Kütahya Health Sciences University Research Information System
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Sexual health literacy and sexual and reproductive health service seeking among young people in Türkiye: levels and determining factors
No full textThe effect of the COVID-19 pandemic on vaccines and vaccination-related beliefs in Türkiye: A cross-sectional study
No full textIt was aimed to determine the beliefs and opinions of the people participating in our research about vaccination and to assess whether the COVID-19 pandemic process affected their belief and opinion about vaccination, and if so, in which direction. This descriptive cross-sectional study conducted a Family Health Centre in Kütahya. In this study, a questionnaire form were used to determine opinions about vaccination practices. Of the 377 people participants, 184 (48.8%) were male and 193 (51.2%) were female. While 313 (83%) of the participants were positive, 10 (2.7%) had negative opinions about vaccines and 54 (14.3%) were undecided. After the COVID-19 pandemic, the opinion of 27.3% (n:103) of the participants about vaccination has changed compared to before. It was found that 64 (63.1%) of 103 people who had a change in their opinion of vaccination had a positive change. According to our work, the risks posed by the pandemic have caused positive changes in overall vaccination opinion of the participants. Cette étude descriptive transversale, menée dans un centre de santé familiale de Kütahya, visait à déterminer les croyances et opinions des participants concernant la vaccination et à évaluer si la pandémie de COVID-19 les avait influencées, et le cas échéant, dans quel sens. Un questionnaire a permis de recueillir les opinions sur les pratiques vaccinales. Parmi les 377 participants, 184 (48,8 %) étaient des hommes et 193 (51,2 %) des femmes. 313 participants (83 %) avaient une opinion positive, 10 (2,7 %) une opinion négative et 54 (14,3 %) étaient indécis. Après le début de la pandémie, l'opinion de 27,3 % des participants (n = 103) a évolué. Parmi ces 103 personnes, 64 (63,1 %) ont vu leur opinion évoluer positivement. D’après nos travaux, les risques liés à la pandémie ont induit une évolution positive de l’opinion générale des participants concernant la vaccination
EVLİLİK ÖNCESİ RİSKLİ CİNSEL DAVRANIŞLARA SAHİP KADINLARA TRANSTEORİK MODEL TEMELLİ VERİLEN EĞİTİMİN ETKİNLİĞİ
No full textTurkish validity and reliability of the parental competence questionnaire in the paediatric hospital emergency setting (ECP-U)
No full textAim: The aim of this study is to conduct Turkish validity and reliability study of the parental competence questionnaire in the paediatric hospital emergency setting. Methods: This study is a descriptive, cross-sectional, correlational and methodological study. Participants were 624 parents with children aged 0–14 who presented to the paediatric emergency department between December 2023 and July 2024. The study was carried out in the emergency department of three hospitals in three different regions of Turkey. The data were collected by using the “demographic information form” and “parental competence questionnaire in the paediatric hospital emergency setting”, “state and trait anxiety inventory”, and “parental stress questionnaire”. Explanatory and confirmatory factor analysis, Horn's parallel analysis, Catell's scree test, Cronbach's ordinal alpha coefficients and Pearson correlation were used in the data analysis. Results: The mean age of the mothers included in the study was 34.63 ± 6.94, and the mean age of the fathers was 37.88 ± 7.83. The scale consisted of 18 items and three sub-dimensions: emotional management and expression, social support, and parental agency, explaining 60 % of the total variance. It was determined that the Cronbach's ordinal alpha coefficients of the scale factors were greater than 0.745. There is a negative correlation between the parental stress questionnaire, the state and trait anxiety inventory, and the parental competence questionnaire in the paediatric hospital emergency setting. Conclusions: According to the results of this study, the parental competence questionnaire in the paediatric hospital emergency setting is a valid and reliable measurement tool for the Turkish population
Kolorektal Kanser Sağkalanlarda Kronotropik Yanıt ve Egzersiz İntoleransının İncelenmesi
No full textPurpose: Advances in colorectal cancer (CRC) treatment have significantly increased patient survival rates. However, cancerspecific therapies can induce chronic adverse effects on the cardiovascular system, leading to various symptoms in survivors. The aim of this study was to investigate exercise capacity and cardiac responses to exercise in CRC survivors and compare them with healthy individuals. Methods: The study included twenty-three CRC survivors (aged 18–65 years) and twenty-two age and sex-matched healthy individuals. All participants underwent a Cardiopulmonary Exercise Test (CPET). Physical activity level (SF-IPAQ) and fatigue severity (BFI) were assessed. The chronotropic index (CI) was calculated using the formula (HRpeak-HRrest)/(220-age)(HRrest). Results: Maximal oxygen consumption and the difference between resting heart rate and the peak heart (ΔHR) rate achieved during exercise were lower in CRC survivors compared to healthy individuals (p<0.001, p=0.04, respectively). CI was observed insufficient in 11 (47.83%) CRC survivors and 3 (13.64%) healthy individuals (p=0.01). Whereas physical activity level was similar between the groups (p=0.10), fatigue was more common in CRC survivors (p<0.001). Discussion: Significant reduction in VO2peak, the objective measure of exercise capacity, and the statistically higher prevalence of CI (CI<80%) in CRC survivors highlight a compromise in the cardiovascular system's functional reserve. We suggest that CI acts as a sensitive functional marker of subclinical cardiotoxicity induced by cancer treatments, pointing to an impaired cardiac autonomic response, rather than solely structural heart damage. These findings underscore the long-term need for routine screening of cardiac functional response in this growing population of survivors. </p
Impact of renin–angiotensin system inhibitors on the clinical outcomes of nivolumab therapy in metastatic non–small cell lung cancer
No full textBackground: The objective of this study is to evaluate the correlation between survival outcomes and renin angiotensin system inhibitors (RASI) use in patients treated nivolmab with metastatic non-small cell lung cancer (mNSCLC). Methods: This retrospective cohort multicentre study was conducted on patients with mNSCLC patients treated Nivolumab monotherapy as second line therapy. Factors affecting the survival of patients receiving concurrent RASI therapy with nivolumab were analyzed. Results: 614 patients were included. A total of 288 patients (46.9%) were using concurrent RASI. Patients using RASIs had a median progression free survival (PFS) of 10 months compared to 7 months in non-users. In the multivariate analysis, RASI use (HR: 0.747, 95% CI: 0.594–0.941; p: 0.013) was associated with improved PFS. RASI use was also significantly associated with overall survival (OS), median OS of 20 months in users and 12 months in non-users. In the multivariate analysis, RASI use (HR: 0.600, 95% CI: 0.458–0.787; p < 0.001) was associated with improved OS. Conclusions: In this multicenter real-world study of patients with mNSCLC receiving second-line nivolumab, concomitant use of RASIs was associated with PFS and OS. The integration of RAS blockade into immunotherapy regimens could represent a promising strategy to enhance treatment efficacy
Papain induces Mitochondria-mediated apoptosis and modulates inflammatory signaling in leukemic cells
No full textBackground: Leukemia remains a major therapeutic challenge due to frequent treatment resistance and relapse. Novel agents that preferentially target leukemic cells are urgently needed. Papain, a cysteine protease derived from Carica papaya, has been reported to exhibit antioxidant, anti-inflammatory, and anticancer properties; however, its molecular effects in leukemia cells remain poorly understood. Objectives: This study aimed to evaluate the antileukemic effects of papain on HL-60 and K562 cells, focusing on apoptosis induction, cell-cycle regulation, inflammatory modulation, and gene/protein expression changes. Methods: HL-60 and K562 cells were treated with papain at 123 µM and 386–483 µM, respectively, for 24–48 h. Concentrations were selected based on IC₂₅ values for HL-60 and IC₅₀ values for K562 obtained from viability assays. Cell viability was assessed using the MTS assay. Apoptosis, cell-cycle distribution, and surface expression of **Sema3A—a semaphorin family member involved in immune regulation and leukemic cell signaling—**were analyzed using flow cytometry. RT-qPCR quantified expression of apoptosis-related genes (P53, PTEN, BAX, CASP3, BCL-2, AKT-1, NF-κB), and ELISA measured Cytochrome c, Cleaved Caspase-3, TNF-α, IL-6, IL-10, GPX4, and ACSL4. Results: Papain significantly reduced cell viability in both cell lines in a dose- and time-dependent manner. Increased Cytochrome c and Cleaved Caspase-3 levels suggested apoptosis induction. Papain exposure led to predominant accumulation of cells in the G₀/G₁ phase accompanied by a reduction in the G₂/M population in HL-60 cells, whereas in K562 cells it induced a significant and dose-dependent accumulation in the S phase rather than G₂/M arrest. Papain induced significant alterations in apoptosis-related gene expression in both leukemia cell lines. These changes reflected activation of apoptotic signaling pathways rather than a uniform dose-dependent or directionally consistent transcriptional pattern. Furthermore, papain significantly downregulated Sema3A surface expression and altered cytokine profiles, increasing TNF-α and IL-10 in both cell lines and IL-6 in K562 cells. Conclusion: Papain exhibits antileukemic effects in vitro, associated with mitochondrial-mediated apoptosis, altering cell-cycle progression, suppressing Sema3A expression, and modulating inflammatory responses. These findings suggest that papain may represent a candidate for further preclinical investigation in leukemia models
Design and Modelling of Virtual Reality Application for Prevention of Mining Accidents and Basic Ohs Training: Case Study in Türkiye
No full textThis study aimed to determine the academic success of mine workers in occupational health and safety training by designing virtual reality (VR) interactive teaching material on “personal protective equipment and fire fighting” for underground mine workers. The research was applied to the personnel working in Ömerler Underground Mine, affiliated with the Garp Lignite Operations Directorate of the Turkish Coal Enterprises. The study sample consisted of 40 underground mine workers, 20 in the control and 20 in the experimental group. The subjects of personal protective equipment and underground firefighting training were explained to the control group by Occupational Health and Safety experts using “Explanatory Teaching Methods,” one of the traditional teaching methods, via slides. The miners in the experimental group were provided with the VR-based interactive teaching environment that we designed for the same subject under the supervision of an OHS Expert. Our study aimed to investigate the relationship between the presence levels of miners in the environment and their academic success in the relevant subject. The study covers workers in a specific mine in Turkey. In addition, training scenarios belonging to the occupational accidents that statistically caused the most loss of life in mining accidents were prepared as Occupational Safety Training. Within the scope of the study, academic achievement tests were applied before and after the training to measure the academic success of both groups. In addition, the “Sense of Presence Scale” was applied to the control group employees, and their opinions were obtained regarding the training in question. As a result of the research, the academic success of the employees in the experimental group was higher than that of the control group as a result of statistical analysis. The VR material of the experimental group increased the feeling of being in the environment, and the motivation of the employees in the experimental group was higher. As a result of the study, the academic success of the employees in the Occupational Health and Safety training increased positively, and there was a positive relationship between the sense of presence scale in the virtual reality environment and the academic success scores of the employees
Mothers' perceptions of respectful maternity care and their parental self-confidence levels: a cross-sectional study.
No full textObjective: This study aimed to examine the relationship between mothers' perceptions of respectful maternity care and their parental self-confidence levels.Method: This descriptive cross-sectional study was conducted online using the snowball sampling method with 425 mothers who had a baby aged 0-1 year and experienced a normal birth.Results: The mean age of the mothers was 28.32 ± 5.46 years. Mothers reported high levels of respectful maternity care perception. Variables such as place of birth, birth experience, medical interventions during birth, and receiving support during childbirth significantly influenced respectful maternity care perception. Additionally, a weak but positive correlation was found between respectful maternity care perception and parental self-confidence levels.Conclusion: These findings emphasize that respectful maternity care plays a key role in strengthening mothers' confidence in their parenting abilities. Enhancing supportive, non-interventionist, and positive birth environments may therefore contribute to improved maternal outcomes and a more empowering childbirth experience.</p
Carbohydrate counting in traditional Turkish fast foods for individuals with type 1 diabetes: Can artificial intelligence models replace dietitians?
No full textObjectives: Carbohydrate counting is a recommended approach for achieving glycemic control in individuals with type 1 diabetes (T1D). This study aimed to compare the accuracy of carbohydrate content estimations for traditional Turkish fast foods made by artificial intelligence (AI) models and dietitian. Methods: Children and adolescents with T1D were pretested to identify the 12 most preferred Turkish fastfood items. Standardized recipes were developed for these meals, and the meals were photographed under standardized angular and lighting conditions. The photos were then uploaded to AI applications (ChatGPT4.0, DeepSeek, Gemini, and CarbManager) and each model was prompted to estimate the carbohydrate content of the respective food items. Dietitians were asked to estimate the carbohydrate content based on these photographs. Results: Of the dietitians in the study (n = 40), 50% had postgraduate education, and 17.5% of those providing carbohydrate counting education (n = 20, 50.0%) had been doing so for more than 7 y. No significant difference was found between the carbohydrate estimates of dietitians who provided and those who did not provide carbohydrate counting training (P > 0.05). The intraclass correlation coefficient (ICC) between the AI models was 0.3554 (95% confidence interval [CI]: 0.0974 0.6801), indicating low reliability. The highest agreement with the estimates of dietitians who provided carbohydrate counting training (ICC = 0.417, 95% CI: 0.247 0.685) and those who did not (ICC = 0.307, 95% CI: 0.163 0.578) was observed with ChatGPT. Conclusions: AI models can assist individuals with diabetes and healthcare professionals in estimating the carbohydrate content of foods, and consequently, can make a significant contribution to diabetes selfmanagement.</p