To save content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about saving content to .
To save content items to your Kindle, first ensure no-reply@cambridge.org
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about saving to your Kindle.
Note you can select to save to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
The Moving Epidemic Method (MEM) is the ECDC/WHO-Europe-endorsed approach for establishing influenza epidemic thresholds and intensity levels, yet no positivity-based MEM analysis exists for Türkiye or any country in the WHO Western Asia transmission zone. Weekly influenza positivity rates from FluNet sentinel surveillance were analysed for ten of twelve seasons (2013/2014–2024/2025, excluding two COVID-19 pandemic seasons) using the mem R package with cross-validated optimized slope parameter, and Türkiye’s average epidemic curve and thresholds were compared with the Western Asia (excluding Türkiye) and South West Europe zones using Lin’s concordance correlation coefficient (CCC), root mean square deviation (RMSD) and complementary correlation metrics. The epidemic threshold was 10.59% positivity, with intensity thresholds at 42.56% (medium), 60.92% (high), and 71.38% (very high); cross-validated sensitivity was 0.77, specificity 0.88, and Matthews correlation coefficient 0.65. Türkiye’s average curve showed higher concordance with Western Asia (CCC=0.890; RMSD=4.22 percentage points) than South West Europe (CCC=0.672; RMSD=12.48) despite similar Pearson correlations (0.922 vs. 0.939), and the Western Asia epidemic threshold (11.50%) closely matched Türkiye’s. These first operational MEM thresholds for Türkiye and the first positivity-based thresholds for the Western Asia zone confirm alignment with the current WHO transmission zone classification and support integration into routine surveillance.
This study aimed to examine breastfeeding continuity and the factors influencing breastfeeding among women whose breastfeeding period overlapped with the earthquakes centered in Kahramanmaraş, Türkiye, on February 6, 2023.
Methods
This descriptive study was conducted in tent and container settlements established in earthquake-affected areas. The sample included 217 women who were breastfeeding at the time of the disaster. Data were collected using a structured form addressing sociodemographic, obstetric, and breastfeeding-related variables. Descriptive statistics (frequency, percentage, mean, and standard deviation) were applied in accordance with the STROBE guidelines.
Results
The mean age of participants was 28.45 ± 5.45 years; most were unemployed (95.4%) and reported that their income was lower than their expenses (78.8%). Before the earthquake, 59.0% of the women exclusively breastfed, whereas this rate decreased to 30.9% after the disaster. The most common facilitators were mothers’ motivation to keep their infants alive (29.5%) and access to transportation (20.3%). The primary barriers were unmet basic needs (30.4%), lack of privacy (22.6%), and psychological distress (21.7%). Overall, 67.3% of the women emphasized that meeting basic needs was essential for continuing breastfeeding, while only 17.5% reported receiving breastfeeding counseling.
Conclusions
This study revealed significant barriers to health care access among breastfeeding women following a major disaster. The findings highlight the necessity of incorporating breastfeeding women into disaster preparedness and response plans. Disaster interventions should prioritize safe environments, psychosocial support, and professional counseling to ensure breastfeeding continuity. Protecting breastfeeding must be recognized as a strategic public health priority within disaster preparedness and response.
The dietary phytochemical index (DPI), an alternative and practical marker for assessing dietary phytochemical intake, has not previously been investigated in relation to primary dysmenorrhoea (PD). This study aimed to investigate the association between the DPI and PD in women university students in Niğde, Türkiye. The sample of this cross-sectional study consisted of women university students aged 19–35 years. The study data were collected through face-to-face interviews using a questionnaire. The questionnaire included general information about the students, dietary intake, the short form of the International Physical Activity Questionnaire, and the Visual Analog Scale. The DPI was calculated from the participants’ food consumption records (DPI = energy from foods rich in phytochemicals (kcal/day)/total energy intake (kcal/day) × 100). Of the 362 women university students who participated in the study, the prevalence of PD was 83.9%. Those affected had higher waist circumference and dietary energy intake, but lower potassium and magnesium intake and DPI (p < 0.05). Students with severe pain were more likely to have a lower DPI (p < 0.05). The results of this study showed that the prevalence of PD a was quite high among students and that the DPI was associated with PD. These findings suggest a potential role of foods rich in dietary phytochemicals in alleviating PD, although causal relationships cannot be established due to the cross-sectional design of the study.
This article presents a recently discovered multipurpose agricultural processing facility constructed within the Small Bath at Antiochia ad Cragum in Türkiye. We argue that the Bath was transformed for the production of wine and olive oil in Late Antiquity, representing the best-preserved and largest-capacity agricultural facility recorded at this urban site. The remarkable discovery of in situ processing equipment continues to develop our understanding of the extensive repurposing of monumental public architecture for agricultural and artisanal production at Antiochia. Discussion in this article sets the excavated complex within a broader context of local viniculture, oleiculture, ceramic production and export, showing how these networks of activity operated together, and underscores investment priorities between the 4th and 6th c. CE. This story of adaptation, resilience, and repurposing ultimately also provides potential insight into the owners and operators of this space.
Archaeology is increasingly shaped by institutional pressures that privilege speed, monumentality and tourist appeal. At Comana, Türkiye, the Covid-19 pandemic created an opportunity to adopt a slower, more deliberate pace of investigation. Here, the author reflects on how practices adopted during this period promoted a deeper engagement with ritual landscapes through embodied interaction with the land and local community. This experience is used to support the argument that slowing down can resist institutional pressures and renew the discipline’s capacity for thoughtful, contextually grounded understanding; slow archaeology could be seen as a form of best practice under conditions of institutional acceleration.
Online platforms have become indispensable tools for political candidates to gain visibility, particularly for female candidates in electoral autocracies who often lack access to traditional networks, party hierarchies, and media platforms. We argue that online visibility, while a resource for female candidates, disproportionately exposes them to online violence that functions as a mechanism of political control, reinforcing patriarchal exclusion from the political sphere. Our analysis draws on more than three million tweets directed at 1,834 candidates across the 2023 parliamentary and 2024 local election campaigns in Türkiye, providing a rare opportunity to observe how these dynamics unfold at both the national and subnational levels. We find that while online visibility increases abuse for all candidates, the effect is markedly stronger for female candidates, who are disproportionately targeted across diverse forms of violence, including profanity, demeaning and ridiculing language, physical threats, and ethnic and religious hate speech. Moreover, our results suggest that in local elections, where candidates rely more heavily on personalized campaigns, increases in visibility are more strongly associated with female candidates’ exposure to online violence.
This article examines how artificial intelligence (AI) impacts state sovereignty and the balance between innovation and control in AI governance through a case study of Türkiye. As AI technologies become increasingly sophisticated, they challenge traditional notions of sovereignty, creating tensions between fostering innovation and maintaining regulatory control. The concept of “AI sovereignty” encompasses a state’s ability to exercise meaningful control over AI infrastructure, data resources, regulatory frameworks, and technological capabilities. Türkiye’s AI strategy illustrates how “middle powers” navigate this balance, especially as it stands at the crossroads of Europe and Asia, requiring Türkiye to develop distinct approaches that reflect its unique geopolitical position. The analysis reveals that sovereignty in the AI domain encompasses multiple dimensions—technical capabilities, regulatory frameworks, and strategic positioning—requiring adaptable governance approaches. The findings offer insights for jurisdictions seeking to balance innovation imperatives with control mechanisms while maintaining strategic autonomy in an evolving global AI landscape.
The parasite fauna of Sardina pilchardus from the Black Sea coast of Türkiye was investigated. The parasitological survey was conducted on a total of 136 fish collected monthly from October 2024 to May 2025. A total of 7 parasite species were recovered: 5 digeneans (comprising 3 adult stages and 2 metacercarial stages), 1 larval nematode and 1 coccidian. The identified taxa included the adult digeneans Pronoprymna ventricosa, Lecithaster confusus and Aphanurus stossichii, metacercariae Stephanostomum sp. and Renicola sp., nematode Hysterothylacium aduncum, and coccidian Eimeria sardinae. Prevalence (%) and infection intensity indices were determined for each parasite species. Overall infection prevalence (82.35%), mean intensity (8.28 ± 0.74) and mean abundance (6.82 ± 0.67) were calculated. Infection parameters for each parasite species were determined and statistically compared across fish length groups, seasons, sex and host body condition factor. The results revealed that parasite abundance and intensity varied significantly among fish length groups and seasons, whereas no significant correlations were found with host body condition or fish sex. Spearman’s correlation analysis was performed to examine co-occurrence patterns among parasite species. A moderate positive correlation was detected between H. aduncum and Stephanostomum sp. (r = 0.494, P < 0.01). In contrast, associations among other parasite species were weak or negligible, indicating largely independent occurrence. Except for H. aduncum, all identified species represent new host records for this species in the Black Sea and Türkiye. Notably, Renicola sp. constitutes the first record of this genus for the parasite fauna of Türkiye.
This study examines clay fragments found at Çemka Höyük, a Pre-Pottery Neolithic site in Mardin, Türkiye (tenth millennium BC). Analysis of mineral inclusions in the clay matrix indicates that these fragments may have been deliberately fired, representing an early example of ceramic technology in South-west Asia. The diversity of forms identified and their likely uses suggest, the authors argue, a formative phase in ceramic innovation during which the properties and potential applications of clay were explored by the local community and adopted and adapted within existing social and economic traditions in advance of widespread application in the seventh millennium BC.
Despite extensive research on asbestos mineralogy and health impacts, comprehensive multi-analytical characterization of naturally occurring asbestos (NOA) in ophiolitic mélanges of central Türkiye is still lacking. The present study examines asbestos-form minerals within the ophiolitic mélange northeast of Kıraman village (Karaman, Türkiye), with a focus on chrysotile, tremolite, and talc. These minerals were formed through intensive alteration processes, including serpentinization, talc formation, listwanitization, chloritization, carbonation, and silicification. The main objective was to characterize the mineralogical, morphological, and chemical features of asbestos-form serpentine and amphibole minerals and to evaluate their potential environmental and health implications. Analytical techniques such as optical microscopy, X-ray diffraction (XRD), differential thermal analysis–thermogravimetry (DTA–TG), Fourier-transform infrared (FTIR) and Raman spectroscopy, as well as scanning and transmission electron microscopy with energy-dispersive X-ray spectroscopy (SEM–EDX, TEM–EDX), were employed. The results confirmed the presence of nearly pure chrysotile, talc, and tremolite. Thermal and vibrational analyses revealed characteristic dehydroxylation reactions and diagnostic spectral bands. The SEM and TEM imaging displayed fibrous and acicular morphologies, while TEM–EDX confirmed typical chemical compositions, including minor Fe content (3–5%). Both chrysotile and tremolite fibers exhibited dimensions within the respirable range and elemental characteristics that are commonly associated with increased toxicity in asbestos minerals. The co-existence of Fe-bearing chrysotile and respirable-size tremolite fibers indicates a potential for asbestos-related health risks under conditions of environmental disturbance or exposure. These findings underscore the need for environmental monitoring and suggest the regional geological formations are a potential public health concern.
Karacadağ rice is a local variety with significant genetic diversity, cultivated for centuries in the Karacadağ basin of South-eastern Anatolia (Türkiye) using traditional methods. The production system relies on basalt stone fields, minimal tillage, no chemical inputs, and irrigation with melted snow waters directed through natural channels. Harvesting is conducted manually using sickles. This rice variety has adapted to the region’s hot and arid climate, demonstrating resilience to pests, diseases, and environmental stresses. Key features of the Karacadağ Rice Production System include its harmony with natural flora, crop rotation practices, contribution to biodiversity, and alignment with the socio-cultural fabric of the region. The Karacadağ steppes are ecologically significant, hosting wild relatives of cultivated crops, including wheat, and supporting rich biodiversity. Additionally, the region’s cultural richness is enhanced by nomadic communities engaged in pastoralism. Preserving this production system contributes to maintaining agricultural biodiversity, protecting the natural environment, and safeguarding the socio-cultural heritage of the area. This study was conducted within the framework of the Management Plan for the Karacadağ Steppes, a pilot area of the ‘Conservation and Sustainable Management of Steppe Ecosystems in Turkey’ project (2017–2021) to support the sustainable conservation and management of the Karacadağ Rice Production System. Using the Globally Important Agricultural Heritage Systems (GIAHS) framework, the system was evaluated against five key criteria, major pressures and changing trends were identified, and inputs were provided for a management plan aimed at enhancing its resilience and sustainability under ongoing socio-economic and environmental change.
Health care workers (HCWs) are vital in disaster response. This study explores HCWs’ experiences delivering care in the earthquake-affected zone in Türkiye.
Methods
A qualitative study with a phenomenological design was conducted. Eighteen HCWs, including physicians, nurses, and National Medical Rescue Team (UMKE) members, were selected through maximum variation sampling. Data were collected through semi-structured interviews and analyzed thematically using Braun and Clarke’s 6-phase approach, following COREQ guidelines.
Results
Three periods (pre-arrival, in the earthquake zone, and post-departure) and 8 themes were identified. In the pre-arrival phase, emotional symptoms and general organization were the main themes. In the earthquake zone, physical symptoms, basic needs, health care organization, health care delivery, and other services were prominent. The post-departure phase focused on emotional symptoms and return to routine work. Overall, emotional difficulties persisted throughout all phases, while organizational problems were concentrated in the pre-arrival and in the earthquake zone periods.
Conclusion
HCWs experienced emotional challenges across all periods and organizational problems in the pre-arrival and in the earthquake zone period. Clear information before arrival, structured orientation upon arrival, balanced staff distribution, and continuous psychological support throughout all phases are essential to protect HCWs’ well-being and sustain health care delivery during disasters.
This chapter explores bias and fairness in employment testing in Türkiye across governmental and private sectors. It distinguishes fairness – equal opportunity, transparency, and uniform outcomes – from bias, especially in relation to predictive validity. The chapter situates these issues within Türkiye’s cultural, ethnic, and socioeconomic landscape, examining how historical and regional factors shape perceptions and practices. Key legal and regulatory frameworks, such as Turkish Labor Law and constitutional mandates, are reviewed to highlight protections for equal treatment. It also evaluates bias detection methods, including differential item functioning, sensitivity reviews, and predictive bias analyses, and discusses challenges from emerging technologies such as the use of artificial intelligence in personnel selection. The chapter underscores the need for strong validity evidence and proactive strategies to promote fair and equitable hiring in Türkiye.
Syrian refugee women face numerous obstacles that impact their reproductive health. The aim is to assess prevalence and predictors of miscarriage and induced abortion among Syrian refugee women in Türkiye.
Methods
This study is a cross-sectional analysis based on data from 1886 Syrian refugee women aged 15-49 who have a history of marriage, obtained from the 2018 Türkiye Demographic and Health Survey – Syrian Migrant Sample. Univariate Chi-square, independent t-test, and multivariate logistic regression were performed to determine predictors of abortion and miscarriage.
Results
Among ever married Syrian refugee women, 27.3% (n = 514) experienced at least 1 miscarriage, 5% (n = 95) reported having at least 1 abortion. Mean maternal age was predicted with miscarriage and induced abortion (OR = 1.06 [CI: 1.04-1.08; P < 0.001] and OR = 1.08 [CI: 1.04-1.12; P < 0.001] respectively). Women in the southern/eastern region of Türkiye experienced 4.24 times (95% CI = 1.50-12.02; P < 0.01) more abortions than in the western/central region. Women who are related to their spouses had an abortion 1.91 times (95% CI = 1.06-3.43; P < 0.05) more frequently than non-related couples.
Conclusions
The rate of miscarriages and induced abortions is high among Syrian refugee women in Türkiye. Regional differences, maternal age, and marriage between relatives have been identified as important variables that need to be taken into consideration. Interventions concentrating on those elements by the bodies concerned may thereby lessen the burden and effects of abortion and miscarriage.
Comprising the largest group of health care professionals, nurses play a great role and assume many responsibilities during disaster periods, when the public needs health care services the most. The aim of this study was to reveal the experiences of nurses assigned to the disaster area during relief efforts after the February 6, 2023 earthquakes in Türkiye.
Methods
This qualitative and descriptive study used the maximum variation sampling method, one of the purposive sampling methods, and was completed with 20 nurses. Data were analyzed using inductive content analysis.
Results
Four main themes emerged from the experiences of the nurses who provided health care services in the disaster area: experiences related to pre-mission processes, experiences during the mission, post-mission experiences, and recommendations for disaster preparedness.
Conclusions
Nurses’ experiences and suggestions revealed in this study may inform future disaster preparedness and disaster management plans, and this study’s results point to the need for the development of professional nursing skills in disaster management.
The present study was conducted to determine self-management and influencing factors in dialysis patients who experienced the earthquake.
Methods
The study was conducted descriptively with 125 patients receiving dialysis in a city affected by the earthquake in Türkiye. Data were collected with the “Personal Information Form” and the “Chronic Illness Self-Management Scale” (CISMS). Kolmogorov-Smirnov, Mann Whitney U, Kruskall Wallis, Spearman Correlation tests, Wilcoxon, and Linear Regression were used in the statistical analysis.
Results
The study found that 9.6% of the patients were trapped under the rubble in the earthquake, 71.2% lost a relative, 43.8% changed dialysis centers, 36.8% missed dialysis sessions, and 51.2% could not comply with the diet after the earthquake. Women (p < 0.001), those with secondary school or lower educational levels (p < 0.05), those with another chronic disease, and those who lost a relative in the earthquake had lower health care maintenance efficacy (p < 0.05). The treatment adherence of those who adhered to the diet was higher than those who did not (p < 0.05).
Conclusion
It was determined that the level of self-stigma of the patients after the earthquake was low, their treatment adherence was high, and there were many variables affecting their self-management.
Türkiye is a country with many seismic fault lines and has experienced major earthquakes throughout its history. In history, 2 major earthquakes occurred in Kahramanmaraş province in 1544 and 1795, causing serious destruction and damage. On February 6, 2023, 2 major earthquakes of 7.7 Mw and 7.6 Mw occurred, centered in Kahramanmaraş (Elbistan and Pazarcık). This great disaster affected 11 cities (about 14 million people), mostly Kahramanmaraş, Hatay, and Malatya. According to the latest official report, it resulted in 50 783 deaths and more than 122 000 injuries.1,2
On February 6, 2023, 7.7 and 7.6 magnitude earthquakes struck southeastern Türkiye, affecting 11 provinces and causing significant losses. This study aims to assess the mental health status of survivors in the twelfth month after the earthquake.
Methods
A cross-sectional study was conducted using an online survey with the virtual snowball sampling method. The survey included sociodemographic data, previous traumas, earthquake-related experiences, and the Post-Earthquake Trauma Level Determining Scale (PETLDS) and Hospital Anxiety and Depression Scale.
Results
The study included 2544 participants. The mean PETLDS score was 58.14±18.18, indicating that the participants were highly traumatized. Among them, 59.5% had high levels of post-traumatic symptoms, 44.2% had high anxiety, and 61% had high depression symptoms. 35.77% of participants displayed a co-occurrence of post-traumatic stress along with anxiety and depression. Female gender was the strongest predictor of high-level trauma and anxiety, while a history of psychiatric disorder was the strongest predictor of depression. Multiple logistic regression analysis indicated that symptoms were predicted by low income, low education level, smoking, comorbid chronic diseases, past traumatic experiences, the loss or injury of a loved one due to the earthquake, personal injury, temporary displacement, and damage to homes and workplaces.
Conclusions
The findings suggest that one year after the earthquake, mental health problems are prevalent among survivors, highlighting the need for urgent psychiatric interventions.
This study aimed to investigate the relationship between pre-earthquake and earthquake-related characteristics and post-earthquake trauma levels of individuals affected by the February 6, 2023 Kahramanmaraş earthquakes.
Methods
The study is in survey design, one of the quantitative research methods. The participants consist of individuals affected by the earthquake and staying in temporary accommodation centers (student dormitories) in Konya province. A survey including a personal information form and a scale for determining the Post-Earthquake Trauma Levels was administered face to face to 334 volunteer participants.
Results
Adults aged 30-46, those trapped under debris, those injured in the earthquake, those who lost a family member, a relative, a neighbour or a friend, and those who received psychological support after the earthquake are in the risk group in terms of high post-earthquake trauma levels.
Conclusions
The findings reveal the groups in which the traumatic effects of earthquakes on adults are high. It is important to prepare intervention programs by considering the needs of these groups in psychosocial interventions to be carried out after the earthquake.