Objectives: Registries for the causes of death constitute one of the basic components of health s... more Objectives: Registries for the causes of death constitute one of the basic components of health system in all countries. The reliability of the notified causes of death appears to be a common problem. In this study, we compared the information on death certificates routinely sent from the Kocaeli University Hospital to the State Statistics Institute (SSI) with that found on patient records. Study Design: A retrospective review was made on patient records and death certificates sent to the SSI in 2002 and 2003. The causes of death were classified as principal, contributing, and immediate causes according to the WHO criteria. Diagnoses were defined according to the ICD-10 list. Results: Of 744 deaths, records of 665 cases were present in both sources. Certificates of 211 cases (31.7%) included the correct principal death cause, while in 162 cases (24.4%) the deaths were attributed to other disease/conditions such as cardiorespiratory arrest, and in 112 cases, (16.8%), to an immediate ...
International Journal of Occupational and Environmental Health, 2004
The authors evaluated occupational accidents in Koc:aeli, Turkey, using epidemiologic criteria. D... more The authors evaluated occupational accidents in Koc:aeli, Turkey, using epidemiologic criteria. Data were derived from the registries of the service on Occupational Injuries and Diseases of the Social Insurance Institution"s District Authority in Kocaeli. The analysis was based on data from 387 deaths. The rates of occupational injuries and mortality and fatalities from them were 5.1 %,30.6 per 100,000 workers, and 6.0%, respectively, compared with 2.8%, 35.2 per 100.000 workers, and 12.7% in Turkey. Sectors with the highest rates of fatal occupational injuries were construction (30.2%), transportation (13.2%), basic metal indu~try (9.0%), manufacturing of metal products (5.9%), and heating with electricity, gas, and steam (5.9%). 38.2% of these workers were 25-34 years old. Nearly all were male, most were married, and three fourths had children. Of all deaths due to occupational injuries, 121 (31.3%) were caused by traffic injuries, 93 (24.1 %) by falling from high places, and 43 (11.1%) by electrocution; 89% occurred at workplaces, 42% of the workplaces were small, and 45.9% of the deceased workers had been working there for less than three months. Although the situation was better than that in the rest of Turkey in terms of epidemiologic criteria, the death rates, as in other developing countries, are higher than those in the world in general.
In Turkey, the construction sector is responsible for the largest number of work-related fataliti... more In Turkey, the construction sector is responsible for the largest number of work-related fatalities among all industries. This study's objective is to determine the characteristics of the fatalities in the construction sector in Kocaeli Province. The study was carried out retrospectively by investigating the records of occupational deaths between 1990 and 2001 in the Kocaeli District of Turkey. Fatal occupational injuries in the construction sector were investigated in detail by evaluating the records. The analysis was based on data from 153 deaths. The incidence of occupational injuries was found overall to be 4.5% in Kocaeli, while the annual mortality rate was 60.4 in Kocaeli and 79.0 in Turkey per 100,000 workers over the entire time period. On the other hand, the fatality rate of occupational injuries was found to be 12.0 per 1,000 in Turkey and 6.4 per 1,000 in Kocaeli. The evaluation of the type of injuries in construction sector has revealed that in 69 of cases (45.1%) fell down from high altitude, in 22 cases (14.4%) vehicle accident, and in 22 (14.4%) electrocution were the cause of death. The leading causes of death have been found to be blunt-force trauma (37.9%) and head trauma (25.5%). Fourty one percent of those who had occupational accidents have had less than one year work experience. Only in 7.8% of deaths, the cause was determined through an autopsy.
Diş kayıplarının yüzde sabit iz olarak kabul edilip edilmemesi konusunda farklı görüşler mevcuttu... more Diş kayıplarının yüzde sabit iz olarak kabul edilip edilmemesi konusunda farklı görüşler mevcuttur. Bu çalışmada; travmatik diş kayıplarının Türk Ceza Kanunu kapsamında, "yüzde sabit iz niteliğinde kabul edilip edilmemesi" hususundaki görüşleri belirleyerek uygulama ortaklığı sağlanmasına katkı sağlamak amaçlanmıştır. Yöntem: Çalışma, adli tıp uzmanı, diş hekimi ve yargı mensuplarına yönelik, belli başlı farklı görüşleri içeren bir bilgilendirme metnine ek olarak, kişilerin uzmanlık alanı, görev yaptıkları il ve deneyim süreleri ile benimsedikleri görüş ve gerekçesini içeren bir anket uygulanarak yapılmıştır. Anket verileri, bir istatistik programı aracılığı ile analiz edilip değerlendirilmiştir. Bulgular: Ankete, 103'ü adli tıp uzman/asistanı, 38'i hukukçu, 21'i diş hekimi olmak üzere toplam 162 kişi katılmıştır. Adli tıp uzman/ asistanlarının %38,8'i, diş hekimlerinin %90,5'i, hukukçuların %34'ü üç büyük ilde (İstanbul, Ankara, İzmir) görev yapan profesyonellerdi. Katılımcıların %61,1'i 10 yıl ve daha az süreli deneyime sahip iken, %38,5'i 11 yıl ve daha uzun süreli deneyime sahipti. Adli tıp uzman ve asistanları grubunda 10 yıl ve daha az süreli deneyimli grup istatistiksel olarak anlamlı derecede daha fazla iken, diş hekimlerinin çoğunluğunun çalışma süresi 11 yıl ve üzerindeydi (p<0,05). Katılımcıların %13'ü, kesin olarak "diş kayıpları yüzde sabit iz olarak değerlendirilmemelidir" derken geri kalan %87'si koşullu ya da koşulsuz olarak "diş kayıplarının yüzde sabit iz olarak değerlendirilmesi" gerektiği görüşündeydi. Diş kayıplarının yüzde sabit iz olarak değerlendirilmesi konusunda katılımcıların hem uzmanlık alanına göre hem de deneyim süreleri açısından istatistiksel olarak anlamlı bir farklılık saptanmamıştır (p>0,05). Katılımcıların yazılı olarak belirttikleri görüşler de uzmanlık alanlarına göre gruplandırılarak sunulmuştur. Sonuç: Diş kayıpları günümüz diş hekimliği olanakları ile aslına çok yakın estetik görünüm oluşturabilecek şekilde restore edilebilmektedir. Buna karşın kişiler doğal dişlerinin yerine doğal olmayan dişlerle yaşamlarını sürdürmek zorunda kalabilmekte veya dişlerini yaptırmayarak/ yaptıramayarak diş kayıpları ile yaşamlarını sürdürmektedir. Korku, ekonomik kısıt, zamansızlık veya uygun hekime ulaşamamak gibi farklı nedenler tedavinin önündeki engeller olarak gözükmektedir. Diş kayıplarının değerlendirilmesinde genel eğilimin tedavisi yapılamayan diş kayıplarının yüzde sabit iz olarak değerlendirilmesi yönünde olduğu saptanmıştır.
Adli tıp hizmetleri; sağlık sistemi içinde hukuk sistemine sunulan hizmetlerin bir parçasıdır. Ad... more Adli tıp hizmetleri; sağlık sistemi içinde hukuk sistemine sunulan hizmetlerin bir parçasıdır. Adli tıp uzmanlan tarafından verilen adli tıp hizmetlerinin büyük çoğunluğu adli tıp şube müdürlükleri aracılığı ile yürütülmektedir. Çalışmada, Kocaeli Devlet Hastanesi (KDH) Adli Tıp Birimi'nin adli tıp hizmetlerindeki etkinliğinin belirlenmesi amaçlanmıştır. Çalışmada, Kocaeli Devlet Hastanesi (KDH) Adli Tıp Birimi tarafından 01.07.2005 - 31.12 2007 tarihleri arasında hazırlanan 1406 adli rapor retrospektif olarak değerlendirilmiştir. Olguların %41,l'ı kadın, %58,9'u erkek, olguların yaş ortalamasının 36,1+23,6 olduğu saptanmıştır. Olgularda en sık (%43,4) vücut dokunulmazlığına karşı işlenen suçlarla ilgili sorular sorulurken, yaş tespiti % 22,8 oranmda, adli psikiyatrik değerlendirme kapsamında soruların %19,9 oramnda olduğu görülmüştür. Olguların %23,9 (n = 336)'unun adli rapor düzenlenmeden önce Kocaeli Devlet Hastanesi'nde tedavi olduğu belirlenmiştir. Olguların...
Objectives: Intimate partner violence (IPV) is an important public health problem in many countri... more Objectives: Intimate partner violence (IPV) is an important public health problem in many countries including Turkey, with serious short-and long-term physical and mental health consequences, as well as significant social and public health costs. To understand the violence characteristics and the individual risk factors for both the married women victims and the perpetrator partners are the objectives of this study. Methodology: 243 married women, who have consulted to hospitals and village clinics between 2008 and 2009 with the mean age of 36.76 (SD=11.59), accepted to participate in the study voluntarily. Participants were divided into two groups as "victimized" (58.8%, n=143) and "non-victimized" (41.2%, n=100) women. Victimized group consisted of women who have had any type of violence from their husbands during their life. A 61-item questionnaire was prepared that included items on demographics, IPV experience, attitudes about IPV and knowledge of legal rights. Results: As compared to non-victimized group, women in victimized group mostly lived in villages than in town/city centers, were illiterate, had bride-price agreement and were younger when married. Place of accommodation, age and number of pregnancies were associated with the risk of victimization. Conclusions: In order to prevent IPV, further qualitative research is required to evaluate the involved risk factors and training programs on how to behave against violence in association with the legal rights should be designed for poorly educated women in their natural settings and hospitals.
... Başar ÇOLAK,1 Şahika G. ŞİŞMANLAR,2 Işık KARAKAYA,3 Nilay ETİLER,4 Ümit BİÇER5 ... Nor-mal da... more ... Başar ÇOLAK,1 Şahika G. ŞİŞMANLAR,2 Işık KARAKAYA,3 Nilay ETİLER,4 Ümit BİÇER5 ... Nor-mal dağılıma uygun olmadığı durumlarda orta-lamaların karşılaştırılmasında Mann-Whitney U testi, uygun olduğu durumlarda t testi kullanıl-mıştır. ...
The American Journal of Forensic Medicine and Pathology, 2010
The postmortem interval is estimated based on physical, biochemical, and morphologic changes in d... more The postmortem interval is estimated based on physical, biochemical, and morphologic changes in dead bodies, scene investigation findings, and judicial investigation findings. Many factors affect the onset and the course of the postmortem changes. There is no established method for accurate estimation of the postmortem interval, especially with regard to putrefied dead bodies. Aiming to determine the consistency and the variation of postmortem interval estimations in cases with various putrefaction degrees by forensic medicine assistants and specialists from different centers, a prospective study was undertaken. A form containing data about the time, environment, and geographical location where the cases were found, along with their postmortem changes was mailed to 110 forensic medicine assistants and specialists from different centers, who were also asked to note their postmortem interval estimations. About half of the forms were returned. Those postmortem interval estimations made based on the information included in the forms, showed great variability between the participants, and in only 6 cases a consistency exceeding 50% was found between the participants and the autopsy teams. It is not possible to estimate the postmortem interval in a standard way by using only the postmortem changes of putrefied bodies. Therefore, especially in the cases involving putrefied bodies, in addition to the postmortem changes, factors such as environmental conditions, the scene, and judicial investigation findings should be taken into consideration.
American Journal of Forensic Medicine & Pathology, 2009
Because forensic medicine workers have a greater occupational risk for infectious diseases, stric... more Because forensic medicine workers have a greater occupational risk for infectious diseases, strict rules and measures against infections must be implemented at every stage of forensic medicine practices. In this study, we aim to evaluate the infection control implementations in forensic medicine practices in Turkey.A questionnaire survey was mailed to forensic medicine specialists and residents between April and June 2005. The questionnaire consisted of 36 questions whose designed was based on standard precautions and protective barriers against infectious risks.In all, 111 doctors from 27 different cities responded to the questionnaire. Of those doctors who responded, 43.2% reported performing external examination anywhere. The percentage of doctors performing external examinations who regularly wore gloves, masks, and gowns, and washed hands with a disinfectant were 81.5%, 24.7%, 30.9%, and 81.5%, respectively. The percentage of doctors performing autopsies who regularly wore masks, protective eye-wear, gloves, special gloves, and special boots were 59.6%, 10.6%, 98.9%, 71.3%, and 36.2%, respectively. Only 2 negative pressure rooms were reported.According to these results, precautionary measures against infectious risks in forensic medicine practice in our country are insufficient. Conditions to facilitate and to improve the compliance with infection control procedures must be prepared.
Objectives: Registries for the causes of death constitute one of the basic components of health s... more Objectives: Registries for the causes of death constitute one of the basic components of health system in all countries. The reliability of the notified causes of death appears to be a common problem. In this study, we compared the information on death certificates routinely sent from the Kocaeli University Hospital to the State Statistics Institute (SSI) with that found on patient records. Study Design: A retrospective review was made on patient records and death certificates sent to the SSI in 2002 and 2003. The causes of death were classified as principal, contributing, and immediate causes according to the WHO criteria. Diagnoses were defined according to the ICD-10 list. Results: Of 744 deaths, records of 665 cases were present in both sources. Certificates of 211 cases (31.7%) included the correct principal death cause, while in 162 cases (24.4%) the deaths were attributed to other disease/conditions such as cardiorespiratory arrest, and in 112 cases, (16.8%), to an immediate ...
International Journal of Occupational and Environmental Health, 2004
The authors evaluated occupational accidents in Koc:aeli, Turkey, using epidemiologic criteria. D... more The authors evaluated occupational accidents in Koc:aeli, Turkey, using epidemiologic criteria. Data were derived from the registries of the service on Occupational Injuries and Diseases of the Social Insurance Institution"s District Authority in Kocaeli. The analysis was based on data from 387 deaths. The rates of occupational injuries and mortality and fatalities from them were 5.1 %,30.6 per 100,000 workers, and 6.0%, respectively, compared with 2.8%, 35.2 per 100.000 workers, and 12.7% in Turkey. Sectors with the highest rates of fatal occupational injuries were construction (30.2%), transportation (13.2%), basic metal indu~try (9.0%), manufacturing of metal products (5.9%), and heating with electricity, gas, and steam (5.9%). 38.2% of these workers were 25-34 years old. Nearly all were male, most were married, and three fourths had children. Of all deaths due to occupational injuries, 121 (31.3%) were caused by traffic injuries, 93 (24.1 %) by falling from high places, and 43 (11.1%) by electrocution; 89% occurred at workplaces, 42% of the workplaces were small, and 45.9% of the deceased workers had been working there for less than three months. Although the situation was better than that in the rest of Turkey in terms of epidemiologic criteria, the death rates, as in other developing countries, are higher than those in the world in general.
In Turkey, the construction sector is responsible for the largest number of work-related fataliti... more In Turkey, the construction sector is responsible for the largest number of work-related fatalities among all industries. This study's objective is to determine the characteristics of the fatalities in the construction sector in Kocaeli Province. The study was carried out retrospectively by investigating the records of occupational deaths between 1990 and 2001 in the Kocaeli District of Turkey. Fatal occupational injuries in the construction sector were investigated in detail by evaluating the records. The analysis was based on data from 153 deaths. The incidence of occupational injuries was found overall to be 4.5% in Kocaeli, while the annual mortality rate was 60.4 in Kocaeli and 79.0 in Turkey per 100,000 workers over the entire time period. On the other hand, the fatality rate of occupational injuries was found to be 12.0 per 1,000 in Turkey and 6.4 per 1,000 in Kocaeli. The evaluation of the type of injuries in construction sector has revealed that in 69 of cases (45.1%) fell down from high altitude, in 22 cases (14.4%) vehicle accident, and in 22 (14.4%) electrocution were the cause of death. The leading causes of death have been found to be blunt-force trauma (37.9%) and head trauma (25.5%). Fourty one percent of those who had occupational accidents have had less than one year work experience. Only in 7.8% of deaths, the cause was determined through an autopsy.
Diş kayıplarının yüzde sabit iz olarak kabul edilip edilmemesi konusunda farklı görüşler mevcuttu... more Diş kayıplarının yüzde sabit iz olarak kabul edilip edilmemesi konusunda farklı görüşler mevcuttur. Bu çalışmada; travmatik diş kayıplarının Türk Ceza Kanunu kapsamında, "yüzde sabit iz niteliğinde kabul edilip edilmemesi" hususundaki görüşleri belirleyerek uygulama ortaklığı sağlanmasına katkı sağlamak amaçlanmıştır. Yöntem: Çalışma, adli tıp uzmanı, diş hekimi ve yargı mensuplarına yönelik, belli başlı farklı görüşleri içeren bir bilgilendirme metnine ek olarak, kişilerin uzmanlık alanı, görev yaptıkları il ve deneyim süreleri ile benimsedikleri görüş ve gerekçesini içeren bir anket uygulanarak yapılmıştır. Anket verileri, bir istatistik programı aracılığı ile analiz edilip değerlendirilmiştir. Bulgular: Ankete, 103'ü adli tıp uzman/asistanı, 38'i hukukçu, 21'i diş hekimi olmak üzere toplam 162 kişi katılmıştır. Adli tıp uzman/ asistanlarının %38,8'i, diş hekimlerinin %90,5'i, hukukçuların %34'ü üç büyük ilde (İstanbul, Ankara, İzmir) görev yapan profesyonellerdi. Katılımcıların %61,1'i 10 yıl ve daha az süreli deneyime sahip iken, %38,5'i 11 yıl ve daha uzun süreli deneyime sahipti. Adli tıp uzman ve asistanları grubunda 10 yıl ve daha az süreli deneyimli grup istatistiksel olarak anlamlı derecede daha fazla iken, diş hekimlerinin çoğunluğunun çalışma süresi 11 yıl ve üzerindeydi (p<0,05). Katılımcıların %13'ü, kesin olarak "diş kayıpları yüzde sabit iz olarak değerlendirilmemelidir" derken geri kalan %87'si koşullu ya da koşulsuz olarak "diş kayıplarının yüzde sabit iz olarak değerlendirilmesi" gerektiği görüşündeydi. Diş kayıplarının yüzde sabit iz olarak değerlendirilmesi konusunda katılımcıların hem uzmanlık alanına göre hem de deneyim süreleri açısından istatistiksel olarak anlamlı bir farklılık saptanmamıştır (p>0,05). Katılımcıların yazılı olarak belirttikleri görüşler de uzmanlık alanlarına göre gruplandırılarak sunulmuştur. Sonuç: Diş kayıpları günümüz diş hekimliği olanakları ile aslına çok yakın estetik görünüm oluşturabilecek şekilde restore edilebilmektedir. Buna karşın kişiler doğal dişlerinin yerine doğal olmayan dişlerle yaşamlarını sürdürmek zorunda kalabilmekte veya dişlerini yaptırmayarak/ yaptıramayarak diş kayıpları ile yaşamlarını sürdürmektedir. Korku, ekonomik kısıt, zamansızlık veya uygun hekime ulaşamamak gibi farklı nedenler tedavinin önündeki engeller olarak gözükmektedir. Diş kayıplarının değerlendirilmesinde genel eğilimin tedavisi yapılamayan diş kayıplarının yüzde sabit iz olarak değerlendirilmesi yönünde olduğu saptanmıştır.
Adli tıp hizmetleri; sağlık sistemi içinde hukuk sistemine sunulan hizmetlerin bir parçasıdır. Ad... more Adli tıp hizmetleri; sağlık sistemi içinde hukuk sistemine sunulan hizmetlerin bir parçasıdır. Adli tıp uzmanlan tarafından verilen adli tıp hizmetlerinin büyük çoğunluğu adli tıp şube müdürlükleri aracılığı ile yürütülmektedir. Çalışmada, Kocaeli Devlet Hastanesi (KDH) Adli Tıp Birimi'nin adli tıp hizmetlerindeki etkinliğinin belirlenmesi amaçlanmıştır. Çalışmada, Kocaeli Devlet Hastanesi (KDH) Adli Tıp Birimi tarafından 01.07.2005 - 31.12 2007 tarihleri arasında hazırlanan 1406 adli rapor retrospektif olarak değerlendirilmiştir. Olguların %41,l'ı kadın, %58,9'u erkek, olguların yaş ortalamasının 36,1+23,6 olduğu saptanmıştır. Olgularda en sık (%43,4) vücut dokunulmazlığına karşı işlenen suçlarla ilgili sorular sorulurken, yaş tespiti % 22,8 oranmda, adli psikiyatrik değerlendirme kapsamında soruların %19,9 oramnda olduğu görülmüştür. Olguların %23,9 (n = 336)'unun adli rapor düzenlenmeden önce Kocaeli Devlet Hastanesi'nde tedavi olduğu belirlenmiştir. Olguların...
Objectives: Intimate partner violence (IPV) is an important public health problem in many countri... more Objectives: Intimate partner violence (IPV) is an important public health problem in many countries including Turkey, with serious short-and long-term physical and mental health consequences, as well as significant social and public health costs. To understand the violence characteristics and the individual risk factors for both the married women victims and the perpetrator partners are the objectives of this study. Methodology: 243 married women, who have consulted to hospitals and village clinics between 2008 and 2009 with the mean age of 36.76 (SD=11.59), accepted to participate in the study voluntarily. Participants were divided into two groups as "victimized" (58.8%, n=143) and "non-victimized" (41.2%, n=100) women. Victimized group consisted of women who have had any type of violence from their husbands during their life. A 61-item questionnaire was prepared that included items on demographics, IPV experience, attitudes about IPV and knowledge of legal rights. Results: As compared to non-victimized group, women in victimized group mostly lived in villages than in town/city centers, were illiterate, had bride-price agreement and were younger when married. Place of accommodation, age and number of pregnancies were associated with the risk of victimization. Conclusions: In order to prevent IPV, further qualitative research is required to evaluate the involved risk factors and training programs on how to behave against violence in association with the legal rights should be designed for poorly educated women in their natural settings and hospitals.
... Başar ÇOLAK,1 Şahika G. ŞİŞMANLAR,2 Işık KARAKAYA,3 Nilay ETİLER,4 Ümit BİÇER5 ... Nor-mal da... more ... Başar ÇOLAK,1 Şahika G. ŞİŞMANLAR,2 Işık KARAKAYA,3 Nilay ETİLER,4 Ümit BİÇER5 ... Nor-mal dağılıma uygun olmadığı durumlarda orta-lamaların karşılaştırılmasında Mann-Whitney U testi, uygun olduğu durumlarda t testi kullanıl-mıştır. ...
The American Journal of Forensic Medicine and Pathology, 2010
The postmortem interval is estimated based on physical, biochemical, and morphologic changes in d... more The postmortem interval is estimated based on physical, biochemical, and morphologic changes in dead bodies, scene investigation findings, and judicial investigation findings. Many factors affect the onset and the course of the postmortem changes. There is no established method for accurate estimation of the postmortem interval, especially with regard to putrefied dead bodies. Aiming to determine the consistency and the variation of postmortem interval estimations in cases with various putrefaction degrees by forensic medicine assistants and specialists from different centers, a prospective study was undertaken. A form containing data about the time, environment, and geographical location where the cases were found, along with their postmortem changes was mailed to 110 forensic medicine assistants and specialists from different centers, who were also asked to note their postmortem interval estimations. About half of the forms were returned. Those postmortem interval estimations made based on the information included in the forms, showed great variability between the participants, and in only 6 cases a consistency exceeding 50% was found between the participants and the autopsy teams. It is not possible to estimate the postmortem interval in a standard way by using only the postmortem changes of putrefied bodies. Therefore, especially in the cases involving putrefied bodies, in addition to the postmortem changes, factors such as environmental conditions, the scene, and judicial investigation findings should be taken into consideration.
American Journal of Forensic Medicine & Pathology, 2009
Because forensic medicine workers have a greater occupational risk for infectious diseases, stric... more Because forensic medicine workers have a greater occupational risk for infectious diseases, strict rules and measures against infections must be implemented at every stage of forensic medicine practices. In this study, we aim to evaluate the infection control implementations in forensic medicine practices in Turkey.A questionnaire survey was mailed to forensic medicine specialists and residents between April and June 2005. The questionnaire consisted of 36 questions whose designed was based on standard precautions and protective barriers against infectious risks.In all, 111 doctors from 27 different cities responded to the questionnaire. Of those doctors who responded, 43.2% reported performing external examination anywhere. The percentage of doctors performing external examinations who regularly wore gloves, masks, and gowns, and washed hands with a disinfectant were 81.5%, 24.7%, 30.9%, and 81.5%, respectively. The percentage of doctors performing autopsies who regularly wore masks, protective eye-wear, gloves, special gloves, and special boots were 59.6%, 10.6%, 98.9%, 71.3%, and 36.2%, respectively. Only 2 negative pressure rooms were reported.According to these results, precautionary measures against infectious risks in forensic medicine practice in our country are insufficient. Conditions to facilitate and to improve the compliance with infection control procedures must be prepared.
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