Unlocking time-quantile impact of energy vulnerability, financial development, and political globalization on environmental sustainability in Turkey: Evidence from different pollution indicators.

Increasing energy vulnerability can cause environmental pollution by increasing fossil fuel consumption. If it leads to cost-cutting-oriented industry growth, financial development can lead to environmental regulations being ignored, compromising environmental quality. Political globalization and economic growth can increase short-term environmental pressures, straining long-term ecological balance and causing habitat loss and pollution. This study investigates the impact of energy vulnerability, financial development, and political globalization on environmental sustainability in Turkey for the 2000-2019 period using with wavelet quantile-based techniques. According to results, while the negative effect of energy vulnerability on environmental quality is lower in the short term, the size of the effect increases in the medium and long term. In addition, at low quantiles of environmental quality, the negative effect of financial development is low in the short and long term, while the effect becomes evident in the long term. Moreover, the effects of political globalization on environmental quality are positive in all quantiles. Additionally, the harmful effects of economic growth are more evident at lower quantiles of environmental quality. Turkey should increase its clean energy investments by using its geographically advantageous location. Policymakers should also prioritize environmental regulations and promote sustainable practices in industries. Incentives for cleaner production technologies and environmentally friendly initiatives can help steer the financial sector towards more responsible and environmentally friendly practices. Additionally, the study suggests that increasing institutional capacity and aligning national policies with international agreements can accelerate the positive effects of political globalization.

Developing an ethical attitude scale for pain management in nursing.

OBJECTIVES: The aim of this study is to develop the 'Developing an Ethical Attitude Scale for Pain Management in Nursing' to assign the ethical attitudes of nurses in pain management. METHODS: The population of the study comprised nurses (n=411) working in a university hospital in Izmir. The Ethical Attitude Scale in Nursing Pain Management was developed in five sub-dimensions: 'Care and Dignity,' 'Ethical Values,' 'Attitude,' 'Rights,' and 'Pain Management.' This scale was created by examining many research studies related to pain management in nursing in the literature and taking expert opinions. 'The Ethical Attitude Scale in Nursing Pain Management' initially consisted of 36 items. After expert opinions and validity analyses, the draft scale was reduced to 34 items, and then reliability analysis further reduced the scale to 23 items. RESULTS: In the validity and reliability study of 'The Ethical Attitude Scale in Nursing Pain Management,' the total Cronbach's alpha value of the scale was 0.86. The Cronbach's alpha value for the 'Care and Dignity' sub-dimension was 0.88; for the 'Ethical Values' sub-dimension, it was 0.83; for the 'Attitude' sub-dimension, it was 0.86; for the 'Rights' sub-dimension, it was 0.79; and for the 'Pain Management' sub-dimension, it was 0.72. CONCLUSION: According to these data, it was determined that 'The Ethical Attitude Scale in Nursing Pain Management' is a valid and reliable scale.

Low back pain frequency and the related risk factors in nurses and caregivers.

OBJECTIVES: The objective of this study is to investigate the frequency of low back pain and the relationship between low back pain and personal and occupational risk factors in hospital employees. METHODS: The study sample consisted of 270 nurses and 189 caregivers working in a university hospital. Demographic characteristics, low back pain history, and low back pain risk factors were queried by self-report questionnaires. The Biering-Sorensen Test was used to evaluate the endurance of trunk extensor muscles. Also, the Oswestry Disability Index (ODI) and Hospital Anxiety and Depression Scale (HADS) were used. RESULTS: Of the hospital employees included in the study, 56.5% had low back pain in the last month, and 81.9% had a his-tory of low back pain. The frequency of low back pain was significantly higher among those who work in a stressful working environment, stand for extended periods, lift patients or heavy subjects without using a lifting device, and transfer patients alone. In addition, it was determined that those who exercise regularly and are satisfied with their job had significantly less low back pain (p<0.05). The mean Biering-Sorensen test difference between the two groups was statistically significant (p<0.001). There was a significant difference between the groups with and without low back pain in terms of HADS-Anxiety and HADS-Depression subscale scores. CONCLUSION: The study findings indicated that being a hospital worker is a risk factor for low back pain, and the decrease in the strength and endurance of the lower back muscles increases the risk of low back pain.

Whole-genome sequence of a novel lytic bacteriophage infecting Clavibacter michiganensis subsp. michiganensis from Turkey.

Clavibacter michiganensis subsp. michiganensis (Cmm) is an important plant-pathogenic bacterium that causes canker and wilt diseases. Biological control of the disease with bacteriophages is an alternative to conventional methods. In this study, Phage33 infecting Cmm was characterized based on morphological and genomic properties. Morphological characteristics such as shape and size were investigated using electron microscopy. The whole genome was sequenced using the Illumina Novaseq 6000 platform and the sequence was assembled and annotated. VICTOR and VIRIDIC were used for determining the phylogeny and comparing viral genomes, respectively. Electron microscopy showed that Phage33 has an icosahedral head with a diameter of ~55 nm and a long, thin, non-contractile tail ~169 nm in length. The genome of Phage33 is 56 324 bp in size, has a GC content of 62.49 % and encodes 67 open reading frames. Thirty-seven ORFs showed high homology to functionally annotated bacteriophage proteins in the NCBI database. The remaining 30 ORFs were identified as hypothetical with unknown functions. The genome contains no antimicrobial resistance, no lysogenicity and no virulence signatures, suggesting that it is a suitable candidate for biocontrol agents. The results of a blastn search showed similarity to the previously reported Xylella phage Sano, with an average nucleotide sequence identity of 92.37 % and query coverage of 91 %. This result was verified using VICTOR and VIRIDIC analysis, and suggests that Phage33 is a new member of the genus Sanovirus under the class Caudoviricetes.

[On the issue of logistic support of export of medicinal preparations of national production].

The current geopolitical situation raised pointed question of developing new supply chains and looking for rolling stock to develop newly formed cargo flows, including medicinal preparations transportation. Considering necessity in timely and safe supply of medicines, it is necessary to develop set of measures permitting to implement export of this production of national industry to ensure ultimate independence from unfriendly states. The article considers main indicators of import and export operations of medicinal preparations and measures taken by the state to support industry in current conditions, requirements for international transportation of this category of goods. The measures increasing exports within the framework of the Pharmaceutical Industry Development Strategy until 2030, such as expansion of fleet of autonomous refrigerated containers, use of consolidation warehouses in Turkey and Kazakhstan to ensure decreasing of cost of multi-modal transportation of medicinal preparations, as well as validation of rolling stock in accordance with GDP requirements.

Investment Hysteresis: An Empirical Essay Turkish Case.

After the 2008 World Crisis, there is a view that the economic recovery has not been adequate. In this context, the debate on hysteresis and especially investment hysteresis has increased in the last decade. The aim of this study is to analyze the investment hysteresis and the basic dynamics of hysteresis in the Turkish economy. Structural break tests are used to identify hysteresis. Traditional and asymmetric causality tests are used to identify the fundamental dynamics of hysteresis. Investment, GDP, interest rate, and productivity variables are used to analyze investment hysteresis. Structural break tests were applied to the variables, while conventional and asymmetric causality tests were applied between investments and their determinants. Structural break tests prove the existence of hysteresis. According to the Granger causality test, there is no causality from interest rates, GDP and productivity to investments. The fact that interest rates have no effect on investments proves hysteresis. According to the asymmetric causality test, there is no relationship between interest rates and investments. There is an inverse relationship between GDP and investments. There is an asymmetric relationship between productivity and investments. The fact that productivity shocks cause asymmetric effects on investments makes productivity shocks the main dynamic of hysteresis. In addition, there is considerable evidence that the strong hysteresis and high uncertainty of TFP exacerbate investment hysteresis. Therefore, productivity shocks should be taken into account in policymaking for hysteresis.

Evaluation of the effects of pandemic-related fears on anxiety and depression: the mediating roles of traumatic stress and loneliness.

BACKGROUND: The detrimental mental health effects which emerged from COVID-19 have profoundly affected healthcare workers (HCWs) worldwide. The aim of this study was to investigate the mediating effects of traumatic stress and loneliness on the fears of contracting and dying from COVID-19, and anxiety and depression of HCWs during the pandemic. METHODS: A cross-sectional online survey was completed by HCWs in a province of Turkey. The Hospital Anxiety Depression Scale, Impact of Events Scale-Revised and numerical rating scales (for fears of COVID-19 and loneliness) were used and a bootstrap approach was used in the analyses with SPSS PROCESS macro software. RESULTS: Of the HCWs evaluated, 150 (34.4%) were doctors, with a mean duration of work experience of 10.6 ± 7.5 years. The results indicated that fear of contracting COVID-19 was directly related to anxiety (ß = 0.244, p < 0.001) and depression (ß = 0.135, p < 0.01) and that traumatic stress and loneliness mediated the relationships between the fear of contracting COVID-19 and anxiety (ß = 0.435, p < 0.001; ß = 0.235, p < 0.001, respectively) and depression (ß = 0.365, p < 0.001; ß = 0.294, p < 0.001, respectively). The fear of dying from COVID-19 was determined to be directly associated with anxiety (ß = 0.190, p < 0.001) but not with depression (ß = 0.066, p = 0.116), and traumatic stress and loneliness mediated the relationships between the fear of dying from COVID-19 and anxiety (ß = 0.476, p < 0.001; ß = 0.259, p < 0.001, respectively) and depression (ß = 0.400, p < 0.001; ß = 0.311, p < 0.001, respectively). CONCLUSIONS: The study results demonstrated the important roles of traumatic stress and loneliness in exacerbating the negative consequences of fears of COVID-19 on anxiety and depression, and provide insights for identifying HCWs at greater risk.

Evaluating the impact of social media marketing from the perspective of orthodontists.

OBJECTIVE: In developed countries, orthodontists utilize social media platforms as a pivotal component of their marketing strategies. However, there exists a gap in understanding the broader perspective of healthcare professionals on the utilization of social media in healthcare service delivery. Therefore, this study aims to evaluate the perceptions of healthcare professionals in Turkey regarding the integration of social media within healthcare service delivery. MATERIALS & METHODS: This cross-sectional study, conducted between January and February 2023, surveyed 378 members of the Turkish Orthodontic Society. The survey consisted of two parts: a demographic questionnaire with 28 items and a 21-item "Social Media Marketing Activities Scale," developed with input from three experts. Data analysis will include an explanatory factor analysis. This study provides a snapshot of orthodontists' perspectives on social media marketing practices. RESULTS: When participants' views of patient communication through social media were examined, 19.8% said they "thought it was right" and 80.2% said they "thought it was wrong". The treatment and treatment alternatives shared with patients through social media were implemented in 16.5% of cases and not implemented in 83.5% of cases. When examining the social media accounts used by participants to communicate with patients, 56.8% used personal accounts, 43.2% used professional accounts, and when analyzing the social media accounts they used for promotional purposes, 15.8% had personal accounts, 84.2% of them used professional accounts. More than half (59.8%) of orthodontists believed that communicating with patients on social media could cause legal problems. The majority of orthodontists (88.7%) followed their competitors. CONCLUSION: The prevalence of participants' use of social media posts for advertising purposes was low, and it was determined that the main reason for this was the prohibition of advertising in the provision of health services.

Evaluation of T. gondii, rubella, and cytomegalovirus seroprevalences among female Syrian refugees in Sanliurfa, Turkiye.

INTRODUCTION: Since the Syrian Civil War began in 2011, the official number of refugees under temporary protection in Turkiye is reported to be 3,522,036 in 2023. Most of the Syrians living outside the refugee camps have worse conditions in terms of access to healthcare centers and social opportunities, compared to those living in camps. The Sanliurfa province hosts the third highest number of Syrians (370,291) in Turkiye. There are no data about the seroprevalence of Toxoplasma gondii (T. gondii), rubella (rub), or cytomegalovirus (CMV) among Syrian refugees in Sanliurfa. We aimed to investigate the seroprevalence of T. gondii, rub, and CMV infections among female Syrian refugees of reproductive age (15-49 years) living in Sanliurfa province. METHODOLOGY: A cross-sectional study was conducted in different districts of Sanliurfa. A total of 460 households were selected using the probability sampling method. One married female Syrian refugee aged between 15 and 49 years, was chosen in each household, leading to a sample size of 410 female Syrian refugees. The seropositivity of T. gondii, CMV, and rub IgM and IgG in blood samples were analyzed using enzyme immunoassays (Abbott Architect, Illinois, USA). RESULTS: The seropositivity rates of T. gondii, CMV, and rubella IgM and IgG were 4.4% and 59.8%; 3.9%; and 99%; and 1.9%, and 99.5%, respectively. CONCLUSIONS: A screening program should be implemented for T. gondii, CMV, and rub infections for Syrian refugees. Seronegative women should be vaccinated against rub and educated about the transmission and preventive routes of toxoplasmosis and CMV infection.

Heliotropium thermophilum adapts to high soil temperature in natural conditions due to its highly active antioxidant system protecting its photosynthetic machinery.

Heliotropium thermophilum (Boraginaceae) plants have strong antioxidant properties. This study investigated the effectiveness of the antioxidant system in protecting the photosynthetic machinery of H. thermophilum . Plants were obtained from Kizildere geothermal area in Buharkent district, Aydin, Turkey. Plants in the geothermal area that grew at 25-35°C were regarded as the low temperature group, while those that grew at 55-65°C were regarded as the high temperature group. We analysed the physiological changes of these plants at the two temperature conditions at stage pre-flowering and flowering. We meaured the effect of high soil temperature on water potential, malondialdehyde, cell membrane stability, and hydrogen peroxide analysis to determine stress levels on leaves and roots. Changes in antioxidant enzyme activities, ascorbate and chlorophyll content, chlorophyll fluorescence, photosynthetic gas exchange parameters, and photosynthetic enzymes (Rubisco and invertase) activities were also determined. Our results showed minimal changes to stress levels, indicating that plants were tolerant to high soil temperatures. In general, an increase in antioxidant enzyme activities, ascorbat levels, and all chlorophyll fluorescence parameters except for non-photochemical quenching (NPQ) and F v /F m were observed. The pre-flowering and flowering stages were both characterised by decreased NPQ, despite F v /F m not changing. Additionally, there was a rise in the levels of photosynthetic gas exchange parameters, Rubisco, and invertase activities. High temperature did not affect photosynthetic yield because H. thermophilum was found to stimulate antioxidant capacity, which reduces oxidative damage and maintains its photosynthetic machinery in high temperature conditions and therefore, it is tolerant to high soil temperature.

Age related semen parameters and ICSI pregnancy outcomes of 8046 men in Turkey over a 9-year period.

The effect of paternal age on fertility remains unclear. This retrospective study aims to examine the impact of male age on semen parameters and the reproductive outcomes of men admitted to an infertility center over a 9-year period. A total of 8046 patients were included in the study. Men were divided into four age groups. The groups were evaluated for semen parameters and reproductive outcome. The 21-30 year group presented lower sperm concentrations in comparison to those aged 31-40 and 41-50, yet shared a similar concentration to those over 50 years of age. Moreover, grades A and B decreased significantly in men aged over 50 years. The highest progressive motility and normozoospermia were observed in the age group 31-40 years while men over 50 years of age had the highest rates of asthenozoospermia and oligoasthenozoospermia. Furthermore, live birth results were reported in 5583 of the patients who underwent intracytoplasmic sperm injection (ICSI) and were found highest between 31-40 years of age. To our knowledge, this is the largest study in Turkey focusing on male age-related semen parameters and ICSI pregnancy outcomes. The study demonstrates that age is a significant factor for semen quality and live birth.

Identifying Malnutrition in Oncology Outpatients Using Different Screening Tools.

OBJECTIVE: To compare the results of different nutritional screening tools, including NRS-2002, PG-SGA, and NUTRISCORE for the detection of malnutrition in oncology outpatients. STUDY DESIGN: A descriptive study. Place and Duration of the Study: Daily Chemotherapy Unit, Umraniye Training and Research Hospital, Istanbul, Turkiye, between June and July 2021. METHODOLOGY: A total of 69 patients were included in the study, receiving cancer therapy in an outpatient setting. The NRS-2002, PG-SGA, and NUTRISCORE scores were calculated to determine the nutritional status. RESULTS: The mean age of the patients was 56.74 ± 13.48 years, and 59.4% were females. The mean BMI was 27.29 ± 5.27 kg/m2. Among the patients, 55.1% had insufficient nutritional intake or were at risk of malnutrition according to the NRS-2002, 40.6% according to NUTRISCORE, and 59.4% according to the PG-SGA. There was a significant agreement between the results of the NRS-2002 and PG-SGA in a McNemar test (Kappa: 0.320, p = 0.008). CONCLUSION: NRS-2002 and PG-SGA tools offered greater sensitivity in terms of capturing more patients in the precachectic state than NUTRISCORE. Among these, the NRS-2002 is a shorter test, and thus, would seem to be more practical than the PG-SGA. KEY WORDS: Oncology, Malnutrition, Screening tools, NRS-2002, PG-SGA, NUTRISCORE.

B2 Prognostic Index in Determining Prognosis in Metastatic Breast Cancer.

OBJECTIVE: To determine the relationship between the B2 prognostic index (B2PI) scoring method and prognosis in metastatic breast cancer, and to create a formula based on parameters that can be easily accessed in daily practice. STUDY DESIGN: Descriptive study. Place and Duration of the Study: Department of Medical Oncology, Dokuz Eylul University, Izmir, Turkiye, between May 2010 and June 2021. METHODOLOGY: The clinicopathological characteristics of the patients were compared between the groups. All female breast cancer patients over the age of 18 years with de novo metastatic and non-metastatic breast cancers who developed metastasis during follow-up, were included in the study. Those with a second solid cancer or haematological malignancy and with a life expectancy of less than 3 months were excluded from the study. Chi-square and Fisher's exact tests were used to compare categorical data between the groups. Overall survival evaluations were made using the Kaplan-Meier analysis method and Log-Rank test. Risk factors for mortality were evaluated in Cox regression analysis. In all statistical tests, p <0.05 was considered statistically significant. RESULTS: There were 176 patients in this study, out of which 111 (63.1%) were de novo metastatic. When the effect of B2PI risk groups on overall survival in intrinsic subtypes was analysed, significant differences were found in the overall survival of B2PI risk groups in all subtypes except HER2+ ER- (HER2 overexpression subtype). According to the B2PI scoring system, the median overall survival was higher for both low-risk and moderate-risk patients compared to those in the high-risk category. CONCLUSION: For metastatic breast cancer patients, the B2PI can be used to determine prognosis and develop treatment strategies, as it is a clinical decision-making tool based on parameters that are easily accessible in daily practice. KEY WORDS: Metastatic breast cancer, B2 prognostic index, Prognosis, Survival.

Intolerance of Uncertainty, Job Satisfaction and Work Performance in Turkish Healthcare Professionals: Mediating Role of Psychological Capital.

Objective: Psychological capital refers to internal resources including self-efficacy, hope, optimism and resilience to overcome adverse life events. The current study sought to examine the mediating role of psychological capital in the relationship between intolerance of uncertainty and job satisfaction and work performance in healthcare professionals. Methods: Participants were 302 healthcare professionals [48% females; M(SD) age = 34.0 (7.5)] and completed measures of intolerance of uncertainty, psychological capital, work performance, and job satisfaction. Results: The findings indicated that intolerance of uncertainty was negatively correlated with psychological capital, work performance, and job satisfaction, whereas psychological capital was positively correlated with job satisfaction and work performance. More importantly, the findings revealed that these relationships were mediated by psychological capital. Conclusion: The results provide several contributions that help to understand the role of psychological capital in the relationship between intolerance to uncertainty and job satisfaction and work performance.

Assessment of clinical phenotypic characteristics of patients with angioedema without wheals in a turkish population.

Background: Angioedema (AE) is defined as localized, self-limited swelling of subcutaneous tissues and mucosa. Objective: The aim of this study was to compare the phenotypic characteristics of patients with AE without wheals. Methods: This prospective study included adult patients with recurrent AE without wheals. Demographic and laboratory data of the patients were recorded in the patient file when they presented to the outpatient clinic between August 2018 and August 2020. The patients were contacted by phone to evaluate whether their AE had gone into remission between October 2023 and January 2024. The phenotypic characteristics of AE subtypes were compared. Results: The study included a total of 143 patients. The average age, age of onset of AE, rates of diabetes mellitus, hypertension and coronary artery disease were higher in the patients with angiotensin-converting enzyme inhibitor (ACEI) use related acquired AE (AAE) (AAE-ACEI). The rates of allergic rhinitis, drug allergy, atopy, and aeroallergen sensitivity, and the median total immunoglobulin E level were higher in patients with idiopathic histaminergic AAE (AAE-IH). The rate of face and/or perioral AE attacks was higher in the patients with AAE-ACEI, AAE-IH, and idiopathic non-histaminergic AAE. The rate of AE attacks in limbs, abdominal, genital and other parts of the body was higher in patients with hereditary AE (HAE). The baseline AE activity score was lower in the patients with AAE-IH and higher in the patients with HAE. In long-term follow-up, the remission rate of AE attacks was significant higher in patients with AAE-ACEI and AAE-IH. Conclusion: The phenotypic characteristic features of Turkish patients with AE without wheals may vary, depending on the underlying AE pathogenesis. C1 inhibitor level and function, complement C4 and C1q, and genetic tests contributed to the diagnosis; other laboratory tests did not contribute to the diagnosis.

Heart Failure Awareness Survey in a Turkish Population: HFAS-TR.

OBJECTIVE: Heart failure is a leading cause of death and the most common diagnosis leading to hospitalization. Its awareness is lower than that of other cardiovascular diseases, both in the general population and among patients with heart failure (HF). This study aimed to establish the current level of knowledge about HF in patients with HF with reduced ejection fraction (HFrEF) and mildly reduced ejection fraction (HFmrEF) in Türkiye. METHODS: This questionnaire-based survey study is multicenter, conducted across 34 centers from December 2021 to July 2022. We performed a survey consisting of two sets of questions focusing on individual characteristics of the patients and HF-related knowledge. RESULTS: The study included a total of 2,307 outpatient HF patients, comprising 70.5% males and 29.5% females with a mean age of 64.58 ± 13 (56-74) years and a mean body mass index value of 32.5 ± 10 kg/m2. HFrEF and HFmrEF were determined in 74.7% and 25.3% of patients, respectively. Thirty percent of the patients were unaware that they had HF. While 28.7% of the patients thought that they had sufficient information about HF, 71.3% believed they lacked adequate knowledge. In the study, 25.2% of the participants identified dyspnea, 22% identified tiredness, and 25.4% identified leg edema as the most common symptoms of HF. Only 27.4% of patients recognized all three typical symptoms of HF. CONCLUSION: We found that the study population's knowledge about HF symptoms and the nature of the disease was poor. Educational and awareness activities are necessary to optimize outcomes and benefits.

The relationship between health literacy and family planning attitude in women in Kirsehir province, Turkey.

To develop positive attitudes towards family planning, health literacy is important. This study aimed to investigate a relationship between health literacy and family planning attitudes among married women. 657 married women volunteered to participate in this cross-sectional, correlational and descriptive study. The Türkiye Health Literacy - 32 scale and the Family Planning Attitude Scale were used in the study. According to the results, the women's general health literacy score was 34.5±8.7 out of 50 points, which was adequate, and the family planning attitude score was 128.9±17.7 out of 170 points, which was above the average. It is found a weak positive relationship between health literacy and family planning attitudes. Educational status, occupation and income level affect health literacy and family planning attitude. It is noteworthy that 84.4% of women with inadequate health literacy were using modern family planning methods, while this rate was 77.1% among women with adequate health literacy. To improve women's attitudes towards family planning, it is recommended that health literacy is improved, effective media content is developed and women are encouraged to use primary health care services.

Pour développer des attitudes positives à l'égard de la planification familiale, il est important d'avoir des connaissances en matière de santé. Cette étude visait à examiner la relation entre les connaissances en matière de santé et les attitudes à l'égard de la planification familiale chez les femmes mariées. 657 femmes mariées se sont portées volontaires pour participer à cette étude transversale, corrélationnelle et descriptive. L'échelle Türkiye Health Literacy - 32 et l'échelle Family Planning Attitude Scale ont été utilisées dans l'étude. Selon les résultats, le score général des femmes en matière de santé était de 34,5±8,7 sur 50 points, ce qui est adéquat, et le score de l'attitude de planification familiale était de 128,9±17,7 sur 170 points, ce qui est supérieur à la moyenne. Il existe une faible relation positive entre les connaissances en matière de santé et les attitudes à l'égard de la planification familiale. Le niveau d'éducation, la profession et le niveau de revenu influencent les connaissances en matière de santé et l'attitude à l'égard de la planification familiale. Il convient de noter que 84,4 % des femmes dont les connaissances en matière de santé sont insuffisantes utilisent des méthodes modernes de planification familiale, alors que ce taux est de 77,1 % chez les femmes dont les connaissances en matière de santé sont suffisantes. Pour améliorer l'attitude des femmes à l'égard de la planification familiale, il est recommandé d'améliorer les connaissances en matière de santé, de développer un contenu médiatique efficace et d'encourager les femmes à utiliser les services de soins de santé primaires.

Nursing students' conceptualization of environmental problems: a descriptive cross-sectional study.

BACKGROUND: The significant challenges of the twenty-first century revolve around environmental issues. Knowing individuals' environmental attitudes and what they see as environmental problems is crucial to mobilizing them to action. Nurses hold a significant responsibility in addressing and combating environmental challenges. RESEARCH AIM: This study had two objectives: understanding how nursing students classify environmental issues and examining the effects of gender, economic status, school district, family environmental awareness, and perception of global responsibility on their conceptualization of environmental issues. DESIGN: A descriptive cross-sectional study using a questionnaire. SETTING AND PARTICIPANTS: The sample consisted of 1466 nursing students from four faculties of two public universities in Turkiye. The study was conducted between January and April 2023. METHODS: Data were collected using a form that included 19 issues ranging from ecological problems to social problems related to the environment, as well as the Global Social Responsibility Scale (GSRS). The data were analyzed using explanatory factor analysis, multiple regression, and mediator analysis. RESULTS: Participants classified the environmental issues as eco-social-oriented and human-oriented. First-year students (B = -0.201), male students (B = -0.263), those studying in rural schools (B = -0.123), and those who rarely discuss environmental issues in the family (B = -0.197) describe the problems in the eco-social oriented dimension as less "environmental." The increase in the action-oriented responsibility (B = 0.014) and ecological responsibility (B = 0.077) scores of The Global Social Responsibility Scale leads to an increase in recognizing the problems in this area as environmental issues. Similarly, first-year students (B = -0.340), male students (B = -0.293), and those who rarely discussed environmental issues in the family (B = -0.243) led to a decrease in recognizing problems as environmental in the human-oriented issues dimension. In contrast, poor socioeconomic perception (B = 0.245), negative perception of the future (B = 0.145), and increased action-oriented responsibility (B = 0.024) and ecological responsibility (B = 0.042) led to an increase in recognition of human-oriented issues. The increase in the national responsibility score decreased the score of environmental assessment of the problems in this area (B = -0.017). In addition, the perception of global responsibility partially mediates between students' sociodemographic characteristics and environmental issues recognition scores in both sub-dimensions. CONCLUSION: This study presents results that point to individual differences among nursing students in addressing environmental issues, reveal the impact of family on these differences, and finally show the importance of curricula to increase students' global social responsibility during their education.

Adherence to iron supplementation during the first year of life infants in Izmir, Turkey.

To determine the prevalence of adherence to iron supplementation and the risk factors for incomplete adherence during the first year of life of infants in Izmir, Turkey. In this cross-sectional study, a total of 511 infants aged 2 to 12 months who presented to the Pediatrics outpatient clinics of Ege University Children's Hospital were included. Mothers (n = 511) who agreed to participate in the study were interviewed face-to-face and a comprehensive questionnaire including questions about the sociodemographic characteristics of the children and the family, and their adherence to iron supplementation was administered. The data obtained from 471 (92.2%) mothers who used iron supplements for their babies were subjected to further statistical analysis. Analyses were performed with SPSS 25.0. Chi-square test was used for univariate analysis and logistic regression analysis was used to determine the independent factors associated with incomplete adherence to iron supplementation. A total of 511 mothers were surveyed. Among the infants of mothers who participated in the study, 471 (92.2%) were taking iron supplementation. Of the infants who received iron supplementation, 58.3% were given iron supplementation with complete adherence. The percentage of complete adherence with iron supplementation was 35.1% between 2 and 4 months, 66.3% between 5 and 8 months, and 52.4% between 9 to 12 months. In univariate analysis, statistically significant differences were found between complete and incomplete adherence to iron supplementation in terms of infant age, time of birth, family income, maternal education, and maternal employment status (P < .001). When the data were analyzed using multivariate analysis, only maternal education level and infant age group were found to be statistically significant independent variables for complete and incomplete adherence to iron supplementation (P < .001). In populations with a high prevalence of ID, incomplete adherence to iron supplementation is a serious risk factor for ID/IDA. Although iron supplements are routinely given to infants by the Ministry of Health in Turkey, the prevalence of complete adherence to iron supplementation is low. Therefore, in order to increase the rate of complete adherence to iron supplementation, the iron supplementation status of infants should be reviewed in detail at each health child visit and families should be informed about the importance of supplementation to prevent iron deficiency.

Health literacy as a predictor of cardiovascular disease risk factor knowledge level among women in Turkey: A community-based cross-sectional study.

While more common in men globally, heart diseases also rank as the leading cause of death among women. This study aimed to examine the relationship between Turkish women's level of knowledge about cardiovascular disease (CVD) risk factors and their health literacy. Data for this descriptive and cross-sectional study were collected online by using Health Literacy Scale and CVD risk factor knowledge level scale from October 2022, to May 2023. The study sample consisted of 409 women. It was found that the total score average of the women on the CVD risk factor knowledge level was 20.65 ±â€…4.72 and the Health Literacy Scale was 107.06 ±â€…16.01. There was a moderate, significantly positive correlation between CVD knowledge levels and health literacy (r = .548, P = .000). It was found that women with high health literacy also had increased knowledge levels. Furthermore, all health literacy dimensions of access to information (P < .001), understanding information (P < .001), appraisal/evaluation (P < .001), and implementation (P < .001) were detected as the predictors of CVD risk factor knowledge levels. Factors such as educational level and economic status significantly influenced scores on both scales (P < .05). The study's findings highlight the challenges encountered by women with low socioeconomic status in accessing accurate information. It may be recommended that nurses provide health education and consultancy services to these women on the prevention and management of cardiovascular diseases. Also, public education programs should consider socioeconomic and educational levels, focusing on women who encounter difficulties accessing information.