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As the Syrian crisis has reached its 10th year, this paper explores posttraumatic growth and the related factors among Syrian refugees in Turkey, with the aim of having a better understanding of the predictors of PTG and the risk factors that may play a role in the inhibition of the growth. In this cross-sectional study, 217 displaced Syrian refugees completed the Post Traumatic Growth Inventory (PTGI), Harvard Trauma Questionnaire (HTQ), Brief COPE, General Self-Efficacy Scale (GSES), PTSD Checklist for DSM-5 (PCL-5), and sociodemographic information form by a self-reported online survey. Risk and protective factors were associated in bivariate analysis with growth p<0.05 and were retained in multiple regression models to control the confounders. Participants' 60.7% were females, and the mean age was 32.6± 9.4 years. Growth was found to be highest in the Personal Strengths, New Possibilities and Appreciation of Life, Relating to Others, and Spiritual Change. While the consistency of job education, economic status, education level, number of children, level of self-efficacy, level of Turkish, active coping style, religious coping, and self-distraction (p<0.05) were protective factors, the number of traumatic events, and the PTSD symptoms and self-blame were risk factors (p<0.05) in multiple analysis. However, no significant relationship was found for the variables of marital status, taking support, self-distraction, emotional and instrumental support, positive reframing, planning, cultural perception, working type, and age (p>0.05). In conclusion, the findings have provided valuable insight into the domains of the growth among Syrian refugees and discussed both clinical and research-based future recommendations that could be made to improve the mental health of the refugees based on the obtained results. [ABSTRACT FROM AUTHOR]

Background: Human communities suffered a vast socioeconomic burden in dealing with the pandemic of coronavirus disease 2019 (COVID-19) globally. Real-word data about these burdens can inform governments about evidence-based resource allocation and prioritization. The aim of this scoping review was to map the cost-of-illness (CoI) studies associated with COVID-19. Methods: This scoping review was conducted from January 2019 to December 2021. We searched cost-of-illness papers published in English within Web of Sciences, PubMed, Google Scholar, Scopus, Science Direct and ProQuest. For each eligible study, extracted data included country, publication year, study period, study design, epidemiological approach, costing method, cost type, cost identification, sensitivity analysis, estimated unit cost and national burden. All of the analyses were applied in Excel software. Results: 2352 records were found after the search strategy application, finally 28 articles met the inclusion criteria and were included in the review. Most of the studies were done in the United States, Turkey, and China. The prevalence-based approach was the most common in the studies, and most of studies also used Hospital Information System data (HIS). There were noticeable differences in the costing methods and the cost identification. The average cost of hospitalization per patient per day ranged from 101$ in Turkey to 2,364$ in the United States. Among the studies, 82.1% estimated particularly direct medical costs, 3.6% only indirect costs, and 14.3% both direct and indirect costs. Conclusion: The economic burden of COVID-19 varies from country to country. The majority of CoI studies estimated direct medical costs associated with COVID-19 and there is a paucity of evidence for direct non-medical, indirect, and intangible costs, which we recommend for future studies. To create homogeneity in CoI studies, we suggest researchers follow a conceptual framework and critical appraisal checklist of cost-of-illness (CoI) studies. [ABSTRACT FROM AUTHOR]

This paper aims to investigate the impact of the exchange rate on stock market indices of four main sectors in Turkey. For this purpose, the paper uses monthly data spanning the period between 06/2008-11/2020 and employs the panel GMM estimation method. This method instrumentalizes the past observation values of the dependent variable to control the endogeneity and provides efficient results. Considering that firms operating in many sectors in Turkey are affected by the volatility of the exchange rate, the paper takes initiative in understanding how stock market indices of four sectors react to the fluctuation in USD and Euro prices. This study contributes to the current literature, performing the panel GMM estimation method, unlike studies that only examine the causality relationship on the link between exchange rate and the stock market. The results show that there is unidirectional causality from the exchange rate to stock market indices. According to our findings, the USD/TRY exchange rate negatively affects stock market indices, and the Euro/TRY exchange rate positively affects stock market indices. The findings obtained from the analysis results confirm prior knowledge acquired from Turkey's foreign trade structure. [ABSTRACT FROM AUTHOR]

Background: Language has been well documented to be a key determinant of accessing healthcare. Most of the literature about language barrier in accessing healthcare is in the context of miscommunication. However, it is critical to consider the historical and political contexts and power dynamics underlying actions. The literature in this matter is short. In this paper we aimed to find out how first-language affects access to healthcare for people who do not speak the official language, with a particular focus on language oppression. Methods: We conducted this qualitative study based on patient-reported experiences of the Kurds in Turkey, which is a century-long oppressed population. We conducted 12 in-depth interviews (all ethnically Kurdish, non-Turkish speaking) in Şırnak, Turkey, in 2018–2019 using maximum variation strategy. We used Levesque's 'Patient-Centred Access to Healthcare' framework which addresses individual and structural dimensions to access. Results: We found that Kurds who do not speak the official language face multiple first-language related barriers in accessing healthcare. Poor access to health information, poor patient-provider relationship, delay in seeking health care, dependence on others in accessing healthcare, low adherence to treatments, dissatisfaction with services, and inability to follow health rights were main issues. As an unusual outcome, we discovered that the barrier processes in accessing healthcare are particularly complicated in the context of oppression and its internalization. Internalized oppression, as we found in our study, impairs access to healthcare with creating a sense of reluctance to seek healthcare, and impairs their individual and collective agency to struggle for change. Conclusions: A human-rights-based top-down policy shift, and a bottom-up community empowerment approach is needed. At the system level, official recognition of oppressed populations, acknowledgement of the determinants of their health; and incorporating their language in official capacities (particularly education and healthcare) is crucial. Interventions should include raising awareness among relevant professions and stakeholders that internalized oppression is an issue in accessing healthcare to be considered. Given that internalized oppression can be in other forms than language or ethnicity, future research aimed at examining other aspects of access to healthcare should pay a special attention to internalized oppression. [ABSTRACT FROM AUTHOR]

Objective: This study was carried out to determine the effect of self-management support given to patients diagnosed with hypertension on the hypertension knowledge level, treatment adherence and self-care management, and to examine the changes in patients' blood pressure after the self-management support. Background: The rise of chronic diseases such as hypertension necessitates the equipment of patients with sufficient knowledge and skills necessary to manage their disease and self-care. Methods: This randomised controlled research was conducted with a total of 137 patients, including 69 intervention and 68 control patients. Data were collected using the "Patient Information Form", "Hypertension Knowledge-Level Scale", "Hill-Bone Compliance to High Blood Pressure Therapy Scale" and "Self Care Management Process in Chronic Illness Scale" at the first interview and the last interview three months after the first interview. One week after the first interview, the patients in the intervention group received self-management support including information about hypertension and its management and blood pressure measurement skills. results: After self-management support, a significant improvement was found in hypertension knowledge level (p=0.000), treatment adherence (p=0.000), and self-care management (p=0.000) of patients in the intervention group A significant decrease was determined in systolic (p=0.000) and diastolic blood pressure (p=0.000) of patients in the intervention group. conclusion: Self-management support has shown positive effects in increasing hypertension knowledge level, adherence to hypertension treatment, self-care management, and blood pressure control in patients diagnosed with hypertension. This study also provides nurses with an approach in which they can effectively use training and counselling roles for patients. implications for research, policy, and practice: Patients diagnosed with hypertension should be educated by nurses about the disease. Nurses should teach the patients who are diagnosed with hypertension the ability to monitor their blood pressure at home. Cardiovascular rehabilitation nursing units should be established in hospitals to provide more effective self-management support to hypertensive patients. What is already known about the topic? * Education and support programs offered by nurses are important in controlling chronic diseases such as hypertension. * Guidelines for the management of arterial hypertension emphasise the importance of self-management support in controlling hypertension. What this paper adds * Self-management support is an effective approach to increasing hypertension knowledge level, adherence to treatment, and self-care management. * Self-management support helps patients to achieve blood pressure control and optimal blood pressure values. * Self-management support empowers patients by increasing their control over the disease. [ABSTRACT FROM AUTHOR]

Objective: The aim of the study was to determine views and experiences of intensive care unit nurses and patients on the issue of protecting patient privacy. Background: Intensive care should be delivered to protect the privacy of intensive care patients because these patients experience a loss of personal identity and significant limitations in physical activity and emotional expression. Intensive care patients may not be able to dress themselves; they may not communicate effectively without glasses and hearing aids; they cannot control the environment; they may not govern their actions, and they may not advocate for themselves. For these reasons, nurses should assume a primary role to protect patient privacy because they spend many hours with them and witness patients' loneliness, pain, and death as their primary caregivers. Study design and methods: This is a qualitative study using a phenomenological method with data gathered through interview. The study was conducted with nurses (n = 14) and patients (n = 14) in the intensive care units of a state hospital in a metropolitan city in Turkey between 12 March 2018 - 4 October 2019. Data were collected from nurses and patients using semi-structured interview forms. Content analysis revealed categories, themes, and sub-themes. We have followed the Consolidated criteria for reporting qualitative research (COREQ). Results: The categories explored in the study for both nurses and patients were the concepts of privacy, privacy protection and privacy violation. Some of the sub-themes were physical privacy, not sharing personal information, using screens or curtains, using aprons or sheets, insufficient number of nurses or excessive number of patients, and a lack of inspection and equipment. Conclusion: This study shows that the acquired information and the awareness of privacy, protection of privacy, and violations of privacy were adequate among both nurses and patients. Some of the nurses in the study stated that institution-related violations occurred because of the inadequate numbers of nurses to provide care to an exceedingly large number of patients. The implications for research, policy, and practice: Increasing awareness of nurses and patients on patients' rights and protection of privacy and violations of privacy and taking adequate measures to protect patient privacy increase both patient satisfaction and service quality in health. What is already known about the topic? * Privacy is a fundamental human right. * Protection of patient privacy is the responsibility of healthcare professionals. What this paper adds: * The awareness of patient rights for privacy and privacy protection has been well established among patients and nurses, and both participating patients and nurses were knowledgeable of respective privacy violations. * Institution-related factors such as the insufficient numbers of nurses, exceedingly large numbers of patients, problems with the main door access control systems in intensive care units, and the provision of care in smaller units than optimum ones are significant factors involved in the privacy violations of patients. * Patients were reluctant to report privacy violations because they believed this could negatively affect their treatment and care. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the treatment patterns and associated clinical outcomes in Type 2 diabetes (T2D) patients initiating a second-line glucose-lowering therapy. Material and Methods: This paper presents a preliminary subgroup analysis of the baseline data collected from 536 patients [mean (standard deviation) age: 55.1 (10.0) years, 50.2% were males] in the Turkey arm of global observational DISCOVER study among T2D patients initiating second-line glucose-lowering therapy. Patient demographics, disease (duration, complications) and treatment (type of regimens, modifications) characteristics, hemoglobin A1c (HbA1c), low-density lipoprotein-cholesterol (LDL-C), and systolic blood pressure (BP) target achievement rates and the patient-reported outcomes were recorded at the initiation of second-line therapy. Results: Overall, 11.7% of patients were HbA1c target of <7% at baseline, 62.5% were systolic BP target of <140 mmHg and 21.2% were LDL-C target of <100 mg/dL. Major and minor hypoglycemic events were noted in 5.5% and 10.7% of patients, while macro and microvascular complications in 17.2% and 20.1% of patients, respectively. Metformin monotherapy (47.9%) and metformin+sulfonylurea combination (22.6%) were the two most common first-line therapies. However, insulin (32.3%) was the most commonly prescribed second-line agent. Lifestyle assessment revealed a healthy lifestyle in 50.7% of patients. Conclusion: Our finding revealed a failure to achieve HbA1c, LDL-C, and systolic BP targets and a high rate of diabetes-related complications before initiation of second-line therapy in a significant proportion of Turkish T2D patients. Thus, emphasizing a need for more aggressive risk factor screening and modification at early disease stages and earlier treatment intensification among T2D patients. [ABSTRACT FROM AUTHOR]