Person: AY, NADİYE PINAR
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AY
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NADİYE PINAR
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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 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 Will plain packaging of cigarettes achieve the expected? Perceptions among medical students(2022-10-01) AY, NADİYE PINAR; Ay P., Yasin Y., Elbek O., Guner M., Gezer T., Sonmez U. P., Ceyhan M., Yildiz F., Dagli E.INTRODUCTION Plain packaging is one of the critical strategies in eliminating the promotion of tobacco products. Evidence indicates that plain packaging decreases the attractiveness of tobacco products and enhances the effectiveness of health warnings. This study aimed to explore the perceptions of undergraduate medical students of plain packaging and new pictorial warnings before they came into use in Turkey. METHODS This qualitative study was carried out among undergraduate students in a Medical School in Istanbul in 2019. Participants were recruited through purposive sampling, and data were collected through focus group discussions. The participants were asked to discuss their perceptions regarding one original branded pack and ten plain package models. All discussions were audiotaped and thematic content analysis was conducted. RESULTS A total of 72 students participated in the study. None of the students had seen plain packaging before. Most of the students perceived plain packaging as more favorable compared to the branded packs. The terms used to describe plain package were: ‘appealing/desirable’, ‘attractive’, ‘beautiful’, ‘cool/eye-catching’, ‘charming’, ‘elegant’, and ‘special’. Some students indicated that they would have preferred plain packs over the branded ones if both types of products had been in the market and provided they were of the same brand. Pictorials had different impacts based on their content. At the same time, outer body deformities were perceived as ‘real’ and provoked unfavorable feelings; inner organ images were defined as ‘imaginary’ and had little to no impact. CONCLUSIONS Plain packaging was perceived as a more attractive alternative to the conventional branded packs among most participants. We must be aware of the unforeseen effects of plain packaging among different subgroups in the new generations. We suggest using outer body deformities in the pictorials more frequently due to their higher impact.Publication Open Access Do family physicians perceive electronic cigarette use as a harm reduction strategy for smokers? A survey from Istanbul(2022-03-01) AY, NADİYE PINAR; HIDIROĞLU, SEYHAN; Tanriover O., HIDIROĞLU S., AY N. P., Cook R. L.Background: E-cigarettes (ECs) are gaining popularity in Turkey among smokers. With the rapid increase of EC consumption, it is important to ascertain how family physicians (FPs) perceive ECs as they play a key role in providing smoking cessation services. Aim: Our main objectives were to determine FPs\" level of awareness and harm reduction perceptions of ECs and to delineate the factors associated with their counseling practices. Methods: This was a cross-sectional study with descriptive and analytical components. Data were collected through questionnaires. Questions mainly focused on demographic characteristics, knowledge and own use of ECs, general attitudes towards ECs, and daily practices while performing counseling on tobacco use. In order to control confounding factors, logistic regression analysis was performed. Findings: Among a total of 271 FPs, 49.1% (n = 133) were males and the median age (IQR) was 41 years (32-46). Almost one-fifth of the FPs (n = 52) reported that they did not provide counseling services to their smoking patients. Only 26.6% (n = 72) of the FPs stated that they felt confident enough to advise patients on smoking cessation. Of the FPs, 6.6% have stated that they have recommended ECs to their patients for smoking cessation with the strategy of harm reduction. Factors associated with providers\" recommendation of ECs to their patients as a harm reduction strategy included \"believing that ECs help smokers to quit, ECs could be vaped in closed areas, and ECs were healthier than combustible tobacco products\". Conclusion: In our study, FPs stated lack of confidence to advice patients on smoking cessation. Furthermore, they recommended ECs to their smoking patients as a harm reduction strategy. FPs\" confidence should be increased with the trainings based on recent evidence on ECs.Publication Open Access Has the cancer-related death trend been changing in Turkey? An evaluation of the period between 2009 and 2019(2022-10-01) AY, NADİYE PINAR; TEKER SAYIN, AYŞE GÜLSEN; Teker A. G., AY N. P.Background: The objective of this study was to determine the trend of cancer-related death rates between 2009 and 2019 in Turkey for all cancers combined and the five cancer types with the highest mortality: lung, stomach, pancreas, breast, and colon cancers. Methods: Cancer mortality data were obtained from the Turkish Statistical Institute (TURKSTAT) and standardized by age using the World Health Organization (WHO) standard population ratios. The change in cancerrelated mortality over the years was evaluated using Joinpoint Regression Analysis (JRA). Results: Total cancer-related deaths increased by 2.2% annually between 2009 and 2014 and decreased by 2.9% annually between 2014 and 2019 (p < 0.05). Among men; lung cancer-related deaths increased by 2.4% annually between 2009 and 2014 and decreased by 3.4% annually between 2014 and 2019 (p < 0.05), stomach cancer-related deaths decreased by 5.1% annually between 2014 and 2019 (p < 0.05), colon cancer-related deaths increased by 5.8% annually between 2009 and 2015 and decreased by 3.3% annually between 2015 and 2019 (p < 0.05), pancreatic cancer-related deaths increased annually by 5.6% in 2009–2013 (p < 0.05). Among women; lung cancer-related deaths increased by 2.5% annually between 2009 and 2016 (p < 0.05), stomach cancer-related deaths increased annually by 2.3% between 2009 and 2014 and decreased annually by 4.5% between 2014 and 2019 (p < 0.05), colon cancer-related deaths increased by 2.5% annually between 2009 and 2017 (p < 0.05), pancreatic cancer-related deaths increased by 7.4% annually between 2009 and 2013 (p < 0.05) and breast cancer-related deaths increased by 2.2% annually between 2009 and 2019 (p < 0.05). Conclusion: Mortality data in Turkey are collected only by TURKSTAT, which raises concern regarding the incompletion of the data. While this might lead to underestimation, the trend shows that there has been a decrease in total cancer-related deaths in Turkey. Pancreatic cancer, on the other hand, gains a higher proportion in cancer-related deaths in Turkey as in the world. Increasing deaths from lung and breast cancer in women remind of the importance of tobacco control interventions and cancer screening programs.Publication Open Access Validation of the Turkish version of European Organization for Research and Treatment of Cancer QLQ-OV28 ovarian cancer specific quality of life questionnaire(GALENOS YAYINCILIK, 2020-04-06) AY, NADİYE PINAR; Akdemir, Yesim; Cam, Cetin; Ay, Nadiye Pinar; Karateke, AtesObjective: To examine reliability and validity of the European Organization for Research and Treatment of Cancer (EORTC) QLQ-OV28 questionnaire into the Turkish language according to the instructions provided by EORTC. Materials and Methods: Ninety-seven patients who were diagnosed as having ovarian cancer and treated between January 2005 and June 2010 with an expected survival time of at least 3 months, were enrolled into the study. The exclusion criteria were diagnoses of any disease that could disrupt consciousness and concurrent malignancies. The EORTC QLQ-OV28 module was translated into Turkish by professional translators and physicians. The test-retest reliability of the Turkish version of the questionnaire was performed on 30 patients. Answers were scored according to the instructions provided by the EORTC. The total score was calculated as explained above and after scoring procedures, all subscale scores were linearly transformed to a 0-100 scale. All patients concomitantly completed the Spielberg State Trait Anxiety Inventory (STAI) and Beck Depression Inventory (BDI). Patients were analyzed in two groups: on-treatment and off-treatment groups consisted of patients who did and did not undergo chemotherapy or surgery within the last two months, respectively. The demographic data of all patients were recorded. EORTC QLQ-OV28 scores of both groups were compared. Correlations between EORTC QLQ-OV28 subscales and total score of BDI and STAI were analyzed. Results: For test-retest reliability, Spearman's rho was 0.84 (p<0.001). The on-treatment group scored statistically significantly higher than the off-treatment group in peripheral neuropathies, attitude to disease and treatment, sexual function and other chemotherapy adverse effect subscales of the questionnaire. Correlations between EORTC QLQ-OV28 subscales and the total scores of BDI and STAI of the groups were statistically significant, except the sexual function subscale. Conclusion: The Turkish translated version of EORTC QLQ-OV28 module is a reliable, consistent, and a valid instrument for assessing the impact of treatment modalities on QoL among Turkish speaking women with ovarian cancer.Publication Open Access Evaluation of mucosal status in the follow-up of pediatric patients with celiac disease: the role of serology(2022-09-01) AY, NADİYE PINAR; ERTEM ŞAHİNOĞLU, DENİZ; ÇELİKEL, ÇİĞDEM; Sengul O. K., Akkelle B. S., Ay P., Volkan B., Tutar E., Celikel Ç., Ertem D.Recent guidelines suggest non-biopsy serology-based approach for the diagnosis of celiac disease; however, there is no evidence-based data regarding noninvasive follow-up of mucosal healing. The aim of this study is to investigate the efficacy of serology in reflecting mucosal status in the follow-up of pediatric patients with celiac disease. This is a validation study conducted at a university hospital. Patients who had biopsy proven celiac disease (Marsh III) at diagnosis, and had been followed-up for at least 12 months, were prospectively evaluated with duodenal biopsies. tTG-IgA and EMA tests were performed on the day of endoscopy. One hundred four patients with a mean age of 7.4 +/- 4.02 years were included in the study. The sensitivity and specificity of tTG-IgA were 85.2% and 61% respectively, with a high negative predictive value (NPV) of 92.2% but a very low positive predictive value (PPV) of 43.4%. We found that a cutoff value of 68.5 U/mL for tTG-IgA had a sensitivity, specificity of 85.2% and 85.7% respectively. The AUC was 0.891. The sensitivity and specificity of EMA was 77.8% and 87% respectively, with a high NPV of 91.8% but low PPV of 67.7%.Publication Open Access Night-to-night variability of polygraphy in children with sleep disordered breathing symptoms(2023-04-04) AY, NADİYE PINAR; Yilmaz Yegit C., Erdem Eralp E., Gokdemir Y., Ergenekon P., Sabancı M., Ay P., Karadag B., Ersu R.Introduction: Polygraphy (PG) can be used as an alternative test for the diagnosis of obstructive sleep apnea syndrome (OSAS) in children. Night‐to‐night variability of PG in children is not known. Our aim was to determine whether a single night PG was reliable for OSAS diagnosis in children with symptoms of sleep‐disordered breathing (SDB). Materials and Methods: Otherwise healthy children who had been evaluated for symptoms of SDB were included. Two nocturnal PGs were performed 2–7 days apart. Demographic and clinical characteristics, Pediatric Sleep Questionnaire, and modified Epworth Sleepiness Scale were recorded. OSAS was diagnosed if obstructive apnea–hypopnea index was (oAHI) ⩾ 1/h and classified as mild (oAHI: 1–4.9/h), moderate (oAHI: 5–9.9/h), and severe (oAHI ⩾ 10/h). Results: Forty‐eight patients were included (37.5% female, age 10.8 ± 3.9 years) to the study. There were no significant differences in oAHI values and other respiratory parameters between the two PGs (p > 0.05). Thirty‐nine children were diagnosed with OSAS if the highest oAHI over any single night was used for diagnosis. Thirty‐ three of the 39 children (84.6%) were diagnosed with OSAS with the first PG while 35 of 39 (89.7%) children were diagnosed with OSAS with the second PG. There was an agreement for identifying OSAS and its severity between the two PGs in our study even though there were few individual intra‐subject differences in oAHI. Conclusion: There was no significant first‐night effect for PG in this study which suggests that a single night PG is adequate for diagnosis of OSAS in children with SDB‐ related symptoms.Publication Open Access Untitled Reply(2022-01-01) KARAVUŞ, MELDA; ILGIN, CAN; AY, NADİYE PINAR; LÜLECİ, NİMET EMEL; SAVE, DİLŞAD; HIDIROĞLU, SEYHAN; Ozdemir M., Ilgin C., KARAVUŞ M., HIDIROĞLU S., LÜLECİ N. E., AY N. P., Sarioz A., SAVE D.