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.

Heat waves are one of the most common direct impacts of anthropogenic climate change and excess mortality their most apparent impact. While Turkey has experienced an increase in heat wave episodes between 1971 and 2016, no epidemiological studies have examined their potential impacts on public health so far. In this study excess mortality in Istanbul attributable to extreme heat wave episodes between 2013 and 2017 is presented. Total excess deaths were calculated using mortality rates across different categories, including age, sex, and cause of death. The analysis shows that three extreme heat waves in the summer months of 2015, 2016, and 2017, which covered 14 days in total, significantly increased the mortality rate and caused 419 excess deaths in 23 days of exposure. As climate simulations show that Turkey is one of the most vulnerable countries in the Europe region to the increased intensity of heat waves until the end of the 21st century, further studies about increased mortality and morbidity risks due to heat waves in Istanbul and other cities, as well as intervention studies, are necessary.

Introduction: Tobacco companies use social media to bypass marketing restrictions. Studies show that exposure to tobacco promotion on social media influences subsequent smoking behavior, yet it is challenging to monitor such content. We developed an artificial intelligence that can automatically identify tobacco-promoting content on social media. Aims and Methods: In this mixed methods study, 177,684 tobacco-related tweets published on Twitter in Turkish were collected. Through inductive content analysis of a sample of 200 tweets, the main mechanisms by which tobacco is promoted on social media were identified. Then, a sample of 5000 tweets was deductively analyzed and labeled based on those mechanisms. A pre-trained transformer-based Large Language Model was fine-tuned using the labeled dataset. Then, tobacco promotion in all tweets was predicted using this model. Results: The main mechanisms of tobacco promotion on social media included modeling the behavior, expressing positive attitudes, recommending use, and marketing brands or vendors. The developed model identified tobacco-promoting social media content with 87.8% recall and 81.1% precision. The utility of the model was demonstrated in the analysis of tobacco promotion in tweets for a period of a month. Conclusions: This tool makes it possible to monitor tobacco promotion in social media and creates new opportunities for tobacco control policy and practice, not only in surveillance and enforcement but also in health promotion. Implications: Tobacco promotion in social media is a well-known yet hard-to-addressed problem due to the nature of social media. This study leverages a cutting-edge AI approach, Large Language Models, to identify tobacco promotion in social media content automatically and precisely. The developed model offers better prediction performance than previously proposed techniques. The study enables surveillance of tobacco-promoting content both for research purposes and enforcement of tobacco control measures. Furthermore, we suggest a range of health promotion opportunities this tool can help with from developing personal skills to creating supportive environments and strengthening community actions.

This study aims to compare the level of burnout syndrome in medical residents before and during the COVID-19 pandemic and identify potential risk factors. This cross-sectional study was conducted on medical residents from three different university hospitals in Turkey in March 2021, one year after the pandemic hit Turkey. Burnout is measured by the Maslach Burnout Inventory which assesses three dimensions of it: emotional exhaustion, depersonalization, and personal accomplishment. Collected data were combined and compared with data from a previous study which was held in the same hospitals in December 2019, three months before the pandemic. 412 medical residents from three universities participated. The mean age was 27.8 ± 2.4 and half of them were female. Compared to pre-pandemic levels, no significant differences in emotional exhaustion (pre:19.0 ± 7.6 post:18.8 ± 7.8), depersonalization (pre:7.3 ± 4.3 post:7.2 ± 4.4), and personal accomplishment (pre:20.8 ± 5.1 post:21.1 ± 5) scores were observed one year after pandemic. Adjusting for confounders, multiple linear regression models indicated that who are female, are in surgical specialty, have vulnerable cohabitant, and have more night shifts faces higher emotional exhaustion. Depersonalisation is higher among who spent more years in residency, have more night shifts, or COVID-19 outpatient duty. Females and those who have vulnerable cohabitant has lower levels of Personal Achievement. This study does not support the hypothesis that pandemic increases the burnout levels. Yet it identifies a couple of pandemic related factors that are associated with burnout and confirming the association of several previously known factors.

During the COVID-19 pandemic, Türkiye implemented a distinctive contact tracing approach involving in-person home visits by medical professionals to individuals who tested positive for the virus. This study examines the experiences of health professionals involved in contact tracing, exploring how they reappropriated their professional subjectivity and agency during their deployment in this role. It is an interpretive phenomenological qualitative study. We conducted 21 semi-structured in-depth interviews, subsequently carried out two separate focus group interviews with an additional 31 participants from various districts in Istanbul. Participants were selected from different medical professions (i.e. doctors, nurses, midwives), career stages, gender and age groups, and hierarchical levels (i.e. officers and directors). Data analysis was conducted collaboratively by the research team from sociology and public health disciplines. Our main finding is that for the majority of health professionals, contact tracing was a novel experience with challenges and ambivalances. Yet, regardless of their perceptions (positive, negative, or mixed), the experience promoted a reaffirmation of professional identity and reappropriation of professional subjectivity and agency, which discloses that professional subjectivity is not firm but dynamic, carrying stability as well as flexibility and adjustment. Four main themes are identified in their reappropriation of professional subjectivity and agency: uncovering professional fulfillment, feeling restrained in professional dissatisfaction, assessing the job, and engaging in professional and bureaucratic negotiations.The profound exploration into the dynamics of contact tracing amidst the pandemic illuminates a multidimensional narrative that transcends the conventional discourse on physical and psychological stress experienced by medical professionals. Contact tracing experience had a transformative impact on meaning and purpose of professional identity. Our findings highlight a need for a balanced approach between centralized decision-making, mobilization of professionals, quantitative evaluation, and professional autonomy and discretion, qualitative assessments, and meaningful engagement.

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.