Erdal Özer

Evaluation of suicide cases in Turkey, 2007–2012

Background The aim of this study was to determine the demographic and sociocultural characteristics of suicide attempts by using data from the Turkish Statistical Institute. It is our intent that the work data may contribute to the national suicide data and the development of suicide prevention policies. Material/Methods We obtained our data, which cover the years 2007 to 2012, from the database accessible at the official website of the Turkish Statistical Institute, which permits the use of its data for research purposes. The data were evaluated by using the SPSS 10.0 program. The chi-square test was used for statistical analysis, and the percentage distribution and odds ratios were calculated. Results According to data from the Turkish Statistical Institute, the total number of suicide deaths in Turkey between 2007 and 2012 changed yearly (χ2=42,035–59,209; P<0.001). While suicide deaths in 2007 made up 0.00396% of the total deaths for that year, that figure increased to 0.00426% in 2013. According to the data from the Turkish Statistical Institute, over 1.9 million people died due to all causes between 2007 and 2012 in Turkey. Over 17,000 deaths (0.9%) were due to suicide. Conclusions Suicide is an important public health problem and is multidimensional in nature. Examining this subject from etiological, epidemiological, biological, psychological, sociological, and anthropological perspectives is important to improve the prevention of suicides.

Autopsy evaluation of coal mining deaths in the city of Zonguldak, Turkey

Background In this study, our aim was to evaluate the fatal occupational accidents that occurred in Zonguldak coal mines between the years 2005–2008. Material/Methods We retrospectively evaluated 42 fatal coal mine occupational accidents in Zonguldak (Turkey) between the years 2005–2008. The forensic records of autopsies referred to the chief prosecutors’ office during 2005–2008 were reviewed retrospectively. There were 42 cases. The cases were evaluated with respect to age, mechanism of injury, body region of wound, cause of death, and legality of the mine. Results Ages of the deceased ranged between 17 and 52 (median: 32.9 yrs). Deaths were mostly in the 21–30 (35.8%), and 31–40 (30.9%) age groups. Only 1 case was younger than 18 years of age. Review of occupational fatalities has revealed that fatal accidents occurred mostly (76.2%) in the private, and fewer (23.8%) in the public mining enterprises. Crime scene investigation findings have demonstrated that of all occupational deaths (total n=42), 27 (64.3%) were due to subsidence, followed by methane gas poisoning (n=6, 14.2%), tram crash (n=3, 7.1%), log falls (n=2, 4.8%), electrocution (n=2, 4.8%), and methane explosion (n=2, 4.8%). Conclusions Despite laws and regulations concerning mining and because of problems in their implementation, Turkey leads the world in work-related accidents, occupational injuries, and deaths. Evaluation of autopsy findings of deaths in fatal occupational accidents occurring in coal mines is quite important in planning to decrease rates of occupational fatalities.

Evaluation of social and demographic characteristics of incest cases in a university hospital in Turkey.

Background Incest is defined as any sexual activity between close blood relatives including step relatives and family members who are forbidden by law to marry. It is a problem that can be seen in all the social classes in developed and undeveloped societies. The World Health Organization classifies this problem as a silent health emergency. Father-daughter incest is reported to be the most common incest type followed by the other types like brother-sister, sister-sister and mother-son incest. Material/Methods Subjects for this study were recruited from a sample of incest cases referred to Forensic Medicine Department of Gaziosmanpasa University Medical Faculty Hospital between 2008 and 2012. Data involved social and demographic characteristics and clinical features of victims, perpetrators and the families. The ethical committee of the faculty of medicine approved the study. Results The study sample consisted of 43 incest cases (36 females and 7 males) with an age rage 4–40 years. Two third of the victims were under 18 years old. All perpetrators were males. Father – daughter incest (34.9%) was found to be most common incest type followed by brother – sister incest (14%). 75% of the perpetrators were family members and relatives with consanguinity while 25% of them were not consanguineous but faithful and intimate relatives to victims. Conclusions Increasing awareness about incest and its damaging effects is so important and clinicians should keep in mind sexual abuse or incest when examining the risky population. Multidisciplinary approach is necessary for determining short term or long term results and preventing the negative consequences of incest.

Assessment of Cases of Suicide in Turkey Based on Turkish Statistical Institute Data

‹ntiharlar tüm dünyada sosyo-ekonomik fark gözetmeksizin önemli bir halk ve ruh sa¤l›¤› sorunu olarak de¤erlendirilmektedir. Birçok ülkede özellikle gençlerde trafik kazalar›ndan sonra önde gelen ölüm nedenleri aras›ndad›r. Bu çal›flmada; Türkiye’de 2002-2009 y›llar› aras›nda meydana gelen intihar vakalar›n›n yafl, cinsiyet, e¤itim düzeyi, intihar nedeni ve y›llar içerisindeki de¤iflimini de¤erlendirmek ve dünyadaki genel intihar e¤ilimi ile karfl›laflt›rmak amaçlanm›flt›r. Çal›flmam›zda Türkiye ‹statistik Kurumunun (TU‹K) ‹ntihar ile ilgili 2002-2009 y›llar› aras›ndaki intihar istatistikleri de¤erlendirilmifltir. Elde edilen verilerin analizinde Windows SPSS 15.0 istatistiksel program› kullan›lm›flt›r. Olgular›n %64,4‘ünün erkek oldu¤u ve %35,6’s›n›n kad›n oldu¤u saptanm›flt›r. Erkek intihar olgular›nda tüm yafl gruplar›nda 2002-2009 y›llar› aras›nda sürekli bir art›fl oldu¤u dikkati çekmektedir. Kad›n intihar olgular›nda 0-19 ve 20-39 yafl grubunun 2002-2009 y›llar› içerisinde azalma gösterdi¤i ancak 40-59 ve 60 ve üzeri yafl grubunda ise art›fl oldu¤u görülmektedir. ‹ntihar eden olgular›n %62,9’unun ilkokul-ilkö¤retim-ortaokul düzeyinde, %16,3’ünün lise düzeyinde, %5,1’inin yüksek ö¤retim düzeyinde e¤itim durumu oldu¤u saptanm›flt›r. 2002-2009 y›llar› aras›ndan intihar eden olgular›n %47’sinin as›, %23,5’inin ateflli silah, %14,2’sinin kimyevi madde, %9’unun yüksekten atlama yöntemini kulland›¤› gözlenmifltir. 20022009 y›llar› aras›nda intihar eden olgular›n %34,3’ünün bilinmeyen bir sebep, %23,8’sinin hastal›k, %15,1’inin aile geçimsizli¤i, %10,2’sinin geçim zorlu¤u, %6,7’sinin hissi iliflki nedeniyle intihar etti¤i gözlenmifltir. Dünya Sa¤l›k Örgütünün verilerine göre intihar nedeniyle küresel mortalite oran› yüz binde 16 olarak bildirilmifltir. 2009 y›l›nda Türkiye’nin toplam nüfusunun 72.561.312 oldu¤u dikkate al›nd›¤›nda, Türkiye’de 2009 y›l›nda intihar oran›n›n yüz binde 4 oldu¤u gözlenmektedir. Amerika Birleflik Devletleri’nin (ABD) 2005 y›l› istatistikleri incelendi¤inde intihar eden olgular›n %52,1’inin ateflli silah yöntemi kulland›¤›, %22,2’sinin asma-bo¤ulma yöntemini kulland›¤›, %17,6’s›n›n ise zehir yöntemi kulland›¤› bildirilmifltir. Türkiye’deki intihar olgular›nda as› yönteminin ABD’ye göre 2,1 kat daha fazla oldu¤u, ABD’de ise ateflli silah yönteminin Türkiye’ye göre 2,2 kat daha fazla oldu¤u gözlenmektedir. Anahtar kelimeler: ‹ntihar, intihar yöntemleri, intihar nedenleri, adli t›p

Underage mothers in Turkey

Background All individuals under the age of 18 are considered as children by the Convention on the Rights of Children. Underage mothers are a pediatric-age group of children that become pregnant and give birth. It may be unfamiliar in Western countries, but in Middle-Eastern countries ruled by religious laws and old-fashioned traditions, it is common for an older man to marry a girl. The aim of this study was to describe the status of underage mothers within the framework of children’s rights and to draw attention to this issue. We presented this study to increase awareness and sensitivity, and to scrutinize and discuss these topics. Material/Methods We retrospectively investigated cases of underaged pregnant girls who applied to Forensic Science Department outpatient clinics and Obstetrics and Gynecology Department outpatient clinics of Gaziosmanpasa University Faculty of Medicine between 2003 and 2013. Results We accessed records of 163 underage mothers (≤18 age). Mean age was 16.9±0.83 (14–18 years). Gravida and parity rates increased proportionately with increasing age. Most of our cases were 16 and 17 years of age (n: 117, 71.8%). Conclusions Underage motherhood is not only a medical issue; it is a multi-dimensional problem with social, economic, traditional, religious, and legal aspects.

A Stain on Humanity: Child Mothers Below the Age of 10 Years

Objective: The concept of child mothers includes individuals who have given birth below the age of 18 years. In this study, the subject is addressed of individuals who have given birth at a much younger age (10 years and below). Material and methods: Studies were examined from different countries to examine the information on the ages of cases, types of birth and by whom they had been made pregnant. Results: The child mothers had been made pregnant by the husband in 3 (3%) cases, by the step-father in 11 (12%) cases, by a relative in 30 (32.4%) cases and by others in 35 (37.8%) cases. In 29 caes (31.3%) the identity of the father was not known. Conclusion: This study aimed to be a reminder of the need to overcome child abuse, which is masked by the excuses of religion or tradition, by presenting a reminder of the reality of ‘mothers below the age of 10 years’. Better identification and increased awareness of child abuse will prevent the confusion of it with the historical concept of child mother. By presenting a reminder of one of the greatest shames of humanity in the last century, it is aimed to create an awareness against the concept of child abuse and child bride/child mother.

Adli Belge İncelemelerinin 780 Olgu Üzerinden Değerlendirilmesi Trabzon 2007-2013

Insan vucudunda anatomik norolojik ve fizyolojik bir dizi sistemin calismasi sonucu gerceklestirilen karmasik bir eylem olan el yazisi ve imza, kimlik tespitinde yararlanilan ve hala guncelligini koruyan onemli bir parametredir. El yazisi ve/veya imza ile olusturulan belgelerin bilimsel olarak incelenmesi neredeyse 100 yildir adli bilimlerin ayrilmaz bir parcasi olmustur. Bu calisma Trabzon il ve ilcelerinden yasal mevzuat cercevesinde resen bilirkisi atamasi ile rapor tanzim edilmek uzere bir belge inceleme bilirkisisine verilen adli belge dosyalari uzerinde yapilmistir. Calismada kayitli 780 olgu geldikleri adli merciler, inceleme konusu belge adetleri, turleri ve nitelikleri, sorular, elde edilen sonuclar ve raporlarin teslim sureleri yonunden incelenmistir. Sonuc olarak ulkemizde laboratuvar eksikliginden cok tecrubeli ve bilgili uzman acigi ciddi bir sorun olmakla birlikte belgeler belirli bir formata veya standarda sahip olmadiklarindan incelemelerde kiyaslanacak ornek materyal bulma konusunda cok guclukler yasanmaktadir. Bu hususta ciddiyetle calisilmali ve belgelere bir standart getirilmelidir.Anahtar Kelimeler: Yazi-Imza, Belge Inceleme, Trabzon

Relationship between Organisational Commitment and Burnout Syndrome: A Canonical Correlation Approach

Objective Burnout syndrome can significantly reduce the performance of health workers. Although many factors have been identified as antecedents of burnout, few studies have investigated the role of organisational commitment in its development. The purpose of the present study was to examine the relationships between subdimensions of burnout syndrome (emotional exhaustion, depersonalisation and personal accomplishment) and subdimensions of organisational commitment (affective commitment, continuance commitment and normative commitment). Methods The present study was a cross-sectional survey of physicians and other healthcare employees working in the Ministry of Health Ordu University Education and Research Hospital. The sample consisted of 486 healthcare workers. Data were collected using the Maslach Burnout Inventory and the Organisation Commitment Scale, and were analysed using the canonical correlation approach. Results The first of three canonical correlation coefficients between pairs of canonical variables (Ui , burnout syndrome and Vi, organisational commitment) was found to be statistically significant. Emotional exhaustion was found to contribute most towards the explanatory capacity of canonical variables estimated from the subdimensions of burnout syndrome, whereas affective commitment provided the largest contribution towards the explanatory capacity of canonical variables estimated from the subdimensions of organisational commitment. Conclusions The results of the present study indicate that affective commitment is the primary determinant of burnout syndrome in healthcare professionals. What is known about the topic? Organisational commitment and burnout syndrome are the most important criteria in predicting health workforce performance. An increasing number of studies in recent years have clearly indicated the fields continued relevance and importance. Conversely, canonical correlation analysis (CCA) is a technique for describing the relationship between two variable sets simultaneously to produce both structural and spatial meaning. What does this paper add? To our knowledge, CCA has not been used to determine the relationships between burnout and organisational commitment of physicians and other healthcare staff. Accordingly, the present study adds information regarding the relationship between burnout and organisational commitment variables determined using CCA. This analysis is used to describe the relationship between two variable sets simultaneously and allows for an easy method of interpretation. What are the implications for practitioners? Burnout syndrome is a major threat to both the health workforce and its organisations. In addition, it affects the quality and effectiveness of health care. Thus, the findings of the present study offer a solid foundation from which actions to decrease burnout levels in healthcare professionals can be implemented by successfully increasing levels of organisational commitment.

Evaluation of the Post-Mortem Superoxide Dismutase, Glutathione Peroxidase Activities and Malondialdehyde Level in Renal and Brain Tissues: Is it Possible to

BACKGROUND Estimation of the postmortem interval (PMI) is one major area of interest in forensic medicine. We investigated changes of superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) activities and malondialdehyde (MDA) levels in rat brain and renal tissues in the PMI and examined the potential changes which may be useful for an estimation of time of death. METHODS Forty albino female rats were used in this study. The rats were sacrificed and divided into five groups: Group 1: 0 hour, Group 2: 6 hours, Group 3: 12 hours, Group 4: 24 hours, and Group 5: 48 hours. The rats were housed at room temperature (22 degrees C ± 2 degrees C) for the defined period for each group, and their brains and kidneys were excised. RESULTS The postmortem MDA levels were significantly different between groups for both renal and brain tissues (p = 0.003; p = 0.007). The diagnostic adequacy of MDA was calculated. Regarding SOD and GSH-Px, we were not able to obtain any date that would be useful for the prediction of PMI. CONCLUSIONS According to this study, it is possible that an estimation of the PMI can be made using postmortem MDA levels. Regarding SOD and GSH-Px, we were not able to obtain any data that would be useful for the prediction of PMI.

Frontal Lobe Syndrome Developing After Head Trauma: Case Report

Frontal lobe syndrome (FLS) is a clinical picture caused by damages due to reasons like prefrontal cortex cerebrovascular disease, tumor, infection or head trauma and displaying itself through distinct and permanent personality, social adaptation, and behavior changes. A 13-year-old, right-handed male case was in deep coma for 1.5 months after a traffic accident 28 months ago. His brain tomography revealed fractures in right orbital floor and anterior skull base, subarachnoid hemorrhage, right frontal contusion, left frontal epidural hematoma and pneumocephalus. Two months after the accident, case could perform simple commands and was right hemiplegic and motor aphasic. Motor deficit was treated through rehabilitation. His family was complaining about his hoarseness, inattentiveness, forgetfulness, overeating, meaningless crying, itchiness, nervosity, aggressiveness, swearing, and repeating the same sentence. In the examination, he had partial time orientation, intermediate self-care, increased euphoric, psychomotor activity, labile and inappropriate affect, disinhibition, no insight, hoarse voice, foul language, near-far memory disorder and impaired reading, writing, calculating and judging compared to his peers. FLS was considered for the patient. This case was reported since his daily-life activities considerably deteriorated due to FLS remaining as sequellae despite full recovery in deep coma and motor deficit, developing after head trauma.