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

Pnömoni makalelerinin bibliyometrik analizi (2016-2020)

Lower respiratory infections are one of the leading factors of death in the world. During the COVID-19 pandemic, pneumonia comes to the fore from respiratory diseases. We aim to close the information gap regarding the characteristics of pneumonia articles published between the years 2016 and 2020 and indexed in the Web of Science (WoS) database by bibliometric analysis. We collected the data for this study from the articles published in the WoS, from 2016 to 2020 by using “pneumonia” as the keyword. Articles were found among the "Science Citation Index Expanded" of the WoS advanced search engine and 24,896 articles that met the criteria were included. MS Excel, Python, MS Power BI, and Flourish website were used for data extraction and visualization.This bibliometric analysis showed that while the number of articles published regarding pneumonia was more stable between 2016 and 2019 it has increased dramatically in 2020. It was seen that the countries that caused this significant increase were the United States of America and China. More than one-fifth of all articles were written in cross-country collaboration. The magnitude of the impact of COVID-19 on pneumonia research has been numerically demonstrated by this bibliometric analysis.Alt solunum yolu enfeksiyonları dünyadaki başlıca ölüm sebeplerinden biridir. COVID-19 pandemisinde pnömoni solunum yolu hastalıkları arasında öne çıkmıştır. Bu çalışmada COVID-19 pandemisini de kapsayan 2016-2020 yılları arasındaki dönemde, Web of Science (WoS) veri tabanında yer alan, pnömoni makalelerinin özelliklerinin incelenmesi amaçlandı. WoS veritabanında 2016-2020 yılları arasındaki literatür “pnömoni” anahtar kelimesi kullanılarak taranıp, makaleler "Science Citation Index Expanded" ile sınırlandırılarak, kriterleri karşılayan 24.896 makaleye ulaşıldı. İndirilen veriler, Python programı vasıtasıyla tasnif edildi. Verilerin görselleştirilmesinde MS Excel, Python, MS Power BI programları ve Flourish web sitesi kullanıldı. Bu çalışmayla beraber pnömoni hakkında yapılan çalışma sayısı 2016-2019 yılları arasında stabil bir şekilde seyrederken bu sayının 2020 yılında belirgin oranda arttığı gözlemlendi. Bu orandaki belirgin artışa neden olan ülkelerin de ABD ve Çin olduğu görüldü. Tüm makalelerin beşte birinden fazlası ülkeler arası iş birliğiyle yazıldı. Bu bibliyometrik analizle COVID-19’un pnömoni araştırmaları üzerindeki etkisinin büyüklüğü sayısal olarak gösterilmiş oldu

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

Sleep quality and depression of older people living at care home

Ülkemizde nüfusun giderek yaşlanmakta olduğu ve yaşlıların artan şekilde yaşlı bakımevi ve huzur evlerinde barınacağı düşüncesiyle gerçekleştirilen bu çalışmada; İstanbul'daki Türkiye’nin en eski yaşlı bakımevlerinden birinde yaşayan 65 yaş üstü kişilerin uyku kalitesi ve depresyon durumlarının belirlenmesi amaçlanmıştır. Kesitsel tipteki bu araştırmanın evrenini, yaşlı bakımevinde yaşamakta olan 149 kişi oluşturmaktadır. Araştırmanın verileri, Aralık 2019’da katılımcıların sosyodemografik özellikleri, depresyon durumları (Geriatrik Depresyon Ölçeği 15 Kısa Form- GDÖ15) ve uyku kalitelerini (Pittsburgh Uyku Kalitesi İndeksi-PUKİ) belirlemeye yönelik bir soru formu aracılığı ile 107 kişiden yüz yüze olarak toplandı. Evrenin çalışma grubuna katılım oranı %71,8 olarak bulundu. Çalışmaya katılanların yaş ortalaması 74,06±7,07 olup %69,2’si erkekti. Depresyon belirtilerine sahip olanların oranı %29,0, uyku kalitesi kötü olanların oranı ise %51,4 olarak bulundu. GDÖ-15 depresyon puanı açısından kronik hastalığı olan grupla olmayan grup arasında istatistiksel olarak önemli fark bulunurken (p=0,047), PUKİ skoru açısından bulunmadı. Cinsiyet ve ziyaret edilme durumları açısındansa hem uyku kalitesi hem de depresyon puanı açısından gruplar arasında istatistiksel olarak önemli fark saptanmadı. PUKİ skoru ile GDÖ-15 depresyon puanı arasında pozitif yönde önemli bir korelasyon bulunmakta (r=0,421; p<0,001), uyku kalitesi kötü olanların depresyon puanları da yüksek bulundu.As Turkey's population is getting older, a growing number of older people live in care and nursing homes. This study aims to determine the depression and the sleeping quality states of people aged 65 and older, who live in a care home. The population of this cross-sectional study is 149 elderly people who live in one of the oldest care home in Istanbul. In December 2019, the data of the study were collected from 107 participants via face-to-face questionnaires that included the Geriatric Depression Scale -15 (GDS-15) and Pittsburgh Sleeping Quality Index (PSQI), besides sociodemographic questions. The participation rate was 71.8%. The average age of the participants was 74.06±7.07, and the majority of them were male (69.2%). The findings of the study revealed 29.0% had depression symptoms and 51.4% had poor sleep quality. It was determined that there was a statistically significant difference between the groups whether having at least a chronic disease or not, in terms of depression scores (p=0.047), but no difference between sleep quality. There were no significant differences between groups of gender and whether they were being visited by their acquaintances or not, as far as depression score and sleep quality are concerned. There was a significant positive correlation between PSQI and GDS-15 depression scores (r=0.421; p<0.001), that people with poor sleep quality were found to have increased GDS-15 depression scores

Evaluation of infant mortality and risk factors before and during COVID-19 pandemic in a district of Istanbul

Objective: The aim of this study is to evaluate infant mortality in 2019 and 2020 years at the local level, considering the beginning of the pandemic period.Methods: The population of this cross-sectional study are infants registered in a district of Istanbul in 2019 and 2020. Infant mortality rates before and during the COVID-19 pandemic were calculated. Antenatal healthcare and delivery practices in addition to the underlying risk factors for infant deaths were identified and compared by the year of mortality.Results: Infant mortality rates were calculated as 4.8 and 5.1; neonatal mortality rates were 3.9 and 2.7; postneonatal mortality rates were 0.9 and 2.4 per thousand live births, respectively by the years. No statistically significant difference was found between maternal and infant characteristics of the two years. The number of pregnancy follow-up records was significantly higher for the infants that died in 2020 compared to 2019. Yet, there wasn’t any difference in number of prenatal physician visits.Conclusion: Increase in the infant mortality rate during the pandemic compared to the pre-pandemic period is due to postneonatal mortality. The increase in postneonatal mortality is related to deaths caused by infections. This should be investigated with the characteristics of infants and healthcare accessibility features. No disruption was identified in access to antenatal care in cases of infant mortality during the research period. This continuity in health services must be preserved. Our experience during the study revealed a room for improvement in data access on always-important public health indicators for evidence-based decision-making

Yaşlı Bakımevi Yaşlılarında Uyku Kalitesi ve Depresyon

Ülkemizde nüfusun giderek yaşlanmakta olduğu ve yaşlıların artan şekilde yaşlı bakımevi ve huzur evlerinde barınacağı düşüncesiyle gerçekleştirilen bu çalışmada; İstanbul'daki Türkiye’nin en eski yaşlı bakımevlerinden birinde yaşayan 65 yaş üstü kişilerin uyku kalitesi ve depresyon durumlarının belirlenmesi amaçlanmıştır. Kesitsel tipteki bu araştırmanın evrenini, yaşlı bakımevinde yaşamakta olan 149 kişi oluşturmaktadır. Araştırmanın verileri, Aralık 2019’da katılımcıların sosyodemografik özellikleri, depresyon durumları (Geriatrik Depresyon Ölçeği 15 Kısa Form- GDÖ15) ve uyku kalitelerini (Pittsburgh Uyku Kalitesi İndeksi-PUKİ) belirlemeye yönelik bir soru formu aracılığı ile 107 kişiden yüz yüze olarak toplandı. Evrenin çalışma grubuna katılım oranı %71,8 olarak bulundu. Çalışmaya katılanların yaş ortalaması 74,06±7,07 olup %69,2’si erkekti. Depresyon belirtilerine sahip olanların oranı %29,0, uyku kalitesi kötü olanların oranı ise %51,4 olarak bulundu. GDÖ-15 depresyon puanı açısından kronik hastalığı olan grupla olmayan grup arasında istatistiksel olarak önemli fark bulunurken (p=0,047), PUKİ skoru açısından bulunmadı. Cinsiyet ve ziyaret edilme durumları açısındansa hem uyku kalitesi hem de depresyon puanı açısından gruplar arasında istatistiksel olarak önemli fark saptanmadı. PUKİ skoru ile GDÖ-15 depresyon puanı arasında pozitif yönde önemli bir korelasyon bulunmakta (r=0,421; p<0,001), uyku kalitesi kötü olanların depresyon puanları da yüksek bulundu.As Turkey's population is getting older, a growing number of older people live in care and nursing homes. This study aims to determine the depression and the sleeping quality states of people aged 65 and older, who live in a care home. The population of this cross-sectional study is 149 elderly people who live in one of the oldest care home in Istanbul. In December 2019, the data of the study were collected from 107 participants via face-to-face questionnaires that included the Geriatric Depression Scale -15 (GDS-15) and Pittsburgh Sleeping Quality Index (PSQI), besides sociodemographic questions. The participation rate was 71.8%. The average age of the participants was 74.06±7.07, and the majority of them were male (69.2%). The findings of the study revealed 29.0% had depression symptoms and 51.4% had poor sleep quality. It was determined that there was a statistically significant difference between the groups whether having at least a chronic disease or not, in terms of depression scores (p=0.047), but no difference between sleep quality. There were no significant differences between groups of gender and whether they were being visited by their acquaintances or not, as far as depression score and sleep quality are concerned. There was a significant positive correlation between PSQI and GDS-15 depression scores (r=0.421; p<0.001), that people with poor sleep quality were found to have increased GDS-15 depression scores

Family physicians overestimate diagnosis probabilities regardless of the test results

INTRODUCTION: As useful tools for clinical decision-making, diagnostic tests require careful interpretation in order to prevent underdiagnosis, overdiagnosis or misdiagnosis. The aim of this study was to explore primary care practitioners' understanding and interpretation of the probability of disease before and after test results for six common clinical scenarios.METHODS: This cross-sectional study was conducted with 414 family physicians who were working at primary care in Istanbul via face-to-face interviews held between November 2021 and March 2022. The participants were asked to estimate the probability of diagnosis in six clinical scenarios provided to them. Clinical scenarios were about three cancer screening cases (breast, cervical and colorectal), and three infectious disease cases (pneumonia, urinary tract infection, and COVID-19). For each scenario participants estimated the probability of the diagnosis before application of a diagnostic test, after a positive test result, and after a negative test result. Their estimates were compared with the true answers derived from relevant guidelines.RESULTS: For all scenarios, physicians' estimates were significantly higher than the scientific evidence range. The minimum overestimation was positive test result for COVID-19 and maximum was pre-test case for cervical cancer. In the hypothetical control question for prevalence and test accuracy, physicians estimated disease probability as 95.0% for a positive test result and 5.0% for a negative test result while the correct answers were 2.0 and 0%, respectively ( p  &lt; 0.001). DISCUSSION: Comparing the scientific evidence, overestimation in all diagnostic scenarios, regardless of if the disease is an acute infection or a cancer, may indicate that the probabilistic approach is not conducted by the family physicians. To prevent inaccurate interpretation of the tests that may lead to incorrect or unnecessary treatments with adverse consequences, evidence-based decision-making capacity must be strengthened.</p

Data_Sheet_1_Family physicians overestimate diagnosis probabilities regardless of the test results.PDF

IntroductionAs useful tools for clinical decision-making, diagnostic tests require careful interpretation in order to prevent underdiagnosis, overdiagnosis or misdiagnosis. The aim of this study was to explore primary care practitioners’ understanding and interpretation of the probability of disease before and after test results for six common clinical scenarios.MethodsThis cross-sectional study was conducted with 414 family physicians who were working at primary care in Istanbul via face-to-face interviews held between November 2021 and March 2022. The participants were asked to estimate the probability of diagnosis in six clinical scenarios provided to them. Clinical scenarios were about three cancer screening cases (breast, cervical and colorectal), and three infectious disease cases (pneumonia, urinary tract infection, and COVID-19). For each scenario participants estimated the probability of the diagnosis before application of a diagnostic test, after a positive test result, and after a negative test result. Their estimates were compared with the true answers derived from relevant guidelines.ResultsFor all scenarios, physicians’ estimates were significantly higher than the scientific evidence range. The minimum overestimation was positive test result for COVID-19 and maximum was pre-test case for cervical cancer. In the hypothetical control question for prevalence and test accuracy, physicians estimated disease probability as 95.0% for a positive test result and 5.0% for a negative test result while the correct answers were 2.0 and 0%, respectively (p DiscussionComparing the scientific evidence, overestimation in all diagnostic scenarios, regardless of if the disease is an acute infection or a cancer, may indicate that the probabilistic approach is not conducted by the family physicians. To prevent inaccurate interpretation of the tests that may lead to incorrect or unnecessary treatments with adverse consequences, evidence-based decision-making capacity must be strengthened.</p