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Günümüzde bilgisayar, akıllı telefon gibi teknolojilerin ve internet kullanımının yaygınlaşması ile dijital oyunlara ulaşım artmakta ve dijital oyun oynamanın etkileri gün geçtikçe daha belirgin hale gelmektedir. Özellikle adölesan ve genç erişkin grubunda yer alan lise ve üniversite öğrencileri diğer bağımlılıklarda olduğu gibi internet oyun bağımlılığı için de en önemli risk grubu olarak karşımıza çıkmaktadır. Koruma ve müdahale çalışmaları için yol gösterecek ve özellikle risk grubu olan genç bireylerde internet oyun bağımlılığının yaygınlığını ve etyolojisini belirleyecek çalışmalara ihtiyaç duyulmaktadır. Bu çalışmada lise ve üniversite öğrencilerinde internet oyun bağımlılığı sıklığı ve etkili faktörlerin belirlenmesi amaçlanmaktadır. Araştırma, Gazi Üniversitesine bağlı Tıp Fakültesi, Sağlık Bilimleri Fakültesi ve Sincan ve Çankaya’da belirlenen birer lisede eğitim gören toplam 1350 katılımcı ile yürütülen kesitsel tipte bir araştırmadır. Araştırmanın veri kaynağı sosyo demografik bilgileri, katılımcıların sağlıkla ilgili bazı özelliklerini, oyun bağımlılığını değerlendiren bilgileri ve İnternet Oyun Bağımlılığı Ölçeği Kısa Formunu (IGDS9-SF) içeren anket formudur. Çalışmada olası internet oyun bağımlılığı prevalansı %5,6’dır. Lojistik regresyon analizinde internet oyun bağımlılığına etki eden faktörlerin erkek olma (OR:2,850), ebeveynlerin ayrı olması veya vefatı (OR:4,127), tek çocuk olma (OR:4,560), fiziksel aktivite yapmama (OR.3,165), kendine güven duymama (OR:3,029), aile ilişkilerinin kötü olması (OR:5,427), online oyunları tercih etme (OR.7,034) olduğu gözlemlenmiştir. Sonuçları ile birlikte değerlendirildiğinde önemli bir halk sağlığı sorunu haline gelen internet oyun bağımlılığı için müdahale çalışmaları planlamak ve farkındalık oluşturmak önemlidir.

Bullying, which is an important public health problem, is a complex problem that affects children and adults of all ages. It is both humane and inexpensive to identify risk groups that may be victims and perpetrators of bullying and to develop intervention programs to reduce risks. Primordial and primary protection in view of public health is the most important form of prevention; policies and programs aimed at provision of multifaceted community education, development, and improvement should be implemented in order to reduce or even prevent bullying in society.

Human T-lymphotropic virus-I/II (HTLV-I/II) and human immun viruses (HIVs), that have similar genomic characteristics also share the same transmission routes and infect T lymphocytes. Regarding this epidemiological similarity, HIV and HTLV infections can be seen together. HIV and HTLV-I/II coinfection occurs with variable frequencies in different populations and geographic regions. There are not any population-based studies carried out defining the number of individuals coinfected with HIV and HTLV-I/II in Turkey. The aim of this study was to determine the seropositivity rates of HTLV-I/II in patients whose HIV viral load was monitored in Gazi University Faculty of Medicine Medical Virology Laboratory Forty-seven HIV positive cases followed-up in Medical Virology Laboratory for HIV viral load monitoring between May 2017-January 2019 were included in the study. HIV seropositivity of the samples was confirmed by the chemiluminescence microparticle immunoassay method. HIV viral load values of the samples were evaluated by real-time reverse transcriptase polymerase chain reaction. The samples were screened for antibodies against HTLV-I/II using chemiluminescent microparticle immunoassay. The study population range was between 19 to 60 years of age. Among the study population, 39 (83%) patients were male and 8 (17%) patients were female. Of 47 samples, 18 samples (38.3%) had viral load of = 10000 copies/ml. HTLV serology was negative in all samples included in the study. CD4+ results were available for 42 patients and the CD4+ results of five patients could not be studied. Co-infection with different retroviruses is a well-known fact which should be thoroughly examined. HTLV-I co-infection leads to faster progression of the disease in HIV-1 positive patients. Although it is known that the co-infection has a significant effect on the progression of the disease, there are very few centers in the world and in our country that routinely perform HTLV testing in HIV-positive patients. We think that in order to evaluate the clinical and microbiological importance of the coinfection of retroviruses with each other and to determine the frequency of these infections together, there is a need for studies involving a larger number of patients, including detailed clinical backgrounds of individuals, and that the importance of this issue should be realized at the same time.

Objective:The physical or emotional difficulties faced by academicians negatively affect their productivity. The aim of this study is to translate and adapt a Turkish version of the Work Limitations Questionnaire-Short Form (WLQ-SF) and investigate its validity and reliability. The WLQ-SF assesses academicians who have suffered from physical or emotional health limitations in the past 2 weeks while working.Methods:In this study, the mean age of 104 participants who completed the Turkish version of the WLQ-SF was 37.75±9.43 years. The test-retest reliability was evaluated using the WLQ-SF with a 7-day interval. The test-retest reliability assessed through intraclass correlation coefficient (ICC) and Cronbach’s alpha (α) were used to determine the construct validity and time-invariant reliability of the scale over time.Results:The WLQ-SF provided construct validity with 68.62% variance under two factors (Bartlett’s test of sphericity value, 407.830; Kaiser-Meyer-Olkin (KMO) value, 0.746; p=0.0001) and was found to be valid. It demonstrated a high test-retest reliability (ICC =0.96) and good internal consistency (Cronbach’s alpha =0.83) for all domains. Therefore, the WLQ-SF in the Turkish language is a valid and reliable test.Conclusion:The Turkish version of the WLQ-SF was found to be valid and reliable for evaluating the effect of physical and emotional health among academicians. It is an important scale to measure the impact of both physical and emotional health at work.

Purpose: In this study, it is aimed to increase the level of health literacy of the students who are studying at the Faculty of Health Sciences and who will take place in different stages of health service provision in the future with educational intervention.Method: This study is an intervention study. Students of Ankara Gazi University Faculty of Health Sciences were given a 12-week face-to-face training within the sope of 2019-2020 Fall Period Health Literacy course. Pre and post-training health literacy levels were measured with Turkey Health Literacy Scale-32. The data were analyzed with the SPSS 23 program. Pre-test and post-test scores were compared using the Wilcoxon test. The statistical significance level was accepted as p

Background: Previous studies have not shown the level of health literacy or associated factors on a national level in Turkey using a scale that has been adapted to the country and its culture. Objective: This study aimed to determine health literacy levels in Turkey and to investigate the association of health literacy with socioeconomic factors as well as with the instruments used as sources of health-related information. Methods: This cross-sectional, nationally representative study was conducted using a computer-assisted personal interview approach and included 6,228 households (response rate, 70.9%). The Turkey Health Literacy Scale was used to measure health literacy. Sources of health-related information, such as newspapers, television, internet, and smartphones, were included in the regression model for health literacy. Key Results: The proportion of participants with inadequate and problematic health literacy was 30.9% and 38%, respectively, showing that approximately 7 of 10 participants had limited health literacy. The frequencies of inadequate and problematic health literacy were higher in the disease prevention and promotion domains (37.4% and 34.2%, respectively) compared with those in the health care domain (27.1% and 31.3%, respectively). The most frequently used medium as a source of health-related information was the internet (48.6%), followed by television (33%). In controlled models, higher health literacy scores were associated with higher education and income levels. The effects of television (β = 1,917), internet (β = 2,803), newspapers (β = 1,489), and smartphones (β = 1,974) as sources of health-related information were statistically significant in the general health literacy index model. Conclusions: Health literacy in Turkey reflects social inequalities. The model accounting for socioeconomic variables demonstrated the relevance of sources of health information to level of health literacy. These findings emphasize the importance of improving sources of health information to improve health literacy. [ HLRP: Health Literacy Research and Practice . 2021;5(2):e109–e117.] Plain Language Summary: This is a cross-sectional study that is representative of the population of Turkey. We reported that health literacy scores were higher for people in higher levels of socioeconomic status. We showed that using the television, internet, newspapers, and smartphones as a source of health-related information is associated with health literacy even when accounting for socioeconomic variables.

Background: Although dentists are among high-risk groups for COVID-19 due to their practice requiring to be in close proximity to patients’s oral cavities, there is a clear lack of studies on the frequency of hesitancy towards COVID-19 vaccines and the factors that influence the said hesitancy. This study aims to determine the factors causing hesitancy to receive COVID-19 vaccines in dentists and the frequency of the hesitancy. Methods: The universe of this online cross-sectional survey was 23,664. Participants were then selected from the association’s member list using the numbers table. Dentists were selected by random sampling method and the sample size was 458. SPSS 22.0 for Windows was used for the data analysis. Chi-square test was used in the comparison analysis of categorical variables, and the statistical significance level was set as p

2019’un sonunda Çin’in Hubei eyaleti Wuhan şehrinde ortaya çıkan ve yayılanSARS-CoV-2 virüsü sonucu meydana gelen COVID-19 pandemisihalen ciddi bir halk sağlığı problemi olarak etkisini sürdürmektedir. Virüsün yarasa kaynaklı olduğu düşünülmektedir. Hastalık damlacık ve temas yolu ile insandan insana bulaşmaktadır. İnkübasyon süresi ortalaması 4-5 gün (0-14 gün) olarak gösterilmiştir. En yaygın semptomları ateş, kuru öksürük ve nefes darlığıdır. Hastalık ileri yaş ve komorbid hastalığı olan kişilerde şiddetli ve mortal seyredebilmektedir. Erkeklerde daha fazla fatalite hızı gösterilmiştir. Fatalite hızı dünya genelinde %2-3 olarak değişmektedir. Yaş arttıkça fatalite hızı artmaktadır. Rutin BCG aşısı politikasının mortaliteyi azalttığı düşünülmektedir. Teşhis olası vakalarda virüsün solunum sekresyonlarında özel moleküler testlerle gösterilmesi ile konur. Klinik şüphe varlığında tedavi planlamasında akciğer grafisi ve bilgisayarlı tomografi gibi görüntüleme yöntemleri kullanılmaktadır. Esas olarak destekleyii ve ampirik tedavi uygulanmakta olup spesifik tedavisi ve aşısı henüz yoktur. İnsanların temasının azaltılması, kesin ve şüpheli vakaların izolasyonu ve bulaştan korunmak için kişisel koruyucu ekipmanların etkin kullanımı salgın ile mücadelede çok büyük öneme sahiptir.

INTRODUCTION: During this time when the COVID-19 is rising in Turkey, assessing the knowledge, attitude and practices of the public about the COVID-19 will be useful in finding out whether the interventions to control the outbreak are effective and viable Furthermore, such studies are needed to properly manage the outbreak process and cast light on future interventions This study aims to assess the knowledge, attitude and practices of people in Turkey about the COVID-19 METHODS: A cross-sectional survey was implemented between 11 and 21 April 2020 using an online questionnaire The survey was applied online, and social media platforms were used to reach out to the highest number of people who met the inclusion criteria (i n , people aged 18 or older) The questionnaire consists of three parts (socio-demographic 40 questions, medical history, and knowledge, attitude, and practice section) Descriptive statistics and a comparison of participants' knowledge degrees about COVID-19 is tested using the Chi square test RESULTS: A total number of 8505 participant were accepted for the study 59 3% (5045) of respondents were women and 77 7% (6808) had a university degree or higher 85 6% (7277) of the participants had a good level of knowledge about COVID-19 Over 90% of participants have answered the questions about the mode of transmission of the COVID-19, symptoms, risk groups, isolation, and treatment correctly 55 2% (4696) of respondents thought that the disease would be successfully taken under control in Turkey and 38 6% (3282) in the world eventually 55 6% (4731) believed that the COVID-19 will not go away when the weather gets warmer 35 1% (2983) believed that getting the disease is preordained by fate The most frequently practiced protective behaviors included hand hygiene, staying at home and wearing mask outside 98 8% reported that they use their hands in order to protect theirselves from COVID-19 DISCUSSION AND CONCLUSION: Though, the knowledge attitude and practice of participants in our study was evaluated high, there were some knowledge and practice gaps in study population that should be considered in further community interventions The future interventions for the epidemic control need to consider social determinants such as the level of education, employment status and religious beliefs of people

Çocuklarda ev kazaları önlenebilir, önemli bir halk sağlığı sorunudur. Bu çalışmanın amacı Gazi Üniversitesi Tıp Fakültesi Hastanesi Çocuk Sağlığı ve Hastalıkları polikliniklerine başvuran 0-6 yaş grubu çocuğu olan annelerin ev kazalarına yönelik güvenlik önlemlerini tanılama düzeyleri ile sağlık okuryazarlığı ilişkisinin incelenmesidir. Araştırmanın tipi kesitseldir. %95 güvenilirlik, %5 hata, %4 sapma ve %30 yeterli-mükemmel SOY düzeyi sıklığı ile hesaplanan örneklem sayısı 443’tür. Araştırmada veri kaynağı olarak tanımlayıcı özellikleri içeren bir anket formu, annelerin sağlık okuryazarlığını değerlendiren Türkiye Sağlık Okuryazarlığı Ölçeği ve 0-6 Yaş Çocuklarda Annenin Ev Kazalarına Yönelik Güvenlik Önlemlerini Tanılama Ölçeği kullanılmıştır. Araştırma verisi SPSS 23,0 istatistik paket programı aracılığıyla değerlendirilmiştir. İstatistiksel yöntem olarak; iki bağımsız grup arasındaki istatistiksel anlamlılıklarda Mann-Whitney U, ikiden fazla bağımsız grup arasındaki istatistiksel anlamlılıklarda Kruskal Wallis testleri kullanılmıştır. SOY puanı ile annelerin ev kazalarına yönelik güvenlik önlemleri tanılama ölçek puanı ilişkisini değerlendirmek için Spearman korelasyon testi uygulanmıştır. Araştırmaya 491 kişi dahil edilmiştir. Araştırmaya katılan annelerin %23,6’sı yetersiz, %39,3’ü sorunlu sınırlı, %24,6’sı yeterli ve %12,4’ü mükemmel SOY düzeyine sahiptir. Annelerin ev kazalarına yönelik güvenlik önlemlerini tanılama ölçeğinden aldıkları puan ortalaması 164,84±19,71, ortancası 167 (min:95, max:200)’dir. Çalışma sonucunda, annelerin sağlık okuryazarlığı düzeyi ile ev kazalarına yönelik alınan güvenlik önlemleri ölçek puanları arasında orta düzeyde pozitif yönde bir korelasyon mevcuttur (r:0,487; p, Home accidents in children can be prevented, it is an important public health problem. The aim of this study is to examine the relationship between health literacy and the level of diagnosing safety measures for home accidents of mothers with 0-6 age group children who applied to Gazi University Medical Faculty Hospital Pediatrics outpatient clinics. The type of research is cross-sectional. The number of samples calculated with 95% confidence, 5% error, 4% deviation, and 30% adequate-perfect SOY level was 443. In the research, a questionnaire containing descriptive features, the Turkish Health Literacy Scale, which evaluates the health literacy of mothers, and the Scale for Diagnosing the Mother's Safety Precautions for Home Accidents in Children aged 0-6 were used as data sources. The research data were evaluated through the SPSS 23.0 statistical package program. As statistical methods, Mann-Whitney U tests were used for statistical significance between two independent groups, and Kruskal Wallis tests were used for statistical significance between more than 2 independent groups. Spearman correlation test was applied to evaluate the relationship between the SOY score and the mothers' safety measures for home accidents diagnosis scale scores. 491 people were included in the study. 23.6% of the mothers participating in the study had an inadequate, 39.3% problematic-limited, 24.6% adequate, and 12.4% excellent HL levels. The mean score obtained by the mothers from the scale for diagnosing safety measures for home accidents is 164.84±19.71, with a median of 167 (min:95, max:200). As a result of the study, there is a moderate positive correlation between the health literacy level of the mothers and the scale scores of the safety measures taken for home accidents (r:0.487; p

Background: Sedentary lifestyle is common in various age groups all over the world and it is an important public health issue because of its adverse effects on health. Taking actions against inactivity among medical students is important because they will become role models for their patients as future doctors. In this research, physical activity (PA) frequency and factors affecting participation in PA among medical students were studied. Methods: Six hundred sixty-eight medical students from Gazi University Medical Faculty took part in the study. The students answered sociodemographic questions in addition to completing the Global Physical Activity Questionnaire (GPAQ). Results: One-quarter (24.9%) of the participants did no physical activity. Logistic regression indicated that being female (OR: 1.7), father’s inactivity (OR: 2.2), and family income less than 4500 TL (OR: 1.5) were significant factors in not doing PA among the medical students. Conclusions: As medical students will play a critical role in improving public health as future doctors, intervention programs should be encouraged in order to increase the PA level of medical students to create a healthy lifestyle habit.

Background Studies have shown, ambient temperature can affect the transmission and survival of coronaviruses. This study aimed to determine whether the number of COVID-19 cases and 14-day fatality rates (FR) in Berlin are associated with temperature. Methods Within the scope of this study, a total of 240 days of Berlin belonging to the dates 28.08.20- 24.04.21 were examined. Daily highest temperature, lowest temperature, daily average temperature, number of daily cases, number of deaths were accessed free from the berlin.de and weather.com site. In addition, the incubation period of COVID-19 was assumed to be 14 days, and the fatality rates of 14 days and the average temperatures of these days were calculated. The relationship between the data was evaluated with the Spearman correlation test. Results When the 240 days are examined, the average daily temperature varies between -7.5- 23.5 °C, the fatality rates of 14 days vary between 0- 7,3%. The period with the highest fatality rate of 14 days is between 29.1.21-11.2.21 (FR = 7.3%) and the average temperature of this period (-1.8 °C) is the 14 days with the lowest average temperature. Very strongly negative relationship (r = -0.920; p < 0.001) was determined between FR and 14-day average temperature. It was noted that as the daily temperature decreased, the number of deaths per day (r = -0.695; p < 0.001) and the number of daily cases (r = -0.296; p < 0.001) increased. 1 °C decrease in temperature was associated with an increase in daily new deaths by 1.29 (B = -1.29, 95% CI: -1.55, -0.1.09; p < 0.001, Adj. R2 = 0.3). Conclusions Our analysis results showed that the number of COVID-19 daily cases and 14-day fatality rate increased with a low temperature in the Berlin sample. Key messages Temperature showed a negative correlation between COVID-19 fatality rate. Further evaluation may be required globally with more data to determine temperature and COVID-19 cases.

Objective This study aimed to determine the level of anxiety in elderly individuals during the COVID‐19 pandemic in Ankara province of Turkey and determine its associated factors. Methods A quantitative, qualitative mixed‐method study performed in 1–10 June 2020 during the compulsory home‐stay for elderly people in Turkey. The quantitative study was conducted using a structured online questionnaire with 278 participants aged 65 or older. The Geriatric Anxiety Inventory (GAI) was used to assess the anxiety. An in‐depth interview with 20 participants was used to fill the gap of face‐to‐face interview due to pandemic situation and strengthen the results of quantitative survey. Qualitative and quantitative data were analyzed separately. Results Of all participants, 88 (31.7%) had a score above the cut‐off point for GAI. The prevalence of Generalized Anxiety Disorder (GAD) was significantly higher in female (37.8%) than in male (23.8%). Female gender, economic loss, uncertainty, and the time participants expend to follow news about COVID‐19 pandemic were risk factors of GAD. On the other hand, higher education level, hobbies, and regular physical activity were protective factors against GAD. Conclusion During the pandemic, social isolation and lockdown for elderly people make serious risk factor for their mental well‐being. Measures must be taken to support the psychological well‐being of elderly by promoting physical activity and hobbies at home, and reducing their economic concerns., Key points The measures taken against the pandemic have important effects on the mental health of the elderly population. The most important psychological consequences of isolation are loneliness, uncertainty, and anxiety.It was seen in this study that the anxiety level of the elderly population was affected by various factors, including social and psychological, during the pandemic period.We have found in this study that having a hobby, high education level, and regular physical activity were protective in terms of anxiety level in pandemic conditions for the elderly population.Considering that the elderly population is increasing in developing countries, especially in Turkey, it is crucial to protect the mental health of the elderly population under pandemic conditions.

The Covid-19 outbreak that emerged in the world at the end of 2019 turned into a pandemic by affecting the whole world at the beginning of 2020. Measures such as domestic / international travel restrictions, curfew, quarantine implementation, closure of schools / universities, and closure of some workplaces against the Covid-19 pandemic have changed the daily life routines of many people in the world. The mitigation of these measures has been considered due to their social and economic adverse effects. Maintaining the basic principles such as the use of masks, compliance with the social distance rules, paying attention to personal hygiene, and continuing with limited life is almost a new normal. Therefore, normalization processes have started in the countries. © Copyright 2021 by Gazi University Medical Faculty - Available on-line at web site http://medicaljournal.gazi.edu.tr/

Penoxsulam is a new sulfonamide herbicide used on rice crops for annual grasses, broadleaf weeds, and sedges control, either grown through transplanting or direct dry or direct seeding methods of planting. In this study, Allium cepa ana-telophase and comet assay were used to examine the cyto-genotoxic effects of herbicide penoxsulam on A. cepa roots. A. cepa bulbs were exposed to ½xEC50 (12.5 µg/L), EC50 (25 µg/L) and 2xEC50 (50 µg/L) concentrations of penoxsulam for 24, 48, 72 and 96 h. Distilled water and 10 ppm of methyl methanesulfonate (MMS) were used as negative and positive control groups, respectively. Penoxsulam showed a cytotoxic effect by reducing root growth and mitotic index (MI), a genotoxic effect because it statistically increased chromosome aberrations (CAs, anaphase bridge, chromosomal laggards, polyploidy, disturbed ana-telophase and stickiness) and DNA damage as compared to control. Liquid chromatography-tandem mass spectrometry (LC-MS/MS) was also used for quantitative analysis of penoxsulam in A. cepa root meristem cells. Further molecular toxicological evaluations associated in the cyto-genotoxicity of penoxsulam on plants are needed to confirm these results

The current outbreak of the Coronavirus, severe acute respiratory syndrome Coronavirus-2, which originated in the Wuhan province of the People's Republic of China became a pandemic. Although the clinical findings of the infection vary in adults, the most common symptoms are fever, dry cough, and shortness of breath. The diagnosis of the Coronavirus disease-2019 (COVID-19) is made by clinical symptoms, laboratory tests, and radiological methods. Many drugs such as antivirals, antibiotics, and corticosteroids are used in the treatment of COVID-19. For the successful control of the pandemic, prevention strategies are the key. There is strong consensus that, in addition to wearing masks, hand hygiene, and social distancing, an effective COVID-19 vaccine is probably the most effective approach to sustainably control the pandemic. In this article, current information about the pathogenesis, epidemiology, risk groups, diagnosis, treatment, prevention strategies, and vaccination of the disease in the first year of the COVID-19 pandemic are discussed.

The World Health Organization defines health literacy as the cognitive and social skills which determine the motivation and ability of individuals to gain access to understand and use information in ways which promote and maintain good health. Health literacy improves the life expectancy and quality and removes health inequalities. Health literacy includes the stages of reading, listening, analyzing, participating, and making decisions and adapting to life. An infodemic is an overabundance of information. It includes deliberate attempts to disseminate wrong information to undermine the public health response and advance alternative agendas of groups or individuals. Mis- or disinformation can be harmful to people's health, threaten precious health gains, and lead to poor observance of public health measures, thus endangering countries' ability to stop the pandemic. Media is one of the important sectors in health and health literacy. The concepts of infodemic became a current issue with the COVID-19 pandemic and revealed how important the role the media plays in intervening the health problems is.

Pandemics as global crises affect our daily routines and practices nowadays. On 11 March 2020, WHO announced the COVID-19 as a pandemic. As the COVID-19 is a communicable disease, public health practices constitute the major preventive mechanism as primary protection besides treatment. Risk communication is essential for public awareness, preventive measures, and containing the outbreak during the pandemic. In a broader aspect, “crisis and risk communication” corresponds to a greater frame that consists of urgent crisis communication, empowering the decision-making process, and building a communication network between the experts and the common. The media plays an important role in conveying information amongst the risk communication experts, administrators, and the common. Pandemic is a dynamic period. In this period, changes are possible in human perception, sensitivity levels, and behaviors. Uncertainty is present in this course. To overcome this uncertainty, correct risk communication with media collaboration is essential.

Purpose: We designed a multicenter, retrospective study to investigate the current trends in initial management of reflux with respect to EAU guidelines in Urology clinics of our country. Materials and Methods: The study group consisted of 1988 renal units (RU) of 1345 patients treated surgically due to VUR between years 2003-2017 in 9 different institutions. Patients were divided into 2 groups according to time of initial treatment and also grouped according to risk factors by “EAU guidelines on VUR”. Results: 1426 RUs were treated initially conservatively and 562 RUs were initially treated with surgery. In initially surgically treated group, success rates of surgery decreased significantly in low and moderate risk groups after 2013 (p=0.046, p=0.0001, respectively), while success rates were not significantly different in high risk group (p=0.46). While 26.6% of patients in low risk group were initially surgically treated before 2013, this rate has increased to 34.6% after 2013, but the difference was not statistically significant (p=0.096). However, performing surgery as the initial treatment approach increased significantly in both moderate and high risk groups (p=0.000 and p=0.0001, respectively) after 2013. Overall success rates of endoscopic and UNC operations were 65% and 92.9% before 2013, 60% and 78.5% after 2013, respectively. Thus the overall success rate for surgery was 72.6%. There was significant difference between success rates of UNC operations before and after 2013(p=0.000), while the difference was not significant in the STING group (p=0.076). Conclusion: Current trends in management of reflux in our country do not yet follow the EAU guidelines on VUR in low and moderate risk groups.

PURPOSE We designed a multicenter, retrospective study to investigate the current trends in initial management of reflux with respect to European Association of Urology (EAU) Guidelines in Urology clinics of our country. MATERIALS AND METHODS The study group consisted of 1988 renal units (RU) of 1345 patients treated surgically due to vesicoureteral reflux (VUR) (between years 2003 and 2017) in nine different institutions. Patients were divided into two groups according to time of initial treatment and also grouped according to risk factors by "EAU guidelines on VUR." RESULTS In this series, 1426 RUs were treated initially conservatively and 562 RUs were initially treated with surgery. In initially surgically treated group, success rates of surgery decreased significantly in low and moderate risk groups after 2013 (P = .046, P = .0001, respectively), while success rates were not significantly different in high risk group (P = .46). While 26.6% of patients in low risk group were initially surgically treated before 2013, this rate has increased to 34.6% after 2013, but the difference was not statistically significant (P = .096). However, performing surgery as the initial treatment approach increased significantly in both moderate and high risk groups (P = .000 and P = .0001, respectively) after 2013. Overall success rates of endoscopic treatments and ureteroneocystostomy (UNC) operations were 65% and 92.9% before 2013 and 60% and 78.5% after 2013, respectively. Thus, the overall success rate for surgery was 72.6%. There was significant difference between success rates of UNC operations before and after 2013 (P = .000), while the difference was not significant in the injection group (P = .076). CONCLUSION Current trends in management of reflux in our country do not yet follow the EAU guidelines on VUR in low and moderate risk groups despite these reliable and accepted guidelines were expected to influence our daily approach.

Aim: Our aim is to determine the risk factors for patients whose clinical stability can not be reached or whose can not be discharged with the optimal care. Material-Method: It is a multicenter, prospective observational study. 434 patients who were hospitalized (non-ICU) with severe exacerbation were included in the study. The primary endpoint for "difficult-to-manage COPD exacerbation" is prolonged hospitalization (PH). Hospitalizations of >8 days accepted as PH. To identify risk factors and to develop a scoring system that predicts PH. Results: 361 (83.2%) of the patients are male and the mean age is 69.2±9.3 year. 285 (67.2%) of the patients are in the GOLD-D group. There was prolonged hospitalization in 237 patients (54.6%). The factors related with PH are smoking,pathological X-ray,GOLDgroup C/D,high CRP, HAP,requiriment of NIV/parenteral nutrition,delaying examination. A combined scoring system that can predict the odds of PH is shown in Table1. The risk of PH increases 4 times in patients who score ≥3 (OR:3.9, 95%GA 2.5-61,P>0.001). Conclusion: Factors that can be related with PH for the COPD exacerbations should be evaluated in terms of patient, disease and hospital dynamics. We think that the scoring system developed in this study can be used to predict PH and therefore diffucult to manage COPD.

A new type of coronavirus caused a serious public health crisis in early 2020 and virus started to spread rapidly and required serious preventions. Understanding and implementing these preventions may be insufficient in some vulnerable groups. The migrants is one of these groups. Migrants may not be able to adequately understand the suggestions expected to reach the public due to language differences. Some negative living conditions brought by the migration process may make it difficult for them to implement these preventions adequately. Also such as socioeconomic level and legal status can restrict migrants access to healthcare. Especially with regard to infectious diseases and epidemics that require rapid intervention, immigrants' disregard may prevent the measures from achieving their intended purpose. Therefore, immigrant groups should be included in the intervention plans and health strategies of the states. immigrants should be made part of the holistic efforts against the COVID-19 epidemic in the general community. It should be ensured that all measures can be taken and implemented for immigrants, regardless of their status and inclusion.

Turkey is one of the countries which have taken precautions against the COVID-19. The precautions taken brought the first case in our country to be seen later than many countries and to spread the epidemic less. After the first COVID-19 case was detected in our country on March 11, 2020, the four periods of 14 days have been examined separately about the course of the epidemic and the public health interventions implemented in these periods. And the results it has generated between the periods have been evaluated. The steady decline in case of increase shows we have controlled the epidemic.

In outbreaks, human behavioral responses have been shown to affect social outcomes. For emergency intervention, it is important to integrate approaches and interventions based on public science. The perception and implementation of interventions by the community is closely related to the level of health literacy of individuals. In this review, individual behavior models and effective factors were examined in outbreaks. During the epidemic, the effect of health literacy was mentioned in the success of crisis communication., Salgınlarda, insanların davranışsal tepkilerinin toplumsal sonuçları etkilediği görülmüştür. Acil müdahale için toplum bilimlerine dayalı yaklaşımları ve müdahaleleri entegre etmek önemlidir. Müdahalelerin toplum tarafından algılanması ve uygulanması ise bireylerin sağlık okuryazarlığı düzeyi ile yakından ilişkilidir. Bu derlemede salgınlarda birey davranış modelleri ve etkili faktörler incelenmiştir. Salgın esnasında uygulana kriz iletişiminin başarısında sağlık okuryazarlığının etkisine değinilmiştir.

Background Several studies have documented human papillomavirus (HPV) in extra-cervical tumors. We aimed to detect HPV type 16 and HPV other than type 16 (OT-16) DNA in esophageal papilloma and esophagus squamous cell carcinoma (ESCC) samples and to compare clinicopathological features of HPV positive and negative patients. Methods Materials were obtained from a tertiary care public hospital and studied in an university hospital for this cross-sectional study. Seventy-six tissue samples (50 papilloma and 26 ESCC) were included. After deparaffinization by xylene and DNA extraction by phenol chloroform-isoamyl-alcohol, 76 samples were studied with a G6PDH control kit. Forty-four papilloma and 21 ESCC samples with enough tissues were studied for HPV DNA. HPV OT-16 DNA and HPV type 16 were detected by real time-polymerase chain reaction. Results Twelve (27.3%) and one (2.3%) of the papilloma samples were HPV type 16 and other than type 16 positive, respectively. Eleven (52.4%) and one (4.8%) of ESCC samples were HPV type 16 and mixed type positive, respectively. Conclusions We suggest that HPV infection is common in esophageal papilloma and ESCC. Due to the wellknown association of HPV with premalignant and malignant conditions, follow-up of these patients accompanied by HPV should be implemented.

[No Abstract Available]

Adolescents are mostly considered as a healthy population; however, failure to acquire positive health behaviors during this period makes them vulnerable to poor health outcomes and long-term chronic disorders. Health literacy is one of the most influential parameters in promoting adolescent health. This study aimed to determine the level and promoters of health literacy in adolescents, emphasize the importance of internet use, and evaluate the relationship between self-efficacy and health literacy.A total of 756 adolescents aged 15 and 18 years attending two high schools in socioeconomically different districts in Ankara, Turkey were included in this cross-sectional study. A survey consisting of descriptive questions, a health literacy survey, and a general self-efficacy scale were used to collect data. p0.05 was considered statistically significant.Among the adolescents who participated in the study, the level of health literacy was inadequatelimited in 56.1%, sufficient in 30.1%, and excellent in 13.8%. A statistically significant correlation was found between health literacy and general self-efficacy levels (r: .412, p0.001). There was also a statistically significant difference between the health literacy groups in terms of the education level of the adolescents` mothers, internet use frequency, and self-efficacy level. The multivariate logistic regression analysis revealed that the participants whose mothers had only received primary school education or no formal education, those that were not using the internet regularly, those that did not search health information on the internet, and those with poor self-efficacy levels were more likely to have an inadequate level of health literacy [odds ratio (OR)=2.6, 95% confidence interval (CI)=1.4-4.9; OR=5.5, 95% CI=1.2-25.1; OR=1.7, 95% CI=1.1-2.9; and OR=3.7, 95% CI=2.6- 5.2, respectively].In this study, it was concluded that the adolescents` health literacy and general self-efficacy levels were related. Furthermore, the health literacy level of the adolescents was associated with internet use and maternal education status.

Background/aim: To determine the frequency, genotype distribution, and genetic relatedness of adenoviruses in children under 5 years old with diarrhoea and to investigate their distribution according to clinical findings, age, months, and seasons. Materials and methods: Stool samples were collected from 180 children with acute gastroenteritis who presented from July 2007 through June 2011 at the Ankara Training and Education Hospital. Stool samples were analysed by immune chromatographic test (ICT), enzyme immunoassay (EIA), and polymerase chain reaction (PCR). All adenovirus types were determined by nucleotide sequence analysis. A phylogenetic tree was constructed by Mega 6.0 using the neighbour-joining method. Results: Five percent of the samples were positive for adenovirus (9/180) by ICT, 6.1% (11/180) by EIA, and 13.9% (25/180) by PCR. Adenovirus gastroenteritis did not show any differences in age group, sex, month, or season. In this study, 16 (64%) of the PCR positive samples were AdV41, 6 (24%) were AdV40, 2 (8%) were AdV31, and 1 (4%) was AdV7, as determined by nucleotide sequencing. Conclusion: AdV31 and AdV7 were associated with gastroenteritis. Adenovirus serotypes showed a similarity of 80% (20/25) and 20% (5/25) with Asian and American serotypes, respectively.

Background/aim: Investigation of the association between obesity and the distinction of radiographic patterns in knee osteoarthritis. Materials and methods: Seven hundred and thirty-four women underwent weight-bearing antero-posterior knee radiography. Osteophytes and joint space narrowing (JSN) were graded according to the OARSI atlas. Each subject was assigned to one of the following groups with respect to the maximum score: osteophyte-dominant, indeterminate, JSN-dominant, and radiographically normal. Results: Obese patients had a significantly more frequent osteophyte-dominant pattern compared to nonobese subjects (74.5% and 38%, respectively, P < 0.001). Logistic regression analysis demonstrated that obesity had a stronger association with an osteophytedominant pattern compared to a JSN-dominant pattern (OR and 95% CI = 7.16 (3.15-16.26) and 1.63 (0.96-2.78), respectively). Age had a very weak effect on the distinction to an osteophyte-dominant pattern and no effect on JSN dominance (OR and 95% CI = 1.1 (1.06-1.15) and 1.02 (0.99-1.05), respectively). Conclusion: There might be an association between obesity and the radiographic phenotype in patients with knee osteoarthritis. The findings suggest that the association between obesity and the osteophyte formation is stronger than that of JSN.

Background Human papillomavirus (HPV), the causative agent of cervical cancer, is also suggested as a risk factor for gastric adenocarcinoma. Many infectious agents besides Helicobacter pylori have been associated with gastritis. The aim of this study was to investigate HPV DNA and genotyping HPV type 16 DNA in gastric adenocarcinoma and Helicobacter pylori gastritis cases. Methods A hundred and six gastric adenocarcinoma and Helicobacter pylori gastritis samples and 26 controls were included. After deparaffinization by xylene, DNA extraction was performed by the phenol-chloroform-isoamyl alcohol method and 106 samples were studied with a G6PDH control kit (Eurogentec, Seraing, Belgium). Fifty-three adenocarcinoma and 43 Helicobacter pylori samples were thought to have enough tissue and were studied for HPV DNA. HPV types other than 16 and HPV type 16 DNA were detected by Real Time PCR using the L1 region. Amplifications of MY09/11 products were done by GP5+/GP6+ primers and Cyanine-5 labeled HPV DNA and HPV 16 DNA specific probe in Light Cycler 2.0 (Roche Diagnostics, Germany) device. Results Among gastric adenocarcinoma and Helicobacter pylori gastritis samples, 20/53 (38%) and 18/43 (41.8%) were HPV DNA positive, respectively. Five (19.2%) of 26 controls were HPV DNA positive. Conclusions Our 38% positive result in the gastric carcinoma group is in concordance with previous reports. This is the first study revealing the HPV-H. pylori relationship in gastritis cases and we concluded that with regard to the nearly three-fold higher HPV DNA (41.8%) in gastritis cases compared to controls, Helicobacter pylori positive cases should also be evaluated in favor of HPV in the gastritis group.

We aimed to describe rotavirus epidemiology and clinical findings including extraintestinal manifestations in a setting that has yet to introduce rotavirus vaccines in the national immunization program. A literature search was performed by using the key words "Turkey" and "rotavirus." Ninety-eight studies published between 1987 and 2016 including epidemiological, clinical, and genotypical data at least 1 year duration were included. There were a total of 117 741 children with diarrhea and 26 566 rotavirus gastroenteritis with a median detection rate 31.8% (95% CI, 31.3-32.4) under 5 years of age. The rate of dehydration was 47% (95% CI, 23.4-91.6). There were 328 cases reported to be presenting with a various complication related to rotavirus in 2750 children in eight studies. The overall complication rate was 11.7% (95% CI, 10.7-12.9). The cumulative incidence of the most common genotypical combinations circulating worldwide was only 59.7% (G9[P8], 25%; G1[P8], 22%; G2[P4], 5.6%; G3[P8], 2.6%; G4[P8], 4.5%) whereas mixed, untypeable, and other genotypes were 2.4%, 15%, and 22.9% respectively. Our results point out the importance of rotavirus vaccination by presenting that rotavirus may cause severe complications besides severe gastroenteritis. The role of strain diversity in the variability of clinical presentations of rotavirus infections needs to be further investigated.