INTRODUCTION: The Health Belief Model (HBM) is an effective instrument in explaining and measuring behaviors protecting and improving the health. It was aimed to evaluate the compliance of healthcare professionals (HCP), who are on the front-line in the combat with COVID-19 pandemic, with protective measures according to the HBM.
METHODS: The present study is a cross-sectional study, which was carried out in the period in the first wave of epidemic in a province in the central Anatolian region of Turkey, with 316 ambulance medics serving. Compliance with protective measures was evaluated with an online form. The questionnaire consisted of questions related to the sociodemographic characteristics of the individuals (age, gender, marital status, etc.), variables related to health beliefs (chronic diseases, smoking and alcohol addiction, COVID-testing, etc.), the protective measures they applied during the COVID-19 process (staying at home, washing hands, wearing masks, etc.), and the COVID-19 HBM Scale questions created by the researchers through a literature review.

RESULTS: In the study group, 63.0% of participants were female and the ages ranged from 20-60. The mean age ±Standard Deviation (SD) was calculated to be 32±6.9 years. After the analyses of the COVID-19 HBM, which consists of four sub-dimensions (perceived threat, perceived barriers, perceived benefit, cues to action, and self-efficacy) and includes 20 items, the scale explained 57.8% of the total variance. Factor loads of the items ranged from 0.44 to 0.89, and their total correlations ranged between 0.22 and 0.61. The Cronbach’s alpha value was found to be 0.85. Overall, 71.8% of the participants were found to implement all the protective measures. In the study group, among those implementing all the protective measures, the scores of perceived threat (p=0.001) and benefit (p=0.006) sub-dimensions and the total score (p=0.001) were found to be higher. The COVID-19 HBM scale score was found to be higher in those who were diagnosed with COVID-19, those who had a test, those who had an increased level of anxiety, and those who thought the pandemic would last longer than a year.
DISCUSSION AND CONCLUSION: The COVID-HBM Scale developed in the study is a valid and reliable. According to the health belief model among healthcare professionals, perceiving COVID-19 as a threat and believing in the benefits of preventive measures is important for better control of the disease.

INTRODUCTION: The measures taken to prevent the spread of SARS-CoV-2 after the new coronavirus disease 2019 (COVID-19) pandemic also affected the incidence of other infectious diseases. In this study, it was aimed to investigate the effect of infection control measures applied during the COVID-19 pandemic on the rate of rotavirus and enteric adenovirus positivity, which are important factors of childhood acute gastroenteritis.
METHODS: A total of 1,911 pediatric patients aged 0-18 years, who were diagnosed with acute gastroenteritis and who had stool rotavirus antigen test and/or enteric adenovirus antigen tests were included in our study. The comparison of rotavirus and enteric adenovirus positivity rates before the pandemic (October 1, 2019 - March 10, 2020) and after (March 11, 2020 - May 31, 2021) and the distribution of demographic data were evaluated using the chi-square method.
RESULTS: Rotavirus and adenovirus positivity rates were 10.4% and 3.3% in the pre-pandemic period, and 5.0% and 2.3% in the post-pandemic period (p<0.001, p=0.171). The overall incidence of acute gastroenteritis caused by rotavirus and/or enteric adenovirus decreased from 13.3% to 5.9% (p<0.001). In the post-pandemic period, rotavirus positivity in children aged 13-24 months and 2-4 years decreased significantly. In the pre-pandemic period, the rate of rotavirus positivity in the group under 5 years old was significantly higher than in the group over the age of 5 (p<0.001), while there was no significant difference between the groups below the age of 5 and above in the post-pandemic period (p=0.066). The positivity of rotavirus before the pandemic was 26.3% and 13.1% in the spring and winter, respectively, while it was 8.2% and 3.5% after the pandemic, There was no significant difference between the two periods in terms of adenovirus positivity, age groups, gender and seasonal distribution.
DISCUSSION AND CONCLUSION: COVID-19 infection control measures focusing on hygiene practices and social distance have reduced the positivity rate of rotavirus and enteric adenovirus, which are important pathogens of childhood acute gastroenteritis.

INTRODUCTION: Cryptococcus neoformans causes life-threatening severe cryptococcosis in humans. These species are colonized in the nature and are spread from the environment to the host. Various media have been produced for the identification of C. neoformans. Yeast is easily identified due to the production of melanin in culture media containing pigment precursors. The red pitahaya (Hylocereus polyrhizus) which has just started to planted in our country has flavonoid pigments. In this study, it was aimed to evaluate the melanin pigment production of C. neoformans in the agar media prepared by newly defined from white and red pitahaya fruits.
METHODS: Molecularly confirmed thirteen environmental strains of C. neoformans were included in the study. In the study, in-house media were prepared from two different pitahaya [white pitahaya (Hylocereus undatus) agar (WPA) and red pitahaya) agar (RPA)] with mesocarp and endocarp parts of the fruits. Staib agar and potato dextrose agar media were used as positive and negative controls. Candida albicans has been used for nonpigmented yeasts. The strains were cultured in sterile 24-well polystyrene plates and pigment production was measured by Fiji/ImajeJ (GPLv3, NIH, USA) during one week.
RESULTS: It was observed that brown pigmented colonies, which can be easily separated from the non-pigmented C. albicans yeast colonies, were formed in the grown on KPA medium. Colony pigment formed in KPA medium was less than those formed on Staib agar. C. albicans colonies were larger on Staib agar, while C. neoformans formed more mucoid colonies on RPA. It was observed that the colony pigment formed in the RPA medium was less than the other in the cultivations on Staib agar and RPA medium. While RPA pigments are higher than WPA’s, the yeasts’ melanin production in Staib agar have higher data (p<0.05). No pigment production has been observed in PDA.
DISCUSSION AND CONCLUSION: Although the pigment production on RPA is less than on Staib agar medium, RPA can be used to demonstrate pigment production of C. neoformans. Descriptive media should be prepared with easily accessible inexpensive environmental resources containing phenolic chemicals for the research of pigment production of C. neoformans.

INTRODUCTION: P. aeruginosa frequently causes healthcare associated infections (HAI) in immunocompromised patients. Antiseptics and disinfectants play an important role in the control of HAI. However, the widespread use of biocides in hospitals may cause a decrease in biocidal sensitivity and the emergence of resistance in bacteria. In this study, it was aimed to investigate the frequency of qacE, qacE∆1 and cepA gene associated with biocide resistance in carbapenem resistant P. aeruginosa strains, isolated from clinical specimens.
METHODS: In this study, 75 P. aeruginosa strains (58 carbapenem resistant and 17 carbapenem sensitive) isolated from clinical samples were included. Species identification and antibiotic susceptibility tests were performed with conventional methods and VITEK®2 (bioMérieux, France) automated system. Biocide resistance gene regions qacE, qacE∆1 and cepA were investigated by PCR method.
RESULTS: In the study, qacE and qacE∆1 genes were determined in 65.3% (n=49) and 50.7% (n=38), respectively. However, cepA gene was found negative in all isolates. qacE and qacE∆1 genes were found positive 75.8% (n=44) and 60.3% (n=35) in carbapenem resistant isolates, while 29.4% (n=5) and 17.6% (n=3) were found positive in carbapenem susceptible isolates. The frequency of qacE and qacE∆1 genes in carbapenem resistant isolates was found to be significantly higher than in susceptible ones (p<0.05).
DISCUSSION AND CONCLUSION: In this study, biocide resistance genes qacE and qacE∆1 frequencies were found to be quite high in carbapenem resistant P. aeruginosa isolates. The high prevalence of resistance genes suggests that these isolates may have potential biocide resistance. Especially in cases where carbapenem resistance is high, keeping in mind that P. aeruginosa may also be resistant to biocides, is important in preventing spread and controlling outbreaks.

INTRODUCTION: Forensic microbiology is the developing field of forensic science. Forensic microbiologist can use trace evidence to match people to crime scenes, to investigate bioterrorism incidents, and to determine cause and time of death. In recent years, important studies on the environmental microbiota have been carried out. These studies can be associated with many legally valuable data as well as being related to the microbiota of environmental events. Actinobacteria are gram-positive micelle bacteria with enormous diversity, common in soil, and have high economic value. So far 47 families and 711 species of Actinobacteria were isolated and identified in variety of habitats. Increasing forensic studies in recent years show that microbial profiles can be used as evidence.
METHODS: In this study, actinobacteria were isolated from forest soil samples exposed to eight different blood groups for two weeks and control group. Genomic DNA isolation from colonies selected by considering comparative colony morphology, PCR amplification targetted 16S rRNA and sequence analysis were carried.
RESULTS: A total of five Actinobacteria type bacteria (three Micromonospora sp., one is Streptomyces sp., and one Actinomadura sp.) were obtained from the soil samples mixed with the B Rh (+) blood group in the 7th day. No Actinobacteria growth was observed neither in the control group nor in the soils to which other blood groups were added. According to the p-distance values of all isolates, they were determined as subspecies rather than a new species.
DISCUSSION AND CONCLUSION: This is a preliminary study to identify bacterial communities that may be present and differ in soil exposed to blood. The inability to isolate Actinobacteria from most of the soil samples may be due to the chemical or enzymatical properties of the bloods that can degrade the bacterial spores. In the further studies, different media and genomic techniques should be tried in different types of soils.

INTRODUCTION: Parvovirus B19 can cause conditions such as Erythema Infectiosum in children, transient aplastic crises in individuals with chronic hemolytic anemia, permanent anemia in immunosuppressed patients, and hydrops fetalis in pregnant women. Joint complaints may be seen in patients due to primary infection or as a complication of Erythema Infectiosum. The incidence of joint complaints in individuals infected with Parvovirus B19 may vary depending on age. While 8% of infected children have joint complaints; this percentage may increase to 60-80% in adults. On the other hand, it has been reported that information on the prevalence of joint complaints due to viral causes such as Parvovirus B19 is limited and epidemiological data may show regional differences. In our study, it was aimed to investigate the presence of Parvovirus B19 IgG and IgM antibodies in patients admitted to our hospital and to determine the percentages of Parvovirus B19 seropositivity in the patient group with joint complaints.
METHODS: In the study, Parvovirus B19 IgG and IgM test results obtained from serum samples sent to the Medical Microbiology Laboratory between 2010-2019 were retrospectively analyzed.
RESULTS: A total of 679 patients with joint complaints, including 437 women (64.4%) and 242 men (35.6%), were included in this study. Parvovirus B19 IgG test result was positive in 364 (53.6%) of these patients. Parvovirus B19 IgG seropositivity percentage was found to be higher in patients with joint complaints (53.6%) than in patients without joint complaints (38.4%) (p<0.0001). Parvovirus B19 IgG seropositivity percentage was 32.1% in children with joint complaints and 62.3% in adults (p<0.0001). In addition, this percentage was found to be higher in women (58.1%) with joint complaints compared to men (45.5%) (p=0.002). On the other hand, the Parvovirus B19 IgM seropositivity percentage was determined as 3.2% for these patients. This percentage was 1% in children and 4.1% in adults.
DISCUSSION AND CONCLUSION: In particular, the possibility of a primary infection or complication due to Parvovirus B19 should be kept in mind for adult patients with joint complaints. We think that the results of the serological test (IgG-IgM) for Parvovirus B19 in this patient group will contribute to the differential diagnosis.

INTRODUCTION: The increase in the need for antiseptic products with the pandemic has led scientists to work on the development of more effective new formulations. It is important to evaluate the newly produced antiseptic solutions according to the standards in terms of content and effectiveness. In our study, it is aimed to compare an antiseptic product with superoxidized water content according to the 60% isopropyl alcohol formulation referenced by the TSE EN 1500 standard.
METHODS: In our study, the antimicrobial activity of an antiseptic product with superoxidized water content was investigated by comparing it with 60% isopropyl alcohol. For this purpose, a total of 20 volunteers were included in the study and were seperated into two separate groups. Standard Escherichia coli ATCC strain was used as test bacteria. In the first group, the sample was taken after applying 30 ml of antiseptic solution to the contaminated hands for 30 seconds, in the second group, both antiseptic solution and 60% isopropyl alcohol were applied twice. After incubation of Triptone Soya Agar (TSA) media at 37°C for 18±4 hours, all colonies were counted using the colony counting method.
RESULTS: The logarithmic reduction rates obtained with both antiseptics according to the initial contamination are shown in the table.
DISCUSSION AND CONCLUSION: A comparable logarithmic reduction was detected with the antiseptic containing superoxidized water compared to standard isopropyl alcohol.

INTRODUCTION: Albumin is the main carrier molecule that makes up 55-60% of the proteins in the blood. In clinical applications, its levels are measured in serum, urine and body fluids. In the case of urinary albumin loss and/or decreased liver production, albumin levels in the blood decrease, but the reasons for increasing serum albumin levels are very limited. We planned this study as a method comparison study due to the feedback that albumin measurements made in our hospital’s laboratory were relatively high.
METHODS: Fourty patients were included in the study, albumin levels in serum samples were measured with bromcresol green and bromcresol purple methods on the same day, and the data were evaluated with SPSS 26.0 package program. Measurements were made on the Alinity c-series (Abbott Laboratories, Chicago, IL, USA) autoanalyzer using their kit. Average Bias was 0.535 and % Bias was 14.22 between the two methods.
RESULTS: While the difference between the means of the two methods was statistically significant (p<0.001), there was a positive, strong (r=0.959) and statistically significant (p<0.001) correlation between the methods, and the p<0.05 level was considered statistically significant.
DISCUSSION AND CONCLUSION: It was evaluated that the measurement results for both methods were within the limits of medically permissible error, but further study was needed to compare both methods separately with the reference method.

INTRODUCTION: Monitoring and comparing regional service performance is inevitable to use resources effectively and allocate resources without creating interregional inequalities. With the Health Transformation Program, there has been an increase in the amount and quality of the service provided throughout the country. In addition, there has been a decrease in the inequalities between regions due to its implementation. In order to ensure continuity in health service delivery, health service activities in provinces and regions should be followed regularly, and their performance should be evaluated.
METHODS: The study calculated Data Envelopment Analysis efficiencies and Cross-efficiency for 26 subregions in the NUTS-II classification in Turkey. The number of hospital beds and primary care units were the inputs of the research; the number of primary, secondary and tertiary care visits and the number of inpatients are also the output of the study. Subregions are reordered and grouped according to their cross-efficiency. Decision-making units with unusual production structures were investigated by calculating Maverick Index scores.

RESULTS: Regarding DEA efficiency, the average efficiency score of the ten subregions classified as efficient is 0.97 (sd. 0.0395). The average cross-efficiency score obtained from the benevolent method is 0.89 (sd. 0.058), while the average score achieved through the aggressive method is 0.86 (sd. 0.574). Maverick index scores had a balanced distribution. The average maverick index score for aggressive and benevolent are 0.13 (std. 0.0474), and 0.0871 (std. 0.0420), respectively. Although only the Malatya subregion was classified as efficient in the traditional DEA method, it had low scores in the cross-efficiency evaluation and was classified as a maverick decision unit with an MI score of 0.21.
DISCUSSION AND CONCLUSION: The cross-efficiency method yields more valuable results because it employs more realistic weights for peer evaluation. These outcomes are simpler for decision-makers to comprehend and assess. The regions of Kocaeli, Adana, Aydın, Hatay, Şanlıurfa, and Tekirdağ exhibit notable performance in the cross-efficiency examination, as they have attained the most significant efficiency scores. The regions of Kastamonu, Erzurum, Van, and Ağrı exhibit poor levels of efficiency, thereby requiring the implementation of precautionary measures.

INTRODUCTION: Brucellosis is one of the most frequent zoonotic infectious diseases and is a global public health concern, particularly in developing countries. Brucellosis causes systemic symptoms and can affect different parts of the body. Brucellar pericarditis is a rare involvement of the cardiovascular system. This study aimed to investigate the clinical outcomes of Brucella pericarditis cases.
METHODS: A pooled analysis study was conducted by searching four international online databases with the terms “Brucella” and “pericarditis” and their synonyms. The full texts or abstracts were screened using these keywords. The publications were examined in terms of the age and gender of cases, publication year and country, additional diagnosis, diagnostic methods, treatments, and outcomes.

RESULTS: The study included 25 cases (14 males, 56%), with a mean age of 38.84 ± 9.7 (12-79) years. Systemic findings were present in 17 (68%) patients, and 17 (68%) had a cardiac presentation. 10 (40%) patients had retrosternal pain/ chest pain, 10 (40%) patients had pericardial frontman, and five (%10) cases had tachycardia. The most commonly used diagnostic method was a serological test (96%), and a positive blood culture result was determined in 64%. The Rose Bengal test was performed in seven cases, of which six had positive results. Complete recovery was reported for 22 cases, and death in two patients.
DISCUSSION AND CONCLUSION: Although brucellosis is less common in many developed countries, it should be keep in mind differential diagnosis in endemic areas. Brucellosis is a rare cause of pericarditis and requires specific treatment. Standard tube agglutination tests are highly sensitive and specific in the diagnosis of brucellosis. This non-invasive, practical test should be used in the differential diagnosis of pericarditis.

INTRODUCTION: Opioid dependence, which has environmental and genetic components, is an important public health problem. OPRM1 gene encodes mu opioid receptor (MOR) which is a primary target for opioids. Polymorphisms on the OPRM1 gene have been shown to alter the properties and physiology of MOR and also may have impact on opioid dependence. The association between OPRM1 rs540825 and rs510769 polymorphisms and substance dependence have been shown through various studies. The purpose of this study is to develop reliable, robust and easily applicable genotyping procedures for OPRM1 rs540825 and rs510769 polymorphisms as they possess rising importance in the context of addiction and therapy success.
METHODS: A novel and an improved method based on polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) was employed to determine OPRM1 gene polymorphisms at positions rs510769 and rs540825, respectively. OPRM1 gene regions containing these two polymorphisms were amplified using PCR; then, RFLP method was performed using the restriction enzymes NlaIII and SspI for rs540825 and rs510769, respectively. A total of 70 healthy samples from the Turkish population were tested to evaluate these two developed PCR-RFLP methods.
RESULTS: Amplicons were 276 base pair (bp) and 563 bp in length for rs540825 and rs510769, respectively. The length of the restriction products of OPRM1 rs540825 were 276 bp for wild type AA genotype, 153 bp and 123 bp for polymorphic TT genotype. Digestion of PCR region including rs510769 polymorphism yielded 364 bp, 146 bp and 53 bp fragments for polymorphic TT genotype and 417 bp and 146 bp fragments for wild-type CC genotype. Allelic and genotypic frequencies of rs540825 in the Turkish population were calculated as 29 % for allele A and 71 % for allele T, 10 % for AA, 38.6 % for AT, and 51.4 % for TT. For rs510769 polymorphism, 60 % of the individuals had CC genotype, 24.3 % and 11.4 % of them had CT and TT, respectively. Allele frequencies of rs510769 polymorphism were 75 % for allele C and 25 % for allele T.
DISCUSSION AND CONCLUSION: Novel, reliable and easy-to-apply PCR-RFLP technologies were developed to detect rs540825 and rs510769 polymorphism in the OPRM1 gene. Moreover, genotype and allele frequencies of them were determined in the Turkish population.

INTRODUCTION: Neurofibromatosis type 1 (NF1) is an autosomal dominant disease that affects 1 in 2,500 people worldwide. The disease is developed due to the occurrence of mutations in NF1 gene. NF1 gene is coding cytoplasmic protein which is negative regulator of RAS proteins. The loss of neurofibromin results in activation of RAS cascade and cell proliferation. For this reason, NF1 gene is categorized as tumor suppressor gene. It is clinically characterized by cafe-au-lait spots, Lisch nodules, axillary and inguinal freckling, multiple peripheral nerve tumors, bone lesions, and a predisposition to malignancy. Variations in NF1 mutations may not correlate with the variations in clinical phenotype. This unclear genotype–phenotype correlations is assumed to be due to modifier genes. One of these modifier candidates is telomere length and telomerase activity. Telomeres are repetitive nucleotide sequences located at the ends of chromosomes and protect them from fraying and sticking to each other. The length of telomeres is shortening in each cell division. Nevertheless, this shortening can be prohibited by the enzyme telomerase which adds a species-dependent telomere repeat sequence to the 3’ end of telomeres. However, telomerase activity usually diminished after birth in somatic cells. Researches done in last years have shown the importance of telomere and telomerase activity and they are causally connected to human disease. However, the number of research on this concept for NF1 patients is very few.
METHODS: The DNA and proteins isolated from tumors of nine NF1 patients was analyzed by quantitative PCR based technics. Telomere length measurement were done using the DNA samples. The pathological status of tumor tissues was confirmed by routine pathological examination. Telomerase activity were evaluated from proteins isolated from acquired tumor samples.
RESULTS: Considering the preliminary results, higher telomerase activity is measured in some NF1 tumors and also variations in telomere size were detected.
DISCUSSION AND CONCLUSION: These primary data indicate that telomere length may play an important role in NF1-associated tumor’s progression and could provide information about the telomere-targeted therapeutic approaches for treatment of telomere dysfunction in the clinic.

Adequate, safe and sustainable access to water, sanitation and hygiene services is an important worldwide public health issue. Healthcare facilities are also the units most affected by the lack of water, sanitation and hygiene services. Global projections highlight that one-third of healthcare facilities lack what is necessary to ensure hand hygiene where patient care is provided. One out of every four institutions does not have water service and 10% do not have sanitation service. In other words, 1.8 billion people lack basic water services and 800 million people has to use sanitary facilities without toilets. Healthcare workers also need adequate and safe water to provide appropriate services. As drinking water and for meals, hand hygiene, washing, and a variety of general and specific medical uses all require reliable sources of water for healthcare workers and patients. Sanitation refers to public health conditions related to the provision of clean drinking water and the appropriate treatment and disposal of human excreta and sewage. Sanitation systems aim to protect human health by providing a clean environment that will stop transmission, especially by fecal-oral route. The most important step of the hygiene service in healthcare facilities is effective hand hygiene. Effective hand hygiene is the cornerstone of infection prevention and control (IPC) guidelines and practices and is recognized as a primary measure to prevent healthcare-associated infections and the spread of antimicrobial resistance. Healthcare professionals are the main target of efforts to improve hand hygiene, as they care for large numbers of patients and may come into contact with blood and other bodily fluids in the process. Like washing hands with soap, avoiding human contact with faeces is also part of sanitation. It is important that healthcare facilities provide handwashing facilities with soap and water in the toilets for healthcare facility applicants and in the restrooms where they can meet their other needs. Improving access to these services supports health, life expectancy, education, gender equality and other important goals of international development. In this study, it aims to present the situation of water, sanitation and hygiene services in healthcare facilities on a global scale. One of the essential methods required to take the COVID-19 pandemic under full control without harming the nature is to invest in water, sanitation, hygiene and energy services in these facilities.

In order to cape with counter the smallpox epidemics that frequently occured the vast Ottoman geography, the Vaccine Administration was established in 1840 in the Mekteb-i Tıbbiye-i Şahane (currently Istanbul Faculty of Medicine), and smallpox vaccine production took start (1840). The vaccine strains were imported from Paris, propagated through human passages and provided free of charge to the public and army in the Payitaht (royal capital) Istanbul. The material was contained in glass tubes or vaccination pens and sent to all provinces free of charge Towards the end of the 19th century, smallpox vaccine production took start in smallpox vaccine stations in France, and the Ottoman government switched from importing smallpox strains to smallpox vaccine production in the official Imperial Vaccination Center (1892). However, vaccine tubes and vaccines were sent to the Balkans, remote provinces in Anatolia and especially to the Arab Peninsula through postal service. Delivery by the means of transport of that period took a lot of time, and the vaccines spoiled on the way and would not hold. In order to solve this problem, it was decided to open filigree branches in remote provinces at the beginning of the 1900s, but the planned branches could not be activated due to lack of financial means, and a few opened branches were closed due to inefficiency. The official Ottoman Institute of Vaccination (Telkihhane-i Şahane) produced vaccines during the Second Constitutional period and during the era of Republic under different names. After the foundation of the Republic, while operating under the name of Istanbul Vaccination Institute under the directorate of Dr. Şerafettin Mustafa, it was closed and merged with the Central Hygiene Institute in Ankara. Alongside its director and staff, equipment and two and a half million doses of smallpox vaccine were moved to Ankara (1934). The Central Hygiene Institute’s Smallpox Vaccine Branch was found on the experiences in vaccine production acquired in Istanbul after the 1840s. This article is the first to discuss historical accounts on the vaccine production institutions in Turkey as a whole. Production methods, storage of vaccines and supply of vaccine tubes were also evaluated all together for the first time.

The causes and consequences of violence against healthcare workers need to be evaluated from different perspectives. Studies show that there is a communication problem, but this problem is not only between healthcare workers and patients. Especially the discourse used by external factors and the influence of the media are important in the occurrence of violence. From this point of view, improving the communication training given to healthcare professionals, regulating the discourse through the media and planning awareness activities are important factors for the solution of the problem. There is a clear relationship between individual physical violence and social discursive violence. The discourses of people who are followed or supported by many segments of the society can be applied more sharply by the followers in the lower segments. This situation occurs between three factors: The perpetrator of violence, The subject of violence, The cause of violence. What is reflected in the media and the law has always been the “perpetrator of violence” and the “victim of violence”. The hidden subject is the one who causes the violence. This study is a retrospective study conducted by examining the discourses used by whom and for what purpose, examining the statements reflected in the media and reviewing the literature. Especially when the discourses of politicians, who are followed through the media, are evaluated in the case of health workers, the transformation of the action into violence increases significantly according to the negativity of the discourse. As a result of the evaluation of political messages in the past-present axis and their application in the context of the rights obtained, it makes it inevitable that violence will occur as a result of discourses and expressions that legitimize violence, even if they do not directly involve violence. Violence goes beyond the perpetrator and victim, as it leads to a mental coding of discourse and action. Exposure to violent expressions in the media can have a negative impact on society, and the use of non-marginalizing language is key to preventing the legitimization of violence. Healthcare workers may quit or leave the country due to feeling undervalued, and violent discourses can become physical over time.

Blood transfusion, which is one of the most frequently performed procedures in clinics, is a life-saving treatment method, but it also contains many side effects and complications. Especially erythrocyte concentrate, thrombocyte concentrate and fresh frozen plasma are the most preferred blood components. In addition to its known benefits, it should not be forgotten that blood transfusions can cause side effects and cause undesirable clinical pictures. Correct indication is very important in transfusion decisions. In addition, patient-specific factors (age, diagnosis, comorbidity), laboratory findings (Hemoglobin value, platelet count, coagulation tests), presence of coagulopathy and known physiological factors (oxygen requirement and hemodynamic status) should also be taken into account when making this decision. Indications for use of blood for transfusion started to change with the patient blood management project. It is not possible to completely avoid transfusion with patient blood management (PBM) applications, but the current consumption can be greatly reduced and costs can be reduced side effects can be prevented and the risk of pre-existing or developing anemia can be minimized.