Estimation of the size of the COVID-19 pandemic using the epidemiological wavelength model: results from OECD countries

OBJECTIVES

This study aimed to simplify the previously developed epidemiological wavelength model and to expand the scope of the model with additional variables to estimate the magnitude of the COVID-19 pandemic. The applicability of the extended wavelength model was tested in Organisation for Economic Cooperation and Development (OECD) member countries.

STUDY DESIGN

The epidemiological wavelengths of OECD member countries for the years 2020, 2021 and 2022 were estimated comparatively, considering the cumulative number of COVID-19 cases.

METHODS

The size of the COVID-19 pandemic was estimated using the wavelength model. The scope of the wavelength model was expanded to include additional variables. The extended estimation model was improved by adding population density and human development index variables, in addition to the number of COVID-19 cases and number of days since the first case reported from the previous estimation model.

RESULTS

According to the findings obtained from the wavelength model, the country with the highest epidemiological wavelength for the years 2020, 2021 and 2022 was the United States (W_e = 29.96, W_e = 28.63 and W_e = 28.86, respectively), and the country with the lowest wavelength was Australia (W_e = 10.50, W_e = 13.14 and W_e = 18.44, respectively). The average wavelength score of OECD member countries was highest in 2022 (W_e = 24.32) and lowest in 2020 (W_e = 22.84). The differences in the periodic wavelengths of OECD countries were analysed with the dependent t-test for paired samples in two periods, 2020-2021 and 2021-2022. There was a statistically significant difference between wavelengths in the 2020-2021 and 2021-2022 groups (t(36) = -3.670; P < 0.001).

CONCLUSIONS

Decision-makers can use the extended wavelength model to easily follow the progress of the epidemic and to make quicker and more reliable decisions.

Real-world patient-level cost-effectiveness analysis of omalizumab in patients with severe allergic asthma treated in four major medical centers in Turkey

Aims. To evaluate the cost-effectiveness of standard-of-care treatment (SoC) to SoC in combination with omalizumab (OML + Soc) in patients with severe asthma using real-world prospective clinical data from 4 major medical centers in Turkey.Materials and methods. Between February 2018 and November 2019, a total of 206 patients with severe astma, including 126 of whom were in the OML + SoC group and 80 in the SoC group, were followed for 12 months to evaluate their asthma status and quality of life. Cost data for this patient-level economic evaluation were sourced from the MEDULA database of the hospitals and expressed in Turkish Lira (₺). Efficacy data were obtained by means of Turkish versions of the Asthma Control Test for asthma status, and the 5-level EQ-5D-5L version (EQ-5D-5L) and the Asthma Quality of Life Scale for quality of life. A Markov model with 2-week cycles was specified, comparing costs and treatment effects of SoC versus OML + SoC over a lifetime from the Turkish payer perspective.Results. Per-patient costs were ₺23,607.08 in the SoC arm and ₺425,329.81 in the OML + Soc arm, for a difference of ₺401,722.74. Life years (LY) and quality-adjusted life years (QALY) were 13.60 and 10.08, respectively, in the SoC group; and 21.26 and 13.35, respectively, in the OML + SoC group, for differences of 7.66 LYs and 3.27 QALYs. This yielded an incremental cost-effectiveness ratio of an additional ₺52,427.04 to gain 1 LY and an incremental cost-utility ratio of an incremental ₺122,675.57 to gain 1 QALY; the latter being below the ₺156,948 willingness-to-pay threshold for Turkey referenced by WHO. One-way and multivariate sensitivity analyses confirmed that base-case results.Conclusion. Whereas most economic evaluations are based on aggregate data, this independent cost-effectiveness analysis using prospective real-world patient-level data suggests that omalizumab in combination with standard-of-care is cost-effective for severe asthma from the Turkish public payer perspective.

The effect of macro-control and organizational support perception on nurses and physicians intention to quit during the COVID-19 pandemic

AIM

The aim of this study is to determine the effect of organizational support and COVID-19 macro-control perception levels on intention to quit in physicians and nurses.

BACKGROUND

During the pandemic process, healthcare workers faced great health risks and workloads. Many health workers are considering quitting their job.

METHOD

A cross-sectional and explanatory research. The sample of the study consisted of 300 nurses and 73 physicians. To collect data, COVID-19 perception of macro-control, perceived organizational support, and intention to quit scales were used. Structural equation modeling was used.

RESULTS

COVID-19 macro-control perception and perceived organizational support have a negative effect on the intention to quit. The perceived organizational support has a partial mediating role, on the COVID-19 macro-control perception and the intention to quit.

CONCLUSION

This study demonstrated that the macro measures taken against the pandemic and the organizational support received by the nurses and physicians, who are the main actors in the fight against the epidemic, negatively affected their intention to leave.

IMPLICATIONS FOR NURSING PRACTICE AND CLINICAL RELEVANCE

To reduce the intention to quit health workers during the COVID-19 pandemic, scientific-based macro-control measures should be taken, and organizational support should be provided.

Cluster analysis of health systems in Europe according to life expectancy at birth

PURPOSE

The aim of this study was to group European countries according to life expectancy at birth and to determine the impact of economic growth and financial indicators on European country groups.

METHOD

This study planned and conducted by using life expectancy at birth time series, economic growth and financial development indicators data for the period of 1980 to 2015. European countries are classified in terms of life expectancy (LE) at birth time series data from 1980 to 2015 by using hierarchical clustering analysis method. Random Forest and Classification and Regression Tree (CART) algorithm was used to examine predictors of European country groups in terms of long-term LE time series data by using economic growth and financial development indicators.

RESULTS

The results of this study show that Eastern and Western countries are mostly in two different clusters in terms of long-term LE time series. This study sheds light on the difference between Eurosceptic countries and other European countries. This study revealed that inflation in consumer prices, which is an indicator of economic growth, outperforms financial development indicators to predict country groups in terms of long-term life expectancy at birth data.

CONCLUSION

Countries in the same cluster may have similar problems and solutions in their health care systems. Priority should be given to health problems that adversely affect the life expectancy of the countries in the same cluster in order to raise the quality of life and extend life expectancy in the European continent.

A conceptual framework of quality of life in chronic kidney disease in Turkey: A patient-focused approach

This study aimed to determine the quality of life of patients with chronic kidney disease who were receiving dialysis treatment. It also aimed to identify the factors affecting the quality of life of these patients. The independent variables analyzed were: patients' sociodemographic characteristics, organizational characteristics, adherence to treatment, patient-physician relationship, and patient activation level. The sample consisted of 328 patients with chronic kidney disease who received services from dialysis units of two university hospitals and two private dialysis centers. Data analysis was performed through multivariate regression. Results showed that receiving treatment from a hospital-based dialysis unit may have a positive effect in patients' quality of life; and patient-physician relationship, patient activity, and adherence to treatment may positively affect quality of life. Thus, planning of health service delivery that focus on improving the quality of life of patients who are more active by allowing them to establish positive relationships with their physicians and to have a better adherence to treatment should be adopted. These findings may provide health managers, health professionals, and individual patients with evidence-based information about treatment management and health service planning processes related to chronic kidney disease.

An Evidence-Based Approach to Outcome Measurement in Oral and Dental Health Services: Oral Health-Related Quality of Life and Oral Health Impact

PURPOSE

The purpose of this study was to examine the Oral Health-Related Quality of Life (OHRQOL) and Oral Health Impact Profile (OHIP) of oral and dental health patients in terms of gender, educational status, and the reason for coming to the oral health center. Also, we investigated the relationships between OHRQOL and OHIP.

METHODS

This cross-sectional study was conducted and planned for dental patients in Turkey. OHRQOL-United Kingdom (OHRQOL-UK) and OHIP-14 were used for data collection. Descriptive statistics, correlation analysis, student t-tests, and ANOVA were used for data analyses.

RESULTS

Of 527 respondents, 62.8% were female, and 37.2% were male. One-hundred-forty-one (26.8%) participants were illiterate. Three-hundred-fifty-four (67.20%) dental patients had an elementary school degree. Only 32 (6.10%) participants graduated from college and bachelor programs. For dimensions of the OHIP-14 and OHRQOL-UK, we detected statistically significant differences in personal characteristics. We found that gender, marital status, age, education status, and reasons for coming to the hospital have a significant impact on OHRQOL and OHIP.

LINKING EVIDENCE TO ACTION

These results are expected to provide important evidence-based information to health managers and decision-makers in health planning and reimbursement policies. Clinicians and health managers should use OHIP, quality of life (QOL), and evidence-based practice to determine individual treatments and approaches to improve oral health. QOL is an outcome indicator in healthcare services and evidence-based practice. Measurements of evidence-based health outcomes in national health systems can be made, and global comparisons and policies in oral and dental health can be developed.

Opinions and evaluations of stakeholders in the implementation of the public-private partnership (PPP) model in integrated health campuses (city hospitals) in Turkey

PURPOSE

This study aimed to define the public-private partnership (PPP) model, eliciting the views and assessments of stakeholders and identifying associated health policies and planning issues.

METHOD

It uses qualitative research methods to examine the extent to which PPPs promote or interfere with the provision of health services, equality, efficiency, quality, health tourism, and initiatives to strengthen the national economy. Having selected an appropriate sample, researchers approached bureaucrats and experts from the Ministry of Health, Social Security Institution, Ministry of Development, Ministry of Finance, NGOs, and other state institutions and organizations. A total of 83 people were asked to complete a semi-structured questionnaire. The qualitative research data were analyzed using a descriptive-analysis method; a content analysis was carried out using a computer-based qualitative research program, MAXQDA Versions 11.

RESULTS

The majority of participants expressed positive opinions about PPPs, their applicability in Turkey, and the financial viability and scope of PPPs in the health sector. They also commented on the aims, advantages, and disadvantages of such partnerships. The majority of participants believed that a PPP was an appropriate finance model for the integrated health-campus substructure of Turkey's health sector. The most positive views were expressed by public and private sector-stakeholders, while some negative views were voiced by NGO representatives.

CONCLUSION

This study identified and assessed integrated health-campus projects to determine the aim, suitability, advantages, and disadvantages of the model in the health sector, particularly in relation to the cost, quality, and availability of health services. This study discusses the current positive and negative effects of integrated health-campus implementation.

The Effect of Organizational Justice and Trust on Job Stress in Hospital Organizations

PURPOSE

The primary purpose of this study was to explore the relationships among distributive justice, procedural justice, interactional justice, job stress, cognition-based trust, and affect-based trust; the secondary purpose was to determine the effect of distributive justice, procedural justice, interactional justice, cognition-based trust, and affect-based trust on job stress in hospital organizations.

METHOD

Data were collected using scales of job stress, organizational justice, and organizational trust. The study was conducted in two public hospitals in Turkey. A total of 432 health personnel participated in this study.

RESULTS

This study showed that both cognition-based trust and affect-based trust were significantly positively correlated to the three dimensions of organizational justice (distributive justice, procedural justice, and interactional justice), but they were significantly negatively related to job stress. According to regression analysis, organizational justice was a significant predictor for job stress.

CONCLUSIONS

In the working environment of hospitals, job stress and perceptions of organizational justice are significant variables that affect employees' working processes and their feelings of trust in their organization.

CLINICAL RELEVANCE

Reducing employees' job stress and improving their perceptions of organizational trust and organizational justice can improve their levels of cognition-based trust and affect-based trust regarding their managers. As the job stress of nurses decreases, the effectiveness of health services may increase as organizational trust and justice develop.

Evaluation of electronic prescription implications in Turkey: an investigation of the perceptions of physicians

BACKGROUND

Electronic prescribing (e-prescribing) is an evolving area of healthcare information technology that aims to support physician decision-making by capturing, reviewing, and issuing medical prescriptions with high potential for improving the quality and safety of the process.

PURPOSE

To describe physician perception of e-prescription use in healthcare organizations that work with social security and to evaluate their infrastructures for MEDULA (an information system for billing and other health informatics) in healthcare organizations in Turkey.

METHODS

A cross-sectional survey design was used for this study. A convenience sample of physicians in eight general hospitals and in two oral and dental health centers of the Ministry of Health in Turkey were surveyed.

RESULTS

Survey response rate was 47% (248/425). The majority of physicians (62%) support e-prescribing but have not used an electronic signature for prescriptions (78.2%). Almost half of them believe that e-prescriptions would positively contribute to patient safety (43%)

LINKING EVIDENCE TO ACTION

Our study provides a first look at the perceptions of physicians regarding the implications of e-prescriptions, which became mandatory on January 15, 2013, in Turkey. Advocates of e-prescribing have suggested that additional efforts are needed to strengthen clinical decision systems. Physicians and nurses are better able to adopt e-prescribing systems and to view them positively if they recognize the limitations of paper-based prescribing and understand the utility of electronic systems in addressing some of these limitations. This study represents a starting point for government and related organizations to improve their knowledge on how well the implied benefits of e-prescriptions are realized in their acquisition, appraisal, and use in health policy decision-making and health systems.

Computer anxiety in nursing: an investigation from Turkish nurses

The purpose of this study was to determine and analyze levels of computer anxiety in nurses at a public university hospital in Turkey. This study investigated the dimensions of computer anxiety in terms of computer literacy, self-efficacy, physical arousal, affective feelings, positive beliefs, and negative beliefs. Moreover in this study it was aimed to analyze relationships among computer anxiety and some characteristics of nurses (age, gender etc.). This study based on Beckers and Schmidt's computer anxiety model. The Beckers and Schmidt's Computer Anxiety Scale (BSCAS) was used for data collection. BSCAS comprises six factors: computer literacy, self-efficacy, physical arousal in the presence of computers, affective feelings towards computers, positive beliefs, and negative beliefs. At the end of the data collection period, 175 nurses were received from the population. The response rate was 43.75%. This study showed that a majority of nurses had medium levels of computer anxiety. Overall computer anxiety means score was 12.11±1.72. Computer anxiety has significant relationship with age (r=-.153; p<.05), personal computer ownership (r=.171; p<.05). The highest correlation was between overall computer anxiety and self efficacy (r=-.859), the lowest correlation was between overall computer and negative beliefs (r=-.653). Multiple regression analysis revealed that computer anxiety of nurses was predicted significantly by self efficacy, affective feelings, physical arousal, computer literacy, positive beliefs, and negative beliefs, respectively.

[Ulipristal acetate (Esmya): a selective modulator of progesterone receptors, new treatment of uterine fibromatosis]

Uterine fibromatosis is a frequent benign gynaecological disease causing heavy menstrual bleeding and in some cases anaemia. Until now, medical treatment aimed to obtain amenorrhea by administration of progestins or Gn-RH agonists. By inducing hypo-oestrogenism, a reduction of myoma size is observed with Gn-RH agonists but after cessation of the treatment, initial myoma size is noted. The impact of progesterone in myoma growth is nowadays demonstrated and use of selective modulators of progesterone receptors represents a new medical approach of this disease.

An analysis of relationships among transformational leadership, job satisfaction, organizational commitment and organizational trust in two Turkish hospitals

The purpose of this study was to investigate the relationships among employee organizational commitment, organizational trust, job satisfaction and employees' perceptions of their immediate supervisors' transformational leadership behaviors in Turkey. First, this study examined the relationships among organizational commitment, organizational trust, job satisfaction and transformational leadership in two Turkish public hospitals. Second, this investigation examined how job satisfaction, organizational trust and transformational leadership affect organizational commitment. Moreover, it was aimed to investigate how organizational commitment, job satisfaction and transformational leadership affect organizational trust. A quantitative, cross-sectional method, self-administered questionnaire was used for this study. Eight hundred four employees from two public hospitals in Turkey were recruited for collecting data. The overall response rate was 38.14%. The measurement instruments of survey were the Job Satisfaction Survey (developed by P. Spector), the Organizational Commitment Questionnaire (developed by J. Meyer and N. Allen), the Organizational Trust Inventory-short form (developed by L. Cummings and P. Bromiley) and the Transformational Leadership Inventory (TLI) (developed by P. M. Podsakoff). Five-point Likert scales were used in these measurement instruments. Correlation test (the Pearson's rank test) was used to examine relationships between variables. Also, multiple regression analysis was used to determine the regressors for organizational commitment and organizational trust. There were significant relationships among overall job satisfaction, overall transformational leadership and organizational trust. Regression analyses showed that organizational trust and two job satisfaction dimensions (contingent rewards and communication) were significant predictors for organizational commitment. It was found that one transformational leadership dimension (articulating a vision), two job satisfaction dimensions (pay and supervision) and two organizational commitment dimensions (affective commitment and normative commitment) were significant regressors for organizational trust. There is a lack of research in the health organizations regarding organizational commitment, organizational trust, job satisfaction and transformational leadership. The investigator of the proposed study intends to add to the literature and intends to prove that the proposed study would be important for healthcare organizations. A number of specific measures should be undertaken to reduce factors that negatively affect organizational commitment, organizational trust and job satisfaction of hospital personnel and to improve transformational leadership behaviors of hospital administrators.

Quality of life and attitudes to ageing in Turkish older adults at old people's homes

OBJECTIVES

The purpose of this study was to investigate quality of life (QOL) and attitudes to ageing in Turkish older adults at two old people's homes (nursing homes) and to explain relationship between QOL and attitudes to ageing.

METHODS

This study is a quantitative and descriptive exploratory study of QOL and attitudes to ageing of older adults in nursing homes in a developing country.

INSTRUMENTS

Two international data measurement tools were used for data collection. Data measurement instruments in this study are The World Health Organization Quality of Life Instrument-Older Adults Module (WHOQOL-OLD) and the WHO - Attitudes to Ageing Questionnaire (AAQ). The WHOQOL-OLD module consists of 24 items assigned to six facets (sensory abilities, autonomy, past, present and future activities, social participation, death and dying and intimacy) AAQ consists of 24 items classified in three domains (psychosocial loss, physical change and psychological growth) with eight items each.

PARTICIPANTS

The Turkish version of the WHOQOL-OLD and AAQ was administered to 120 older (>65 years) adults living in two old people's homes in Samsun Province, Turkey. This study was conducted and planned between on 1 November 2011 and on 31 November, 2011.

RESULTS

The results indicated that there was significant relationship between QOL and attitudes to ageing of older adults. In this study, the highest significant relationship is between psychological growth subscale of attitudes to ageing and sensory abilities subscale of QOL (r = 0.579; P < 0.01). Overall QOL and overall attitudes to ageing had a significant and positive relationship (r = 0.408; P < 0.01). The dimensions of attitudes to ageing (psychosocial loss, physical change and psychological growth) were significant predictors for QOL in older adults in Turkey. It was found that the gender does not affect overall QOL in older adults. However, happiness is significant variable for overall QOL in this study.

CONCLUSION

The results suggest that QOL is a complex, multidimensional concept that should be studied at different levels of analysis in Turkey and other developing countries. The results of this study emphasize the importance of QOL in older adults in older people's homes in Turkey and attitudes to ageing of nursing home residents in Turkey.

Quality of Life (QOL) and Attitudes Toward Aging in Older Adults in Şanlıurfa, Turkey

Objectives: The purpose of this study was to investigate quality of life (QOL) and attitudes toward aging in older adults in a province in Turkey. Methods: This is a quantitative and descriptive study of QOL and the attitudes toward aging in older adults. Instruments: The data measurement instruments used in this study are the World Health Organization (WHO) Quality of Life Instrument–Older Adults Module (WHOQOL-OLD) and the WHO–Attitudes to Ageing Questionnaire (AAQ). Participants: The Turkish versions of the WHOQOL-OLD and AAQ were administered to 550 older adults living in şanlıurfa Province, Turkey. Results: The results indicated a significant relationship between QOL and attitudes toward aging in older adults. Two dimensions of attitudes toward aging (physical change and psychological growth) were significant predictors of QOL in older adults. It was found that gender, literacy, social security, age, and marital status affect some dimensions of QOL and some subscales of attitudes toward aging.

An examination of mobbing and burnout of residents

AIM

Mobbing and burnout in human resources management are important topics in labor psychology. It is important to research the levels of mobbing and burnout of human resources in the health sector, primarily in doctors. Although there have been some studies on the mobbing and burnout of doctors, there has been a limited number of studies on the relationship between mobbing and burnout in the health sector. This study aims to examine the relationship between mobbing and burnout (emotional exhaustion, depersonalization, personal accomplishment) levels of resident doctors at a public university research and training hospital in Turkey and to investigate whether mobbing and burnout levels vary significantly according to gender, marital status, medical branch and age.

METHOD

This study was conducted on resident doctors at the Ondokuz Mayıs University Research and Training Hospital between 01.04.2009 and 30.06.2009. Legal permission for the study was received from the Rector's Office of Ondokuz Mayıs University. The Maslach Burnout Inventory for measuring burnout levels in doctors and the Leymann Inventory of Psychological Terror for measuring doctors' mobbing levels were the research instruments employed. Sampling was not used in this study. The aim was to administer the research instruments to all the residents (the universe of this study consisted of 510 assistant doctors). 52.94 % of residents responded to all of the questions in these instruments. In the data analysis, a t-test, ANOVA, regression analysis and descriptive statistics were used.

FINDINGS

At the end of the analyses, it was found that the mean mobbing level of residents is 1.97; the mean emotional exhaustion level of residents is 2.97; the mean level of depersonalization is 2.95; and the mean level of personal accomplishment is 2.94. Mobbing and burnout levels of residents vary significantly in terms of medical branch.

CONCLUSION

This study indicated that there are relationships between mobbing, emotional exhaustion, depersonalization and personal accomplishment. Mobbing is a significant regressor for emotional exhaustion, depersonalization and personal accomplishment in this study.

[Treatment of severe preeclampsia: until when and for what risks/benefits?]

The four major hypertensive disorders related to pregnancy are preeclampsia, chronic hypertension, preeclampsia superimposed upon chronic hypertension, and gestational hypertension. The development of hypertension and proteinuria in pregnancy is usually due to preeclampsia, particularly in a primigravida. These findings typically become apparent in the latter part of the third trimester and progress until delivery, but some women develop symptoms in the latter half of the second trimester, or intrapartum, or the early postpartum period. Preeclampsia is characterized as mild or severe. Severe hypertension, coagulopathy, thrombocytopenia, liver function abnormalities, and fetal growth restriction are features of severe disease. Laboratory evaluation should assess haemoglobin/hematocrit and platelet count, renal and hepatic function, as well as assessment of fetal well-being and growth. Timing of delivery is based upon gestational age, maternal and fetal condition, and the severity of preeclampsia. Maternal end organ dysfunction and nonreassuring tests of fetal well-being are indications for delivery at any gestational age. Antihypertensive treatment aims at protecting the mother from severe hypertensive encephalopathy, but may jeopardize the fetus. We recommend antenatal corticosteroids (betamethasone) be given to women with preeclampsia at 26 to 34 weeks of gestation. Magnesium sulfate is more effective than phenytoin for prevention of eclamptic seizures.