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Objective: We aimed to explain the details of the “We, as well, are in the Fight Against Novel Coronavirus Disease (COVID-19)!” “online” Social Responsibility Project as a model to be used in medical education in the COVID-19 fight. The Project has been developed as a part of Phase 1 Medicine and Social Responsibility Program at Hacettepe University, Faculty of Medicine in Turkey, and aimed to increase the social responsibility, awareness and sensitivity of the students in COVID-19 pandemic days. Material and Methods: All project phases were developed in collaborative work with Faculty Dean’s Office, Project Coordination Team, facilitators, and project groups student representatives. The Project was conducted online in May 2020 in 33 student groups, each of which comprised 10-15 students and an academic staff of the Faculty. All materials were shared simultaneously via the official website of Hacettepe University Faculty of Medicine. Results: Various types of materials like reminders, infographics, videos, and other visuals have been prepared for the Project. Students shared all these materials via social media such as Instagram, Facebook, WhatsApp groups. International students translated some materials into different languages to share the materials in their home-countries. The materials were prepared by Project Coordination Team by having the opinions and suggestions of the faculty members and students. Conclusion: Social Responsibility Project is thought to facilitate improving the sensitivity of the students in COVID-19 crisis. The Project has also contributed to improve the students’ capacity in the management of infodemic and accessing to the community.

WOS: 000468613100013 PubMed ID: 30238284 Purpose Obesity is among the known risk factors for obstructive sleep apnea syndrome (OSAS). In this study, our aim was to investigate the correlation of waist-to-height ratio, an indicator of central obesity, with presence and severity of OSAS; to compare the use of this ratio with the use of waist circumference and body mass index (BMI); and to determine OSAS-related cutoff values. Methods The patient records were retrospectively analyzed for whom a polysomnography was conducted at our sleep. Sex, age, Apnea-Hypopnea Index (AHI), waist circumference, height, and BMI values of those patients were recorded. AHI scores were used to classify severity of OSAS. Results The study included 437 OSAS patients and 72 control cases. Out of the patient group, OSAS was severe in 208 (47%) patients, moderate in 124 (28%), and mild in 105 (24%) of them. In the group of OSAS patients, waist-to-height ratio, waist circumference, and BMI were higher compared to the control group with a further difference of all three parameters among severe, moderate, mild OSAS, and controls both in males and females. Cutoff values for OSAS of females were 95.5cm for waist circumference, 0.595 for waist-to-height ratio, and 27.75 for BMI whereas the cutoff values of males were 100.5cm, 0.575, and 27.75, respectively. Conclusions A high value of waist circumference, waist-to-height ratio, and BMI is associated with the presence and severity of OSAS. We have determined the cutoff values of the studied anthropometric measurements in both sexes for OSAS and severe OSAS.

WOS: 000435398900004 Objective: Restless Legs syndrome (RLS) is a frequent neurological disease. Levetiracetam (LEV) is an effective and broad-spectrum anticonvulsant drug. The aim of this study is to investigate the frequency of RLS in patients diagnosed with epilepsy who took LEV monotherapy. Materials and Methods: Two neurologists were reviewed the files of 1680 patients, who were followed in epilepsy outpatient clinic. One hundred seven patients under LEV monotherapy for at least six months and 120 healthy controls were included in the study. The criteria for the International Restless Legs Syndrome Study Group were taken into consideration for the assessment of RLS. Results: The mean age of patient group was 38.26 +/- 17.39 years, while the mean age of healthy controls was 39.17 +/- 16.12 years. There were no statistically significant differences in terms of age and sex between each two groups. The mean duration of LEV usage was 28.34 months. The LEV usage dose was between 500-3000 mg/day. RLS was seen in 7 (5.83%) healthy controls, whereas 4 patients (3.73%) had RLS in patient group before LEV treatment. The symptom of RLS in two patients disappeared after LEV treatment started and this rate decreased to 1.87%. The biochemical parameters were normal in all patient groups, after LEV treatment, peripheral neuropathy was detected in one patient whose symptoms were not relieved. Conclusion: LEV may have therapeutic effect on RLS. It may be preferred especially in comorbid situations where epilepsy and RLS are seen together. Longitudinal and prospective studies are needed to manifest better the therapeutic effects of LEV on RLS.

18th National Sleep Medicine Congress - OCT 26-29, 2017 - Bodrum, TURKEY Saruhan, Ercan/0000-0001-6416-1442 WOS: 000495454200003 Objective: Although the presence of a systemic inflammatory response is known in obstructive sleep apnea syndrome (OSAS), there have not been adequate investigations on the association of such a response with the predominance of apneas either in rapid eye movement (REM) or in the non-REM (NREM) phase. In this study, we compared interleukin-23 (IL-23) concentrations, a marker of systemic inflammatory process, in individuals with sleep apnea syndrome, whose apneas where predominant in the REM or NREM phase. Methods: Fifty-four patients aged over 18 years who were diagnosed as having OSAS based on polysomnography were included in the study. The apnea-hypopnea index (AHI) was used to divide patients into groups of AHI(REM)>AHI(NREM) and AHI(NREM)>AHI(REM). In the blood samples drawn from the patients, IL-23 concentrations were measured using enzyme-linked immunosorbent assay. Results:The study included patients with OSAS aged 28-65 years, of whom 29 were AHI(REM)>AHI(NREM) and 25 were AHI(NREM)> N-REM. The AHI(REM) >AHI(NREM) OSAS group had no sex-based variance (14 males, 15 females), but the AHI(NREM) >AHI(REM) group was substantially composed of males (21 males, 4 females). The average AHI( )of the AHI(NREM) >AHI(REM) group (43.34 +/- 21.40) was significantly higher than in the AHI(REM) >AHI(NREM) Nifm group (26.79 +/- 17.32). IL-23 concentrations were higher in patients with AHI(REM) >AHI(NREM) sleep apnea (225.38 +/- 77.29) compared patients with AHI(NREM) >AHI(REM), sleep apnea (183.68 +/- 78.49). Conclusion: In AHI(REM) >AHI(NREM )sleep apnea, the systemic inflammatory response may be more dramatic. Taking the AHI(REM) value into consideration along with the average AHI value seems to be important for treatment modalities.

Amaç: Adolesan dönemi sağlık sorunları, ihmal edilen ve sıklıkla önlem alınmayan durumlardır. Bu sorunlar bireylerin şu anki sağlık düzeylerini etkilediği gibi yetişkinlik döneminde meydana gelebilecek hastalıkların da temelini oluşturmaktadır. Bu çalışmada adolesan dönemde 2009 ve 2016 yılları arasında meydana gelen ölüm nedenleri incelenmiş, ölümlerin yıllar içindeki değişimleri değerlendirilmiştir. Gereç ve Yöntem: Türkiye’de 2009-2016 yıllarına ait adolesan ölüm nedenlerini inceleyen tanımlayıcı tipteki bu araştırma için gerekli veriler Türkiye İstatistik Kurumu’ndan yazılı başvuru ile elde edilmiştir. Adolesan dönem ölüm nedenlerinin boyutunu değerlendirmek amacıyla; yaşa-özel ve yaşa-nedene-özel ölüm hızları ile ölüm nedenlerinin tüm ölümler içerisindeki yüzdeleri ölçüt olarak kullanılmıştır. Bulgular: Adolesan yaş grubunda 2009 yılında yüz binde 22.4 olan yaşa-özel ölüm hızı 2016’da yüz binde 29.2’ye çıkmıştır. 2016 yılında adolesan yaş grubunda birinci ölüm nedeni “dışsal yaralanma nedenleri ve zehirlenme kaynaklı ölümler”’dir. Bu nedene bağlı ölüm hızı adolesan yaş grubunda 2009’dan (yüz binde 6.8) 2016 yılına (yüz binde 12.7) artış göstermiştir. Dışsal yaralanma nedenleri ve zehirlenme kaynaklı ölümler içerisinde en büyük paya sahip olan taşıma kazalarına bağlı ölümler de 2009’dan (yüz binde 3.0) 2016 yılına (yüz binde 5.1) artış göstermiştir. Sonuç: Ölüm nedenlerinde meydana gelen değişimlerin düzenli olarak değerlendirilmesi önemlidir. Bu değerlendirmeler alınacak olan önlemleri etkileyebilmektedir. Bu nedenle benzer değerlendirmelerin yapıldığı bilimsel zeminli çalışmaların sürdürülmesi önerilmektedir.

Novel Coronavirus Disease (COVID-19) raised many questions needing answers in order to overcome the disease burden globally. Uncertainty about COVID-19 contributes to the complexity of the burden on the health, social, economic, and cultural influences of COVID-19. In this context, all related disciplines are working together to mitigate the negative influences of the disease. In particular, health promotion, a discipline of public health, matters to the pandemic as it may address the threats at different levels. Health promotion strategies mostly use solution-oriented efforts with inter- and multidisciplinary approaches. Nevertheless, as the COVID-19 burden has many time-critical determinants, these approaches cannot be sufficient to overcome the problem. A transdisciplinary approach in its broader sense using almost all inputs to synthesize and produce an integrative solution may be extremely helpful. In this paper, the importance of transdisciplinary approaches in health promotion to combat COVID-19 has been discussed.

Background Evidence suggests that advice from motivated physicians to their smoking patients is effective in promoting smoking cessation. Yet, detection rate of smokers is often low and, the proportion of smokers receiving special advice to quit varies. This study aimed to detect how frequently European physicians enquire about their patients' smoking status, and to compare and contrast how (if any) smokers benefit from physicians' enquiry and/or advice about smoking cessation. Methods The study was based on secondary analysis of data from six European countries that conducted Global Adult Tobacco Survey, namely, Greece, Poland, Romania, Russia, Turkey and Ukraine. Results Out of Global Adult Tobacco Survey participants who were smoking 12 months preceding the survey and had 'at least one visit to a physician' before the survey, half were asked by their physicians about their smoking status and only 37.7% got a brief advice from their physicians to quit smoking. Remarkably, 25% of current smokers did not get any advice from their physicians to quit even when the smoking status was enquired. The adjusted odds ratio was found as 1.55 (95% confidence interval=1.29-1.87) for the association between physician's enquiry about smoking status of a patient and his/her attempt to quit smoking. Conclusion Even a simple enquiry of the physician about smoking status of a patient could be effective in smoking cessation, yet, enquiry and advice rates are still far below expected. Regardless of the reason for admission, each contact with a patient should be used as an opportunity to combat smoking-related health risks.

Methylation is a key epigenetic modification of DNA and regarding its impact on epilepsy, it is argued that "DNA methylation may play an important role in seizure susceptibility and maintenance of the disorder". DNA methylation status of KCC2 (SCL12A5) and NKCC1 (SCL12A2) associated with refractory temporal lobe epilepsy was investigated in our study.Thirty-eight patients with temporal lobe epilepsy (TLE) who were diagnosed by video EEG monitoring and 32 healthy control subjects were included in the study. Twenty-three patients in TLE group were men and the remaining 15 were women. Among them, 27 had unilateral temporal focus (9 with right; 18 with left) and 11 patients had bilateral TLE. We analyzed promoter region methylation status of the KCC2 (SCL12A5) and NKCC1 (SCL12A2) genes in the case and control groups. Gene regions of interest were amplified through PCR and sequencing was accomplished with pyro-sequencing.We found a significant relationship between TLE and methylation on the NKCC1. However, there was no association between TLE and methylation on the KCC2 gene. Also, we found no association between right or left and unilateral or bilateral foci of TLE. There was no relationship between TLE and methylation on the NKCC1and KCC2 genes in terms of mesial temporal sclerosis in cranial MRI, head trauma or febrile convulsions.The methylation of NKCC1 can be a mecha-nism of refractory temporal lobe epilepsy. There are limited findings about DNA methylation in TLE. Therefore, further studies with large sample sizes are necessary.A metiláció kulcsfontosságú a DNS epigenetikai módosítása során. Az epilepsziában fontos a metiláció szerepe, olyannyira, hogy az is felmerül: a DNS-metiláció közreműködik a rohamokra való fogékonyság kialakulásában, továbbá a betegség fenntartásában is. Vizsgálatunkban elemeztük a refrakter temporalis epilepsziával asszociált KCC2 (SCL12A5) és NKCC1 (SCL12A2) gének metilációs státuszát.38, video-EEG-monitorral diagnosztizált temporalis epilepsziában szenvedő beteget és 32 egészséges kontrollszemélyt vontunk be a vizsgálatba. A 38 betegből 23 volt férfi, 15 nő; 27-en unilaterális temporalis epilepsziában (9 jobb oldali, 18 bal oldali), 11-en kétoldali temporalis epilepsziában szenvedtek. A vizsgálati és a kontrollcsoportban egyaránt elemeztük a KCC2 (SCL12A5) és NKCC1 (SCL12A2) gének promoter régióinak metilációs státuszát. A kérdéses régiókat PCR-rel amplifikáltuk és piroszekvenálással elemeztük.Szignifikáns kapcsolat mutatkozott a temporalis epilepszia és az NKCC1 metilációja között. Mind­azonáltal, nem volt kapcsolat a temporalis epilepszia és a KCC2 gén metilációja között, továbbá nem találtunk össze­függést az epilepto­gén fókusz elhelyezkedése (jobb vagy bal oldali unilaterális, il­let­ve kétoldali temporalis epilepszia), valamint a metilációs státusz között sem. Nem mutatkozott kapcsolat a temporalis epi­lep­szia, a KCC2, NKCC1 gének metilációs státusza, valamint a koponya-MRI-n ábrázolódó mesialis halántéki sclerosis, a fejet ért trauma vagy a lázgörcs között sem.A refrakter temporalis epilepszia hátterében az NKCC1 metilációja állhat. További nagy esetszámú vizsgálatokra van szükség, mivel korlátozott adattal rendelkezünk a DNS metilációjával kapcsolatosan refrakter temporalis epilepszia esetében.

Objectives Food-related issues, which directly concern all societies and are closely related to the management of limited resources, are always high up on the world agenda. In this context, we addressed healthy nutrition and sustainable food matters using different methods within the scope of Towards Inclusive Research Programming for Sustainable Food Innovations, one of the projects of the 7th Framework Programme. This study presents the opinions of representatives from different sectors towards innovative approaches to healthy nutrition and sustainable food in Turkey. Methods Three European Awareness Scenario Workshops were organised to apply the qualitative research method to group activities like brainstorming and the study of scenarios. This study considers and descriptively analyses the subjects that came into focus among the results of the workshops. Results Considering the topics discussed in the workshops, it is clear that food policies, food and nutrition themed research, healthy nutrition, rational distribution and use of resources, and food safety practices were the most prominent approaches to creating food sustainability. Conclusions As a result of the activities organised during this project, participants found that most food sustainability problems are widespread and commonly encountered. Thus, the relevant sectors must work together to eliminate visible and invisible obstacles between the consumer and healthy food and to ensure the performance of duties and responsibilities by relevant parties in food manufacturing, transportation, etc.

Objectives The aim of this descriptive study was to determine the sociodemographic characteristics of electronic (e)-cigarette users for clarifying the causes of e-cigarette smoking and to identify the carbon monoxide (CO) and urinary cotinine levels of the volunteers. Materials and methods Twenty volunteers who smoked e-cigarettes completed a questionnaire, and their exhaled CO and urinary cotinine levels were measured. An enzyme-linked immunosorbent assay kit was used for cotinine analysis. Results Overall, 85% of the participants were males, 60% were married, and 75% were college/university graduates. The median age of participants was 38.5 years. The participants' main reasons for starting to smoke were peer influence and curiosity. The participants' main reasons for smoking e-cigarettes were to quit and reduce smoking the conventional cigarettes and cost effectiveness. Only three people knew that smoking was harmful to health. The participants' CO levels were measured as a median of 3, lowest of 1, and highest of 22. Cotinine levels were "positive" in all samples. A moderate and statistically significant correlation was found between the amount of fluids used by the participants in 1 day (mL) and cotinine levels in urine specimens (Pearson correlation test, r=0.511, p=0.025). Conclusion The study is an important proof of the country's scientific work on e-cigarettes. Preventive strategies should be very strictly implemented for any tobacco products, including e-cigarettes, as they harm individuals and the community.

The electronic cigarette (e-cigarette), which is accepted as a new market by the tobacco industry, is highly dependent on health and is addictive due to its nicotine content. Informing and raising awareness is extremely valuable to protect the identified risks of e-cigarette in society. The aim of this study was to determine the socio-demographic characteristics of volunteer e-cigarette users, to determine the causes of e-cigarette smoking, to identify some risks (nicotine, carbon monoxide). In this descriptive study, volunteer electronic cigarette smokers participated in the questionnaire, carbon monoxide was measured, urine sample was taken and directed to the toxicology laboratory for measurement of cotinine, and cotinine was measured in urine. Twenty volunteer e-cigarette smokers participated in the survey. Eighty five percent of the participants were male, 60% were married, 75% were college / university graduates, 80% were working, 65% of them were economical, 35% were good, 40% and 35% regularly use medicines. The median age of participants was 38.5 years, the youngest participant was 22, the oldest was 69 years old. Fifteen (75%) of the respondents stated that they were passively affected by tobacco smoke. Eight of these 15 (73%) were exposed to friends, eight (54%) were at home, eight (54%) were at cafes, etc., and four were exposed at work. The participants' main reasons for starting to smoke are friend influence and curiosity. Thirty percent of participants had tried e-cigarette before using e-cigarette, 90% used e-cigarette every day, e-cigarette was most frequently obtained from internet and friends / relatives, 79% did not use cigarette e-cigarette and all use nicotine. Participants' median e-cigarette smoking duration was 5.5 months; monthly e-cigarette expenditures are median 60 TL. Participants main reasons to smoke e-cigarette are to quit smoking, reduce smoking cigarettes and for reasons of cheapness. Eleven of the respondents (55%) stated that they never smoked together with e-cigarette but 9 (45%) smoked together with e-cigarette, but e-cigarette smoking significantly reduced the cigarette. Only 15% of the participants (three people) knew that smoking was harmful to health; only 45% of e-cigarette users knew that e-cigarette is addictive although they all use nicotine in their e-cigarettes. Of the 19 people who responded to the question 15 (79%) do not consider leaving e-cigarettes. Participants' carbon monoxide levels were measured as median 3, lowest 1, highest 22. Carbon monoxide level in 25% of participants was found to be above 7 ppm, which is used as threshold value in determining smokers. The levels of cotinine detected in urine samples are 709.9, lowest 318.6, highest 825.3 ng / ml. A moderate and statistically significant correlation was found between the amount of fluids used by the participants in one day (ml) and cotinine levels in urine specimens (Pearson correlation test, r = 0.511, p = 0.025). As a result, this study, in which nicotine exposure and increase in carbon monoxide and urine cotinine levels due to the use of e-cigarettes is documented, is an important proof of the country's scientific work on e-cigarettes. Preventive strategies should be strictly used for any tobacco products including e-cigarettes. Funding Statement: This project was funded by Hacettepe University, Scientific Research Projects Coordination Unit (Project nb. TAY-2016-9469).

AIM: Increase in aged population in number brings along the risk of falls and fall-related injuries among elderly. It has been reported that almost 60% of falls occur in nursing homes and majority of admissions to emergency departments due to falls consist of elderly. The purpose of this study conducted in a nursing home in Ankara was to determine the frequency of falls and risk factors, and to clear out the opinions and views of the participants on planning and promoting interventions for prevention. METHOD: This cross-sectional study was carried out among 60 years of age and older residents who lived in a nursing home. Data of the study was collected via face to face interviewing technique. The questionnaire consisted of four sections including socio-demographic characteristics, health status of the participants, healthy/risky behavior and fall related characteristics. RESULTS: Mean age of the 75 female and 59 male participants involved in the study was 73.99+/-7.18. Females were found to fall more in frequency than males (p>0.05). It was found that nearly half of the males (47.5%) and more than half of the females (56.0%) fell at least once within the previous year. Number of falls were higher among 75 years of age and older participants compared to the other age groups (p=0.003). Compared to the participants with fall background, aged people without fall background gave more correct answers in number to the questions which were asked to assess the knowledge on falls. Six out of 20 answers were statistically significantly correct (p

MATERIAL AND METHODS: The study was conducted at the smoke-free zones around Hacettepe University Sihhiye Campus Hospi- tals with 182 participants over 18 years-old. Data was collected through a questionnaire using face to face interview technique in this descriptive study. The official permission was obtained prior to the data collection. SPSS 15.0 predictive analytics software was used to analyze the data. RESULTS: Among 182 participants, 58.8% stated that they continue smoking in public areas during the presence of non-smokers. Eighty three point six percent of the participants who were aware of the health problems associated with smoking found the smoke-free zones in the hospital garden useful. The survey indicated that the awareness of the health problems associated with smoking and the usefulness of the establishment of smoke-free zones in a hospital garden was strongly correlated (p

Hearing loss, usually due to presbycusis, is frequent in old age and goes often undetected or untreated. Older subjects with hearing loss have increasing communication problems, reduced quality of life, isolation, depression and also feelings of frustration and discouragement. Hearing loss is also linked to cardiovascular problems, depression and dementia. Despite its relevance, country-level epidemiological data on age-related incidence and prevalence of presbycusis are limited, and no specific data in different geriatric settings are usually available. Population screening programs similar to those in infants are not widely implanted, although both primary care providers and geriatricians have incorporated strategies to detect hearing loss. No guidelines are available on when and how to screen and manage hearing loss in old age. Management of presbycusis is usually directed by ENT specialists, in cooperation with audiologist. These may be hospital-based or work in for profit centres, depending on the country. Funding of hearing aids by health care providers is limited, so some patients do not have access to them due to their high cost. Attitudes towards hearing loss, including considering it an inevitable age-related problem, may also limit access to care. Cochlear implants are still anecdotal in older patients in most countries. There is still a long way to go in the detection and management of hearing loss in older people. Systematic screening, careful assessment and treatment guidelines will have to be developed and implemented, both at country and European level.

In this study, we aimed to assess the knowledge and opinions of the public health residents recorded in the Society of Public Health Specialists’ inventory by August 2013 on mentoring related concepts, as well as to determine whether their training period is compatible with the requirements of mentoring idea. Materials and Methods: Two hundred and eighty three research assistants who were in the list of the Society of Public Health Specialists’ working at the 43 universities’ Public Health Departments was the universe of the study. Nevertheless, 160 residents participated in this study (participation rate=55.9%). Data was collected via electronic data collection method. Results: Mean age of the participants was 28.9±2.9. 60.8% of the research assistants started their thesis process and 69.2% of the research assistants had an advisor. The average time of determining the thesis content was9.4±10.5 months (median=2.0). 50.3% of the residents’ definition on academic advisor was found as “sufficient”. 72.0% of the residents declared that their academic plan had been completed at the beginning of their training period whereas 18.6% of them mentioned their un-satisfaction on that their expectations. 91.1% of the participants attended the internship education, 97.5% of them attended seminars, 91.1% of them attended literature classes, and 56.6% of them attended to the post graduate Public Health classes. Conclusion: In both under and post graduate medical education, the term of mentoring is need to be known accurately and to be practiced more effectively in resident training. It is recommended that the administrative bodies of Public Health departments with their academic members and the society of Public Health Specialists’ should collaboratively work to improve the current curricula and programs in this regard.

Tularemia is a zoonotic infectious disease which is caused by a Gram negative coco basil named Francisella tularensis mostly found in the Northern hemisphere. F. tularensis is a resistant bacteria that can survive in cold and moist environment for weeks. However it is susceptible to sun light and high degrees of heat, and it can’t live in chlorinated water. It is known that illness can be transmitted by either direct or indirect ways, however, epidemics occur when the agent is orally taken. In Turkey, especially laboratory workers, farmers, veterinary surgeons, hunters are majorly at risk as tularemia is transmitted by contagious water sources. F. tularensis grows in 2-5 days at 35 oC, in medium. For diagnosis, frequently used methods are serologic tests. In early phases, methods like PCR, immunfluorescent antibody testing and direct antigen detection can be used. Clinical findings can vary due to patient’s immunity status, severity of systemic spread, virulence of bacteria, etc. The most frequent form of tularemia is ulceroglandular form that is a painless ulcer, adjacent to a cutaneous lesion, accompanied by regional lymphadenitis. Other clinical forms are known as glandular, oculoglandular, oropharyngeal, respiratory and typhoidal tularemia. Endemic regions of tularemia are; Canada, Mexico, former Soviet Union countries, Tunisia, Turkey, Israel, Iran, China, and Japan worldwide. OZET Tularemi, Gram negatif kokobasil olan Francisella

Özet İnternet, birçok alanda olduğu gibi sağlık alanında da farklı amaçlarla yaygın olarak kullanılmaktadır. Bu amaçlar arasında, bilgi sistemleri oluşturulması, değerlendirme sistemleri yapılandırılması, epidemiyolojik veri toplanması, sağlıkla ilgili müdahalelerin planlanması ve davranışla ilgili verilerin toplanması sıralanmaktadır. Bu denli yaygın olarak kullanılan İnternet kullanımının bir yansıması olarak, web tabanlı araştırmalar son dönemlerde toplumun sağlığını korumayı ve geliştirmeyi öncelikli hedefleri arasında alan halk sağlığı uygulamalarının çalışma alanları arasına girmiştir. Bununla birlikte, web tabanlı araştırmaların kullanımının katılım sınırlılığı, araştırma metodolojisinde sorunlar, etik açısından sınırlılıklar gibi kimi önemli kısıtlılıkları da bulunmaktadır. Halk Sağlığı araştırmacılarının web tabanlı araştırmaları yürütürken bu kısıtlılıklara dikkat edebilmeleri önemlidir. Bu yazıda web tabanlı araştırmaların halk sağlığı alanında kullanımının gerekçesi, kullanıma ilişkin yöntem ve kısıtlılıkların tartışılması amaçlanmıştır. Anahtar Kelimeler: İnternet, halk sağlığı, araştırma Use of Web Based Research in Public Health Abstract The internet is frequently used for health issues and for many other related purposes: creating information systems, structuring evaluation systems, gathering epidemiological data, planning intervention methods are examples. As a reflection of such wide use of the internet, web based research has been one of the working areas of the public health discipline, which basically aims to prevent and promote health and wellbeing of the community. Nevertheless, there are a number of limitations of web based research and these include limitations in participation, methodological issues, ethical limitations, and others. It is important for public health researchers to take all these limitations into consideration during their research. In this paper, the rationale of web based research in Public Health, its methods and basic limitations in use were discussed. Key Words: Internet, public health, research

Purpose: A content analysis of five newspapers with the highest circulation numbers in selected months on obesity including assessment of the news’ concordance status with recent scientific data and the manipulation status by the advertisement sector. Material and Methods: Newspapers were determined via “Press Announcement Institution” data in May 2012. Random selection of 4 months were completed to evaluate the newspapers within one year period before February 2012 which was the last accessible date of the National Library Archive. In conclusion, 151 published news in March, August, October 2011, February 2012 were evaluated. Results: Majority of the news were found in concordance with the recent scientific data (61,6%) and majority of them were not manipulated by the advertisement sector (86,1%). Statistically significantly difference were found between the concordance of the news with recent scientific data and news’ characteristics like main content, being published in a particular section, type of the news, being noted of the person(s) who had prepared the news, source of scientific data, etc. News were found as they were statistically significantly manipulated by the advertisement sector due to a number of characteristics as well. Conclusion: Systematic solution is recommended to be developed to overcome determined lacking. [TAF Prev Med Bull 2013; 12(3.000): 271-282]

Background/aims Functional bowel disorders (FBDs) impair the quality of life in patients with end-stage renal disease (ESRD). The aim of our study was to determine the prevalence and distribution of the subtypes of FBDs in hemodialysis (HD) patients. Materials and methods This prospective, cross-sectional study included 80 patients who received HD for more than 3 months (patient group) and 80 healthy controls (control group). FBDs were diagnosed according to the Rome II diagnostic criteria by excluding organic pathologies. Results Forty-six (57.5%) patients were males, and their average age was 62.13±12.92 (23-90) years. The mean duration of dialysis was 57.48±59.23 (3-312) months, and the mean Kt/V (K: dialyzer clearance of urea, t: dialysis time, V: volume of distrubition of urea) value was 1.53±0.31. The rate of FBDs was significantly higher in the patient group than in the control group (p=0.01). In total, 7.5% of the patients had irritable bowel syndrome, 3.8% had functional bloating, and 16.3% had functional constipation. FBDs were significantly higher in women (p=0.004). While there was no statistically significant difference between patients with and those without FBDs in terms of the presence of additional diseases, smoking, alcohol use, educational level, marital status, and resi- dential areas (p>0.05), serum phosphorus (P) levels were significantly higher in the patients with FBDs (p=0.03). Conclusion FBDs and their functional constipation subtype are more common in HD patients than in the healthy population in Turkey. FBDs are most frequently observed in females and housewives with high serum P levels.

WOS: 000438303700008 Sudden unexpected death in epilepsy (SUDEP) is a serious problem, and its importance has increased in recent years. It is responsible for the death of 17% of epilepsy patients. As the age of onset rises, the risk increases. Patients with refractory epilepsy are particularly at risk. Likewise, male gender, early age of onset, polytherapy, nocturnal seizures, generalized tonic-clonic seizures (GTCS) are also among the risk factors. Respiratory, cardiac, autonomic and brain stem related pathologies are held to be responsible for its pathophysiology.

In this follow-up study, we aimed to assess national and international pharmaceutical companies' Web sites using guidelines of The Association of Research-Based Pharmaceutical Companies (AIFD) and Pharmaceutical Manufacturers Association of Turkey (IEIS) to define whether there has been progress since 2004.We used two national guidelines in order to evaluate the Web sites of pharmaceutical companies in our study. The first guideline was from IEIS, and the second was from AIFD, which was issued recently. We collected our data between February 1 and April 30, 2011. Data analyses were performed using SPSS version 15.0. Chi squared test was done for comparing the two assessments in different years (2004 and 2011).In general, the progress that we were expecting was not satisfactory for both the international and national companies. The percentage of unmet criteria increased for "links" (from 48.0% to 52.0%) and for "mentioning the responsible person/firm for the Web site design" (from 40.6% to 59.4%) among national companies. We observed statistically significant progress only for the "information for the public" criterion (from 52.9% to 100%) among international companies. On the other hand, there was progress and a statistically significant difference in terms of not displaying any "drug ads" on the Web sites of national firms (from 55.9% to 87.5%), availability of "mail address" (from 88.2% to 100%), "telephone number" (from 88.2% to 100%), "indication of the target group" (from 23.5% to 52.1%), and "disclaimer stating the given information cannot replace a physician or pharmacist" (from 29.4% to 53.1%).Our major recommendation to pharmaceutical companies is to update their Web sites with evidence-based scientific information about themselves and their products using international and national standards. From the companies' perspective, this should be a priority responsibility based on the ethical aspect of individual and community health.

There are two types of malnutrition in patients with chronic renal failure (CRF); type 1 and type 2. The aim of this study was to investigate the relationship between malnutrition and inflammation and also the relationship between malnutrition and volume status. Ninety-four pre-dialysis CRF patients were included in the study. Nutritional status of the patients was calculated using the subjective global assessment. Scores of 1-5 were given according to the severity of the symptoms and physical examination findings. Serum inflammation markers [high-sensitive C-reactive protein (hs-CRP), interleukin-1β, interleukin-6 and tumor necrosis factor-alfa] and nutrition parameters (albumin, pre-albumin, transferrin, fetuin-A, insulin like growth factor-1 and insulin-like growth factor-binding protein-3)] were measured in all the patients. Serum N-terminal pro-brain natriuretic peptide levels and echocardiography were performed to evaluate the volume status of the patients. The mean age of the patients was 59.6 ± 13.3 years, the mean malnutrition score was 17.2 ± 6.01, the mean and the median of hs-CRP levels were 18.5 ± 40.7 and 5.6 mg/L, respectively, the mean albumin level was 3.46 ± 0.48 and the mean creatinine clearance was 23.7 ± 13.5 mL/min. A positive correlation between malnutrition scores with inflammation and volume parameters was found in the bivariate and multivariate analysis. In the multiple regression analysis, volume parameters proved to be the most important factors influencing malnutrition scores. Thus, the elimination of volume excess would ameliorate both inflammation and malnutrition. This hypothesis needs to be supported or proved with prospective studies.

Objective A student-oriented basic life support and first-aid training is practical to enlarge the number of qualified people in the field. In this study, we aimed to describe and discuss the training process of a group of medical students at Hacettepe University, School of Medicine and their assessment as basic life support and first-aid trainers. Methods A ‘6-hour’ ‘Training the Trainers’ course was conducted and participants’ demonstration and coaching skills were evaluated by using a 3-point scale (1 – needs improvement; 2 – competently performed; 3 – proficiently performed). In total, 31 students out of 45 volunteers were certified as trainers. Results All of the students proficiently performed ‘explain the aim of the demonstration’, ‘motivate participants to use checklists’, and ‘motivate the participants to ask questions’ for demonstraton skills. Similarly, they all got the maximum grade for ‘answer the questions of the participant’, ‘discuss the coach role of the participant’, ‘apply the skills’, and ‘follow up with the participant by using the checklist’ as steps of coaching skills. None of the skills within the checklists needed improvement for any of the candidates. Conclusion Although there are limitations, we hope that our experience of the Training the Trainers course will be useful for readers to highlight the importance of skill-based peer education on a very important public health concern, especially for the developing countries.

This study, performed in two phases, compared the smoking status of first- and last-year pharmacy students and identified underlying factors of smoking using both "quantitative" and "qualitative" research techniques. The quantitative phase was a cross-sectional study with 207 students (of these, 102 were first-year and 105 were last-year students). The mean age at which first-year students tried tobacco/tobacco products was 14.1 +/- 3.2 and for last-year students, 16.0 +/- 2.4. The students completed an 18-item questionnaire at the end of the spring semester in May 2004. Chi-square and t-test analyses were used for statistical comparisons. Furthermore, focus group discussion techniques were used to find out the underlying factors of smoking in the second phase.

Objective: This study was designed to evaluate the role of zygote intrafallopian transfer (ZIFT) procedure in patients with repeated failure of implantation. Study Design: A total of 141 ZIFT cycles of 132 women and 145 embryo transfer (ET) cycles of 97 women in whom five or more embryos were transferred were included in this study. Transcervical uterine embryo transfer and ZIFT cycle outcome in patients with five or more previous implantation failure were compared. Embryos were transferred by laparoscopy into the fallopian tube 24–27 h following oocytes retrieval in the ZIFT group. In the ET group, embryos were transferred transcervically on the third day following oocytes retrieval. Results: The mean age was 34 ± 4.9 and 34.9 ± 5.0 years in ZIFT and ET group, respectively. No difference was determined between the two groups regarding the basal FSH, E2 value on the day of HCG injection and the number of oocytes retrieved or fertilized. The implantation rate was 6.5% versus 7.2%, clinical pregnancy rate was 22.7% versus 24.8% and live birth rate was 21.2% versus 16.5% in ZIFT and ET groups, respectively. Conclusions: Implementation of ZIFT procedure in patients with repeated implantation failure is not superior to transcervical uterine embryo transfer.

Background Asthma, which is a chronic inflammatory disorder of the airways characterized by the infiltration of inflammatory cells, is a common cause of morbidity in adults. It is almost the third leading cause of preventable hospitalization in the developed countries and accounts for approximately millions of visits to emergency departments. Methods In this study, we aimed to determine asthma prevalence in five urban centers in Turkey. Three of the cities were located in the middle-west region of the Anatolia one of them as located across the Mediterranean cost and the last one was in the north part of the country. Data of totally 2353 participants was collected by the trained interviewers, who visited the households and administered the questionnaire to the household members at or over the age of 15 years. Results The prevalence of asthma was found to be 6.6 % and the difference of asthma prevalence between the urban centers was statistically non-significant (p = 0.059).

Objective: The aim of the study was to evaluate the voiding symptoms of pregnant women and to compare the symptoms amongst trimesters and controls by means of the International Prostate Symptom Score (IPSS). Materials and Methods: Voiding symptoms of 256 pregnant and 230 non-pregnant healthy women hospitalized for other reasons were evaluated. Subjects who had a history of urological and neurological problems or previous pelvic surgery associated with urinary symptoms and those who had urinary tract infection were excluded from the study. The pregnant group was then subdivided into subgroups as to the trimesters of pregnancy. The IPSS assesses seven symptoms on a scale of 0 (no symptoms) to 5 (symptom always present) and was administered as a self-administered questionnaire with the assistance of a trained nurse. Symptom scores of each group and subgroup and the distribution of scores were assessed. Results: The mean scores for all questions in the pregnant group were significantly higher than controls. The comparison of mean scores according to trimesters showed a significant difference for the questions of frequency, intermittency, urgency, weak stream, nocturia, quality of life and for the total scores. The distribution of the scores for each question showed that frequency and nocturia were the most prominent symptoms in pregnancy. The percentage of the respondents with an IPSS score of >7 was 47.6% and the percentage of a quality of life score of ≧4 (mostly dissatisfied) was 48.4%. Conclusions: Voiding symptoms during pregnancy are highly prevalent. These symptoms worsen as the pregnancy progresses.

Aim. In this study, “active” web sites related to health which were selected due to determined criteria have been evaluated in terms of formal, contextual and institutional characteristics. Methods. In this descriptive study, web sites which have been accessed when selected key words on the most frequently seen symptoms of the diseases were entered into the most frequently used search engine in Turkey. Four key words for each symptom were determined like “symptom alone”, symptom and prevention”, “symptom and diagnosis”, “symptom and treatment”. Researchers determined the most frequently seen symptoms of the neural, gastro intestinal, cardiovascular, respiratory, musculo-skeletal, endocrine, urinary, male genital, female genital, skin and lymphatic systems due to the answers of chief residents’ working at a university hospital to the question “Would you kindly say the most frequently seen five symptoms in your daily practice?”. All stated symptoms were listed by the researchers and three of five for each system were selected by random. For each key word, four searches were completed (the key word itself as well as three more searches using; “key word, prevention”, “key word, diagnosis”, “keyword, treatment”. Four different searches were done for each symptom which equals to 12 searches for one system. The first five web sites excluding the web sites used advertisements were investigated for one search. In the end, 60 web sites for each system and 600 web sites for all systems were assessed in the first run of the study. After exclusion of the duplicated sites, 475 web sites were included in the study. SPSS program was used for data entry and analysis. Results. Ninety two percent of the web sites did not include evidence based information. Besides, 40.6% of the current sites did not direct their users to either physicians or health professionals. Sixty five percent nine of the accessed web sites included advertisements. Only 9.7% of the researchers stated their possibility to recommend the web sites to their patients. The advertisement and sponsor relationships influenced their recommendation status. Conclusion. Web sites’ related to health/diseases need improvement (s) in order to be useful for their users in the community independently from commercial expectations, ÖzetAmaç. Bu çalışmada, sağlığı ilgilendiren konularda kullanımda olan ve belirlenmiş kriterlere göre seçilmiş bazı web sitelerinin şekil, içerik ve kurumsallık gibi özelliklerinin araştırılması amaçlanmıştır. Yöntem. Tanımlayıcı tipte olan bu araştırmada, Türkiye’de en sık kullanılan arama motoruna vücut sistemleri ile ilgili semptomlara ilişkin seçilmiş anahtar sözcükler verildiğinde ulaşılan web siteleri değerlendirilmiştir. Anahtar sözcükler, her bir semptom için dört adet olmak üzere “semptomun kendisi”, “semptom ve koruma”, “semptom ve tanı”, “semptom ve tedavi” şeklinde belirlenmiştir. Anahtar sözcükler, araştırmacılar tarafından belirlenen vücut sistemleri (sinir, sindirim, kardiyovasküler, solunum, kas-iskelet, endokrin, üriner, erkek genital, kadın genital, deri ve lenfatik sistemleri) ile ilgili araştırmacıların çalıştıkları hastanenin ilgili bölümlerinin baş asistanlarına ilgilendikleri sistemle ilgili “En sık gördüğünüz beş semptomu söyler misiniz?” sorusuna verilen yanıtlara göre belirlenmiştir. Baş asistanlar tarafından ifade edilen anahtar sözcükler listelenmiş, araştırmacılar tarafından kura çekilerek beş semptom içinden üç semptom seçilmiştir. Her bir anahtar sözcük için anahtar sözcük yanında virgül kullanılarak üç farklı ek sözcük kullanılmıştır (“anahtar sözcüğün kendisi”, “anahtar sözcük, korunma”, “anahtar sözcük, tanı”, “anahtar sözcük, tedavi”). Bir semptom için toplam dört farklı arama yapılmıştır. Toplamda, her bir sistem için 12 anahtar sözcük incelenmiştir. Her bir anahtar sözcük için reklam kullanarak üst sırada olan siteler hariç ilk 5 site değerlendirilmiştir. Sonuç olarak, ilk aşamada her bir sistem için toplam 60, on sistem için ise 600 web sitesi incelenmiştir. Sitelerde çakışmalar dışarıda bırakıldığında toplamda 475 web sayfası incelenmiştir. Veri girişi ve analizi için SPSS programı kullanılmıştır. Bulgular. Araştırmaya dahil edilmiş sitelerin %92’sinde kanıta dayalı hiçbir bilgi olmadığı bulunmuştur. Bununla beraber sağlıkla ilgili bilgi veren mevcut sitelerin %40,6’sında hekime veya sağlık çalışanına yönlendirme olmaması dikkat çekmiştir. Ayrıca sitelerin %65,9’u reklam içermektedir. Araştırmacıların sadece %9,7’si web sayfalarını hastalarına önereceklerini belirtmişlerdir. Reklam içerme ve sponsor olması araştırmacıların öneri seçeneklerini etkilemiştir. Sonuç. Sonuç olarak sağlık/hastalıkla ilgili web sitelerinin kullanıcıları için ticari kaygılardan bağımsız olarak yararlı olabilmeleri için gelişmeye/iyileşmeye gereksinimi bulunmaktadır.Anahtar sözcükler: Semptom, sağlık arama davranışı, internet AbstractAim. In this study, “active” web sites related to health which were selected due to determined criteria have been evaluated in terms of formal, contextual and institutional characteristics. Methods. In this descriptive study, web sites which have been accessed when selected key words on the most frequently seen symptoms of the diseases were entered into the most frequently used search engine in Turkey. Four key words for each symptom were determined like “symptom alone”, symptom and prevention”, “symptom and diagnosis”, “symptom and treatment”. Researchers determined the most frequently seen symptoms of the neural, gastro intestinal, cardiovascular, respiratory, musculo-skeletal, endocrine, urinary, male genital, female genital, skin and lymphatic systems due to the answers of chief residents’ working at a university hospital to the question “Would you kindly say the most frequently seen five symptoms in your daily practice?”. All stated symptoms were listed by the researchers and three of five for each system were selected by random. For each key word, four searches were completed (the key word itself as well as three more searches using; “key word, prevention”, “key word, diagnosis”, “key word, treatment”. Four different searches were done for each symptom which equals to 12 searches for one system. The first five web sites excluding the web sites used advertisements were investigated for one search. In the end, 60 web sites for each system and 600 web sites for all systems were assessed in the first run of the study. After exclusion of the duplicated sites, 475 web sites were included in the study. SPSS program was used for data entry and analysis. Results. Ninety two percent of the web sites did not include evidence based information. Besides, 40.6% of the current sites did not direct their users to either physicians or health professionals. Sixty five percent nine of the accessed web sites included advertisements. Only 9.7% of the researchers stated their possibility to recommend the web sites to their patients. The advertisement and sponsor relationships influenced their recommendation status. Conclusion. Web sites’ related to health/diseases need improvement(s) in order to be useful for their users in the community independently from commercial expectations.Keywords: Symptom, health seeking behavior, internet

The Framework Convention on Tobacco Control is a multilateral international agreement which has been generated to protect the health of nationals and nations against the hazards/risks of tobacco and its products. All high contracting parties to the Convention undertake the international responsibility to fulfill all the requirements of the Convention's articles in national legal systems. The Framework Convention on Tobacco Control has a considerable place among other international conventions on health. Within the self-executing desing/system of the Convention, a vital regulation focuses on banning the advertisement, promotion, and sponsorship of tobacco products. Because they are one of the various components of tobacco advertisement, promotion, and sponsorship, taste panels should be assessed within the content of the Convention. Thus, banning taste panel activities is an important step in tobacco control and it is one of the basic areas where medical and law sciences should collaborate. In this article, a comprehensive frame has been drawn to the issue and recommendations have been developed for the future.

OBJECTIVES The present study aimed to investigate smoking status of households having children under 5 years of age and any changes in their smoking habits after the enforcement of the anti-tobacco Law Nb. 4207 and after the birth of the child based on the records of two Family Health Centres in Ankara. MATERIAL AND METHODS Within the scope of this cross-sectional study, 192 houses, in which 228 children under five years of age were living, were evaluated. Data were collected via face-to-face interview. Data collection form included information regarding socio-demographic characteristics, health status, smoking habits, status of exposure to second-hand smoke. Data transfer to the computer and data analyses were performed using the SPSS 15.0 statistical package program. RESULTS According to the statements of the study participants, the rate of smoking in the balcony, kitchen, toilet-bathroom, and rooms of the house decreased after the enforcement of the anti-tobacco Law Nb. 4207. Similar decrease was valid also for working environment. The decrease in the rate of smoking was the least in "Balconies" at both home and working environments. Birth of a child was also a factor that decreased the rate of smoking. A decrease was observed in almost all parts (bedroom, kitchen, balcony, and toilet-bathroom) of the houses after birth of a child. CONCLUSION Exposure to second-hand smoke at homes, where children under the age of five years were living, could not be completely (100%) prevented. Health care workers' persistent study on this issue may contribute to the awareness of parents in preventing exposure to second-hand smoke.

WOS: 000410870800004 PubMed ID: 29042878 Objective Stroke is the second most common cause of death and the leading cause of adult disability. Both stroke patients and their family can therefore experience increased traumatic stress level. Methods The participants are close relatives of patients (n=65) who had a first time stroke (CRPWS) hospitalized. A control group (CG) (n=61), who had no history of chronic illness in their family and had at least one traumatic life event experience. The National Institutes of Health Stroke Scale, Modified Rankin Scale, Personal Information Form, Life Events Checklist, Traumatic Stress Symptom Scale, and Multidimensional Scale of Perceived Social Support, were used in the study. Results We found no significant association between NIHSS and MRS of patients and traumatic stress level of the family member. The traumatic stress level was significantly higher in the CRPWS group than in the CG group. Traumatic stress level was higher in women than men and was not associated with perceived social support in the CRPWS group. Conclusion The traumatic stress level of the relatives was not associated with the clinical features of the stroke patients. In the early phase, after the diagnosis of stroke, psychological support may be important to prevent CRPWS from PTSD.

To evaluate the health-related quality of life of women living in Van city center by SF-36 and its association with the women's characteristics. Materials and methods: The women (n = 1527) answered a questionnaire through a face-to-face interview, and some measurements were made. The variations of physical component score (PCS) and mental component score (MCS) of SF-36 were investigated by non-parametric tests, and by linear regression analysis. Results: The percentage of early marriages among married women was 55.6. Number of pregnancies per married woman was 4.5 ± 2.8, the lowest mean in vitality (44.0 ± 20.6) and the highest mean in physical functioning (73.2 ± 28.2) components of SF-36. The women's means on PCS was 43.7 ± 11.4, and on MCS was 37.2 ± 8.9. In regression analysis, the age of marriage, the number of live births, and presence of still birth-spontaneous miscarriage, and BMI were associated with PCS; the age of marriage, smoking cigarette, physical exercise and BMI were associated with MCS. Conclusion: Policies to improve the status of women and interventions for reproductive health and for promotion of healthy behavior are needed to enhance the HRQOL of women living in the city of Van.

Objective To determine community pharmacists’ burnout levels and prevalences as well as factors associated with burnout. Setting Study was conducted in Ankara, the capital of Turkey. Method In this cross-sectional study, 251 pharmacists were randomly selected from 1,504 community pharmacists registered in Ankara Chamber of Pharmacists. A questionnaire including questions related to pharmacists’ individual and professional characteristics and Maslach Burnout Inventory was administered. The data was collected between February 27 and May 25, 2007. Main outcome measure Three Maslach Burnout Inventory subscales (emotional exhaustion-EE, depersonalization-D, and personal accomplishment-PA) scores. Results Pharmacists’ mean emotional exhaustion score was found to be 16.84 (SD: 6.25), depersonalization score was 4 (Range: 0–14), and personal accomplishment score was 22 (Range: 9–32). Of the pharmacists, 1.2% had high level of EE, .8% had high level of D, and 71.3% had high level of inefficacy. Age, marital status, work experience, work contentment, workload, time pressure, stress, and satisfaction with customers were found to be related with pharmacists’ burnout levels. Conclusion It can be useful to monitor pharmacists’ burnout levels and prevalences periodically. Interventions on individual and organizational basis were needed to cope with burnout, respond to job demands, minimize the level of chronic stress, and increase work contentment and satisfaction.

Objective: Male factor infertility accounts for 30% to 50% of the total infertile couples seeking for infertility treatment. In about 40-60% of these men, a specific etiology can not be found. The aim of this study was to confirm the presence of eotaxin and interleukin-4 (IL-4) in human seminal plasma, to show the differences between eotaxin and IL-4 concentrations in fertile and infertile men, and to show the potential relationship between eotaxin and IL-4 levels in semen and spermiogram parameters. In literature, this is the first study that evaluates eotaxin in the human seminal plasma. Material and Methods: The participant of the study was 55 infertile males with abnormal semen parameters as study group and 16 healthy volunteers with normal sperm parameters as the control group. Semen samples were classified according to criteria of the World Health Organization Laboratory Manual. The Morphology of the smears was scored using Kruger's strict criteria. Seminal eotaxin and IL-4 levels were measured by bead based immunoassay multiplex methods. Results: Seminal eotaxin levels were significantly higher in infertilite group compared to fertile donors. There were negative correlations between eotaxin concentrations and parameters such as motility (r= -0.293, p< 0.01) and, +4 motility (r= -0.307, p< 0.01) in the study group. IL-4 levels were similar in fertile and infertile seminal plasma. There were positive correlations between eotaxin and IL-4 levels (r= 0.436 p< 0.01). The receiver operating characteristic curve (ROC) analysis revealed a diagnostic value for eotaxin activity with respect to male factor infetility in case group, with an area under curve of 0.69 (95% confidence interval= 0.55-0.84). Conclusion: Increased levels of eotaxin may play a role in the pathogenesis of male infertility.

We developed 24 and 12-h programs for first aid and basic life support (FA-BLS) training for first-year medical students and evaluated the opinions of both the trainers and trainees on the effectiveness of the programs. The trainees were the first-year students of academic years 2000-2001 (316 students) and 2001-2002 (366 students). The evaluations of the participants were collected from short questionnaires created specifically for the study. For the 24-h training program, most of the students stated that FA-BLS sessions met their expectations (85.9%) and they were satisfied with the training (91.1%). Of the participants, 75.6% stated that they could apply FA confidently in real situations simulating the topics they learned in the FA-BLS sessions. For the 12-h training program, 84.4% of the students felt themselves competent in FA-BLS applications. The trainers considered both of the programs as effective.

The objective of this study was to find all the existing Web sites of Turkish community pharmacies and evaluate their "quality" in terms of Health on the Net (HON) Code of conduct principles. Multiple Internet search engines were used (google.com, yahoo.com, altavista.com, msn.com). While searching on the Internet, "eczane (pharmacy)" and "eczanesi (pharmacy of)" key words were used. The Internet search lasted for 2 months starting from March 1, 2007 until May 1, 2007. SPSS ver. 11.5 statistical program (SPSS, Inc., Chicago, IL) was used for data entry and analysis. At the end of the Internet search via all the indicated search engines, a total of 203 (all different from each other) community pharmacy Web sites were determined; of these, 14 were under construction and 6 were not accessible. As a result, 183 community pharmacy Web sites were included in the study. All of the Web sites could be accessed (100%). However, the availability of some characteristics of the pharmacies were quite poor. None of the pharmacies met all of the HON principles. Only 11 Web sites were appropriate in terms of complementarity (6.0%). Confidentiality criteria was met by only 14 pharmacies (7.7%). Nine pharmacies (4.9%) completed the "attribution" criteria. Among 183 pharmacy Web sites, the most met HON principle was the "transparency of authorship" (69 pharmacy Web sites; 37.7%). Because of the results of our study, the Turkish Pharmacists Association can take a pioneer role to apply some principles such as HON code of conduct in order to increase the quality of Turkish community pharmacists' Web sites.

Although the physical activity is a very basic lifestyle activity, the physical inactivity has been estimated to cause 1.9 million deaths worldwide annually, according to the 2002 World Health Organization (WHO) Report. In this cross-sectional study, we aimed to determine the frequency of and factors influencing regular exercise among elders living in the catchment area (CA) of a primary health care unit (PHCU) of a district in Ankara. The district has 7 subregions and 50 people were interviewed from each region. From the total number of elderly in the region, these 350 were selected for the study sample. Five of the authors collected data by a self-administered questionnaire. The dependent variable of the study was "doing physical activity", and there were various independent variables including sociodemographic characteristics and risky health behaviors, etc. Significantly positive associations were determined between "not doing regular exercise" and age of 65 years of older (odds ratio (OR)=1.059, 95% confidence interval (CI)=1.010-1.110; p=0.018), female gender (OR=1.992, 95% CI=1.245-3.185; p=0.004), presence of a chronic disease (OR=2.704, 95% CI=1.444-5.066; p=0.002), and lower/higher body mass index (BMI) (OR=2.568, 95% CI=1.573-4.192; p

The Turkish Pharmaceutical Manufacturers Association-Ilaç Endüstrisi Isverenler Sendikasi (IEIS) set guidelines for pharmaceutical companies when designing their websites in 2003. The objective of this study is to evaluate whether pharmaceutical company websites comply with these guidelines. The list of all the national and international pharmaceutical companies active in Turkey is obtained from Farmalist Vademecum. We evaluated each site in terms of availability of drug advertisement, mail address, e-mail address, telephone number, fax number, update information, indication of target group, links, references, information, appropriate content for the intended target group, disclaimer stating the given information is only for health care professionals, disclaimer stating the given information cannot replace a health care professional, responsible body for the website design. The search was done throughout February 2005. We used x(2) test and Fisher's exact x(2) tests for statistical analysis. Of the 82 pharmaceutical companies active in Turkey, 51 had a website eligible for evaluation. Of the 51 companies, 34 (66.7%) were national and 17 (33.3%) were international. Eighteen companies had drug advertisement on the home page of their websites (64.7%). Of the total companies majority had mail address (89.2%); telephone number (89.2%); fax number (84.3%); links (66.7%); and appropriate content for the health care professionals (62.7%). The frequency of having update information and a separate pharmacist/physician information part was higher among international pharmaceutical company websites compared to the national ones. These differences were statistically significant (p0.05). As a result of the evaluation, the majority of the pharmaceutical companies failed to comply wholly with the guidelines set by IEIS when designing their website on the Internet.

Obesity and its associated metabolic complications can impair the physiologic regulation of fibrinolysis, leading to a hyper coagulable state. We aimed to assess circulating thrombin activatable fibrinolysis inhibitor (TAFI) levels in obese female patients and to test the effects of orlistat-induced weight loss on basal TAFI concentrations. Obese female outpatients age 18 and older, with a body mass index (BMI, calculated as weight in kilograms divided by the square of height in meters) of at least 30, were included into the study. Thirteen nonobese (median BMI, 22.60 kg/m2) age-matched females were taken as controls. Plasma TAFI levels were measured before orlistat administration and after 6 months of orlistat treatment in the obese group and only one measurement was done in the control group. Twenty-seven obese patients were recruited into the study. The median TAFI level of the control group was 124.00; this value was significantly lower than the basal TAFI level of the obese group (p < 0.001). TAFI levels after orlistat therapy were statistically significantly lower than basal TAFI levels (p < 0.001) in the obese group. Hemostatic abnormalities including TAFI alterations represent a link between obesity and vascular thrombosis. Effective interventions should be considered in improving the obesity-associated prothrombotic risk profile.

To investigate the efficacy of gonadotrophin-releasing hormone (GnRH) antagonist supplementation during natural cycles in poor responders undergoing IVF-ET treatment.We retrospectively evaluated 540 cycles of 433 suitable patients who were divided by treatment protocol into modified natural, antagonist, and long agonist groups. There were 52 modified natural cycles with GnRH antagonist supplementation, 200 stimulated cycles with GnRH antagonist, and 288 long GnRH agonist cycles. Cycle characteristics and treatment outcomes were compared between the groups.The mean number of oocytes retrieved in the modified natural group was significantly lower than in the stimulated antagonist and long agonist groups (1.4 +/- 0.5 vs. 2.3 +/- 1.1 and 2.5 +/- 1.1, respectively, p0.05). The respective implantation and pregnancy rates were 10% and 14.3%, 6.75% and 10.2%, and 7.4% and 10.6%. Cycle outcome and cycle properties were similar.Modified natural IVF cycle with GnRH antagonist supplementation is a feasible alternative to ovarian stimulation protocols in poor responders.