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Yeni Koronavirüs Hastalığı-2019 hızla dünyaya yayılmış ve büyük bir halk sağlığı sorunu olarak, sosyal ve ekonomik zararlara neden olmuştur. Risk faktörleri; sosyodemografi, tıbbi durum ve çevresel maruziyetler şeklinde gruplandığında; çevresel risk faktörlerinden biri de hava kirliliğidir; nüfusun COVID-19 patogenezine olan duyarlılığının artmasında önemli rol oynayabileceği düşünülmektedir. Sokağa çıkma yasağı gibi insan hareketliliğini kısıtlayan önlemlerin; yemek, eğlence, endüstri, madencilik, ulaşım ve ticaret faaliyetlerinin azalması dikkate alındığında hava kirleticilerinin emisyonu üzerinde azaltıcı etki gösterebileceği öngörülebilir. Hava kalitesi değerlendirilirken kullanılan ana kirletici parametrelerin artışlarının bulaş, hastalığın seyri ve sonuçları üzerinde, viral iletimde kolaylaştırıcı olduğu, solunum ve kardiyovasküler hastalık riskini arttırdığı çalışmalarda gösterilmiştir. COVID-19 için R0 katsayısı hesaplanırken kullanılan faktörlerin incelenmesinde hava kirliliğinin; temas oranı, bulaş yolu, enfekte dönem üzerinde etkileri olduğu görülmektedir. Yüksek partikül madde konsantrasyonuna uzun süreli maruziyet ile kardiyovasküler hastalık riskleri de artmış olan bazı insanlar yüksek kan basıncı nedeniyle tedavi almaktadır. Angiotensin Converting Enzyme (ACE2), bazı korona virüsler için hücrelere giriş noktası görevini üstlenir. Yüksek kan basıncını tedavi etmek için kullanılan ACE inhibitörleri ve anjiyotensin reseptör blokerlerinin (ARB'lerin) ikisinin de ACE2 miktarını arttırdığı ve bu nedenle koronavirüs enfeksiyonlarının şiddetini arttırabileceği gösterilmiştir. Profesyonel topluluklar standart ACE inhibitörü ve ARB tedavisine devam edilmesini önermektedir. Kısıtlamaların uygulanması ile genel olarak faaliyet kaynaklı kirleticilerin miktarının azalması ve bu süreçte insanların hava kirleticilerine maruz kalmalarının da azalmasından dolayı etkili halk sağlığı müdahaleleri yapılmıştır. Sağlık profesyonellerince; hava kirliliğini önlemeye yönelik kanıt temelli çalışmalar yapılmalı ve paylaşılmalıdır.

Bloodspot screening in newborns is an exemplary public health intervention as it is essential secondary prevention with proven efficacy and benefit for the early diagnosis and prompt treatment of rare diseases. In this mini review, newborn bloodspot screening (NBS) programs of 12 countries were examined in terms of the extent of diseases/disorders screened to form recommendations for Turkey's expanded newborn screening program. Essentially, Turkey and 11 selected countries' official policies/ national programs or strategies in terms of newborn screening and the number of diseases/conditions screened were examined. The current status of spinal muscular atrophy (SMA) screening was also checked through the SMA NBS Alliance. In addition, WHO and EURORDIS guidelines for newborn screening were also reviewed. On the Pubmed database, following the search strategy "((newborn screening[Title/Abstract]) OR (newborn screening program[Title/Abstract])) OR (newborn blood spot screening[Title/Abstract])" in the PubMed database from 1 January 2008 to 1 December 2021. Diseases that will be recommended to be included in the Turkish national newborn bloodspot screening program will be presented by evaluating the updated criteria of Wilson and Jungner by constructing international comparisons. The number of diseases/disorders screened by the inspected 12 countries is eminently variable and ranges from 5 in Turkey to 51 in New York, United States of America (USA). Acknowledging the programs of other countries, it is evident that Turkey must advance its program by evaluating the epidemiological data in Turkey, the health workforce, and infrastructure while relying on the updated screening criteria. The newborn bloodspot screening program should be expanded based on the cost estimates and implemented starting with pilot applications and the diseases/disorders that are deemed appropriate should be included in the national program.

Dünya Sağlık Örgütü SAGE Aşı Tereddüdü Çalışma Grubu, toplumda aşı tereddüdünün ölçümünü standardize etmek amacıyla Aşı Tereddüt Ölçeğini geliştirmiştir. Türkiye’de beş yaş altı çocukların ebeveynlerinde sahadan elde edilen verilerle Aşı Tereddüt Ölçeğinin Türkçe geçerlilik ve güvenirliğine yönelik bir çalışma bulunmamaktadır. Bu çalışmanın amacı, beş yaş altı çocukların ebeveynlerinde Aşı Tereddüt Ölçeğinin geçerlilik ve güvenirliğinin değerlendirilmesidir. Araştırma, Tokat il merkezinde Ekim Aralık 2020 tarihleri arasında beş yaş altı çocuğu olan ebeveynlere yapılmış metodolojik tip bir çalışmadır. Tokat il merkezinde rastgele seçilmiş 18 mahallede hanelere gitmek suretiyle beş yaş altı çocuğa sahip 200 ebeveynle görüşülmüştür. Veri toplama aracı olarak DSÖ SAGE Aşı Tereddüdü Çalışma Grubu tarafından geliştirilen Aşı Tereddüt Anketi ve Aşı Tereddüt Ölçeği ile tanımlayıcı anket formu kullanılmıştır. Ölçeğin yapı geçerliliği Doğrulayıcı Faktör Analizi ile güvenirliği madde toplam korelasyonları değerlendirilmiş ve boyutların Cronbach α değerleri belirlenmiştir. Yapılan doğrulayıcı faktör analizinde madde 10 ve madde 5’in t değerleri 1,96’dan düşük ve hata varyansları 0,90’dan yüksek çıkmıştır. Öncelikle t değeri daha düşük olan 10. madde ve 5. madde sırası ile veri setinden çıkarılmıştır. Geriye kalan sekiz madde ile yenilenen doğrulayıcı faktör analizi sonucunda 9. maddenin t değeri 1,96’dan düşük ve hata varyansı 0,90’dan yüksek olduğundan dolayı 9. madde de veri setinden çıkarıldıktan sonra ölçeğin yapı geçerliği için doğrulayıcı faktör analizinde kabul edilebilir uyum iyiliği değerleri elde edilmiştir. Aşı Tereddüt Ölçeğinin, beş yaş altı çocuğu olan ebeveynlerde aşı tereddüdünü belirlemede tek faktörlü yedi maddeden oluşan bir yapı ile geçerli ve güvenilir olduğu tespit edilmiştir., The World Health Organization SAGE Vaccine Hesitancy Working Group developed the Vaccine Hesitancy Scale to standardize the measurement of vaccine hesitancy in the population. There is no study on the Turkish validity and reliability of the Vaccine Hesitancy Scale among parents of children under the age of five in Turkey. The aim of this study is to evaluate the validity and reliability of the Vaccine Hesitancy Scale in parents of children under the age of five. The research is a study conducted on parents with children under the age of five between October and December 2020 in the city center of Tokat. 200 parents with children under the age of five were interviewed by going to households in 18 randomly selected neighborhoods in the city center of Tokat. Vaccine Hesitancy Survey Questions and Vaccine Hesitancy Scale and descriptive questionnaire form developed by WHO SAGE Vaccine Hesitancy Working Group were used as data collection tools. Construct validity of the scale, reliability, and item-total correlations were evaluated with Confirmatory Factor Analysis and Cronbach α values of the dimensions were determined. In the confirmatory factor analysis, the t values of item 10 and item 5 were lower than 1.96, and error variances were higher than 0.90. First of all, the 10th item and the 5th item with a lower t value were removed from the data set, respectively. As a result of the renewed confirmatory factor analysis with the remaining eight items, since the t value of the 9th item was lower than 1.96 and the error variance was higher than 0.90 after the 9th item was removed from the data set, acceptable goodness of fit in the confirmatory factor analysis for the construct validity of the scale was obtained. values have been obtained. It has been determined that the Vaccine Hesitancy Scale is valid and reliable with a structure consisting of seven items with a single factor in determining the vaccine hesitancy in parents with children under the age of five.

Background/aim: Cancer has become an important public health challenge all around the world. Though the demographic and clinical features of cancer patients are well documented in Turkey, the establishment of social support networks has been somewhat neglected. The aim of the study was to assess cancer patients' perceived social support and quality of life characteristics. Materials and methods: The Multidimensional Perceived Social Support Scale, European Organization of Research and Treatment of Cancer Quality of Life Questionnaire, and Turkish version of the EUROHIS measurements were obtained from the study group. Associations between the scores and sociodemographic variables of the patients were evaluated. Determination of the best predictors that affect social support perception scores was performed by multiple linear regression analysis. Results: A total of 364 patients (217 females, 147 males) were analyzed. Regarding the mean scores of perceived social support, statistically significant differences were found between education, perceived economic status, and ECOG groups (P < 0.001). Conclusion: The best predictors that have an effect on perceived social support need to be studied in depth with further research.

Background/aim: The aims of this study were to evaluate measles incidence and the effect of elimination strategy interventions on the disease from 1960 to 2014 in Turkey. The administration of measles vaccine started in the rural regions in 1970; it was carried out as a campaign along with the National Vaccine Campaign in 1985, and it has been employed as combined measles, mumps, and rubella under the scope of the Measles Elimination Program (MEP) since 2006 in Turkey. While a dramatic decrease in the reporting of measles was observed between 2000 and 2010, the number of the cases has increased since 2011. Materials and methods: The time series of measles incidence was evaluated for possible structural changes with regression models using dummy variables, autocorrelated with error terms. Results: The incidence of measles showed a statistically significant decline between 1985 and 1988 (P = 0.0072) and between 2005 and 2011 (P < 0.0001). However, a statistically significant increase in incidence was noted after 2013 (P = 0.0008). Conclusion: Over the last 54 years, the pattern of measles cases demonstrated a significant decline in incidence. However, the increase in incidence in 2013 should be carefully analyzed and interpreted in terms of the MEP.

Bodur, Said (Balikesir Author), Violence in the workplace is an increasing occupational health concern worldwide. Health care workers are at high risk of assault. To develop, monitor, and manage prevention policies, baseline data should be available. This cross-sectional study was designed to determine the current extent of workplace violence nationwide in Turkey. The study population of 12.944 health care workers was a stratified sample of all health care workers (612,639) in the country. A probabilistic sampling was made on the basis of the “multistage stratified random cluster sampling method.” This study was conducted by a structured questionnaire in a face-to-face interview. The questionnaire items were adapted and translated into Turkish based on questionnaires of International Labor Organization, International Council of Nurses, World Health Organization, and Public Services International. The percentage of health care workers who experienced workplace violence in Turkey in the previous 12 months was 44.7%. The types of violence included physical 6.8%, verbal 43.2%, mobbing (bullying) 2.4%, and sexual harassment 1%. Multivariate analysis showed that level of health care system, type of institution, gender, occupation, age, working hours, and shift work were independent risk factors for experiencing workplace violence (p

Objectives: Unintentional injuries are one of the leading causes of death, hospitalization and disability across the world. Detailed work on child injury in low-income and middle-income countries began more recently and is now indicating priorities for prevention. This study aims to draw attention to the subject with the assessment of the injuries sustained by the study group. Methodology: Data of the descriptive study was collected at the Emergency Department’s trauma section of a Training and Research Hospital, located in Ankara during the period of October-November 2010. Children visiting the hospital due to an injury under the age of 18 were included to the study group by assent of the child and consent of the parents. Results: Of the study group 75.3% were boys, 35.31% were 11-15 year of age. The most frequent cause of the injuries were falls among boys (48.3%), girls (50.0%) and, 11-15 years of age (32.8%). Most injured organs (63.6%) were extremities and most frequent damage caused by the injury was fracture (29.5%). Almost half of the injuries (44.0%) occurred in and around the school. Conclusion: Development and implementation of systematic surveillance is necessary to identify the epidemiologic characteristics of childhood injuries at national level. Definition of the risk factors and protective factors is a priority of countries to prevent such injuries.

Affecting 106 countries, malaria is a major global burden. Though intensive antimalaria efforts in Turkey have been successful in bringing down the number of cases, historically malaria was a serious public health concern.This paper reviews the prevalence rates of malaria in Turkey over the last 85 years (1925-2010). The time series of malaria prevalence was evaluated for possible structural changes by using Chow breakpoint tests and regression models using dummy variables, with autocorrelated errors and generalized autoregressive conditional heteroscedasticity models to assess the impact of volatility in prevalence.Seventy-eight cases of malaria were diagnosed in Turkey in 2010. Malaria prevalence rates in the country show a statistically significant volatility, which underlines the fragility of efforts to control the disease.It is necessary to analyse the national malaria control programme to evaluate to what extent its programmatic capacity, financial resources, and political commitment are sufficient to avoid eroding the gains that have already been made and, ultimately, eradicate malaria. It is essential that there should be no lessening in the long-standing efforts to reduce malaria.

This study aimed to determine the prevalence of and factors contributing to musculoskeletal system complaints (MSC) in office workers of a vehicle production factory and absenteeism due to these complaints. A total of 86.2% (n = 333) of the workers completed the survey. Of the workers, 73 (21.9%) were women, and 260 (78.1%) were men, and the mean age was 36.9 ± 8.75 years. The majority of the personnel had more than one symptom with a prevalence of 80.8%. The most frequently observed discomfort was tension and pain in the back muscles (58.6%) and in the neck muscles (58.3%), followed by low back pain (41%) and shoulder pain (30.3%). Pain in the shoulders, neck, and the back and pain and numbness in the fingers were statistically significantly more prevalent in employees who spent more than 5 hours per day performing desk work. Furthermore, all of the complaints, excluding pain in the elbows and knees, were statistically significantly more common in the women. When each complaint and the effects of contributing risk factors were analyzed by logistic regression analysis, pain in the shoulders, neck, and back; pain that spread to the arms; and pain in the fingers were correlated with longer work hours and the female gender (p < 0.05). The number of employees who had used sick leave within the past year due to MSCs was 11.7%. In conclusion, duration of work hours, frequency of breaks, and gender were determined as the most important risk factors in computer users regarding MSCs. © 2011 Wiley Periodicals, Inc. © 2011 Wiley Periodicals, Inc.

Aim: The study was conducted to identify breastfeeding status and effecting factors of mothers have 0-11 month’s babies at a Health Centre Area.Materials and Method: The cross sectional study was conducted at Health Centre Area in Ankara city centre. The target population of this study has been constituted 122 mothers that their ba-bies were born 1 January 2006-31 December 2006 and have been reached 121 mothers (99.2%). Prepared questionnaire forms have been filled by nurses using face-to-face interview method with mothers.Results: Sixty percent of mothers were between 20-29 ages and 40.5 percent graduated from the primary school. Eighty four percent of babies were desired and 52.9 percent girl. All mothers bre-astfed their babies sometime and 88.5 percent of mothers continue to breastfeed their babies. Mothers started to breastfeeding within first hour after delivery have been continuing to breast-feeding more than mothers started to breastfeeding after first hour. Seventy percent of mothers initiated to supplementary food at appropriate time. Mothers graduated from the primary school and below than the secondary school and above and monthly income was less than 1000 Turkish Liras than more than 1000 Turkish Liras initiated to supplementary food at more appropriate time.Conclusion: Necessity of researching of the causes of behavior of mothers have high level of edu-cation and income that initiate to supplementary food at inappropriate time and giving educa-tion according to this and also giving more knowledge to mothers about continue to breastfeed and don’t give feeding bottle and pacifier have been thought.

Summary Turkey is among the ten countries constituting almost half of the global traffic accident deaths. As regard to their frequencies, health and economic outcomes, traffic accidents must have a priority in public health agenda. From the epidemiological perspective, within the vehicle, person and the environment components; person (driver, occupant, pedestrian) (99.12 %) is the most responsible component for the traffic accidents. According to the accident statistics, drivers have the biggest defect share with a 95 % ratio. Main components of the driver defect are; speed, alcohol and substance use, sleep and fatigue, not using safety belt, child car seat and helmet. Related legislation has been developed in Turkey but is not applied as it should be.The United Nations has developed a Global Plan for the Decade of Action for Road Safety 2011-2020 to decrease the traffic accidents and burden of disease all over the world and especially in the low and middle-income countries. The objective of this article is to draw attention to the problem of road safety and traffic accidents in Turkey.

Amac: Bu arastirmanin amaci dogal afetler sonrasinda zarar goren aileleri daha sonra ortaya cikabilecek aile islevi sorunlarindan ve bireylerini psikiyatrik hastaliklardan koruyabilecek ve erken donemdeki sorunlarini giderebilecek, aile temelli, yapilandirilmis bir mudahale modeli olusturulmasidir. Yontem: Bu arastirma prospektif bir mudahale calismasidir. Bolu Ili\\'ndeki ispanyol Cadirkenti\\'nde yasayan ve buradan sistematik orneklem ile secilen 77 aileye, aile temelli koruyucu bir mudahale calismasi uygulanmistir. Arastirmaya katilmayi kabul eden ailelerde yer alan 281 aile bireyi ile ilgili bilgi toplanmistir. Ruhsal sorunlari degerlendirmede 6-14 yas grubunda Cocuk Depresyon Olcegi (CDO), Cocuk Travma Sonrasi Stres Reaksiyonu Tepki Indeksi (CTSS-RI), Spielberger Cocuklar Icin Durumluk ve Surekli Kaygi Olcegi (CDSKDO) kullanilmistir. 15 yas ustu grubun degerlendirilmesinde ise Beck Depresyon Olcegi (BDO), Genel Saglik Anketi (GSA), Cok Boyutlu Algilanan Sosyal Destek Olcegi (CBASD) ve Travma Sonrasi Stres Bozuklugu Kisa Tani Olcegi (TSSB-KTO) kullanilmistir. Bu gorusmeler sirasinda islevlerinde bozukluk saptanan aileler ve herhangi bir psikiyatrik hastalik saptanan bireyler tedaviye alinmislardir. Bulgular: Arastirmaya 145\\'i erkek, 136\\'si kadin cinsiyetinde yaslari 0-82 arasinda degisen (ortalama 24.93±17.40) 281 aile bireyi katilmistir. 6-14 yas grubundaki bireylerin % 16.7\\'sinde depresyon, % 18.8\\' inde agir, % 52.1\\'inde orta duzeyde TSSB belirtileri saptanmistir. 15 yas ve uzerindeki bireylerin ise % 44.0\\'inda depresyon, % 36.3\\'unde TSSB tespit edilmistir. Sonuc: Bu calisma sonuclari buyuk felaketler sonrasinda klinige basvurmayan kisilerde de psikopatoloji oraninin yuksek oldugunu gostermesi acisindan literaturdeki diger calismalarla uygunluk icindedir. Bu durum bu tur travmalarla karsilasan ailelere ruhsal destek saglamanin koruyucu psikiyatri acisindan onemini ortaya koymaktadir.

A survey in the year 2007 among medical students of Ankara University Medical School to assess the smoking rates showed that 25.1 % of them were smoking. Moreover, the smoking rate was 35 % at sixth grade students and 60 % of the smokers specified that they started smoking at medical school. This report provides a successful approach to decrease smoking among medical students by measures against starting smoking. An “Antismoking Group” composed of voluntary academic staff, nurses, students, psychologists, and a social worker of the medical school was established to engage in lowering the smoking rate and eliminating it eventually among our students. Several methods including regular monthly meetings, annual “Smoking or Health” symposiums, and lectures to first, second, and third grade students to increase their awareness related to harms of smoking and their role in the fight against smoking were carried out. Our surveys in the years 2009 (641 students) and 2012 (975 students) showed that total smoking rates dropped to 15.0 and 11.0 %, respectively (p < 0.0002). Moreover, the smoking rate for the sixth grade students dropped from 35.0 % in 2007 to 21.8 and 8.8 % in the years 2009 and 2012, respectively (p < 0.0002). In 2012, the smoking rates of first year and sixth year students were 7.8 and 9.0 %, respectively. These close rates of smoking at the first and last years of medical school training and the significant drop in smoking rates in 5 years confirm that our group pursued a realistic and successful strategy against smoking.

WOS: 000313614900003 PubMed: 23298420 The aim of this study was to assess the prevalence of symptoms of work-related musculoskeletal disorders (MSDs) and to determine the risk factors among ammunition factory workers in Turkey. This cross-sectional study was performed on 955 ammunition factory workers. Potential risk factors were investigated with a questionnaire and multivariate logistic regression analysis was performed. During the previous year, 39.3% of ammunition workers experienced symptoms of work-related MSDs. Logistic regression analysis showed smoking (odds ratio [OR] = 1.372), chronic diseases (OR = 1.795), body mass index (BMI; overweight) (OR = 1.631), working year (OR = 1.509), cold temperature (OR = 1.838), and work load (OR = 2.210) were significant independent risk factors for the development of symptoms of MSDs. It was found that both work-related conditions and personal and environmental factors are important for the development of occupational MSDs.

To evaluate that habitual behaviors related to genital hygiene in women living in a Health Care Center Area.In this cross-sectional study, 400 women were sampled to represent women in reproductive ages (15-49 ages) living in the Park Health Care Center Area, Ankara, Turkey between June and September 2008. Three hundred and eighty-six (96.5%) women were interviewed for evaluation of habitual behaviors related to genital hygiene. The chi-square test was used for statistical analysis.The mean age of the study group was 32.19+/-9.54 (15-49) years. Of the study group, 21.5% had daily baths, 77.2% used cotton underwear, and 71.8% wiped front to back after using the toilet. Of those who menstruated, 83.4% used hygienic pads during menstrual periods, and 42.1% of the 321 married women confirmed practicing vaginal douching. The education level p=0.001, p=0.000, income level p=0.034, p=0.005, employment p=0.022, p=0.000, and house type p=0.005, p=0.006 were found as factors affecting general frequency of bathing and type of pad used during the menstrual period. Frequency of vaginal douching was higher in housewives than employed women p=0.000.The rate of women who had appropriate behaviors related to genital hygiene among the study group was found to be low, particularly within groups with a low socioeconomic level. Thus, it will be useful for health care employers to emphasize this issue at every opportunity.

WOS: 000265321200007, PubMed ID: 19328549, Objectives: The University of Iowa Child Protection Program collaborated with Turkish professionals to develop a training program on child abuse and neglect during 2002-2006 with the goals of increasing professional awareness and number of multidisciplinary teams (MDT), regional collaborations, and assessed cases. This paper summarizes the 5-year outcome. Methods: A team of instructors evaluated needs and held training activities in Turkey annually, and provided consultation when needed. Descriptive analysis was done via Excel and SPSS software. Results: Eighteen training activities were held with 3,570 attendees. Over the study period, the number of MDTs increased from 4 to 14. The MDTs got involved in organizing training activities in their institutions and communities. The number of medical curriculum lectures taught by MDTs to medical students/residents, conferences organized by the MDTs, and lectures to non-medical professional audiences increased significantly (R-2 = 91.4%, 83.8%, and 69.2%, respectively). The number of abuse cases assessed by the MDTs increased by five times compared to pre-training period. Conclusions: A culturally competent training program had a positive impact on professional attitudes and behaviors toward recognition and management of child abuse and neglect in Turkey. The need to partner with policy makers to revise current law in favor of a greater human services orientation became clear. Practice implications: Pioneers in developing countries may benefit from collaborating with culturally competent instructors from countries with more developed child protection systems to develop training programs so that professional development can improve recognition and management of child abuse and neglect. Published by Elsevier Ltd.

OBJECTIVE: The objective of this study was to investigate the relationship between occupation and head and neck cancers. PATIENTS AND METHODS: In this case-control study, 206 Turkish patients with head and neck cancers comprised the case group. The control group consisted of 206 age- and sex-matched patients without malignant disease. All patients completed a questionnaire regarding occupation; tobacco and alcohol consumption; educational status; and history of any systemic disease, benign head and neck disease, and cancer among family members. High-risk jobs were considered those in the industries of construction, wood, mining, metal, chemistry and agriculture. RESULTS: Patients with head and neck cancers worked in high-risk occupations more frequently than did controls [odds ratio (OR): 3.42, p0.05). CONCLUSION: Our analysis showed that occupation and smoking were significant independent risk factors for the development of head and neck cancers among workers.