Evaluation of Sleep Quality, Work Stress and Related Factors in Hospital Office Workers.

BACKGROUND:  Occupational factors, working conditions, age, gender, exercise, acquired habits, and stress affect a person's sleep quality. The aim of this study was to investigate sleep quality, work stress, and related factors among office workers in a hospital. METHODS:  This cross-sectional study was conducted with office workers actively working in a hospital. A questionnaire consisting of a sociodemographic data form, the Pittsburgh Sleep Quality Index (PSQI), and Swedish Workload-Control-Support Scale were used to assess the participants.    Results: The mean of PSQI score was 4.32±2.40 and 27.2% of the participants had poor sleep quality. In the multivariate backward stepwise logistic regression analysis, it was found that shift workers were 1.73 times (95% CI: 1.02-2.91) more likely to have poor sleep quality, and a one-unit increase in work stress score increased the risk of having poor sleep quality by 2.59 times (95% CI: 1.37-4.87). An increase in age was found to decrease the risk of poor sleep quality in workers (OR =0.95; 95% CI: 0.93-0.98). CONCLUSION:  This study suggests that reducing workload and increasing work control as well as enhancing social support will be effective in preventing sleep disturbances. It is important, however, in terms of providing guidance for hospital employees in planning future measures to improve working conditions.

Does occupational ionizing radiation exposure in healthcare workers affect their hematological parameters?

Blood cells are used as the most sensitive marker to determine the effects and intensity of ionizing radiation. This descriptive study aimed to evaluate the effect of radiation exposure on hematological parameters in healthcare workers who were exposed to radiation in a university hospital between May and June 2021. A total of 339 participants were included, of which 169 (49.9%) were radiation workers and 170 (50.1%) were in the control group. A decrease was observed in white blood cell and neutrophil counts in those exposed to ionizing radiation for less than 10 years; however, white blood cell, neutrophil, hemoglobin levels decreased, and red cell distribution width (RDW) levels increased in those exposed to ionizing radiation for 10 years or more (p < 0.005). A statistically significant increase was observed in the RDW and lymphocyte levels as the years of work experience in the profession increase in the group exposed to IR. The findings indicate that the effect of low-dose ionizing radiation on the hematopoietic system is related to the frequency and duration of the dose. Hematological parameters can be sensitive biomarkers of low-dose ionizing radiation; possible disturbances in the hematopoietic system can be recognized before the onset of symptoms, and necessary precautions can be taken promptly.

Food-induced anaphylaxis in early childhood and factors associated with its severity.

Background: Several factors that increase the risk of severe food-induced anaphylaxis have been identified. Objective: We aimed to determine the demographic, etiologic, and clinical features of food-induced anaphylaxis in early childhood and also any other factors associated with severe anaphylaxis. Methods: We carried out a medical chart review of anaphylaxis cases from 16 pediatric allergy and immunology centers in Turkey. Results: The data of 227 patients with 266 food-induced anaphylaxis episodes were included in the study. The median (interquartile range) age of the first anaphylaxis episode was 9 months (6-18 months); 160 of these patients were boys (70.5%). The anaphylaxis episodes were mild in 75 cases (28.2%), moderate in 154 cases (57.9%), and severe in 37 cases (13.9%). The most frequent food allergens involved were cow's milk (47.4%), nuts (16.7%), and hen's egg (15.8%). Epinephrine was administered in only 98 (36.8%) of these anaphylaxis episodes. A logistic regression analysis revealed two statistically significant factors that were independently associated with severe anaphylaxis: the presence of angioedema and hoarseness during the anaphylactic episode. Urticaria was observed less frequently in patients who developed hypotension. In addition, confusion and syncope were associated with 25.9- and 44.6-fold increases, respectively, in the risk of concomitant hypotension. Conclusion: Cow's milk, nuts, and hen's egg caused the majority of mild and moderate-to-severe anaphylaxis episodes. The presence of angioedema and hoarseness in any patient who presents with a history of food-induced anaphylaxis should alert clinicians that the reaction may be severe. In addition, the presence of confusion, syncope, or stridor probably indicates concomitant hypotension.

An easy-to-use nomogram for predicting in-hospital mortality risk in COVID-19: a retrospective cohort study in a university hospital.

BACKGROUND: One-fifth of COVID-19 patients are seriously and critically ill cases and have a worse prognosis than non-severe cases. Although there is no specific treatment available for COVID-19, early recognition and supportive treatment may reduce the mortality. The aim of this study is to develop a functional nomogram that can be used by clinicians to estimate the risk of in-hospital mortality in patients hospitalized and treated for COVID-19 disease, and to compare the accuracy of model predictions with previous nomograms. METHODS: This retrospective study enrolled 709 patients who were over 18 years old and received inpatient treatment for COVID-19 disease. Multivariable Logistic Regression analysis was performed to assess the possible predictors of a fatal outcome. A nomogram was developed with the possible predictors and total point were calculated. RESULTS: Of the 709 patients treated for COVID-19, 75 (11%) died and 634 survived. The elder age, certain comorbidities (cancer, heart failure, chronic renal failure), dyspnea, lower levels of oxygen saturation and hematocrit, higher levels of C-reactive protein, aspartate aminotransferase and ferritin were independent risk factors for mortality. The prediction ability of total points was excellent (Area Under Curve = 0.922). CONCLUSIONS: The nomogram developed in this study can be used by clinicians as a practical and effective tool in mortality risk estimation. So that with early diagnosis and intervention mortality in COVID-19 patients may be reduced.

Proven Food-Induced Acute Urticaria and Predictive Factors for Definitive Diagnosis in Childhood.

BACKGROUND: Urticaria can be the only sign of a food allergy or can be seen together with other signs and symptoms of a food allergy. OBJECTIVE: To determine the demographic, etiologic, and clinical features of food-induced acute urticaria in childhood. METHODS: Patients suspected of food-induced acute urticaria were included in this prospective cross-sectional multicenter study. RESULTS: Two hundred twenty-nine urticaria cases were included in this study. Seventeen patients who did not meet the inclusion criteria of the study were excluded. Of the 212 included cases, 179 (84.4%) were diagnosed with definitive food-induced acute urticaria. The most common foods causing acute urticaria were cow's milk, hen's eggs, and nuts in 56.4, 35.2, and 19% of cases, respectively. The positive predictive value of a history of milk-induced acute urticaria together with a milk-specific IgE >5 kU/L for cow's milk-induced acute urticaria was 92% (95% CI: 81-96%). A history of cow's milk-induced and/or hen's egg-induced acute urticaria was consistent with a definitive diagnosis of food-induced urticaria (Chen's kappa: 0.664 and 0.627 for milk and eggs, respectively). Urticaria activity scores were higher in patients with food-induced acute urticaria (p = 0.002). CONCLUSION: Cow's milk, hen's eggs, and nuts were the most common allergens in the etiology of childhood food-induced acute urticaria. Although the urticaria activity score provides guidance for diagnosis, an oral food challenge is often essential for the definitive diagnosis of a patient with a history of food-induced acute urticaria.

Determinants of General Health, Work-Related Strain, and Burnout in Public Versus Private Emergency Medical Technicians in Istanbul.

This study investigated the impact of working for public versus private ambulance services in Turkey and elaborated on predictors of mental, physical, and emotional well-being in emergency medical technicians (EMT-Bs). In this observational cross-sectional study, an 81-question self-report survey was used to gather data about employee demographics, socioeconomic status, educational background, working conditions, and occupational health and workplace safety (OHS), followed by the 12-item General Health Questionnaire (GHQ-12), the Work-Related Strain Inventory (WRSI), and the Maslach Burnout Inventory (MBI) with three subscales: Emotional Exhaustion (MBI-EE), Depersonalization (MBI-DP), and Diminished Personal Accomplishment (MBI-PA). In 2011, 1,038 EMT-Bs worked for publicly operated and 483 EMT-Bs worked for privately owned ambulance services in Istanbul, Turkey, of which 606 (58.4%) and 236 (48.9%) participated in the study (overall participation rate = 55.4%), respectively. On all scales, differences between total mean scores in both sectors were statistically insignificant (p > .05). In the public sector, work locations, false accusations, occupational injuries and diseases, work-related permanent disabilities, and organizational support were found to significantly influence self-reported perceptions of well-being (p < .05). In the private sector, commute time to and from work (p < .05), false accusations (p < .05), vocational training and education (p < .05), informed career choices (p < .05), and work-related permanent disabilities (p < .05) were found to significantly influence self-reported perceptions of well-being. EMT-Bs were asked about aspects of their working lives that need improvement; priority expectations in the public and private sectors were higher earnings (17.5%; 16.7%) and better social opportunities (17.4%; 16.8%). Working conditions, vocational training, and OHS emerged as topics that merit priority attention.

Survey of the opinions on the occupational health system in Turkey expressed by patients of the Istanbul hospital of occupational diseases.

OBJECTIVE: To examine the opinion of patients of an occupational diseases hospital on the quality of provision of occupational medicine services in Turkey. MATERIALS AND METHODS: A total of 189 patients were interviewed using a 13-item survey about their jobs and workplaces. RESULTS: The overall results of this study were as follows: 80.4% of the patients stated that physicians were located at their workplaces; 66.1% stated that inadequate attention was given to ensure the physical, psychological and social health of the employees; and 63.5% stated that sufficient protection against health risks was not provided. CONCLUSIONS: The quality of provision of occupational medicine services should be improved.

Knowledge, attitudes, and opinions of Turkish private school principals regarding substance abuse.

OBJECTIVE: To determine the knowledge, attitude, and opinion of private school principals in Kocaeli, Turkey regarding substance abuse. METHODS: Data of this descriptive study was collected by questionnaires in December 2008. The questionnaire, developed based on Turkey's "substance abuse regulations," was applied to the principals of private schools in Kocaeli affiliated with the Ministry of National Education. A survey was conducted and risk factors for these schools were determined. The data was analysed with Pearson correlation test, Spearmen correlation test and Kruskal-Wallis one way analysis used. RESULTS: Principals of 27 of 31 schools were reached. Six (22.2 %) were women; 21 (77.8 %) were men. Average age was 43.37 +/- 10.08 years. Average years of teaching was 21.55 +/- 10.77 years. Mean period as a school principal was 9.42 +/- 9.36 years. Seventy-one percent of the principals who participated in the survey were non-smokers. CONCLUSION: The majority of principals considered substance abuse as a problem in Turkey and believed it to be more among primary and high school students.

The epidemiology of hepatitis a virus infection in children, in Edirne, Turkey.

Turkey is a middle endemic area with respect to Hepatitis A virus (HAV) infection. However, the frequency of this infection varies due to socio-economic differences in various regions. The aim of this study was to detect the most likely age of exposure to HAV and factors affecting infection rates among children living in Edirne. A sample of 645 children between the ages of 0-19 living in Edirne were tested for total anti-HAV levels using ELISA method. A questionnaire on socio-economic status (SES), possible risk factors, and place of residence was completed for each child. Anti-HAV seropositivity was found to be 4.4, 25, 37.3 and 43.2%, in 2-5, 6-10, 11-14 and 15-19 age groups, respectively. Seropositivity was found to be increasing with age (p < 0.05). According to logistic regression analysis results; mother's education, SES of family, history of hepatitis in primary family members and the number of brothers or sisters were determined as factors increasing the seropositivity of HAV. Furthermore, HAV infection risk was found to be a decreasing function of income that is higher the income less likely the infection. These results showed that HAV infection rate in Edirne is in middle endemicity and the most likely way of exposure is transmission from family members. Although it requires further cost-effectiveness studies, our results indicate that applying the HAV vaccination in early childhood would be beneficial to decrease the prevalence of the infection and prevent HAV epidemics.