The Delphi process allowed a consensus to be achieved in an area where there are limitations to the current evidence.

Researchers agree that early marriage (EM) and adolescent pregnancy (AP) can form severe risks for women's somatic, mental, and reproductive health, as well as on educational and social status. Yet, less is known about factors that may moderate or mediate these associations. This study examined, first, retrospectively the impacts of EM and AP on self-reported mental and somatic health among multicultural group of women living in Eastern Anatolia, Turkey. Second task was to analyze whether and how the partner violence would mediate and/or moderate between EM and AP and mental health problems. The participants were 1569 women (16-72 years of age), who reported their age of being married, first pregnancy, and demographic characteristics. They described their mental health status through General Health Questionnaire (GHQ-28: depressive, anxiety, social dysfunction, and somatization symptoms) and symptoms of posttraumatic stress disorder (PTSD; DSM-5). Women's reports of somatic illnesses were classified according to WHO-ICD-10. The revised conflict tactics scale, short form was used as a proxy to partner violence. Women who gave birth at 13-19 years of age reported more anxiety and somatization symptoms than later delivered, and those married younger than 25 showed a higher level of depressive symptoms than later married. Both AP and EM formed a heightened risk for somatic illnesses. The partner violence functioned as a moderator; AP was associated with especially high levels of depressive and anxiety symptoms among women exposed to sexual coercion in their marriage. Non-significant mediation analysis indicates that partner violence did not explain the severe impacts of the AP and EM on women's mental health. Yet, the AP and EM were associated with heightened level of partner violence. Adolescent pregnancy forms a comprehensive mental health risk, and both AP and EM were risks for somatic illnesses, such as cardiovascular problems. The mental health risk of AP further intensified if women experienced sexual coercion in their partnership. Our fundamental work is to abolish these patriarchal phenomena.

In this study, we examined social relations in women exposed to earthquake trauma in Eastern Anatolia, Turkey. We examined women's perceptions regarding the changes in their social relations within their neighbourhood, within their marriage and with their children; analysed the factors that were associated with these relations; and tested the hypothesis that an improvement in social relations will protect women's mental health from the negative impact of earthquake trauma. Participants consisted of a random selection of 1253 women, who were interviewed regarding their psychosocial needs and mental health status 1 year after earthquake. They reported trauma-related changes in their social relations; their mental health was evaluated using the Post Traumatic Stress Diagnostic Scale and Brief Symptom Inventory. Our study demonstrated severe earthquake trauma was associated with deteriorated social relations, especially neighbourhood and marital relations. Deteriorated marital and child relations were associated with increased levels of psychiatric distress; deteriorated neighbourhood relations were associated with intrusive posttraumatic stress symptoms. Improved neighbourhood relations, but not family relations, were able to protect women's mental health from the negative impact of trauma. The results are discussed regarding their relevance to gender effects and the provision of relation-specific and symptom-specific disaster relief. Copyright © 2014 John Wiley & Sons, Ltd.

No abstract

ÖzetDünyada ve Türkiye'de sağlık çalışanlarına yönelik şiddet artarak önemli bir iş sağlığı problemi haline gelmektedir. Sağlık kurumlarındaki şiddet "Hasta, hasta yakınları ya da herhangi bir bireyden gelen, sağlık çalışanı için risk oluşturan; tehdit davranışı, sözel tehdit, ekonomik istismar, fiziksel saldırı, cinsel saldırıdan oluşan durum" olarak tanımlanmıştır. Çalışmamızda İstanbul Tıp Fakültesi Adli Tıp Anabilim Dalı Polikliniği'ne başvuran sağlık çalışanlarına yönelik şiddetin değerlendirilmesi amaçlanmaktadır. Hasta/yakını tarafından şiddet görme nedeni ile başvuran 5 sağlık çalışanı değerlendirildi. Olgular 26-47 yaşlarında olup, yaş ortalamaları 30.8 yıl idi. Olguların biri erkek, üçü doktor, biri hemşire, diğeri de hasta bakıcıydı. Muayenelerinde dört olguda olaya bağ-lı fiziksel şiddet bulgusu, dört olguda ise ruhsal travma bulgusu saptanmıştır. Sağlık politikaları değişiklikleri ile sağlık çalışanı ve hastaların karşı karşıya getirilmesi, basında tıbbi uygulama hatalarının ele alınış biçimi ve güvenli çalışma koşullarının sağlana-maması sonucunda sağlık çalışanı adeta sistemin tüm aksaklık-larının sorumlusu, şiddetin hedefi olmuştur. Sağlık çalışanlarının %72.6'sının çalıştıkları süre boyunca herhangi bir şiddet türüne maruz kaldığı, %72.4'ünün son 12 ay içerisinde şiddete uğradığı bildirilmektedir. Çalışmada sorunun yaygınlığı, ciddiyeti yanı sıra çözüm önerileri tartışılmıştır.Anahtar Kelimeler: Şiddet; Sağlık Hizmetleri; Adli Tıp. AbstractThe violence against health workers has been increasing worldwide and in Turkey and is becoming a significant occupational health problem. The violence at healthcare settings is defined as "the threat behavior, verbal threat, economic abuse, physical aggression or sexual assault committed by the patient, patient's relatives, or another individual, and causes risk for healthcare workers". Our objective isevaluating the violence against healthcare workers who presented to outpatient clinics of Department of Forensic Medicine at Istanbul Faculty of Medicine. Five healthcare workers who presented due to the committed violence by the patient/patient's relative were evaluated. The patients were aged between 26-47 years, and the mean age was 30.8 years. One patient was male. Three were physicians, one was a nurse, and the other was a caregiver. Physical violence in four patients, and psychiatric trauma in four patients were detected during the forensic examinations. Health workers have almost become the main responsible for the defects in the system, and the target for the violence due to the confrontation of health workers and patients after the changes in health policy, the way of the media in handling the medical practice errors, and the failure to meet safe working conditions. It has been reported that 72.6% of the health workers were exposed to violence during their working period, and 72.4% were exposed to violence in the last 12 months. Resolution suggestions, and the prevalence and severity of the problem were discussed in the present study.