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This study, it was aimed to determine the need for disease management in diabetes in Turkey and to reveal the recommendations for diabetes disease management policies as part of the identified needs. In this study, the research design was planned as a case study and, the snowball sampling method was used as part of the scope of qualitative research. A total of 21 individuals, 6 doctors, 3 diabetic nurses, 6 academics, and 6 adult diabetics were actualized using semi-structured forms with a thorough interview technique. The data collected were evaluated with descriptive analysis and content analysis methods. In the analysis of the data, the “Nvivo 12. Program” was used. The findings were discussed based on the relevant literature, and conclusions and recommendations were reached in line with the research purposes. The participants stated that the practices related to disease management in diabetes have improved compared to the past, but that the development process should continue. The participants stated that there is a need for a multidisciplinary systematic process structuring that will prioritize the patient and their needs and that will help patients to live their lives healthy and free from complications. In terms of the burden of disease, diabetes is a significant issue that affects both Turkey and the rest of the world. We propose that the health policy, health service delivery, health system structure, and multidisciplinary work related to the disease management approach in diabetes in Turkey should be determined and steps should be taken to improve it.

Coronavirus disease 2019 or COVID-19 caused by novel coronavirus/severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2 or 2019-nCoV) is an ongoing pandemic that has emerging global effects and requires rapid and reliable diagnostic testing. Quantitative reverse transcription-polymerase chain reaction (q-RT-PCR) is the gold standard method for SARS-CoV-2 detections. On the other hand, new approaches remedy the diagnosis difficulties gradually. Reverse transcription loop-mediated isothermal amplification (RT-LAMP) as one of these novel approaches may also contribute to faster and cheaper field-based testing. The present study was designed to evaluate this rapid screening diagnostic test that can give results in 30-45 min and to compare the effectiveness of LAMP to the q-RT-PCR. The 30 randomly chosen patient samples were generated by nasopharyngeal swabs with a portion of the SARS-CoV-2 nucleic sequence. The sample of quantification cycle (Cq) values was tested using RT-LAMP as well as by conventional q-RT-PCR. The patient samples were tested with four different kits (SENSObiz COVID-19 [SARS-CoV-2] LAMP Assay, the QIAseq DIRECT SARS-CoV-2 kit, Biospeedy SARS-CoV-2 Variant Plus kit, and CoVirion-CV19-2 SARS-CoV-2 OneStep RT-PCR kit) and two different PCR devices (GDS Rotor-Gene Q Thermocycler and Inovia Technologies GenX series). Based on 30 patient samples, the positive/negative ratio (P/N) was 30/0 as Biospeedy and Covirion (positivity 100%), 28/2 as Qiagen kit (positivity 93.3%) for the samples studied on the Inovia device while the same samples on the Rotor-Gene device were 30/0 as Biospeedy and Covirion (positivity 100%), 29/1 as Qiagen kit at the first day (96.7%). On the fifth day, the samples were studied in the Inovia device and the respective results were obtained: 27/3 as Biospeedy (positivity 90%), 16/14 as Qiagen (positivity 53.3%), 28/2 as Covirion kit (positivity 93.3%). When these samples were studied in the Rotor-Gene device, it was 29/1 in Biospeedy and Covirion (positivity 96.7%), 19/11 in the Qiagen kit (positivity 63.3%). When these samples were compared with the LAMP method it was found to be 19/11 (positivity 63.3%) on the first day and 18/12 (positivity 60%) on the fifth day. SARS-CoV-2 test studies will contribute to a proactive approach to the development of rapid diagnosis systems. The LAMP approach presents promising results to monitor exposed individuals and also improves screening efforts in potential ports of entry.

It has been reported that the tensions, incoordination and incompatibility between the central and local government, and the disconnection in the institutional capacity in the fight against the COVID-19 epidemic, adversely affected the epidemic management. This study was carried out to evaluate the centralization and decentralization practices in the management of the COVID-19 health crisis in the world within the scope of the literature. With the spread of COVID-19 around the world in 2020, most governments have had to take drastic central measures to reduce the spread of the virus. It was emphasized that the measures taken in most countries in the early stages of the epidemic were not taken in coordination with the local units, causing incompatibilities with the local. As of 2021, due to the different experiences of the local effects of the epidemic during the pandemic process, it has been observed that the measures applied in the countries against the epidemic differ according to the local and regions. Ensuring that coordination and harmony between central government and local government/units are important that is explained by the fact that the local effects of the epidemic are different (infection rate, population density, effectiveness of the measures taken, etc.). During the COVID-19 process, it has been observed that countries have different centralization and decentralization practices suitable for their own conditions. It is reported that the simultaneous and complementary coordination of centralization and decentralization in governance in COVID-19 and similar crises will prevent complexity at management levels and positively affect the effective management of the crisis.

COVID-19 is a devastating disease, and its control is difficult due to its high transmissibility rate and a long incubation average period (6.4 days). Additionally, more than half of the infected patients were asymptomatic young people or children. The asymptomatic virus transmission is the actual challenge to controlling the disease. Because of limited treatment options, diagnosis techniques have been the first focus all over the world, involving q-RT-PCR as a gold standard, serological tests, point of care studies, or RT-LAMP. Generally, nasopharyngeal, and oropharyngeal samples are preferred clinically as sources. However, alternative sources are being researched, particularly for healthcare professionals who have difficulty taking samples, patients who are afraid of giving samples, and pediatric patients. Herein, physiological saline has been utilized to offer an alternative source besides the swab samples for use in q-RT-PCR. In this study, 212 randomly chosen patients' samples were studied, and we evaluated the concordance and accurate q-RT-PCR results in two different sources, obtained from swab and gargle samples of patients. Herein, physiological saline is utilized, which is widely used medically as a recommended irrigating and wound dressing solution. We obtained in our experiments with this method, the confidence interval determines 74.50% positivity when compared to the routine q-RT-PCR procedure as summarized. In addition, when only the gargle sampling method is studied in low-income countries, the cost of testing for COVID-19 will decrease significantly. Because this method does not require vNAT or VTM transport solution sterile swab sticks as shown. The plastic container with a lid in which the patient can gargle with SF and spit it out is an ideal method for this. Additionally, it provides a great cost-benefit in low-income countries. Private Viromed Istanbul Central Laboratory; Imaging Center, Istanbul, Turkey This study was supported by the Private Viromed Istanbul Central Laboratory and Imaging Center, Istanbul, Turkey.

Human papilloma virus infection (HPV) is the most common sexually transmitted disease. It may increase the risk of several cancers, including those of the cervix, vulva, vagina, head and neck. HPV is usually transmitted during sexual intercourse; there are limited data about sexual dysfunction (SD) after infection with this virus. We aimed to measure the incidence of SD in women with HPV. In this study, we evaluated 67 HPV-infected female patients and 66 healthy controls. The Arizona Sexual Experience Scale (ASEX), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI) and Socio Demographic Form were used for evaluation. Gynaecologists and psychiatrists evaluated the participants. Women with HPV were found to have significantly higher Arizona Sexual Experience Scale (ASEX) total scores and ASEX sub scores than the control group in the domains of sexual desire, arousal, genital response, orgasmic experience and their satisfaction from orgasm (p ≤ .05). The study group shows a statistically significant difference in the Beck Depression Inventory (BDI), but Beck Anxiety Inventory (BAI) scores show no significant differences between the experimental and control groups. Our study shows that HPV positivity in female patients is associated with a significant impairment in sexual function and that this impairment is not related to depression or anxiety. Impact statement What is already known on this subject? There are only a few studies concerned with sexual dysfunction in HPV patients. These studies have methodological problems, as they do not rule out the effect of depression on sexual dysfunction. It is very difficult to perform studies on sexual dysfunction and sexually transmitted diseases, because both physicians and patients are reluctant to talk about sexual problems. In the present study, only 6 out of 15 physicians accepted to contribute to the study. Although the physicians gave a questionnaire to more than 400 patients, only 133 of them completed that questionnaire. The most important difficulties in this study was to find enough patients. What do the results of this study add? Depression and sexual dysfunction are frequently seen in HPV patients. Although depression is one of the most common causes of sexual dysfunction, an HPV infection may lead to sexual dysfunction even in the patients without depression. What are the implications of these findings for clinical practice and/or further research? HPV infections may be associated with mental health problems and sexual dysfunction. The gynaecologists and other clinicians working with HPV patients should also evaluate patients psychologically and refer patients to psychiatry if required. The psychiatric problems associated with an HPV infection do not only impair sexual functions, but also may lead to difficulties in social life.

Turkey is the country that hosts most migrants worldwide. Although migrants are a risk group for alcohol and substance addiction (ASA), literature is limited. This study aims to explore and identify the present state and influencing factors of ASA among Syrian migrants in Turkey by integrating perspectives of addicts, their relatives, and local and national institutions. This qualitative study was designed by the grounded theory approach and took place in 5 cities in Turkey between 2018 and 2019. It is composed of 4 focus group discussions with 77 informants from local governmental, non-governmental, and academic organizations; 11 key person interviews with heads of national organizations; and in-depth interviews with 45 addicted Syrian migrants and 21 relatives. Themes that emerged from the data are characteristics of addicted migrants, types of addictions, predisposing and exacerbating factors, preventing factors, obtaining alcohol and substances, manners of use, consequences of use, public services and utilization of them, and the experiences of addicted migrants. The findings of this study provide guidance for future research and policies. Addicted migrants have awareness and motivation to quit but face many environmental barriers. Activities of institutions in Turkey on ASA in Syrian migrants are insufficient. Specific, well-coordinated action is needed. It should also utilize Syrian human resources. Turkish Green Crescent Society

Bu calismada saglik sektorundeki bir meslek grubu ele alinmis; is tanimlari geregi kayit islemlerini gerceklestiren calisanlarin stres karsisinda iletisim becerilerinin ne yonde etkilendiginin tespiti amaclanmistir. Bu calismada Ersanli ve Balci (1998) tarafindan gelistirilen “Iletisim Envanteri” ile Lovibond ve Lovibond (1995) tarafindan gelistirilen “DAS, Depresyon, Anksiyete, Stres” olcegi birlestirilerek; duygusal, zihinsel ve davranissal olarak tanimlayabilecegimiz iletisim becerilerinin hangisinin depresyon, anksiyete ve stres faktorlerinden ne oranda etkilendigi tespit edilmeye calisilmistir. Sonuc olarak iletisim becerileri olceginin duygusal ve davranissal boyutlarinda, egitim seviyesi acisindan %5 anlamlilik duzeyinde istatistiksel olarak anlamli farklilik gozlemlenmistir. Iletisim becerileri olceginin zihinsel iletisim becerisi boyutunda, cinsiyete gore istatistiksel olarak %5 anlamlilik duzeyinde bir farklilik gozlemlenmistir. Iletisim becerileri olceginin duygusal boyutu ile DAS olceginin her uc boyutu arasinda negatif yonlu ve %1 anlamlilik duzeyinde istatistiksel olarak anlamli bir iliski oldugu soylenilebilir.

Objective: This study was planned as a community-based research study to estimate the prevalence of osteoporosis and explore related risk factors in the Thrace region of Turkey. Material and Methods: The community-based study involved a total of 620 people, 498 women and 122 men, aged between 40 and 89 years. A questionnaire on the medical history and lifestyles of the participants was applied with a face-to-face interview. Body weight height, and arm span of each participant were measured, together with bone mineral density at the middle phalanges of the second, third, and fourth digits of the non-dominant hand using dual-energy X-ray laser absorptiometry. Results: Age, clothing, lack of regular exercise, and giving birth to more than two children seem to contribute to osteoporosis, while high education, high economic level, tea and moderate alcohol consumption, oral contraceptive use, and hormone replacement therapy seem to retard osteoporosis. Osteoporotic patients had more fractures in the past. Height and weight were significantly lower in osteoporotic women. Conclusion: Lifestyle affects the prevalence of osteoporosis. Drinking tea and alcohol seems to be controversial with regard to osteoporosis risk.

Bu calismanin amaci, (Dunya Saglik Orgutu) WHO tarafindan belirlenen temel saglik harcamasi gostergeleri cercevesinde, Turkiye ve diger AB uyesi-aday ulke konumundaki ulkelerin grafiksel duzlemde gosteriminin saglanarak alt gruplara ayrilmasi, aralarinda var olabilecek benzerlik ve farkliliklarin ortaya konulmasi ve ulkemizin genel egilime gore konumunun tespitinin yapilmasidir. Dunya Saglik Orgutu’nun aciklamis oldugu raporlardan ve istatistiklerden elde edilen veriler 28 ulke icin toplanmis ve ilgili veriler Cok Boyutlu Olcekleme (Multidimensional Scaling- MDS ) yontemi ile analiz edilmistir. MDS analizi sonucunda ulkelerin amaca uygun sekilde iki grup altinda toplandiklari gorulmustur. Yapilan analiz sonucunda birinci boyutta Avusturya, Danimarka, Fransa, Almanya, Luksemburg ve Hollanda analiz kapsamina alinan saglik harcamasi gostergeleri bakimindan benzer ulkelerdir ve bir alt grup olarak dusunulebilirler. Ayrica birinci boyutta Turkiye, Bulgaristan, Estonya, Letonya, Polonya, Romanya ve Makedonya’nin benzer ulke olarak algilandiklari tespit edilmistir. Saglik harcamalari acisindan Turkiye’nin en benzer oldugu ulkelerin Polonya ve Romanya oldugu gorulmustur. Yirmi sekiz Avrupa ulkesi arasinda saglik harcamasi gostergeleri bakimindan Hollanda ve Kibris birbirine en benzemez ulkelerdir. Farklilik matrisine gore Turkiye’nin saglik harcamalari acisindan en farkli oldugu ulkelerin ise Avusturya, Belcika, Kibris, Danimarka, Fransa, Almanya, Irlanda, Isvec oldugu tespit edilmistir. Kisi basina toplam saglik harcamasi duzeyi, ulusal saglik harcamasinin Gayri Safi Milli Hasila (GSMH)’daki payi, kisi basina toplam kamu saglik harcamasi duzeyi ve genel kamu harcamalari icinde kamu saglik harcamalarinin payi gibi gostergelerde Turkiye’nin gelismis Avrupa ulkelerinden geride oldugu gorulmustur.

AMAÇ: Profesyonellik, mesleki değerleri ve bağlılığı vurgulayan bir kavramdır. Mesleki profesyonellik ise mesleğin standartlarının oluşturulmasında ve kaliteli bakım sunulmasında yer alan önemli bir olgudur. Bu çalışma, Türkiye'de hemşirelik mesleğinin profesyonelleşmesi ve Avrupa Birliği (AB)'ne uyum sürecinde hemşirelikte profesyonelleşmeyi değerlendirmek amacıyla yapılmıştır.YÖNTEM: Araştırma niteliksel bir çalışma olup, amaçlı örnekleme yöntemi kullanılmıştır. Araştırmanın çalışma grubunu, Türkiye'deki üniversitelerin hemşirelik bölümlerinden öğretim üyeleri, hastanelerin hemşirelik hizmetleri müdürleri ve AB konusunda uzman toplam 15 kişi oluşturmuştur. Veriler, yarı yapılandırılmış derinlemesine görüşme yöntemiyle toplanmıştır. BULGULAR: Türkiye'de hemşireliğin henüz profesyonellik ölçütlerine göre bir meslek olarak kabul edilmediği belirlendi. Mesleki eğitim düzeyindeki çeşitlilik, istihdam tiplerinde görülen farklılıklar, mesleki otonomi ve örgütlenme düzeylerinin düşüklüğü mesleğin profesyonelleşme sürecindeki temel sorunları olduğu ve AB ölçütlerinin, itici bir güç olarak hemşirelik mesleğindeki profesyonelleşmenin gelişmesi adına olumlu olacağı saptandı. Çalışmanın verileri; hemşirelikte profesyonelleşmeye ilişkin değerlendirme, hemşirelikte profesyonelleşmeye ilişkin ölçütleri değerlendirme ve AB ye uyum sürecinde hemşireliğin durumu olmak üzere üç tema altında toplanmıştır. SONUÇ: Sonuç olarak, Türkiye'de hemşirelik mesleğinin profesyonellik sürecinin hala devam ettiği ve AB ye uyum standartlarının bu süreci hızlandırma adına itici güç olacağı ortaya konmuştur., AIM: Professionalism is a concept that emphasizes occupational values and commitment. Occupational professionalism is a significant phenomenon which has roles in establishing the standards of the occupation and providing high quality care. This study was conducted with the purpose of evaluation of professionalization of the occupation of nursing in Turkey and within the frame of the harmonization process to the European Union (EU). METHODS: While the study is a qualitative one, purposive sampling was used. Study group of the research consisted of total 15 individuals consisting of faculty members from nursing departments of universities in Turkey, nursing service managers of hospitals and EU experts. The data were collected using the semi-structured in-depth interview method. RESULTS: It was determined that nursing is not yet accepted as an occupation in Turkey based on criteria of professionalism. Fundamental problems in professionalization of the occupation are the variety of occupational education levels, differences seen in types of employment, and low levels of occupational autonomy and organization, and EU criteria will have positive effects as a driving force on the development of professionalization in the occupation of nursing. The study's data were collected under three themes: evaluation of professionalization in nursing, evaluation of the criteria for professionalization in nursing and situation of nursing in the EU harmonization process. CONCLUSION: In conclusion, it was established that the professionalization process of the nursing profession is still in progress in Turkey, and EU harmonization standards will be a driving force to accelerate this progress.