16 research outputs found
Evaluation of COVİD-19 pandemic management in Turkiye
No full textThree years since the first cases were identified and 2 years since an effective vaccine was developed, COVID-19 continues to claim lives and impact people's health and wellbeing, both socially and economically. While the world has been waiting for its leaders to come together to form a collective response to end the pandemic, we still have not seen a multisectoral response, nor any whole-of-society approach. Like many other countries around the globe, Turkiye was caught unprepared by the pandemic. This was exacerbated by the unsuccessful management of the pandemic by the authorities. The reasoning and/or scientific explanations for enforcing or lifting public health measures have never shared with the public. Throughout the pandemic, no epidemiological details have been released on cases and deaths, other than the numbers of these two measures. Civil society organizations, professional associations, and the public in general have been kept out from policy formulation and decision making. As a result, community engagement has never been properly put into practice. In this paper, we analyzed Turkiye's pandemic management response through the continuum of the response cycle to emergencies: prevention, preparedness, readiness, response, and recovery
Prevalence and associated risk factors of type 2 diabetes mellitus in Nilufer District, Bursa, Turkey
No full textThe objectives of this study were to determine the prevalence of diabetes mellitus in Nilufer District, Bursa, Turkey using standardized diagnostic criteria to investigate associated factors, and to determine the risk groups for a preventive public health program. This cross-sectional study was conducted in Nilufer Public Health Training and Research Area, Bursa Province in Turkey. The study population of 727 persons (382 women and 345 men) were selected by a random sampling method. The response rate was 80.6 %. According to the fasting blood glucose levels of the 727 subjects, 44 (6.1 %) were diabetic. In this study, the prevalence of known diabetes was 5.0 %, and the prevalence of previously undiagnosed diabetes was 1.1 %. The ratio of previously undiagnosed to known diabetes was 1:5. Multivariate logistic analyses showed that age (50 and over), family history of diabetes, hypertension and overweight (BMI > 25.0 kg/m2) were risk factors for type 2 diabetes (P < 0.05) in Nilufer District. A public health program in the district should be aimed primarily at these risk groups. The people in the risk groups should be registered and followed-up in a program aimed at preventing overt diabetes. The program can also provide efficient therapy if needed
All-cause excess mortality in 2020: The example of Bursa city in Turkey
No full textBackground: This study aimed to estimate excess all-cause mortality rates in Bursa Province in 2020. Methods: In this study, a retrospective descriptive analysis of the mortality rates in Bursa, Turkey's fourth biggest city, between 2015-2020 was conducted. The data were taken from Bursa Metropolitan Municipality death records. Daily mortality data were classified as age, gender, the date and cause of death (communicable or non-communicable disease). An Excel mortality calculator was used to analyze the data and calculate the excess mortality. Excess mortality was calculated with a 5-year death average. The excess mortality-expected death ratio (P-score) was calculated as a percentage difference between the average number of deaths in 2015-2019 and the number of deaths in the same period (week or month) of 2020. The Chi-square test was used for statistical analysis. Results: In 2020 in Bursa, crude excess mortality was calculated as 5390 (95% CI: 4525-6256) compared to the previous five years' average, and the P-score was 35%. Excess mortality decreased in the 0-14 age group in both genders and increased mainly in the 65+ age group. In 2020, 85.3% of the excess mortality was due to communicable diseases, and 4596 (95% CI: 4562-4631) people reported to die due to communicable diseases. Thus, deaths because of communicable diseases increased approximately 76 times in 2020 compared to the previous five years' average. Conclusion: Compared to the previous five years' average, the annual number of deaths in Bursa increased by approximately one-third in 2020, and most of the excess deaths were due to communicable diseases. For the use of revealing the actual burden of the COVID-19 pandemic on all-cause mortality, it is crucial to assess the extreme all-cause mortality
The effect of house visits on hypertension control in the elderly: A study from Bursa, Turkey
No full textIntroduction: The aim of this study was to evaluate the effect of house visits on hypertension control in the elderly.Materials and Method: In Bursa, the Nilufer Public Health Training and Research Area conducts a follow-up program for the elderly. Nurses and midwives visit people over 65 years of age every six months, which is a new practice in Turkey. During these visits, they measure blood pressure and ask questions about their patients' health conditions. If the patients' blood pressure is high then they are referred to a physician. In that case, the patients are also re-visited by the nurse or midwife the following month to check whether they consulted a physician and to observe the current condition of the patients' health. Follow-up cards of elderly patients were analysed. People who were visited regularly every six months and who had four blood pressure measurements (1063 women and 713 men) were included.Results: The prevalence of women with normal blood pressure (normal, prehypertension or controlled) was 34.5% at the first visit and it increased to 46.4% at the fourth visit (p < 0.05). For men, the corresponding percentages were 41.4% and 54.4%, respectively (p < 0.05).Conclusion: In this study, there was a positive effect of house visits by public health nurses and midwives on hypertension management in the elderly
The effect of house visits on hypertension control in the elderly: A study from Bursa, Turkey
No full textIntroduction: The aim of this study was to evaluate the effect of house visits on hypertension control in the elderly.Materials and Method: In Bursa, the Nilufer Public Health Training and Research Area conducts a follow-up program for the elderly. Nurses and midwives visit people over 65 years of age every six months, which is a new practice in Turkey. During these visits, they measure blood pressure and ask questions about their patients' health conditions. If the patients' blood pressure is high then they are referred to a physician. In that case, the patients are also re-visited by the nurse or midwife the following month to check whether they consulted a physician and to observe the current condition of the patients' health. Follow-up cards of elderly patients were analysed. People who were visited regularly every six months and who had four blood pressure measurements (1063 women and 713 men) were included.Results: The prevalence of women with normal blood pressure (normal, prehypertension or controlled) was 34.5% at the first visit and it increased to 46.4% at the fourth visit (p < 0.05). For men, the corresponding percentages were 41.4% and 54.4%, respectively (p < 0.05).Conclusion: In this study, there was a positive effect of house visits by public health nurses and midwives on hypertension management in the elderly
Ethical problems in an era where disasters have become a part of daily life: A qualitative study of healthcare workers in Turkey.
No full textBackgroundNatural disasters, armed conflict, migration, and epidemics today occur more frequently, causing more death, displacement of people and economic loss. Their burden on health systems and healthcare workers (HCWs) is getting heavier accordingly. The ethical problems that arise in disaster settings may be different than the ones in daily practice, and can cause preventable harm or the violation of basic human rights. Understanding the types and the determinants of ethical challenges is crucial in order to find the most benevolent action while respecting the dignity of those affected people. Considering the limited scope of studies on ethical challenges within disaster settings, we set upon conducting a qualitative study among local HCWs.MethodsOur study was conducted in six cities of Turkey, a country where disasters are frequent, including armed conflict, terrorist attacks and a massive influx of refugees. In-depth interviews were carried out with a total of 31 HCWs working with various backgrounds and experience. Data analysis was done concurrently with ongoing interviews.ResultsSeveral fundamental elements currently hinder ethics in relief work. Attitudes of public authorities, politicians and relief organizations, the mismanagement of impromptu humanitarian action and relief and the media's mindset create ethical problems on the macro-level such as discrimination, unjust resource allocation and violation of personal rights, and can also directly cause or facilitate the emergence of problems on the micro-level. An important component which prevents humanitarian action towards victims is insufficient competence. The duty to care during epidemics and armed conflicts becomes controversial. Many participants defend a paternalistic approach related to autonomy. Confidentiality and privacy are either neglected or cannot be secured.ConclusionIntervention in factors on the macro-level could have a significant effect in problem prevention. Improving guidelines and professional codes as well as educating HCWs are also areas for improvement. Also, ethical questions exposed within this study should be deliberated and actualized with universal consensus in order to guide HCWs and increase humane attitudes
Airborne particulate matter (PM2.5 and PM10) and associated metals in urban Turkey
No full textAirborne particulate matter (PM) and associated metals were measured in a district of an industrial city in Western Turkey. We compared PM concentrations in Bursa, Turkey (Nilufer district) with international air quality standards. Turkish legislature adopted the EC Air Quality Framework in 2008, and compliance is required in the medium term. State-of-the-art reference methods were used for all measurements. A Partisol sampler measured urban background PM2.5 and PM10 between May 2007 and April 2008, and PM2.5 samples were later analysed for selected metals using ICP-MS. Average PM2.5 and PM10 mass concentrations over the year were 53 and 83 mu g/m(3), respectively. The annual mean PM2.5:PM10 ratio in Bursa was 0.64. PM2.5 and PM10 were highly correlated at the site (R=0.91 overall), especially in winter. In the cold seasons, the coarse and fine fractions were strongly correlated R=0.67 (p<0.1), while in the warm seasons, they were not (R=0.01). Sampler results correlated well with a nearby Government sampler. Current PM10 and PM2.5 levels in Bursa breach current and prospective EU air quality standards, with significant implications in public health.Nilüfer Belediyesi Çevre Sağlığı Daire Başkanlığı, Burs
