Twitter is a useful source for detecting anti-vaccine content due to the increasing prevalence of these arguments on social media. We aimed to identify the prominent themes about vaccine hesitancy and refusal on social media posts in Turkish during the COVID-19 pandemic. In this qualitative study, we collected public tweets (n = 551,245) that contained a vaccine-related keyword and had been published between 9 December 2020 and 8 January 2021 through the Twitter API. A random sample of tweets (n = 1041) was selected and analyzed by four researchers with the content analysis method. We found that 90.5% of the tweets were about vaccines, 22.6% (n = 213) of the tweets mentioned at least one COVID-19 vaccine by name, and the most frequently mentioned COVID-19 vaccine was CoronaVac (51.2%). We found that 22.0% (n = 207) of the tweets included at least one anti-vaccination theme. Poor scientific processes (21.7%), conspiracy theories (16.4%), and suspicions towards manufacturers (15.5%) were the most frequently mentioned themes. The most co-occurring themes were “poor scientific process” with “suspicion towards manufacturers” (n = 9), and “suspicion towards health authorities” (n = 5). This study may be helpful for health managers, assisting them to identify the major concerns of the population and organize preventive measures through the significant role of social media in early spread of information about vaccine hesitancy and anti-vaccination attitudes.

Background Vaccine hesitation, which is defined as one of the most important global health threats by World Health Organization, maintains its universal importance during the COVID-19 period. Due to the increasing appearance of anti-vaccine arguments on social media, Twitter is a useful resource in detecting these contents. In this study, we aimed to identify the prominent themes about vaccine hesitancy and refusal on social media during the COVID-19 pandemic. Methods In this qualitative study we collected Twitter contents which contain a vaccine-related keywords and published publicly between 9/12/2020 and 8/1/2021 (n=551,245). A stratified random sample (n=1041) is selected and analyzed by four researchers with content analysis method. Results All tweets included in the study were shared from 1,000 unique accounts of which 2.7% were verified and 11.3% organizational users. 90.5% of the tweets were about vaccines, 22.6% (n=213) of the tweets mentioned at least one COVID-19 vaccine name and the most frequently mentioned COVID-19 vaccine was CorronaVac (51.2%). Yet, it was mostly as “Chinese vaccine” (42.3%). 22.0% (n=207) of the tweets included at least one anti-vaccination theme. Among tweets that included an anti-vaccination theme; poor scientific processes (21.7%), conspiracy theories (16.4%), and suspicions towards manufacturers (15.5%) were the most frequently mentioned themes. The most co-occurred themes were “Poor scientific process” theme come along with “suspicion towards manufacturers” (n=9) and “suspicion towards health authorities” (n=5). Conclusions This study may be helpful for health managers to identify the major concerns of the population and organize the preventive measures, through the significant role of social media on early information about vaccine hesitancy and anti-vaccination attitudes.

Introduction: As useful tools for clinical decision-making, diagnostic tests require careful interpretation in order to prevent underdiagnosis, overdiagnosis or misdiagnosis. The aim of this study was to explore primary care practitioners’ understanding and interpretation of the probability of disease before and after test results for six common clinical scenarios.Methods: This cross-sectional study was conducted with 414 family physicians who were working at primary care in Istanbul via face-to-face interviews held between November 2021 and March 2022. The participants were asked to estimate the probability of diagnosis in six clinical scenarios provided to them. Clinical scenarios were about three cancer screening cases (breast, cervical and colorectal), and three infectious disease cases (pneumonia, urinary tract infection, and COVID-19). For each scenario participants estimated the probability of the diagnosis before application of a diagnostic test, after a positive test result, and after a negative test result. Their estimates were compared with the true answers derived from relevant guidelines.Results: For all scenarios, physicians’ estimates were significantly higher than the scientific evidence range. The minimum overestimation was positive test result for COVID-19 and maximum was pre-test case for cervical cancer. In the hypothetical control question for prevalence and test accuracy, physicians estimated disease probability as 95.0% for a positive test result and 5.0% for a negative test result while the correct answers were 2.0 and 0%, respectively (p < 0.001).Discussion: Comparing the scientific evidence, overestimation in all diagnostic scenarios, regardless of if the disease is an acute infection or a cancer, may indicate that the probabilistic approach is not conducted by the family physicians. To prevent inaccurate interpretation of the tests that may lead to incorrect or unnecessary treatments with adverse consequences, evidence-based decision-making capacity must be strengthened.

Aim: The aim of the study is, evaluation of the pandemic data of and measures taken by 20 countries with the highest reported number of cases in the first 100 days of the pandemic, in terms of demographic data and healthcare resources.Materials and Methods: The data used in the study were obtained from ECDC, OECD and Oxford COVID-19 Government Response Tracker. The countries were categorized into two groups, early-onset and late-onset countries, in terms of their date of first confirmed cases and Stringency Index (SI) were calculated. Results: United States has the highest number of cases (432,132). France was the first country to report death, outside of China. Top three countries with the highest Case Fatality Rate (CFR) are France (13.25), Italy (12.67) and United Kingdom (11.69). There was a strong negative correlation between “total death/total population proportion” and the intensive care unit bed per million population (r= -0.720; p= 0.008). The ‘’proportion of ≥65 age’’ was found to have a moderately positive correlation with “total case / total population proportion” as well as “total death / total population proportion” (r= 0.687; p= 0.001; r= 0.635; p= 0.003, respectively). In the late-onset countries, the logarithmic growth of both case and death numbers is faster than the early-onset countries. The SI is higher in late-onset counties both on the dates of logarithmic growth in the number of cases and on the 100th day of the pandemic. Restrictions on international travel is the earliest measure taken by countries. Turkey is the only country to implement 3 of 9 measures before its first case.Discussion and Conclusion: The first encounter dates of countries with the pandemic are important in terms of preparedness. Despite, late-onset countries benefited from the experiences of early-onset countries and implemented measures, the emergence of cases and deaths could not be prevented. Moreover, the increase in cases and deaths was faster. Countries which have more elderly population are affected more adversely. Because the transmission patterns of the pandemic are related with country-specific characteristics, all variables that have an impact on the pandemic should be considered.

Objective: The aim of this research was to determine whether social media addiction had an effect on high school students' posture habits and awareness. Materials and methods: This study has done among high school students in Keşan, Edirne. By using the cluster sampling method, 5 high schools in the district with a total number of 956 students were selected by random. This study was conducted face-to-face using a 38-questions personal information form, Social Media Addiction Scale for Adolescents (SMASA) and Postural Habits and Awareness Scale (PHAS). In the analysis of data, number, percentage, mean, standart deviation that are definer statistical analysis, Student’s t-test, ANOVA, Mann-Whitney U and Kruskal Wallis tests, Pearson correlation analysis, Kendall tau-b correlation analysis, multivariate linear regression analysis that are analyzing analysis are used. Statistical significance level was taken as p<0,05. Results: 771 students in high schools in the sample group participated in the research. In this study, 53.8% of participants are women and 34.9% of students attend from high school grade 3. While the mean value of the Social Media Addiction Scale for Adolescents is 20.2 (7.3), the mean value of the Postural Habits and Awareness Scale is 61.2 (7.0). There is a moderately positive correlation between time spent on social media and SMASA score (p<0.001; τ=0.440). There is a weak negative relationship between SMASA point and PHAS point (p<0.001; r=-0.186). A one unit increase in the SMASA score reduces the PHAS score by 0,140 points (p<0.001). Conclusion: Based on the results of this study, we can conclude that an increase in social media addiction affects a decrease in postural habits and awareness. Nevertheless, social media addiction cannot be attributed as the sole cause of decreased postural habits and awareness. Reducing inappropriate social media use in students and providing students with exercise habits will be beneficial in terms of preventing bad posture habits during adolescence.

Aim: We aim to compare the past trajectory of immunization services and different types of follow-ups with their current states during the COVID-19 pandemic. Methods: This cross-sectional study was conducted in a district of Istanbul in February 2020, and included 138 Family Medicine Units. Services were compared monthly between 2019 and 2020, based on the antenatal, postpartum, infant, child follow-ups, and vaccine doses provided by the units. To examine the impact of the pandemic, the April-December periods of both years were also compared. Results: It was found that follow-ups and immunizations were continued without any decline despite an increase in delayed vaccines. When the monthly mean number of delayed vaccines were compared, the mean number of delayed vaccines was significantly higher in April-May-June 2020 than in the same months of the previous year. Conclusion: Performance scores of different services do not differ according to the descriptive characteristics of physicians. Although physicians are successful in services such as follow-ups, delayed vaccines are prevalent among them as well. While services that can be carried out remotely seem to be continued, services that require face-to-face contact are interrupted. Interventions should be done to ensure the sustainability of indispensable services even during extraordinary times. Keywords: COVID-19, immunization, maternal-child health services, primary health care