STANDARDIZATION OF THE NUMBERS OF WORK ACCIDENTS, OCCUPATIONAL DISEASES AND MORTALITY RATES ACCORDING TO SOCIAL SECURITY INSTITUTION'S 2010-2015 YEARS DATA BASED UPON CITIES

Objective: To evaluate Turkey according to the number of work accidents, occupational diseases and related mortality rates, insured workers, establishments and cities, which are important issues in terms of showing countries' situation

Qualitative evaluation of reasons for healthcare professionals being unvaccinated against COVID-19

© 2023, The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.Background and Aim: The importance of immunization has increased even more during the pandemic. This study aimed to evaluate the reasons for healthcare professionals not being vaccinated against COVID-19 and to develop solutions for the causes. Subject and Methods: This qualitative study was carried out with in-depth interviews between July 2021 and October 2021, with 32 healthcare professionals and five key people who had never been vaccinated against COVID-19. Results: The most common reasons that healthcare professionals were not vaccinated against COVID-19 were concerns about vaccine side effects, believing that the vaccine is not effective, distrust of the vaccine content and COVID-19 treatment methods, the rapid production of the vaccine, the fact that the vaccine is produced with a new technology, thinking that the vaccine is not the definitive solution, seeing themselves as healthy and young, and the belief that they would have a mild case of the disease and recover. The main themes were COVID-19 vaccine-related reasons, individual reasons/group effects, contextual reasons, and vaccination-related general issues. The main sub-themes were vaccine production, distrust, risk perception, policies and infodemic. Conclusion: It has been seen that the uncertainty, infodemic, and insecurity that emerged especially during the pandemic period are related to each other. As knowledge and awareness about the disease increase, there is an increase in risk perception. For this reason, social information studies should be increased and physicians should be enabled to use media tools more effectively

Comparison of Incidence and Clinical Outcomes of COVID-19 among Healthcare Workers in the Pre- vaccination and Post-vaccination Periods: A Real-world Impact Study

Aim: Real-life data on the effect of coronavirus disease-2019 (COVID-19) vaccination is limited. We aimed to compare the incidence of COVID-19 among healthcare workers (HCWs) in the pre-vaccination and post-vaccination periods during the COVID-19 pandemic and identify associated factors for COVID-19 development.Methods: In this single-center and cross-sectional study, HCWs employed in a tertiary care hospital were included. Pre-vaccination (14 October, 2020 and 14 January, 2021) and post-vaccination periods (1 March, 2021 and 1 June, 2021) were compared. A subgroup analysis was performed on HCWs without a previous history of COVID-19. Additionally, univariate regression analysis of COVID-19 development in the post-vaccination period was performed.Results: Of 2,922 HCWs, 2,096 (71.7%) were vaccinated. The incidence of COVID-19 was higher in the pre-vaccination period (16.3%) than in the post-vaccination (6.6%) (p<0.01). In the subgroup analysis, the incidence of COVID-19 was 16.6% in the pre-vaccination period and 8.1% in the post-vaccination period (p<0.01). Previous history of COVID-19 (p<0.01) and double-dose vaccination (p<0.01) were associated with a decreased risk of COVID-19 development.Conclusion: This study demonstrates the real-life impact of COVID-19 vaccination in reducing disease development and preventing poor clinical outcomes in a setting where the vaccination rate among HCWs was fairly low

INDEPENDENT PROGNOSTIC INDICATORS IN THE ELDERLY WITH PNEUMONIA: A SINGLE-CENTRE PROSPECTIVE OBSERVATIONAL STUDY

Background: The goal of this study was to identify and investigate the indicators of a poor prognosis in the elderly with pneumonia

Evaluation of Sharp and Needle-stick Injuries in A Tertiary Care Hospital: A Two-year Analytical Cross-sectional Study

Aim:Healthcare workers are at risk of infections due to needle-stick and sharp injuries (NSSIs) and through contact with blood and contaminated body fluids. This study aimed to investigate NSSIs and associated factors in healthcare workers.Methods:This single-center analytical cross-sectional study included healthcare workers who were admitted to “the Hospital Infections Control Committee” following NSSIs at University of Health Sciences Turkey, Istanbul Haseki Training and Research Hospital, between January 1, 2020, and December 31, 2021. Demographic and epidemiological data, serological tests, and routine follow-up results were retrospectively collected from NSSI surveillance. Healthcare workers were divided into two groups according to the occurrence of stab wounds (injury or no injury). The age, sex, occupation, and working area of healthcare workers were compared.Results:A total of 232 (7%) experienced NSSIs among 3,312 healthcare workers. The NSSI was 35.0 [confidence interval (CI)=34.9- 35.2] per 1000 person-years. Needle-stick and sharp injuries were most frequently observed in nurses (n=148, 63.8%). Nurses [odds ratio (OR)=5.97, CI=4.51-7.90, p<0.001], cleaning staff (OR=1.64, CI=1.13-2.37, p=0.009), medical waste personnel (OR=10.79, CI=2.88-40.46, p<0.001), and medical technicians/technologists (OR=1.92, CI=1.03-3.57, p=0.039) were at increased risk for NSSIs.Conclusion:This study highlights the need for assigning sufficient healthcare workers, prioritizing vaccination programs for high-risk groups, and providing regular hands-on training as crucial measures to prevent injuries

Risk factors for development of vancomycin-resistant enterococcal bacteremia among VRE colonizers A retrospective case control study

Aims We aimed to determine the proportion of vancomycin-resistant enterococci (VRE) colonized patients among all inpatients who later developed VRE bacteremia during hospital stay and to identify the risk factors for VRE bacteremia at a tertiary hospital. Material and methods Patients with positive rectal screening or any clinically significant positive culture results for VRE were included in 1-year follow-up. Colonization with VRE was defined as a positive culture (rectal, stool, urinary) for VRE without infection and VRE bacteremia was defined as positive blood culture if the signs and symptoms were compatible with infection. To determine the risk factors for VRE bacteremia among VRE colonized patients, a retrospective case control study was performed. The two groups were compared in terms of variables previously defined as risk factors in the literature. Results Of 947 positive samples, 17 VRE bacteremia were included in the analysis. Cephalosporin use for more than 3 days within 3 months was a significant risk factor for bacteremia (p= 0.008). Prior use of carbapenems was found to be statistically significant for bacteremia (p= 0.007). In multivariate analyses the use of carbapenems and cephalosporins was an independent risk factor for developing bacteremia among VRE colonizers (odds ratio, OR, 6.67; 95% confidence interval, CI, 1.30-34;p= 0.022 and OR 4.32, 95% CI 1.23-15;p= 0.022,respectively). Conclusion A VRE colonization in patients receiving broad-spectrum beta-lactam antibiotics including carbapenems and cephalosporins may result in bacteremia. It is possible to keep mortality at very low levels in VRE bacteremia with effective infection control measures, rapid infectious diseases consultation and rational antimicrobial treatment based on current epidemiological data

Casebook for Advocacy in Public Health

The Global Charter for Public’s Healthhighlights advocacy as a key function of public health. However, in many countries the study, teaching, and application of advocacy to improve population health remains neglected. Increasing the capacity for advocacy can have many positive effects on population health such as stimulating the development of health policies in public and private sectors or prioritizing public health efforts higher in political agendas globally through public health evidence based research on advocacy. The Casebook on Advocacy in Public Health serves as a tool for national public health associations and other actors to improve their capacity of influence on national public health policies through advocacy efforts.The Casebook establishes what is public health advocacy and emphasizes the importance of advocacy as an essential public health function by bringing together 18 cases of public health advocacy from different corners of the world. It covers a range of public health topics from tackling climate change at a global level to improving the conditions in African prisons with investigative journalism and strategic litigation. Additionally, by drawing on the similarities and differences of the various experiences included in the casebook, key issues such as gender equity, discrimination, and investment in wellbeing and health equity are raised and advocacy is highlighted as an essential public health tool to tackle these issues.Ultimately, the Casebook aims to increase knowledge and the capacity to develop and implement advocacy strategies to improve population health at local, regional, national and international levels, as well as inspire the development of curricula and other training materials to strengthen advocacy efforts by supporting instruction, debate, dialogue and action

The effect of liver test abnormalities on the prognosis of COVID-19

Introduction: COVID-19 caused by the SARS-CoV-2 continues to spread rapidly across the world. In our study, we aim to investigate the relationship between the liver enzymes on admission (AST, ALT, ALP, GGT) and severity of COVID-19. We evaluated course of disease, hospital stay, liver damage and mortality. Materials and methods: Our study included 614 patients who were hospitalized with the diagnosis of COVID-19 between 03.16.20 and 05.12.20. Patients with liver disease, hematological and solid organ malignancy with liver metastases were excluded, resulting in 554 patients who met our inclusion criteria. We retrospectively evaluated liver transaminase levels, AST/ALT ratio, cholestatic enzyme levels and R ratio during hospital admission and these were compared in terms of morbidity, mortality and clinical course. Results: Mean age of 554 subjects were 66.21 ± 15.45 years, 328 (59.2%) were men. The mean values of liver enzymes on admission were AST (36.2 ± 33.6 U/L), ALT (34.01 ± 49.34 U/L), ALP (78.8 ± 46.86 U/L), GGT (46.25 ± 60.05 U/L). Mortality rate and need for intensive care unit were statistically significant in subjects that had high ALT–AST levels during their admission to the hospital (p = 0.001). According to the ROC analysis AST/ALT ratio was a good marker of mortality risk (AUC = 0.713: p = 0.001) and expected probability of intensive care unit admission (AUC = 0.636: p = 0.001). R ratio, which was used to evaluate prognosis, showed a poor prognosis rate of 26.5% in the cholestatic injury group, 36.1% in the mixed pattern group and 30% in the hepato-cellular injury group (p 0.001). Conclusions: ALT–AST elevation and AST/ALT ratio >1 was associated with more severe course and increased mortality in COVID-19

Evaluation of clinical outcomes of vaccinated and unvaccinated patients with hospitalization for COVID-19

We aimed to compare vaccinated and unvaccinated patients hospitalized with COVID-19 in terms of disease severity, need for intensive care unit (ICU) admission, and death. In addition, we determined the factors affecting the COVID-19 severity in vaccinated patients. Patients aged 18-65 years who were hospitalized for COVID-19 between September and December 2021 were retrospectively analyzed in three groups: unvaccinated, partially vaccinated, and fully vaccinated. A total of 854 patients were included. Mean age was 47.9 +/- 10.6 years, 474 patients (55.5%) were male. Of these, 230 patients (26.9%) were fully vaccinated, 97 (11.3%) were partially vaccinated, and 527 (61.7%) were unvaccinated. Of the fully vaccinated patients, 67% (n 5 153) were vaccinated with CoronaVac and 33% (n 5 77) were vaccinated with Pfizer-BioNTech. All patients (n 5 97) with a single dose were vaccinated with Pfizer-BioNTech. One hundred thirteen (13.2%) patients were transferred to ICU. A hundred (11.7%) patients were intubated and 77 (9.0%) patients died. Advanced age (P 5 0.028, 95% CI 5 1.00-1.07, OR 5 1.038) and higher Charlson Comorbidity Index (CCI) (P 3 (19.1 vs 5.8%, P < 0.01, OR 5 3.7). Therefore, the booster vaccine especially in individuals with comorbidities should not be delayed, since the survival expectation is low in patients with a high comorbidity index