COVID-19 Pandemisinde Kapanma ve Kısıtlamaların Etkileri: Ankilozan Spondilit Hastalarının Bakış Açıları ve Deneyimleri.
Year 2022,
Volume: 32 Issue: 3, 265 - 271, 01.08.2022
Barış Uzunok
,
Ender Salbaş
,
Kaan Özpazarcık
,
Burçin Çobanoğlu
,
Simge Kaynar
,
Nil Demircan
,
Cavit Yazgan
,
Alper Yıldırım
Abstract
AMAÇ: COVID-19 pandemisi 2 yıldır dünyamızı ve tüm insanları etkiliyor ve literatürde yayınlanmış birçok çalışmaya konu olmuştur. Bu çalışmaların ortak sonucu, pandeminin insanların stres düzeylerini arttırdığı ve ayrıca birçok makalenin pandeminin kronik hastalıkları olanlar gibi özel hasta popülasyonları üzerindeki olumsuz etkisini bildirmesidir ancak Türkiye'de pandemik kısıtlamaların romatizmal hastalığı olan hastalar üzerindeki etkilerini ortaya koyan hiçbir klinik çalışma bulunmamaktadır. Çalışmamız, karantinanın ve COVID-19 pandemisi sırasında uygulanan kısıtlamaların Ankilozan Spondilitli hastalar üzerindeki etkilerini değerlendirmeyi amaçlamaktadır.
GEREÇ VE YÖNTEM: Bu çalışma 18-65 yaş arası ankilozan spondilitli hastalar ile Türkiye'nin UŞAK ilinde gerçekleştirildi. Ayrıntılı bir literatür taramasından sonra 35 soruluk bir anket hazırlandı. Bu anket, egzersiz ve beslenme durumu gibi COVID-19 kısıtlama döneminde hastaların tedavi rutinlerini ve alışkanlıklarını belirlemeyi amaçladı. Aynı zamanda, kapatma ve kısıtlama süresinin hastaların ruh sağlığı üzerindeki etkileri araştırıldı.Bu dönemde doktorların ve hastaların ilaçlarının mevcudiyeti sorgulandı.
BULGULAR: Tüm katılımcılar kapanmanın bir etkisi olduğunu bildirdi. Hastaların %43.7'si karantina öncesine göre daha az egzersiz seviyesi bildirdi. Bu hastalar, medya tavsiyesi esas olarak daha fazla C vitamini (65.7) tüketti. Ancak uzman tavsiyesine rağmen bazı hastalar daha fazla alkol tüketmiştir (%21,4). Hastaların %78'i kısıtlama altında uyku-uyanıklık ritimlerinin belirgin şekilde değiştiğini ve hastaların çoğunluğunun takip için bir romatologa gidemediğini bildirdi.
SONUÇ: Ankolizan spondilit hastalarının çoğunluğu kapanma döneminde uzmanlara veya doktorlara danışmadı, ancak hastaların çoğu hastalık aktivitesini kontrol etmek için ilaçlarına devam etti. Hastaların %78'i kısıtlama altında uyku-uyanıklık ritimlerinin belirgin şekilde değiştiğini ve hastaların çoğu takip için bir romatologa gidemediğini bildirdi. Aynı zamanda, kapatma( kapanma) ve kısıtlama süresinin hastaların ruh sağlığı üzerindeki etkileri araştırıldı.
Supporting Institution
Yok
Project Number
192-192-03
Thanks
Çalışmamıza katılmayı kabul eden bütün Ankolizan Spondilit hastalarına teşekkür ederiz.
References
- Cielo F, Ulberg R, Di Giacomo D. Psychological Impact of the COVID-19 Outbreak on Mental Health Outcomes among Youth: A Rapid Narrative Review. Int J Environ Res Public Health. 2021 Jun 4; 18 (11): 6067. doi: 10.3390/ijerph18116067.
- Pogany L, Horvath AA, Slezak A, Rozsavolgyi E, Lazary J. A COVID-19 járvány miatt elrendelt első veszélyhelyzet a pszichiátriai betegek szemszögéből: gondozói felmérés [The first lockdown due to COVID-19 pandemic from the psychiatric patients' perspective: an ambulatory care client experience survey]. Neuropsychopharmacol Hung. 2020 Dec; 22 (4): 144-153.
- Wolf MS, Serper M, Opsasnick L, et al. Awareness, attitudes, and actions related to COVID-19 among adults with chronic conditions at the onset of the US outbreak: a cross-sectional survey. Annals of internal medicine, 2020; 173 (2), 100-109.
- O'Conor R, Opsasnick L, Benavente JY, et al. Knowledge and Behaviors of Adults with Underlying Health Conditions During the Onset of the COVID-19 U.S. Outbreak: The Chicago COVID-19 Comorbidities Survey. J Community Health. 2020; 45 (6):1149-1157. doi: 10.1007/s10900-020-00906-9.
- Jones J, Sullivan PS, Sanchez TH, et al. Similarities and Differences in COVID-19 Awareness, Concern, and Symptoms by Race and Ethnicity in the United States: Cross-Sectional Survey. J Med Internet Res. 2020; 22 (7): e20001. doi: 10.2196/20001.
- Treharne G, Johnstone G, Fletcher BD, et al. Fears about COVID‐19 and perceived risk among people with rheumatoid arthritis or ankylosing spondylitis following the initial lockdown in Aotearoa New Zealand. 2021, Musculoskeletal Care, 1–9. https://doi.org/10.1002/msc.1585.
- Antony A, Connelly K, De Silva T, et al. Perspectives of Patients with Rheumatic Diseases in the Early Phase of COVID-19. Arthritis Care Res (Hoboken). 2020 Sep; 72 (9): 1189-1195. doi: 10.1002/acr.24347.
- Richez C, Flipo RM, Berenbaum F, et al. Managing patients with rheumatic diseases during the COVID-19 pandemic: The French Society of Rheumatology answers to most frequently asked questions up to May 2020. Joint Bone Spine. 2020 Oct; 87 (5): 431-437. doi: 10.1016/j.jbspin.2020.05.006.
- Antony A, Connelly K, De Silva T, et al. Perspectives of patients with rheumatic diseases in the early phase of COVID‐19. Arthritis Care & Research, 2020; 72 (9), 1189–1195. https://doi.org/10.1002/acr.24347.
- WHO/Europe. Coronavirus Disease (COVID-19) Outbreak. Available online at: https://www.euro.who.int/en/health- topics/health- emergencies/ coronavirus- covid- 19 (Jan 2021).
- Karahan F, Hamarta E, Karahan AY, The Turkish adaptation and psychometric properties of the geriatric anxiety scale. Mental Illness, 2018: 10:1-5. 10.4081/mi.2018.7580.
- Akkoc Y, Karatepe AG, Akar S, Kirazli Y, Akkoc N. A Turkish version of the Bath Ankylosing Spondylitis Disease Activity Index: reliability and validity. Rheumatol Int 2005; 25: 280-284.
- Karahan AY, Bagcaci S, Salbas E, et al. The assessment of knowledge level about their disease in patients with rheumatoid arthritis. J Clin Exp Invest. 2014; 5: 429-34.
- Alkan S, Yıldız E, Çinpolat HY, Oğuz Mızrakçı S. Presepsin ve COVID 19: Literatürün gözden geçirilmesi. Ege Tıp Bilimleri Dergisi. 2021; 4 (2): 69-72.
- Zhu N, Zhang D, Wang W, et al. A Novel Coronavirus from Patients with Pneumonia in China, 2019. N. Engl. J. Med. 2020, 382, 727–733.
- Shrestha N, Shad MY, Ulvi O, et al. The impact of COVID-19 on globalization. One Health 2020, 11, 100180.
- Fiorillo A, Gorwood P. The consequences of the COVID-19 pandemic on mental health and implications for clinical practice. Eur. Psychiatry 2020, 63, 1–4.
- Rossi R, Socci V, Talevi D, et al. COVID-19 pandemic and lockdown measures impact on mental health among the general population in Italy. Front. Psychiatry 2020, 11, 790.
- Kang L, Ma S, Chen M, et al. Impact on mental health and perceptions of psychological care among medical and nursing staff in Wuhan during the 2019 novel coronavirus disease outbreak: A cross-sectional study. Brain Behav. Immun. 2020, 87, 11–17.
- Karahan Ay, Tok F, Yildirim P, et al. The Effectiveness of Exergames in Patients with Ankylosing Spondylitis: A Randomized Controlled Trial. Adv Clin Exp Med 2016; 25 (5): 931–936. DOI: 10.17219/acem/32590.
- Maxwell LJ, Zochling J, Boonen A, et al. TNF-alpha inhibitors for ankylosing spondylitis. Cochrane Database Syst Rev. 2015 Apr 18; (4): CD005468. doi: 10.1002/14651858.CD005468.
- Annapureddy N, Nalleballe K, Onteddu SR, et al. Biologics in systemic autoimmune diseases during COVID-19 pandemic. Clin Rheumatol. 2020; 39 (12): 3529-3531. doi: 10.1007/s10067-020-05439-z.
- Rosenbaum JT, Hamilton H, Choi D, et al. Biologics, spondylitis and COVID-19. Ann Rheum Dis. 2020; 79 (12): 1663-1665. doi: 10.1136/annrheumdis-2020-217941.
- Brito CA, Paiva JG, Pimentel FN, Guimarães RS, Moreira MR. COVID-19 in patients with rheumatological diseases treated with anti-TNF. Ann Rheum Dis. 2020 Jun 16: annrheumdis-2020-218171. doi: 10.1136/annrheumdis-2020-218171.
- Monti S, Balduzzi S, Delvino P, et al. Clinical course of COVID-19 in a series of patients with chronic arthritis treated with immunosuppressive targeted therapies. Ann Rheum Dis. 2020; 79 (5): 667-668. doi: 10.1136/annrheumdis-2020-217424.
- Haberman R, Axelrad J, Chen A, et al. COVID-19 in immune-mediated inflammatory diseases—case series from New York. N Engl J Med. 2020; 383 (1): 85-88. doi: 10.1056/NEJMc2009567.
- Constandt B, Thibaut T, De Bosscher V, et al. Exercising in Times of Lockdown: An Analysis of Impact of COVID-19 on Levels and Patterns of Exercise among Adults in Belgium. Int. J. Environ. Res. Public Health 2020, 17, 4144.
- Schweda S, Krauss I. The influence of the COVID-19 lockdown on regular physical exercise habits in multiple chronic diseases. Dtsch Z Sportmed. 2021; 72: 365-372. doi:10.5960/dzsm.2021.495.
- Khan AH, Sultana MS, Hossain S, et al. The impact of COVID-19 pandemic on mental health & wellbeing among home-quarantined Bangladeshi students: A cross-sectional pilot study. J. Affect. Disord. 2020, 277, 121–128.
- Idowu A, Olawuyi DA, Nwadioke CO. Impacts of covid-19 pandemic on the psychological wellbeing of students in a Nigerian university. JMSR 2020, 7, 798–806.
- Gundendi Z, Yurdakul FG, Bodur H, et al. The impact of COVID 19 on familial Mediterranean fever: a nationwide study. Rheumatology International (2021) 41:1447–1455.
- Jiang R. Knowledge, attitudes and mental health of university students during the COVID-19 pandemic in China. Child. Youth Serv. Rev. 2020, 119, 105494.
- Faize FA, Husain W. Students with severe anxiety during COVID-19 lockdown—Exploring the impact and its management. J. Ment. Health Train. Educ. Pract. 2021, 16, 153–163.
- Karahan AY, Kucuk A, Balkarli A, et al. Alexithymia, depression, anxiety levels and quality of life in patients with rheumatoid arthritis. Acta med. Mediterr 2016: 32 (5); 1675–1682.
- Cellini N, Canale N, Mioni G, Costa S. Changes in sleep pattern, sense of time and digital media use during COVID-19 lockdown in Italy. J. Sleep Res. 2020, 29, e13074.
- Bennett G, Young E, Butler I, Coe S. The Impact of Lockdown During the COVID-19 Outbreak on Dietary Habits in Various Population Groups: A Scoping Review. Front Nutr. 2021 Mar 4; 8:626432. doi: 10.3389/fnut.2021.626432.
- Zhao A, Li Z, Ke Y, et al. Dietary diversity among chinese residents during the COVID-19 outbreak and its associated factors. Nutrients. (2020) 12:1–13. doi: 10.3390/nu12061699.
- Zachary Z, Brianna F, Brianna L, et al. Self-quarantine and weight gain related risk factors during the COVID-19 pandemic. Obes Res Clin Pract. (2020) 14:210–6. doi: 10.1016/j.orcp.2020.05.004.
- Karahan FS, Hamarta E, Karahan AY. An anthropological contribution about ageism: Attitudes of elder care and nursing students in Turkey towards ageism. Stud Ethno-Medicine. 2016; 10(1):59–64.
- Erkeç Alkan S, Duyur Çakıt B, Salbaş E, Genç H. The Effects Of Vitamin D On Muscle Strength And Functional Status Of The Elderly Patients With Knee Osteoarthritis. Ege Tıp Bilimleri Dergisi. 2020; 3(2): 46-53.
- Bulut N, Ölmez Budak F, Taşkapan MÇ. Retrospective Analysis of Vitamin D Levels in Patients with Chronic Renal Failure, Obesity, and Cancer. Ege Tıp Bilimleri Dergisi. 2021; 4(2): 52-60.
- Pearson N. Biddle SJH. Sedentary behavior and dietary intake in children, adolescents, and adults: a systematic review. Am J Prev Med. (2011) 41:178–88. doi: 10.1016/j.amepre.2011.05.002.
- Bracale R, Vaccaro CM. Changes in food choice following restrictive measures due to Covid-19. Nutr Metab Cardiovasc Dis. (2020) 30:1423–6. doi: 10.1016/j.numecd.2020.05.027.
- Ruiz-Roso MB, Padilha P de C, Mantilla-Escalante DC, et al. Covid-19 confinement and changes of adolescent’s dietary trends in Italy, Spain, Chile, Colombia and Brazil. Nutrients. (2020) 12:1–18. doi: 10.3390/nu12061807.
The Effects of Lockdowns and Restrictions During the COVID-19 Pandemic: Perspectives and Experiences From Ankylosing Spondylitis patients.
Year 2022,
Volume: 32 Issue: 3, 265 - 271, 01.08.2022
Barış Uzunok
,
Ender Salbaş
,
Kaan Özpazarcık
,
Burçin Çobanoğlu
,
Simge Kaynar
,
Nil Demircan
,
Cavit Yazgan
,
Alper Yıldırım
Abstract
OBJECTIVE: The COVID-19 pandemic has been affecting our world and all people for 2 years and It has been the subject of many studies that have been published in the literature. Common result of these studies is that the pandemic has increased people's stress levels and also many papers report the negative impact of the pandemic on private patient populations, such as those with chronic diseases, but there are no clinical studies in Turkey that have revealed the effects of pandemic restrictions on patients with rheumatic diseases yet. Our study aims to evaluate the effects of quarantine and restrictions imposed during the COVID-19 pandemic on patients with Ankylosing Spondylitis.
METHOD: This study was carried out in the USAK province of Turkey with patients with ankylosing spondylitis aged 18-65 years. After a detailed literature review, a 35-question questionnaire was prepared. This survey was aimed at determining the treatment routines and habits of patients during the COVID-19 restriction period, such as exercise and nutritional status. At the same time, the effects of the closure and restriction period on the mental health of patients were investigated.During this period, the availability of doctors and medicines of patients was questioned.
RESULTS: All participants reported an impact of lockdown. 43.7% reported lesser exercising levels than before the lockdown. These patients mainly consumed more vitamin C (65.7), as media advice for the public. However, despite specialist advice, some patients consumed more alcohol (21.4%). 78% of the patients reported sleep-wake rhythms markedly changed under restriction and the majority of patients could not go to a rheumatologist for follow-up.
CONCLUSION: The majority of the AS did not consult specialists or physicians during the lockdown period but most of them continued their medications to control the disease activity.
Project Number
192-192-03
References
- Cielo F, Ulberg R, Di Giacomo D. Psychological Impact of the COVID-19 Outbreak on Mental Health Outcomes among Youth: A Rapid Narrative Review. Int J Environ Res Public Health. 2021 Jun 4; 18 (11): 6067. doi: 10.3390/ijerph18116067.
- Pogany L, Horvath AA, Slezak A, Rozsavolgyi E, Lazary J. A COVID-19 járvány miatt elrendelt első veszélyhelyzet a pszichiátriai betegek szemszögéből: gondozói felmérés [The first lockdown due to COVID-19 pandemic from the psychiatric patients' perspective: an ambulatory care client experience survey]. Neuropsychopharmacol Hung. 2020 Dec; 22 (4): 144-153.
- Wolf MS, Serper M, Opsasnick L, et al. Awareness, attitudes, and actions related to COVID-19 among adults with chronic conditions at the onset of the US outbreak: a cross-sectional survey. Annals of internal medicine, 2020; 173 (2), 100-109.
- O'Conor R, Opsasnick L, Benavente JY, et al. Knowledge and Behaviors of Adults with Underlying Health Conditions During the Onset of the COVID-19 U.S. Outbreak: The Chicago COVID-19 Comorbidities Survey. J Community Health. 2020; 45 (6):1149-1157. doi: 10.1007/s10900-020-00906-9.
- Jones J, Sullivan PS, Sanchez TH, et al. Similarities and Differences in COVID-19 Awareness, Concern, and Symptoms by Race and Ethnicity in the United States: Cross-Sectional Survey. J Med Internet Res. 2020; 22 (7): e20001. doi: 10.2196/20001.
- Treharne G, Johnstone G, Fletcher BD, et al. Fears about COVID‐19 and perceived risk among people with rheumatoid arthritis or ankylosing spondylitis following the initial lockdown in Aotearoa New Zealand. 2021, Musculoskeletal Care, 1–9. https://doi.org/10.1002/msc.1585.
- Antony A, Connelly K, De Silva T, et al. Perspectives of Patients with Rheumatic Diseases in the Early Phase of COVID-19. Arthritis Care Res (Hoboken). 2020 Sep; 72 (9): 1189-1195. doi: 10.1002/acr.24347.
- Richez C, Flipo RM, Berenbaum F, et al. Managing patients with rheumatic diseases during the COVID-19 pandemic: The French Society of Rheumatology answers to most frequently asked questions up to May 2020. Joint Bone Spine. 2020 Oct; 87 (5): 431-437. doi: 10.1016/j.jbspin.2020.05.006.
- Antony A, Connelly K, De Silva T, et al. Perspectives of patients with rheumatic diseases in the early phase of COVID‐19. Arthritis Care & Research, 2020; 72 (9), 1189–1195. https://doi.org/10.1002/acr.24347.
- WHO/Europe. Coronavirus Disease (COVID-19) Outbreak. Available online at: https://www.euro.who.int/en/health- topics/health- emergencies/ coronavirus- covid- 19 (Jan 2021).
- Karahan F, Hamarta E, Karahan AY, The Turkish adaptation and psychometric properties of the geriatric anxiety scale. Mental Illness, 2018: 10:1-5. 10.4081/mi.2018.7580.
- Akkoc Y, Karatepe AG, Akar S, Kirazli Y, Akkoc N. A Turkish version of the Bath Ankylosing Spondylitis Disease Activity Index: reliability and validity. Rheumatol Int 2005; 25: 280-284.
- Karahan AY, Bagcaci S, Salbas E, et al. The assessment of knowledge level about their disease in patients with rheumatoid arthritis. J Clin Exp Invest. 2014; 5: 429-34.
- Alkan S, Yıldız E, Çinpolat HY, Oğuz Mızrakçı S. Presepsin ve COVID 19: Literatürün gözden geçirilmesi. Ege Tıp Bilimleri Dergisi. 2021; 4 (2): 69-72.
- Zhu N, Zhang D, Wang W, et al. A Novel Coronavirus from Patients with Pneumonia in China, 2019. N. Engl. J. Med. 2020, 382, 727–733.
- Shrestha N, Shad MY, Ulvi O, et al. The impact of COVID-19 on globalization. One Health 2020, 11, 100180.
- Fiorillo A, Gorwood P. The consequences of the COVID-19 pandemic on mental health and implications for clinical practice. Eur. Psychiatry 2020, 63, 1–4.
- Rossi R, Socci V, Talevi D, et al. COVID-19 pandemic and lockdown measures impact on mental health among the general population in Italy. Front. Psychiatry 2020, 11, 790.
- Kang L, Ma S, Chen M, et al. Impact on mental health and perceptions of psychological care among medical and nursing staff in Wuhan during the 2019 novel coronavirus disease outbreak: A cross-sectional study. Brain Behav. Immun. 2020, 87, 11–17.
- Karahan Ay, Tok F, Yildirim P, et al. The Effectiveness of Exergames in Patients with Ankylosing Spondylitis: A Randomized Controlled Trial. Adv Clin Exp Med 2016; 25 (5): 931–936. DOI: 10.17219/acem/32590.
- Maxwell LJ, Zochling J, Boonen A, et al. TNF-alpha inhibitors for ankylosing spondylitis. Cochrane Database Syst Rev. 2015 Apr 18; (4): CD005468. doi: 10.1002/14651858.CD005468.
- Annapureddy N, Nalleballe K, Onteddu SR, et al. Biologics in systemic autoimmune diseases during COVID-19 pandemic. Clin Rheumatol. 2020; 39 (12): 3529-3531. doi: 10.1007/s10067-020-05439-z.
- Rosenbaum JT, Hamilton H, Choi D, et al. Biologics, spondylitis and COVID-19. Ann Rheum Dis. 2020; 79 (12): 1663-1665. doi: 10.1136/annrheumdis-2020-217941.
- Brito CA, Paiva JG, Pimentel FN, Guimarães RS, Moreira MR. COVID-19 in patients with rheumatological diseases treated with anti-TNF. Ann Rheum Dis. 2020 Jun 16: annrheumdis-2020-218171. doi: 10.1136/annrheumdis-2020-218171.
- Monti S, Balduzzi S, Delvino P, et al. Clinical course of COVID-19 in a series of patients with chronic arthritis treated with immunosuppressive targeted therapies. Ann Rheum Dis. 2020; 79 (5): 667-668. doi: 10.1136/annrheumdis-2020-217424.
- Haberman R, Axelrad J, Chen A, et al. COVID-19 in immune-mediated inflammatory diseases—case series from New York. N Engl J Med. 2020; 383 (1): 85-88. doi: 10.1056/NEJMc2009567.
- Constandt B, Thibaut T, De Bosscher V, et al. Exercising in Times of Lockdown: An Analysis of Impact of COVID-19 on Levels and Patterns of Exercise among Adults in Belgium. Int. J. Environ. Res. Public Health 2020, 17, 4144.
- Schweda S, Krauss I. The influence of the COVID-19 lockdown on regular physical exercise habits in multiple chronic diseases. Dtsch Z Sportmed. 2021; 72: 365-372. doi:10.5960/dzsm.2021.495.
- Khan AH, Sultana MS, Hossain S, et al. The impact of COVID-19 pandemic on mental health & wellbeing among home-quarantined Bangladeshi students: A cross-sectional pilot study. J. Affect. Disord. 2020, 277, 121–128.
- Idowu A, Olawuyi DA, Nwadioke CO. Impacts of covid-19 pandemic on the psychological wellbeing of students in a Nigerian university. JMSR 2020, 7, 798–806.
- Gundendi Z, Yurdakul FG, Bodur H, et al. The impact of COVID 19 on familial Mediterranean fever: a nationwide study. Rheumatology International (2021) 41:1447–1455.
- Jiang R. Knowledge, attitudes and mental health of university students during the COVID-19 pandemic in China. Child. Youth Serv. Rev. 2020, 119, 105494.
- Faize FA, Husain W. Students with severe anxiety during COVID-19 lockdown—Exploring the impact and its management. J. Ment. Health Train. Educ. Pract. 2021, 16, 153–163.
- Karahan AY, Kucuk A, Balkarli A, et al. Alexithymia, depression, anxiety levels and quality of life in patients with rheumatoid arthritis. Acta med. Mediterr 2016: 32 (5); 1675–1682.
- Cellini N, Canale N, Mioni G, Costa S. Changes in sleep pattern, sense of time and digital media use during COVID-19 lockdown in Italy. J. Sleep Res. 2020, 29, e13074.
- Bennett G, Young E, Butler I, Coe S. The Impact of Lockdown During the COVID-19 Outbreak on Dietary Habits in Various Population Groups: A Scoping Review. Front Nutr. 2021 Mar 4; 8:626432. doi: 10.3389/fnut.2021.626432.
- Zhao A, Li Z, Ke Y, et al. Dietary diversity among chinese residents during the COVID-19 outbreak and its associated factors. Nutrients. (2020) 12:1–13. doi: 10.3390/nu12061699.
- Zachary Z, Brianna F, Brianna L, et al. Self-quarantine and weight gain related risk factors during the COVID-19 pandemic. Obes Res Clin Pract. (2020) 14:210–6. doi: 10.1016/j.orcp.2020.05.004.
- Karahan FS, Hamarta E, Karahan AY. An anthropological contribution about ageism: Attitudes of elder care and nursing students in Turkey towards ageism. Stud Ethno-Medicine. 2016; 10(1):59–64.
- Erkeç Alkan S, Duyur Çakıt B, Salbaş E, Genç H. The Effects Of Vitamin D On Muscle Strength And Functional Status Of The Elderly Patients With Knee Osteoarthritis. Ege Tıp Bilimleri Dergisi. 2020; 3(2): 46-53.
- Bulut N, Ölmez Budak F, Taşkapan MÇ. Retrospective Analysis of Vitamin D Levels in Patients with Chronic Renal Failure, Obesity, and Cancer. Ege Tıp Bilimleri Dergisi. 2021; 4(2): 52-60.
- Pearson N. Biddle SJH. Sedentary behavior and dietary intake in children, adolescents, and adults: a systematic review. Am J Prev Med. (2011) 41:178–88. doi: 10.1016/j.amepre.2011.05.002.
- Bracale R, Vaccaro CM. Changes in food choice following restrictive measures due to Covid-19. Nutr Metab Cardiovasc Dis. (2020) 30:1423–6. doi: 10.1016/j.numecd.2020.05.027.
- Ruiz-Roso MB, Padilha P de C, Mantilla-Escalante DC, et al. Covid-19 confinement and changes of adolescent’s dietary trends in Italy, Spain, Chile, Colombia and Brazil. Nutrients. (2020) 12:1–18. doi: 10.3390/nu12061807.