Browsing by Author "Ünal B."

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    Decomposing socioeconomic inequalities in self assessed health in Turkey
    (2012) Sözmen K.; Baydur H.; Simsek H.; Ünal B.
    Introduction. This study aimed to measure socioeconomic inequalities in Self Assessed Health (SAH) and evaluate the determinants of such inequalities in terms of their contributions amongst the Turkish population. Methods. We used data from the Turkish part of World Health Survey 2003 with 10,287 respondents over 18 years old. Concentration index (CI) of SAH was calculated as a measure of socioeconomic inequalities in health, and contributions of each determinant to inequality were evaluated using a decomposition method. Results: In total 952 participants (9.3%) rated their health status as either bad or very bad. The CI for SAH was -0.15, suggesting that suboptimal SAH was reported more by those categorised as poor. The multiple logistic regression results indicated that having secondary, primary or less than primary school education, not being married and being in the lowest wealth quintile, significantly increased the risk of having poor SAH. The largest contributions to inequality were attributed to education level (70.7%), household economic status (9.7%) and geographical area lived in (8.4%). Conclusion: The findings indicate that socioeconomic inequalities measured by SAH are apparent amongst the Turkish population. Education and household wealth were the greatest contributing factors to SAH inequality. These inequalities need to be explicitly addressed and vulnerable subgroups should be targeted to reduce the socioeconomic disparities. © 2012 Sözmen et al.; licensee BioMed Central Ltd.
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    Decreasing trends in cardiovascular mortality in Turkey between 1988 and 2008
    (2013) Dinç G.; Sözmen K.; Gerçeklioǧlu G.; Arik H.; Critchley J.; Ünal B.
    Background: Cardiovascular disease (CVD) mortality increased in developed countries until the 1970s then started to decline. Turkey is about to complete its demographic transition, which may also influence mortality trends. This study evaluated trends in coronary heart disease (CHD) and stroke mortality between 1988 and 2008. Methods. The number of deaths by cause (ICD-8), age and sex were obtained from the Turkish Statistical Institute (TurkStat) annually between 1988 and 2008. Population statistics were based on census data (1990 and 2000) and Turkstat projections. European population standardised mortality rates for CHD and stroke were calculated for men and women over 35 years old. Joinpoint Regression was used to identify the points at which a statistically significant (p < 0.05) change of the trend occurred. Results: The CHD mortality rate increased by 2.9% in men and 2.0% in women annually from 1988 to 1994, then started to decline. The annual rate of decline for men was 1.7% between 1994-2008, whilst in women it was 2.8% between 1994-2000 and 6.7% between 2005-2008 (p < 0.05 for all periods).Stroke mortality declined between 1990-1994 (annual fall of 3.8% in both sexes), followed by a slight increase between 1994-2004 (0.6% in men, 1.1% in women), then a further decline until 2008 (annual reduction of 4.4% in men, 7.9% in women) (p < 0.05 for all periods). Conclusions: A decrease in CVD mortality was observed from 1995 onwards in Turkey. The causes need to be explored in detail to inform future policy priorities in noncommunicable disease control. © 2013 Dinç et al.; licensee BioMed Central Ltd.
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    Determinants of prevalence, awareness, treatment and control of high LDL-C in Turkey
    (Turkish Society of Cardiology, 2016) Sözmen K.; Ünal B.; Sakarya S.; Dinç G.; Yardım N.; Keskinkılıç B.; Ergör G.
    Objective: High blood cholesterol is one of the main modifiable risk factors for cardiovascular diseases (CVDs). The aim of the study is to determine the factors associated with the prevalence, awareness, treatment, and control of high "low-density lipoprotein-cholesterol" (LDL-C) among adults aged ≥ 20 years in Turkey. Methods: We used data from Chronic Diseases and Risk Factors Survey conducted in 2011-2012. The presence of high LDL-C, lipid-lowering treatment eligibility, and achievement of target LDL-C were defined according to the third Adult Treatment Panel guidelines on treatment of high cholesterol. Multivariate logistic regression analyses were performed to determine the associations between participant characteristics and high LDL-C prevalence, awareness, treatment, and control. Results: Framingham risk score categorization was performed for 13121 individuals aged ≥ 20 years. Approximately, 28% of the participants presented with high LDL-C. Among those with high LDL-C, 55.8% were aware of their situation; among those aware of high LDL-C, 46.9% were receiving lipidlowering medication, and 50.6% of individuals who were receiving treatment achieved target LDL-C levels on the basis of their coronary heart disease (CHD) risk. Control of high LDL-C was negatively associated with the presence of diabetes mellitus (odds ratio: 0.36, 95% CI: 0.27-0.49, p< 0.001). Conclusion: Despite the high awareness rates, there was a high proportion of adults who did not receive treatment or achieve recommended levels of LDL-C during treatment. The low treatment and control levels among individuals based on their CHD risk levels call for a better application of recommendations regarding personal preventive measures and treatments in Turkey. © 2016 by Turkish Society of Cardiology.
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    An evaluation of cause-of-death trends from recent decades based on registered deaths in Turkey
    (Elsevier B.V., 2017) Özdemir R.; Dinç Horasan G.; Rao C.; Sözmen M.K.; Ünal B.
    Objectives Although cause-of-death analyses are very important to define public health policy priorities and to evaluate health programs, there is very limited knowledge about mortality profiles and trends in Turkey. The aim of this study was to measure the trends in mortality within three broad cause-of-death groups and their distribution by age groups and gender and to describe the changes of leading causes of death between 1980 and 2013 in Turkey. Study design Descriptive study. Methods In the study, data on the number of deaths by year, gender, age and cause was obtained from the Turkish Statistical Institute. The causes of death were classified as group I: communicable, maternal, perinatal, and nutritional conditions; group II: non-communicable diseases (NCDs); and group III: injuries. Unknown or ill-defined causes of death were distributed within group I and group II. The percentage distribution of the cause-of-death groups by gender and age groups between 1980 and 2013 was identified. Age-standardized mortality rates (ASMRs) per 100,000 of broad causes-of-death groups were calculated using European Standard Population 1976 between 1980 and 2008. Changes in mortality rates per hundred were calculated using the formula ([the rate of last year of the period−the rate of the first year of the period]/the rate of the first year of the period). Gender and age-specific data were analyzed using the Joinpoint software to examine trends and significant changes in trends of mortality rates. Results Crude death rates for group I, group II, and group III were 157.3, 147.2, and 21.4 per 100,000 in 1980 and 35.3, 377.5, and 15.8 in 2008 for males; 161.8, 120.2, and 5.8 in 1980 and 38.6, 318.4, and 6.4 in 2008 for females, respectively. ASMRs for group I, group II, and group III were 146.3, 394.3, and 29.3 per 100,000 in 1980 and 49.7, 723.6, and 18.8 in 2008 for males; 138.0, 291.5, and 7.6 per 100,000 in 1980 and 47.7, 478.8, and 7.2 in 2008 for females, respectively. The mortality rates of group I for almost all age groups particularly below 5 years of age decreased significantly. Conclusion This study indicates that Turkey is at an advanced stage in the epidemiological transition, with the majority of the causes of death from NCDs. Considering the regional differences, it is necessary to carry out studies on the specific details of epidemiological transition and the social determinants of deaths in Turkey. © 2017 The Royal Society for Public Health
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    The skills of defibrillation practice and certified life-support training in the healthcare providers in Turkey
    (Wiley-Hindawi, 2021) Derinoz-Guleryuz O.; Uysal-Yazici M.; Udurgucu M.; Karacan C.; Akça H.; Ongun E.A.; Ekinci F.; Duman M.; Akça-Çaglar A.; Vatansever G.; Bilen S.; Uysalol M.; Akcan-Yıldız L.; Saz E.U.; Bal A.; Piskin E.; Sahin S.; Kurt F.; Anil M.; Besli E.; Alakaya M.; Gültekingil A.; Yılmaz R.; Temel-Koksoy O.; Kesici S.; Akcay N.; Cebisli E.; Emeksiz S.; Kılınc M.A.; Köker A.; Çoban Y.; Erkek N.; Gurlu R.; Eksi-Alp E.; Apa H.; Kalkan G.; Azapagası E.; Yener N.; Sarac-Sandal O.; Horoz O.O.; Öztürk A.; Tuygun N.; Özdemir İ.; Göktuğ A.; Gökulu G.; Gümüs S.; Teksam O.; Turan C.; Zengin N.; Kardeş H.; Bozan G.; Ünal B.; Bardak S.; Arslanköylü A.E.; Yorulmaz A.; Celegen M.; Sevketoglu E.; Dursun O.; Perk O.; Başpınar O.; Akgul F.
    Aim of the study: Successful cardiopulmonary resuscitation and early defibrillation are critical in survival after in- or out-of-hospital cardiopulmonary arrest. The scope of this multi-centre study is to (a) assess skills of paediatric healthcare providers (HCPs) concerning two domains: (1) recognising rhythm abnormalities and (2) the use of defibrillator devices, and (b) to evaluate the impact of certified basic-life-support (BLS) and advanced-life-support (ALS) training to offer solutions for quality of improvement in several paediatric emergency cares and intensive care settings of Turkey. Methods: This cross-sectional and multi-centre survey study included several paediatric emergency care and intensive care settings from different regions of Turkey. Results: A total of 716 HCPs participated in the study (physicians: 69.4%, healthcare staff: 30.6%). The median age was 29 (27-33) years. Certified BLS-ALS training was received in 61% (n = 303/497) of the physicians and 45.2% (n = 99/219) of the non-physician healthcare staff (P <.001). The length of professional experience had favourable outcome towards an increased self-confidence in the physicians (P <.01, P <.001). Both physicians and non-physician healthcare staff improved their theoretical knowledge in the practice of synchronised cardioversion defibrillation (P <.001, P <.001). Non-certified healthcare providers were less likely to manage the initial doses of synchronised cardioversion and defibrillation: the correct responses remained at 32.5% and 9.2% for synchronised cardioversion and 44.8% and 16.7% for defibrillation in the physicians and healthcare staff, respectively. The indications for defibrillation were correctly answered in the physicians who had acquired a certificate of BLS-ALS training (P =.047, P =.003). Conclusions: The professional experience is significant in the correct use of a defibrillator and related procedures. Given the importance of early defibrillation in survival, the importance and proper use of defibrillators should be emphasised in Certified BLS-ALS programmes. Certified BLS-ALS programmes increase the level of knowledge and self-confidence towards synchronised cardioversion-defibrillation procedures. © 2021 John Wiley & Sons Ltd