PCV13, PCV15, PCV20 and PPV23 was 63.9%, 66.6%, 74.1% and 75.9%, respectively, in all isolates. Penicillin non-susceptibility in invasive pneumococcal disease (IPD) was 70.8% and 57.1% in the patients aged

Persistent infection with high-risk (HR) Human Papilloma Virus (HPV) genotypes has been shown to play a significant role in the development of cervical intraepithelial neoplasia (CIN) and CC (cervical cancer). The present study aimed to determine the distribution and quantification of viral load of HPV genotypes in numerous genital samples obtained from women undergoing routine gynaecological care in different regions of Turkey.HPV typing was done by HPV QUANT-21 Quantitative RT-PCR Kit®, which is intended for the specific identification and quantification of low-risk (HPV 6, 11, 44) and high-risk (HPV 16, 18, 26, 31, 33, 35, 39, 45, 51, 52, 53, 56, 58, 59, 66, 68, 73, 82) from female subjects in Turkey.From the total of 5975 samples, 2777 were positive for at least one HPV genotype, with an overall frequency of 46.4%. 1695 patients were positive for only one or more LR-HPV genotypes (61%) and 812 patients were positive for one or more HR-HPV genotypes (29%). The frequency of LR-HPV genotypes was 31.4%, while the frequency of HR-HPV genotypes was 118.8%. Our tecnology had a positive advantage to calculate the concentration of each genotypes. Although genotype 52 ranked fifth in frequency, it showed the highest mean concentration, with a value of 5.38 log (copies/sample).The presence and genotype of viruses before HPV vaccination have also gained importance. The data obtained would provide guidance for prevention strategies, mainly of vaccination. We decided to add a new estimate to the effectiveness of currently available HPV vaccines and the development of screening programs to prevent and decrease the incidence of CC in Turkey. Further studies would be planned to measure and define the high infection level that can lead to the development of cervical neoplasia. Using this tecnology could give us a clinical desicion to degree the cytological changes.

To assess the effects of cognitive emotion regulation, emotional intelligence status and related factors on postpartum depression (PPD) in postpartum women.This descriptive and cross-sectional study was conducted in 268 mothers with babies aged 1-12 months. The study was carried out between 01 November 2021 and 01 February 2022 in the pediatric outpatient clinic of the Medical Faculty Hospital of a province in the Central Anatolian Region of Turkey. Data were collected using the sociodemographic and obstetric data collection form, Edinburgh Postnatal Depression Scale (EPDS), Cognitive Emotion Regulation Questionnaire-Short Form (CERQ), and Trait Emotional Intelligence Questionnaire-Short Form (TEIQue-SF).Seventy-one (26.5 %) mothers received scores above the cut-off point (13) in the depression scale. Experiencing emotional violence, having cognitive emotion regulation difficulties, and low emotional intelligence characteristics affected the risk of developing postpartum depression by 16 % (F = 13.757, p 0.001).Exposure to emotional violence, cognitive emotion regulation, and emotional intelligence status reveal that they are important in identifying women at risk of PPD. These findings highlight the need for nurses to develop comprehensive cognitive emotion regulation and emotional intelligence traits assessment programs, including depression screening.

Introduction: The aim of this study was to evaluate the demographic and clinical characteristics and treatment outcomes of children with Salmonella gastroenteritis. Methodology: We retrospectively reviewed the medical records of pediatric patients aged between 1 month and 18 years with the diagnosis of Salmonella gastroenteritis between May 2015 and December 2021. Results: A total of 172 children diagnosed with Salmonella gastroenteritis, including 113 outpatients and 59 hospitalized children, were included in this study. There were 95 (55.2%) males and 77 (44.8%) females with a median age of 59.5 months (interquartile range [IQR]: 33.5–96 months, min–max: 1–205 months). The most common clinical symptoms were diarrhea (n = 166, 96.5%), fever (n = 113, 65.7%) and abdominal pain (n = 73, 42.4%). Bloody diarrhea was seen in 19.2% of patients. Fifty (29.1%) of the Salmonella species could not be typed. Serogroup D (n = 106, 61.6%) was the predominant serogroup isolated from stool cultures, followed by serogroup B (n = 16, 9.3%). 62.2% of the isolates were susceptible to ampicillin, 97.7% to ciprofloxacin, 98.8% to trimethoprim-sulfamethoxazole, and 98.8% to ceftriaxone. Fever, vomiting, and underlying disease occurred more frequently in hospitalized patients than in outpatients (p: 0.005, p: 0.000, p: 0.000, respectively). C-reactive protein value was found to be higher in hospitalized patients (p: 0.000). Conclusions: Salmonella should be considered as a causative agent in pediatric patients with abdominal pain, fever, and bloody-mucous diarrhea, and patients with severe clinical conditions should be hospitalized and antibiotic therapy initiated if indicated.

Offending and incarceration are important societal problems that might be reduced by improving early intervention. Most prior work identifying risk factors has focussed on early oppositional or aggressive behaviours and environmental problems. Among adults, it is well recognised that offenders have much poorer health than the wider population. This raises questions about whether behaviours that put health at risk while a teenager may also be good markers of subsequent offending.To examine the relationship between risky health behaviours and delinquency by comparing male teenage offenders with a history of incarceration and male teenagers with no criminal involvement.In this cross-sectional study, 66 male 12-18-year-old offenders with an incarceration history who were referred for evaluation to the Forensic Medicine Polyclinic in 2021 were compared with 74 similar aged adolescents without a criminal record but attending another clinic in the same hospital, using the Risky Health Behaviour Scale (RHBS). This covers dietary, road safety and sexual behaviours as well as exercise, substance use and violent behaviours. Negative items were reverse scored so that higher scores indicated more pro-health activities.Total RHBS scores were significantly lower among the offender-group than the comparison teenagers (Means 93.19 ± 17.00: 107.20 ± 10.83; p ≤ 0.001). This reflected significant differences in each of the subscale scores except dietary and risky sexual behaviour. Only substance use behaviours, however, were independently related to offender group membership, as was family socio-economic status.Our findings add indications of risky health-related behaviours to the already extensive literature on risky social behaviours in the history of young offenders. It is possible that focussing on young offenders referred to a health service, albeit one primarily directed at mental health, has exaggerated such differences, but if substantiated in larger and more diverse samples, these findings may open new avenues for early identification of young people at risk of offending and commensurate early interventions. Focus on substance use by young people seems especially important, but low family socio-economic status needs remedies too.

Vaccine hesitancy is a growing problem globally. This study aimed to detect the rates of vaccine refusal (VR) during childhood in each province and region of Turkey from 2016 to 2017 and to evaluate the experiences of Expanded Programme on Immunization (EPI) managers regarding childhood VR and opinions to solve and reduce vaccine hesitancy in Turkey.VR was defined as the refusal to vaccinate for at least one vaccine in children aged 0-23 months. In this descriptive study, information on notified VR cases and recommended solutions from every province in Turkey was accessed by the local EPI manager for the period 2016-2017. The VR rates were calculated.From 80 provinces, 8977 VR cases were detected in 2016 (VR rate 3.5‰) and 14,779 cases in 2017 (VR rate 5.9‰; p0.001). One quarter of Family Health Units reported at least one case of VR. The highest VR rate in children aged under 2 years was in East Marmara (8.4‰) in 2016, and the West Anatolia Region (10.9‰) and East Marmara region (10.9‰) in 2017. Concerns about the vaccine content, harmfulness, and fears about adverse effects were the most common reasons underlying VR. Educating healthcare workers about vaccines and interpersonal communication skills, increasing patient information with informative brochures, and preventing anti-vaccination publications in the media were the most frequent recommendations to solve VR.In Turkey, VR cases continue to increase. Correct and adequate information, effective communication, and trust between healthcare workers and parents can help reduce VR.

Mothers face social and cultural obstacles to breastfeeding in public.This study evaluated the attitudes and practices of Turkish women regarding breastfeeding in public.This cross-sectional, descriptive study was carried out in a university hospital among 200 new postnatal mothers and their 200 accompanying female relatives. Data were obtained using a questionnaire and the Infant Feeding Attitude Scale (IIFAS).Respondents mostly believed that there was nothing wrong with breastfeed in public and almost half of them thought the society would perceive breastfeeding in public negatively. Some 56.5% of the mothers who had previously had children and 37.2% of their relatives had breastfed in public before. The acceptance of breastfeeding in public increased "if the breast is covered" and "if a private space is provided". The mean total IIFAS score was 61.53 (6.19) in the mothers and 60.65 (6.69) in their relatives. Based on IIFAS, the mothers (92.0%) and their relatives (89.5%) were neutral to breastfeeding, but age, education, employment status, and opinions regarding breastfeeding in public affected the IIFAS scores. IIFAS score was significantly higher in women who had breastfed in public before.Although the women knew the importance of breastfeeding, they mostly did not breastfeed in public because of the cultural implications and the lack of private breastfeeding areas. Awareness-raising, availability of breastfeeding rooms, and education of supporting relatives can help the increase willingness of mothers to breastfeed even if it is in public.اتجاهات الأمهات بعد الولادة وقريباتهن المرافقات من مباشرة الرضاعة الطبيعية في الأماكن العامة وممارساتهن في هذا الصدد: دراسة في أحد المستشفيات الجامعية في تركيا.إلكاي جونجور ساتيلمز، بشرا يلمز، زهرة أكار.تواجه الأمهات عقبات اجتماعية وثقافية بشأن مباشرة الرضاعة الطبيعية في الأماكن العامة.هدفت هذه الدراسة الى تقييم إتجاهات النساء التركيات إزاء مباشرة الرضاعة الطبيعية في الأماكن العامة وممارساتهن في هذا الشأن.أُجريت هذه الدراسة الوصفية المقطعية في مستشفى جامعي، وضمت 200 من الأمهات حديثات الولادة و200 من قريباتهن المرافقات. وقد جُُمِعت البيانات باستخدام استبيان ومقياس توجُّهات تغذية الرُّضَّع.غالبًا ما رأت المشارِكات في البحث أنه لا ضير ولا خطأ في مباشرة الرضاعة الطبيعية في الأماكن العامة، ولكن رأى نصفُهن تقريبًا أن المجتمع سينظر إلى مباشرة الرضاعة الطبيعية في الأماكن العامة نظرةً سلبية. وتبيََّّن أن نحو 56.5٪ من الأمهات اللاتي سبق لهن الإنجاب و37.2٪ من قريباتهن قد أرضعن أطفالهن في الأماكن العامة من قبل. وزاد تقبُّل مباشرة الرضاعة الطبيعية في الأماكن العامة في حالة «تغطية الثدي» و«توفير مكان خاص للأمر». وكان متوسط إجمالي النتيجة على مقياس توجُّهات تغذية الرُّضَّع 61.53 (6.19) لدى الأمهات و60.65 (6.69) لدى قريباتهن. وحسب مقياس توجُّهات تغذية الرُّضَّع، فإن 92.0٪ من الأمهات و89.5٪ من قريباتهن لديهن موقف محايد من مباشرة الرضاعة الطبيعية، ولكن عوامل العمر والتعليم والوضع الوظيفي والآراء المتعلقة بمباشرة الرضاعة الطبيعية في الأماكن العامة أثَّرت جميعًا على النتائج في مقياس توجُّهات تغذية الرُّضَّع. كانت النتائج على مقياس توجُّهات تغذية الرُّضَّع أعلى كثيرًا لدى النساء اللاتي سبق لهن مباشرة الرضاعة الطبيعية في الأماكن العامة.إن النساء يعرفن أهمية الرضاعة الطبيعية، ومع ذلك فإنهن في الغالب لا يُرضعن أطفالهن في الأماكن العامة بسبب العوامل الثقافية، وغياب مناطق خاصة لمباشرة الرضاعة الطبيعية. لذا يمكن لزيادة الوعي، وتوفُّر غُرَف لمباشرة الرضاعة الطبيعية، وتثقيف الأقارب الداعمين، أن يساعد في زيادة استعداد الأمهات لمباشرة الرضاعة الطبيعية، وإن كان ذلك في الأماكن العامة.Attitudes et pratiques des mères en période postnatale et de leurs accompagnatrices de l'entourage proche vis-à-vis de l'allaitement en public dans un hôpital universitaire en Turquie.Les mères font face à des obstacles sociaux et culturels concernant l'allaitement en public.La présente étude a évalué les attitudes et les pratiques des femmes turques en matière d'allaitement en public.Cette étude transversale et descriptive a été menée dans un hôpital universitaire auprès de 200 nouvelles mères en période postnatale et de leurs 200 accompagnatrices de l'entourage proche. Les données ont été obtenues au moyen d'un questionnaire et de l'échelle d'attitude à l'égard de l'alimentation des nourrissons (IIFAS).La plupart des personnes interrogées pensaient qu'il n'y avait rien de mal à allaiter en public et près de la moitié d'entre elles étaient d'avis que la société perçoit négativement l'allaitement en public. Près de 56,5 % des mères qui avaient déjà eu des enfants et 37,2 % de leurs proches avaient déjà allaité en public. L'acceptation de l'allaitement en public était renforcée « si le sein est couvert » et « si un espace privé est prévu ». Le score total moyen de l'échelle d'attitude à l'égard de l'alimentation des nourrissons était de 61,53 (6,19) chez les mères et de 60,65 (6,69) chez leurs proches. Selon cette échelle, les mères (92,0 %) et leurs proches (89,5 %) étaient neutres vis-à-vis de l'allaitement, mais l'âge, le niveau d'éducation, le statut professionnel et les opinions concernant l'allaitement en public affectaient les scores IIFAS. Ces derniers étaient significativement plus élevés chez les femmes qui avaient déjà allaité en public.Même si les femmes connaissaient l'importance de l'allaitement, elles n'allaitaient généralement pas en public en raison des implications culturelles et du manque d'espaces privés pour l'allaitement. La sensibilisation, la disponibilité de salles d'allaitement et l'éducation des proches qui soutiennent les mères peuvent contribuer à accroître la volonté des mères d'allaiter, même dans un lieu public.

The detection of hepatitis B surface antigen positivity in pregnant women before delivery is crucial to preventing mother-to-child transmission of hepatitis B virus.This study aimed to evaluate the status and rate of testing for hepatitis B surface antigen, rate of hepatitis B surface antigen positivity, hepatitis B surface antigen positivity distribution rate by age, and changes in hepatitis B surface antigen positivity rate in pregnant women over the study period.We conducted a multicentre, cross-sectional, descriptive study covering the period January 2005 to June 2019 for 2 145 668 pregnant women from 27 provinces in all 7 regions of Turkey, collected using Microsoft Excel before statistical analysis.We found that 1 012 593 (47.1%) pregnant women were tested for hepatitis B surface antigen over the 15-year period, out of which 11 471 (1.1%) were hepatitis B surface antigen-positive. Overall, 97% of the hepatitis B surface antigen positive women were born before 1998, the year that national HBV vaccination was launched in Turkey. The rate of hepatitis B surface antigen positivity in that group was 1.1%, compared with 0.3% among women born after 1998.There was a downward trend in the hepatitis B surface antigen positivity rate among pregnant women in the younger age groups, especially among those born after universal hepatitis B vaccination was inaugurated, and low rate of HBsAg testing during pregnancy.تقييم 15 عامًا من التغييرات في معدل النتائج الإيجابية للمُستضَدِّ السطحي للالتهاب الكبدي B/ المستضد الأسترالي لدى النساء الحوامل في تركيا: التأثير البارز للتطعيم على المستوى الوطني.سلمى طوسون، عائشة أردوغان، عائش تورن، سلمى سيفر، سيبيل ألتونتاس، إلكنور يلديز، حسين كوتلو، محمد سيلان، بيمبي يسيلباج، بيهان بكتوري، نفيس أوزتوبراك، بوكيت جونجور، سيزين كوبران، جولنور كول، علي أولوت، بولنت ألتونتاش، فريق دراسة متعدد المراكز.ثمة أهمية كبرى لاكتشاف النساء الحوامل الإيجابيات للمستضدات السطحية للالتهاب الكبدي B اكتشافًا مبكرًا في مرحلة ما قبل الولادة، لتَوقِّي انتقال فيروس الالتهاب الكبدي B من الأم إلى الطفل.هدفت هذه الدراسة إلى تقييم حالة ومعدل اختبار المستضدات السطحية للالتهاب الكبدي B، ومعدل الحالات الإيجابية لهذه المستضدات، وتوزيع الحالات حسب العمر، والتغيُُّّرات في معدل النتائج الإيجابية للمستضدات لدى النساء الحوامل على امتداد فترة الدراسة.أجرينا دراسة وصفية مقطعية متعددة المراكز عن المدة من يناير/ كانون الثاني 2005 إلى يونيو/ حزيران 2019، وشملت ما مجموعه 2145668 امرأة حاملًًا من 27 محافظة في جميع المناطق السبع في تركيا، وجُُمعت البيانات باستخدام برنامج مايكروسوفت إكسيل قبل إجراء التحليل الإحصائي.وجدنا أن 1012593 امرأة حاملًًا (47.1٪) قد خضعن لاختبار المستضد السطحي للالتهاب الكبدي B على مدى 15 عامًا، وجاء بينهن 11471 عينة إيجابية (1.1٪) لهذه المستضدات. وإجمالًًا، تبيََّّن أن 97٪ من النساء الإيجابيات للمستضدات قد وُلدن قبل عام 1998، وهو العام الذي دُشِّنَ فيه التلقيح الوطني ضد فيروس التهاب الكبد B في تركيا. وبلغ معدل الإيجابية تجاه المستضدات السطحية للالتهاب الكبدي B في هذه المجموعة 1.1٪، مقارنة بنسبة 0.3٪ بين النساء اللاتي وُلدن بعد عام 1998.تبيََّّن وجود اتجاه لانخفاض في معدل النتائج الإيجابية تجاه المستضدات السطحية للالتهاب الكبدي B بين النساء الحوامل في الفئات العمرية الأصغر، ولا سيما بين أولئك اللاتي قد وُلدن بعد تدشين التطعيم الشامل ضد التهاب الكبد B، وانخفاض معدل اختبار المستضدات السطحية للالتهاب الكبدي B في أثناء الحمل.Quinze ans d'évaluation de l'évolution du taux de positivité de l'AgHBs chez les femmes enceintes en Turquie : l'effet majeur de la vaccination nationale.La détection d'une positivité à l'antigène de surface de l'hépatite B chez les femmes enceintes avant l'accouchement est cruciale pour prévenir la transmission mère-enfant du virus de l'hépatite B.La présente étude visait à évaluer le statut et le taux de dépistage de l'antigène de surface de l'hépatite B, le taux de positivité à l'antigène de surface de l'hépatite B, le taux de distribution de l'antigène de surface de l'hépatite B selon l'âge, et l'évolution du taux de positivité de l'antigène de surface de l'hépatite B chez les femmes enceintes au cours de la période d'étude.Nous avons mené une étude multicentrique, transversale et descriptive couvrant la période allant de janvier 2005 jusqu'à juin 2019 pour 2 145 668 femmes enceintes de 27 provinces dans les sept régions de Turquie, collectée à l'aide de Microsoft Excel avant l'analyse statistique.Nous avons constaté que 1 012 593 (47, 1 %) femmes enceintes avaient été testées pour l'antigène de surface de l'hépatite B au cours de cette période de 15 ans, dont 11 471 (1,1 %) étaient positives. Globalement, 97 % des femmes positives à l'antigène de surface de l'hépatite B étaient nées avant 1998, année où la vaccination nationale contre le VHB a été lancée en Turquie. Le taux de positivité à l'antigène de surface de l'hépatite B dans ce groupe était de 1,1 %, contre 0,3 % chez les femmes nées après 1998.On a constaté une tendance à la baisse du taux de positivité à l'antigène de surface de l'hépatite B chez les femmes enceintes des groupes d'âge plus jeunes, en particulier chez celles nées après le lancement de la vaccination universelle contre l'hépatite B, et un faible taux de dépistage de l'AgHBs pendant la grossesse.

Introduction: Vaccine-preventable diseases can be effectively managed through timely vaccine booster doses. In this study, the tetanus vaccination status of healthcare professionals and their level of knowledge about tetanus vaccination were investigated Methodology: The data were obtained through a survey questionnaire from 336 healthcare professionals. The survey participants were recruited on a voluntary basis among the personnel working in a tertiary hospital between 1 July 2021 and 30 September 2021. The participants were asked about their tetanus vaccination status and general awareness about the tetanus vaccine. Results: The survey participants included nurses (41.4%, n = 139), doctors (39.9%, n = 134) and support unit personnel (18.8%, n = 63). The support unit personnel had insufficient knowledge about military service period, pregnancy period, vaccination of women aged 15-49 years, and the necessity of booster tetanus vaccine every 10 years. Interestingly, the nurses had significantly inadequate knowledge of geriatric tetanus vaccination. Conclusions: Although the tetanus immunization program is widely implemented throughout the country, our study concluded that it is necessary to educate healthcare professionals on the importance of the tetanus vaccine.

The purpose of this study is to examine the prevalence of bullying among high school students, its associated factors, and the effects of engaging in bullying behaviors on mental health.This cross-sectional study was conducted between 2021 and 2022 in the province with the highest population of children in the Southeast Anatolia region of Turkey. The data of the study were collected using the Sociodemographic Characteristics Questionnaire prepared by the researchers, Olweus Bully/Victim Questionnaire (OBVQ), and Depression Anxiety Stress Scale 42 (DASS-42).Of the 880 students who participated in the study, 34.2% reported being a victim of bullying and 13.9% reported bullied someone. Regression analysis revealed that overweight/obesity was a risk factor for both victims and bullies. On the other hand, male gender and alcohol consumption were significantly associated with bullying. Scores for depression, anxiety, and stress were significantly higher in both the victim and the bullying groups compared to students who did not fall into this cycle.The present findings suggest that bullying in school creates problems not only for the bullying victims but also for the bullies. Health professionals assessing youth should be aware of the characteristics of young people who may be involved in bullying.

The COVID-19 pandemic has put enormous stress on the health care workers, threatening not only their physical health but also their mental well-being. No mental health support program (MHSP) addressing depression and anxiety in healthcare workers (HCWs), has been shown to be effective in Turkey previously. We aimed to measure the effect of our MHSP among healthcare workers who applied for psychological help associated with the COVID-19 pandemic.An MHSP has been created for healthcare professionals working in a pandemic hospital during the COVID-19 period. Health workers were recruited between July and September 2020. Anxiety, depression, and insomnia levels were evaluated with HAM-A (Hamilton Anxiety Scale), HDRS (Hamilton Depression Scale), and Insomnia Severity Index (ISI) before and after the intervention. Sexual complaints were questioned by a consultant psychiatrist. MHSP (n=31), and treatment as usual (TAU, n=27) groups were compared using repeated-measures ANOVA.Sociodemographic data, medical history of COVID-19, and psychiatric diagnoses were similar between the groups. There was no difference in baseline HAM-A, HDRS, and ISI scores (p0.05). At the end of the study, there was a significant difference between study groups regarding anxiety scores (For post-treatment, MHSP=8.0±2.6 vs. TAU=17.9±3.1, p0.001) and depression symptoms (For post-treatment, MHSP=8.8±2.7 vs. TAU=20.0±2.4, p0.001) but not in insomnia levels (For post-treatment, MHSP=6.5±2.4 vs. TAU=7.3±2.4, p=0.499). Likewise, both groups reported similar levels of improvement in reduced sexual drive.Our study results suggest that the MHSP effectively alleviates the psychiatric complaints of healthcare professionals. It is recommended to have mental support teams for healthcare professionals in hospitals.

What is known and objective:Drug-related problems (DRPs) are common inhospitalized patients in intensive care unit (ICU). The aim of the study is to reduceDRPs and associated costs with clinical pharmacist's (CP) recommendations.Methods:The study is a prospective, non-randomized controlled study conducted inthe ICU for a total of 6 months (1 January 2021–30 June 2021) in 2-month con-trol, 2-month study, and 2-month control periods. Patients who were hospitalizedfor more than 24 h and used more than one medication were included in thestudy. The PCNE V9.1 Classification system was used in the classification ofDRPs. During the intervention period, CP recommendations for DRPs wereproposed to the healthcare team.Results and discussion:A total of 146 patients were included in the study. A total of1061 DRPs from all periods were detected. The most common causes of DRPs werepotential drug–drug interactions (31.76%), high dose (12.44%), and dose timinginstruction errors (9.24%). For 347 DRPs identified during the study period, 259 inter-ventions (74.63%) were recommended, and 238 (91.89%) were accepted by physi-cians. Interventions were mostly made as interrupting/discontinuing the drug(28.02%), changing the dose (25.27%), changing the instructions for use (20.32%),and starting a new drug (15.93%). Cost savings were achieved with CP recommenda-tions applied.What is new and conclusion:The CP's recommendations were highly accepted bythe healthcare team. With the CP's participation in routine patient rounds in thehealthcare team of the ICU, drug-related costs would also decrease.

This study aims to perform a detailed analysis of the validity and reliability of the Turkish version of the Person-Centered Perioperative Nursing Scale (PCPON).Methodological and descriptive study.This study was conducted online between December 2020 and February 2021, with 240 nurses working in the surgical wards of private hospitals in Istanbul, Turkey. Individual Characteristics Questionnaire and PCPON were used to collect data. Cronbach Alpha reliability analysis and Confirmatory Factor Analysis (CFA) were applied using R Project software to the data.As a result of the analysis, all corrected item correlation values for compassionate interaction, respect, comfort, sharing information, and expertise were found to be positive following the original factors structure of the scale. According to reliability analysis statistics, Cronbach's Alpha coefficients were calculated as 0.781, 0.758, 0.780, 0.750 and 0.808 for compassionate interaction, respect, comfort, sharing information, and expertise sub-dimensions, respectively. According to these findings, all five sub-dimensions had high reliability levels. As a result of CFA, the items in all sub-dimensions were statistically significant. Standardized factor loads were also positive in the five sub-dimensions of the scale. Based on these results, all PCPON items were under appropriate sub-dimensions.PCPON as adapted from English to Turkish had high levels of validity and reliability. It was concluded to be a valid and reliable scale, which we believe will be useful for our country in the fields of education, practice, and research to evaluate the attitudes and behaviors of surgical nurses towards the care-oriented nurse-patient relationship.

This study was conducted in order to determine the factors that affected the early mobilization after surgery of patients who had undergone knee and hip arthroplasty.This study is descriptive correlational.The study population consists patients who met the inclusion criteria and were hospitalized in a State Hospital Orthopedics and Traumatology Clinic in Turkey in order have the knee or hip arthroplasty surgery between the dates of November 7, 2017 and September 21, 2018. While selecting the sample, the purposive sampling method was used. The sample consists of 60 patients who were in the universe of the study, who meet the inclusion criteria and who voluntarily agreed to participate in the study.The mean time of the first mobilization of the patients was 19 (9.15-72) hours. There were statistically significant relationships between mobilization time and age, gender, marital status, body mass index, past surgical history, chronic pain, blood transfusion before surgery, medical diagnosis, surgical procedure, bone cement usage, the score for American society of Anesthesiologists, surgical intervention time, post-operation nutrition, and defecation time.The early mobilization time of the great majority of the patients who underwent knee and hip arthroplasty was in conformity with the enhanced recovery after surgery protocol.

In this study, it was aimed to evaluate the opinions of psychiatrists in Turkey on whether to change the name of schizophrenia in order to reduce stigma. This cross-sectional survey was conducted with psychiatrists (resident in psychiatry, specialist, and lecturer) in Turkey. An online survey was created via the Google Forms public web address. Online questionnaires were delivered through Google Forms by emailing and messaging on WhatsApp, Telegram, Google and Yahoo groups and asking them to pass the questionnaire to other possible participants in their network. The study was performed between June 20, 2021 and July 10, 2021. 460 psychiatrists participated in the study. Forty-five-point 2 % of psychiatrists think that the name of schizophrenia should be renamed to reduce stigma. Forty-two-point 8 % of those who support the name change state that this change should be done as soon as possible. While 64.1 % of psychiatrists stated that naming the disease with another (new) name instead of schizophrenia could increase the hopes of patients and their relatives for recovery, 12.6 % stated that renaming would not cause any positive or negative changes. There is no statistical difference between psychiatrists who have a relative diagnosed with schizophrenia and psychiatrists who do not, in terms of thinking that the name of schizophrenia should be renamed to reduce stigma. In order to remove the stigma on schizophrenia, many interventions are required in social, cultural, economic and political fields. Renaming schizophrenia may be a good start for interventions.

The significant risk of cross-infection in dental practice has caused indecision among dental patients about whether to attend dental appointments. The coronavirus disease 2019 (COVID-19) pandemic has had a significant psychological impact on dental patients.The aim of this study was to evaluate the levels of and the associated factors for fear and anxiety among dental patients during the COVID-19 pandemic in Turkey.A cross-sectional questionnaire-based survey consisting of 6 parts was conducted. The 6 parts were sociodemographic data, knowledge about COVID-19, information sources, the perception of COVID-19, the fear of COVID-19 scale (FCoV-19S), and the generalized anxiety disorder-7 scale (GAD-7). A total of 301 participants completed the survey.As many as 81% of the participants perceived COVID-19 as a serious disease, and 73% reported the fear of visiting their dental clinic due to the possibility of being infected with COVID-19. The participants' knowledge about COVID-19 was significantly correlated with gender, the educational status and the use of the Internet. There was a strong negative correlation between the participants' levels of knowledge and the FCoV-19S and GAD-7 scores. A significant positive correlation was observed between the FCoV-19S score and the GAD-7 score. In regression analysis, being female, perceiving COVID-19 as a serious disease, being afraid of going to the dentist, having a low knowledge score, and having a high GAD-7 score were the predictors of a high FCoV-19S score.This study determined that the COVID-19 pandemic had had significant psychological effects on dental patients in Turkey. The results also underline the importance of providing more educational information to the public about the strict infection control measures taken by dental clinics against COVID-19 transmission in order to eliminate misperception.

© Author(s).Background: Pulmonary embolism is a clinical condition caused by the obstruction of the pulmonary artery and its branches with endogenous, exogenous embolism, or local thrombus formation. It is a rare but potentially life-threatening event in the pediatric population. Pediatric pulmonary embolism has many unknown characteristics. Aims: To evaluate clinical features, genetic and acquired risk factors, diagnostic imaging, and treatment strategies with long-term results in children with pulmonary embolism. Study Design: A retrospective multicenter clinical trial Methods: Patients aged 0-18 years who were diagnosed with pulmonary embolism with computed tomography pulmonary angiography (CTPA) findings (intraluminal filling defect in the lobar or main pulmonary artery) in 3 university hospitals between 2006 and 2021 were included in the study. A form was created for data standardization, and variables were collected retrospectively through medical record review. In addition to the features given above, we also evaluated in situ pulmonary artery thrombosis (ISPAT) and patients’ Wells scores. Follow-up CTPA results were evaluated for patient response to treatment. Complete recovery means that there were no lesions, incomplete recovery if there was still embolism, and no response if there was no change. Results: Twenty-four patients (female:13, male:11) were included in the study. The mean age was 13.5 years. All patients but one had at least one or more genetic or acquired risk factors. Factor V Leiden mutation (16.6%) was the most common genetic risk factor. Six of 16 patients with Doppler ultrasonography were diagnosed with ISPAT because there was no sign of thromboembolic thrombosis. Nine (41.6%) patients had a Wells score of >4 (pulmonary embolism clinically strong), and 15 (58.4%) patients scored

Introduction:Even under normal circumstances, anxiety is quite common among nursing students. Therefore, this study compared nursing students’ health and coronavirus anxiety in two European countries.Method:The sample of the descriptive, cross-sectional study consisted of 685 undergraduate students studying at two different nursing schools in Turkey and Portugal. The study data were collected with the Personnel Data Collection Form, Coronavirus Anxiety Scale, and Short Health Anxiety Inventory.Results:While there was no difference between the Coronavirus Anxiety Scale scores of Turkish and Portuguese nursing students ( p > .05), a statistically significant difference was found between the Short Health Anxiety Inventory total scores and negative consequences scores ( p < .05).Discussion:Against the pandemic that the whole world is experiencing, it is recommended to compare nursing students in a cultural context and take precautions.

The aim of this study was to analyze the effect of a school-based FV promotion program developed in line with the transtheoretical model (TTM) on the consumption behavior of middle school students.The study was designed as semi-experimental research with pre-/post- and follow-up tests and a control group. It was conducted at a total of six middle schools in the district of Fethiye/Muğla, Turkey. Three of the schools were selected with the random clustering method as an intervention group and the others as the control group. The FV promotion program was executed in the intervention group for a period of 24 weeks.It was found in the 6th and 12th months after the intervention that the daily number of portions of fruits (p.01) and vegetables (p.01) consumed by the students in the intervention group was significantly more compared to the control group. The perception of the pros of FV consumption and self-efficacy in the intervention group were higher than in the controls (p.01).The school-based FV consumption promotion program was effective in increasing the number of portions of fruits and vegetables students consumed and in improving their behaviors in this regard.The study indicates that the interventions described may be recommended to school nurses for use in their efforts to increase levels of FV consumption.

It was aimed to examine the effects of attitudes and beliefs regarding sexuality on sexual function during pregnancy.Descriptive cross-sectional type research was conducted throughout Turkey between December 2021 and April 2022. The sample was made up of 718 pregnant women across Turkey. The data were obtained through "Data Collection Form", "Attitudes and Beliefs Scale about Sexuality during Pregnancy (ABSSP)" and "Female Sexual Function Scale (FSFI)" using online questionnaires using snowball sampling method.The mean age of the participants was 27.48 ± 4.26 and the gestational weeks were 26.65 ± 6.87. A negative relationship was found between the ABSSP total score average and age, marriage age, gestational week and living child. It was determined that the women's ABSSP total score average and all sub-dimensions were positively related to each other. It was determined that there was a positive relationship between the lower dimension of anxiety and sexual desire, arousal, satisfaction, orgasm and pain and negative. Gender/Attraction sub-dimension was found to be positively related to sexual desire, arousal, lubrication, satisfaction and FSFI total score average. Concern about pregnancy was found to be negatively related to sexual desire, arousal and satisfaction positive, orgasm and pain with lower size.The study findings show that sexual beliefs and sexual desire situations during pregnancy are negatively affected. Sexuality can be negatively affected in societies where counseling on sexuality is inadequate during pregnancy and superstition and behaviors are common.

This study examines the effectiveness of lemon essential oil in reducing test anxiety in first-year nursing students.A randomized, pre-test-post-test design was used in this study. The study included 46 first-year students from the Faculty of Medical Sciences of a private university in Istanbul, Turkey. Students were divided into two groups through randomization (Intervention, N = 22; Control, N = 24). In the pre-test, a personal information form, State Test Anxiety Scale (STAS) and Test Anxiety Schedule (TAS) were administered to students in both groups. The students in the intervention group smelled lemon essential oil for 15 min. The study was completed by applying STAS and TAS as post-test.After smelling lemon essential oil, a significant difference was found between the mean pre-test and post-test scores for STAS, its sub-dimensions and TAS (p0.01) in the intervention group. It was observed that the nursing students' mean scores for STAS, its sub-dimensions and TAS decreased after smelling lemon essential oil (p0.05). It was found that the intervention group's mean post-test scores for STAS, cognitive sub-dimension and TAS were lower than those of the control group. Mean post-test scores of physiological sub-dimension in the intervention group were also significantly lower than the control group. It was concluded that lemon essential oil reduced test anxiety by 43.3%.Lemon essential oil was found to be effective in reducing test anxiety in nursing students.

The dairy and meat industry has rapidly developed in the last decade in Turkey and is playing a key role in supplying animal proteins for human consumption. Viral pathogens continue to threaten the dairy and meat industry leading to serious economic losses worldwide, including Turkey. The Turkish cattle industry has been vulnerable to the spread of viral diseases within the country in the continent. Combating animal diseases is crucial for the economy of Turkey. A good cattle health management policy may reduce the direct losses associated with viral diseases and thereby lead to increase in export of animals and animal products. Countries that are unable to combat animal diseases remain excluded from international trade. Control and eradication of cattle diseases require the availability of effective and practical interventions including vaccination and biosecurity measures. This review summarises the currently available information about viral diseases in cattle in Turkey and emphasizes the need for disease monitoring and research, along with implementation of disease control measures to mitigate economic losses to farmers and the country. The information presented here can be of great value in the research, prevention, and control of cattle diseases.

With the increasing use of whole-exome sequencing, one of the challenges in identifying the causal allele for a Mendelian disease is the lack of availability of population-specific human genetic variation reference databases. The people of Turkey were not represented in GnomAD or other publicly available large databases until recently, when the first comprehensive genomic variation database, Turkish Variome (TRV), was published. The aim of this study was to evaluate whether TRV or other publicly available large genomic variation databases can reliably be used for rare disease variant evaluation in Turkish individuals.Sixty non-disease-causing, non-synonymous variants (minor allele frequencies1%) were identified in 58 genes that are known to be associated with idiopathic hypogonadotropic hypogonadism from a large Turkish patient cohort. The allelic frequencies of these variants were then compared with those in various public genomic variation databases, including TRV.Our cohort variants showed the highest correlations with those in the TRV, Iranome, and The Greater Middle East Variome, in decreasing order.These results suggest that the TRV is the appropriate database to use for rare genomic variant evaluations in the Turkish population. Our data also suggest that variomes from geographic neighborhoods may serve as substitute references for populations devoid of their own genomic variation databases.

Resilience in diabetes refers to the capacity overcome diabetes-related challenges to achieve favorable psychosocial and health outcomes. Despite the known benefits of resilience in adolescents with type 1 diabetes mellitus (T1DM), there tends to be more emphasis on risk factors in research and practice. This study evaluated the psychometric properties of the Diabetes Strengths and Resilience Measure for Adolescents with Type 1 Diabetes (DSTAR-Teen) in Turkey.This descriptive, methodological study was conducted between October 2020 and May 2021. The Turkish DSTAR-Teen was administered to 120 adolescents with T1DM, and the data were evaluated using Cronbach’s alpha coefficients, factor analyses, test-retest correlation, and item-total score correlations.The Turkish DSTAR-Teen has 12 items in two factors that explained 50.64% of the total variance. Confirmatory factor analysis revealed goodness-of-fit and comparative fit indices of 0.92 and 0.95, respectively. The total Cronbach’s alpha value of the scale was 0.85. Item-total score correlations ranged from 0.49 to 0.74 (p0.001).Our analyses showed that the Turkish DSTAR-Teen is a valid and reliable instrument in Turkish adolescents with T1DM. The Turkish DSTAR-Teen can be used to evaluate strengths and resilience associated with diabetes management in adolescents with T1DM in Turkey.

Objective: Chimeric antigen receptor T (CAR-T) cell therapies have already made an impact on the treatment of B-cell malignancies. Although CAR-T cell therapies are promising, there are concerns about commercial products regarding their affordability and sustainability. In this preliminary study, the results of the first production and clinical data of an academic CAR-T cell (ISIKOK-19) trial in Turkey are presented. Materials and Methods: A pilot clinical trial (NCT04206943) designed to assess the safety and feasibility of ISIKOK-19 T-cell therapy for patients with relapsed and refractory CD19+ tumors was conducted and participating patients received ISIKOK-19 infusions between October 2019 and July 2021. The production data of the first 8 patients and the clinical outcome of 7 patients who received ISIKOK-19 cell infusions are presented in this study. Results: Nine patients were enrolled in the trial [5 with acute lymphoblastic leukemia (ALL) and 4 with non-Hodgkin lymphoma (NHL)], but only 7 patients could receive treatment. Two of the 3 participating ALL patients and 3 of the 4 NHL patients had complete/ partial response (overall response rate: 72%). Four patients (57%) had CAR-T-related toxicities (cytokine release syndrome, CAR-T-related encephalopathy syndrome, and pancytopenia). Two patients were unresponsive and had progressive disease following CAR-T therapy. Two patients with partial response had progressive disease during follow-up. Conclusion: Production efficacy and fulfillment of the criteria of quality control were satisfactory for academic production. Response rates and toxicity profiles were also acceptable for this heavily pretreated/refractory patient group. ISIKOK-19 cells appear to be a safe, economical, and efficient treatment option for CD19+ tumors. However, the findings of this study need to be supported by the currently ongoing ISIKOK-19 clinical trial. Amaç: Kimerik antijen reseptör T (CAR-T) hücre uygulamaları B-hücreli malignitelerin tedavisinde etkili olmaktadır. CAR-T hücre uygulamalarının sonuçları umut vaadedici olsa da, ticari CAR-T ürünlerinin yükek maliyetleri nedeniyle ulaşılabilirlik açısından ciddi sorunlar yaşanmaktadır. Bu ön raporda, Türkiye’deki ilk akademik CAR-T hücre çalışmasının üretim ve klinik uygulama sonuçları sunulmuştur. Gereç ve Yöntemler: Relaps refrakter CD 19+ hematolojik maligniteli hastalarda ISIKOK-19 T-hücre tedavisinin güvenliği ve etkinliğini değerlendirmek amacıyla yürütülen klinik çalışmaya (NCT04206943) Ekim 2019-Temmuz 2021 tarihleri arasındaki hastalar dahil edilmiştir. Bu raporda ilk 8 hastanın üretim bilgileriyle, ISIKOK-19 hücre infüzyonu yapılan 7 hastanın klinik sonuçları sunulmuştur. Bulgular: Çalışmaya toplam 9 hasta dahil edilmiştir (5 akut lenfoblastik lösemi [ALL] ve 4 non-hodgkin lenfoma [NHL]), ancak sadece 7 hastaya hücre infüzyonu yapılabilmiştir. Hücre infüzyonu alan 3 ALL hastasından 2’sinde ve 4 NHL hastasının 3’ünde tam/kısmi cevap gözlenmiştir (toplam yanıt oranı %72). Dört hastada (%57) CAR-T ilişkili toksisite (sitokin salınım sendromu, immün efektör hücre ilişkili nörotoksisite sendromu ve pansitopeni) tespit edilmiştir. İki hastada ise CAR-T hücre uygulaması sonrası cevapsızlık ve progresif hastalık izlenmiştir. Kısmi cevap veren hastalardan 2’sinde de takip sırasında progresif hastalık tespit edilmiştir. Sonuç: Akademik CAR-T üretimimiz, üretim etkinliği ve kalite kontrol kriterlerinin tam olarak karşılanması açısından tatmin edici sonuçlara sahiptir. Çalışmaya dahil edilen hastaların tedavi yükü hesaba katıldığında tedaviye cevap oranı ve toksisite profili açısından da sonuçlar kabul edilebilir düzeydedir. Bu sonuçlarla, ISIKOK-19 hücrelerinin güvenli, ekonomik ve etkili bir tedavi seçeneği olduğu düşünülebilir. Ancak bu ön sonuçların halen devam eden ISIKOK-19 klinik çalışmasıyla desteklenmesi beklenmektedir. Technology and Innovation Funding Programs Directorate (TEYDEB) of the Scientific and Technological Research Council of Turkey (TUBITAK) ; Acibadem Healthcare Group