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1.
Lancet ; 400(10368): 2125-2136, 2022 Dec 10.
Artículo en Inglés | MEDLINE | ID: mdl-36502850

RESUMEN

Intersectionality is a useful tool to address health inequalities, by helping us understand and respond to the individual and group effects of converging systems of power. Intersectionality rejects the notion of inequalities being the result of single, distinct factors, and instead focuses on the relationships between overlapping processes that create inequities. In this Series paper, we use an intersectional approach to highlight the intersections of racism, xenophobia, and discrimination with other systems of oppression, how this affects health, and what can be done about it. We present five case studies from different global locations that outline different dimensions of discrimination based on caste, ethnicity and migration status, Indigeneity, religion, and skin colour. Although experiences are diverse, the case studies show commonalities in how discrimination operates to affect health and wellbeing: how historical factors and coloniality shape contemporary experiences of race and racism; how racism leads to separation and hierarchies across shifting lines of identity and privilege; how racism and discrimination are institutionalised at a systems level and are embedded in laws, regulations, practices, and health systems; how discrimination, minoritisation, and exclusion are racialised processes, influenced by visible factors and tacit knowledge; and how racism is a form of structural violence. These insights allow us to begin to articulate starting points for justice-based action that addresses root causes, engages beyond the health sector, and encourages transnational solidarity.


Asunto(s)
Racismo , Humanos , Etnicidad , Clase Social , Justicia Social , Violencia
2.
J Pediatr Nurs ; 62: e170-e177, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-34702595

RESUMEN

BACKGROUND: Creating a womb-like environment for the preterm infant is vital to reduce the stress caused by stimuli and facilitate optimal neurological-behavioral development. PURPOSE: This randomized-controlled study aimed to determine the effect of simulative heartbeat nest use on vital signs, pain level, and comfort in preterms. METHODS: The study population consisted of 52 (experiment: 25, control: 27) preterms hospitalized in a university hospital's neonatal intensive care unit between May-November 2018. Before the application, preterms in both groups were evaluated with PIPP and Comfort scales. The experiment group was monitored in the nest with a heart beating device for 15 min. The control group was observed in the nest without the device for 15 min. Their heartbeats and oxygen saturation were recorded. After the application, preterms in both groups were re-evaluated with PIPP and Comfort scale. RESULTS: There was no statistically significant difference between the groups in terms of gestation week, age, birth weight and height, HB, SaO2, PIPP, and Comfort Scale total scores before and after the application (p > .05). However, the mean SaO2 increased significantly during the application (p < .003) in the experiment group; and that the PIPP total score decreased statistically significantly (p: 0.001) after the application. The comfort scale total score averages of the preterms in both groups decreased statistically significantly after the application (experiment:p < .01; control:p < .05). IMPLICATIONS FOR PRACTICE AND RESEARCH: Preterms in both groups had similar indicators. The nests that create heartbeat provide positive outcomes, such as the standard nests'.


Asunto(s)
Recien Nacido Prematuro , Dolor , Frecuencia Cardíaca , Humanos , Lactante , Recién Nacido , Turquía , Signos Vitales
3.
BMC Public Health ; 21(1): 1537, 2021 08 11.
Artículo en Inglés | MEDLINE | ID: mdl-34380444

RESUMEN

BACKGROUND: Turkey hosts nearly four million refugees and 99% live in urban areas. Research in urban settings pose different challenges and opportunities than research in refugee camps. In this article, we aimed to share the challenges and experiences we encountered in a mixed-methods study to assess mental health problems and barriers to accessing mental health care among refugees in urban areas of Turkey. DISCUSSION: In our case, the main challenges in conducting research with refugees were collecting data from a highly traumatized population, difficulties with contacting undocumented asylum seekers including trust issues and the fear of deportation, the risk of secondary traumatization among data collectors, and the bureaucracy during study approval processes. Targeting a representative sample was not feasible, because of the lack of publicly available demographic data on a district level, presence of undocumented asylum seekers and high mobility among the refugees. Although respondents with significant psychological symptoms were routinely referred to available mental health services, we were able to do less for unregistered refugees with problems in accessing health care. Language/alphabet differences and differing dialects of Arabic posed another challenge in both translation and administration of the scales. Based on cultural characteristics, a gender-balanced team was used and the interviewers were gender-matched whenever needed. Also, the research team had to work after work hours and during weekends to be able to interview male refugees, since most refugee men were at work during working hours and most days of the week. CONCLUSIONS: The research team's experience showed that refugee population characteristics including level of trauma, language, culture, gender, legal status, and urban setting characteristics including places of living, mobility, availability of publicly available demographic data, and outreach-related barriers lead to different challenges and ethical responsibilities of researchers and affect the research costs in terms of time, human resources and finance. Even in a host country with geographical, religious and cultural proximity to the refugees, profound challenges exist in conducting mental health research in urban settings. Learning from previous experience and collaborating with local researchers and institutions are vital for better public health research and practice outcomes.


Asunto(s)
Refugiados , Accesibilidad a los Servicios de Salud , Humanos , Masculino , Salud Mental , Campos de Refugiados , Turquía
5.
An Acad Bras Cienc ; 92(3): e20190465, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33263659

RESUMEN

The evolution of SNP-SNP interactions has become an interesting field in genetic epidemiology. Most of the studies, aimed to analyze the relationship between genetic factors and disease of interest, are focused on single SNP associations. However, for quantitative traits, influenced by the interplay of environmental and more than one genetic factors, interaction between the multi factors should be taken into consideration. In this study, symmetry models for square contingency tables are applied to the cross-classified SNP-SNP interactions data. Results from a genome-wide association analysis of blood pressure are used as a prior evidence for the interacted SNPs.


Asunto(s)
Estudio de Asociación del Genoma Completo , Polimorfismo de Nucleótido Simple , Fenotipo , Polimorfismo de Nucleótido Simple/genética
6.
Eur Arch Otorhinolaryngol ; 277(12): 3423-3430, 2020 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-32458122

RESUMEN

PURPOSE: This study sought to assess the relationships between a morphological characteristic of the superior semicircular canal (SSC) and both the roof thickness of the glenoid fossa (GF) and bone changes of the temporomandibular joint (TMJ) on three-dimensional images. METHODS: Cone-beam computed tomography (CBCT) images of 200 individuals (105 females and 95 males; 400 temporal bone regions) were examined by two different observers. The correlations between the bone thickness overlying the SSC and the thickness of the roof of the GF with TMJ's bone pathologies were analyzed. RESULTS: The superior semicircular canal dehiscence (SSCD) was significantly associated with dehiscence of the roof of the GF. The relationship between the dehiscence of the SSC and the roof thickness of the GF was found to be strongly correlated (p < 0.05). There were no statistically significant differences between the bone changes of TMJ and the presence or absence of the SSCD. CONCLUSIONS: A correlation between the bone thickness overlying the SSC and the roof thickness of the GF was found. However, there was no relationship between the bone thickness overlying the SSC and bone changes of TMJ.


Asunto(s)
Cavidad Glenoidea , Tomografía Computarizada de Haz Cónico , Pruebas Diagnósticas de Rutina , Femenino , Humanos , Masculino , Canales Semicirculares/diagnóstico por imagen , Hueso Temporal/diagnóstico por imagen , Articulación Temporomandibular/diagnóstico por imagen
7.
Surg Radiol Anat ; 42(9): 985, 2020 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-32444936

RESUMEN

In the original publication of the article, the given name and family name of the author were swapped. The correct author name is given in this erratum.

8.
Surg Radiol Anat ; 42(9): 977-983, 2020 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-32356044

RESUMEN

PURPOSE: The main aim of the present study was to investigate the dimensions and morphological appearance of the sella turcica in cleft lip and palate patients using cone-beam computed tomography (CBCT) images, compared to non-cleft individuals. METHODS: CBCT images of 40 (20 females and 20 males) cleft lip and palate patients and 60 (27 males and 33 females) non-cleft individuals were assessed, retrospectively. The linear dimensions (depth, diameter and length) of the sella turcica and inter-clinoid distance were measured. Sella turcica shapes were examined in the cleft lip and palate patients and non-cleft individuals. Non-cleft individuals were divided into skeletal malocclusion classes. All variables were analyzed using the Kruskal-Wallis test, Mann-Whitney U tests and Chi-square test. RESULTS: No significant difference was observed between individuals with and without cleft in the linear dimensions (depth, diameter and length) of the sella turcica (p > 0.05). However, a significant difference was found in the inter-clinoid distance between patients with cleft and non-cleft individuals (p < 0.05). Comparison of the sella turcica shape between skeletal malocclusion classes and patients with cleft showed significant differences (p < 0.05). CONCLUSIONS: No significant difference was determined in the depth, diameter, or length of the sella turcica in cleft patients when compared with non-cleft individuals. The inter-clinoid distance was lower in cleft patients than in non-cleft individuals, and this difference was statistically significant.


Asunto(s)
Puntos Anatómicos de Referencia , Cefalometría/métodos , Labio Leporino/diagnóstico por imagen , Fisura del Paladar/diagnóstico por imagen , Maloclusión/diagnóstico por imagen , Silla Turca/anatomía & histología , Adolescente , Adulto , Factores de Edad , Tomografía Computarizada de Haz Cónico , Femenino , Humanos , Masculino , Estudios Retrospectivos , Silla Turca/diagnóstico por imagen , Adulto Joven
9.
Med Princ Pract ; 29(3): 279-284, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-31842016

RESUMEN

OBJECTIVE: A tonsillolith is a concretion of the tonsillar crypt. The aim of this retrospective study was to compare panoramic radiography (PR) and cone-beam computed tomography (CBCT) for the detection of tonsilloliths. MATERIALS AND METHODS: The CBCT images of 527 patients with maxillofacial volume were evaluated retrospectively. Of these, 175 patients (81 females, 94 males; mean age 51.05 years) had unilateral or bilateral tonsilloliths. In total, 151 of them (67 females, 84 males; mean age, 51.03 years) had PR images performed in the same period and were included in the study. The PR images were examined to ascertain whether known tonsilloliths (from CBCT images) could be detected. The location (unilateral; left or right and bilateral), size, and number of the tonsilloliths were examined on both CBCT and PR images. Descriptive analysis, Spearman's rho correlation coefficient, and χ2 tests were used for the statistical analysis. RESULTS: The detection rate of tonsillolith was 33.2% on CBCT images. Only 51.4% of the tonsilloliths detected on CBCT were evaluated by PR; the correlation between CBCT and PR was found to be significant (Spearman's r = 0.399, p = 0.000). PR was not adequate to detect tonsilloliths 1 mm or smaller in size. All the calcifications larger than 5 mm were detected on PR images. CONCLUSION: The results of this study showed that more than half of the tonsilloliths observed in CBCT were also detected in PR. Tonsilloliths larger than 2 mm were more likely to be detected on PR images.


Asunto(s)
Calcinosis/diagnóstico por imagen , Enfermedades Faríngeas/diagnóstico por imagen , Adulto , Anciano , Calcinosis/diagnóstico , Calcinosis/patología , Tomografía Computarizada de Haz Cónico , Femenino , Humanos , Masculino , Persona de Mediana Edad , Enfermedades Faríngeas/diagnóstico , Enfermedades Faríngeas/patología , Radiografía Panorámica , Estudios Retrospectivos
10.
Med Princ Pract ; 29(4): 354-363, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-31760388

RESUMEN

OBJECTIVE: The aim of this study was to evaluate the correlation between the length of the infundibulum and ostium height with the anatomic variations of osteomeatal complex (OMC) and sinus pathology using cone-beam computed tomography (CBCT). METHODS: CBCT images of 204 patients (408 maxillary sinuses) were evaluated retrospectively. The height of the ostium and the length of the infundibulum were measured. The presence of maxillary sinus pathology, nasal septal deviation, Haller cells, concha bullosa, and sinus septa were analyzed. The correlation between the size of the maxillary sinus drainage system and anatomic variations was compared using the t test, Fisher's exact test, and χ2 test. The effect of tooth loss on the length of the infundibulum and ostium height was also analyzed using ANOVA. RESULTS: The height of the ostium and the maximal septal deviation angle were found to be significantly greater in males (p < 0.05). As ostium height increased, the presence of maxillary sinus septa increased (p < 0.05). No statistically significant association was detected between other variations and the length of infundibulum or ostium height. The relationship between tooth loss and both the length of the infundibulum and ostium height were found to be insignificant (p > 0.05). CONCLUSIONS: Radiographic examination, especially on CBCT images, is important for an evaluation of maxillary sinuses. here, we demonstrated a significant relationship between ostium height and the presence of maxillary sinus septa. However, it was found that nasal septal deviation, concha bullosa, Haller cells, and other sinusopathies did not have a major effect on the size of the maxillary sinus drainage system.


Asunto(s)
Seno Maxilar/anatomía & histología , Seno Maxilar/diagnóstico por imagen , Tabique Nasal/anatomía & histología , Tabique Nasal/diagnóstico por imagen , Adolescente , Adulto , Anciano , Tomografía Computarizada de Haz Cónico , Femenino , Humanos , Masculino , Persona de Mediana Edad , Tabique Nasal/patología , Estudios Retrospectivos , Distribución por Sexo , Turquía , Adulto Joven
12.
J Obstet Gynaecol ; 36(5): 649-53, 2016 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-26926158

RESUMEN

Surgical abortion is one of the most frequently performed gynaecological procedures and its associated pain has always been a problem in gynaecology. Here we studied the analgesic efficacy of lidocaine spray and paracervical block (PCB) in patients undergoing first-trimester surgical abortion. A randomised double-blind placebo-controlled study was conducted on 108 women requesting pregnancy termination. The subjects were randomly assigned into four groups: Group 1 (PCB plus lidocaine spray) (n=27), Group 2 (PCB) (n=27), Group 3 (lidocaine spray) (n=27) and Group 4 (placebo) (n=27). Intra-procedural and post-procedural pain scores were measured with a standard visual analogue scale (VAS). The median VAS scores during procedure in placebo, lidocaine spray, PCB plus lidocaine spray and PCB groups were 8 (7-9), 5 (4-8), 4 (3-4) and 5 (3-5), respectively. The most effective method of pain relief during first-trimester abortion can be achieved through a combined use of PCB plus lidocaine spray. Therefore, lidocaine spray is a non-invasive complementary anaesthetic method versus traditional PCB for first-trimester surgical abortion.


Asunto(s)
Aborto Inducido/efectos adversos , Anestesia Obstétrica/métodos , Anestésicos Locales/administración & dosificación , Complicaciones Intraoperatorias/tratamiento farmacológico , Lidocaína/administración & dosificación , Dolor/tratamiento farmacológico , Aborto Inducido/métodos , Adulto , Terapia Combinada , Método Doble Ciego , Femenino , Humanos , Dolor/etiología , Dimensión del Dolor , Embarazo , Primer Trimestre del Embarazo , Resultado del Tratamiento
13.
Gynecol Obstet Invest ; 79(2): 78-82, 2015.
Artículo en Inglés | MEDLINE | ID: mdl-25660129

RESUMEN

UNLABELLED: BACKGROUD/AIMS: Widely prescribed in routine practice, isotretinoin has an unknown impact on ovarian reserve. With a long history in acne treatment and numerous potential side effects, it is surprising that very few prospective studies have investigated its effect on ovarian reserve. Therefore, we aimed to evaluate the impact of oral isotretinoin on ovarian reserve based on hormonal parameters, anti-Müllerian hormone (AMH), ovarian volume (OV), and antral follicle count (AFC) in women of reproductive age with acne. METHODS: Our study group consisted of 82 women of reproductive age with acne who were treated with oral isotretinoin. The patients were evaluated for ovarian reserve prior to therapy and reevaluated 6 months after isotretinoin treatment with regard to hormonal parameters, AMH, OV, and AFC. RESULTS: Significant differences were found between the pre- and posttreatment period for AMH [2.20 ng/ml (25th-75th percentile 1.14-4.07) vs. 1.31 ng/ml (0.32-2.28)], total AFC [16 (14-18.25) vs. 12.5 (10-15)], and total OV [23 ml (18-29) vs. 15 ml (13-18); p < 0.001]. CONCLUSION: Our study is the first to analyze the levels of serum AMH, AFC, and OV together in patients treated with oral isotretinoin for acne. The results of our study demonstrated that oral isotretinoin had a significant negative effect on ovarian reserve.


Asunto(s)
Acné Vulgar/tratamiento farmacológico , Hormona Antimülleriana/sangre , Fármacos Dermatológicos/efectos adversos , Isotretinoína/efectos adversos , Reserva Ovárica/efectos de los fármacos , Ovario/efectos de los fármacos , Adolescente , Adulto , Femenino , Estudios de Seguimiento , Humanos , Folículo Ovárico/efectos de los fármacos , Adulto Joven
14.
J Obstet Gynaecol Res ; 41(10): 1556-61, 2015 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-26171763

RESUMEN

AIM: To investigate the possible effect of maternal obesity on the accuracy of sonographically estimated fetal weight in the third-trimester shortly before induction of labor and to compare the accuracy of the estimation between normal weight, overweight, and class I, class II and class III obese groups. METHODS: This was a prospective study of singleton pregnancies with sonographic fetal weight estimation prior to scheduled delivery. Women were classified according to current body mass index (BMI) into five categories: normal (BMI 18.5-24.9 kg/m(2), n = 41), overweight (BMI 25.0-29.9 kg/m(2), n = 44), obese class I (BMI 30.0-34.9 kg/m(2), n = 40), obese class II (BMI, 35.0-39.9 kg/m(2), n = 38) and obese class III (BMI ≥ 40.0 kg/m(2), n = 35). The estimated fetal weight was compared with the actual birthweight, and the difference between them was recorded as the error. RESULTS: Mean absolute error of sonographic fetal weight estimation was 106.97 ± 80.83 g, 198.88 ± 124.32 g, 248.82 ± 122.75 g, 308.31 ± 138.97 g and 446.00 ± 151.46 g in the normal, overweight, obese class I, obese class II, and obese class III groups, respectively (P < 0.001). The corresponding mean absolute percentage errors were 3.51 ± 2.76, 6.37 ± 3.91, 7.93 ± 4.81, 9.87 ± 4.32 and 14.06 ± 5.83 (P < 0.001). CONCLUSIONS: Maternal obesity decreases the accuracy of sonographic fetal weight estimation. Clinicians should be aware of the limitations of sonographic fetal weight estimation, especially in obese patients.


Asunto(s)
Peso al Nacer , Obesidad , Ultrasonografía Prenatal , Adulto , Femenino , Humanos , Embarazo , Tercer Trimestre del Embarazo , Estudios Prospectivos , Adulto Joven
15.
Turk Psikiyatri Derg ; 35(2): 87-94, 2024.
Artículo en Inglés, Turco | MEDLINE | ID: mdl-38842150

RESUMEN

OBJECTIVE: Although Syrian refugees have high rates of mental health problems due to war trauma, little is known on their degree of need for and contact with mental health services. Using a population sample of Syrian refugees living in Ankara, we assessed the perceived need for and contact with mental health services, as well as the barriers to access these services. METHOD: This was a cross-sectional mixed-method study of 420 Syrian refugees living in Ankara city center, using face to face interviews administered at the respondents' home by trained, Arabic-speaking interviewers. PTSD and depression were assessed using Harvard Trauma Questionnaire and Beck Depression Inventory, respectively. RESULTS: Of all the refugees in our sample, 14,8% (N=62) stated that they felt the need for mental healthcare since arriving in Turkey. The actual number contacting any mental health service was very low (1,4%, N=6). The most important barriers to accessing mental health services were reported by the respondents to be language problems and lack of information on available mental health services. Service providers and policymakers also reported similar topics as the most important barriers: low awareness about mental health problems, daily living difficulties, and language and cultural barriers. Multivariate analyses revealed that presence of medical or mental disorders and female gender predicted the perceived need for contacting services. CONCLUSION: Our results show that, although refugees report high rates of mental health problems, the perceived need for and actual contact with services are very low. To address this treatment gap, and to provide adequate care for refugees with mental health problems, common barriers (language and awareness) should be identified and dealt with.


Asunto(s)
Accesibilidad a los Servicios de Salud , Servicios de Salud Mental , Refugiados , Humanos , Refugiados/psicología , Siria/etnología , Femenino , Masculino , Estudios Transversales , Adulto , Turquía , Persona de Mediana Edad , Adulto Joven , Encuestas y Cuestionarios , Adolescente , Trastornos por Estrés Postraumático/psicología , Trastornos Mentales/terapia
16.
Health Lit Res Pract ; 6(1): e2-e11, 2022 01.
Artículo en Inglés | MEDLINE | ID: mdl-35025613

RESUMEN

BACKGROUND: Improving health literacy has become one of the most important public health-related goals at the global level; however, there is no clear consensus on measurement of health literacy. Despite numerous health literacy scales available in Turkish, none of the existing scales was originally developed and validated at a national level. OBJECTIVE: This study aimed to develop and validate a culturally appropriate original health literacy scale (HLS) to be used as a reference for the Turkish-speaking literate adult population in Turkey and abroad. METHODS: Two multidisciplinary workshops with more than 20 experts were conducted and a large item pool was developed. The first and second draft of the scale were pre-tested with 20 and 150 adults, respectively, from different age groups and socioeconomic levels in Ankara. The validity and reliability study of the revised scale (110 items plus 20 self-efficacy statements) was carried out with a household survey of 2,411 adults in 12 randomly selected provinces from 12 Nomenclature of Territorial Units for Statistics Regions in Turkey. Explanatory and confirmatory factor analysis were performed. The fit indices were obtained. The item analysis was applied, and Cronbach's alpha statistics were obtained. KEY RESULTS: The scale was found to be both a valid and a reliable measurement tool to assess health literacy. Cronbach's alpha for two sub-dimensions ("disease prevention and health promotion" and "treatment and access to health services") were 0.79 and 0.91, respectively. Construction validity indices were Root Mean Square Error of Approximation (RMSEA) = 0.043, Goodness of Fit Index (GFI) = 0.96, Normed Fit Index (NFI) = 0.95, and Adjusted Goodness of Fit Index (AGFI) = 0.95. The scale includes "self-efficacy" as an additional dimension (Cronbach's alpha = 0.83, RMSEA = 0.68, GFI = 0.94, NFI = 0.94, and AGFI) = 0.91). CONCLUSION: HLS is a valid and reliable measurement tool to assess health literacy of Turkish-speaking literate adults with a mixed (objective and subjective) assessment approach. [HLRP: Health Literacy Research and Practice. 2022;6(1):e2-e11.] Plain Language Summary: This study aimed to develop and validate a culturally sensitive original health literacy scale to be used as a reference scale for the Turkish-speaking literate adult population in Turkey and abroad. Study findings showed that HLS is both a valid and a reliable measurement tool to assess health literacy of Turkish-speaking literate adults.


Asunto(s)
Alfabetización en Salud , Psicometría/métodos , Reproducibilidad de los Resultados , Encuestas y Cuestionarios , Turquía
17.
BMC Prim Care ; 23(1): 29, 2022 02 15.
Artículo en Inglés | MEDLINE | ID: mdl-35168554

RESUMEN

BACKGROUND: Antimicrobial resistance may result from inappropriate use of antibiotics in health care. Turkey is one of the countries with the highest antibiotic consumption in the world. Considering the role of transnational ties between Turkish migrants and their social contacts in Turkey, the attitudes and behaviors relating to rational antibiotic use in Turkey can also affect the use of antibiotics by Turkish migrants residing abroad. This study explores physicians' and pharmacists' experiences and perspectives on rational antibiotic use among Turkish adults in Turkey and among Turkish migrants in Germany, Sweden, and the Netherlands, three European countries with large populations of Turkish migrants. METHODS: Following a qualitative study design using convenience and snowball sampling, in-depth interviews with 21 family physicians and 24 pharmacists were conducted in the aforementioned countries. We transcribed all interviews verbatim and performed content analysis separately in the countries, followed by translation, pooling and joint interpretation of the findings. RESULTS: Physicians and pharmacists encountered irrational use of antibiotics among their patients in Turkey. Physicians interviewed in the three European countries explained that Turkish migrants differ from non-migrants with respect to their attitudes towards antibiotics, for example by more often expecting to be prescribed antibiotics. All physicians and pharmacists in the selected countries reported to inform their patients on how to use antibiotics upon prescription; however, Turkish migrants' poor language proficiency was considered as a substantial communication barrier by the physicians and pharmacists interviewed in the European countries. CONCLUSIONS: The study illustrated some aspects of irrational antibiotic use among the population in Turkey and Turkish migrants in selected European countries. It emphasized the need for closer community participation, adequate information campaigns, as well as in-service training of health care providers in Turkey. The strategies and interventions on rational antibiotic use should also be supported and encouraged by health care providers, who need to reach out to people with various cultural backgrounds.


Asunto(s)
Farmacéuticos , Migrantes , Adulto , Antibacterianos/uso terapéutico , Alemania , Humanos , Lenguaje , Países Bajos , Médicos de Familia , Suecia/epidemiología , Turquía/epidemiología
18.
Perspect Psychol Sci ; 17(4): 915-936, 2022 07.
Artículo en Inglés | MEDLINE | ID: mdl-35044275

RESUMEN

COVID-19 has infected millions of people and upended the lives of most humans on the planet. Researchers from across the psychological sciences have sought to document and investigate the impact of COVID-19 in myriad ways, causing an explosion of research that is broad in scope, varied in methods, and challenging to consolidate. Because policy and practice aimed at helping people live healthier and happier lives requires insight from robust patterns of evidence, this article provides a rapid and thorough summary of high-quality studies available through early 2021 examining the mental-health consequences of living through the COVID-19 pandemic. Our review of the evidence indicates that anxiety, depression, and distress increased in the early months of the pandemic. Meanwhile, suicide rates, life satisfaction, and loneliness remained largely stable throughout the first year of the pandemic. In response to these insights, we present seven recommendations (one urgent, two short-term, and four ongoing) to support mental health during the pandemic and beyond.


Asunto(s)
COVID-19 , Humanos , Soledad/psicología , Salud Mental , Pandemias , SARS-CoV-2
19.
Lancet Public Health ; 7(5): e417-e426, 2022 05.
Artículo en Inglés | MEDLINE | ID: mdl-35461592

RESUMEN

BACKGROUND: To date, public health policies implemented during the COVID-19 pandemic have been evaluated on the basis of their ability to reduce transmission and minimise economic harm. We aimed to assess the association between COVID-19 policy restrictions and mental health during the COVID-19 pandemic. METHODS: In this longitudinal analysis, we combined daily policy stringency data from the Oxford COVID-19 Government Response Tracker with psychological distress scores and life evaluations captured in the Imperial College London-YouGov COVID-19 Behaviour Tracker Global Survey in fortnightly cross-sections from samples of 15 countries between April 27, 2020, and June 28, 2021. The mental health questions provided a sample size of 432 642 valid responses, with an average of 14 918 responses every 2 weeks. To investigate how policy stringency was associated with mental health, we considered two potential mediators: observed physical distancing and perceptions of the government's handling of the pandemic. Countries were grouped on the basis of their response to the COVID-19 pandemic as those pursuing an elimination strategy (countries that aimed to eliminate community transmission of SARS-CoV-2 within their borders) or those pursuing a mitigation strategy (countries that aimed to control SARS-CoV-2 transmission). Using a combined dataset of country-level and individual-level data, we estimated linear regression models with country-fixed effects (ie, dummy variables representing the countries in our sample) and with individual and contextual covariates. Additionally, we analysed data from a sample of Nordic countries, to compare Sweden (that pursued a mitigation strategy) to other Nordic countries (that adopted a near-elimination strategy). FINDINGS: Controlling for individual and contextual variables, higher policy stringency was associated with higher mean psychological distress scores and lower life evaluations (standardised coefficients ß=0·014 [95% CI 0·005 to 0·023] for psychological distress; ß=-0·010 [-0·015 to -0·004] for life evaluation). Pandemic intensity (number of deaths per 100 000 inhabitants) was also associated with higher mean psychological distress scores and lower life evaluations (standardised coefficients ß=0·016 [0·008 to 0·025] for psychological distress; ß=-0·010 [-0·017 to -0·004] for life evaluation). The negative association between policy stringency and mental health was mediated by observed physical distancing and perceptions of the government's handling of the pandemic. We observed that countries pursuing an elimination strategy used different policy timings and intensities compared with countries pursuing a mitigation strategy. The containment policies of countries pursuing elimination strategies were on average less stringent, and fewer deaths were observed. INTERPRETATION: Changes in mental health measures during the first 15 months of the COVID-19 pandemic were small. More stringent COVID-19 policies were associated with poorer mental health. Elimination strategies minimised transmission and deaths, while restricting mental health effects. FUNDING: None.


Asunto(s)
COVID-19 , Humanos , Salud Mental , Pandemias/prevención & control , Política Pública , SARS-CoV-2
20.
Lancet Public Health ; 7(1): e86-e92, 2022 01.
Artículo en Inglés | MEDLINE | ID: mdl-34906331

RESUMEN

The COVID-19 pandemic is unprecedented. The pandemic not only induced a public health crisis, but has led to severe economic, social, and educational crises. Across economies and societies, the distributional consequences of the pandemic have been uneven. Among groups living in vulnerable conditions, the pandemic substantially magnified the inequality gaps, with possible negative implications for these individuals' long-term physical, socioeconomic, and mental wellbeing. This Viewpoint proposes priority, programmatic, and policy recommendations that governments, resource partners, and relevant stakeholders should consider in formulating medium-term to long-term strategies for preventing the spread of COVID-19, addressing the virus's impacts, and decreasing health inequalities. The world is at a never more crucial moment, requiring collaboration and cooperation from all sectors to mitigate the inequality gaps and improve people's health and wellbeing with universal health coverage and social protection, in addition to implementation of the health in all policies approach.


Asunto(s)
COVID-19/prevención & control , Inequidades en Salud , Política Pública , Cobertura Universal del Seguro de Salud , Poblaciones Vulnerables/psicología , Salud Global , Humanos , Salud Pública
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