Establishing teams in public administrations for international health promotion projects

Sağlığın geliştirilmesi projelerinin başarılı olması için etkili ve uyumlu proje takımlarının kurulması kritiktir. Bu çalışmanın amacı, kamu idarelerinde sağlığın geliştirilmesine yönelik uluslararası projeler için takım kurma sürecine ilişkin bir yöntem önermek; bir örnek üzerinden proje takımına dahil olmak isteyen çalışanların tanımlayıcı özelliklerini ortaya koymak ve proje takımına seçilen kişilerin başvurularının nitel özelliklerini değerlendirmektir. Bu çalışmada, ekip kurma süreci ve başvurulara ilişkin bir kamu idaresinin kayıtları kullanılmıştır. Ele alınan proje takımı kurma süreci: duyuruların yapılması, başvuruların alınması, ön değerlendirme, başvuru formlarının değerlendirilmesi, mülakat ve proje takımlarının kurulması aşamalarından oluşmaktadır. 2018 yılı Ekim-Kasım-Aralık aylarında yapılan duyurulara ait 300 başvuru kaydı vardır. Mükerrer kayıtlar ve davetli teknik personel çıkarılarak tanımlayıcı analize 240 aday dahil edilmiştir. Başvuranların çoğu kadındır (%68,3). Lisansüstü program mezunları çoğunluktadır (%57,1). Çalışılan kurum olarak Eğitim Araştırma Hastaneleri (%34,6) ile İl Sağlık Müdürlüğü’nün yönetimsel birimleri (%21,7); meslek olarak ise ebe/hemşire/sağlık memurları (%30,8) ile doktor/uzman doktor (%29,2) grupları ön plandadır. İngilizce dil yeterliliği iyi veya çok iyi olanların oranı %20,8’dir; bir proje tecrübesi olanların oranı ise %13,3’tür. Başvuranların 80’i ön değerlendirmeyi geçmiş, 27’si mülakata çağrılmış, 18’i proje takımlarına seçilmiştir. Bu uygulamada hem güçlü bir proje takımı kurmak hem de uzun vadede kurumun kapasitesini geliştirmek için farklı meslek gruplarından, farklı çeşit ve düzeylerde tecrübelere sahip ve projenin farklı yönlerine katkı verebilecek kişiler dahil edilerek çeşitlilik sağlanmıştır. Bu çalışmada değerlendirilen uygulama literatürdeki temel prensipler ile uyumludur ve sağlığın geliştirilmesi projelerine takım kurma süreçlerinde kullanılabilir.Establishing effective and compatible project teams is critical for successful health promotion projects. The aim of this study is to propose a method for the team formation process of international health promotion projects in public administrations; to reveal the descriptive characteristics of employees who are willing to join in the project teams, and to evaluate the qualitative characteristics of the applications of the people selected to the project teams. In this study, the relevant records of a public administration on the team formation process and applications were used. The steps of the team formation process are advertising for projects, receiving applications, pre- evaluation, evaluation of application forms, interviews and forming teams. 300 applications have been recorded in October-November-December 2018 after the adverts published. Duplicate records and invited technical personnel were removed, and 240 candidates were included in the descriptive analysis. Most of the applicants were women (68.3%), have a post-graduate degree (57.1%), working at Training and Research Hospitals (34.6%) and administrative units of the Provincial Health Directorate (21.7%) Midwives/nurses/health officers (30.8%) and physicians (29.2%) were the most common job titles among applications. The percentage of those with good or very good English language proficiency was 20.8%; the percentage of those with project experience is 13.3%. 80 of the applicants passed the preliminary evaluation, 27 were invited for an interview, and 18 were selected for the project teams. In this case, diversity is obtained by including people from different professions, who have different types and levels of experience and who can contribute to different aspects of the project both to establish a good project team and to improve the capacity of the institution in the long term. The project team formation process evaluated in this study is coherent with the basic principles in the literature and can be used in health promotion projects

COVID-19 pandemisi sürecinde serbest eczacıların anksiyete düzeyleri: İstanbul’da bir kesitsel araştırma

Community pharmacists have been on the frontlines during the 2019 Coronavirus Disease (COVID-19) pandemic. Although the mental health and anxiety levels of many other health workers are studied in this period, literature is very limited to understand the experience of pharmacists. This study aims to define the anxiety level of community pharmacists in Istanbul during the COVID-19 pandemic and identify possible influencing factors. The population of the study is community pharmacists from pharmacies in Istanbul. In this cross-sectional study, 348 pharmacies are selected by simple random sampling. Participants are approached via telephone and inquired with questions about sociodemographic information, work conditions, COVID-19 specific concerns, and the Beck Anxiety Inven-tory. 239 (68.7%) pharmacists responded. This study identifies that, by the 6th month of the pandemic, the mean anxiety score of the pharmacists in Istanbul is 9.4±10.6, and 54.8% (n=134) of the participants is experiencing “minimal” anxi-ety. However, they have some COVID-19 specific concerns (becoming infected and transmitting the disease to family or environment) at high and extreme lev-els. Those concerns significantly increase the anxiety score. The findings of this study are promising for public health, as they show that community pharmacists could cope with the psychological effects of the pandemic.Eczacılar, 2019 Koronavirüs Hastalığı (COVID-19) pandemisi döneminde sağlık hizmetlerinin ön saflarında çalışmaktadır. Bu süreçte hastalarla birebir temas halinde olmaları ve çalışma şartlarındaki değişiklikler ruhsal iyilik hallerini etkileyebilir ve anksiyeteye sebep olabilir. Alanyazında COVID-19 pandemisi sürecinde, diğer sağlık çalışanlarının ruhsal iyilik halleri ve anksiyete düzeylerine ilişkin araştırmalar mevcut iken araştırmalar eczacıların deneyimini anlamak için yetersizdir. Bu çalışmanın amacı, COVID-19 pandemisi sürecinde İstanbul’da görev yapmakta olan eczacıların anksiyete düzeyini ve onu etkileyebilecek faktörleri tespit etmektir. Araştırmanın evreni İstanbul’daki eczanelerde görev yapan serbest eczacılardır. Kesitsel türdeki bu araştırmada basit rastgele örnekleme yöntemi ile 348 eczane seçilmiştir. Seçilen eczanelere telefon ile ulaşılıp; sosyodemografik bilgiler, çalışma bilgileri ve COVID-19’a özgü endişeler hakkında sorular ile Beck Anksiyete Ölçeği maddeleri yöneltilmiştir. Örnek gruptaki eczacıların %68,7’ine (n=239) ulaşılmıştır. Pandeminin 6. ayı itibariyle İstanbul’daki eczacıların anksiyete ölçeği puanı ortalamasının 9,4±10,6 olduğu ve %54,8’inin (n=134) “minimal düzeyde anksiyete” sahibi olduğu tespit edilmiştir. Bununla beraber COVID-19’a özgü bazı endişelerinin (hastalığa yakalanma ve çevresine bulaştırma) çok ve aşırı çok hissedildiği ve bu endişelerin genel anksiyete puanını istatistiksel olarak önemli düzeylerde etkilediği tespit edilmiştir. Bu sonuç, eczacıların psikolojik olarak pandemiyle başa çıkabildiklerini göstermesi itibariyle halk sağlığı açısından ümit verici olarak yorumlanabilir

Vaccine hesitancy and anti-vaccination attitudes during the start of COVID-19 vaccination program: A content analysis on twitter data

Twitter is a useful source for detecting anti-vaccine content due to the increasing prevalence of these arguments on social media. We aimed to identify the prominent themes about vaccine hesitancy and refusal on social media posts in Turkish during the COVID-19 pandemic. In this qualitative study, we collected public tweets (n = 551,245) that contained a vaccine-related keyword and had been published between 9 December 2020 and 8 January 2021 through the Twitter API. A random sample of tweets (n = 1041) was selected and analyzed by four researchers with the content analysis method. We found that 90.5% of the tweets were about vaccines, 22.6% (n = 213) of the tweets mentioned at least one COVID-19 vaccine by name, and the most frequently mentioned COVID-19 vaccine was CoronaVac (51.2%). We found that 22.0% (n = 207) of the tweets included at least one anti-vaccination theme. Poor scientific processes (21.7%), conspiracy theories (16.4%), and suspicions towards manufacturers (15.5%) were the most frequently mentioned themes. The most co-occurring themes were "poor scientific process" with "suspicion towards manufacturers" (n = 9), and "suspicion towards health authorities" (n = 5). This study may be helpful for health managers, assisting them to identify the major concerns of the population and organize preventive measures through the significant role of social media in early spread of information about vaccine hesitancy and anti-vaccination attitudes

Comparison of the burnout among medical residents before and during the pandemic

Objective: This study aims to compare the level of burnout syndrome in medical residents before and during the COVID-19 pandemic and identify potential risk factors. Methods: This cross-sectional study was conducted on medical residents from three different university hospitals in Turkey in March 2021, one year after the pandemic hit Turkey. Burnout is measured by the Maslach Burnout Inventory which assesses three dimensions of it: emotional exhaustion, depersonalization, and personal accomplishment. Collected data were combined and compared with data from a previous study which was held in the same hospitals in December 2019, three months before the pandemic. Results: 412 medical residents from three universities participated. The mean age was 27.8 ± 2.4 and half of them were female. Compared to pre-pandemic levels, no significant differences in emotional exhaustion (pre:19.0 ± 7.6 post:18.8 ± 7.8), depersonalization (pre:7.3 ± 4.3 post:7.2 ± 4.4), and personal accomplishment (pre:20.8 ± 5.1 post:21.1 ± 5) scores were observed one year after pandemic. Adjusting for confounders, multiple linear regression models indicated that who are female, are in surgical specialty, have vulnerable cohabitant, and have more night shifts faces higher emotional exhaustion. Depersonalisation is higher among who spent more years in residency, have more night shifts, or COVID-19 outpatient duty. Females and those who have vulnerable cohabitant has lower levels of Personal Achievement. Conclusion: This study does not support the hypothesis that pandemic increases the burnout levels. Yet it identifies a couple of pandemic related factors that are associated with burnout and confirming the association of several previously known factors.Abidin Fatih Emhan ; Ahmet Burak Börekçi ; Kadir Kolça

Perspectives, needs and expectations of healthcare providers for medical tourism policy: A qualitative study

Medikal turizm, küreselleşme sonucu artan insan hareketliliği, bilişim teknolojilerinin yaygın kullanımı gibi nedenlerle hızla gelişen bir sağlık sektörüdür. Toplumların yaşlanması, sağlık hizmeti maliyetlerinin hızla artması, hizmet almak isteyenler için söz konusu olan uzun bekleme süreleri gibi nedenlerle önemi artan medikal turizm konusunda Türkiye önemli bir destinasyon konumundadır. Halen Sağlık Bakanlığı sorumluluğunda yürütülen medikal turizm hizmetleri için çok sayıda yetkilendirilmiş sağlık kurumu hizmet vermekte, çeşitli ülkelerle ikili anlaşmalar bulunmaktadır. Ne var ki bu konuda henüz bir devlet politikası bulunmamakta, ancak sorunlar ve ihtiyaçlar gündeme geldiğinde bazı düzenlemeler yapılmaktadır. Bu araştırmanın amacı, Türkiye’de ulusal medikal turizmi politikasına yol gösterici olabilmek için bu alanda faaliyet gösteren hizmet sunucularının bakış açılarını, mevcut duruma ilişkin değerlendirmelerini incelemek, ihtiyaç ve beklentilerini tespit etmektir. Bu nitel araştırmada medikal turizm hizmeti sunan kurumlardan 10 yönetici ile yapılan derinlemesine görüşme bulgularına göre, Türkiye’nin bu alanda çok sayıda güçlü yanlarının bulunduğu, çeşitli fırsatlarla karşı karşıya olduğu, ancak, politika ve uygulama eksiklikleri nedeniyle çeşitli sorunların ve tehditlerin de söz konusu olduğu görülmektedir. Özellikle Türkiye’nin coğrafi konumu, nitelikli sağlık insan gücü ve gelişmiş sağlık alt yapısından kaynaklanan güçlü yanlarından etkili biçimde yararlanabilmek için konuya ilişkin yasal boşlukların giderilmesi, medikal turizm hizmetlerinin iyi koordine edilerek denetlenmesi, gerçekçi politikalar oluşturulması gerekliliği ön plana çıkmaktadır.Medical tourism is a rapidly developing health sector due to increased human mobility as a result of globalization and the widespread use of information technologies. Turkey is an important destination for medical tourism, whose importance is increasing due to the aging of societies, the rapid increase in healthcare costs, and the long waiting times for those who want to receive services. Currently, many authorized health institutions provide services for medical tourism services carried out under the responsibility of the Ministry of Health, and there are bilateral agreements with many countries. However, there is no comprehensive state policy on medical tourism yet, and regulations are made when problems and needs arise. To inform national medical tourism policy of Turkey, this study aims to understand the perspectives, needs and expectations of healthcare providers working in this sector. According to the findings of in-depth interviews with 10 managers from medical tourism service provider institutions, this qualitative study shows that Turkey has many strengths in this field, faces various opportunities, but there are also various problems and threats due to policy and implementation shortfalls. To get the most out of strengths arising from Turkey’s geographic location, qualified health workforce and advanced health infrastructure, it is required to fix the legal gaps, coordinate and supervise medical tourism services, and create realistic policies

Expanding the university’s responsibility for student safety: A COVID-19 cluster investigation

COVID-19 salgını dolayısıyla uzaktan eğitim modeline geçen bazı üniversitelerde eğitim ve/veya sınavlar önlemler alınarak yeniden yüz yüze yapılmaya başlanmıştır. Bu olay sunumunda, sınavları yüz yüze yapmaya başlayan bir tıp fakültesinde bir aylık süre zarfında tespit edilen bir vaka kümesi incelenmiştir. 20.10.2020-19.11.2020 tarihleri arasında ortaya çıkan COVID-19 vakaları ve temaslıları rutin kayıtlar üzerinden retrospektif olarak analiz edilmiştir. Bu süre zarfında tespit edilen 10 vakadan 6’sının aynı sınıfta okuyan öğrenciler olduğu ve aynı tarihte yüz yüze bir sınava girdiği tespit edilmiştir. Yapılan inceleme sonucunda 6 vakanın bir vaka kümesi oluşturduğu ve vakaların sınav çıkışında birlikte yemek yedikleri, yakın temasta uzun vakit geçirdikleri anlaşılmıştır. Söz konusu vaka kümesi, fiziksel olarak üniversitenin sorumluluk alanı dışında gözükmekle birlikte, bu öğrencilerin bir araya gelmelerinin sosyal bağlamı da göz önünde bulundurulmalıdır. Bu araştırma pandemi döneminde üniversitelerin, öğrencilerinin yalnızca eğitim değil sosyal ihtiyaçlarını da güvenli bir şekilde karşılayabilecekleri imkanlar sunmanın yenilikçi yolları üzerinde çalışması gerektiğini göstermektedir.Due to COVID-19 pandemic, many universities switched to distance learning. After a while, some universities return to face-to-face lear- ning or examination with required measures. In this case study, we investigated a cluster of COVID-19 cases occurred in a month in a medical faculty that returned to carry out face-to-face examinations. We analyzed routine institutional records of cases and contacts oc- curred between 20.10.2020-19.11.2020 retrospectively. 6 out of 10 cases in this period were students in the same class and came toget- her for a face-to-face exam. The investigation revealed that those 6 cases ate lunch together and spent time within close contact. Althou- gh this cluster may seem to be physically occurred out of the uni- versity’s responsibility area, the social context of students gathering should also be considered. This study points out that the universities should develop innovative solutions to provide resources to meet not only educational but also social needs of students

Evaluation of Incidence and Clinical Features of Antibody-Associated Autoimmune Encephalitis Mimicking Dementia

Background. Anti-neuronal autoimmunity may cause cognitive impairment that meets the criteria for dementia. Objective. Our aim was to detect the incidence and clinical features of autoimmune encephalitis imitating clinical findings of primary dementia disorders and to delineate the validity of anti-neuronal antibody screening in dementia patients. Methods. Fifty consecutive patients fulfilling the clinical criteria for primary dementia, 130 control patients, and 50 healthy controls were included. Their sera were investigated for several ion channel and glutamic acid decarboxylase (GAD) antibodies by a cell-based assay, radioimmunoassay, and ELISA, as required. Results. Sixteen patients satisfying dementia criteria had atypical findings or findings suggestive of autoimmune encephalitis. N-methyl-D-aspartate receptor (NMDAR) antibody was detected in a patient with dementia, Parkinsonism, and REM sleep behavior disorder (RBD) fulfilling the criteria for dementia with Lewy bodies (DLB). One control patient with bipolar disease displayed low anti-GAD antibody levels. Conclusions. Our study showed for the first time the presence of parkinsonism and RBD in an anti-NMDAR encephalitis patient mimicking DLB. Although autoimmune encephalitis patients may occasionally present with cognitive decline, most dementia patients do not exhibit anti-neuronal antibodies, suggesting that routine analysis of these antibodies in dementia is not mandatory, even though they display atypical features

Evaluation of individual health literacy among inpatients of different types of hospitals in Istanbul

Objective: The objective of Our study is to evaluate the individual health literacy level among patients who received health services from different types of hospitals in Istanbul.Materials and Methods: This cross-sectional study was conducted among inpatients of a public, private and university hospital in Istanbul. Data were collected by the application of a questionnaire to 1500 adult inpatients who were discharged between February-July 2017. The study questionnaire included questions to determine the health literacy competency and sociodemographic characteristics of patients. Rapid Estimate of Adult Literacy in Medicine (REALM) scale was used to measure the health literacy level.Results: The mean REALM score was higher among females than males (p<0.013). Health literacy mean score was lowest among public hospital inpatients and highest among university hospital inpatients (p<0.001). Primary-school graduate patients had significantly lower scores (p<0.001) than the other groups. The findings of the REALM test were in agreement with the health literacy competencies.Conclusion: Males, patients older than 35 years old, primary-school graduates, and public hospital inpatients had lower levels of health literacy

Exploring alcohol and substance addiction among syrian migrants in Turkey: A qualitative study integrating perspectives of addicts, their relatives, local and national institutions

Turkey is the country that hosts most migrants worldwide. Although migrants are a risk group for alcohol and substance addiction (ASA), literature is limited. This study aims to explore and identify the present state and influencing factors of ASA among Syrian migrants in Turkey by integrating perspectives of addicts, their relatives, and local and national institutions. This qualitative study was designed by the grounded theory approach and took place in 5 cities in Turkey between 2018 and 2019. It is composed of 4 focus group discussions with 77 informants from local governmental, non-governmental, and academic organizations; 11 key person interviews with heads of national organizations; and in-depth interviews with 45 addicted Syrian migrants and 21 relatives. Themes that emerged from the data are characteristics of addicted migrants, types of addictions, predisposing and exacerbating factors, preventing factors, obtaining alcohol and substances, manners of use, consequences of use, public services and utilization of them, and the experiences of addicted migrants. The findings of this study provide guidance for future research and policies. Addicted migrants have awareness and motivation to quit but face many environmental barriers. Activities of institutions in Turkey on ASA in Syrian migrants are insufficient. Specific, well-coordinated action is needed. It should also utilize Syrian human resources.Turkish Green Crescent Societ