Anxiety levels of healthcare personnel in different stages of COVID-19 pandemic: A nationwide study from Turkey

Aim: SARS CoV-2 transmission in healthcare personnel was first reported on January 20, 2020. The aim of this study was to evaluate the anxiety levels experienced by healthcare personnel in Turkey during the COVID-19 pandemic and the factors affecting these levels.Material and Methods: A survey investigating sociodemographic features and examining anxiety levels was conducted among approximately 1000 healthcare personnel who were expected to take active roles in the pandemic across Turkey. The survey was conducted in three stages: before the pandemic spread to Turkey, at the beginning of the pandemic and when the pandemic became prominent. A logistic regression analysis was performed to determine the factors affecting anxiety and predictors of anxiety levels.Results: In the first survey, always (odds ratio, 15.781; p<0.01) and often (odds ratio, 5.365; p<0.05) media use, in the second survey media use (p<0.05) and profession (odds ratio, 0.021; p<0.05) and in the third survey, marital status (odds ratio, 17.716; p<0.01) and gender (odds ratio, 4.431; p<0.05) were determined as the predictors of anxiety related to COVID-19.Discussion: As a result of this study, healthcare personnel groups were defined (women, nurses, married people) who need special intervention and support to provide spiritual comfort when working on the front line in the fight against COVID-19. Further comprehensive studies are needed of the extent of psychological support required by healthcare personnel and to whom and how this support should be provided

Is there a link between pre-existing antibodies acquired due to childhood vaccinations or past infections and COVID-19? A case control study

Background: There is growing evidence indicating that children are less affected from COVID-19. Some authors speculate that childhood vaccinations may provide some cross-protection against COVID-19. In this study, our aim was to compare the circulating antibody titers for multiple childhood vaccine antigens, as an indicator of the state of immune memory between patients with COVID-19 and healthy controls, with a specific aim to identify the association between disease severity and antibody titrations which may indicate a protective function related to vaccine or disease induced memory. Methods: This study is a case-control study including 53 patients with COVID-19 and 40 healthy volunteers. COVID-19 severity was divided into three groups: asymptomatic, mild and severe. We measured the same set of antibody titers for vaccine antigens, and a set of biochemical and infection markers, in both the case and control groups. Results: Rubella (p = 0.003), pneumococcus (p = 0.002), and Bordetella pertussis (p 0.0001) titers were found to be significantly lower in the case group than the control group. There was a significant decline in pneumococcus titers with severity of disease (p = 0.021) and a significant association with disease severity for Bordetella pertussis titers (p = 0.014) among COVID patients. Levels of AST, procalcitonin, ferritin and D-dimer significantly increased with the disease severity Discussion: Our study supports the hypothesis that pre-existing immune memory, as monitored using circulating antibodies, acquired from childhood vaccinations, or past infections confer some protection against COVID-19. Randomized controlled studies are needed to support a definitive conclusion. © 2021 PeerJ Inc.. All rights reserved

Research of Determination of Health Problems and Utilization of Health Services in Agricultural Workers in the Province of Adana and Proposition of Health Delivery Model(s).

TEZ10813Tez (Uzmanlık) -- Çukurova Üniversitesi, Adana, 2014.Kaynakça (s. 101-109) var.xii, 121 s. : res. (bzs. rnk.), tablo ; 29 cm.Giriş ve Amaç: Tarım çalışanlarında özellikle de mevsimlik-gezici tarım işçilerinde; bulaşıcı hastalıklar ve parazitozlar, konut ve su hijyeni ile ilgili sorunlar, iş kazaları ve meslek hastalıkları, eğitim düzeyinin düşük olması, yoksulluk, sosyal güvencenin olmayışı ve sağlık sistemine erişimde yaşanan problemler, önemli bir halk sağlığı sorunu olarak karşımıza çıkmaktadır. Bu tez araştırmasının amacı; Adana ilinde tarım çalışanlarının sosyo-demografik özelliklerinin tanımlanması, sağlık sorunlarının ve sağlık hizmetine erişim durumlarının araştırılması ve elde edilen bulgular ışığında mevcut sağlık sistemine uygun olarak, tarım çalışanlarına yönelik sağlık hizmet model(ler)inin önerilmesidir. Gereç ve Yöntem: Bu araştırma Adana ilinde faaliyet gösteren 15-65 yaş yerleşik tarım çalışanları (YTÇ) ve mevsimlik tarım işçilerinde (MTİ) yapılan tanımlayıcı bir çalışmadır. 2012 yılında Mevsimlik Gezici Tarım İşçilerinin Çalışma ve Sosyal Hayatlarının İyileştirilmesi Projesi (METİP) kapsamında, MTİ’ye altyapı hizmetleri ve eğitimler verilen 53 bölgeden %50’sine ulaşılması hedeflenmiştir. Ceyhan’dan 2, Yüreğir’den 8, Seyhan’dan 7, Karataş’tan 8 ve Yumurtalık’tan 3 olmak üzere; toplam 28 bölge basit rasgele örneklem yöntemiyle seçilmiştir. Örnekleme, son bir yıl içinde sağlık sorunu görülme sıklığı, 2011 yılında yapılan Mevsimlik Tarım İşçilerinin ve Ailelerinin İhtiyaçlarının Belirlenmesi Araştırması’na göre %54 kabul edilerek %95 güvenirlik ve %5 hata payı ile büyüklüğü bilinmeyen evrene göre 382 MTİ’nin; YTÇ için daha önce yapılmış benzer bir çalışma bulunmadığından son bir yıl içinde sağlık sorunu görülme sıklığı %50 kabul edilerek, %95 güvenirlik ve %5 hata payı ile büyüklüğü bilinmeyen evrene göre 384 YTÇ’nin alınması gerektiği hesaplanmıştır. Katılımcılara araştırıcı tarafından geliştirilen, katılımcıların sosyodemografik özelliklerini, yaşadıkları barınma koşullarını, mesleki durumlarını ve sağlık durumlarını sorgulayan dört bölüm ve toplamda 74 sorudan oluşan anket uygulanmıştır. Bulgular ki-kare testi, t testi ve lojistik regresyon modeliyle analiz edilmiş, p değerinin < 0,05 olması anlamlı olarak değerlendirilmiştir. Bu değerlendirmeler için SPSS 19.0 for Windows paket programı kullanılmıştır. Bulgular: YTÇ’nin ortalama yaşı 38,9±13,6; MTİ’nin ortalama yaşı 30,5±13,5 olarak bulunmuş olup; MTİ, YTÇ’ye göre daha genç bir nüfus dağılımı göstermektedir ve fark anlamlıdır (t=-8,703, p=0,0001). MTİ’nin tamamı büyük oranda muşamba, bez, saz ve kamıştan yapılan çadırlarda yaşamaktadır. Araştırmamızda tarım çalışanlarının günlük ortalama çalışma süreleri 10,4±2,2 saattir. Katılımcıların %86,5’i aylık 1000 TL’nin altında gelir elde etmektedir. Tarım çalışanlarının %60’ı son bir yıl içinde hastalanmış ve %76,2’si doktora gitmiştir. Son bir yıl içinde YTÇ’nin %54’ünün, MTİ’nin %40,5’inin aile hekimine başvurusu olduğu saptanmıştır ve fark YTÇ lehine anlamlıdır (?2=14,572, p=0,0001). Araştırmamızda son bir yılda sağlık personelinin evde ziyarete gelme oranı %15,4’tür. Çalışmamızda, tarım çalışanlarının cinsiyeti kadın ise özgeçmişinde hastalık öyküsü olasılığının 2,43 katına; son bir sene içinde hastalık geçirmesi olasılığının 1,87 katına çıktığı; mesleki eğitim almayan tarım çalışanlarının özgeçmişinde hastalık olasılığının, alanların 2,02 katı; son bir yıl içersinde hastalanma olasılığının ise 1,97 katı olduğu, tarlada ilaçlama yapanların son bir yılda hastalanma olasılığının, yapmayanların 1,66 katına çıktığı bulunmuştur. Sonuç:. Araştırmamızda tarım çalışanlarının ve özellikle MTİ’nin oldukça kötü barınma koşullarında yaşadığı, düşük gelirli, uzun saatler boyunca çalışan kişiler konumunda olduğu bulunmuştur. Araştırmamızda; kadınların, mesleki eğitim almamış olanların ve tarlada ilaçlama faaliyetlerinde bulunanların daha fazla hastalandığı belirlenmiştir. Hastalanan tarım çalışanlarının birinci basamak ve gezici sağlık hizmetlerinden yeterince yararlanamadığı saptanmıştır. Tarım çalışanlarının sağlık eğitimi/danışmanlığı hizmetlerinin sunulduğu, uygulanabilir, düzenli-sürekli gezici sağlık hizmetleriyle sağlık düzeylerinin yükseltilmesi gereklidir. Bu hizmetlerin etkin olabilmesi için de barınma, beslenme, eğitim, sosyal güvenlik ve ekonomik sorunların giderilmesi önkoşuldur.Background and Purpose: Among agricultural workers, especially in the seasonal-migratory ones; infectious diseases and parasites, housing and water hygiene related issues, work accidents and occupational diseases, low levels of education, poverty, absence of social security and problems in the access of health care system emerges as a significant public health problem. The purpose of this research is to identify socio-demographic characteristics, investigate health problems and Access status to health services of agricultural workers in Adana and, to propose health service model(s) in accordance with the current health care system for agricultural workers in the light of findings obtained. aterials and Methods: This research, conducted on resident agircultural workers (RAW) and seasonal agricultural workers (SAW) aged 15-65 operating in the province of Adana is a descriptive study. In 2012 under Remediation Project of Labour and Social Life of Seasonal Migrant Agricultural Workers (RPSAW), infrastructure services and training was given to SAW in 53 regions across Adana. 50% of these regions were targeted to be achieved and a total of 28 regions were selected by simple random sampling method including, 2 from Ceyhan, 8 from Yüreğir, 7 from Seyhan, 8 from Karataş and 3 from Yumurtalık. For SAW, the sample should include 382 workers considering 54% incidence of health problems in the last one year based on “Needs Assessment Study on Seasonal Agricultural Workers and Their Families” in 2011 with 95% confidence interval and 5% error margin and according to the size of unknown universe; for RAW there was no previously conducted similar study thus the incidence of health problems in the last year was considered to be 50%; with 95% confidence interval and 5% error margin and according to the size of unknown universe, the sample should include 384 RAWs. Participants were administered a questionnaire developed by researcher, consisting of four sections and a total of 74 questions, querying participants' demographic characteristics, housing conditions, occupational and health status. Chisquare test, t-test and logistic regression tests were performed for statistical analysis and p-value <0,05 was considered to be significant. Evaluation was performed using SPSS 19.0 for Windows software.Results: The mean age of RAW was 38,9±13,6 and the mean age of SAW was 30,5±13,5; SAW shows a young population distribution, and the difference was significant (t=-8,703, p=0,0001). All SAW are living in tents largely made of tarp, canvas and reed. In our study, the average daily working hours of agricultural workers is 10,4±2,2. 86,5% of respondents’ monthly income is below 1000 TL. 60% of agricultural workers became ill in the past year and accordingly 76,2% of the agricultural workers have visited physician. It was determined that 54% of RAW applied to the family physician in the last year of whereas 40,5% of SAW and the difference was significant in favor of RAW (?2 = 14,572, p = 0,0001). In our research the ratio of participants visited at home by the health personnel over the past one year

Self-medication practices and rational drug use habits among university students: a cross-sectional study from Kahramanmaraş, Turkey

Background Self-medication refers to the use of medicines to treat self-diagnosed diseases without consulting any healthcare professionals. Irrational drug use and self-medication have serious negative consequences both on health and economy. Therefore, the aim of this study is to assess the habits related to rational use of drugs (RUD) and to estimate the prevalence of self-medication practices among university students. Methods This cross-sectional study was conducted on university students in Kahramanmaraş. From May 2017 to June 2017 a total of 960 students filled a “Rational Use of Drugs Questionnaire”. Results The prevalence of practicing self-medication in students was 63.4%. The most common medicines that the students had consumed without prescription were analgesics by 39.5%, antibiotics by 36.9% and cold remedies by 24.0%. The rate of students who declared that they were familiar with RUD and “rational use of antibiotics” (RUA) was 45.9%. Reading/checking the instructions in the prospectus (OR = 1.529, 95% CI [1.176–1.990]), understanding the context of the prospectus (OR = 1.893, 95% CI [1.387–2.584]), compliance with the duration of antibiotic treatment (OR = 1.597, 95% CI [1.231–2.071]) and consulting a physician in case of a side effect (OR = 1.350, 95% CI [1.037–1.757]) were significantly higher among students who were familiar with RUD as compared to who were not. Discussion Since the awareness of RUD among university students was found to be inadequate, it has critical importance to hold educational activities with the cooperation of physicians, health organizations, universities, non-governmental organizations and media to avoid negative consequences of irrational drug use and self-medication

The relationship between body mass index and pain, disease activity, depression and anxiety in women with fibromyalgia

Background Obesity is a possible factor which affects severity of symptoms and disease activity in fibromyalgia syndrome (FMS). The aim of our study was to determine the association between body mass index (BMI) and pain, tender point count (TPC), disease activity, anxiety and depression in patients with FMS. Methods This was a descriptive study. A total of 124 female FMS patients between 18 and 55 years of age were enrolled. FMS patients were evaluated with visual analog scale (VAS), fibromyalgia impact questionnaire (FIQ), Hamilton anxiety scale (HAM-A) and Hamilton depression scale (HAM-D). Patients were divided into three groups according to BMI levels: normal weight, overweight and obese. Normal weight was defined as BMI 18.5–24.9, overweight as BMI 25.0–29.9 and obesity as BMI ≥ 30. We assessed the BMI status and its association with symptom severity in patients with FMS. Results Significant differences were detected in VAS, TPC, FIQ and HAM-D among the groups (p < 0.05). There were no significant differences between the groups in HAM-A (p = 0.328). The highest scores were found in the obese group. Significant positive correlations were determined between BMI levels and VAS, TPC, FIQ and HAM-D (r = 0.277, p = 0.002; r = 0.384, p < 0.001; r = 0.292, p = 0.001; r = 0.357, p < 0.001). Discussion Obese female FMS patients had higher levels of pain, TPC, disease activity and depression. BMI was significantly and positively correlated with clinical manifestations of FMS. Therefore, FMS treatment programs should include weight loss strategies

Informed consent and vaccination

Hekimlik yıllar içinde toplumsal yapı ve teknolojik gelişmelere paralel olarak gelişerek evrimleşmiş, tıbbi müdahalelere hastaların da aktif olarak katıldığı modern hekimlik anlayışı vücut bulmuşturortaya çıkmıştır. Bu değişim süreci, karar verme aşamasında rolü belirgin olarak artan hastaların kendilerine yapılacak müdahaleler hakkında hekimlerce aydınlatılması yükümlülüğünü de beraberinde getirmiş, hastalara onamı alınmaksızın hastalara tıbbi müdahale yapılmaması esas olmuştur. Bununla birlikte sağlık hizmeti salt bireysel bir hizmet değildir, kimi hizmetler bireyin yanısıra kamu yararı da gözetilerek verilmektedir. Aşılama da bu sağlık hizmetlerden biridir. Bireyin aşılamayı istememesi halinde, tıbbi müdahaleye onam vermeme hakkı ile kamu yararı çatışmaktadır. Bu yazının amacı, söz konusu çatışmanın halk sağlığı ve hukuk bakış açısıyla tartışılması, aydınlatılmış onam kavramının yürürlükte olan mevzuat ışığında aşılama özelinde incelenmesidirdeğerlendirilmesidirMedicine has evolved over the years, developing in parallel with social structures and technological advances, and leading to an approach of modern medicine that allowed the active participation of patients in decisions about medical interventions. This changing process has made it necessary for doctors to inform patients and increasingly involve them in the decision-making process. No medical interventions without consent have become a principle. However, health care not only concerns the care of the individual but some services are provided in the public interest. Vaccination is one of these healthcare activities. When an individual does not want vaccination, the right to refuse medical intervention is in conflict with the public interest. The objective of this article is to discuss this conflict in the perspective of both public health and law, and to investigate the concept of informed consent in particular as it relates to vaccination in the light of the current legislatio

Occupational health and safety characteristics of agricultural workers in Adana, Turkey: a cross-sectional study

Background Among agricultural workers, especially in the seasonal migratory ones, housing and hygiene related issues, occupational accidents, low levels of education, poverty and absence of social security problems emerge as significant public health problems. This study aims to compare migrant-seasonal workers (MSWs) and resident agricultural workers (RAWs) in terms of socio-demographic characteristics and occupational health and safety in Adana, one of Turkey’s most important agricultural cities. Methods This cross-sectional study was conducted on RAWs and MSWs, aged 15–65, operating in the province of Adana. The calculated sample sizes for both MSWs and RAWs were distributed using stratified simple random sampling to five districts of Adana. Results The mean age of the 798 participating agricultural workers was 34.6 ± 14.2. Of the RAWs, 78.8% and of the MSWs 57.0% were male; 5.8% of RAWs and 32.8% of MSWs were illiterate. The mean number of people in the households of the participating workers was 5.1 for RAWs and 6.6 for MSWs. Of the RAWs, 20.5% were not covered by any social security scheme while this percentage was 35.1% in MSWs. RAWs worked 9.9 h a day while MSWs worked 10.9 h a day. Of the agricultural workers, 12.9% had injuries caused by occupational accidents. Discussion Agricultural workers, who are a large part of Turkey’s economically active population, do not have healthy and safe working conditions. New regulations in the fields of social security, record keeping, monitoring, supervision, education and occupational health have been implemented recently to solve these problems. Despite the recent improvements there are still some problematic issues in the auditing of the necessary practices

Understanding the approach of family physicians in Turkey to the problem of vaccine rejection

Vaccines not only protect individuals, but also prevent the spread of vaccine-preventable diseases in the community. Vaccine rejection in Turkey increased 125-fold between 2012 and 2019. Thus, this cross-sectional study aimed to investigate the level of knowledge of family physicians about vaccination, which can be the keystone of vaccine rejection. Evaluations were also made of vaccine recommendations, practice, and confidence in vaccine safety. The study was conducted using a 41-item questionnaire, completed by 804 (3.3%) family physicians serving in Turkey. The most common reasons for vaccine rejection were found to be fear of disease from the vaccine substance at the rate of 53.7% (n = 298), religious reasons at 32.3% (n = 179), disbelief of protection at 9.9% (n = 55), and fear of infertility at 4.1% (n = 23). Logistic regression analysis was applied to determine the factors affecting the power of the family physician’s recommendation. The results showed that age >41 years (OR = 1.625 (1.129–2.34)), having self-efficacy (OR = 1.628 (1.183–2.24)) and belief in the usefulness of the vaccine made a positive contribution to the power to recommend vaccines (OR = 1.420 (1.996–1.012)). The results of this study demonstrated that training on vaccines and vaccine-preventable diseases has a positive effect on self-efficacy (p < .0001). This study can be considered of value as the first to demonstrate the beliefs and attitudes of family physicians in Turkey. Further training courses to increase knowledge of vaccines, vaccine-preventable diseases, and communication skills would be of benefit for family physicians

Prevalence of eating disorders in female university students and affecting factors

Amaç: Bu çalışmada Çukurova Üniversitesi'nde okuyan kadın öğrencilerde yeme bozukluğu boyutu ve yaygınlığının belirlenmesi ile yeme bozukluğunu etkileyen sosyodemografik ve ruhsal etkenlerin araştırılması amaçlanmıştır. Yöntem: Kesitsel tipteki bu çalışma, Çukurova Üniversitesi'nde öğrenim gören kadın öğrencilerde Kasım 2012Mayıs 2013 arasında yapılmıştır. Ulaşılması planlanan 668 öğrencinin 32'si (%4.7) devamsız olup toplam 636 öğrenci (%95.3) çalışmaya alınmıştır. Yüz yüze görüşme yöntemiyle, katılımcılara sosyodemografik özelliklerinin sorgulandığı anket, Yeme Tutum Testi (YTT), Beck Depresyon Ölçeği (BDÖ) ve Liebowitz Sosyal Kaygı Ölçeği (LSKÖ) uygulanmıştır. Anket katılımcılar tarafından doldurulduktan sonra kişilerin beden kitle indeksinin (BKİ) hesaplanabilmesi için boyları ve kiloları ölçülmüştür. Verilerin değerlendirilmesinde, gruplar arasında sayısal değişkenlerin karşılaştırmasında bağımsız gruplar arasında t-testi; kategorik değişkenlerin karşılaştırılmasında ki-kare testi kullanılmıştır. Bulgular: Katılımcıların yaş ortalaması 21.63±1.80 bulunmuştur. YTT kesme puanına göre katılımcıların %6.3'ünde yeme bozukluğu saptanmıştır. Kalabalık aileleri olanlarda yeme bozukluğu anlamlı olarak düşük bulunmuştur. Yeme bozukluğu bulunanlarda, bildirilen mevcut hastalık varlığı BKİ ve BDÖ puanları, yeme bozukluğu bulunmayanlardan anlamlı derecede yüksektir. LSKÖ puanları açısından ise yeme bozukluğu bulunanlar ve yeme bozukluğu bulunmayanlar arasında anlamlı fark yoktur. Sonuç: Üniversite öğrencilerinde yeme bozukluğu sık görülmektedir. Özellikle depresif belirtileri olan ve BKİ'si yüksek öğrencilerin yeme bozuklukları açısından risk altında oldukları akılda tutulmalıdır. (Anadolu Psikiyatri Derg 2016; 17(1):42-50)Objective: The purpose of this study is to determine the size and the prevalence of eating disordersamong thefemale students at the University of Çukurova and to evaluate the affecting sociodemographic and psychological factors. Methods: This cross-sectional was carried out among female students who study at Cukurova University between November 2012 and May 2013. While 668 students were planned to achieve, 32 (4.7%) of the students were absent, thus a total 636 students (95.3%) were included in the study. A questionnaire that queries sociodemographic characteristics, Eating Attitudes Test (EAT), the Beck Depression Inventory (BDI) and the Liebowitz Social Anxiety Scale (LSAS) were administered to the participants by face to face interview method. After the questionnaires completed, weight and height were measured to calculate the body mass index (BMI). In data evaluation, for comparisons of numerical variables t-test between independent groups; for comparisons of categorical variables chi-square test was used. Findings: The mean age of the participants was 21.63±1.80. According to the EAT cutoff scores 6.3% of the participants were found to have an eating disorder. Eating disorders were found to be significantly low in those who have crowded families. Preexisting disease existence, BMI and BDI scores of eating disorders were significantly higher than those without eating disorders. LSAS scores were not significantly different between students with or without eating disorders. Conclusion: Eating disorders are common in university students. It should be also kept in mind that students who have depressive symptoms and high BMI are at risk in terms of eating disorders. (Anatolian Journal of Psychiatry 2016; 17(1):42-50