Which Threats to Global Health Pose a Problem for Turkey’s Health?

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Work-related musculoskeletal disorders at two textile factories in Edirne, Turkey

Objective: “Work-related musculoskeletal disorders” (WMSDs) is a term used to describe a painful or disabling injury to the muscles, tendons or nerves caused or aggravated by work. WMSDs are preventable or at least can be delayed. The aim of this study to determine the work related musculo-skeletal disorders and risk levels of the these factory workers. Study Design: Cross sectional study. Material and Methods: This is a cross-sectional study conducted at two textile factories in Edirne, Turkey and it involved 381 workers. The questionnaire used for data collection consisted of two parts. The first part described some socio-demographic features, working conditions and health problems of workers in the previous four weeks. In the second part, a Rapid Upper Limb Assessment (RULA) Employer Assessment worksheet was used. Results: In the assessment of the upper limbs of the workers, the arm/wrist score (AWS) is 5.9±1.7 (3-11); neck, trunk, legs score (NTLS) is 5.3±2.5 (3-11); and total score (TS) is 5.5±1.3 (3-7). The ages of the workers are significantly associated with higher RULA scores (r=0.207, p=0.000). AWS, NTLS and TS of the women workers were found to be statistically significantly lower than for the men. Conclusion: Musculoskeletal disorders are a common problem among textile workers. Employers can prevent WMSD hazards by properly designing the jobs or workstations and selecting the appropriate tools or equipment

COVID-19 PANDEMİSİNDE SAĞLIK SİSTEMLERİ: PORTEKİZ ÖRNEĞİ

Koronavirüs hastalığı 2019 (COVID-19), 2 Mart 2020’den beri Portekiz’i de etkilemeye başlayan dünya çapında bir salgın oluşturmuştur. Ciddi komplikasyonlara ve ölüme neden olan ve son derece bulaşıcı olan hastalık tüm dünyada sağlık sistemlerinin kapasitesini zorlamış, sistemleri kırılma noktasına getirmiş ve halk sağlığında uzun süredir devam eden boşlukları ortaya çıkarmıştır. Halen, tüm dünyada enfeksiyonun yıkıcı etkilerine karşı yeni önlemler için çalışmalar devam etmektedir. Bu yazıda, Portekiz’de COVID-19 salgını, sağlık sistemi içinde salgınla baş etme çalışmaları ve yapılan müdahalelerin incelenmesi amaçlanmıştır

The Burden of Premature Mortality in Turkey in 2001 and 2008

Background: Standard expected years of life lost (SEYLL) is a measure that is used to evaluate losses due to premature deaths. Aims: The present study provides an analysis of premature mortality in Turkey for the years 2001 and 2008 and supplies evidence for making policies and setting health agendas over the long term. Study Design: Cross-sectional study. Methods: This study calculated SEYLL by gender, age group and causes of death in Turkey in 2014. The SEYLL measure counts the years lost in a population as a result of premature mortality and is computed by multiplying the number of deaths and standard life expectancy at the age at which death occurs. Results: The burden of premature mortality in Turkey was calculated as 4 104 253 SEYLL and 4 472 443 SEYLL in 2001 and 2008, respectively. Among these 42.7% and 43.9% of SEYLL were in females in 2001 and 2008, respectively. The leading five causes of premature mortality in the Turkish population in 2001 were cardiovascular system diseases (34.72%), perinatal conditions (12.69%), neoplasms (12.51%), external causes of injury (7.66%), and infections and parasitic diseases (6.57%). In 2008, the major causes were cardiovascular diseases (41.17%), neoplasms (14.63%), respiratory system diseases (9.81%), perinatal conditions (5.59%), and external causes of injury (5.29%). Conclusion: The majority of the burden of premature mortality in Turkey is attributable to non-communicable diseases. While premature deaths from infections and parasitic diseases, perinatal conditions and congenital anomalies decreased between 2001 and 2008, deaths from cardiovascular diseases, neoplasms and respiratory system diseases increased dramatically. Coordinated efforts for effective national prevention programs (such as regular monitoring of adults for early diagnosis of cardiovascular diseases and for malignancies by family physicians) should be developed by policy makers to decrease preventable and premature deaths from non-communicable diseases

Gençlik cinsel sağlığı: Türkiye'deki bir üniversitede öğrenciler arasında cinsel bilgi, tutumlar ve davranışlar]

Introduction: To determine sexual attitudes, behavior, and knowledge of Namik Kemal University (NKU) students about sexual health and sexually transmitted infections (STIs). Method: A sample representing 10% of the undergraduate population of NKU in 2009-2010, was studied. Of 1,500 questionnaires distributed, 1,314 (87.6%) were filled out. Results: The mean age of the respondents (52.9% male) was 20.07 +/- 1.75 years. The rate of students who had received sexual health education was 32.0%, and 15.3% had previously used a sexual health service. Eleven percent of the female students and 50.3% of the male students had had sexual intercourse. The average age of initial sexual intercourse was 16.83 +/- 2.07 years. Of the students who had had sexual intercourse, 46.6% reported that they did not use any contraception method. The most preferred method was condoms (37.6%). The rate of contraceptive use was 58.7% in sexually educated students and 43.9% in those not educated (p=0.004). The most well-known STI was AIDS (96.5%), with sexually educated students giving higher rates of correct answers about STIs (p<0.05) Conclusion: The students who had received sexual health education were more knowledgeable about vital consequences of STI's, even though it is not sufficient, than sexually active students. Awareness of safe sexual practices and changes in behavior, in particular, promoting condom use should be established in higher risk youths. Deficiencies in knowledge could be addressed by adding a sexual healthtraining component to the university curriculum, and unmet requirements could be met by reorganizing medico-social centers in universities

Histopathological Features of Gastrointestinal Stromal Tumors and the Contribution of DOG1 Expression to the Diagnosis

Background: Gastrointestinal stromal tumors (GIST) have KIT or platelet-derived growth factor receptor ? (PDGFR?) mutations affecting receptor tyrosine ki-nase activity and do not benefit from classic treatment regimens.Aims: The aim of this study was to review the al-gorithm that may be followed for the diagnosis and differential diagnosis in GISTs by investigating the histomorphological parameters and expression charac-teristics of classical immunohistochemical antibodies used in routine tests in addition to DOG1 expression.Study Design: Diagnostic accuracy study.Methods: We reevaluated the histological and immu-nohistochemical parameters of 37 GISTs. The standard immunohistochemical diagnosis and differential diag-nosis panel antibodies (CD117, PDGFR?, CD34, vi-mentin, desmin, SMA, S-100, and Ki67) were studied on the tumor sections. We also used the popular marker DOG1 antibody with accepted sensitivity for GISTs in recent years and the PDGFR? immune marker for which the benefit in routine practice is discussed.Results: Classification according to progressive dis-ease risk groups of the 37 cases revealed that 54% were in the high risk, 19% in the moderate risk, 16% in the low risk, 8% in the very low risk and 8% in the no risk group.Cytological atypia, necrosis, mucosal invasion and the Ki67 index were found to be related to the progressive disease risk groups of the tumors (p&lt;0.05).Positive immunoreaction was observed with CD117 and PDGFR? in all GISTs in the study (100%). Posi-tivity with the DOG1 antibody was found in 33 (89%) cases. CD34 was positive in 62% (23) of the cases.Conclusion: The CD117 antibody still plays a key role in GIST diagnosis. However, the use of DOG1 and PDGFR? antibodies combined with CD117 as sensitive markers can be beneficia

Increase of Knowledge Level of Nursing Students About Occupational Health and Safety

Aim:This aim of the study is to determine the knowledge of nursing students about work related risk factors, work accidents and occupational diseases and to raise the awareness of the about occupational health and safety.Materials and Methods:This study was carried out as a semi-experimental study. It was conducted with the 62 Namık Kemal University, College of Health, Nursing Department third class students who accepted to participate, between February and May 2015. After applying a pre-test, a training program about occupational health and safety was implemented to the students and a post-test was applied at the end of the training program. The content of training program and pre-test and post-test were developed by the researchers. Data was analyzed with IBM SPSS Ver.18 and descriptive statistics were used.Results:The meanage of students is 21.70±1.32. nearly eighty percent of them female and 21% of them stil working in a health facility. The ratio of the true answers about the description of occupational health, work related risk factors, risk groups, occupational diseases, protection principles and precautionary measures is 20% in pre-test and it raised nearly 90-95% in post-test.Conclusion:A significant increase in the knowledge and awareness of the nursing students was determined with the training program. Occupational health and safety coursess hould be implemented to curriculum of health colleges

Adolesan erkeklerin nutrisyonel durumlarının değerlendirilmesi

Amaç: Bu çalışmanın amacı Türkiye'nin Edirne ilinin kırsal ve kentsel alanında yaşayan adolesan erkek öğrencilerin nutrisyonel durumlarını değerlendirmektir. Hastalar ve Yöntemler: Toplam 1004 erkek adolesanın (ort. yaş 14.4±1.7; dağılım 12-17) makronutrient ve mikronutrient alımları üç günlük diyet kayıtları ile değerlendirilmiştir. Bulgular: Deneklerin enerji, kalsiyum, magnezyum, A, E, B1 (tiamin) vitaminleri, folik asit ve lif alımı önerilen günlük alımların altında saptanırken, protein, B2 (riboflavin), B6 vitaminleri ve demir alımları fazlaydı. Makronutrientlerin günlük enerji alımını oluşturan oranları önerildiği gibiydi. Kırsal ve kentsel alanda yaşayan adolesan erkeklerin nutrisyonel alımları farklılık göstermedi (p>0.05). Sonuç: Bölgemizde yaşayan erkek adolesanların bu bulgulara göre oluşturulacak diyet alım önerileri ve diyet menü örnekleri, eskiye göre daha sağlıklı dengeli besinsel duruma ulaşmalarına yardımcı olabilir.Objectives: The aim of this study was to evaluate the nutritional status of adolescent male students in rural and urban areas of Edirne, Turkey. Patients and Methods: In a sample of 1004 male adolescent boys (mean age 14.4&plusmn;1.7 years; range 12 to 17 years), intake of macronutrients and micronutrients was assessed from three-day self-reported food records. Results: It was observed that energy, calcium, magnesium, vitamin A, E, thiamine, folic acid and fiber intakes of the subjects were below the recommended levels, while protein, riboflavin, vitamin B6 and iron intakes exceeded the target levels. Distribution of macronutrients in daily energy consumption was in agreement with the recommended ratios. Nutritional status did not differ between rural and urban areas (p&gt;0.05). Conclusion: The dietary recommendations and menu samples based on these findings may help the male adolescents living in our region and our country have a more balanced nutritional status than before

Hormone replacement therapy process and effects of reproductive factors on bone mineral density in postmenopausal women

Amaç: Menopoz sonrası kadınlarda hormon replasman tedavi (HRT) sürecinin ve parite, menopoz yaşı, menopoz süresi gibi reprodüktif faktörlerin kemik mineral yoğunluğu üzerine etkileri araştırıldı. Hastalar ve Yöntemler: Trakya Üniversitesi Tıp Fakültesi, Kadın Hastalıkları ve Doğum Kliniği Menopoz Polikliniği'ne başvuran 322 menopoz sonrası kadının (ort. yaş 52.4±6.2; dağılım 38-76) yaş, reprodüktif öykü ve hormon replasmanı ile ilgili bilgileri arşivden çıkarıldı. Hastalar, östrojen kullanım süreleri ve halen kullanmakta olup olmadıklarına göre sınıflandırıldı ve bu özelliklerinin kemik mineral yoğunluğuna etkileri analiz edildi. Kadınların lomber vertebra, femur, trokanter ve wards kemik dansitometreleri DEXA (dual-energy X-ray absorpsiometri) yöntemiyle ölçüldü. Bulgular: Hormon replasman tedavisi kullanımı üç yıldan fazla olan menopoz sonrası kadınlardaki wards ve trokanter kemik mineral yoğunlukları, üç yıldan az olanlara göre anlamlı olarak yüksek bulundu. Vertebral kemik yoğunlukları, üç yılın üzerinde HRT kullananlarda hiç kullanmayanlara göre daha yüksek saptandı. Wards ve vertebral kemik yoğunluğu değerleri, halen HRT'yi kullanmakta olan ve üç yıldan daha uzun süredir kullananlarda hiç HRT kullanmamış kadınlara göre daha yüksek tespit edildi. Geçmişte HRT kullanıp sonradan bırakmış olan kadınlarda kemik mineral yoğunluğu değerleri hiç HRT kullanmamış olan kadınlardan farklı olmadığı bulundu.. Parite ve menopoz sonrasında geçen süre artışının kemik yoğunluğunu düşürdüğü görüldü. Sonuç: Vertebra ve kalça kemik mineral yoğunlukları, HRT kullanımının ancak üç yıl veya daha uzun süreli kullanımlarında ve HRT'nin kullanıldığı dönem içinde artmaktadır. Parite ve menopoz sonrası geçen süre ise osteoporoz riskini artıran faktörlerdir.Objectives: The effects of hormone replacement therapy (HRT) and reproductive factors such as parity, age of menopause, and duration of menopause on bone mineral density (BMD) in postmenopausal women were investigated. Patients and Methods: Age, reproductive history and HRT data of 322 postmenopausal women (mean age 52.4&plusmn;6.2 years; range 38- 76) who applied to the outpatient menopause clinic of Trakya University Medical Faculty were gathered from the medical archives of the outpatient clinic. Patients were grouped according to the duration and current status of estrogen therapy and the effects of these variables on BMD were analysed. Bone mineral densities of lumbar spine, femur, trochanter, and Ward's triangle sites were measured by Dual Energy X-ray Absorptiometry (DEXA). Results: Bone mineral densities of trochanter, and Ward's triangle sites of postmenopausal women who received HRT for more than 3 years were found to be significantly higher than those women who were treated for less than 3 years. Vertebral bone densities were significantly higher in postmenopausal women who received HRT for more than 3 years, compared to those women who were never treated with HRT. Ward's triangle and vertebral bone densities were significantly higher in postmenopausal women who received HRT for more than 3 years and those currently on HRT, compared to those women who never received HRT. BMD values of women who started but interrupted their HRTs, were similar to the values found in women who never received HRT. Increasing parity and duration of menopause were the factors that reduced BMD values. Conclusion: It appeared that BMD of hip and spine increased in postmenopausal women after the third or more years on HRT and during the period of treatment with HRT. Parity and duration of menopause were identified as factors which increase the risk of osteoporosis

Medical Education in the Era of Advancing Technology

Technology is developing rapidly and affecting the field of medicine in two main areas- medical education and health care. As a rapidly evolving field with the need and ability to constantly incorporate newer technologies, medical education must be able to prepare future doctors as per changing trends in practice patterns, the role of medicine in disease diagnosis and treatment, and innovations, and advances in medical science. In this article, we discuss the various digital learning tools introduced into medical education, as well as their advantages and disadvantages. We also try to understand how the shift to artificial intelligence may affect medical education and practice and how we can make technology efficient without losing the human dimension in doctor-patient relationships