Huzurevinde ve Evde Yaşayan Yaşlılarda Yaşam Kalitelerinin Karşılaştırılması ve Bu Durumun Sosyo?Demografik Faktörlerle İlişkisi

Objectives: Improving the quality of life for the rapidly growing elderly population plays a key role ingood health standards. This study aims to compare the quality of life of elderly people living in theirhome and senior centers, and to determine socio?demographic factors that could affect their quality oflife.Materials and Methods: In this study, we enrolled 400 people aged ?65 years; 198 of them were elderlywho applied for any reason to Etfal Training and Research Hospital Family Medicine Policlinic, betweenFebruary?October 2014; and 202 of them were living in Nursing Homes. The survey questioned sociodemographicfeatures and the Turkish version of quality of life developed by World Health Organizationwas applied.Results: We examined 400 people [188(47%) males and 212(53%) females]. Of these, 202 (50.50%;average age=73.26?6.68 years) were living in their homes and 198(49.50%; average age: 73.19?7.27 years)in senior centers. Furthermore, the physical, psychological, social and environmental field scores ofpeople living in their homes were significantly higher than those living in senior centers (P < 0.001).Conclusion: This study reveals that the quality of life is higher in elderly who live in their homes thanthose who live in nursing homes. The older age, marital status, higher education level, increase in theincome, and not having children negatively affect the quality of life in individuals living in their homes.In elderly people living in senior centers, advanced age, female gender and having a chronic illnessnegatively affect the quality of life.Amaç: Hızla artan yaşlı nüfusta yaşam kalitesinin iyileştirilmesi, iyi sağlık standardı için anahtar rol oynamaktadır. Araştırmamızda huzurevinde ve kendi evinde yaşayan yaşlıların yaşam kalitelerini etkileyen faktörler tespit edilmesi hedeflenmiştir. Materyal ve Metot: Çalışmaya Mart?Kasım 2014 tarihleri arasında Şişli Hamidiye Etfal Hastanesi Aile Hekimliği Polikliniğine başvuran 65 yaş ve üstü 198 birey ile huzurevinde yaşayan 202 birey olmak üzere toplam 400 kişi alındı. Araştırmamızda kişilerin sosyodemeografik bilgilerini sorgulayan bir anket formu ve Dünya Sağlık Örgütü tarafından geliştirilen yaşam kalitesi ölçeği kısa formunun Türkçe versiyonu uygulandı. Bulgular: Çalışmamıza 188’i (%47,00) erkek ve 212’si (%53,00) kadın olmak üzere toplam 400 hasta katıldı. Bunların 202'sini (%50,50) kendi evinde kalan bireyler 198'ini (%49,50) ise huzurevinde kalan bireylerdi. Hastaların yaş ortalaması kendi evinde kalanlarda 73,26?6,68 iken huzurevinde kalanlarda 73,19?7,27 idi. Kendi evinde yaşayanların bedensel, ruhsal, sosyal ilişkiler ve çevre alanı skoru huzurevinde kalanlardan anlamlı olarak daha yüksek bulundu (p<0,001). Sonuç: Araştırmamıza göre kendi evinde yaşayanların yaşam kalitesi huzurevinde yaşayanlardan daha yüksektir. Kendi evinde yaşayan bireylerde ileri yaşın, medeni durumun, yüksek eğitim düzeyi, yüksek gelir düzeyi, çocuk sahibi olmama; huzurevinde yaşayan bireylerde ise ileri yaşın, kadın cinsiyet ve kronik hastalık varlığı yaşam kalitesini olumsuz etkilemekteyd

Influence of birth cohort, age and period on suicide mortality rate in Turkey, 1983-2013

Objective: This study is designed to evaluate the potential effects of age, period and cohort (APC) on trends in suicide between 1983 and 2013 in Turkey. Methods: Mortality data were obtained from the Turkish Statistical Institute. The data were grouped into seven age groups, four periods and ten birth cohorts. A nonlinear regression model was estimated for both sexes. The effects of age, period and cohort were parameterized using natural spline smoothing functions. Results: There were 61,795 deaths recorded as suicides during the investigated time period, where 64.5% occurred in males (n = 39,862) and 35.5% in females (n = 21,933). There is an upward trend in mortality by age until the end of the study period for males and females. Age effect is decreased until the forties, kept decreasing during the middle ages, and sharply increased after the sixties. The death rates for females declined from 1999 until the end of the study period. For males, the death rates increased until the end of the study period. Conclusion: If the current trends continue, it can be expected that these effects will continue to reduce female mortality and increase male mortality. Future studies on suicide, strongly focused on specific factors attributed to period effects, are needed in Turkey. © National Institute of Public Health, Prague 2019

Lise Öğrencilerinde Fiziksel Şikâyetler İnternet Bağımlılığı Belirtisi Olabilir mi?

Background: The aim of this study is to measure the level of internet addiction among high school adolescents and to determine the relationshipbetween their time spent on the internet and the back and neck pain and eye health problems they experience.Methods: The study is a simplecross-sectional descriptive study. 8926 high school students participated in the study. Students were selected by cluster sampling method pursuantto their gender, school type, and grade distributions. Young's short internet addiction test (IAT) that was adapted to Turkish was utilized. Results:The average internet addiction score of the students was 26.88 ± 8.80. While the ratio of students with a high risk of addiction was 44.3%(n=3950), the ratio of those, who were addicted, was 15.7% (n=1400). A significant positive correlation was found between the addiction leveland the lower back, neck pain and eye disorders. (p<0.001; p<0.001; p<0.001) The smartphone possession rate of students was 96.4% (n=8606).There was a significant positive correlation between having a smartphone and the level of addiction, neck pain, and eye complaints. (p=0.005;p=0.002; p=0.003, respectively)The ratio of students, who have a computer at home, was 79.8% (n=7122). Eye complaints were found to besignificantly higher in those, who had a computer at home (p<0.001).Conclusion: Internet addiction is an important and common problem amongadolescents. Internet addiction increases, as the age of adolescents increases. Smartphones are the most important risk factor for the spread ofinternet addiction. Internet addiction leads to muscle-joint pain, and eye-related symptoms.Giriş: Bu çalışmanın amacı lise çağındaki adelosanlarda internet bağımlılık düzeyini ölçmek, internette bulunma süresi ile bel, boyun ağrıları ve göz sağlığı problemleri arasındaki ilişkiyi belirlemektir. Yöntem: Çalışma basit kesitsel tanımlayıcı bir çalışmadır. Çalışmaya 8926 lise öğrencisi katıldı. Öğrenciler cinsiyetlerine, okudukları okul tipi ve sınıf dağılımlarına göre küme örnekleme yöntemiyle seçildi. Türkçeye uyarlanmış Young’un kısa internet bağımlılık ölçeği (IAT) kullanıldı. Bulgular: Çalışmaya katılan öğrencilerin yaş ortalaması 15,71±1,14 idi (min=14, maks=18). Öğrencilerin ortalama internet bağımlılık puanı 26,88±8,80’di (min=12, maks=60). Bağımlılık riski yüksek olan öğrencilerin oranı %44,3 (n=3950) iken bağımlı olanların oranı %15,7’di (n=1400). Bağımlılık düzeyi ile bel, boyun ağrısı ve göz rahatsızlıkları arasında anlamlı pozitif ilişki tespit edildi (p<0,001; p<0,001; p<0,001). Öğrencilerin akıllı telefon sahibi olma oranı ise %96,4’tü (n=8606). Akıllı telefon sahibi olmakla bağımlılık düzeyi, boyun ağrısı ve gözlerdeki şikâyetler arasında anlamlı bir pozitif ilişki saptandı (sırasıyla p=0,005; p=0,002; p=0,003). Çalışmada evinde bilgisayar bulunan öğrencilerin oranı %79,8’di (n=7122). Evinde bilgisayar olanlarda gözlerdeki şikâyetlerin anlamlı olarak daha yüksek olduğu tespit edildi (p<0,001). Sonuç: Adelosanlarda internet bağımlılığı önemli ve yaygın bir sorundur. Adelosan yaşı arttıkça internet bağımlılığı da artmaktadır. Adolesanlar arasında çok yaygın kullanım oranı olan akıllı telefonlar internet bağımlılığının yaygınlaşması için en önemli risk faktörüdür. İnternet bağımlılığı kas-eklem ağrıları ve göz ile ilgili semptomlara sebep olmaktadır. Muayene sırasında bu ilişki de dikkate alınmalıdı

Evaluation of Hypertension-Related Mortality in Turkey (2000-2014)

Objective: Hypertension continues to be the leading risk factor for cardiovascular disease (CVD) and mortality worldwide. The purpose of the present study was to analyze the long-term trends of hypertension mortality in Turkey between 2000 and 2014 (for males and females). Methods: Analyses were based on hypertension mortality data obtained from the Turkish Statistical Institute death database. Age-standardized mortality rates were calculated using direct standardization for each calendar year. We estimated the age-adjusted linear trend for annual percent change and average annual percent change (AAPC) with the corresponding 95% confidence interval (CI) using the joinpoint regression analysis. Furthermore, we conducted an age-period-cohort analysis to quantify recent time trends and to evaluate the significance of cohort and period effects. Results: During the study period, a significant upward trend in the mortality of hypertension in Turkey is observed (AAPC=2.7%, 95% CI 1.9%-3.4%). The trend of hypertension mortality has increased in both males (AAPC=7.4%, 95% CI 3.0%-11.9%) and females (AAPC=8.7%, 95% CI 4.1%-13.5%). We found that the net drift rateswere 2.1% (95% CI 0.6%-3.6%) per year for males and 2.0% (95% CI 0.4%-3.7%) per year for females. According to longitudinal age curves, the mortality of hypertension increased with age in both males and females. The period and cohort effects are highly significant in both males and females. Conclusion: Hypertension is one of the leading causes of mortality causing CVD. Knowing the risk factors and preventive methods could help to reduce hypertension-related mortalities

Vaccine rejection and hesitation in Turkey

In Turkey, primary care staffs have observed an increased rate of vaccination refusal in recent years. The aim of the present study was to determine the prevalence of vaccination refusal and hesitancy in Turkey, in addition to the demographic features and underlying reasons. The present descriptive cross-sectional study was conducted in Istanbul and Tekirdag, two big Turkish cities that are exposed to widespread internal migration. To reflect Turkey's demographic structure, 1004 participants were selected using cluster sampling based on birthplace, age, and level of education, from all individuals who attended family medicine outpatient clinics at Namik Kemal University and Sisli Hamidiye Etfal Training and Research Hospital. A face-to-face questionnaire method was used. Data show that this decline was mainly the result of the increasing rate of vaccine rejection and hesitation, for which the most important reason was found to be distrust of vaccine companies. It can be concluded that individuals who display vaccine refusal and hesitation are mostly born in the developed geographical regions of Turkey and have high income and educational levels. According to these results, we anticipate that vaccination rates may fall in Turkey in the coming years

The Knowledge, Attitude and Behavior of Mothers with Children Aged 0-6 Years on Home Accidents and Preventive Measures

Objective: Accidents have become an increasingly important cause of child deaths in both developed and developing countries. In this study, we aimed to evaluate the knowledge and attitudes of mothers of children in the the 0-6 age group on ways of protecting them accidents at home. Material and Methods: A prospective, single-center, descriptive-analytical study was conducted between February 2016 and March 2016. The study included 217 people at Sisli Hamidiye Etfal Training and Research Hospital Family Medicine Polyclinic. Results: The average age of mothers in our study was 33.32 +/- 5.64 years. Mothers with higher levels of education and with high incomes were found to have more knowledge about home accidents (p= 35 years with a high educational level who had one child scored more points on the Scale of Recognizing Security Measures (p=0.005, p=0.009, p=0.017). Conclusion: Social awareness and business cooperation should be raised in the prevention of home accidents. Parents' knowledge of precautions against accidents - especially mothers who spend most of their time with children - and the education they give their children is key for protection against accidents

Artralji ile Başvuran Bir Wegener Granülamatozu Olgusu

Granulomatosis with polyangitis (GPA/WG) (previously known as Wegener granulomatosis) is a multisystemsystemic necrotizing non-caeseating granulomatous vasculitis affecting small to medium sized arteries, capillaries andveins, with a predilection for the respiratory system and kidneys. The average incidence of this disease is 40-55. 90% of theWG patients have pulmonary involvement. Wegener Granulomatosis is a disease with high mortality when its diagnosisand treatment is delayed. Although WG may have symptoms such as hemoptysis and hematuria, it should be noted that itmay present with severe arthralgia and arthritis which may be in many connective tissue diseases and vasculitis. Malepatient, 52 years old. Analgesic treatment was applied when he came to the center due to arthralgia two months ago,however, there was no change in his complaints and intra-articular injection treatment was applied on left knee and bothshoulders. The symptoms did not regress and the patient lost 20 kg within the last two months. In urine analysis, 14-15erythrocyte and 10-15 leucocyte detected in every field; 1 positive detected. The patient was hospitalized in order to makefurther examination upon the determination of CRP: 61 mg/L and ESR: 82 mm/hr in the next polyclinic control after threedays. In the kidney biopsy report, “Pauci-immun glomerulonephritis” was primarily considered in the phenomenon. For thefirst three days 1 gr pulse and by the fourth day 1 mg/kg methylprednisolone and cyclophosphamide treatment was appliedWegener Granülomatozu özellikle üst solunum yolları, akciğer ve böbrekler olmak üzere, tüm organları tutabilen nekrotizan granülomatöz vaskülitik bir hastalıktır. Ortalama görülme yaşı 40-55 tir. Kadın ve erkek eşit etkilenir. Akciğer tutulumu Wegener granülomatozisli hastaların %90’ında mevcuttur. Wegener Granülomatozu, tanı ve tedavisi geciktiğinde, mortalitesi yüksek olan bir hastalıktır. WG’nin hemoptizi ve hematüri gibi semptomları olabileceği gibi; birçok konnektif doku hastalığı ve vaskülitte olabilen şiddetli artralji ve artritle de prezente olabilir. 52 yaşında erkek hasta. 2 ay önce başlayan eklemlerde ağrı şikayetiyle başvurduğu merkezde analjezik tedavisi uygulanmış ancak fayda görmemesi nedeniyle sol diz ve her iki omuzuna intraartiküler enjeksiyon tedavisi yapılmış. Şikayetleri gerilemeyen hastanın son 2 ayda 20kg kaybı olmuş. Tam idrar tahlilinde: her sahada 14-15 eritrosit ve 10-12 lökosit, protein; 1 pozitif saptandı. Hastanın 3 gün sonraki poliklinik kontrolünde CRP’si:61 mg/L, sedimantasyonu: 82 mm saptanması üzerine ileri tetkik amacıyla hospitalize edildi. Böbrek biyopsisi raporunda, ön planda “pauci-immun glomerulonefrit” düşünüldü. İlk 3 gün 1 gr pulse, 4. günden itibaren 1 mg/kg metilprednizolon tedavisi ve siklofosfamid tedavisi uygulandı

Chilaiditi Syndrome After Colonoscopy: A Case Report and Review of the Literature

Chilaiditi Syndrome (CS) was first described by Demetrius Chilaiditi in 1910 as a condition characterized radiologically by thepositioning of the colon between the liver and the diaphragm. This condition of unknown cause is very rare in the general population. Although it is usually asymptomatic, it may present with acute, chronic, or recurrent forms and might be associated with symptoms such as constipa-tion, dyspnea, loss of appetite and chest pain. Diagnosis of CS is important since it might be confused with pneumoperitoneum, may cause intestinal obstruction, perforation, and ischemia, and might possibly result in intestinal perforations during colonoscopy. We report the case of a 62-year-old woman who presented with sudden dyspnea and abdominal pain after colonoscopy and was diagnosed as CS after radiolog-ical imaging

Evaluation of Job Strain of Family Physicians in COVID-19 Pandemic Period- An Example from Turkey

The purpose of this study was to evaluate family physicians' job strain during the Covid-19 pandemic and determine the effective factors. The study was carried out between 01 May 2020 and 01 June 2020 by applying an online questionnaire to family physicians who worked in primary care in Istanbul and could be reached by telephone application. The survey created by us included socio-demographic information and the Job Strain Scale Short Form. P value was accepted as 0.05, and SPSS 20 package program was used in statistical analysis. 448 Family Physicians participated in the study. Anxiety levels of the participants increased after the pandemic (p < 0.001). Job strain score increased significantly during the pandemic process (p < 0.001). The 'Workload' sub-dimension of the job strain score was affected by young age, not having children, thinking that the working hours increased, deterioration of sleep quality and increasing anxiety level. It was determined that there was an increase in the Control sub-dimension score of family physicians who thought that they were not provided with adequate protective equipment during the pandemic process and who did not find the use of their own personal protective equipment sufficient. 'Social support' sub-dimension mean score decreased during the pandemic period. It was determined that it significantly increased in married family physicians compared to single ones. In the pandemic process, anxiety, sleep quality deterioration and job strain increased significantly. In family physicians, after the pandemic, workload and control sub-dimension changes increased, while social support sub-dimension decreased

Evaluation of the Prevalence and Associated Factors of Low Back Pain

Amaç: Bel ağrısı sık görülen bir rahatsızlık olup; prevalansı %60?80 arasında değişmektedir. Bel ağrısıbireysel olarak yaşam kalitesini etkilemesinin yanında iş gücü kaybına neden olması nedeniyle toplumuda etkilemektedir. Bu nedenle çalışmamızda; bel ağrısının görülme sıklığını ve ilişkili faktörlerindeğerlendirilmesini amaçladık.Materyal ve Metot: Bu çalışma 01/05/2016?31/07/2016 tarihleri arasında Şişli Hamidiye Etfal Eğitim veAraştırma Hastanesi Aile Hekimliği Polikliniği’nde yapıldı. Yüz yüze görüşme ile sosyodemografiközelliklerin yanı sıra bel ağrısı sıklığı ve etkileyen faktörlerin sorgulandığı, tarafımızca hazırlanan anketuygulandı. İstatistiksel analiz için SPSS 15.0 for Windows programı kullanıldı. İstatistiksel anlamlılıkseviyesi p<0,05 olarak kabul edildi.Bulgular: Çalışmaya katılanların yaş ortalaması 40,90±14,20 olup %66’sı kadın, %34’ü erkekti. Bel ağrılıhastaların yaş ortalaması 41,90±13,63 idi. Bel ağrısı nokta prevalansı %18,80(n=94), yaşam boyu prevalansise %77,40 (n=387) olarak bulundu. Kadınlarda (p=0.009), ağır yük kaldıranlarda (p=0,007); evli veboşanmış olanlarda (p=0,000), vücut kitle indeksi (VKİ) yüksek olanlarda (p=0,022) diğer gruplara görebel ağrısı yaşama sıklığı daha fazla idi. Sigara kullanım süresi ve miktarı arttıkça bel ağrısı görülmesıklığı, doktora başvuru, tetkik istenme ve tedavi alma sayısı anlamlı olarak daha fazlaydı (p<0,05).Sonuç: Çalışmamızda bel ağrısının özellikle kadın cinsiyette, evli ve boşanmış olanlarda, VKİ yüksekolanlarda ve düşük eğitim düzeyine sahip bireylerde daha sık olduğunu saptadık.Objectives: Low back pain is a common disorder and the prevalence changes between %60 – 80. Low back pain effects individual’s quality of life and affects the society due to the loss of labor force. This study was designed to determine the prevalence and risk factors of low back pain within the community. Materials and Methods: This research was made in the Family Medicine Polyclinic of Şişli Hamidiye Etfal Training and Research Hospital between 01/05/2016?31/07/2016. Volunteers filled the questionnaires out via face?to? face interview questioning sociodemographic properties as well as the frequency and affecting factors about back pain, The data were analyzed by using SPSS 15.0 software programme. Level of significance was taken as p<0,05. Results: The average age was 40.91+14.20, 66% was women, 34% was men. The avarage age of the patients who have low back pain was 41.90. The point prevalence of low back pain was 18.80% (n=94), while the lifetime prevalence was 77.40% (n=387). We identified more low back pain cases in people, who had heavy load lifting stories (p=0.007) of woman gender (p=0.009), married or divorced (p=0.000) and who had higher body mass index (BMI) (P=0.022) compared to other groups. The duration and amount of smoking were positively correlated with the prevelance of low back pain, number of doctor visits, need for laboratory examinations and number of treatments. Conclusion: In our study, we determined that; low back pain is more frequent in women, in married and divorced people,in people with higher BMIs and in people with low education level