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.

Influence of a prophylaxis paste on surface roughness of different composites, porcelain, enamel and dentin surfaces.

OBJECTIVE: To investigate the effect of a prophylaxis paste on surface roughness of different composites, enamel, dentin and porcelain surfaces. METHODS: Three different composites (FiltekZ250/Group1, Filtek Supreme XT/Group2, Premise/Group3), enamel/Group4, dentin/Group5 and porcelain/Group6 samples were used in this study. All specimens were prepared flat by SiC discs and polished with a diamond polishing paste. The surface roughness measurements were determined with a profilometer after polishing (initial surface roughness). Prophylaxis paste was applied to the samples for 12 seconds, renewing every 6 seconds. After cleaning the samples, roughness values were measured again. Data were analyzed by Kruskal Wallis and Dunn's multiple comparison test. Wilcoxon test was performed for the comparison of the initial and final surface roughness values (P<.05). The results were evaluated within the P<.05 confidence level. RESULTS: The initial and final surface roughness values (µm) were determined as follows: Group1: 0.039±0.009 and 0.157±0.018, Group2: 0.023±0.005 and 0.145±0.027, Group3: 0.028±0.008 and 0.109±0.012, Group4: 0.024±0.006 and 0.071±0.015, Group5: 0.030±0.007 and 0.143±0.029, Group6: 0.024±0.006 and 0.064±0.014. Significant difference was determined between the initial and final values for all groups. CONCLUSIONS: Composite and dentin surfaces were more affected by the application of prophylaxis paste than enamel and porcelain surfaces. The prophylaxis paste increased the surface roughness of all groups, but did not reach the bacterial retention roughness rate of 0.2µm.

Therapeutical potential of autologous peripheral blood mononuclear cell transplantation in patients with type 2 diabetic critical limb ischemia.

AIM: The aim was to evaluate the therapeutic effectiveness of granulocyte colony-stimulating factor (G-CSF) mobilized peripheral blood mononuclear cells (PBMNCs) in critical limb ischemia (CLI) of type 2 diabetic patients. METHOD: Forty diabetic patients with CLI were enrolled and randomized to treatment and control groups. In the treatment group, the patients received subcutaneous injections of recombinant human G-CSF (30 MU/day) for 5 days to mobilize stem cells. PBMNCs were collected and transplanted by multiple intramuscular injections of 1 ml in 1-1.5-cm depth into ischemic limbs. RESULTS: At the end of 12 weeks of follow-up, the baseline and end point results in transplant group were as follows: Fontaine score improved from 3.8±03 to 3±0.5 (P=.0001), ankle brachial pressure index increased from 0.68±0.24 to 0.87±024 (P=.001), transcutaneous oxygen increased from 33±14 mmHg to 44±10 mmHg (P=.0001), and 6-min walking distance improved from 280±82 m to 338±98 m (P=.0001). Pain score decreased from 8.2±1.3 to 5.63±1.6 (P=.001), and the number of patients with limb ulcers was reduced from 9/20 (45%) to 3/20 (15%) (P=.031). In the control group, Fontaine score, 6-min walking distance, and pain score were improved; ankle brachial pressure index and transcutaneous oxygen pressure were not improved. The number of patients with limb ulcers did not change in the control group. There are improvement in amputation rates, collateral vessel development, and number of limb ulcers healed. CONCLUSIONS: These results indicate that the autologous transplantation of G-CSF that mobilized PBMNCs in CLI diabetic patients is safe and effective in patient compliant reduction and improved perfusion.

Story of benzene and leukemia: epidemiologic approach of Muzaffer Aksoy.

In 1974, Professor Muzaffer Aksoy established a link to leukemia in humans as a result of occupational exposure to benzene. The aim of this study is to evaluate his epidemiological approach for his investigation on the effects of benzene and to bring attention to the benzene problem in Turkey. Dr. Aksoy observed that a large group of leukemic patients were shoemakers, or they worked in leather manufacturing. In the 1960s, benzene was a popular solvent in the leather industry. Dr. Aksoy conducted a field investigation in Gedikpasa- Istanbul, where the shoemakers worked so that he could draw his key observations from actual environmental conditions. With a gas detector, he found the concentration of benzene in these work places to be 150-210 ppm and up to 650 ppm on rare occasions. He performed an epidemiological study and health education among 28,500 shoe, slipper and handbag workers during the period from 1967 to 1974. He published these data, establishing an association between benzene and leukemia. The incidence of leukemia among the shoe workers was decreased by screening, health education, and legislative actions in Turkey, but it began to increase again because of lack of an occupational health policy and underestimation of the problem. These results suggest the importance of primary prevention of occupational cancers. Dr. Aksoy's epidemiologic approach may highlight the necessity for detailed investigations of the occupational status of patients who need medical aid in order to diagnose the real underlying factor.

The effect of sociocultural status on periodontal conditions in pregnancy.

BACKGROUND: The effects of sociocultural status on periodontal conditions in pregnant women have been reported by a number of researchers and there have been speculations about the effects of hormonal changes, patients' systemic health, and socio-cultural characteristics on periodontal health during pregnancy. METHODS: This study evaluates the periodontal condition of 61 pregnant women at their first, second, and third trimesters, and the relation between the demographic (age, professional level, education) and clinical variables (previous periodontal care, frequency of tooth brushing). The clinical indices, including plaque index, gingival index, and probing depth measurements were repeated at the first, second, and third trimesters. The statistical tests used were stepwise analysis and paired sample test. RESULTS: The results of the study showed that the plaque index, gingival index, and probing depth scores increased gradually in the first, second, and third trimesters, although oral hygiene instructions were given to the entire study population. The level of statistical significance was established at P <0.05. When the clinical parameters and demographic variables were compared, only educational level and periodontal care seemed to be statistically significant (P<0.05). CONCLUSIONS: Our clinical index scores were related to the educational level of the study population. When the educational level of the study group decreased, the plaque, gingival index, and probing depth scores contrarily increased. Also non-attendance for previous periodontal care increased the scores of plaque index and probing depth. In view of the results of our study, it might be suggested that simple preventive oral hygiene programs may help maintain healthy gingiva during pregnancy.