Berna Aydın

Violence Against General Practitioners in Turkey

We aimed to determine the violence against general practitioners (GPs) through their suggestions on its cause and prevention. This is a descriptive cross-sectional study based on self-administered questionnaire answered by a convenience study population consisting of 522 GPs between November and December 2006. Of the participating GPs, 82.8% reported that they experienced violence. They reported 1,020 events, and verbal form was the most common form (89.3%). Verbal and sexual violence were seen more frequently among women, whereas physical and economic violence were more frequent with men. Perpetrators were patients and/or their relatives in 91.1% of the events. However, they were colleagues and superiors in 67.9% of the economic and sexual violence events. Violence against GPs warrants more attention. For its prevention, there is a need of continuous professional, administrative, and legal support from the government along with systematic, coordinated implementations independent from daily political concerns.

Decreased dehydroepiandrosterone sulphate levels in adolescents with post-traumatic stress disorder after single sexual trauma

Background: Recent evidence shows that the hypothalamic–pituitary–adrenal (HPA) axis can be dysregulated in chronic sexual abuse victims with post-traumatic stress disorder (PTSD). We hypothesized that PTSD in adolescents exposed to a single sexual trauma may function as a chronic stressor leading to HPA-axis dysregulation. Aims: The objective of this study was to assess dehydroepiandrosterone sulphate (DHEA-S) and cortisol levels in female adolescents |with single sexual trauma-related PTSD compared to healthy controls. Method: We assessed 20 female adolescent (age 12–18) single sexual trauma victims with PTSD from the Ondokuz Mayis University Department of Child and Adolescent Psychiatry between December 2013 and December 2014. PTSD symptoms were assessed using the Child Depression Inventory (CDI) and Child Posttraumatic Stress Reaction Index (CPSRI). Blood cortisol and DHEA-S were measured in 20 female adolescent sexual abuse victims with PTSD and 20 healthy adolescents after 12-h fasting using the chemiluminescence method. Results: Compared to age-matched controls, female adolescent sexual abuse victims with PTSD had significantly lower DHEA-S levels (U = 70.00, Z = − 3.517, p = 0.01, r = 0.55). There was also a significant negative correlation between DHEA-S and CDI scores (Spearman r = − 0.522, p < 0.01). Conclusions: Decreased DHEA-S levels and correlation with depressive symptoms are evidence for a dysregulated HPA-axis in female adolescent single sexual trauma victims with PTSD. Further research is now recommended with large patient groups in order to maximize generalizations.

Depression and post-traumatic stress disorder in child victims of sexual abuse: perceived social support as a protection factor

Abstract Background Social support has been shown to play a protective role against the development of post-traumatic stress disorder (PTSD) and depression in individuals exposed to trauma. Aims The purpose of this study was to investigate the effect of perceived social support on depression and PTSD in child victims of sexual abuse and to determine the relationship between them. Method In total 182 victims of sexual abuse aged 6–18 at time of interview were assessed. Clinical interviews, the Children’s Depression Inventory (CDI) and the Child Posttraumatic Stress Reaction Index (CPTS-RI) were used to assess children’s psychological status, while the Perceived Social Support Scale-Revised (PSSS-R) was used to measure social support. Results Girls had significantly higher median CDI and CPTS-RI scores than boys, while no significant difference was determined between boys and girls in terms of PSSS-R scores. A statistically significant negative correlation was determined between CDI and PSSS-R scores, CPTS-RI scores and PSSS-R scores in girls, while no significant correlation was identified in male victims. Conclusions In conclusion, we think that social support networks for victims of sexual abuse need to be broadened and increased, and that importance should be attached to protective approaches in that context.

Infection control implementations at forensic medicine practice: a national survey in Turkey.

Because forensic medicine workers have a greater occupational risk for infectious diseases, strict rules and measures against infections must be implemented at every stage of forensic medicine practices. In this study, we aim to evaluate the infection control implementations in forensic medicine practices in Turkey. A questionnaire survey was mailed to forensic medicine specialists and residents between April and June 2005. The questionnaire consisted of 36 questions whose designed was based on standard precautions and protective barriers against infectious risks. In all, 111 doctors from 27 different cities responded to the questionnaire. Of those doctors who responded, 43.2% reported performing external examination anywhere. The percentage of doctors performing external examinations who regularly wore gloves, masks, and gowns, and washed hands with a disinfectant were 81.5%, 24.7%, 30.9%, and 81.5%, respectively. The percentage of doctors performing autopsies who regularly wore masks, protective eye-wear, gloves, special gloves, and special boots were 59.6%, 10.6%, 98.9%, 71.3%, and 36.2%, respectively. Only 2 negative pressure rooms were reported. According to these results, precautionary measures against infectious risks in forensic medicine practice in our country are insufficient. Conditions to facilitate and to improve the compliance with infection control procedures must be prepared.

The Psychiatric Consequences of Child and Adolescent Sexual Abuse

INTRODUCTION The purpose of this study was to investigate the psychiatric consequences of sexual abuse and its associated factors in children and adolescents referred to our child and adolescent psychiatry clinic from official medico-legal units. METHODS All victims of sexual abuse (n=590) aged 1-18 (mean: 13.56±3.38) referred from forensic units to Ondokuz Mayis University Child and Adolescent Psychiatry Clinic over a period of 2 years [boys: 83 (14.1%); girls: 507 (85.9%)] were included. Child and adolescent psychiatry and forensic medicine specialists evaluated all the cases. The Wechsler Intelligence Scale for Children-Revised Form (WISC-R) and the Schedule for Affective Disorders and Schizophrenia for School Age Children-Present and Lifetime Version-Turkish Version (K-SADS-PL-T) were applied. RESULTS Abuse-related psychiatric diagnoses (of which 45.9% were major depressive disorder and 31.7% were post-traumatic stress disorder cases) were made in 75.2% of the cases. In 80.3% of the cases, the perpetrators were known to their victims [incest, n=91 (15.1%)], and intercourse took place in 48.8%. Although gender and age were not significantly associated with the appearance of any psychiatric disorders, severity of abuse (e.g., intercourse; p=.006), additional physical assault (p<.001), and incest (p<.001) had a significant correlation with psychiatric disorders. To explore the predictive value of multiple factors in the appearance of any sexual assault-related psychiatric disorder, a logistic regression model was used to determine the best linear combination of age, gender, abuse severity, incest, involvement of any other victim, additional physical assault, and length of time from first abuse to first psychiatric evaluation. This combination of variables (occurrence of incest, additional physical assault, and a long duration from first abuse to first psychiatric evaluation) significantly predicted the appearance of a psychiatric disorder of any kind (χ2=55.42; df=7; n=522; p<.001). CONCLUSION Our findings reveal that the occurrence of incest, additional physical assault, and a long duration from first abuse to first psychiatric evaluation predict higher rates of sexual abuse-related psychiatric disorders.

Samsun’da Yaşlılık Dönemi Düşmeler: 2010-2015

Objective: The purpose of this study is to evaluate cases over the age of 65 who are admitted for falling and to lead the way for the measures to be taken to minimize the harm.Materials and Methods: 489 patients at and over the age of 65 who were admitted to Ondokuz Mayis University Health Application and Research Center due to falling between the dates of 01.08.2010 and 31.07.2015 were included in the study.Forensic files and hospital automation system data of the cases were analyzed and their genders, ages, time of admission, type of fall, wound areas, fractured bones, presence of comorbid disease, the department in which they were treated and their treatment status were examined retrospectively. The data obtained from this cross- sectional study were assessed with SPSS 15.0 program.Results: 230 (47,0%) of the cases were men, while 259 (53,0%) were women. The cases were mostly admitted in July (12.3%), on Sundays (15.7%) and between 16.00 and 23.59 (46.6%). The most frequent place of fall was inside the house (43,3%). Internal organ injury was seen in 16,4% of the patients while bone fracture was seen in 53,2%. Most frequently fractured bone was the femur (41,5%).Conclusion: Injuries associated with falling due to the increase in old population creates an important social problem. Falling is not an inevitable result of old age. Preventing falls in old age will decrease the dependency about daily life activities, increase life quality and decrease health care costs.

Injuries and Deaths That Resulting From Bicycle and Motorcycle Accidents

SUMMARY Bu cal›flmada; bisiklet ve motosiklet kazas› sonucu yaralanan ve olen olgular›n, demografik ve klinik ozellikleri araflt›r›larak, kazalara bal› yaralanmalar›n nas›l olufltuunun ayd›nlat›lmas›, yaralanmalar›n ciddiyetinin azalt›lmas›na yonelik cozum one- rileri sunulmas› amaclanm›flt›r. Bisiklet ve motosiklet kazas› sonucu yaralanarak Ondokuz May›s Universitesi (OMU) T›p Fakultesi Hastanesinde ilk mu- dahalesi ve tedavisi yap›lan 256 olguya ait demografik ve klinik veriler incelenmifl, elde edilen veriler SPSS 10.0 paket program› ile deerlendirilmifltir. Hem bisiklet hem de motosiklet kazas› sonucu yaralananla- r›n counlukla (%89.1) erkek olduu, bisiklet kazalar›n›n en fazla 10-19 yafl grubunda, motosiklet kazalar›n›n ise 20-29 yafl grubunda goruldu¤u tespit edilmifltir. Bisiklet kazalar›n›n daha cok duflme, motosiklet kazalar›n›n ise carp›flma sonucu meyda- na geldii, her iki grupta da en s›k yuz bolgesinin yaraland›¤›, bunu bisiklet kazalar›nda ust ekstremitenin, motosiklet kazala- r›nda da bafl bolgesinin izledii saptanm›flt›r. Tum veriler dunyada ve ulkemizde motosiklet ve bisiklet kullan›m›n›n ve buna paralel olarak da bu araclarla meydana gelen kazalar›n h›zla artt›¤›n› gostermektedir. Bu sorunun daha buyuk boyutlara ulaflmamas› icin flimdiden daha ciddi onlemler