Person: AY, NADİYE PINAR
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AY
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NADİYE PINAR
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Publication Open Access A qualitative study of hand hygiene compliance among health care workers in intensive care units(J INFECTION DEVELOPING COUNTRIES, 2019-02-28) TEKER SAYIN, AYŞE GÜLSEN; Ay, Pinar; Teker, Ayse Gulsen; Hidiroglu, Seyhan; Tepe, Pinar; Surmen, Aysen; Sili, Uluhan; Korten, Volkan; Karavus, MeldaIntroduction: Studies indicate that adherence to hand hygiene guidelines is at suboptimal levels. We aimed to explore the reasons for poor hand hygiene compliance. Methodology: A qualitative study based on the Theory of Planned Behavior as a framework in explaining compliance, consisting four focus group discussions and six in-depth interviews. Results: Participants mostly practiced hand hygiene depending on the sense of dirtiness and cleanliness. Some of the participants indicated that on-job training delivered by the infection control team changed their perception of emotionally based hand hygiene to indication based. Direct observations and individual feedback on one-to-one basis were the core of this training. There was low social cohesiveness and a deep polarization between the professional groups that led one group accusing the other for not being compliant. Conclusions: The infection control team should continue delivering one-to-one trainings based on observation and immediate feedback. But there is need to base this training model on a structured behavioral modification program and test its efficacy through a quasi-experimental design. Increasing social cohesiveness and transforming the blaming culture to a collaborative safety culture is also crucial to improve compliance. High workload, problems related to work-flow and turnover should be addressed.Publication Metadata only Excess mortailty during Covid-19 pandemic in Istanbul(2021-09-01) AY, NADİYE PINAR; Musellim B., Kul S., Ay P., Uyanusta C., Dagli E., Itil O., Bayram H.Publication Open Access Research publications from the ATS MECOR program in Turkiye(2023-01-01) ARIKAN, HÜSEYİN; AY, NADİYE PINAR; Karakurt Z., Yilmaz O., ARIKAN H., AY N. P., Demir C., Gurkan C. G., Akgun M., Buist S.Background: The American Thoracic Society (ATS) Methods in Epidemiologic, Clinical, and Operations Research (MECOR) Program aims to build research capacit in low and middle-income countries. MECOR has three levels, during which students learn to develop a research protocol and write a manuscript. MECOR Turkiye has been offered every year since 2008. Objective: The aim of this paper is to report the number and impact of published articles generated from research questions developed by students in levels 1, 2, and 3 of the ATS MECOR Program in Turkiye between 2008 and 2018. Methods: We collected the research questions developed in all levels of the ATS MECOR Program in Turkiye between 2008 and 2018. We searched Google Scholar, PubMed, Web of Science, and ResearchGate in April 2022 to see how many of these research questions were published as articles and, if published, in which journals. Results: Of the 176 research questions collected, 49 had been developed in level 1, 82 had been developed in level 2, and 45 had been developed in level 3. Of those 176 research questions, 55 (31.3%) generated articles that were accepted for publication. The frequency of published articles based on MECOR-developed research questions increased linearly as the course level in which they were developed increased (18.4% in level 1, 30% in level 2, 46.7% in level 3; P = 0.012; linear-by-linear association, P = 0.003). The median time from the development of the research question to publication was three years overall and did not differ significantly among the course levels (P = 0.36). Of the research questions developed, 43 were published in Science Citation Index or Science Citation Index Expanded–indexed journals. Conclusion: Acceptance of an article for publication is one way to measure the impact of the ATS MECOR Program. Our data describe significant research output among our participants, which increases with their length of participation in the program.Publication Open Access The Turkish Language and Psychometric Validation of the Bladder Control Self-assessment Questionnaire Evaluating the Lower Urinary Tract Dysfunction(GALENOS YAYINCILIK, 2020-12-01) AY, NADİYE PINAR; Hamarat, Mustafa Bilal; Tarhan, Fatih; Can, Utku; Sahlam, Erkin; Ay, PinarObjective: The aim of this study was to develop and validate the Turkish version of the Bladder Control Self-assessment Questionnaire (B-SAQ). Materials and Methods: B-SAQ that comprises two parts and four questions in each section was translated into Turkish, followed by a back-translation into English. The study included 79 and 49 women who were admitted to the urology outpatient clinic with and without complaints of lower urinary tract symptom (LUTS), respectively. Turkish B-SAQ questionnaire was filled for the second time by 67 patients after a two week interval for test-retest correlation. All patients filled the Turkish B-SAQ form, International Consultation on Incontinence Questionnaire Short Form (ICIQ-SF) and Overactive Bladder Screener (OAB-V8) questionnaire. Results: The Cronbach alpha value for B-SAQ was 0.868. Reliability of the test/retest was found to be 0.860 (p<0.001). There were statistically significant differences in B-SAQ scores between the controls and patients (p<0.001). Convergent validity analyzes with ICIQ-SF and OAB-V8 (respectively r=0.61 and r=0.44, p<0.001). The total B-SAQ cut-off score was determined as 7. The sensitivity and specificity of B-SAQ were 96% in women with LUTS. Conclusion: Turkish version of B-SAQ is a valid and reliable questionnaire to evaluate the symptoms and disorders of patients with LUTS.Publication Metadata only Noncompliance to smoke-free law: which hospitality premises are more prone?(W B SAUNDERS CO LTD, 2016) AY, NADİYE PINAR; Ay, P.; Evrengil, E.; Guner, M.; Dagli, E.Objectives: In Turkey, smoking has been banned in hospitality establishments since July 2009. The objective of this study was to determine noncompliance to the smoke-free law and its change in 2 consecutive years in enclosed spaces of hospitality venues and also to evaluate the factors associated with noncompliance. Study design: This is an observational study. Methods: Hospitality venues in Istanbul were visited, and data were collected through direct observation and interviews. Observation of smoking, cigarette butts or existence of ashtrays were defined as noncompliance. The survey was repeated in 2 consecutive years; the venues were visited both in 2013 and 2014. Logistic regression was used to evaluate factors associated with noncompliance. Results: In 2013, 450 establishments were visited, and in the next year, 367 (81.6%) were revisited. Noncompliance for 2013 and 2014 were 49.0% and 29.7%, respectively. The highest violation was observed in bars and traditional coffeehouses. There was a significant decrease in noncompliance from 2013 to 2014 among restaurants and cafes, while such a change was not observed among bars and traditional coffeehouses. In the multivariate analysis, venues other than restaurants, venues that did not have no-smoking signs and venues which had been issued fines previously had increased probability of noncompliance. Conclusions: While compliance to smoke-free law had increased significantly within 1 year, almost one third of the venues were still violating the law in 2014. The venues which were issued fines continued to violate the law. There is a need to strengthen enforcement efforts and revise the methods of enforcement and penalties in hospitality establishments. (C) 2016 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.Publication Open Access Validation of the Turkish version of the DOSE-Nonadherence measure among patients with cardiometabolic conditions(2022-10-01) AY, NADİYE PINAR; OKUYAN, BETÜL; Yagmur M., Ay P., Sancar M., Voils C. I., Okuyan B.What is known and objective There are no validated self-report measures to assess extent of and reasons for medication nonadherence in the Turkish language. The aim of this study is to evaluate validity and reliability of the Domains of Subjective Extent of Nonadherence Scale, which assesses extent of and reasons for nonadherence in Turkish patients with hypertension, diabetes mellitus and/or dyslipidaemia in community pharmacy settings. Methods The Turkish version of the DOSE-Nonadherence scale was developed through translation and cultural adaption. Psychometric properties of the scale were evaluated in a cross-sectional study among 203 patients who visited six community pharmacies located in Istanbul, Turkey between November 2020 and March 2021. For the extent of nonadherence domain, reliability was estimated through Cronbach\"s alpha, and convergent validity was evaluated with Spearman\"s rank correlation with the validated Turkish version of the Medication Adherence Report Scale (MARS). Reasons for nonadherence were characterized among participants reporting nonadherence to the extent of nonadherence items. The measure was administered at baseline and 2 weeks later to 30 patients to estimate stability of extent scores using the Wilcoxon test and intraclass correlation coefficient. p < 0.05 was set as the level of statistical significance. Results Among the 203 participants (65 male), the median (25th-75th percentiles) age was 59.0 years [51.0-67.0]. Cronbach\"s alpha for the extent of nonadherence scale was 0.86. A moderate negative correlation (r = -0.58; p < 0.001) was found between the extent of nonadherence scores and MARS, supporting convergent validity. The most common reasons for medication nonadherence were forgetfulness (22.5%) and mismatch between the patients\" daily routine and medication taking (17.5%). The intraclass correlation coefficient was 0.97 for extent of nonadherence scores at baseline and 2 weeks (p < 0.001). What is new and conclusion The DOSE-Nonadherence Scale could be used to identify nonadherent patients and their reasons for nonadherence in Turkish patients with chronic cardiometabolic conditions. This scale can be used to evaluate clinical pharmacist-led services to reduce medication nonadherence. Nonadherence could be recorded longitudinally in electronic health records to provide a more accurate picture of medication use. Pharmacists or other providers could administer interventions tailored to patients\" reasons for nonadherence.Publication Open Access Sequential Measurements of Pentraxin 3 Serum Levels in Patients with Ventilator-Associated Pneumonia: A Nested Case-Control Study(HINDAWI LTD, 2018) BİLGİLİ, BELİZ; Bilgin, Huseyin; Haliloglu, Murat; Yaman, Ali; Ay, Pinar; Bilgili, Beliz; Arslantas, Mustafa Kemal; Ozdemir, Filiz Ture; Haklar, Goncagul; Cinel, Ismail; Mulazimoglu, LutfiyePurpose. The main purpose of this study was to investigate the dynamics of pentraxin 3 (PTX3) compared with procalcitonin (PCT) and C-reactive protein (CRP) in patients with suspicion of ventilator-associated pneumonia (VAP). Materials and Methods. We designed a nested case-control study. This study was performed in the Surgical Intensive Care Unit of a tertiary care academic university and teaching hospital. Ninety-one adults who were mechanically ventilated for >48 hours were enrolled in the study. VAP diagnosis was established among 28 patients following the 2005 ATS/IDSA guidelines. Results. The median PTX3 plasma level was 2.66 ng/mL in VAP adults compared to 0.25 ng/mL in non-VAP adults (p < 0.05). Procalcitonin and CRP levels did not significantly differ. Pentraxin 3, with a 2.56 ng/mL breakpoint, had 85% sensitivity, 86% specificity, 75% positive predictive value, and 92.9% negative predictive value for VAP diagnosis (AUC = 0.78). Conclusions. With the suspicion of VAP, a pentraxin 3 plasma breakpoint of 2.56 ng/mL could contribute to the decision of whether to start antibiotics.Publication Metadata only Are home sleep studies useful in diagnosing obstructive sleep apnea in children with down syndrome?(WILEY, 2019) KARADAĞ, BÜLENT TANER; Ikizoglu, Nilay Bas; Kiyan, Esen; Polat, Beldan; Ay, Pinar; Karadag, Bulent; Ersu, RefikaIntroduction and Aim Obstructive sleep apnea syndrome (OSAS) is frequent in children with Down syndrome (DS) and polysomnography (PSG) is recommended for all children with DS. However PSG is not always available and alternative diagnostic methods are needed. The aim of the study was to evaluate the feasibility and validity of home polygraphy (HPG) in children with DS. Methods A national DS association was contacted and children aged 6 to 18 years who accepted to participate were recruited. Otorhinolaryngologic evaluation, in-lab PSG and HPG were performed. OSAS was diagnosed by PSG with an apnea-hypopnea index (AHI) more than or equal to 1. OSAS severity was classified as moderate-to-severe if AHI was more than or equal to 5. Receiver operating characteristic curves were calculated for HPG using PSG as the gold standard. Results Nineteen children (12 girls) completed the study. Median age was 11.3 years. Demographic and clinical characteristics were similar in children with and without OSAS. Eighty-nine percent of HPG studies were technically acceptable at the initial night and the success rate was 100% when two failed studies were repeated. PSG revealed OSAS in six (32%) children, two had mild and four had moderate-to-severe OSAS. All four patients with moderate-to-severe OSAS diagnosed with PSG have been diagnosed with the same severity on HPG. HPG had 100% sensitivity and 83% specificity when AHI >= 3 was set as diagnostic criteria. Conclusion HPG is a feasible and reliable test of OSAS in children with DS and may be useful in diagnosis and treatment of patients with moderate-to-severe OSAS in this patient group.Publication Metadata only Effectiveness of a sleep education program for pediatricians(WILEY, 2017) AY, NADİYE PINAR; Ersu, Refika; Boran, Perran; Akin, Yasemin; Bozaykut, Abdulkadir; Ay, Pinar; Yazar, Ahmet SamiBackground: The high prevalence of sleep problems in children and long-term consequences point to the need for early effective interventions, but health-care providers have limited training in pediatric sleep medicine. The aims of this study were therefore to assess the effectiveness of a sleep health-care education program and to develop a Turkish acronym for brief sleep history taking for pediatric primary caregivers in the ambulatory setting. Methods: This was a quasi-experimental study. Four centers were randomly selected from eight training and research hospitals as the intervention group. The control group was recruited during training in subjects other than sleep. Education was provided to the intervention group. Knowledge and attitudes were evaluated in the short and long term. Results: The intervention and the control groups consisted of 132 and 78 pediatricians, respectively. The intervention group scored significantly higher both in the short and the long term. The Turkish acronym (UYKU) was reported to be easy to remember and effective in prompting the correct questions to ask about sleep issues. Conclusions: The Turkish acronym would be useful in the primary care setting to increase the frequency of screening of sleep problems in children. Although education significantly improved knowledge on sleep issues in children, the percentage of participants who lacked confidence in the management of sleep problems in children was still very high, even in the intervention group. We suggest that a broader educational program, carried out more than once, would be more beneficial.Publication Metadata only Pharmacokinetic characterization of favipiravir in patients with COVID-19(2022) KOCAKAYA, DERYA