OBJECTIVE: There is no sufficient data to provide a clear picture of out-of-hospital cardiac arrest (OHCA) across Türkiye. This study is the first to present the prognostic outcomes of OHCA cases and the factors associated with these outcomes.
METHODS: The study was conducted in a prospective, observational, multicenter design under the leadership of the Emergency Medicine Association of Turkey Resuscitation Study Group. OHCA cases aged 18 years and over who were admitted to 28 centers from Türkiye were included in the study. Survived event, return of spontaneous circulation (ROSC), survival to hospital discharge, and neurological outcome at discharge were investigated as primary outcomes.
RESULTS: One thousand and three patients were included in the final analysis. 61.1% of the patients were male, and the average age was 67.0 ± 15.2. Cardiopulmonary resuscitation (CPR) was performed on 86.5% of the patients in the prehospital period by emergency medical service, and bystander CPR was performed on only 2.9% by nonhealth-care providers. As a result, the survived event rate was found to be 6.9%. The survival rate upon hospital discharge was 4.4%, with 2.7% of patients achieving a good neurological outcome upon discharge. In addition, the overall ROSC and sustained ROSC rates were 45.2% and 33.4%, respectively. In the multiple logistic regression analysis, male gender, initial shockable rhythm, a shorter prehospital duration of CPR, and the lack of CPR requirement in the emergency department were determined to be independent predictors for the survival to hospital discharge.
CONCLUSIONS: Compared to global data, survival to hospital discharge and good neurological outcome rates appear to be lower in our study. We conclude that this result is related to low bystander CPR rates. Although not the focus of this study, inadequate postresuscitative care and intensive care support should also be discussed in this regard. It is obvious that this issue should be carefully addressed through political moves in the health and social fields.

OBJECTIVE: The aim of this study was to evaluate the psychosocial difficulties and life experiences of nurses working in the disaster area following the earthquake on February 6, Kahramanmaraş centered earthquake with a phenomenological approach.
BACKGROUND: After natural disasters such as earthquakes, nurses play a significant role in providing both physical and psychosocial support. Therefore, the experiences of nurses in this field are necessary both to support them and to assist disaster survivors.
METHODS: In this study, in which the phenomenological research method was used, semi-structured in-depth interviews with 18 nurses who provided health care services during the February 6 Kahramanmaraş earthquake were conducted between January and February 2024 via Whatsapp mobile application. Snowball sampling method was used to reach the sample group. Interviews continued until data saturation was achieved. All interviews were audio recorded and then transcribed. The data were analyzed using thematic analysis. The study was conducted and reported according to the COREQ checklist.
RESULTS: Data analysis revealed two themes (psychological and social difficulties caused by the earthquake, traumatic stress and coping experiences as a nurse) and five sub-themes (social difficulties, psychological difficulties, traumatic events, reactions and coping).
CONCLUSIONS: As a result of the study, it was determined that nurses providing health care services were negatively affected psychosocially by the traumatic stress situations they experienced in the earthquake centered in Kahramanmaraş on February 6. It was determined that nurses had great difficulty in coping with the traumatic stress situations they experienced. It was concluded that the February 6 earthquake caused secondary traumatization in nurses.

BACKGROUND: Maternal mortality ratio is one of the significant indicators of a country\'s healthcare quality and development. In recent years, Türkiye has made significant advancements in maternal and child health services. However, it has been discussed that stagnation has been observed in recent years, and the migration from Syria and the COVID-19 pandemic have significantly overshadowed this success. The purpose of this study is to evaluate the current situation of the maternal mortality level in the country based on the experiences and views of experts working in this area.
METHODS: Key informant interviews were conducted with a purposive sample of academics, representatives of public institutions, and NGOs to understand the mechanisms of success in maternal mortality in the 1990s. Thematic analysis was used to understand the reasons for the stagnation of the decline in maternal mortality and to develop recommendations for reducing maternal mortality.
RESULTS: Twenty-five key informant interviews were conducted. Positive developments contributing to the success of maternal mortality, problems and obstacles hindering further progress and suggestions/recommendations are the themes of this research. The key informants highlighted the health transformation policies, the lack of data on the impact of COVID-19, recent migration on maternal mortality, inadequate education and training on sexual and reproductive health (SRH), the absence of rights-based policies, and gender equality as critical issues in current policies.
CONCLUSIONS: The outcomes of this study underline the importance of the availability, accessibility, and quality of SRH services and empowering women, girls, families, and communities to eliminate preventable maternal mortality levels.

BACKGROUND: Unused pharmaceuticals are currently a public health problem. This study aimed to identify unused pharmaceuticals, research practices about the disposal methods, classify the medicines according to Anatomical Therapeutic Chemical codes (ATC) and, to determine the number of unused medicines.
METHODS: The study was designed as a cross-sectional study. Data were collected between April and August 2023 in Burdur-Türkiye by non-probability sampling technique (convenience method). Pharmaceuticals were classified according to ATC. Statistical Package for Social Science SPSS (V.24) package program was used for data analysis.
RESULTS: A total of 1120 people, 1005 in the first sample group and 115 in the second sample group, participated in the study. Findings of first sample group: A total of 4097 boxes of unused pharmaceuticals (4.7 ± 4.3 boxes/per capita) were detected. It was found that pharmaceuticals were stored in areas such as kitchens (59.1%) and refrigerators (38.6%), the reason for keeping them was reuse (41%), and the disposal practice was household garbage (81%). Paracetamol (648 boxes), Other cold preparation (303 boxes), Dexketoprofen (239 boxes), Diclofenac (218 boxes), Amoxicillin and beta-lactamase inhibitor (190 boxes) were found to be the most frequently unused pharmaceuticals. Using the unused medicines at home without consulting a physician was 94.1% (self-medication). Findings of second sample group: Of the 6189 dosage forms in 265 boxes pharmaceutical, 3132(50.6%) dosage forms were used and 3057(49.4%) were found to be unused.
CONCLUSIONS: There is a significant amount and number of unused medicines in households, and self-medication is common. Medicines are not properly disposed of and some of them expire. Public information is needed. A \"drug take-back system\" for unused medicines can be useful in solving this problem.

UNASSIGNED: Violence against women has numerous devastating effects. Exposure to violence not only impacts women but also affects their children both physically and psychosocially.
UNASSIGNED: The study aimed to evaluate the psychosocial problems of children living with their mothers in women\'s shelters from the mothers\' perspective with a phenomenological approach.
UNASSIGNED: Utilizing the phenomenological research method, semi-structured in-depth interviews were conducted with 14 individuals in a women\'s shelter in a province in northern Türkiye. The criterion sampling method, a purposive sampling technique, was employed to select participants. Interviews continued until data saturation was achieved. All interviews were audio recorded and then transcribed, and thematic analysis was applied to analyze the data. The study adhered to the COREQ checklist for reporting.
UNASSIGNED: The data analysis revealed four main categories (effects of violence on the mother, actions taken to protect children from violence, effects of violence and staying in a shelter on the child, and psychosocial needs for the protection of the child\'s mental health in the shelter) and 10 sub-themes (psychological effects, physical effects, social effects, domestic actions, organizational actions, psychological effects, physical effects, social effects, support system, and coping).
UNASSIGNED: The study concluded that violence significantly impacted the mental, physical, and social well-being of both women and children, posing challenges to their ability to cope with the aftermath. Women exerted considerable effort in protecting their children from violence, and they needed psychosocial support to ensure the well-being of their children\'s mental health during their stay in shelters.

OBJECTIVE: Congenital adrenal hyperplasia (CAH) is a group of disorders that affect the production of steroids in the adrenal gland and are inherited in an autosomal recessive pattern. The clinical and biochemical manifestations of the disorder are diverse, ranging from varying degrees of anomalies of the external genitalia to life-threatening adrenal insufficiency. This multicenter study aimed to determine the demographics, biochemical, clinical, and genetic characteristics besides the current status of adult patients with CAH nationwide.
METHODS: The medical records of 223 patients with all forms of CAH were evaluated in the study, which included 19 adult endocrinology clinics. A form inquiring about demographical, etiological, and genetic (where available) data of all forms of CAH patients was filled out and returned by the centers.
RESULTS: Among 223 cases 181 (81.16%) patients had 21-hydroxylase deficiency (21OHD), 27 (12.10%) had 11-beta-hydroxylase deficiency (110HD), 13 (5.82%) had 17-hydroxylase deficiency (17OHD) and 2 (0.89%) had 3-beta-hydroxysteroid-dehydrogenase deficiency. 21OHD was the most prevalent CAH form in our national series. There were 102 (56.4%) classical and 79 (43.6%) non-classical 210HD cases in our cohort. The age of the patients was 24.9 ± 6.1 (minimum-maximum: 17-44) for classical CAH patients and 30.2 ± 11.2 (minimum-maximum: 17-67). More patients in the nonclassical CAH group were married and had children. Reconstructive genital surgery was performed in 54 (78.3%) of classical CAH females and 42 (77.8%) of them had no children. Thirty-two (50.8%) NCAH cases had homogenous and 31 (49.2%) had heterogeneous CYP21A2 gene mutations. V281L pathological variation was the most prevalent mutation, it was detected in 35 (55.6%) of 21OHD NCAH patients.
CONCLUSIONS: Our findings are compatible with the current literature except for the higher frequency of 110HD and 17OHD, which may be attributed to unidentified genetic causes. A new classification for CAH cases rather than classical and non-classical may be helpful as the disease exhibits a large clinical and biochemical continuum. Affected cases should be informed of the possible complications they may face. The study concludes that a better understanding of the clinical characteristics of patients with CAH can improve the management of the disorder in daily practice.

Motivated by the evolving global food landscape and its detrimental impacts on society, the environment, and health, this research aims to understand consumer perceptions, preferences and involvement regarding sustainable food products and consumption practices. To this aim, three countries were chosen for their distinct economic, cultural, and demographic differences (Spain, Türkiye, and Colombia), enabling an exploration of how these factors influence sustainability perceptions. The results show high levels of awareness, knowledge, consumption, and willingness to switch to more sustainable habits, although differences between countries were also found (price sensitivity in Spain and demand for information regarding sustainable food in Colombia). In addition, a group of consumers has been identified that is influenced by health, shows positive behaviours and perceptions towards sustainable food, and is not price sensitive. The study is significant, as it addresses the information gap between consumers, producers, and policymakers regarding sustainable food awareness. It seeks to provide insights into cultural influences on sustainability perceptions and aims to assist in developing educational programs and policies to promote sustainable consumption.

BACKGROUND: Gynecological cancers among women were both chronic and vitally health problems. The increasing prevalence of women with surviving gynecological cancers and the receiving treatments of cancer negatively affected the sexual quality of life.
OBJECTIVE: The study was conducted to determine the sexual quality of life of healthy women and women with gynecological cancer and to determine the predictors of sexual quality of life in women with gynecological cancer.
METHODS: The research is a hospital-based case-control study was conducted. The study was carried out with 65 patients with histologically confirmed gynecological cancer were compared with 75 controls, who were admitted to the different departments of the same hospital in the Izmir, in western Türkiye.
RESULTS: The Sexual Quality of Life Questionnaire score (SQOL) of cases was 60.12 ± 9.01 and controls was 78.92 ± 7.08. SQOL scores of cases were significantly lower than controls (p < 0.05). Multiple linear regression analysis results showed that age (B = -0.295, p = 0.072), working (B = 4.981, p = 0.016), smoking (B = -4.590, p = 0.035), diagnosed with cervical cancer (B = -4.214, p = 0.045), and receiving chemotherapy (B = -4.722, p = 0.028) were associated with sexual quality of life in women with gynecological cancer (p < 0.05, R2 : 0.40).
CONCLUSIONS: Women with gynecological cancer had lower quality of sex life compared with healthy women. Gynecological cancers negatively affect women\'s sexual quality of life. Health professionals (especially nurses) should be aware of the potential problems that women with gynecological cancer may experience with their sexual lives. They should develop coping strategies and offer solutions for the problems experienced by women with gynecological cancer.

OBJECTIVE: The purpose of the study is to determine the disaster preparedness perceptions, psychological resilences and empathy levels of nurses after 2023 Great Turkiye Earthquake.
METHODS: This descriptive study was conducted in 2023 using with E-Anket. This study was carried out with voluntary participation of 464 nurses living in different geographical regions of Turkiye. The data of the study were obtained utilizing Nurses\' Disasters Prepardeness Perception Scale (NDPPS), Pyschological Resileince Scale (PRS) and Empathy Scale (ES).
RESULTS: In this study, the disaster preparedness perception of the nurses was found to be at medium level. More than half of the nurses (65.1%) reported that they did not received any disaster training before. A meaningful was found between the nurses\' disaster preparedness perceptions and their empathy levels and psychological resilence.
CONCLUSIONS: As in many countries, it is possible to state that also in Turkiye, the training of nurses for disasters are inadequate and that the studies on this subject are limited. This study will provide a theoretical platform to develop nurses\' awareness of disaster preparedness and pyschological resilience and empathic approach programs to increase disaster resilience, and to conduct future research on disaster nursing.

BACKGROUND: Gynecological cancers are long-term, challenging, and stressful diseases. In Türkiye, the majority of patients with gynecological cancer use complementary and alternative medicine (CAM). Considering the stress that gynecological cancer patients are exposed to, patients need to know how to cope with stress.
OBJECTIVE: This study aimed to determine the use of CAM and coping with stress by patients with gynecological cancer and the relationships between them and the factors that predict the approaches to coping with stress in women with gynecological cancer in Türkiye.
METHODS: This is a descriptive and cross-sectional study. The study was conducted with 204 patients between April and August 2022. The data of the study were collected by face-to-face interview and filled out by the patients using the Descriptive Information Form and the Stress Coping Styles Scale (SCSS). Number, percentage, mean, χ2, one-way ANOVA, t test, and the Spearman correlation analysis were used in the data analysis. To analyze the multivariate independent associations between variables, a multivariate ordinal logistic regression model was used, with the SCSS domains as dependent variables. A 95% confidence interval was calculated, and all statistical tests had an alpha level of 0.05.
RESULTS: The mean age of the patients was 58.38 ± 12.64 years (32-80). The prevalence of CAM use by patients was 39.2%, and the most common types of CAM were herbal products (43.8%) and supplication (42.5%). The reasons for using CAM were relaxation (symptomatic)-feeling healthy (63.8%) and treating cancer (36.2%). No statistically significant difference was found between the use of CAM and their approaches to coping with stress (p > 0.05). As a result of multivariate ordinal logistic regression analysis, education level under high school, having ovary, cervix, and endometrium cancer, being in the first stage of cancer, receiving chemotherapy, receiving surgical treatment, having another cancer patient in the social environment and increased interest in a partner after the diagnosis of cancer was associated with an effective coping with stress (p < 0.05, adjusted R2 = 0.27, 0.79, and 0.32, respectively). Not working, experiencing an abortion, having another cancer patient in their social environment, being in the third stage of cancer, having an extended family, and living in a rural area of residence were associated with ineffective coping with stress (p < 0.05, adjusted R2 = 0.20 and 0.24, respectively).
CONCLUSIONS: The prevalence of CAM use by patients was low. While determining the approaches of the patients to cope with stress, their education level, place of residence, family type, diagnosis of cancer, stage of cancer, treatment, partner support, and stressful life events should be considered. As nurses, we need to be more knowledgeable about the use of CAM to provide correct guidance to our patients for access to accurate and effective information. We need to determine our patients\' stressors and how our patients cope with stress.
Gynäkologische Krebserkrankungen sind langfristige, herausfordernde und belastende Krankheiten. In der Türkei nehmen die meisten Patientinnen mit gynäkologischen Krebserkrankungen Komplementär- und Alternativmedizin in Anspruch. Angesichts der großen Belastungen, denen Patientinnen mit gynäkologischen Krebserkrankungen ausgesetzt sind, müssen sie wissen, wie sie mit Stress umgehen können.Mit dieser Studie sollen die Inanspruchnahme von Komplementär- und Alternativmedizin und die Stressbewältigung von Patientinnen mit gynäkologischer Krebserkrankung ermittelt werden und es sollen die Zusammenhänge zwischen diesen beiden Aspekten und den prädiktiven Faktoren für die Ansätze zur Stressbewältigung bei Frauen mit gynäkologischer Krebserkrankung untersucht werden.Es handelt sich um eine deskriptive Querschnittsstudie. Die Studie wurde mit 204 Patientinnen zwischen April und August 2022 durchgeführt. Die Erhebung der Studiendaten erfolgte durch persönliche Befragung und mithilfe des deskriptiven Informationsformulars sowie der Stress Coping Styles-Skala, die die Patientinnen ausfüllten. Für die Datenanalyse wurden Anzahl, Prozentanteil, Mittelwert, Chi-Quadrat-Test, einfaktorielle ANOVA, t Test und die Spearman-Korrelationsanalyse verwendet. Zur Analyse der multivariaten unabhängigen Zusammenhänge zwischen den Variablen wurde ein multivariates ordinales logistisches Regressionsmodell verwendet mit den SCSS (Stress Coping Styles-Skala)-Domänen als abhängigen Variablen. Es wurde ein 95%-Konfidenzintervall berechnet, und das Signifikanzniveau betrug für alle statistischen Tests α = 0.05.Das Durchschnittsalter der Patientinnen betrug 58.38 ± 12.64 Jahre (32–80 Jahre). Die Prävalenz der Inanspruchnahme von Komplementär- und Alternativmedizin (CAM) durch die Patientinnen lag bei 39.2%, und die häufigsten CAM-Arten waren pflanzliche Produkte (43.8%) und Bittgebete (42.5%). Die Gründe für die Inanspruchnahme von Komplementär- und Alternativmedizin waren Entspannung (symptomatisch), das Gefühl von Gesundheit (63.8%) und die Behandlung der Krebserkrankung (36.2%). Es fand sich kein statistisch signifikanter Unterschied zwischen der Inanspruchnahme von Komplementär- und Alternativmedizin und ihren Ansätzen zur Stressbewältigung (p > 0.05). Die multivariate ordinale logistische Regressionsanalyse zeigte, dass ein Bildungsniveau unterhalb der Oberstufe sowie Ovarial-, Zervix- und Endometriumkarzinom, Krebs im Anfangsstadium, Chemotherapie, operative Behandlung, eine andere Krebspatientin im sozialen Umfeld und ein gesteigertes Interesse an einem Partner nach der Krebsdiagnose mit effektiver Stressbewältigung assoziiert waren (p < 0.05, adjustiertes R2 = 0.27, 0.79 bzw. 0.32). Fehlende Berufstätigkeit, Fehlgeburt/Schwangerschaftsabbruch, eine andere Krebspatientin im sozialen Umfeld, eine Krebserkrankung im dritten Stadium, eine Großfamilie zu haben und in einer ländlichen Gegend zu leben waren mit ineffektiver Stressbewältigung verbunden (p < 0.05, adjustiertes R2 = 0.20 bzw. 0.24).Die Prävalenz der Inanspruchnahme von Komplementär- und Alternativmedizin durch die Patientinnen war gering. Bei der Ermittlung der Ansätze der Patientinnen zur Stressbewältigung sollten ihr Bildungsniveau, ihr Wohnort, ihr Familientyp, die Krebsdiagnose, das Krebsstadium, die Behandlung, die Unterstützung durch den Partner und belastende Lebensereignisse berücksichtigt werden. Als Pflegekräfte müssen wir mehr über die Inanspruchnahme von Komplementär- und Alternativmedizin wissen, um unsere Patientinnen in Hinblick auf den Zugang zu genauen und wirksamen Informationen die richtige Orientierungshilfe zu geben. Wir müssen die Stressfaktoren unserer Patientinnen ermitteln und herausfinden, wie unsere Patientinnen mit Stress umgehen.