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Objective: Burnout negatively affects personal well-being by reducing job-related satisfaction besides deeply affecting physician lives outside the working environment. This study aimed to determine residents’ burnout levels and related psychosocial risk factors regarding the work and educational environment during the COVID-19 pandemic at a university hospital. Material and Method: Data were collected using an online questionnaire consisting of questions screening the participants’ sociodemographic, clinical and, educational characteristics and the following scales; Postgraduate Hospital Educational Environment Measure (PHEEM), Maslach Burnout Inventory (MBI), Rosenberg Self Esteem Scale (RSES). Results: Of the 632 residents receiving postgraduate education in clinical fields at the university, 99 (15.7%) participated in study, 77 (77.8%) of which reported that they were from medical branches and 12 (12.1%) from surgical branches.The emotional exhaustion (EE) dimension of burnout emerged as the most strongly related dimension with perceptions of the educational environment (PHEEM) (p

Civa halk sagligi acisindan endise olusturan kimyasallardan biri olan bir agir metaldir. Cevreye dogal ve insan kaynakli aktiviteler kaynakli yayilmaktadir. Komurlu termik santraller gibi enerji tesisleri, isinma amacli komur kullanimi, atik yakma ve metal madenciligi, hurda metal isleme gibi islemler, civanin cevrede bulunmasina neden olan insan kaynakli aktivitelerdir. Civa maruz kalimi onemli saglik etkilerine neden olmaktadir. Olusan saglik etkileri maruz kalinan civanin turune, maruz kalinan doza, maruz kalan kisinin yasina ve gelisimsel durumuna, maruz kalim suresine ve maruz kalim yoluna gore degiskenlik gostermektedir. Civa bircok olumsuz saglik etkisine, ozellikle de bobrek toksisitesine ve norotoksik etkilere sahiptir. Bu yazida agirlikli olarak cevresel maruz kalimlar olmak uzere civa maruz kalimi ve saglik etkileri incelenmektedir.

Purpose: The aim of this study was to determine the level of electromagnetic fields in houses and the symptoms of residents near high power lines. Materials and Methods: For this purpose, in this descriptive study, electromagnetic fields levels were measured in 74 residences close to high power lines and some symptoms of 141 adults living in these houses were evaluated with a questionare. Results: Electromagnetic field average in homes was 2,18 ± 1,25 mG and 41,9 of them were between first and third floor. The balconies of the houses had the highest electromagnetic field averages. 50,4% of the participants were male and 66,4% were over 50 years old. There was a statistically significant and negative correlation between the electromagnetic field level in the houses and the distance to the high voltage line. No significant difference was found between the frequency of the symptoms and total number of symptoms and the level of electromagnetic field measured at home.Conclusion: Electromagnetic fields cause various health concerns and studies about health impacts should be increased. The results of this descriptive study show that different evaluation approaches will be useful., Amaç: Bu çalışmanın amacı yüksek gerilim hattı yakınında bulunan evlerde elektromanyetik alan düzeylerinin ve bu evlerde yaşayanlarda bazı semptomların varlığının belirlenmesidir. Gereç ve Yöntem: Bu amaçla bu tanımlayıcı çalışmada Ankara’da, yakınında yüksek gerilim hattı bulunan 74 evde ve evin bulunduğu binanın çevresinde elektromanyetik alan ölçümü yapılmış ve bu evlerde yaşayan 18 yaş üstü 141 kişiye sağlık durumlarının ve semptomların değerlendirildiği bir anket uygulanmıştır. Bulgular: Evlerde elektromanyetik alan ortalaması 2,18 ±1,25 mG olarak saptanmıştır, %41,9’u 1-3. kattadır. Evlerin balkonları elektromanyetik alan ortalamalarının en fazla olduğu alanlar olmuştur. Katılımcıların %50,4’ü erkek, %%66,4’ü 50 yaş üstündeydi. Evlerdeki elektromanyetik alan düzeyi ile yüksek gerilim hattına uzaklık arasında istatistiksel olarak anlamlı ve negatif bir korelasyon belirlenmiştir. Sorgulanan semptom sıklığı ve toplam semptom sayısı ile evde ölçülen elektromanyetik alan düzeyleri arsında anlamlı farklılık bulunamadı. Sonuç: Elektromanyetik alanlar sağlıkla ilgili çeşitli endişelere neden olmaktadır. Bu alanda sağlık etkileri ile ilgili çalışmalar artırılmalıdır. Bu tanımlayıcı çalışmanın sonuçları farklı değerlendirme yaklaşımlarının ortaya konulmasının yararlı olacağını göstermektedir.

Günümüzde geleneksel iletişim araçlarının yavaş yavaşönemini kaybettiği onun yerine dijital ortamlarda kendini gösteren ve her geçengün yaygınlaşan sosyal medya mecralarının insanların hayatında yer aldığınaşahit oluyoruz. Sosyal medya ortamları sadece kişilerin değil ama aynı zamandakurumların da yapılanmalarında etkisini göstermekte, kurumsal iletişimingelişmesinde önemli bir enstrüman olarak karşımıza çıkmaktadır. Çalışmamızın dakonusu olan ve halka en yakın kurumlardan birisi olan belediyelerin hizmetlerinintanıtımında, vatandaşların talepleri, beklentileri, memnuniyet ya damemnuniyetsizlikleri gibi nedenlerle çalışmalarında kurumsal iletişime ağırlıkverdikleri görülmektedir. Belediyelerin kurumsal iletişimden beklentileri ilebu beklentilerin karşılanmasında sosyal medyanın sağlayacağı avantajlarbirbiriyle örtüşmektedir. Çalışmamızda, Karadeniz Bölgesinde yer alan 32belediyenin kurumsal iletişimlerinde sosyal medya kullanımları içerik analiziyöntemi ile incelenmiştir. Bu doğrultuda belediyelerin sosyal medyahesaplarında 17 Eylül – 16 Ekim 2018 tarihleri arasında yaptıkları paylaşımlarirdelenmiştir. Yapılan içerik analizi sonucunda, belediyelerin sosyal medyakullanımına ilgi gösterdiği, kurumsal iletişimlerinde sosyal medyayı gelenekseliletişim mecralarına benzer şekilde tek taraflı kullandığı görülmektedir.Ayrıca sosyal medya mecralarının belediyeler tarafından sadece dış hedefkitleye yönelik kullanıldığı, kurum içiiletişimde ise bu mecralardan faydalanılmadığı anlaşılmaktadır., Today, instead of the traditional communication toolsthat have lost their importance, we are witnessing that the social mediachannels that are becoming widespread in digital environments and which arebecoming more and more common every day take part in people's lives. Socialmedia environments are effective in structuring not only individuals but alsocorporations and appear as an important tool in the development of corporatecommunication. It is seen that the municipalities, which are the subject of ourstudy and one of the closest institutions to the public, give importance tocorporate communication in their activities due to the demands, expectations,satisfaction or dissatisfaction of citizens. The expectations of themunicipalities from corporate communication and the advantages of social mediain meeting these expectations overlap. In our study, the use of social media incorporate communications of 32 municipalities in the Black Sea Region wasexamined by content analysis method. In this respect, the shares ofmunicipalities in their social media accounts between 17 September and 16October 2018 were analyzed. As a result of the content analysis, it is seenthat municipalities show interest in the use of social media, and in theircorporate communications, they use social media unilaterally similar totraditional communication channels. In addition, it is understood that socialmedia channels are used by the municipalities only for the external targetaudience, and that these channels are not used for internal communication.

Okul cantalari okul cagi yas grubunda cesitli saglik sorunlarina yol acabilmektedir. Bunlar arasinda vucut posturu sorunlari, agri ve karincalanma gibi cesitli semptomlar ve kas iskelet sistemi sorunlari yer almaktadir. Gerek cantanin ergonomik ozellikleri gerekse de tasinma sekli bu saglik sorunlarinin olusumunda etkili faktorlerdir. Bu sorunlar okul cagi yaslari kas iskelet sisteminin gelisim asamasinda oldugu yaslar olmasi nedeniyle sonraki yaslarda da onemli sikintilar olusturabilmektedir. Bu yazida saglik acisindan okul cantalarinin ergonomisi incelenmis ve bilgiler verilmeye calisilmistir.

COVID-19 etkeni SARS CoV-2 için gösterilen başlıca bulaş yolları damlacık ve temas yoludur. Hasta kişiden saçılan damlacıklar sağlıklı bireylere ya da eşya ve yüzeylere yayılmaktadır. Bunun yanında virüs, hasta bireyle doğrudan temas eden sağlıklı bireylere bulaşmaktadır. Bulaşı önlemek için alınacak fiziksel mesafe ve maske gibi önlemlerin yanında eşya ve yüzeylere yönelik standart temizlik ve dezenfeksiyon uygulamaları ve temas yolu ile gerçekleşebilecek bulaşa karşı el hijyeni uygulamaları önerilmektedir. Pandeminin ilk günlerinden bu yana özellikle medyada yer alan kafa karıştırıcı ve uygunsuz uygulamalar, abartılı, yanlış ya da gereksiz kimyasal kullanımına sebep olduğu gibi yeterli düzeyde hijyenin sağlanmasına da engel olabilmektedir. Bu sebeple günlük pratikte temizlik maddesi ve dezenfektanların uygulama yöntemi ve sıklığının uygun olması toplum ve çevre sağlığı açısından önem taşımaktadır. Bu amaçla el hijyeninde kullanılan sabun ve alkollü antiseptiklerin, eşya ve yüzey temizliğinde kullanılan deterjanın, yüzey dezenfeksiyonunda kullanılan etil/izopropil alkol, çamaşır suyu, hidrojen peroksit ve quaterner amonyum bileşikleri gibi dezenfektanların ve diğer yöntemlerin özellikleri, kullanım ilkeleri ve oluşturabilecekleri riskler incelenmiştir.

Web siteleri; kurum ve kuruluşların/organizasyonların dünyaya açılan kapısı olarak görülmektedir. Özellikle web2.0’ın hayata geçmesiyle tüm dünyayı saran sosyal ağlar, kullanım kolaylığı, karşılıklı iletişime olanak sağlaması, ulaşım rahatlığı ve sürekli güncel olması gibi sebeplerle başta gençler olmak üzere hedef kitleye ulaşmada en sık kullanılan iletişim ortamlarının başında gelmektedir. Kurumun varlığını sürdürebilmesi için kurum ile çevresi arasında sürekli bilgi ve düşünce alışverişine imkan sağlayan bir iletişim ve ilişki yönetimi süreci olarak tanımlanan kurumsal iletişim ile sosyal medyanın sağladığı kolaylıkların benzer özellikler göstermesi, kurumları giderek artan şekilde kurumsal iletişimde sosyal medyayı kullanmaya yöneltmektedir. Artık kurumlar, “sosyal medyayı kurumsal iletişim alanında kullanmalı mıyız?” sorusundan öte, “onu etkili bir biçimde nasıl kullanabiliriz?” sorusuna cevap aramaktadır. Kurumsal web siteleri kamunun artan bilgi ihtiyacına karşılık vermek, kurumun/organizasyonun yapısı, hizmetleri, ürünleri hakkında kullanıcıları bilgilendirmek, kurumun duyuru, tanıtım ve reklamını yapmak, kurumun amaç ve hedeflerini kamuya aktarmak gibi sayılabilecek pek çok alanda önemli ihtiyaçlara cevap vermektedir. Doğu Karadeniz Bölgesi’nde yer alan devlet üniversitelerinin sosyal medya hesaplarının gözlemlenerek, kurumsal iletişimde sosyal medya kullanım alışkanlığının tespit edilmeye çalışıldığı araştırmanın sonucunda; sosyal medya kullanımlarında benzer özellikler bulunan üniversitelerin, genel olarak sosyal medya için bir strateji geliştirilmediği, mevcut medya araçları için geliştirilen mesajların sosyal medyaya aktarıldığı ve üniversitelerin sosyal medyayı daha çok tanıtma için kullandığı görülmüştür.

Sutemin ve dağıtım sistemindeki bazı faktörler suyun kalitesini etkilemektedir.Bu faktörler arasında su kaynağınınkimyasal ve biyolojik kalitesi, arıtma sürecinin etkinliği ve verimliliği,arıtma tesisi, depolama, dezenfeksiyon ve dağıtım sisteminin bütünlüğü, dağıtımhattının(şebekenin) yaşı, tipi, dizaynı ve bakımı, kaynaktan tüketim noktasınakadar geçen süre ve ölü noktaların varlığı, su basıncı, arıtılan suyunkalitesi, farklı kaynaklardan gelen suyun bir dağıtım sisteminde karıştırılmasıve diğer hidrolik koşullar yer almaktadır. Su dağıtım sisteminin önemli birbileşeni olan su depolarının fiziki koşullarının uygun olmaması,depoların düzenli olarak temizlenmemesi, bakımlarının ve klorlamanın yapılmaması ve sürekliliğinin sağlanmamasıiçme kullanma suyu kalitesini etkilemekte ve sonuçta olumsuz sağlık etkilerineneden olabilmektedir. Depoların fiziksel kontrollerinin, temizliğinin vedezenfeksiyonunun belirli aralıklarla düzenli olarak yapılması sağlıkla ilgiliolumsuz sonuçları önleme açısından önem taşımaktadır. Bu yazıda su dağıtım ve depolama sitemlerihakkında bilgiler verilmesi ve sağlık açısından ortaya çıkabilecek riskleredeğinilmesi amaçlanmıştır., Somefactors about water supply and distribution system affect the water quality. These factors include chemical andbiological quality of water source, effectiveness and efficiency of thetreatment process, integrity of water treatment facility and system (storage, disinfectionand distribution), age, type, design and maintenance of the distribution pipes,time from source to consumption point and presence of dead spots, waterpressure, quality of treated water, mixing water from different sources in common distribution system andother hydraulic conditions. Unsuitable physical conditions, maintenance, chlorination, failure to ensure continuity and not be cleaned regularlyof the water tanks can affect qualityn of drinking water and cause negativehealth effects. Regular inspection of physical controls, periodicallycleanliness and disinfection of water tanks is important for preventing adversehealth consequences.In this paper it is aimed to give information about waterdistribution and storage systems and to point out the risks about health.

Objective Every year, 230 million patients undergo major general surgery with anaesthesia worldwide, and 7 million resulted with major complications. Monitorisation and equipment has a great role in increasing patient safety and safe surgery during anaesthesia. Methods Turkey is divided into 12 Eurostut-NUTS regions and 26 subregions statistically. Totally, 303 hospitals that are included in these regions were enrolled in this descriptive trial. The hospitals were contacted by telephone between October 2012 and August 2013. Data collecting forms were e-mailed to any of the anaesthetists or anaesthesia technicians of the hospital and they were requested to fill the forms and forward them to one of the investigators. Results Data were obtained from 221 of 303 hospitals (73%). Twenty-three hospitals were tertiary (university and education and research), 21 were city and 177 were county hospitals. No anaesthetist, operating rooms or intensive care units were available in 114 of the county hospitals. Anaesthetists were responsible for 61% of these active working theatres. Electrocardiogram, heart rate, non-invasive blood pressure and saturation could be monitored in 97% of them. End-tidal carbon dioxide could be monitored in 91% of at least one operating room in these hospitals. However, if the subject became to end-tidal carbon dioxide monitoring in every room, this ratio decreased to 63%. Defibrillators were absent in 6% of these rooms. Adult intensive care units were available in 33% of the hospitals and paediatric intensive care units were available in 32.4%; the responsibility of these intensive care units were carried out by anaesthetists at a 91.4% ratio. End-tidal carbon dioxide could be monitored in 54% of these units; invasive monitorisation could be applied in 68.4% if needed. Conclusion It was observed that hospitals have different standards according to their infrastructures of anaesthesia and intensive care unit equipment. We think that the elimination of these differences is an important step with respect to increasing patient safety and enhancement of the service quality in hospitals.

Objectives: The aim of this study is to determine the risk factors of childhood diarrhoea in Turkey throughout Turkey Demographic and Health Survey (DHS) 1998 and 2008 data. Methods: This study is a further analysis of the database of children under 5 years of age from the Turkey Demographic and Health Survey. Binomial logistic regression and Chi square analysis were used by weighted data of Turkey Demographic and Health Surveys. Results: In 1998 DHS there were 3,459 and in 2008 DHS 3,463 children under 5 years of age. Diarrhoea prevalence was 30.1% and 18.3%, respectively. Multivariate analysis revealed that household wealth status index, region, mother's education, mother's age (15-19 age), age (under 2 years of age), and sex (male) of the child were the risk factors for 1998 DHS. In 2008 significant risk factors were geographic region, education of the mother and father, breastfeeding status of the child (still being breastfed), mother's age (20-29 age group), and age of child (under 2 years of age). Conclusions: As a result, patterns of the risk factors of diarrhoea has changed from 1998 to 2008 DHS in Turkey. However, impact of factors related with socioeconomic environment such as region and mother's education persisted.

Özet İnternet, birçok alanda olduğu gibi sağlık alanında da farklı amaçlarla yaygın olarak kullanılmaktadır. Bu amaçlar arasında, bilgi sistemleri oluşturulması, değerlendirme sistemleri yapılandırılması, epidemiyolojik veri toplanması, sağlıkla ilgili müdahalelerin planlanması ve davranışla ilgili verilerin toplanması sıralanmaktadır. Bu denli yaygın olarak kullanılan İnternet kullanımının bir yansıması olarak, web tabanlı araştırmalar son dönemlerde toplumun sağlığını korumayı ve geliştirmeyi öncelikli hedefleri arasında alan halk sağlığı uygulamalarının çalışma alanları arasına girmiştir. Bununla birlikte, web tabanlı araştırmaların kullanımının katılım sınırlılığı, araştırma metodolojisinde sorunlar, etik açısından sınırlılıklar gibi kimi önemli kısıtlılıkları da bulunmaktadır. Halk Sağlığı araştırmacılarının web tabanlı araştırmaları yürütürken bu kısıtlılıklara dikkat edebilmeleri önemlidir. Bu yazıda web tabanlı araştırmaların halk sağlığı alanında kullanımının gerekçesi, kullanıma ilişkin yöntem ve kısıtlılıkların tartışılması amaçlanmıştır. Anahtar Kelimeler: İnternet, halk sağlığı, araştırma Use of Web Based Research in Public Health Abstract The internet is frequently used for health issues and for many other related purposes: creating information systems, structuring evaluation systems, gathering epidemiological data, planning intervention methods are examples. As a reflection of such wide use of the internet, web based research has been one of the working areas of the public health discipline, which basically aims to prevent and promote health and wellbeing of the community. Nevertheless, there are a number of limitations of web based research and these include limitations in participation, methodological issues, ethical limitations, and others. It is important for public health researchers to take all these limitations into consideration during their research. In this paper, the rationale of web based research in Public Health, its methods and basic limitations in use were discussed. Key Words: Internet, public health, research

In this study, it is aimed to determine environmental awareness of secondary and high school students in Bodrum, Turkey. This cross-sectional designed study was conducted on 381 students from secondary school and 335 high school students between 5th and 12th grades in Bodrum. In order to assess the environmental consciousness level, a questionnaire form consisting 58 questions and 17 statements for evaluation of environmental consciousness was developed by researchers. t test was used for the difference between the distribution of percentages and the difference between the averages of environmental consciousness level. The top three environmental health issues that were determined as "very harmful" were "smoking, air pollution resulting from power plants and being in a smoking area" for secondary school students and "smoking, air pollution resulting from power plants and ozone depletion" for high school students. Both in secondary and high school students, the mean environmental consciousness level of female students was higher than that of male students. The mean environmental consciousness level was 12.4 ± 2.7 for secondary school students and 12.1 ± 3.1 for high school students. There was a need of training activities of both the teachers and the students to improve the environmental awareness of the secondary and high school students.

Background and Design: Both the alterations in the immune system and the presence of pathergy reaction in patients with Behçet’s disease may lead to differences in the results of purified protein derivative (PPD) test reaction in these patients and healthy people.Materials and Methods: Twenty-one patients with Behçet’s disease aged 19-44 years old were included in this study. None of these patients were using any systemic drug (except colchicum) and had any immunosuppressive disease. All patients were under colchicum treatment and all had had BCG vaccination. Control group was formed by 27 volunteers aged 19-42 years who have applied to our dermatology outpatient clinic on the same dates and were diagnosed as tinea pedis. None of them were using any immunosuppressive drug and had any immunosuppressive disease. All of them also had had BCG vaccination. PPD test was performed to both control and patient groups.Results: The results of PPD test were found higher in the patients with Behçet’s disease compared to the control group. Active tuberculosis infection was not determined in any of the patients with increased PPD reaction.Conclusion: Increased PPD test results in patients with Behçet’s disease do not always imply tuberculosis infection and might be accepted as a false-positive result.

Background and Design: Although photosensitivity is considered as one of the side effects of retinoids, there is no consensus on this issue. In this study, we aimed to evaluate the minimal erythema dose (MED) for narrowband ultraviolet B in patients receiving isotretinoin treatmentMaterial and Method: Phototesting was done by narrowband ultraviolet B irradiation on fifty patients for whom isotretinoin treatment was planned. MED values were calculated before treatment (MED1) and during treatment after reaching half of the target dose (kgx120 mg) (MED2), and it was evaluated whether there was statistically significant difference between the two MED values. In addition, the patients were assessed according to their skin phototypes in this respect. Results: When the mean values of MED1 and MED2 were compared in all patients who were treated with 0.5-0.7 mg/kg/day isotretinoin, the mean of MED2 values was found to be lower than the mean of MED1 values. Clinically, sunburn erythema was seen in only 3 (6%) patients during the treatment. When the patients were evaluated according to their skin phototypes, significant difference between the means of MED 1 and MED 2 values was not determined. Conclusion: Although isotretinoin treatment does not cause clinically sunburn erythema, it was associated with decrease in MED values.

WOS: 000295492900027, Disasters, which are defined as "situations or events which overwhelm the capacity of local sources to address needs", have been increasing in terms of frequency, diversity and destructiveness, both in our country and throughout the world. The situation of healthcare systems becomes more complicated in disasters because of the increased healthcare needs of populations and the necessity for multidisciplinary work and collaboration with volunteer teams, besides the direct damages on infrastructure and loss of manpower. One of the main tools for coping with these problems is training healthcare workers for disasters. However, it is difficult to claim that disaster preparedness and education for health professionals for responding efficiently are adequate, both for Turkey and the world. Although there are numerous training programs, many of them are organized without any collaboration of institutions, have severe gaps in the content, are unable to cover target groups, and are unable to support coordination of disaster workers from different sectors. In this study, it was aimed to review the existing situation of disaster education in the health sector, and to define the needs for education. Also, core competency objectives for undergraduate medical education are determined and a program is proposed.

Amac: Bu calisma calismanin cocuklarin bedensel gelisimine etkisini ortaya koymak amaciyla yapilmistir Gerec ve Yontem: Calismada Izmit rsquo;te ortaogrenime devam eden ogrenciler ile Mesleki Egitim Merkezi rsquo;nde egitim goren calisan cocuklari temsil eden bir orneklemde yurutulmus ayni doneme ait iki kesitsel arastirmanin verileri kullanilmistir Her iki arastirmanin veri setinden benzer yas gruplarindaki cocuklar alinmis boylece 15 17 9 yas arasinda 401 ogrenci ve 243 calisan cocuk karsilastirilmistir Iki grubun karsilastirilmasinda yasa gore boy yasa gore agirlik ve beden kitle indeksi Z skorlari gibi cesitli antropometrik olcutler kullanilmistir Antropometrik olcutlerin hesaplanmasinda CDC Center for Disease Control tarafindan gelistirilmis Dunya Saglik Orgutu rsquo;nun de onerdigi toplumu temel alan Epi Info 2000 programi kullanilmistir

Ama c : Genetig i de gistirilmis gidalar modern biyoteknolojinin gi da uretimine uygulanan seklidir. Gittik c e yayginlasan kullanim alani, bu gidalari toplum sagligi acisindan dikkat c ekici bir noktaya tasimistir. Bu arastirmada bu c alisma ve yayinlarin incelenmesi ama c lanmistir. Gere c ve Y o ntem: Arastirmada 2008-2017 yillari arasinda PubMed veri tabaninda yayimlanan genetig i de gistirilmis gidalarin saglik etkileri ile ilgili yayinlar incelenmistir. Calismada belirlenen anahtar kelimelerle ulasilan 85 makalenin 49’u kriterleri sagladigi i c in arastirmaya dâhil edilmis tir Bulgular: Arastirmada toplam 49 makale incelenmistir. 16 farkli ulkeden yapilan yayinlarin 2’sinin turu g o zlemsel arastirma (%4,1), 43’unun turu deneysel arastirma (%87,8), 3’unun turu derleme makale (%6,1), 1’inin turu ise olgu sunumu (%2,0) oldugu belirlenmistir. Insanlarda yapilmis d o rt c alismaya rastlanmistir. Saglik etkileri acisindan en sik metabolik etkiler uzerinde duruldugu belirlenmistir. Sonu c : Calisma kisitliklarina karsin bu konuda yapilan yayinlarin buyuk oranda hayvan deneylerini kapsadigini ortaya koymaktadir. Insan sagligina y o nelik olarak konuya ihtiyatlilik prensibi c er c evesinde yaklasilmasi yararli olacaktir.

BACKGROUND: This study aimed to examine the extent of death and injuries among the 0-17 years of age group recorded in the official road traffic injury statistics. METHODS: This is a record-based study covering a 5-year-period (2003-2007) using the annual records of national road traffic injury statistics in Turkey. RESULTS: The 0-17 age group accounted for 10.9% of deaths and 20.1% of injuries over the 5-year-period that served as the scope of the study. It was found out that 53.5% of deaths and 70.7% of injuries occurred in residential areas. The occurrence of death among pedestrians in residential areas is notable. Injuries showed a similar tendency. CONCLUSION: According to the 5-year period statistics examined in this study, road traffic-related deaths and injuries are a public health problem, and necessitate the development of programs and policies aimed at their prevention. Language: en

Objective The aim of this study is to examine the prevalence of selective mutism (SM) in Kocaeli, Turkey. Method Kindergarten, first, second and third grade students of all public/private schools within the city were included in the study. "SM screening forms" prepared on basis of DSM-IV were submitted to classroom teachers in all these schools asking whether they had any students meeting such symptoms. Results About 84.51% of the schools returned forms covering 64,103 children. Five hundred and twenty six of these children were thought to have symptoms of SM by their teachers. After their DSM-IV based clinical evaluation by a child and adolescent psychiatrist, only 21 children were diagnosed as SM. Among the SM group, three were in the kindergarten, 15 were in the first grade and three were in the second grade. Twelve of the children were male and nine were female (male: female ratio is 1.3:1). In this cross-sectional study, 0.83% of children were reported to have SM symptoms by their teachers. After the clinical evaluation of these children, the prevalence rate of SM was found to be 0.033%.

Purpose – This paper has been produced to enumerate and discuss threats which are caused by industry and may affect health in the province of Kocaeli.Design/methodology/approach – Industries in the province, depending on their function, were grouped into sectors. Air, water and solid waste pollutants produced by each sector were assessed for each region of the province.Findings – Of the 7,400 industries in the province, only 1,198 are registered with the Kocaeli Chamber of Industry and of this number only a minority are subject to controls by the Ministry of the Environment through the Kocaeli Provincial Directorate of the Environment (KPDE). Data on pollutants were obtained from the KPDE. Liquid waste was controlled in 370 firms (5 per cent) of all industries in the province, air quality in 444 (6 per cent) and dangerous waste in 4 (0.06 per cent). A total of 41 firms were designated as having dangerous pollution profiles.Practical implications – These figures suggest that industrial development in the p...

Deaths and injuries linked to traffic accidents are important public health issues. In this descriptive study, the accidents resulting in death and injury between 2000 and 2004 on the city portion of the D-100 were compared with those on the other roads within the city. The D-100 had a fatality risk approximately 2 times higher than that of the other roads within the city. The percentage of trucks of the total vehicles involved in accidents that occurred on the D-100 resulting in death and injury was 14.87% in 2002, 13.18% in 2003, and 9.88% in 2004. The main proposals of this study are to limit the use of the D-100's city portion to city traffic, and prevent heavy cargo vehicles from using the road as a transit route.

Background: Child labor remains a widespread phenomenon in today's world. The purpose of the present study was to describe the working conditions and health status of child workers in Kocaeli. Methods: A cross-sectional research study has been carried out on 365 working children at the Kocaeli Occupational Training Center. Data were collected on working conditions, smoking habits, work accidents, perceived health status and psychological status using General Health Questionnaire-12. In order to evaluate the physical growth of children, their height and weight were measured. Results: Most working children usually have a low level of education, low income and extended families. The mean age for children to start working was 14.8 1 1.5 years and their daily working periods were 11.3 1 1.3 h on average.Girls were found to have more psychopathology compared to boys on the GHQ-12 and the results were statistically significant. The height z score was less than -2 SD at 6.9% while the weight z score was less than -2 SD at 1.9%. According to body mass index (BMI) percentiles range, 3% of children were found to be underweight. A statistically significant and negative directional correlation was detected between body mass index z scores with age and daily working periods. Statistically significant but weak correlations were detected between height for age z scores and the starting age of work and also between weight for age z scores and chronological age. Conclusions: Both the mental and the physical health of children were found to be negatively affected, by having to work at an early age, and by long working hours. For this reason, immediate and direct intervention should be taken to eradicate child labor, and protect children from unsafe and exploitative working conditions.

The aim of this study is to examine the volumetric differences of the fronto-temporal region in the offspring of schizophrenic patients in comparison to normal. Twenty-six offspring of chronic schizophrenic patients aged between 8 and 15 years and 23 control children were matched with respect to cranial MRI. Chronic schizophrenic patients were reevaluated with SCID-I to confirm their diagnosis. Parents of children in the control group completed SCL-90-R and were evaluated by clinical interview to exclude any psychotic disorder. The diagnoses of psychiatric disorders in all of the children were established by DSM-IV-based clinical interviews with children and parents. They underwent IQ evaluation by WISC-R and evaluated with cranial MRI. Hippocampus, thalamus, amygdala, corpus callosum, frontal, and temporal lobe volumes were measured and compared by using MANCOVA. After covarying whole brain volume, age and gender, statistically significant decrease in the measurements of corpus callosum and hippocampi, and a non-significant trend toward smaller temporal lobes were observed in the high-risk children. The structure of hippocampal formation and corpus callosum were impaired in the children of the schizophrenic patients which suggests a neurodevelopmental abnormality in subjects with genetic high risk for schizophrenia.

The authors' purpose in this study was to examine the effects on health, as measured by blood lead levels (BLLs), of living and working near the D-100 international road, which passes through Kocaeli, Turkey. In this cross-sectional study, the authors examine BLLs in 3 groups to determine the health effects of exposure to motorized road transport. By comparing the 3 groups, the investigators found that the mean BLL was 4.23 +/- 1.59 microg/dL in a group of candy sellers who worked beside the road, 4.18 +/- 2.07 microg/dL in a group of city residents, and 3.82 +/- 1.71 microg/dL in a group of village residents. (The latter 2 groups were not in close proximity to the road, and the authors used their measurements for comparison.) The difference in BLLs between the candy sellers and the village residents was statistically significant (p.05). No significant difference in BLLs was determined between city and village residents or between candy sellers and city residents (p.05). The authors recommend limiting the use of the D-100's city section to only local traffic and preventing heavy cargo vehicles from passing through.

Processes and conditions of production may produce unhealthy effects. Both must therefore be included in the education of health care personnel. Vocational training in occupational health at Kocaeli University Medical School, Turkey aims to demonstrate students that occupational health is a specific and important area of work within the context of primary health care. This research is a cross-sectional study. It was planned as a three stage study: 1- reviewing literature and grouping of countries according to their occupational health curricula; 2- reviewing the occupational health programs of medical schools in Turkey, and 3- recommendations for an occupational health curriculum to include an occupational health vocational training period of one week in the two month public health education program for medical interns. During this experience, senior students would be assigned to workplace health units. Of 283 medical schools found on the web, with occupational health teaching, only 20 have a curriculum that includes training in workplace health care units. In Turkey, there is no structured practical education on occupational health. In the third part of this study, we initiated at Kocaeli University School of Medicine's curriculum, a new occupational health education model applied in the workplace health units of factories. Practical experience of occupational health in the workplace is useful in introducing the community-based approach to occupational health in undergraduate medical education and understanding the determinants of health in industry.

Aluminium is one of the most abundant metal in earth crust and has in many product of human life. Drugs, some of goods, cosmetics, foods, food stroage containers and drinking water are sources of aluminium’s exposures. Water, food and drugs are the main sources for oral exposure. Knowledge of health effects of aluminium in drinking water is limited. There are some studies that have been introduced effects of aluminium in many human body systems, especially nervous system. This paper aims to review health effects of aluminium in drinking water.

Background Studies consistently found remarkable rates of posttraumatic stress symptoms (PTSS) in children with chronic diseases. But, only one study had searched PTSS in children with diabetes, until now. So, the present study aimed to examine incidence rate and predictors of PTSS in children with type 1 diabetes. Method PTSS were evaluated by Child Posttraumatic Stress Reaction Index in fifty four children with diabetes (aged between 8–18 years). This assessment was based on hypoglycaemia as the potential traumatic event. Children were also introduced a brief questionnaire about demographic and disease related information. Some other information was obtained from families, medical stuff and records. Among 54 children, forty two had complete information. Hence, to evaluate possible predictive factors related with PTSS, multiple regression analysis was conducted for 42 children. Results 18.5% of children were reported PTSS at severe or very severe level, and 51.9% were reported PTSS at moderate level or above. Multiple regression analyses were shown that child PTSS were not significantly related with possible predictive factors other than number of hypoglycaemic attacks for the last month. Conclusion The study results support that posttraumatic stress symptoms are not rarely seen in paediatric patients with diabetes, and even if not severe, hypoglycaemic attacks may be perceived as traumatic by the children with diabetes. But, because of some limitations, the results should be carefully interpreted.