Search

The aim of this study was to develop a scale to measure the attitudes of the university academic and administrative staff and students toward sexual harassment and assault, and examine its psychometric properties. After the development of the item pool and examination of the content validity of the intended items, Exploratory Factor Analysis (EFA) and parallel analysis was conducted and Cronbach’s alpha reliability coefficient was calculated collecting data from 150 participants (54.7% of female and 45.3% of male) for the initial version (comprised of 12 items) of the Attitudes Toward Sexual Harassment and Assault Scale (ATSHAS). In the second phase, Confirmatory Factor Analysis (CFA) was conducted with 354 participants (54% of female and 46% of male) for the revised version (10 items) of the ATSHAS. Additionally, Cronbach’s alpha reliability coefficient was calculated with second sample. After developing the item pool, the completion of the first phase of the study took 5 months, and the second phase took 4 months. The final version of the ATSHAS consisting of nine items demonstrated sufficient psychometric properties for measuring attitudes toward sexual harassment and assault in the university environment.

Background Interprofessional education is an important approach to prepare healthcare students for future interprofessional teams. It is suggested that interprofessional education programs should be started during undergraduate education and collaborative learning activities should be increased. A family planning themed educational program for Dokuz Eylul University Faculty of Medicine and Nursing Faculty students was planned and implemented with the purpose of providing a collaborative learning environment and gaining communication and team work skills. The objective of this article is to present the interprofessional learning experiment. Methods Family planning themed educational program was implemented by using flipped classroom method in the first week of Life Cycle Block of the third-year program. After presentation of the program, educational material and pretest were shared with the students in an electronic format. During the practice, students performed role plays on family planning counselling with the facilitation of the trainers. The educational session was completed with oral and written feedback. A post-test was implemented one month after the completion of the educational session in the same electronic format. Results Statistically significant increase has been observed in the students’ post-test scores compared to the pre-test scores. Although, a fair amount of increase in Medical Faculty students’ scores was observed, a statistical significant difference was not found. The increase in the scores is believed to have resulted from Nursing Faculty students’ scores. Each of two groups’ feedback points on educational activity was found as high. In general, students stated positive opinions about the program, pointed out problems in using electronic system and necessity for the early introduction of the program. Conclusions In the light of the students’ and trainers’ feedback, the educational program is thought to have been providing an opportunity for interprofessional learning and the program is being planned to be continued with revisions and improvements in the following years.

Aim:The purpose of this study was to elicit data concerning the clinical and laboratory features of children with growth hormone deficiency monitored by the Pediatric Endocrinology and Metabolism Polyclinic in order to produce useful information for future cases. Methods: The medical records of 185 patients diagnosed with growth hormone deficiency at the Dr. Behçet Uz Pediatrics and Pediatric Surgery Research Hospital Pediatric Endocrinology and Metabolism Polyclinic were examined retrospectively. The subjects were allocated into 4 groups according to the cause of growth hormone deficiency. Demographic and clinical characteristics of the patients were assessed and compared across these groups. Results: One hundred and fifty-four patients were diagnosed with idiopathic growth hormone deficiency, 16 (8.6%) with combined growth hormone deficiency, 13 (7%) with Turner’s Syndrome, and 2 (1.1%) with chronic renal failure. On the other hand, the most common accompanying hormone deficiency was TSH deficiency, determined in 21 (11.4%) patients. Two or more hormone deficiencies were present in 10 (5.4%) patients. Intracranial pathologies were present in 15.6% of the idiopathic growth hormone deficiency group and 81.2% of the combined growth hormone deficiency group. Bone age, height SDS, and stimulation test peak responses were significantly lower in the combined growth hormone deficiency group than in the other groups. Conclusion: The principal risk factors determining prognosis in cases of growth hormone deficiency are etiology, accompanying hormonal or chromosomal disorders, and early treatment.

Objective:Musculoskeletal system pain is related with learned posture and habits.Analyzing this problem in university period is especially important in terms ofprotection and awareness. Objective of the research is to define the occurrenceof musculoskeletal system pain and related factors in sophomore students infaculty of education.Material and Method:Twenty one major departments in the Faculty of Education have been included inthe study population and by using simple random numbers table, Department ofPreschool Education, Department of Mathematics and Department of SocialSciences have been included. Three hundred twenty six students in these departments established thestudy group and data from 317 students have been analyzed. Musculoskeletal paindata of the students have been collected with a questionnaire, by usingextended version of Nordic Musculoskeletal Questionnaire.Results: 70% ofparticipant students are female, and average age is 20.5±1.2. The most commonpain is back pain, low-back pain and neck pain among the participants. Dailysitting time and weight are determined as the predominant variables on pain.When the sitting time increases both in and out of school, it was detected thatthe possibility of any pain on any part of the body increases as well.Conclusion:In line with the findings of the study,it was determined that musculoskeletalsystem pain of the university students is significantly high and that studentsmay even fail to do some daily activities because of such pain. To preventthese pains from causing more trouble in their adult life, there are possibleprecautions such as ergonomic designs or increasing physical activities., Amaç:Kas iskelet sistemi ile ilgili ağrıların öğrenilmiş postürve alışkanlıklarla ilişkisi vardır. Üniversite eğitim döneminde bu sorununincelenmesi korunma ve farkındalık acısından özel önemdedir. Araştırmanınamacı, Eğitim Fakültesi ikinci sınıfa devam eden öğrencilerde kas iskeletsistemi ağrılarının varlığı ve ilişkili etmenlerin belirlenmesidirGereçve Yöntem: Eğitim Fakültesi’nin 21 anabilim dalı kesitsel tiptekiçalışmanın evrenine alınmış ve basit rasgele sayılar tablosu kullanılarak OkulÖncesi Eğitim Bölümü, Matematik Bölümü ve Sosyal Bilgiler Bölümü çalışmayaalınmıştır. Bu bölümlerdeki 326 öğrenci çalışma grubunu oluşturmuş, 317öğrenciden elde edilen verilerle analizler gerçekleştirilmiştir. Öğrencilerinkas iskelet sistemi ağrılarına ilişkin veriler Genişletilmiş Nordic Kas İskeletAnketinden yararlanılarak oluşturulan bir anket ile toplanmıştır.Bulgular: Araştırmayakatılan öğrencilerin %70’i kadındır ve yaş ortalaması 20,5±1,2’dir.Katılımcılarda en sık sırt, bel ve boyun ağrıları görüldüğü saptanmıştır.Günlük oturulan süre ve kilonun ağrı varlığını en çok etkileyen değişkenlerolduğu saptanmıştır. Kadınların erkeklere göre ağrı yaşama olasılığının dahafazla olduğu tespit edilmiştir. Hem okulda hem de okul dışında oturularakgeçirilen süre arttığında vücudun herhangi bir yerinde ağrı yaşama olasılığınınarttığı saptanmıştır.Sonuç: Çalışmadaelde edilen bulgular doğrultusunda üniversitede öğrencilerinde kas iskeletsistemine bağlı ağrıların önemsenecek ölçüde yüksek olduğu ve bu ağrılarnedeniyle öğrencilerin bazı günlük aktiviteleri yerine getiremedikleri tespitedilmiştir. İleriki yaşantıda bu ağrıların daha büyük sıkıntılara yol açmamasıiçin ergonomiye uygun tasarımlar ve fiziksel aktivitenin artırılması gibiönlemler alınabilir.

Objectives: To evaluate the effectiveness of peer education on changing the smoking behavior of high schoolage children’s. Methods : In this interventional study; transtheoretical model, which is one of the cognitive-behavioral models was used for application of the peer education. Study was conducted in Izmir during 2011-2012 education period and included 338 students from 2 high schools The independent variable of the study is peer training. Descriptive variables for a student are age, gender, tendecy of friends to smoke inside and outside the school, the age they have first experienced the habit, reasons for nicotine consumption, levels of addiction, chatting about smoking and related harms. Family descriptive variables are education level of parents and whether their smoking tendency is present or not. Results : Approximately 18.3% of the students were current smoker. A positive behavioral change of smoking quitting among smoker students was observed after peer education. The number of students in precontemplation stage was reduced while the number of students in stages of preparation/determination action and maintenance was increased. Conclusion : Peer education was observed to be an effective method in the behavioral change of smoking teens. Authors strongly suggest peer education to be one of the preferred tools in changing the teen behavior in use of tobacco. Saudi Med J 2018; Vol. 39 (1): 74-80 doi: 10.15537/smj.2018.1.21774 How to cite this article: Bilgic N, Gunay T. Evaluation of effectiveness of peer education on smoking behavior among high school students. Saudi Med J . 2018 Jan;39(1):74-80. doi: 10.15537/smj.2018.1.21774.

Introduction: Environmental tobacco smoke (ETS) is thought to increase the severity and number of attacks in wheezy children. Objective assessments are needed to change the behavior of families to reduce the exposure of wheezy children to ETS. Aim: To determine whether informing families about their children’s urinary cotinine levels curtailed the exposure of children to ETS. Material and methods: A survey was used to determine the ETS exposure level, and the urinary cotinine level of each patient was tested. Children with positive urinary cotinine levels were included in the second part of the study. The families were randomly divided into two groups: an intervention group that was advised about urinary cotinine levels by telephone and a non-intervention group that was not so advised. The groups were followed-up 2 months later, and urinary cotinine levels were measured once again. Results: The intervention group contained 65 children of average age of 24.4 ±8.9 months, of whom 46 (70.8%) were male. The non-intervention group contained 69 children of average age of 25.3 ±9.8 months (p > 0.05), of whom 52 (75.4%) were male. The urinary cotinine levels at the time of the second interview were lower in both groups. The number of cigarettes that fathers smoked at home decreased in the intervention group (p = 0.037). Conclusions: Presenting objective evidence on ETS exposure to families draws attention to their smoking habits. Measurement of cotinine levels is cheap, practical, and noninvasive. Combined with education, creating awareness by measuring cotinine levels may be beneficial.

Breastfeeding has substantial short- and long-term positive influences on maternal and infant health. Many studies have indicated that it is highly protective against childhood infections and malocclusion, enhances intelligence and decreases obesity. Prolonged breastfeeding provides a natural protection for women against breast and ovarian cancer while postponing the next pregnancy by means of extending the birth intervals. Breastfeeding, beyond its benefits for maternal and infant health, it is a substantial component for sustainable development on a global scale. When breastfeeding is assessed based on country's income brackets, for all of indicators apart from the indicator of "commencing breast-feeding within the first hour", the higher the income bracket of the country is, the lower are the rates of breastfeeding. In Turkey 96% of the children under five years of age are subject to breastfeeding for a while. Notwithstanding with the "Exclusive Breastfeeding up to six months of age" recommendation of the World Health Organization, this rate of 4.7% among the babies of six months of age in Turkey is far below the expected level. World Sustainable Development Summit was held in January 2016 and Sustainable Development Goals spearheaded by the United Nations were determined in order to replace the Millennium Development Goals which was ended in 2015. Although breastfeeding is more or less essentially associated with the entire goals, in this compilation, emphasis has been laid on eight goals (1, 2, 3, 4, 5, 8, 10, 12) that are mostly associated with breastfeeding.

Objective: Overweight and obesity comprise one of the most serious public health problems of the 21st century. The aim of this study is to investigate the incidence of overweight and obesity in an age group of 3-6 years in central towns of Izmir Metropolitan City and to examine the risk factors of obesity.

Background/aim: Smoking is the leading preventable cause of death in the world. There is growing evidence of the need for community-based programs on smoking cessation. The main purpose of this study is to establish the rate of smoking cessation and restarting in 1 year at the Balçova Smoking Cessation Center. Materials and methods: This is a prospective study with a study group of 359 individuals who quit smoking at the Balçova Smoking Cessation Center for at least 4 weeks between October 2009 and April 2010. The outcomes of the study were 1-year cessation rate and relapse rate. Individuals who reported restarting and/or had CO measurements above 6 ppm were accepted as quitters who had relapsed. Results: The 1-year rate of smoking cessation was 30.1% for the study group. Of the subjects who quit smoking, 50.1% started smoking again during the 1-year follow-up. Relapse rate was also higher in nicotine addicts. Pharmacological treatment was associated with increased success rates in smoking cessation. Conclusion: Nicotine dependency was shown to be associated with lower rates of smoking cessation and higher rates of relapse. Therefore, it is important to begin smoking cessation attempts before individuals become serious addicts.

Sipahi S, Nacaroglu HT, Can D, Gunay I, Unsal-Karkiner CS, Kamali H, Ozdemir A, Gunay T. Effect of socioeconomic status on allergic diseases and atopy in school children. Turk J Pediatr 2017; 59: 670-677. Higher family socioeconomic status (SES) has been suggested as a risk factor for allergic diseases. We investigated the effect of SES on the prevalence of allergic diseases and atopy. The study included 13-14-year-old primary school students in Kemalpasa, Turkey. The International Study of Asthma and Allergies in Childhood phase 1 questionnaire was administered to all students to identify allergic diseases. Those identified as having allergic diseases underwent a skin prick test (SPT). Group I included students with allergic diseases and a positive SPT. Group II comprised students with allergic disease who were SPT negative. The control group was randomly selected from the students with no allergic diseases. Three weighted SES scores were calculated for each student (equally weighted, education-weighted, and social class-weighted). SES was classified as lower, middle, or upper according to the weighted SES scores. Allergic diseases were detected in 657 of the 1,373 children who participated in the study. A higher percentage of children with allergic diseases and atopy were in the lower SES group in all weighted SES analyses compared with controls (Group I: 59%, 83.1%, 67.5%; Group II: 62.9%, 80%, 63.5%; control group: 12.4%, 12.9%, 21.2%). Significantly more children with allergic and atopic diseases (Groups I and II) were in the lower SES group compared with the control group (p < 0.001). In contrast to the hygiene hypothesis, we found the incidence of atopic disease was higher in families with lower SES.

BACKGROUND Pulmonary thromboembolism (PE) is a major disease in respiratory emergencies. Thoracic CT angiography (CTA) is an important method of visualizing PE. Because of the high radiation and contrast exposure, the method should be performed selectively in patients in whom PE is suspected. OBJECTIVES The aim of the study was to identify the role of clinical scoring systems utilizing CTA results to diagnose PE. MATERIAL AND METHODS The study investigated 196 patients referred to the hospital emergency service in whom PE was suspected and CTA performed. They were evaluated by empirical, Wells, Geneva and Miniati assessments and classified as low, intermediate and high clinical probability. They were also classified according to serum D-dimer levels. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were calculated and evaluated according to CTA findings. RESULTS Empirical scoring was found to have the highest sensitivity, while the Wells system had the highest specificity. When low D-dimer levels and "low probabilty" were evaluated together for each scoring system, the sensitivity was found to be 100% for all methods. Wells scoring with a cut-off score of 4 had the highest specificity (56.1%). CONCLUSIONS Clinical scoring systems may be guides for patients in whom PE is suspected in the emergency department. The empirical and Wells scoring systems are effective methods for patient selection. Adding evaluation of D-dimer serum levels to the clinical scores could identify patients in whom CTA should be performed. Since CTA can only be used conservatively, the use of clinical scoring systems in conjunction with D-dimer levels can be a useful guide for patient selection.

Objective: In this study, we evaluated the knowledge and perception and mitigation of hazards involved in radiological examinations, focusing on healthcare personnel who are not in radiation-related occupations, but who use ionising radiation as a part of their work. Methods: A questionnaire was applied to physicians, nurses, technicians and other staff working in different clinics that use radiation in their work, in order to evaluate their knowledge levels about ionizing radiation and their awareness about radiation doses resulting from radiological examinations. The statistical comparisons between the groups were analyzed with the Kruskal Wallis test using the SPSS program. Results: Ninety two participants took part in the study. Their level of knowledge about ionizing radiation and doses in radiological examinations were found to be very weak. The number of correct answers of physicians, nurses, medical technicians and other personnel groups were 15.7±3.7, 13.0±4.0, 10.1±2.9 and 11.8±4.0, respectively. In the statistical comparison between the groups, the level of knowledge of physicians was found to be significantly higher than the level of the other groups (p=0.005). Conclusion: The present study demonstrated that general knowledge in relation to radiation, radiation protection, health risks and doses used for radiological applications are insufficient among health professions using with ionizing radiation in their work.

oBJeCTIVe: The aim of this research was to determine the views of both smokers and non-smokers on smoking and cessation of smoking. MATerIAL ANd MeTHods: This research was the focus group study performed with 33 subjects participating in the Balcova Heart Project (BHP). resULTs: The smokers described smoking mostly as a friend whereas non-smokers described smoking as illness and unsoundness and associated with death. The smokers indicated that the causes of cigarette smoking were a way of coping in difficulty and being accepted as friends; however, non-smokers indicated the cause of smoking was “pretension”. All of them reported that the basic factor for cessation of smoking is self-control. Smokers signified that service for cessation of smoking should be free, continuous, and applied by experts. Informational meetings should have explanations of methods of cessation of smoking, affectivity in smoking cessation process, and health differences after cessation smoking. CoNCLUsIoN: Perceptions of smokers and non-smokers on cigarette were different. Services related to cessation of smoking should be free, continuous, and given by experts.

Özet Tütün kullanımı son zamanlara kadar bir erkek davranışı olarak algılanmış, özellikle gelişmekte olan ülkelerdeki kadınlarda tütün kullanımı çok düşük düzeyde kalmıştır. Toplumun yüklediği roller gereği kadınlar “zayıf”, erkekler “güçlü” olarak algılanmıştır ve bu kadınları erkekler gibi güçlü olma arayışına itmiştir. Tütün endüstrisi bu durumu kendi lehine kullanarak cinsiyet normlarını değiştirmeye yönelik girişimlerde bulunmuştur. Sigarayı modern kadın olmanın, erkeklerle eşit olmanın, güçlü olmanın, özgürlüğün sembolü olarak göstermiştir. Kadınların tütün endüstrisinin ana hedefi haline gelmesiyle, tütün kullanım sıklığı açısından erkeklerle kadınlar arasındaki fark giderek kapanmaya başlamıştır. Sigara kadınlar için de büyük bir sağlık sorunu olmaya başlamıştır. Tütün kontrolünde, sigarayı cinsiyet eşitliğinin simgesi olarak gösteren anlayışla mücadeleye başlanmış, kadınları tütün endüstrisinin zararlarından korumak amaçlanmıştır. Bu makalede dünyada ve Türkiye’de sigara içme sıklığının cinsiyete ve yıllara göre nasıl değiştiğini, toplumsal cinsiyet ve tütün ilişkisini, sigaranın kadın sağlığı üzerine etkilerini ve kadınların tütün endüstrisinin ana hedefi haline nasıl geldiğini anlatmak amaçlanmıştır. Anahtar Kelimeler: Toplumsal cinsiyet, tütün endüstrisi, tütün kontrolü, sigara içme, sağlıkAbstract Until recently tobacco use has been perceived as a male behavior and especially among women in developing countries- tobacco use has remained very low. According to the roles imposed by society, women are perceived as “weak”, men are perceived as “strong” and this has led women to seek to be as strong as men. The tobacco industry has attempted to change gender norms by using this situation to its own advantage, showing the cigarette as a symbol of modern women, of being equal to men and being strong and free. As women have become the main goal of the tobacco industry, the difference between men and women in terms of the frequency of tobacco use has gradually started to close. Smoking has started to be a major health problem for women. A struggle has started on the issue of controlling tobacco use and for understanding how to protect women from the damage done by the tobacco industry, which shows smoking as a symbol of gender equality. In this article, we show how the prevalence of smoking has changed in the world and in Turkey in relation to gender and age, and examine the relationship between gender and tobacco use, the effects of smoking on women's health, and demonstrate how women have become the main target of the tobacco industry. Key Words: Gender, tobacco industry, tobacco control, smoking, health

Amaç: Araştırmanın amacı 25-49 yaş arası evli erkeklerde eşlerine yönelik şiddet uygulama durumunun, türlerinin ve etkileyen etmenlerin belirlenmesidir. Yöntem: Kesitsel tipteki çalışmanın evreni, İzmir’in Konak İlçesi’nde bulunan Esentepe Sağlık Ocağı Bölgesi’nde yaşayan 25-49 yaş arası 2615 evli erkektir. Sistematik örnekleme yöntemi ile seçilen 254 kişiye ulaşılmıştır. Bağımlı değişken olan şiddet varlığı “Yeniden Gözden Geçirilen Çatışma Taktikleri Ölçeği” (The Revised Conflict Tactics Scales=CTS 2) ile belirlenmiştir. Bağımsız değişkenler erkeğe ve eşine ilişkin sosyodemografik değişkenler, evliliğe ve aileye, sağlık durumuna, cinsel yaşama ilişkin özelliklerdir. Veri t Testi, Ki-kare, Lojistik Regresyon Analizi ile çözümlenmiştir. Bulgular: Eşe yönelik psikolojik şiddet sıklığı %93, fiziksel şiddet %37.5, ekonomik şiddet %34.4, cinsel şiddet %3.9 olarak saptanmıştır. Psikolojik şiddete maruziyet, ortaokul ve üzeri öğrenimli kadınlarda anlamlı olarak daha fazladır. Erkeklerin işsiz olması ya da düzensiz işlerde çalışması, haftada birkaç kez ya da her gün alkol kullanması, istenmeyen gebelik varlığı, kadının 25-34 yaş grubunda olması fiziksel şiddette belirleyici etmenler olarak saptanmıştır. Sonuç: Eşleri tarafından kadına yönelik olarak uygulanan psikolojik şiddet sıklığı beklenenden çok yüksek bulunmuştur. Üç erkekten biri ekonomik ve fiziksel şiddet uygulamaktadır. Cinsel şiddet düşük saptanmasına karşın sorunun daha büyük boyutlarda olabileceği düşünülmektedir. Anahtar Kelimeler: Aile içi şiddet, toplumsal cinsiyet, kadın sağlığı Spouse violence and related factors in married men Objective:The purpose of this study is to examine the presence, patterns and related factors of spouse violence among 25-49 years old men. Methods: The cross-sectional study was conducted in the Esentepe Health Centre district which is affiliated to the Konak District Health Directorate. The study group was composed of 2,615 married men, aged between 25 to 49 years. It was planned to reach a group size of 254 participants that would be selected by systematic sampling.The dependent variable was the presence of violence and this was defined by the Revised Conflict Tactics Scales (CTS). Independent variables were sociodemographic variables of man and wife and features of marriage, family, health conditions and sexual activity Chi-square test, t test and logistic regression were used for statistical analyses. Results: The frequency of psychological, economic, physical and sexual violence toward wife was estimated to be 93%, 34.4%, 37.5% and 3.9%, respectively. Associated factors for physical violence determined by a logistic regression analysis were unemployment or irregular employment, alcohol consumption, daily or several times per week, presence of an undesired pregnancy and the age of the woman between 25-34 years. Conclusion: The results of the study showed that psychological abuse was more frequent than expected. One third of the men apply economic and physical abuse against their spouse. Sexual abuse was considered to be higher than the low level recorded. Key Words: Domestic violence, gender, women’s health

Balikesir Saglik Bilimleri Dergisi ISSN: 2146-9601 e-ISSN: 2147-2238 bsbd@balikesir.edu.tr www.bau-sbdergisi.com OZET GIRIS: Bu calismanin amaci; Balikesir Universitesi Balikesir Saglik Yuksekokulu Ebelik Bolumunde halk sagligi dersi icin gelistirilen egitim programinin ogrenci geri bildirimleri ile degerlendirilmesidir. GEREC VE YONTEM: Calisma halk sagligi dersini alan ebelik bolumu ogrencileri (n=40) uzerinde yurutulmus, tanimlayici bir calismadir. Arastirmanin verileri ogrenci geri bildirim formu ile toplanmistir. Geribildirim formu 5’li likert olcegi kullanilarak hazirlanmistir. Verilerin degerlendirilmesinde SPSS 16.0 paket programi kullanilmistir. Arastirmanin verileri sayi, yuzde dagilimlari ile degerlendirilmistir. BULGULAR: Ogrencilerin %92.5 ile %97.5'i dogum oncesi bakimda oyku alma, fizik muayene, egitim ve danismanlik konusunda becerilerinin arttigini dusunmektedir. Ogrencilerin %95'i bebek/cocuk izleminde oyku alma, anneye egitim ve danismanlik verme, fizik muayene yapma becerisinin arttigini belirtmistir. Ogrencilerin %92.5’i ogrendiklerinin mesleki yasantisinda yararli olabilecegini dusunmektedir. Ogrencilerin cogu, beceri egitimini yer ve sure olarak yeterli oldugunu belirtmistir. Kendini yeterli hissetme hakkinda, %92.5’i egitim sonrasinda kendini yeterli hissettigini bildirmistir. SONUC: Ogrencilerin cogunlugunun, dogum oncesi bakim, bebek/cocuk izlemi, egitim ve egiticiyi degerlendirme konusunda geri bildirimleri olumlu olmustur. Bu calismanin sonuclari ogrencilerin halk sagligi egitim programindan memnuniyetini gostermektedir. Anahtar Kelimeler: Ebelik egitimi, egitim programi, halk sagligi

OBJECTIVE: Aim of the study was to determine effects of social inequalities on coronary heart disease risk factors in individuals living in an urban district of Izmir; namely Balcova. METHODS: In this cross-sectional study, no sampling was done and it was aimed to reach all residents living in that area aged 30 years and over (n=4409). Dependent variables were smoking, physical inactivity, unhealthy diet, obesity, hypertension, diabetes, dyslipidemia where social inequality was the independent variable. Educational status, income and social class were considered as the components of social inequality. Age, gender, family health histories were the confounding factors. Data were collected at home and in the neighborhood-house. For data analyses Chi-square test, and logistic regression analysis were used. RESULTS: Smoking is higher in men and women in lower socio economic class, where unhealthy diet is higher in self-employed men (OR=9.24, 95% CI=1.14-74.81, p=0.037) and in women who have a lower education (OR=1.53, 95% CI=1.02-2.30, p=0.040), lower income or unemployed (OR=3.43, 95% CI=1.28-9.14, p=0.014). Obesity is more frequent in lower educated women (OR=1.89, 95% CI=1.37-2.59, p

Objective: To evaluate the extent to which oximetry, spirometry and dyspnea scoring can reflect hypoxemia and hypercapnia among patients admitted to the emergency department (ED) with acute exacerbations of chronic obstructive pulmonary disease. Subjects and Methods: Spirometry, oxygen saturation by pulse oximetry (SpO2), arterial blood gas analysis and dyspnea scoring assessments were made in the ED. Correlations of these parameters were evaluated by means of Pearson’s test. Pulse oximetry cutoff values to express hypoxemia were demonstrated by receiver operating characteristic (ROC) curves. Results: 76 patients with a mean age of 68.0 years were included in the study. Mean spirometric values, expressed as percentages of predicted values, were forced expiratory volume in 1 s (FEV1) = 23.1 ± 9%; forced vital capacity (FVC) = 32.8 ± 11%, and mean FEV1/FVC = 72.4 ± 21.6%. While there was a positive correlation between the SpO2,SaO2 and PaO2 values (r = 0.91 and 0.80, respectively), a negative correlation (r = –0.74) was observed between PaCO2 and SpO2. In determining hypoxemia, both SpO2 and FEV1 were sensitive (83.9 and 90.3%, respectively) while dyspnea scoring was the most sensitive (93.5%). In the evaluation by means of an ROC curve, a saturation of 88.5% for the pulse oximeter was the best cutoff value to reflect hypoxemia (sensitivity 95.6%, specificity 80.6%). Conclusion: SpO2 alone appears to be as highly specific as a combination of other tests in the evaluation of hypoxemia. A cutoff value for SpO2 of ≤88.5% is proposed as a criterion in screening for hypoxemia.

Amaç: Bu çalışmada amaç, KKH riski olup Toplum Tabanlı Sigara Bırakma Merkezi’ne davet edilenlerin başvurusuna etki eden faktörlerin belirlenmesidir. Yöntem: Balçova’da yaşayan 30 yaş üzeri kişilerin KKH risk durumlarının belirlendiği ve buna yönelik girişimlerin planlandığı Balçova’nın Kalbi(BAK) projesi kapsamında 2008 yılında yapılan durum saptama çalışmasında belirlenen Framingham risk düzeylerine göre KKH riski orta ve yüksek düzeyde riski olup sigara içen kişiler (1390 kişi) veri tabanından seçilmiştir. Projede eğitimli yedi kişiden oluşan Toplum Sağlığı Destek Grubu (TSDG) hedef gruba ev ziyaretleri ya da telefonla ulaşarak projeye katılmaları için merkeze davet etmişlerdir. Sigara Bırakma Merkezi’nde tüm hizmetler ücretsiz olarak sunulmuştur. Araştırmanın bağımlı değişkeni, Sigara Bırakma Merkezi’ne başvuru durumudur. Bağımsız değişkenleri ise yaş, cinsiyet, öğrenim durumu, medeni durum, sosyal güvence durumu, düzenli sigara içmeye başlama yaşı, günlük içilen sigara sayısı, sigara bırakmayı deneme, sigara bırakmayı düşünme, sigara bırakma hizmeti almak istemedir. Bulgular: Hedef grup olan 1390 kişiden %49’una(681) evinde ulaşılmıştır. Sigara Bırakma Merkezi’ne davet edilip randevu alan 444 kişiden %68.2’si başvurmuş, randevu almadığı halde başvuran 28 kişi de izleme alınmışlardır(n=330). Hedef grubun başvurusunu yaş, cinsiyet, medeni durum, öğrenim durumu, sosyal güvence durumu anlamlı olarak etkilememektedir. Sigarayı bırakmayı düşünenlerde, daha önce bırakmayı deneyenlerde ve sigara bırakma hizmeti almak isteyenlerde merkeze başvuru anlamlı olarak daha yüksek bulunmuştur. Sonuç: Toplum tabanlı olarak çalışmaya başlayan, KKH riski orta ve üzerinde olan kişilerin davet edilerek, ücretsiz hizmet sunulan bir sigara bırakma merkezinde davete yanıt verme düşüktür. Sigara bırakmada, KKH riski olanlarda bile, bireyin bu konudaki isteği hizmete ulaşmada önemli bir etkendir., Objective: The aim was to evaluate the factors that affect attendance at a community based smoking cessation center by people who are at risk of coronary heart disease. Method: The study population was drawn from/ obtained from the database of the Balçova Heart Study, and included those who were older than 30 years and had been assessed for their CHD risk status in a survey in 2008. Smokers, who are at medium or high risk according to the Framingham risk score, were selected (1390 people). Seven young people were trained as a Community Health Support Group in the project and they were invited the target the studygroup by visiting homes or by telephone. Services in the smoking cessation center were free of charge. The dependent variable of the study was attendance at the smoking cessation center. Independent variables were; socio-demographic variables, age when starting to smoke, number of cigarettes per day, attempts at cessation, considering cessation, willingness to participate in a smoking cessation service. Results: Forty nine percent of the target group was reached at their homes. Among the people who made an appointment (n=444), 68.2% had attended. The attenders and non-attenders from the target group did not differ statistically in age, gender, marital status, educational level or social security type. The people who had considered or attempted to quit or who wanted a support service in the baseline survey attended significantly more than the ones who had not.Conclusion: Less than one in three people with medium and high CHD risk and who were advised to attend, to a service provided free of charge. Willingness to quit is an important factor for attending the center, even in the high risk individuals.

WOS: 000382762400003, PubMed ID: 29404123, OBJECTIVES: The objective of this study was to determine the pattern and effects of tobacco and tobacco products use among students of dentistry. MATERIAL AND METHODS: A cross sectional study was performed in the Dentistry Faculty of Ege and Dicle Universities between April and May 2013. All freshmen and senior year students receiving education in both universities were included into the study (n=321). A questionnaire consisting of 26 questions was used to determine the smoking habits of the students and the influencing factors regarding this habit. Students replied the questions under supervision. RESULTS: A survey was conducted among 298 students out of 321 who were attending both universities. 46.6% of the participants were female and 53.4% were male. Smoking prevelance of the students was 29.9%. It was 19.9% in freshmen students and 45.8% in senior students. According to the first class of students in the fifth grade students in the prevalence of smoking in was found to be highly statistically significant (p

Studies of the prevalence of asthma should be supported by objective markers. We aimed to measure the prevalence of childhood asthma in a particular area and age group using a questionnaire, and to compare the results with the rates of asthma diagnosed by objective measures. All students aged 13-14 (n=1511) in Kemalpasa, Izmir, were included in the study. Children whose responses on the ISAAC Phase-I Questionnaire revealed current wheezing were invited to the district health center. The prevalence of clinically proven asthma (current wheezing supported by objective markers) was investigated. The questionnaire was answered by 1373 (90.87%) students. Current wheezing was indicated in 428 children (31.0%), significantly more in girls than in boys (p0.05). However, the prevalence of clinically proven asthma decreased by 42.5% when using objective markers. This study provided important epidemiologic information about the prevalence of asthma as indicated by questionnaires as opposed to that indicated by objective measures, especially in countries where the language lacks a word for "wheezing."

The objective was to determine the level of knowledge on diabetes in an adult population in Turkey. In this cross-sectional study, 524 people aged over 30 were selected from the population of Narlidere Health District, Izmir, Turkey. A questionnaire was performed to determine sociodemographic characteristics and knowledge of diabetes. Each item on the questionnaire was given a score with a possible final total of 100 points. Knowledge level was evaluated in the whole group, DM-positive and -negative groups. "DM-positive" group refers to respondents who either have diabetes themselves or whose relatives have it. "DM-negative" group refers to respondents who do not have diabetes themselves and whose relatives do not. In total, 479 people were included in the study (response rate=87.6%). The mean age of the study group was 50.2 +/- 12.8 and 61% of them were women. Mean diabetes knowledge scores were 62.9 +/- 17.9 for the study group, 68.3 +/- 16.1 for the "DM-positive" group and 60.6 +/- 18.2 for the "DM-negative" group. The "DM-negative" group had a significantly lower mean score than the other two groups. Overall, diabetes knowledge was higher in participants with diabetes or who had a relative with diabetes, who were educated for more than 5 years and who had health insurance. The diabetes knowledge of the study group was not satisfactory. Diabetics and people who have relatives with diabetes had a higher knowledge level than the population without diabetes. Detailed information regarding diabetes should be provided to not only diabetics, but also the population as a whole.

Background Menarche is one of the most important biologic signals in the life of a woman. Menarche is a biological variable which has a significant genotypic component in girls. In recent years, many studies reporting the earlier onset of menarche owing to the improvement of socio-economic conditions have been published. Design We asked some questions about menarche to 1017 female students studying in the high schools of Manisa region in order to determine the menarcheal age and the correlation of menarcheal age between the mothers and daughters in our region. Results The mean age at menarche for the girls was 12.82 ± 1.07 years and for the mothers was 13.6 ± 1.39 years. The mean menarcheal age of the mothers was higher than the mean menarcheal age of the girls (P 25 (r = 0.04, P = 0.813). In girls with BMI

Aim: The lifestyle and environmental changes associated with industrialization and urbanization are crucial factors in determining the prevalence of allergic diseases. Material and Methods: The aim of this study was to determine the prevalence of asthma and other allergic disorders in an industrial town.Study Design: Prospective, Cross-sectional study. This cross-sectional population-based study was conducted in Kemalpasa, Ýzmir, Turkey, which is an industrial town. Using the International Study of Asthma and Allergies in Childhood (ISAAC), the questionnaire was carried out on 1511 school-children aged between 13-14 years living in the district center. Results: The ISAAC Phase One questionnaire was answered by 1373 (90.87%) students. Six hundred ninety two (50.5%) of the children were girls and 681 (49.5%) were boys. The frequency of ever wheezing was 34%,that of current wheezing was 31.1% and that of physician-diagnosed asthma was 4.1%. The frequency of ever rhinitis was 36.6%, current rhinitis was 31.3%, current allergic rhino-conjunctivitis was 22.1% and physician-diagnosed allergic rhinitis was 11.1%. The frequency of ever eczema was 11.3% and that of physician-diagnosed eczema was 3.6%. Conclusion: The prevalence of asthma was found to be significantly higher, although there was no significant difference in allergic rhinitis and eczema compared with non-industrial neighboring states. The incidence of asthma was higher than other provinces which may be explained by the risk factors associated with this industrialized area. The fact that only children of the same age group and residence were evaluated contributed to the epidemiological value of our study.

WOS: 000380974300010, PubMed ID: 27434246, Background and Aim: Tobacco consumption is still a prevalent issue. Given that teachers are respected in society, they have a great responsibility for tobacco control. This study examines, using the Transtheoretical Model (TTM), the prevalence of tobacco use among teachers and their different stages of tobacco use. It also evaluates teachers' views on smoking and the effectiveness of training on tobacco use. Methods: This study is quasi-experimental. Pre-test and post-test were used first with a cross-sectional group, then with a single group to determine the frequency of tobacco use. The research participation complied with the voluntary principles and the participation rate was 84.9%. The research sample comprised 450 teachers working at schools (N =17) under the Kemalpasa Directorate of Education. The data form contained 29 questions about socio-demographic characteristics and smoking habits. The Fagerstrom Test for Nicotine Dependence (FTND), Smoking Decisional Balance Scale (SDBS), and the Stage of Change were used. A pre-test was also administered, and training was given between January 13 and March 4, 2014. After the training sessions, two short messages (SMS) were sent on March 12 and March 19, 2014. A post-test was administered between April 1 and May 21, 2014. The relevant institutions and participants gave the requisite permission for the data used in this study. Percentage distribution, dependent t-tests and chi-square tests were used to evaluate the research data. Results: The median age of the teachers was 37.49 +/- 7.84. The teachers' mean score for the pre-test of FIND was 5.7 +/- 2.03, and their mean score for the post-test was 3.25 +/- 2.07. Post-test scores were remarkably lower than the pre-test scores. It was found that teachers' mean scores for SDBS were different before and after training. After training, anti-smoking attitudes increased (pros-cons scores: pre-test: -3.64 +/- 4.68, post-test: -11.25 +/- 5.48). The training helped the entire group to make progress in the process change. Conclusion: After training on "the health effects of smoking", teachers' anti-smoking attitudes rose on the smoking decision balance scale, their nicotine dependency was reduced, and they were able to move forward in a positive direction., Ege University Research FundEge University, The authors would like to thank the Ege University Research Fund for funding this research and the personnel of Kemalpasa Directory of Education and participant schools in Kemalpasa, Izmir, for their support in carrying out the research, and are grateful to the teachers for their participation in this study.

Smoking is the most important cause of disability, death and preventable illness in Turkey and all over the world. According to the Global Youth Survey, smoking prevalence among young people increased from 9.4% in males and 3.5% in females in 2003 to 10.2% and 5.3% in 2009. Cigarette smoking affects a large part of the society with increasing frequency among young people. Therefore, the tobacco industry targets youth and women. The decrease in the starting age of smoking will cause longer term exposure to the harmful effects of cigarettes. Adolescents start smoking due primarily to a desire to imitate adults, peer pressure, affectation and easy access to cigarettes. Peer group has a great impact on both risky and safe behaviours of an adolescent. Adolescents want to be independent in their behaviours, attitudes and interests. They want to have activities with friends without prior permission and explanation. Peer education aims to use peer influence in the positive way, as peers can be positive models for behaviour. The increase in tobacco consumption among adolescents in the recent years has increased the importance of peer education. The purpose of this article is to explain how to use peer education in changing the cigarette smoking behaviours of adolescents. © 2014 by Turkish Thoracic Society.

WOS: 000317361900003, PubMed ID: 23070631, Objective: Cardiovascular diseases (CVD) are the largest cause of morbidity and mortality in Turkey and in the World. Heart of Balcova Project is a community-based health promotion project that aims to reduce CVD incidence and prevalence through risk factor modification in the individual and population level. This paper presents results of the baseline survey that aimed to define CVD risk factors and risk of developing coronary heart disease (CHD) in the Balcova population. Methods: The study population included 36,187 people over 30 years of age residing in Balcova in 2007. Individuals were interviewed at their homes. Anthropometrics and blood pressure were measured and in total 12914 fasting blood samples were collected for lipid and glucose analyses. CHD risk was estimated using Framingham risk equation. Student's t test, Chi-square for trend test and ANOVA were used to compare mean levels and percentages of risk factors between age groups and gender. Results: In total 5552 men and 10528 women participated in the study. Smoking prevalence was 38.6% in men and 26.8% in women. The prevalence of obesity was 29.4% among men and 44.2% among women and obesity prevalence increased until the age group 75 years old. While 14.6% of men and 12.6% of women had diabetes, 39.8% of men and 41.8% of women had hypertension. The prevalence of high total cholesterol was 56.0% in men and 50.6% in women. Men had a higher risk of developing CHD compared to women in the following 10 years (13.4% vs 2.5%). Conclusion: The prevalence of preventable risk factors for CHD is very high in Balcova population. Community-based interventions should be planned and implemented targeting both the high-risk individuals and whole population. (Anadolu Kardiyol Derg 2013; 13: 9-17), Balcova MunicipalityBelediyeler; Dokuz Eylul University Research FundDokuz Eylul University [2007161], This study was supported jointly by Balcova Municipality and Dokuz Eylul University Research Fund (Grant no:2007161)

Turkey is facing increasing rates of cardiovascular disease (CVD). The study is designed to meet the growing need to obtain information about the recent status and trends of CVD risk factors and their impact on mortality. Balcova heart study (BHS) is a prospective cohort study, focusing on reducing the CVD risk factors of people over 30 years old living in Balcova District, Izmir, Turkey. Information about risk factors, anthropometric and biochemical measurements was collected in community centers. Interventions were planned, based on the 10-year coronary heart disease (CHD) risk and lifestyle characteristics with the collaboration of university and municipality. Mean age of the 16,080 participants was 52 years. The percentage of current smoking was 41.6 in men and 31.1 in women. One-third of the men were physically inactive. Hypertension was reported as 25% in men and 33% in women. The project is unique for being the first community-based cohort on CVD risk factors in a Turkish setting. This project will have a valuable contribution on not only determining CVD risks, but also incorporating interventions for prevention.

Objective: The arcuate eminence (AE) is an arc-like prominence in middle cranial fossa (MCF). Its long axis is obliquely directed anteriorly and medially. The AE is one of the anatomical landmarks for MCF approaches. However, if the AE is not prominent in MCF, it can go unnoticed and is likely that it has individual variations. The aim of this study is to define the anatomical characteristics of the AE in detail and to show its variations and their incidences. Material and Methods: We used 24 cranial bases (48 specimens), 38 right-side and 33 left-side temporal bones; 119 specimens overall. After assessment of the presence or absence of the AE, we grouped them as single arc, dual arc or complex arc. Cases with the complex arc shape were grouped into five subgroups for the first time in the literature. Data were then analyzed. Results: The overall incidence of AE was 94.1% with 64.3% single arc, and 35.7% dual or complex arc. In the group in which the variations of complex arc were remarkable, the most common ones were those with triangle-shaped origo at 36.7%. Conclusion: According to the hypothesis in the literature, the All corresponds to the anterior semicircular canal (ASC), the air cells underneath, or the third temporal sulcus. Although the association between the AE and ASC has not yet been proven, the importance of the All in MCF surgery is still valid. The data in our study will be helpful in surgery by defining the formal characteristics of the AE.

To determine the primary health care working general practitioners' knowledge, attitude and behavior towards alcohol use disorders.In this descriptive and cross-sectional study 135 general practitioners (GPs) completed the questionnaire.Pre and post graduate education on alcohol use disorders is low (25.4 % and 11.7% respectively). Most of the GPs do not know the levels of risky alcohol use, screening tests, and biochemical markers. The mean knowledge score is 6.67+/-1.70. Most GPs think that alcohol use disorders are not an important issue in primary health care (57%), they do not have time to deal with patients' alcohol problems (74.1%), it is difficult to diagnose risky alcohol users without clear symptoms (91.1%), patients do not follow advice on alcohol use (85.2%), and physicians themselves are tolerant towards alcohol (71.1%). Half of the GPs reported that they find it difficult to talk about alcohol use with patients and think that patients may be angered by alcohol consumption questions. Mean attitude score is 4.44+/-2.15. Most of the GPs reported that they would ask questions about alcohol use to their patients (91.7%) and declare that the patients' problems were related to alcohol (90.2%). More than half of them reported that they would refer the patient to a specialist or an alcohol treatment center (58.5%). The mean behavior score is 5.96+/-1.46.In our country it is clear that more education and support for GPs is needed due to their important role in intervention for alcohol use problems.

Results: The data were compared statistically between the 2 groups. Of these patients 78.1% were diagnosed with PTB while 21.9% were diagnosed with EPTB. The proportion of male patients was 79.3% in the PTB group and 49.4% in the EPTB group (P < 0.0001). According to the medical histories of the patients, the mean duration between the onset of symptoms and diagnosis was 85.75 ± 77.02 (days) in PTB patients and 193.65 ± 340.40 (days) in EPTB patients (P = 0.001). The rates of bacteriological diagnosis of tuberculosis were 95.37% in PTB patients and 5.06% in EPTB patients, which indicated a significantly higher rate of bacteriological diagnosis in PTB patients. Conclusion: There were statistically significant differences between the PT and EPT patients over 15 years, and EPT was found to be associated with female sex, a lower rate of bacteriological diagnosis, and delay in diagnosis.

BACKGROUND: The risk of sexually transmitted diseases is high but opportunities of sexual education for adolescents are limited in Turkey. The aim of this study was to evaluate sexual attitudes and behaviors and to determine the predictors of sexual initiation among adolescents. METHODS: A questionnaire designed by the researchers was administered to 861 senior year high school students in their classrooms. RESULTS: The rates of masturbation and sexual intercourse and the median partner numbers among males were higher than females. The rates of having negative feelings after the first sex among females were higher than males. The rates of having sexual intercourse and the mean age at first sexual intercourse among males were similar to developed countries. However, the use of a condom at first intercourse was low. Lower academic performance and grade repetition experience among males and cigarette smoking among both gender groups were related to having sexual intercourse. CONCLUSIONS: This is one of the first studies about sexual risk-taking behaviors among high school students in Turkey. Differences found between gender groups regarding attitudes and behaviors reflect the social structure in Turkey. These findings may be helpful in producing effective solutions for improving education and preventive health care.

Study Objective Adolescent pregnancy is considered a high risk for both the mother and infant. The aim of this study was to determine obstetric and neonatal outcomes and risk factors in adolescent pregnant women and to compare perinatal outcomes among the teen age groups and between adolescent and adult women. Design Retrospective study including adolescent pregnant women and adult women. Setting A public maternal hospital. Main Outcome Measures This retrospective cohort study included 945 teenagers who gave birth at year 2004 in a maternity hospital in Izmir. Dependent variables included perinatal and maternal outcomes. Independent variables were miscellanous socio-demographic characteristics and obstetric complications. Chi-square, Fisher exact test, and t-tests were used for the comparison of the adolescent group and adult women. Results Overall, adolescents accounted for 11.8% of all deliveries in hospital. 99.7% of teenagers were unemployed, and 59.8% of those had no health insurance. 81.5% of the pregnant adolescents were nulliparous. 27.5% of teenagers gave birth by cesarean delivery. The rates of preterm birth and low birthweight of teen mothers were 18.2% and 12.1%, respectively. Twenty-eight percent of women had some obstetric and neonatal complications. The rate of preterm delivery was higher in adolescent mothers; however, cesarean delivery rate was higher in adult women (P = 0.000, P = 0.0002 respectively). Absence of health insurance, less education, and non-official marriage were significantly higher in pregnant women aged 17 years or younger compared with women aged 18–19 years (for all, P = 0.000). However, there was no statistically significant difference between the adolescent age groups regarding perinatal complications. Conclusion The rates of pregnancy and the rates of adverse obstetric and neonatal outcomes were considerably higher in teenagers.

WOS: 000242218200010, PubMed ID: 17125563, Objective: The aim of the present study was to determine the interaction of and association between frequency of goitre detected by palpation, nutritional status evaluated by anthropometric indices and socio-economic status in school-aged children. Subjects: One thousand and eighteen prepubertal and pubertal children (aged 6-14 years) attending primary schools in an urban area were included in this study. Design and setting: All subjects were evaluated for the presence of goitre and nutritional status. Thyroid size was assessed using the World Health Organization's (WHO) palpation system (1960). Severity of protein-energy malnutrition (PEM) was based on WHO criteria. Children were grouped into four categories of socio-economic status. Results: Eight per cent of children were detected to have goitre by palpation. Body mass index and weight-for-height were significantly lower in children who had palpable goitre than in children who did not have goitre (P < 0.05). Frequencies of having palpable goitre and being stunted and underweight were especially higher in children with very low socio-economic status (P=0.016, 0.01 and 0.01, respectively). Frequency of being stunted, underweight and wasted in children with palpable goitre did not change significantly according to socio-economic status (P > 0.05). In logistic regression analyses, the most important factor in detection of palpable goitre was socio-economic status (B=0.517, P=0.004). Fathers' education and occupation were found to be most significant (P=0.031 and 0.020, respectively). Conclusion: Children detected to have palpable goitre were thinner. However, nutritional disorders were not more frequent among children with palpable goitre compared with children without goitre. Goitre and nutritional deficiencies were more common in children with lower socio-economic status but the frequency of nutritional disorders in children with palpable goitre did not change according to socio-economic status.

We aimed to determine the level of knowledge of Emergency Medical Services (EMS) physicians on Basic Life Support (BLS), Advanced Cardiac Life Support (ACLS) and medicolegal responsibilities in conjunction with related factors.Fifty-three physicians (43 male, 10 females; mean age 39 years; range 28 to 50 years) employed in EMS were required to respond a questionnaire consisting of demographic data and educational background. They also answered 25 multiple-choice questions about BLS, ACLS and medicolegal responsibilities of physicians in a face-to-face manner. The data were analyzed using Mann-Whitney U-test and Kruskal-Wallis Analysis of Variance test.Mean level of knowledge was 45.4 on a hundred-point scale. Attendance to courses covering emergency aid and working as an ambulance physician for more than one year were associated with higher levels of knowledge (p=0.012; p=0.015).In-service training should be undertaken to raise the level of knowledge of the physicians employed in rural EMS and to improve the quality of field care.

Purpose: The aim of this study was to determine the age at menarche, the menarcheal features, and the association between menarcheal age and socioeconomic status in an urban area in Turkey. In addition, we tried to assess whether there is a relationship between age at menarche and body composition. Methods: We asked some questions about menarche of 1017 female adolescent students in the high schools of Manisa region. Height and weight were measured. The body mass index (BMI; kg/M-2) was used as an index of relative weight. Adolescent girls were grouped into three socioeconomic status according to the educational and occupational levels of their parents. The age at menarche and the menarcheal pattern were evaluated according to the socioeconomic status. Results: The ages of girls involved in the study ranged between 14 and 18 years, with a mean of 15.7+/-1.1 years. Although the menarcheal age was found to be lower in girls with higher socioeconomic status, there was no significant difference between the three different socioeconomic status. In all of the three groups, menarche was more common in summer and fall than in spring and winter. Although the mother was an important source of knowledge in all groups, it was significantly more important in the group with high socioeconomic status. Adolescent girls with low socioeconomic status had fewer premenstrual complaints. However, there was no significant difference between the groups. We found an inverse correlation between menarcheal age and postmenarcheal weight and the BMI (r = -0.14, p = 0.000). However, there was no correlation between menarcheal age and postmenarcheal height. Conclusion: These results indicate that as the social status differences decrease, the difference observed in menarcheal age and pattern disappears in urban areas of developing countries. Menarcheal age may be an indicator of socioeconomic development. It does not influence postmenarcheal height; however, as menarcheal age decreases, BMI increases. (C) 2003 Elsevier Ireland Ltd. All rights reserved.