Evaluation of the Relationship of Internet Addiction with Academic Success and Grit.

The present study aimed to evaluate the effect of internet addiction, an ever-increasing phenomenon, on success and grit in academics. This descriptive cross-sectional study was completed by reaching participants on social media platforms, using socio-demographic information, grade point averages (GPA), internet addiction scale, and the academic grit scale. No difference was found between the median scores of GPA, the academic grit scale, and the internet addiction scale according to the field of study (p-values = 0.360, 0.539, and 0.170, respectively). There was a difference between the median scores of the academic grit scale according to gender (p=0.025). There was also a statistically significant positive and very weak relationship between the grade point average and the academic grit scale (r=0. 096 and p=0.041). Therefore, when there is a desire to increase academic success and academic grit, different methods should be considered rather than increasing internet use and thus addiction. Key Words: Academic success, Grit, Internet, Internet addiction.

Problems in Coding Causes of Deaths.

Null.

The effects of the COVID-19 pandemic on sedentary life in young adults: a cross-sectional study.

In this study, the effects of the COVID-19 pandemic on physical activity and sedentary lifestyle of young adults were evaluated. The cross-sectional study was conducted on individuals aged 18-35 years between December 2021 and March 2022. In the study, sedentary life was evaluated with the International Physical Activity Questionnaire (IPAQ), screening time and the Brief Eating Behaviors Questionnaire. 397 people participated in the study and the mean age was 24.41 ± 4.18. Body Mass Index (BMI), time spent in front of the screen, need for psychosocial support, and Short Diet Behaviors Questionnaire (SDBQ) scores showed a significant increase during the pandemic compared to the pre-pandemic period (respectively; p < 0.001, p < 0.001, p < 0.001, p < 0.001). It has been observed that there is an increase in the time spent in front of the screen, worsening in eating behaviors, decrease in physical activity, and an increase in BMI values of young adults during pandemic.

The experiences and thoughts of Turkish family physicians about COVID-19 pandemic: A qualitative study.

BACKGROUND: Efforts to contain the SARS-CoV-2 virus would fall short without strong primary health care. OBJECTIVES: In this study, we aimed to determine the experiences, views and suggestions of family physicians regarding their roles, primary care health systems' preparedness and the challenges/needs for a better organisation during the pandemic via in-depth exploration. METHODS: Twenty-one family physicians working in different cities of Turkey participated in semi-structured interviews between 15/08/2020-21/01/2021. Convenience sampling was used. We did this qualitative study through interviews by telephone. Participants were asked seven open-ended questions. Thematic analysis was used, which included reading the transcript, identifying significant phrases and formulating meanings and validating meanings through research team discussions to reach consensus, identifying themes. RESULTS: Ten of the participants were female and the average age of the participants was 39.5 (SD = 10.5) years. Twelve of the family physicians are specialists in family medicine. Four themes were identified: role of primary care in the pandemic, pandemic preparedness of primary care, challenges of working in primary care centres during the COVID-19 pandemics, and approaches to future pandemics. CONCLUSION: Our study showed that, despite unprepared primary care and undefined roles of family physicians in pandemic planning, family physicians played a significant role in pandemic management.

Why Turkish Parents Refuse Childhood Vaccination? A Qualitative Study.

BACKGROUND: Anti-vaccination is spreading among parents. In 2017, 23000 families in Turkey refused vaccinations for their children. Meanwhile an increase in infectious diseases was observed, which might be caused by vaccination rejection. The reasons why families do not vaccinate their children may be very different, such as side effects, or advocation for "healthy life" by gurus. However, the real reasons for vaccine refusal are unknown. Our aim is to determine the reasons for anti-vaccination in Turkey. METHODS: In order to reveal the real reasons for not taking the vaccine, we planned to conduct interviews with the representatives of the vaccine rejection group using qualitative research methodology with the "grounded theory" method. We searched some anti-vaccination blogs to find candidates for interviews. Within the scope of our study, parental concerns about vaccinations were classified by analyzing the data obtained from semi-structured questions and interviews recorded with voice recorders in face-to-face interviews with 21 parents in 13 cities of Turkey. RESULTS: The obtained findings were classified under the headings of ''mistrust'', ''vaccine efficacy-importance'', ''decision-making processes - bases'', and ''law-ethics''. Mistrust was the main theme, almost singularly, as the most important reason for vaccine rejection. The salient reasons for mistrusts were: Companies which produce vaccines especially international companies because of conspiratory beliefs; health authorities, because of the belief about non-transparency in epidemiologic data, immunization council etc. and healthcare professionals, because of their non-communicative and non-concerned attitude. CONCLUSION: Mistrust is hard to overcome. The beliefs of the patients cannot be easily changed. As a result of our study, we made some recommendations for health authorities, healthcare professionals, companies and other related stakeholders.

Evaluation of factors affecting the fat phobia level.

AIM: The aim of the study was to investigate and evaluate factors affecting levels of negative bias or attitude towards obesity, known as "fat phobia." METHODS: The study included 583 individuals who agreed to participate in this research among those presented at our outpatient clinics for any reason. Participants were asked to complete a survey after their written consent was received. The survey consisted of two parts: the first related to socio-demographic information; the second including a "Fat Phobia Scale," the "State-Trait Anxiety Inventory" and the "Beck Depression Inventory." Data analysed using SPSS 20 statistical software. RESULTS: Of the participants, 50.6% were male, and 49.4% were female. Among participants, 49.7% had a weight problem in their family, while 50.6% had experienced weight problems. In addition, 35.7% of participants were overweight, 27.4% severely overweight, 20.1% medium-to-normal weight, 7% severely underweight, 6.7% underweight and 3.1% obese. The median score for fat phobia level did not differ by gender (P = .790) and was 3.07 in both men and women. The fat phobia level did not vary by profession, previous diets, previous weight problems and weight self-assessment (P > .05). There was no significant relationship between fat phobia and age, weight, height, body mass index, state anxiety, trait anxiety and Beck depression score (P > .05). CONCLUSION: The common opinion across studies on bias is that the effective factor in being free from the relevant bias can be achieved through education. Although fat phobia is a new concept, it is an emotion that is always with us at varying levels. In order to minimise the level of fat phobia as much as possible, to draw attention to this situation and to raise awareness, weight management should be ensured for the health of individuals in addition to psychological sessions.

The primary care physicians' despair levels: Original research article.

OBJECTIVES: The profession of medicine is very depressing both mentally and physically. There were studies conducted to investigate the reasons of depression and burnout. Hopelessness leads to depression and may be it is the first sign. The aim of our study is to determine the despair levels of primary care physicians. METHODS: This research is a descriptive study. The study conducted with family physicians and Beck Hopelessness Scale was applied. Statistical analysis of the data was performed using IBM SPSS 23. RESULTS: 40.9% of those without children, 48.9% of those with chronic diseases, 47% of those who had been subjected to violence and 53.5% of those who are not satisfied with working in the primary care received severe hopelessness scores, and these score were significant (P < .05). CONCLUSION: The dissatisfied aspects of Family Medicine System should be examined in detail, and necessary measures should be taken against violence, which is a common problem in the whole healthcare sector. In this way, employee satisfaction and therefore patient satisfaction can be achieved.

Evaluation of the effect of the COVID-19 pandemic on sleep disorders and nutrition in children.

AIMS: The aim of the study was to evaluate the possible changes in sleep behavior and nutrition in children during the pandemic period. METHODS: One hundred fourteen parents who accepted to participate in the study aged 18 and over and who had children between the ages of 6 and 16 were included in the study. A questionnaire was carried out after written consents were obtained. In the first part of the questionnaire, there were a total of 9 questions including socio-demographic information and nutritional characteristics, and the second part included the "Sleep Disturbance Scale for Children" (SDSC). The data were analyzed with the SPSS 20 statistical program. RESULTS: The total number of participants was 114 parents; 64 (56%) of the children were girls and 50 (43.9%) were boys. Among the participants, the number of children who had COVID-19 was 38 (33.3%). There was no statistically significant relationship between going through COVID-19 status and the variables examined in general. The proportion of participants who stated that if the pandemic period was prolonged, COVID-19 would not change their diet was found to be statistically significant (P = .038). The SDSC score was found to be significantly high in girls (P < .05). CONCLUSION: Sleep and nutritional disorders affect the quality of life for all ages for both genders, and their importance increases even more in extraordinary periods such as pandemic. Sleep problems increasing especially with an accompanying anxiety state may lead to developmental problems as well as deepening psychological disorders.

Evaluation of the effect of the Covid-19 pandemic on smoking addiction levels.

AIMS: This study aims to evaluate the changes in smoking addiction levels during the on-going Covid-19 pandemic. METHODS: This study included 104 participants, ≥18 years old who were previous patients of family health clinics for a variety of reasons in the months preceding the onset of the Covid-19 pandemic. The Fagerström Test for Nicotine Dependence was administered to these patients as part of their initial intakes. The participants were asked to complete a questionnaire related to socio-demographic information and the Fagerström Test for Nicotine Dependence after obtaining agreement to participate during the pandemic period. In addition, written informed consent was obtained. The Statistical Package for the Social Sciences, version 20, was used to analyse the acquired data. RESULTS: The participants were 48.1% and 51.9% women and men, respectively. The pre-pandemic and Covid-19 pandemic mean smoking addiction scores were 5.03 and 5.6, respectively. The smoking addiction levels before and during the Covid-19 pandemic significantly differed (P < .001). Of the individuals with low smoking addiction levels before the pandemic, 17.6% and 29.4% became moderately and highly addicted, respectively. Of the individuals with moderate smoking addiction level, 6.3% and 43.9% became lowly and highly addicted, respectively. CONCLUSION: The smoking addiction level may change based on various factors including behavioural changes. While increases in smoking addiction during the pandemic can be observed caused by behavioural changes and anxieties that may arise because of the pandemic, a decrease in addiction levels and even smoking cessation can also be observed during these times because of the more progressive course of Covid-19 in smokers. Health institutions should therefore take advantage of this period and focus more efforts on the cessation of smoking and other substance abuse issues.

Family medicine research assistants' experiences during COVID-19 pandemic: A qualitative study.

OBJECTIVE: We aimed to learn about the experiences of family medicine research assistants during COVID-19 pandemic and to obtain information about improvement activities that can be done in similar situations. MATERIALS AND METHODS: The study was conducted with the research assistants of X University Faculty of Medicine, Department of Family Medicine, who worked in the COVID-19 outpatient clinic during the pandemic period. The research was a qualitative research. Data were analysed using a thematic framework method. RESULTS: In all, 15 research assistants (11 females and 4 males) were included in the study. No remarkable difference was detected in the opinions with respect to their gender and their working period as a physician. The analysis revealed four main themes: emotions experienced during pandemic, working environment, gains and reasons to choose "family medicine." CONCLUSION: Family medicine research assistants have important roles during pandemic. However, in this period, it is very important to know their views to provide the most accurate management and to meet their training needs.

Medical safety reporting system neccessity and analysis of Turkey 2016 data: A health policy report.

BACKGROUND: The National Safety Reporting System, which is developed for Turkey, aims to classify medical errors with a coding methodology that handles errors in subcategories. Error entries done via the system are added to the statistics immediately by advanced live data reporting capabilities of the software. OBJECTIVE: Our aim was to provide information about the Turkey local reporting system to ensure patient safety by detecting medical errors. METHODS: The data used for analyses were obtained from https://www.grs.saglik.gov.tr and the web service used by hospital information systems. The error reporting time, most commonly reported errors, errors by professions and errors by location were examined under the major error categories and percentages that have been used in relevant data. RESULTS: In total, 53,477 errors were submitted to the National Safety Reporting System in 2016. When these entries were split into relevant categories such as drug errors, laboratory errors, surgical errors and patient safety errors, the most common errors were wrong dosage order, hemolyzed sample, not marking the side to be operated on and patient fall (patient/caretaker related), respectively. CONCLUSION: In order to reduce medical errors and provide patient safety, every institution must first of all do its own self-assessment. New user-friendly systems can be developed in order to increase medical error notifications and thus institutions can improve their healthcare quality.

While studies on COVID-19 vaccine is ongoing, the public's thoughts and attitudes to the future COVID-19 vaccine.

OBJECTIVE: In this study, we aim to investigate the thoughts and attitudes of individuals towards the future COVID-19 vaccine. METHODS: This descriptive study was carried out on the web between 10/06/2020 and 10/07/2020. The sample constitutes all individuals above 18 years of age using social media and smartphone. The e-survey form was shared by the researchers via the web for a month, and those who completed the survey were included in the study and formed the sample of the research. RESULTS: Seven-hundred and fifty-nine people participated. 49.7% of the participants stated to be vaccinated; 38.4% of them stated to be vaccinated their children against COVID-19; if the vaccine for COVID-19 is developed. The request for the COVID-19 vaccine had relationship with gender, occupation, health insurance, anxiety level, having children and willing to get vaccinated for their children. "Afraid of the side effects of vaccine", "don't think it can be reliable as it will be a new vaccine" and "COVID-19 infection is a biological weapon and the vaccine will serve those who produce this virus" were the most common reasons for rejection of vaccine. CONCLUSION: In our study, afraid of the side effects of vaccine and not thinking it can be reliable as it will be a new vaccine are the most reasons of indecision and rejection about COVID 19 vaccine. In order for the future COVID 19 vaccination campaign to not fail, media, politicians and healthcare professionals should closely follow the vaccination development processes, inform the public transparently and consider public's concerns.

Evaluation of clinical practice guideline quality: comparison of two appraisal tools.

OBJECTIVE: The tools used for critically appraising the quality of clinical practice guidelines are complex and not suitable for the busy end users. So rapid, effective and simple instruments are more preferred. The aim of this study is to compare two critical appraisal tools: iCAHE as a rapid instrument and AGREE II as a complex instrument on guideline quality assessment. MATERIAL AND METHODS: The diabetes mellitus guidelines of the Scottish Intercollegiate Guidelines Network (SIGN), the National Institute for Health and Clinical Excellence (NICE), the International Diabetes Federation (IDF) and the Society of Endocrinology and Metabolism of Turkey (SEMT) were assessed separately by four appraisers using the iCAHE and AGREE II instruments. The mean iCAHE criteria scores and the total and domain AGREE II scores given by the four appraisers are presented for each guideline. RESULTS: No statistically significant difference was detected between the iCAHE scale scores of the guidelines evaluated (P = 0.063). The rank of the guidelines according to their average total iCAHE and AGREE II instrument scores was similar. The iCAHE mean scores of the guidelines were as follows: NICE, 92.85%; SIGN, 92.85%; IDF, 66.07% and SEMT, 73.21%. The AGREE II mean scores of the guidelines were as follows: NICE, 87.13%; SIGN, 78.25%; IDF, 53.44% and SEMT, 53.22%. CONCLUSIONS: In addition to being a quality scale, the iCAHE checklist is easy, practical and short to implement. It also helps the users to understand the quality of the guideline in a shorter time. To increase the use of guidelines, it is important that users with little experience and time use the iCAHE scale as a rapid appraisal tool, but more studies are needed to decide the best appraisal tool.

Quality assessment of clinical practice guidelines for management of type 2 diabetes mellitus: Assessment of type 2 diabetes mellitus guidelines.

AIMS: Diabetes mellitus is one of the most significant global health emergencies of the 21st century. Every year, an increasing number of people succumb to the condition and therefore suffer life-changing complications. So management of this disease has an important role to prevent complications. In this study, our objective is to assess the quality of guidelines related to the significant public health problem diabetes that have been developed by international and national organizations using the AGREE II tool. METHODS: This observational study assesses the quality of clinical practice guidelines used in the management of diabetes with AGREE II tool. Statistical analysis was performed using the SPSS 20 program package. RESULTS: The overall quality score of the guidelines ranges between 3 and 6.25. While NICE's guidelines scored the highest, the guidelines of the National Diabetes Foundation scored the lowest. CONCLUSION: More comprehensive studies are needed for assessing the quality of guidelines in every subject.

Exploring guideline adaptation strategy for Turkey: Is "ADAPTE" feasible or does it need adaptation as well?

RATIONALE, AIMS, OBJECTIVES: Clinical Practice Guidelines are mostly developed by 3 methods; namely, de novo, adoption, and adaptation. Nonpublished studies and authors experience shows that most guidelines in Turkey are either by adoption or by adaptation. There is no available local tool for adaptation, so the process is not standardized and most of the time not explicitly defined. The objective of this study is to search for international guideline adaptation tools and test their feasibility in Turkish context, to serve a final goal of developing a unique local strategic tool for guideline adaptation. METHODS: The methodological design of this study includes selection of an international tool for Clinical Practice Guideline adaptation, piloting this tool with selected Turkish guidelines, identifying the feasibility of this tool and exploring the needs for adaptation of the tool, drawing recommendations for adaptation of the strategies, and validation of the process by local experts. RESULTS: The study from planning phase to finalizing the guidance, including pilot studies and panel but excluding translation of ADAPTE, lasted 18 months. Nine researchers were involved in the adaptation process and 15 more experts were involved in the validation panel. Following the suggestions of the research team on modifications and validation through the expert panel; 2 steps of the ADAPTE toolkit were rejected, 2 steps were accepted by modification, 7 steps were accepted by additional recommendations. In addition, 2 tools were suggested to be added to the toolkit. CONCLUSION: This is the first study on adaptation of guidelines in Turkey. Pilot adaptation of 2 guidelines with ADAPTE revealed that ADAPTE is a useful and feasible tool in Turkish setting, but might require certain changes in recommendations and revision of tools.

The ideas about advanced life support and affecting factors at the end-stage of life in a hospital in Turkey.

BACKGROUND: The participation of the people in health decisions may be structured in various levels. One of these is participation in decisions for the treatment. "Advanced directives" is one of the examples for the participation in decisions for the treatment. AIM: We wanted to determine the decisions on advanced life support at the end-stage of life in case of a life-threatening illness for the people themselves and their first degree relatives and the factors effecting these decisions. DESIGN AND SETTING: The cross-sectional study was conducted with volunteers among patients and patient relatives who applied to all polyclinics of the Ankara Numune Training and Research Hospital except the emergency, oncology and psychiatry polyclinics between 15.12.2012 and 15.03.2013. METHOD: A questionnaire, the Hospital Anxiety Depression (HAD) scale, and Templer's Death Anxiety Scale (TDA) were applied to all individuals. SPSS for Win. Ver. 17.0 and MS-Excel 2010 Starter software bundles were used for all statistical analysis and calculations. RESULTS: The participants want both themselves and their first degree relatives included in end-stage decision-making process. Therefore, the patients and their families should be informed adequately during decision making process and quality communication must be provided. CONCLUSION: Participants who have given their end-stage decisions previously want to be treated according to these decisions. This desire can just be possible by advanced directives.When moral and material loads of end-stage process are taken into consideration, countries, in which advanced directives are practiced, should be examined well and participants' desire should be evaluated in terms of practicability.

Physicians' attitudes toward home healthcare services in Turkey: A qualitative study.

BACKGROUND: Because of the growth of the older population and the prevalence of chronic diseases, home care services (HCS) have become an important aspect of healthcare worldwide. However, various difficulties and deficiencies are present in the provision of these recently implemented services in Turkey. Modifications to home healthcare services are in progress. OBJECTIVE: Physicians have an active role in home healthcare services. The present study was performed to examine physicians' attitudes toward this service in detail. METHODS: Twenty-six physicians who provide home healthcare services in the city of Ankara were included in the study. We conducted in-depth, semi-structured, face-to-face interviews. The interviews were audio-recorded, transcribed, and qualitatively analysed. RESULTS: Most physicians thought that home care could be provided to patients who are bedridden, are very old, have a chronic disease, have problems leaving the house, or do not have family support. They also expressed displeasure about the abuse of services and discordance of organization between hospitals and primary care centres. They noted that real circumstances in practice were not compatible with regulations and that cooperation and coordination between departments are necessary and important. CONCLUSION: The current study underlines physicians' interest in and support of the home care system, which has various drawbacks and limitations. Legislation needs to be further changed to improve the quality of service and eliminate deficiencies in home healthcare.