Recep Akdur

Establishment of interdisciplinary child protection teams in Turkey 2002–2006: Identifying the strongest link can make a difference!

OBJECTIVES The University of Iowa Child Protection Program collaborated with Turkish professionals to develop a training program on child abuse and neglect during 2002-2006 with the goals of increasing professional awareness and number of multidisciplinary teams (MDT), regional collaborations, and assessed cases. This paper summarizes the 5-year outcome. METHODS A team of instructors evaluated needs and held training activities in Turkey annually, and provided consultation when needed. Descriptive analysis was done via Excel and SPSS software. RESULTS Eighteen training activities were held with 3,570 attendees. Over the study period, the number of MDTs increased from 4 to 14. The MDTs got involved in organizing training activities in their institutions and communities. The number of medical curriculum lectures taught by MDTs to medical students/residents, conferences organized by the MDTs, and lectures to non-medical professional audiences increased significantly (R(2)=91.4%, 83.8%, and 69.2%, respectively). The number of abuse cases assessed by the MDTs increased by five times compared to pre-training period. CONCLUSIONS A culturally competent training program had a positive impact on professional attitudes and behaviors toward recognition and management of child abuse and neglect in Turkey. The need to partner with policy makers to revise current law in favor of a greater human services orientation became clear. PRACTICE IMPLICATIONS Pioneers in developing countries may benefit from collaborating with culturally competent instructors from countries with more developed child protection systems to develop training programs so that professional development can improve recognition and management of child abuse and neglect.

Workplace Violence in the Health Sector in Turkey A National Study

Violence in the workplace is an increasing occupational health concern worldwide. Health care workers are at high risk of assault. To develop, monitor, and manage prevention policies, baseline data should be available. This cross-sectional study was designed to determine the current extent of workplace violence nationwide in Turkey. The study population of 12.944 health care workers was a stratified sample of all health care workers (612,639) in the country. A probabilistic sampling was made on the basis of the “multistage stratified random cluster sampling method.” This study was conducted by a structured questionnaire in a face-to-face interview. The questionnaire items were adapted and translated into Turkish based on questionnaires of International Labor Organization, International Council of Nurses, World Health Organization, and Public Services International. The percentage of health care workers who experienced workplace violence in Turkey in the previous 12 months was 44.7%. The types of violence included physical 6.8%, verbal 43.2%, mobbing (bullying) 2.4%, and sexual harassment 1%. Multivariate analysis showed that level of health care system, type of institution, gender, occupation, age, working hours, and shift work were independent risk factors for experiencing workplace violence (p < .05). Our study indicates that the workplace violence among health care workers is a significant problem. The results of the study can serve as the basis for future analytical studies and for development of appropriate prevention efforts.

Symptoms of Musculoskeletal Disorders Among Ammunition Factory Workers in Turkey

ABSTRACT The aim of this study was to assess the prevalence of symptoms of work-related musculoskeletal disorders (MSDs) and to determine the risk factors among ammunition factory workers in Turkey. This cross-sectional study was performed on 955 ammunition factory workers. Potential risk factors were investigated with a questionnaire and multivariate logistic regression analysis was performed. During the previous year, 39.3% of ammunition workers experienced symptoms of work-related MSDs. Logistic regression analysis showed smoking (odds ratio [OR] = 1.372), chronic diseases (OR = 1.795), body mass index (BMI; overweight) (OR = 1.631), working year (OR = 1.509), cold temperature (OR = 1.838), and work load (OR = 2.210) were significant independent risk factors for the development of symptoms of MSDs. It was found that both work-related conditions and personal and environmental factors are important for the development of occupational MSDs.

An analysis of the prevalence of malaria in Turkey over the last 85 years

Abstract Background: Affecting 106 countries, malaria is a major global burden. Though intensive antimalaria efforts in Turkey have been successful in bringing down the number of cases, historically malaria was a serious public health concern. Methods: This paper reviews the prevalence rates of malaria in Turkey over the last 85 years (1925–2010). The time series of malaria prevalence was evaluated for possible structural changes by using Chow breakpoint tests and regression models using dummy variables, with autocorrelated errors and generalized autoregressive conditional heteroscedasticity models to assess the impact of volatility in prevalence. Results: Seventy-eight cases of malaria were diagnosed in Turkey in 2010. Malaria prevalence rates in the country show a statistically significant volatility, which underlines the fragility of efforts to control the disease. Conclusions: It is necessary to analyse the national malaria control programme to evaluate to what extent its programmatic capacity, financial resources, and political commitment are sufficient to avoid eroding the gains that have already been made and, ultimately, eradicate malaria. It is essential that there should be no lessening in the long-standing efforts to reduce malaria.

Early Diagnosis in Gastric Cancer: Pilot Project

ABS TRACT Objective: Gastric cancer, fourth most common cancer type around the world is the second leading cause of cancer related deaths. Nevertheless when appropriately treated at early stage 5 year survival rates are higher than 90%. In eastern countries extensive endoscopic screening increased early gastric cancer (EGC) diagnosis rate up to 70%. In Turkey EGC diagnosis rate is low, a pilot screening project therefore is planned by Department of Surgical Oncology, Ankara University School of Medicine. Material and Methods: 7316 subjects were included in the study to whom upper gastrointestinal endoscopy was applied. From 1120 of these participants 1139 biopsy samples were taken. Results: In gastric cancer patients (n:21) 4 had a diagnosis at the early stage. Also 14 (1.41%) mild dysplasia and 2 (0.2%) severe dysplasia were detected. In addition, 54.8% of volunteers with endoscopic biopsies were Helicobacter pylori positive and a rate of 41.23% and 22.47% for atrophic gastritis and intestinal metaplasia was detected, respectively. Previously EGC detection rate was 6.3% among the subjects admitted to a hospital with gastric cancer in Turkey. By this screening programme we found an almost 4 fold increase in EGC rate. Conclusion: We therefore recommend that endoscopic screeening for gastric cancer is a requirement for Turkey. This preliminary study should be followed by a more extensive project evaluating the cost effectiveness of screening and its effect on mortality rates.

An analysis of the incidence of measles in Turkey since 1960

BACKGROUND/AIM The aims of this study were to evaluate measles incidence and the effect of elimination strategy interventions on the disease from 1960 to 2014 in Turkey. The administration of measles vaccine started in the rural regions in 1970; it was carried out as a campaign along with the National Vaccine Campaign in 1985, and it has been employed as combined measles, mumps, and rubella under the scope of the Measles Elimination Program (MEP) since 2006 in Turkey. While a dramatic decrease in the reporting of measles was observed between 2000 and 2010, the number of the cases has increased since 2011. MATERIALS AND METHODS The time series of measles incidence was evaluated for possible structural changes with regression models using dummy variables, autocorrelated with error terms. RESULTS The incidence of measles showed a statistically significant decline between 1985 and 1988 (P = 0.0072) and between 2005 and 2011 (P < 0.0001). However, a statistically significant increase in incidence was noted after 2013 (P = 0.0008). CONCLUSION Over the last 54 years, the pattern of measles cases demonstrated a significant decline in incidence. However, the increase in incidence in 2013 should be carefully analyzed and interpreted in terms of the MEP.