Associations between IL-17A G/A-rs2275913 and IL 23R A/G-rs11209026 gene polymorphisms and severe coronavirus disease 2019 (COVID-19).

Severe COVID-19 disease was linked to a severe proinflammatory response and cytokine storm interleukin 17 (IL-17) is one of these cytokines, was associated with severe acute lung injury and multiorgan dysfunction. Single nucleotide polymorphisms (SNPs) in genes coding IL-17 can affect level of IL-17 hence its role in diseases. Also, SNPs in IL-23 R which control IL-23 is the main activator of IL-17 production. This study aimed to determine whether the IL-17A (G/A-rs2275913), IL-23R (A/G rs11209026) SNPs and serum levels of IL-17 were related to the risk of severe COVID-19. This case-control study included 120 confirmed COVID-19 patients, divided into two categories according to the severity of the disease and 74 normal subjects as controls. COVID-19 patients were SARS-CoV-2 positive by a reverse transcription-polymerase chain reaction and subjected to full clinical examinations, routine laboratory tests, and radiographic evaluations. The IL-17 levels were assessed using ELISA method, and genotyping of IL-17A (197 A/G; rs2275913) and IL-23R rs11209026 (A/G) was performed by the TaqMan Genotyping Assay. There were no differences in the distribution of IL-17A or IL-23R genotypes between COVID-19 groups and the control group (p=0.93 and p=0.84, respectively). Severe COVID-19 patients had significantly higher IL-17 serum levels than non-severe COVID-19 (p=0.0001). The GG genotypes of IL-17A were significantly higher in severe COVID-19 patients (p=0.004). Multivariate logistic regression analysis revealed that AG, GG genotypes of IL-17 and IL-17A were independent predictors of COVID-19 disease severity (p < 0.0001, p=0.06 and p=0.04, respectively). ROC curve analysis for IL-17, as predictor of severe COVID-19 disease revealed a sensitivity of 87.9% and specificity of 66.1% at a cutoff point of 114 pg/ml with AUC = 0.799. In conclusion, these findings indicated that IL-17 may be considered a marker of severe COVID-19. IL-17A SNPs may have a role in COVID-19 severity. IL-23R SNPs had no role in COVID-19.

Socio-Economic, Demographic and Health Determinants of the COVID-19 Outbreak.

OBJECTIVE: In this study, the effects of social and health indicators affecting the number of cases and deaths of the COVID-19 pandemic were examined. For the determinants of the number of cases and deaths, four models consisting of social and health indicators were created. METHODS: In this quantitative research, 93 countries in the model were used to obtain determinants of the confirmed cases and determinants of the COVID-19 fatalities. RESULTS: The results obtained from Model I, in which the number of cases was examined with social indicators, showed that the number of tourists, the population between the ages of 15 and 64, and institutionalization had a positive effect on the number of cases. The results obtained from the health indicators of the number of cases show that cigarette consumption affects the number of cases positively in the 50th quantile, the death rate under the age of five affects the number of cases negatively in all quantiles, and vaccination positively affects the number of cases in 25th and 75th quantile values. Findings from social indicators of the number of COVID-19 deaths show that life expectancy negatively affects the number of deaths in the 25th and 50th quantiles. The population over the age of 65 and CO2 positively affect the number of deaths at the 25th, 50th, and 75th quantiles. There is a non-linear relationship between the number of cases and the number of deaths at the 50th and 75th quantile values. An increase in the number of cases increases the number of deaths to the turning point; after the turning point, an increase in the number of cases decreases the death rate. Herd immunity has an important role in obtaining this finding. As a health indicator, it was seen that the number of cases positively affected the number of deaths in the 50th and 75th quantile values and the vaccination rate in the 25th and 75th quantile values. Diabetes affects the number of deaths positively in the 75th quantile. CONCLUSION: The population aged 15-64 has a strong impact on COVID-19 cases, but in COVID-19 deaths, life expectancy is a strong variable. On the other hand, it has been found that vaccination and the number of cases interaction term has an effect on the mortality rate. The number of cases has a non-linear effect on the number of deaths.

The Problems Experienced by Employees with Chronic Disease during the COVID-19 Pandemic.

Chronic diseases served as a silent global epidemic before the pandemic, and individuals living with chronic disease now form one of the groups most affected by COVID-19. This study aims to determine the problems that employees with chronic disease face during the COVID-19 pandemic. As part of the study, data were collected from 952 individuals who live with chronic disease in Turkey. Of these, 76.6% of respondents worked for the public sector, a large majority of whom (67.7%) have worked full time during the COVID-19 pandemic. It was found that the COVID-19 fear level of employees living with chronic disease was higher than moderate (21.061 ± 7.607). When the variables affecting the COVID-19 fear level are listed in order of relative significance, eating problems, residing in the Mediterranean region, having asthma, and working as a female employee made the greatest impact, respectively. Necessary conditions of work should be provided to those living with chronic disease who could adapt themselves to working flexibly or working from home, so that they would not feel isolated from business life. This group should be provided with essential protective equipment, their working conditions must be reviewed and vaccination priority could be given to them.

Modeling Users’ Empowerment in E-Health Systems

In conventional e-health initiatives, customers (patients) are mostly perceived as recipients of medical care, where they play little roles in the process of health decision making. Empowerment in e-health enables individuals to access their health data and consult online with medical staff. The proposed concept is intended to improve the existing e-health theory in relation to patient empowerment. The study suggests a model that expands the role of customers (patient) in three dimensions: as an individual health actor, social health agent, and medical partner. This study is theoretically significant because it explores a comprehensive approach of patient empowerment in e-health systems to achieve best practice customer service, establish long-term customer relationships to improve customer satisfaction, and achieve better health literacy of individuals.

How Does the Social Support Affect Refugees’ Life Satisfaction in Turkey? Stress as a Mediator, Social Aids and Coronavirus Anxiety as Moderators

The number of refugees has increased exponentially due to international crises, wars, and political pressures in recent years worldwide. Turkey hosts the largest refugee population in the world with 3,672,646 Syrian refugees. This study aimed to examine the relationship among refugees’ stress, life satisfaction, social support, coronavirus anxiety, and social aids they get during the COVID-19 process. We hypothesized that stress, social aids, and coronavirus anxiety could play a role in the relationship between life satisfaction, stress, and social support. A cross-sectional survey was used to collect data from 628 Syrian refugees via an online questionnaire in Turkey. Confirmatory factor, correlation, and multiple regression analyses were conducted. In addition, the moderator and mediator role of variables tested using the 95% bias-corrected confidence interval from 5000 resamples was generated by the bias-corrected bootstrapping method. The study results show that stress partially mediated the relationship between family support and life satisfaction and between friend support and life satisfaction. In addition, coronavirus anxiety had a moderating effect on the relationship between family support and stress and friend support and stress. Finally, social aids moderated the relationship between stress and life satisfaction. In conclusion, the role of social aids, stress, and coronavirus anxiety in the relationship between social support, stress, and life satisfaction has been revealed.

The Impact of Interpersonal Cognitive Distortions on Satisfaction with Life and the Mediating Role of Loneliness

Loneliness and cognitive distortions have serious negative effects on life satisfaction and are seen as related to each other. However, what mediates in these relationships has not been adequately analyzed. This study aims to analyze the effect between cognitive distortions and life satisfaction by asserting the mediating role of loneliness. For this purpose, we conducted a cross-sectional study with 978 people over the age of 20 from various parts of Turkey using a general screening model. Firstly, we analyzed the direct effect of interpersonal rejection, interpersonal misperception, and unrealistic relationship expectation, which are sub-dimensions of cognitive distortions, loneliness, and life satisfaction. Secondly, we analyzed the effects of independent, mediation, and interaction (Loneliness X age) variables on satisfaction with life. Thirdly, we applied direct regression analysis between independent, mediating, and dependent variables to conduct the mediation analysis of the study. Also, we examined age as a moderator between loneliness and life satisfaction. The results showed loneliness as an essential determinant between cognitive distortions and life satisfaction. Moreover, in the moderation analysis, we found some age-related differences between loneliness and life satisfaction. According to this, both loneliness and life satisfaction increased with increasing age. However, life satisfaction decreased as loneliness increased in young people. Being able to compensate for loneliness in the aging process is an essential psychological indicator. Although young people have more opportunities than older people, their ability to cope with negative situations such as loneliness is largely undeveloped. These results showed both psychological and sociological problems of loneliness. Therefore, the results can be useful for the prevention of loneliness and the development of intervention programs.

Liver function test abnormalities in COVID-19 patients and factors affecting them - a retrospective study.

AIM OF THE STUDY: We aimed to study liver function test abnormalities in our COVID-19 patients and factors affecting them and to evaluate whether liver function test abnormalities are related to the severity of COVID-19. MATERIAL AND METHODS: Our retrospective study included 118 patients who were SARS-CoV-2 positive. Their median age was 40 years. Fifty percent were male. Clinical and biochemical data were collected from patient records during the period from the start of June 2020 to the end of July 2020. Liver function test abnormalities included: alanine aminotransferase (ALT) > 40 U/l, aspartate aminotransferase (AST) > 40 U/l, serum albumin < 3.5 mg/dl, total bilirubin > 1.2 mg/dl, and international normalized ratio (INR) > 1.2. RESULTS: Forty-four percent of COVID-19 patients had liver function test (LFT) abnormalities. In patients with severe SARS-CoV-2, AST, total bilirubin and INR levels were significantly higher than in patients with the non-severe disease. Levels of hemoglobin, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), serum ferritin, D-dimer, and serum glucose were significantly higher in SARS-CoV-2 patients with LFT abnormalities than those with normal liver function. CONCLUSIONS: LFT abnormalities are very common in SARS-CoV2 positive patients, especially those with the severe form. Levels of ESR, CRP, serum ferritin, and D-dimer were higher in COVID-19 patients with LFT abnormalities than those with normal LFT. High serum ferritin levels might be potential risk factors for LFT abnormalities.

The Mediating Role of Gaming Disorder in the Effect of Narcissism on Happiness in Children.

We aimed to determine the relationship between gaming disorder, narcissism, and happiness levels of children between the ages of 9 and 15. This study was based on the compensation theory. The sample consists of 461 boys who continue their education in public schools in Istanbul. In the study, a mixed research design, which nests qualitative data into quantitative, was used. In addition to the scales and sociodemographic form, the Draw-a-Person test was also used to better understand children's inner world. According to the findings, there is a significant relationship between gaming disorder and narcissism and happiness levels in children. Accordingly, as narcissism increases in children, the gaming disorder level increases, and happiness decreases. We also found a mediation effect in the impact of narcissism on happiness through gaming disorder. According to the results, we think that the problem is not caused by the individual but by society. For a solution, we recommend making more macro-level social work interventions within the framework of system theory instead of the current medical model in combating gaming disorder.

The Psychological Consequences of COVID-19 Fear and the Moderator Effects of Individuals' Underlying Illness and Witnessing Infected Friends and Family.

The COVID-19 virus has become a fearful epidemic for people all over the world. In Turkey, long quarantine periods and curfews have increased both physical and psychological problems. Due to the rapid spread and substantial impact of the COVID-19 virus, different psychological effects were observed among different segments of society, such as among young people, elderly people, and active workers. Because of fear caused by the COVID-19 virus, it is thought that depression, stress, and anxiety levels have increased. It is estimated that there are more psychological issues for people with poor health and others whose friends or family became ill or have died because of COVID-19. To explore and test the situation mentioned above, we conducted a cross-sectional study in Turkey with 3287 participants above 16 years old. We measured COVID-19 fear, along with anxiety, stress, and depression levels (DASS21) and demographics. Firstly, we tested whether COVID-19 fear predicts stress, anxiety, and depression. Secondly, we investigated if the effect of COVID-19 fear is stronger for those who have underlying illness and for those whose friends or family became ill or have died because of COVID-19. The results showed that women and 16-25 years old youths have higher COVID-19-related fear, anxiety, depression, and stress. Furthermore, we found a significant relationship between COVID-19 fear and stress, anxiety, and depression, as well as significant moderation effects of having an underlying illness and having friends or family who were infected or have died. These results show the importance of implementing specific implementations, particularly for vulnerable groups, to minimize the psychological problems that may arise with the pandemic.