The Validity and Reliability of the Turkish Version of the Autism Family Experience Questionnaire (AFEQ)

The aim of this study was to examine the reliability and validity of the Turkish version of the AFEQ for Turkish parents of children with ASD. The Turkish-translated version of the AFEQ was administered to 241 parents of children aged 2-12 years with ASD to examine the construct validity and internal consistencies. Parents completed the Autism Behavior Checklist (ABC), and Quality of Life in Autism Questionnaire Parent version, along with the AFEQ. The mean age of the children of 241 individuals in the study group was 7.63 ± 3.02 and 88.4% (n = 213) were male. Cronbach's alpha coefficient was 0.921 of the total variance. Cronbach alpha coefficients are 0.813 for the "Experience of being a parent" subscale, 0.768 for the "Family Life" subscale, 0.810 for the "Child Development, Understanding and Social Relationships" subscale, and 0.804 for the "Child Symptoms (Feelings and Behaviour)" subscale. In conclusion, the translated and culturally adapted AFEQ shows good reliability and validity to measure the priorities of autistic children and their families in Turkey. It can also be useful in monitoring the effectiveness of intervention programs and changes in the child.

Push and Pull Factors of Why Medical Students Want to Leave Türkiye: A Countrywide Multicenter Study

Phenomenon: Physician immigration from other countries is increasing as developed countries continue to be desirable destinations for physicians; however, the determinants of Turkish physicians' migration decisions are still unclear. Despite its wide coverage in the media and among physicians in Türkiye, and being the subject of much debate, there is insufficient data to justify this attention. With this study, we aimed to investigate the tendency of senior medical students in Türkiye to pursue their professional careers abroad and its related factors. Approach: This cross-sectional study involved 9881 senior medical students from 39 different medical schools in Türkiye in 2022. Besides participants' migration decision, we evaluated the push and pull factors related to working, social environment and lifestyle in Türkiye and abroad, medical school education inadequacy, and personal insufficiencies, as well as the socioeconomic variables that may affect the decision to migrate abroad. The analyses were carried out with a participation rate of at least 50%. Findings: Of the medical students, 70.7% had emigration intentions. Approximately 60% of those want to stay abroad permanently, and 61.5% of them took initiatives such as learning a foreign language abroad (54.5%) and taking relevant exams (18.9%). Those who wanted to work in the field of Research & Development were 1.37 (95% CI: 1.22-1.54) times more likely to emigrate. The push factor that was related to emigration intention was the "working conditions in the country" (OR: 1.89, 95% CI: 1.56-2.28) whereas the "social environment/lifestyle abroad" was the mere pull factor for the tendency of emigration (OR: 1.73, 95% CI: 1.45-2.06). In addition, the quality problem in medical schools also had a significant impact on students' decisions (OR: 2.20, 95% CI: 1.83-2.65). Insights: Although the percentage of those who want to emigrate "definitely" was at the same level as in the other developing countries, the tendency to migrate "permanently" was higher in Türkiye. Improving working conditions in the country and increasing the quality of medical faculties seem vital in preventing the migration of physicians.

Evaluation of Relationship Between Cyberchondria and Obsessive Beliefs in Adults

OBJECTIVE

The aim of this study was to evaluate the relationship between cyberchondria and obsessive beliefs and determine the potential risk of the former.

METHODS

This was a cross-sectional study conducted with 777 individuals. The Cyberchondria Severity Scale and the Obsessive Beliefs Questionnaire were applied to the participants. Univariate and hierarchical multiple linear regression analyses were used to analyze the data.

RESULTS

Of the study group 382 (49.2%) were male, 395 (50.8%), female. Their ages ranged from 18 to 63 years, with an average of 32.6 (± 9.6) years. Multiple linear regression analysis found that the frequency of internet use (several times a day; n = 670), using the internet as a source of health-related information (n = 320), using the internet to research a doctor before making and/or attending an appointment with same (n = 363), halting the use of prescribed medication based on information obtained on the internet (n = 177), and obsessive beliefs were factors linked to cyberchondria. Cyberchondria and obsessive beliefs were positively related and in the final model were found to be the strongest determinants of cyberchondria.

CONCLUSION

Obsessive beliefs may be a potential risk factor for cyberchondria. Since cyberchondria affects people's health related behaviors, it is important to ensure the safety of health-related information on the internet. The results of this study may guide future ones that thoroughly investigate the factors associated with cyberchondria. More comprehensive studies are needed to reveal the relationship between cyberchondria and obsessive beliefs.

Preoperative anxiety and health literacy in patients applying to the anesthesia outpatient clinic

Background

Evaluation of preoperative anxiety and health literacy is important for healthcare professionals to understand the needs and expectations of patients and provide them with the necessary support. The study aimed to evaluate the preoperative anxiety levels of patients who applied to the anesthesia outpatient clinic and its relationship with health literacy.

Methods

A cross-sectional study was conducted on patients who applied to the anesthesia outpatient clinic of Eskişehir Osmangazi University Medical Faculty Hospital in March 2022. The questionnaire form, which was prepared by making use of the literature, was filled in by face-to-face interview method after obtaining the participants’ verbal consent. The 6 item Amsterdam Preoperative Anxiety and Information Scale (APAIS) in which the scores that can be taken range from 6 to 30 and higher score means higher anxiety was used to assess the level of anxiety, and the 16 item European Health Literacy Scale Short Form was used to assess health literacy. Descriptive statistics, Chi-Square test and Logistic Regression analysis were used to analyze the data.

Results

In the study group, 197 (50.3%) were female. Their ages ranged from 18 to 86, with a mean of 45.7 ± 17.2 years. The median (min-max) APAIS score was 15 (6-30). There was a moderate negative correlation between the scores obtained from the APAIS and the European Health Literacy Scale Short Form (r= -0.50, p < 0.01). According to the logistic regression analysis, preoperative anxiety was found to be 1.53 (%95 CI; 1.01-2.30) times higher in women, 3.49 (%95 CI; 1.23-9.94) times higher in those with low family income, and 1.61 (%95 CI; 1.07-2.42) times higher in those with type A personality.

Conclusions

More than half of the patients had preoperative anxiety. The level of preoperative anxiety decreased as the health literacy level increased.

Key messages

The Level of Cyber-Ostracism and Self-Esteem in Medical Faculty Students

Background

Social media, which has become an indispensable part of our lives in recent years, is important for young people to socialize in online groups and to develop their self-esteem (SE). One of the dangers of increased use of social media is cyber ostracism (CO), defined as not being able to join a group and being ignored on social media. In the study, it was aimed to evaluate the level of CO and SE in medical faculty students.

Methods

This is a cross-sectional study conducted on students of Eskişehir Osmangazi University Faculty of Medicine in 2021 spring semester. The questionnaire prepared based on the literature was filled out online by the participants. The study group consisted of 1092 (70% response rate) students who agreed to participate in the survey. The CO Scale was used to assess the level of CO, and the Rosenberg SE Scale was used for the assessment of SE. Mann Whitney-U test, Kruskal Wallis test, Spearman correlation analysis and Multiple Linear Regression analysis were used to analyze the data.

Results

In the study group; 593 (54.3%) were female. Their ages ranged from 17-27, with a mean of 21.6 ± 2.0 years. The scores obtained from the CO scale ranged from 14 to 70, with an average of 24.8 ± 9.9 points. A moderate positive correlation was found between the scores the students got from the CO Scale and the SE Scale (r: 0.49, p: 0.001). Multiple Linear Regression analysis showed that; living in an extended family, not sparing time for hobbies during the day, having a type-A personality, poor face-to-face communication with peers, negative evaluation of parental attitudes, age at first use of smartphone below years 12 or less, use of smartphones for 5 hours or more a day, and Creating membership in social media by hiding their identity was a predictor for CO (F: 30.338, R2: 0.212, p < 0.001).

Conclusions

It can be said that CO is at a moderate level in medical faculty students. An inverse relationship between CO and SE was found in the study.

Key messages

İt’s recommended to plan more comprehensive studies on CO which is a new concept for digital health. Public health policies to reduce the level of CO may contribute to higher SE in future physicians.

Prevalence of onychophagia and its relation to stress and quality of life

INTRODUCTION

Onychophagia is defined as putting one's fingers into the mouth and biting the nails. We sought to evaluate the prevalence of onychophagia in university and high school students and its relation to sociodemographic factors, perceived stress, and quality of life.

METHODS

A total of 3,475 students were included in the study. A questionnaire including sociodemographic characteristics, items about onychophagia, the Perceived Stress Scale (PSS), and the European Health Impact Scale were used.

RESULTS

The prevalence of onychophagia among university students was 17.6%, and among high school students it was 29.2%. In university students with onychophagia, the median score on the PSS was higher than the median score of students without onychophagia. In high school students, the median score on the PSS was 28.2 for students without onychophagia and 28.0 for students with onychophagia; the difference was not significant. The median scores on the quality of life scale for both university and high school students with onychophagia were lower than the mean score of students without onychophagia.

CONCLUSIONS

Onychophagia is a common problem in the general population with a multidimensional etiology. It has dermatological, dental, and psychiatric consequences and comorbidities, and so a multidisciplinary approach is necessary for the prevention and treatment of onychophagia.

Traditional school bullying and cyberbullying: Prevalence, the effect on mental health problems and self-harm behavior

Bullying is widely recognized as a major psychosocial problem with substantial negative consequences. The current study aimed to estimate the prevalence of traditional school bullying and cyberbullying and reciprocal associations between bullying involvement and mental health problems. The sample of the study consisted of 6202 middle and high school students (age 11-18, M= 14.4 ±1.9 years, 54% boy). Bullying involvement, self-harm behavior, anxiety, depression, and psychosocial difficulties were assessed by self-report questionnaire. The prevalence of traditional school bullying and cyberbullying victimization was 33% (95% CI 32.1-34.5%) and 17% (95% CI 16.3-18.2%), respectively. The prevalence of traditional school bullying and cyberbullying perpetration was 22.4% (95% CI 21.3-23.4%) and 10.4% (95% CI 9.7-11.3%), respectively. Bullying involvement -as a victim, perpetrator, or both- was associated with anxiety, depression, psychosocial difficulties, and self-harm behavior. Girls were more likely to be affected than boys in mental health outcomes. A significant association between bullying victimization and negative mental health outcomes were also observed. These findings provide evidence to intervention strategies need to target both traditional and cyberbullying involvement. Understanding the risk profile will help create useful and appropriate interventions, which will reduce the early effect of bullying on mental health and modify the clinical course.

Assessment of knowledge of metabolic syndrome and health literacy level among adults in Western Turkey

Background

Metabolic syndrome (MetS) has become an issue in the public health discipline.

Aims

The primary aim of this study is to assess the potential determinants for both knowledge level of metabolic syndrome and health literacy (HL) level among the adult population. The second purpose of this study is to show whether there is a relationship between the MetS knowledge level and the HL level in western Turkey.

Methods

This cross-sectional study was conducted between October 10, 2017 and November 15, 2017 in western Turkey. The participants of the study were adult population who applied to seven "family health centers". The MetS knowledge level was measured with the Metabolic Syndrome Knowledge Level Scale (MetS-KS). HL level was measured with the HLS-EU-Q16. A General Linear Model was constructed to evaluate the relationship between MetS-KS scores and HLS-EU-Q16 scores. For statistical significance, P < 0.05 was accepted.

Results

Younger age, having higher education level, being single, having a high family income, not having a chronic disease, doing regular physical activity, viewing television less than 3 hours a day, previous measurement of waist circumference, previous attempts to lose weight, not being abdominally obese, not being at risk for hypertension and not having optimal body mass index (BMI) were associated with high HL levels (P < 0.05 for each one). According to the general linear model, the level of HL was not related to the level of MetS knowledge level (P > 0.05).

Conclusions

Younger age, having a high educational level, high socioeconomic level and positive health behaviors were related with both MetS knowledge level and HL level. However, there was no direct relationship between MetS knowledge level and HL level.

Perception of Social Gender Roles in Medical Faculty Students

Background

“Gender equality’’ is the fifth of the Sustainable Development Goals put forward in order to ensure the development in all areas. Medical faculty students, who will be a doctor, should practice with a gender equality perspective and shape their views and attitudes with equality in mind which will have an important part in the adoption of equality by society. The aim of the study was to evaluate the perception of social gender roles in medical students.

Methods

This cross - sectional study was performed with all students in Eskisehir Osmangazi University Faculty of Medicine. The questionnaire includes sociodemographic characteristics and Gender of Perception Scale(PCS) to measure perception of social gender roles. The scores that can be taken from the scale are ranged from 25 to 125, and high scores indicate that perception of gender is positive and equality. Mann Whitney U, Kruskal Wallis were used in univariate analysis; multivariate linear regression was used in multivariate analysis.

Results

The study group consisted of 1023 (84.3%) students in the study group, 52.8% were females and their ages ranged from 17 to 30 and the mean was 21.36 ± 2.06. The PCS scores ranged from 32 to 125 and the mean was 108.07±16.58. Multivariate linear regression analyzes were performed to determine the factors associated with the PCS. According to the results of last model sex, living with grandparents until the age of 18, region of the majority of life and parental attitudes were found to be related to perception of social gender roles (F = 29.602, R2=0.170, p &lt; 0.001).

Conclusions

The perception of gender of medical students was found to be positive. Sex and the characteristics of the social environment were related to perception of gender. In order to raise awareness on gender equality, it might be useful to ensure integration in the medical education curriculum.

Key messages

Factors that can be changed, such as the social characteristics of the living environment, were found to be related to perception of social gender roles. Ensuring gender equality, one of the Sustainable Development Goals, is important for medical students who will be a role model for society.

Evaluation of Social Media Use Disorder in Medical Faculty Students

Background

Recently, social media usage disorder has become a behavioral addiction with the internet which has entered our daily life rapidly. One of the important factors considered to be associated with social media use disorder is thought to be loneliness. The aim of the study was to evaluate the social media use disorder in medical school students.

Methods

This study is a cross-sectional study conducted on the students who were studying in Eskisehir Osmangazi University Faculty of Medicine between January 2 and February 28, 2019. The study group consisted of 422 internet user students. The level of social media usage was assessed by Social Media Disorder Scale (SMD-scale). The level of loneliness was evaluated with the short-form of the UCLA Loneliness Scale (ULS-8). Mann Whitney U, Kruskal Wallis, Spearman correlation analysis were used.

Results

Of the participants 226 (53.6%) was male. The age of the study group ranged from 17 to 29 years and the mean (SD) was 19.78 (1.33) years. The scores obtained from SMD-scale ranged from 0 to 63, with a mean of 12.18±10.35 (median = 9.0). All students had at least one social media account. In the study, no difference was found between the scores obtained from gender, age group, father’s education status, family income status and family type. While the scores of the students whose mothers have a university education level are lower; those who spent more than 2 hours a day on social media had a higher score. There was a weak positive correlation between the scores obtained from SMD-scale and ULS-8 (p &lt; 0.001, r = 0.215). There was a weak negative correlation between the scores obtained from the SMD-scale and the academic grade point average (p = 0.012, r = -0.123).

Conclusions

It is concluded that the correct use of social media can be increased by informing about this issue. Increasing platforms such as student clubs in which individuals could socialize in real life may be useful in reducing this disorder.

Key messages

Public health studies could help prevent social media use disorder transform into more serious health problem in future. Further studies are needed to determine the effects of social media use disorders on mental and physical health.

Evaluation of the Effectiveness of Health Education on Menopause Symptoms and Knowledge and Attitude in Terms of Menopause

This study was carried out to evaluate the effectiveness of health education on menopausal symptoms, knowledge, and attitudes about menopause. To evaluate the efficacy of a training program, information about menopausal symptoms, knowledge, and attitude toward menopause was collected before and after health education. After the health education intervention, it was determined that there was a decrease in the somatic and psychological subdimensions of the menopausal symptom evaluation scale and in the total score. Positive changes were observed in the levels of knowledge about menopause, and positive and negative emotional subscales of the menopause attitude assessment scale. It is concluded that health education is an effective method to positively change the perceived severity of menopausal symptoms and menopause-related level of knowledge and attitude.

The frequency of alopecia and quality of life in high-school students in rural areas (Sivrihisar, Mahmudiye, Alpu, and Beylikova) of Eskisehir

OBJECTIVE

The aim of the present study was to determine the incidence of alopecia and related factors and the health-related quality of life (HRQoL) in high-school students in rural areas of Eskisehir. This was a cross-sectional study.

METHODS

The study was performed between March 2, 2015 and April 30, 2015. A total of 1662 (74.9%) students were included in the study. The questionnaire performed for the purpose and consisted of four sections was filled out by the students themselves under supervision. The HRQoL was evaluated by Short Form-36 (SF-36). Students' hair and scalps were examined by a dermatologist. The acquired data were analyzed by SPSS 20 statistical package program. Chi-square test, Mann-Whitney U test, and logistic regression analyses were used for statistical analyses. A p value ≤0.05 was accepted as statistically significant.

RESULTS

In the present study, the incidence of alopecia was found to be 37.4% (n=622). Alopecia was more frequently seen in male students who have complaints about their scalps and those with a fatty scalp. In the study group, students with alopecia had poor HRQoL in general health perception, vitality, and mental health of SF-36.

CONCLUSION

There is a need to provide early diagnosis and treatment to decrease the incidence of alopecia and to improve the quality of life. Health education studies must be performed to increase the awareness of students about alopecia. Integrating hair and scalp examination into school health screening studies, steering the students who have alopecia to the dermatologists, and suggesting students who have fatty scalp regular hair washing will be appropriate.

Viral etiological causes of febrile seizures for respiratory pathogens (EFES Study)

BACKGROUND

Febrile seizure is the most common childhood neurological disorder, is an important health problem with potential short- and long-term complications, also leading to economic burden and increased parental anxiety about fevers and seizures occurring in their children. There are no routine recommendation to detect etiological causes of FS for neurological perspective, further knowledge about the etiological causes of FS in children will support preventive measures and follow-up strategies. The aim of this study is to evaluate the percentage of respiratory viruses in children with FS.

METHODS

This prospective multicenter study, entitled "Viral etiological causes of febrile seizures for respiratory pathogens (EFES Study)" examined representative populations in eight different cities in Turkey between March 1, 2016 and April 1, 2017. Nasopharyngeal swabs were taken from all children at presentation. A respiratory multiplex array was performed to detect for influenza A and B; respiratory syncytial virus A and B; human parainfluenza virus 1-2-3 and 4; human coronavirus 229E and OC43; human rhinovirus; human enterovirus; human adenovirus; human bocavirus; human metapneumovirus.

RESULTS

During the study period, at least one virus was detected in 82.7% (144/174) of children with FS. The most frequently detected virus was adenovirus, followed by influenza A and influenza B. Detection of more than one virus was present in 58.3% of the children with FS, and the most common co-existence was the presence of adenovirus and influenza B. In children younger than 12 months, Coronavirus OC43 was the most common, while influenza A was most frequently observed in children older than 48 months (p < 0.05). Human bocavirus was common in children who experienced complex FS, while respiratory syncytial virus (RSV) A was more common in children who experienced simple FS. Influenza B virus was the most common virus identified in children who were experiencing their first incidence of FS (p < 0.05).

CONCLUSIONS

This study indicates that respiratory viruses are important in the etiology of FS in children. The results show that antibiotics must be prescribed carefully in children with FS since the majority of cases are related to viral causes. Widespread use of the existing quadrivalent influenza vaccine might be useful for the prevention of FS related to the flu. Further vaccine candidates for potential respiratory pathogens, including RSV, might be helpful for the prevention of FS.

Menstruation-related headache in adolescents: Point prevalence and associated factors

BACKGROUND

The aim of this study was to investigate the prevalence of menstruation-related headache and the impact of associated factors in adolescents.

METHODS

This cross-sectional study was conducted in seven randomly selected high schools, and 3,886 girls attending those schools were invited to take part. After the consent of the school principals, a final total of 2,485 girls (63.9%) were involved in the study. A specific questionnaire was distributed to adolescent girls (14-19 years old). The first part of the survey investigated the features of menstruation (age at first menstruation, duration of period, pad fully soaked per day). The last part of the questionnaire surveyed the presence of headache during the menstrual period. The severity of headache was measured using a visual analog scale. Last, participants were requested to complete the Beck Depression Inventory (BDI). The prevalence of menstruation-related headache and associated factors were studied.

RESULTS

Mean subject age was 15.89 ± 1.07 years (range, 14-19 years) and mean age at menarche was 12.96 ± 1.09 years old. The prevalence of menstruation-related headache was 25.9% (n = 646). Onset of menstruation at <12 years of age, longer duration of menstruation period, dysmenorrhea, daily consumption of coffee and cola and smoking significantly affected the frequency of menstruation-related headache. Mean BDI score was 21.68 ± 13.65 and was significantly associated with menstruation headache.

CONCLUSION

Menstruation-related headache is a common problem in adolescent girls. It might be associated with different comorbidities such as depression. Accordingly, a multidisciplinary treatment approach must be considered to improve the quality of life.

The opinions of adults about the ban on cigarette sales to minors

BACKGROUND

Selling of tobacco products to minors has been banned since 1996 by the tobacco control law in Turkey. However, it is also important for the public to support practices that prevent the access of tobacco products to minors. In addition, every individual has the responsibility of carrying out society based programs that restrict access to tobacco products especially to children and the youths. Social sensitivity is considered an important factor in the prevention of tobacco use. This study aims to learn about the opinions and attitudes of adults with regards to minors access to tobacco products.

METHODS

The study was a descriptive study conducted in nine city centers in Turkey. The total number of participants reached was 3241. The questionnaire was developed by the research team and consisted of 22 questions concerning knowledge and behaviors of adults on restriction of tobacco sales to minors and their observations with regards tobacco sales to minors. Data was collected through face to face interview. Pearson chi-square test was used for the bivariate analysis whereas logistic regression was investigate the relationship between "the participant's response against tobacco sales to minors" and the following explanatory variables; "age", "educational status", "income level", "working status", "minors access to cigarettes", "smoking ratio in high school" and "sales of tobacco to minors".

RESULTS

More than half of the participants (60.5%) belonged to the age group 25-44 years, 61.3% graduated from high school or university. Most of the participants were smoker (39.2%) or ex-smoker (19.1%), and 41.7% of the participants was non-smoker. A greater proportion of the participants (76.2%) believed that smoking prevalence was greater than 40% among high school students. One in four (27.8%) adults did not know that tobacco control law bans sell of tobacco products to minors in Turkey. More than half of the participants (57.1%) ever witnessed tobacco sales to minors and 63.6% of them did not act when confronted with the event. Almost all (96.8%) of the respondents thought that access of minors to tobacco products was not difficult. The results of logistic regression of participant's response against tobacco sales to minor and related factors for current smokers showed that respondents who believed smoking ratio in high school was 4-5 adolescent out of 10 (aOR: 1.59; 95% CI: 1.09-2.34) were more likely to give a warning or informing the police or other people as compared to respondents whose perception on the smoking ratio among high school students was 6-7 adolescents out of 10. The results of logistic regression of non-smokers' response against tobacco sales to minor were who are from higher educational level, higher economic status, working status and who believed smoking ratio in high school was 4-5 adolescent out of 10 and 2-3 adolescent out of 10 were more likely to give a warning or informing the police or other people as compared to the others.

CONCLUSIONS

Although laws prohibiting the sale of tobacco products to the under age group is very important with regards to accessibility of minors to tobacco products, most of the study participants believed that minors can still easily access tobacco products, and more than half of the participants did not act when confronted with the event. The education, information and monitoring program most especially as it concerns salesman, should be reviewed and strengthened to obey the rules on sales of tobacco products to minors. Education program should be carried out to increase the knowledge and awareness of the community for sale of tobacco to minors. Social sensitivity is important for the prevention of tobacco use and every individual have a responsibility in carrying out this society based program, most especially as it related to prevention of tobacco usage among children and youths.

What is the Risk of Metabolic Syndrome in Adolescents with Normal BMI who have Polycystic Ovary Syndrome?

OBJECTIVE

The purpose of this study is to evaluate the effect of polycystic ovarian syndrome (PCOS) on the prevalence of metabolic syndrome (MBS) in adolescent girls with normal BMI.

MATERIALS AND METHODS

Our study group consisted of 63 pubertal girls with a BMI less than 25 kg/m(2) who were referred to our center with signs of hirsutism or oligomenorrhea. The diagnosis of PCOS was based on the recent ESHRE/ASRM proposal and required that all 3 of the Rotterdam criteria for diagnosing PCOS in adolescents be met. The control group consisted of 159 pubertal girls matched for age and BMI. Glucose, insulin, testosterone, and sex hormone-binding globulin, free testosterone and all lipid parameters measured. For to diagnose the cases with MBS, modified Cook criteria were used and cases who had at least 3 of 5 criteria's were diagnosed as MBS.

RESULTS

Girls with PCOS had higher blood pressure parameters (systolic/diastolic) (P < .01), fasting insulin (P = .007), low-density lipoprotein (P = .017), triglyceride (P = .045), total (P < .001) and free testosterone (P = .001) levels compared to control group. There were more cases who had at least 1 Cook criterion in girls with PCOS compared to the control group but the difference was not significant. However, there were more cases who had MBS in girls with PCOS compared to the control group (P = .02).

CONCLUSION

MBS prevalence is higher in normal BMI adolescent girls with PCOS compared to age and BMI matched control group. So as clinicians, we must search for the MBS criteria's in girls with PCOS even if they have a normal BMI.

Health promoting lifestyle behaviour in medical students: a multicentre study from Turkey

BACKGROUND

The aim of this study was to determine the predictors of health promoting lifestyle behaviour among medical students attending seven of the medical schools in Turkey.

MATERIALS AND METHODS

This cross- sectional descriptive study was performed during the second semester of the first and last (sixth) years of study from March to May 2011. A questionnaire with two sections was specifically designed. The first section contained questions on demographic characteristics; the second consisted of the Health Promoting Lifestyle Profile II (HPLP) Scale. From a total of 2,309 medical students, 2,118 (response rate 91.7%) completed the questionnaire. Data were analyzed using descriptive statistics, t, Anova, Tukey test and binary logistic regression analysis. The research was approved by the Ethics Committee of Erciyes University.

RESULTS

The mean age was 20.7±2.9 years and it was found that 55.1% were men, 62.3% were in the first year. The overall prevalence of smoking was 19.1%, and for drinking alcohol was 19.4%. HPLP point averages of the first year students were 129.2±17.7, and for last year 125.5±19.0. The overall mean score for the HPLP II was 2.5±0.4. They scored highest on the spiritual growth subscale (2.9±0.5), interpersonal relations (2.8±0.5), health responsibility subscale (2.3±0.5), nutrition subscale (2.3±0.5), stress management subscale (2.3±0.4), and the lowest subscale physical activity (2.0±0.5). It is established that student's grade, educational level of parents, economic status of family, marital status, smoking and general health perception of the students resulted in a significant difference in HPLP Scale total score average and the mean score of majority of subscales.There was no statistically significant difference between the total HPLP when evaluated for gender, chronic disease, alcohol drinking status and BMI.

CONCLUSIONS

Based on these results, particularly in the curriculum of medical students in order to increase positive health behaviours including physical activity, health promotion issues, and giving more space to aim at behaviour change in these matters is recommended.

Prevalence of domestic violence and associated factors among married women in a semi-rural area of western Turkey

Objective: To determine the prevalence of domestic violence and associated factors among married women in a semi-rural area of western Turkey.

Methods: This descriptive study was conducted between March 1 and April 29, 2011 on married women aged 15-49 years. Exposure to at least one of these types of violence at least one time within the past one year was regarded as the presence of domestic violence. Chi-square test and Logistic Regression analysis was used for statistical analysis.

Results: Prevalence of domestic violence against women was found to be 39.0%. About 38,4% and 26.8% of women reported verbal and psychological violence respectively. The risk factors found for the domestic violence included youngest age group, an educational level of secondary/high school for men, form of the first marriage, number of children, alcohol and gambling habits of the husband.

Conclusion: Our study found higher prevalence of domestic violence than expected. Verbal violence is also a significant problem particularly in terms of its consequences. It was concluded that further informative studies are needed on domestic violence to find out the causative factors to chalk out preventive strategies.

Assessment of internet addiction and loneliness in secondary and high school students

OBJECTIVE

To determine the frequency of Internet addiction and loneliness in secondary and high school students.

METHODS

The cross-sectional study was conducted between May 7 and June 8, 2012, among secondary and high school students in Sivrihisar, which is a district in rural part of Anatolia, Turkey. The study group consisted of 1157 students. Young Internet Addiction Scale was used to assess the internet addiction. University of California, Los Angeles Loneliness Scale was used for the evaluation of the level of loneliness. SPSS 15 was used for statistical analysis.

RESULTS

Of the 1157 students, there were 636 (55.0%) male and 521 (45.0%) female aged 11 to 19 years (mean: 15.13 ± 1.71 years). According to the Internet Addiction Scale, 91 (7.9%) of the subjects were addicted to the internet. Obesity (odds ratio: 9.57), "Type A" personality (odds ratio: 1.83), first time usage of internet before age 12 (odds ratio: 2.18), using the internet every day (odds ratio: 2.47) and use the internet more than 2 hours a day (odds ratio: 4.96) were risk factors of internet addiction (p < 0.05). A positive correlation was found between the internet addiction and loneliness (rs = 0.121; p < 0.001).

CONCLUSION

Internet addiction was found to be a major health problem in middle and high school students. A positive correlation between loneliness and internet addiction was also found.

Headache and its effects on health-related quality of life among adults

AIM

This study was conducted with aim of determining prevalence of headache and evaluating its effects on health-related quality of life (HRQoL) in Beylikova town of Eskisehir city in the west of Turkey.

MATERIAL AND METHODS

This study was conducted on adults aged 20 years and over aged between May 11 and June 04 2009 in Beylikova town of Eskisehir city in the west of Turkey. A total of 587 people were selected by simple randomized method. The International Headache Society criteria were used for the determination of severity of headache. The 36-item short-form (SF-36) was used for the assessment of healthrelated quality of life.

RESULTS

The number of men and women was 302 (51.4%), and 285 (48.6%), respectively. The mean age was 46.70 ± 15.26 years (range, 20-87 years). Headache prevalence was found to be 78.2% (n=459). Decreased headache prevalence was found in the ages older than 30-44 age group (p < 0.05). All domains of SF-36, the mean scores were higher in individuals without headache than those with headache (for each, p < 0.05). Migraine prevalence was found to be 7.2% (n=33).

CONCLUSION

In accordance with the literature, this study found the presence of headache in adults at high frequency (78.2%). Particularly the presence of migraine and increased severity of headache were found to decrease the quality of life.

The Prevalence of Infertility and Loneliness among Women Aged 18-49 Years Who Are Living in Semi-Rural Areas in Western Turkey

BACKGROUND

To determine the correlates and the prevalence of infertility in a group of women.

MATERIALS AND METHODS

This cross-sectional study was carried out on 570 subjects aged 18-49 years in a town of western Turkey between July and August 2012. Women who have inability to become pregnant despite regular sexual intercourse during the last year were considered to be infertile. UCLA Loneliness Scale was used to assess the severity of loneliness. The data were analyzed by Kruskal-Wallis, Mann Whitney U and Chi-square tests.

RESULTS

The mean age of the participants was 35.48 ± 8.39 years. The frequency of the infertility in our study was 12.8% (n=73). The prevalence of infertility was higher in those with a history of gynecological disease or gynecologic surgery and in those with menstrual irregularity (p<0.05; for each). The mean score on the UCLA Loneliness Scale was 32.16 ± 9.49 (from 20 to 70). In this study, no difference was found between the level of loneliness and who is responsible for infertility among infertile/fertile women (p≥0.05). Level of loneliness among the women with primary infertility was higher compared to the women with secondary infertility (p<0.05).

CONCLUSION

The prevalence of infertility among the women was relatively high. It was concluded that prospective studies are needed in order to expose the relationship between the infertility and the level of loneliness in women.

Acute mercury poisoning among children in two provinces of Turkey

Elemental mercury exposure occurs frequently and is potentially a toxic, particularly in children. Children are often attracted to elemental mercury because of its color, density, and tendency to form beads. Clinical manifestations of elemental mercury intoxication vary depending on its form, concentration, route of ingestion, and the duration of exposure. We present data on 179 pediatric cases of elemental mercury poisoning from exposure to mercury in schools in two different provinces of Turkey. Of all patients, 160 children had both touched/played with the mercury and inhaled its vapors, while 26 children had only inhaled the mercury vapor, two children reported having tasted the mercury. The median duration of exposure was 5 min (min 1-max 100), and 11 (6 %) children were exposed to the mercury for more than 24 h at home. More than half of the children (51.9 %) were asymptomatic at admission. Headache was the most common presenting complaint. The results of physical and neurological examinations were normal in 80 (44.6 %) children. Mid-dilated/dilated pupils were the most common neurological abnormality, and this sign was present in 90 (50.2 %) children. Mercury levels were measured in 24-h urine samples daily, and it was shown that the median urinary level of mercury was 29.80 μg/L (min, 2.40 μg/L; max, 4,687 μg/L). A positive correlation was also found between the duration of exposure and urinary mercury levels (r = 0.23, p = 0.001). All patients were followed up for 6 months. On the first follow-up visit performed 1 month after discharge, the neurological examinations of all patients were normal except for those patients with peripheral neuropathy and visual field defects. On the last follow-up visit at the sixth month, only two children still experienced visual field defects. In conclusion, this study is one of the largest case series of mercury intoxication of students in schools. Elemental mercury exposure can be potentially toxic, and its symptomatology is variable, particularly in children. Therefore, school staff and children should be aware of the risk of mercury toxicity. Pediatricians also need to warn parents and children about the hazards of playing with any chemical.

Breath holding spells: point prevalence and associated factors among Turkish children

BACKGROUND

Breath holding spells (BHS) are known as paroxysmal non-epileptic disorder. There are two subtypes of BHS: cyanotic and the pallid. BHS have been reported to occur in 0.1-4.6% of children in Western countries. Although it is easy to diagnose in its typical form, the data on prevalence of BHS are insufficient in developing countries.

METHODS

This study was performed in Turkey's Eskisehir province. A total of 1000 randomly selected 0-6-year-old children were invited to family health centers. A specific questionnaire was given to parents. Children who had a history BHS were referred to the hospital to for investigation of medical history and neurological examinations.

RESULTS

A total of 933 children participated and were included in analysis. Thirty-four children (3.6%) had had BHS. Children's birthweight, parent consanguinity and mothers' education status significantly affected the frequency of BHS. Increase in birth sequence decreases the risk of BHS 0.65-fold. Fathers' education status also affected the prevalence of BHS, with the risk of BHS being 0.39-fold less if the father had completed high school or some higher education. And, as the age of the fathers increased, the risk that their children would have BHS was 1.14-fold higher.

CONCLUSIONS

Although the calculated prevalence rate was compatible with previous studies, positive family history for BHS, birth sequence, parents' education status and fathers' age were identified as risk factors associated with BHS.

Apraxia for differentiating Alzheimer's disease from subcortical vascular dementia and mild cognitive impairment

Although ideomotor limb apraxia is considered to be a typical sign of cortical pathologies such as Alzheimer's disease (AD), it has been also reported in subcortical neurodegenerative diseases and vascular lesions. We aimed to investigate the difference between AD, subcortical vascular dementia (SVaD) and mild cognitive impairment (MCI) patients by means of ideomotor limb apraxia frequency and severity. Ninety-six AD, 72 SVaD, and 84 MCI patients were assessed with the mini-mental status examination (MMSe), clinical dementia rating (CDR) and the apraxia screening test of TULIA (AST). Apraxia was significantly more frequent in the AD patients (32.3%) than in both of the SVaD (16.7%) and MCI (4.8%) patients. The frequency of apraxia was also significantly higher in SVaD patients than in MCI patients. AD patients had significantly lower apraxia scores than both SVaD and MCI patients. In addition, a significant difference was found between SVaD and MCI patients in terms of apraxia scores. These results suggest that the widespread belief of the association between apraxia and cortical dementias is not exactly correct. The significant difference between both of the dementia groups and the MCI patients suggests that the absence of apraxia can be an indicator for MCI diagnosis.

Prevalence of depression, its correlates among students, and its effect on health-related quality of life in a Turkish university

OBJECTIVE

The aims were to investigate the prevalence of depression among university students, and to determine some of the risk factors connected to depression, and also to evaluate its effect on health-related quality of life (HRQoL).

METHODS

This cross-sectional survey was conducted between 1 December 2007 and 31 January 2008 at Osmangazi University, Eskisehir, in western Turkey. The study group consisted of 822 students. The questionnaire included the students' socio-demographic characteristics, the Beck Depression Inventory, and the Medical Outcomes Study Short Form-36 (SF-36). The data were analyzed by using chi-square, Student's t test, percent (%) ratios, and backward logistic regression analysis with a significant value of P<0.05.

RESULTS

Of the students, 377 (45.9%) were males and 445 (54.1%) females. Overall, the prevalence of depression was 21.8% (n=179/822). Family history of depression, acne on face, any physical defect on body, smoking, alcohol consumption, and future-related occupational preoccupation were all deemed important risk factors for depression (P <0.05, for each one). It was found that, in those with depression, all the mean domain scores of SF-36 scale were lower than those without depression (P <0.05, for each one).

CONCLUSIONS

The prevalence of depression among the university students in this region of Turkey was wide-spread, affecting negatively the HRQoL of the students. For prevention and control of depression, depression information and knowledge need to be addressed by health education programs.

Prevalence of hypertension among individuals aged 50 years and over and its impact on health related quality of life in a semi-rural area of western Turkey

BACKGROUND

Hypertension is common, especially in individuals aged 40 years and over, and it affects about half of the population aged 60 years and over. This study aimed to determine the frequency and risk factors of hypertension among individuals aged 50 years and over, and to examine its effect on the health related quality of life (HRQOL).

METHODS

This population-based cross-sectional study was conducted in two settlements in a region of western Turkey between March 1 and April 30, 2007. A questionnaire concerning life habits associated with hypertension, medical histories, and demographic characteristics was filled in by a face to face interview. The SF-36 scale was used to assess HRQOL. Body mass index (BMI) was calculated by measuring the weight and length of the body.

RESULTS

Of 1599 individuals living in the region, 1193 participated in the survey (48.3% men and 51.7% women). The overall prevalence rate of hypertension was 59.5% (n=710), being 58.0% in men and 60.9% in women (P > 0.05). The variables that most positively influenced hypertension (P < 0.05, for each one) were older age (especially the age group of those aged 60 and over), single, no health insurance, consumption of animal fat in meals, and family history of hypertension. The HRQOL of the patients with hypertension was lower than that of those without hypertension (P < or = 0.05). The HRQOL was better in hypertensive patients whose blood pressure was under control, whereas it was worse in those with at least one chronic disorder accompanying hypertension (P < 0.05, for each one).

CONCLUSIONS

Great emphasis should be placed on the need for a public health program for the detection, prevention, and control of hypertension, including other risk factors, as well as for the modification of foods and life habits, specifically in individuals who are most likely to be at risk of hypertension.

Use of emergency departments by elderly patients in a city of Western Turkey

OBJECTIVE

To evaluate the reasons behind the demographic characteristics of patients presented to emergency departments.

METHODS

The entire patient records of all the hospitals' emergency departments in the city of Eskisehir were retrospectively assessed in this study. The study was conducted between the years 1998 and 2000. Data were evaluated using chi2, t-tests, and percent rates.

RESULTS

Of 608,528 patients visiting the emergency departments, 79 123 (13.0%) were elderly patients. The treatment and discharge rate was 78.3%. Mean admission rate was 21.2%. The death rate during the visits was 0.4%. The proportion of the five most frequently seen diseases was 41.9%.

CONCLUSION

Demographical trends show that emergency department visits by elderly patients would increase in time. So, in Turkey, emergency department staff should be trained to provide for the special needs of this population in emergency departments.

Genomic alterations in low-grade, anaplastic astrocytomas and glioblastomas

To extend our understanding of potential stepwise genetic alterations that may underlie tumor progression from low-grade astrocytomas to glioblastomas, histopathologic and comparative genomic hybridization analyses were performed on tumor specimens from 68 primary lesions, including 40 glioblastomas, 10 anaplastic and 18 low-grade astrocytomas. The number of aberrations per case increased towards the higher grade tumors (grade II: 1.66+/-1.49; grade III: 2.80+/-1.68; grade IV: 3.02+/-1.07; F=6.955, p=0.002). A gain of 7/7q was common and the most frequently seen aberration in low-grade astrocytomas, whereas loss of 10q was the most frequently seen anomaly in anaplastic astrocytomas and glioblastomas. Chromosome 7p amplification was only detected in glioblastomas. Chromosome 10/10q deletion and combination of 1p, 19q and 17p deletions were specific to high-grade astrocytic tumors. Sequences of chromosome 7 and 10 seem to have pivotal roles in the biology of human gliomas. The genomic copy deletions of chromosomes 1p and 19q might provide an alternative mechanism in the genesis of astrocytomas.

Frequency and risk factors of dermatophytosis in students living in rural areas in Eskişehir, Turkey

Our study included 2384 students from five villages around Eskişehir, Turkey. We asked every student for their personal identification and also for their sanitation in order to get an idea about dermatophytosis. Samples taken from suspicious lesion were collected and inoculated onto Sabouraud dextrose agar slants. For identification of fungi which were grown, macroscopic appearance of colonies, microscopic examination and biochemical tests were used. We found suspicious lesions in 245 (10.3%) and diagnosed dermatophytosis in 86 (3.6%) of the students. The dermatophyte species were Trichophyton rubrum 37 (43%) at first, Trichophyton mentagrophytes 17 (19.8%), Microsporum canis 11 (12.8%), Microsporum gypseum 8(9.3%), Epidermophyton floccosum 6 (7%), Trichophyton verrucosum 6 (7%) and Trichophyton violaceum 1 (1.1%). Tinea pedis (59.3%) was the most frequent clinic form of dermatophytosis, followed by tinea corporis (22.1%), tinea capitis (9.3%), tinea manum (7.0%) and tinea unguium (2.3%). Older age, male gender, poor hygiene, living in dormitory, low level mother education, history of dermatophytosis within family and sanitary conditions were computed as independently variables associated with dermatophytosis infection. For prevention and control of dermatophyte infection in children living rural areas, field studies should be done and sanitary conditions should be improved.