Dental caries and associated factors among Turkish children and adults: Findings from the 3rd National Oral Health Survey.

BACKGROUND: Information on the current status of oral health and related risk factors is lacking in Turkiye. This study aimed to evaluate dental caries and associated factors among the Turkish population using the findings of the third national oral health survey. METHODS: This cross-sectional epidemiological survey was carried out between March and September in 2018 including five index ages and age groups (5-, 12-, 15-year-olds, 35-44 and 65-74 age groups). A multistage cluster sampling design was used to obtain a national representative sample of these age groups. Participants were interviewed face-to-face using a structured questionnaire, and oral examinations were performed based on the methods and criteria suggested by the World Health Organization. The adjusted prevalence ratio for dental caries was estimated considering sociodemographic and behavioural characteristics by using log-binomial and robust Poisson regression analysis in R and SAS software. RESULTS: After data cleaning, a total of 11 091 participants remained. The prevalence of dental caries was 76.5% (95% confidence interval: 75.4%-77.7%) and determined to be associated with age, dental visit, and pain or discomfort history during the previous year among the Turkish population. Prevalence was also associated with the mother's education level among 5-, 12- and 15-year-olds. For the 35-44 age group, individuals living in urban areas had lower dental caries than those living in rural areas. For 65-74 age group, none of the factors were significantly associated with dental caries. CONCLUSION: A high prevalence of dental caries was observed in Turkish children and adults. Therefore, it is necessary to strengthen current preventive oral health programs. Regular disease surveillance should be maintained. National oral health targets should be formulated in accordance with Turkiye's needs, resources and structure.

Organ Donation in Turkey: The Knowledge, Approaches and Opinions of Family Physicians.

BACKGROUND: Considering the gap between organ donors and receivers, it can be assumed that family physicians may play an important role in organ donation. Thus, we aimed to investigate the family physicians' approaches to organ donation in Turkey. METHODS: In this cross-sectional study, an online survey was sent to all family physicians working in Family Health Centers in Turkey Between Jul - Sep 2018. The survey questioned the knowledge, approaches, and opinions about organ donation issues, besides the socio-demographic characteristics. RESULTS: Most physicians stated that they had given information to their patients on this subject at least occasionally (59.19%, n=998). Among participants, the most common reason for refusing consent for organ donation was the fear of commercial abuse (19.66%, n=244). Most participants (52.61%, n=887) stated that they had been positively affected by the media about organ donation. Some physicians were uncertain about the reliability of the brain death diagnosis (18.39%, n=310). A minor group stated that organ donation might be religiously inappropriate (10.50%, n=177). CONCLUSION: Although most of the family physicians had a positive manner about organ donation, there was still some wrong knowledge of the participants about legal and medical aspects of organ donation, as well as some other concerns like organ trafficking and reliability of brain death diagnoses, whereas religious concerns were not significant.

Three dimensional gait analyses in dizygotic twin athletes.

Gait analysis and gait indices are frequently used to evaluate gait pathologies and outcomes. The aim of this study is to investigate the differences in gait parameters of dizygotic twin athletes according to each other and athletes group who are similar age but non-twin. Eighty-four athletes without any disease that could cause gait pathology were included the study. Time-distance measurements, kinematic - kinetic variables, and gait deviation index (GDI) of the gait functions of twin athletes (17 boys and 25 girls, height: 153.9 ± 15 cm, weight: 45.9 ± 12 kg, leg length 80.5 ± 11 cm) were compared with each other and with 42 sex and age matched non-twins athletes (height: 155 ± 15 cm, weight: 47 ± 14 kg, leg length 80.6 ± 9.8 cm, mean age 11.8 ± 2.29, range 6-15 years). No statistically significant difference was found about the time, distance parameters and GDIs in comparison of twin athletes with each other and the non-twin group. Additionally, kinetic and kinematic variables were similar in between twins. We measured lower adduction angles and higher abduction angles in non-twin athletes in comparison to the twin athletes (p = 0.01, 0.04). Additionally, the angle of knee flexion at the first contact was higher in non-twins (p = 0.003).Being dizygotic twin seems to have no clinical effect on gait function in athletes.

The Prevalence of Asthma and Asthma-Like Symptoms among Seasonal Agricultural Workers.

AIM: The aim of the study was to determine the prevalence and risk factors of asthma and asthma-like symptoms in seasonal agricultural workers living in fields with toxic chemical exposure. METHODS: European Community Respiratory Health Survey (ECRHS) questionnaire was used to assess the prevalence of asthma and asthma-like symptoms in the study. RESULTS: Of the study group, 51.1% (267) were male and the age of the study group ranged from 18 to 88 years and the mean (SD) was 45.68 (13.39) years. The prevalence of asthma attacks in seasonal agricultural workers in the last one year (current prevalence) was 11.2%; the prevalence of asthma (cumulative prevalence) was 15.1%. In the study, smoking was found to be an important risk factor for current asthma. The prevalence of cumulative asthma was higher in seasonal agricultural workers with allergic rhinitis (p < 0.05 for each). CONCLUSIONS: Seasonal agricultural workers are exposed to the worst conditions of working groups. These difficult conditions also cause many health problems. Asthma has also been identified as an important health problem among seasonal agricultural workers.

Vaccination rates for Syrian population under temporary protection in Turkey.

OBJECTIVES: The aim of this study was to gather information on demographic and health indicators, primarily vaccination status, of Syrians under temporary protection in five provinces of Turkey and to develop infrastructure for vaccination planning. METHODS: The population under study consists of 89,986 Syrian children, 0-4 years of age, residing in Ankara, Mersin, Gaziantep, Izmir, and Bursa. Initially, we planned to evaluate 2,339 children, although a total of 2,827 children were evaluated by the end of the study. RESULTS: Of these children, 74% were born in Turkey, while 20% were born in Syria. In addition, 22.4% (n = 634) of the children were never vaccinated, and of these, 67.0% (n = 425) were born in Turkey. In other words, one in five Syrian children born in Turkey (20.3%) had never been vaccinated. Of the Syrian children under temporary protection, the missing vaccinations were as follows: hepatitis B (54.7%); Bacillus Calmette-Guérin (62.5%); five-component combined vaccine (64.6%); conjugated pneumococcal vaccine (58.0%); oral polio vaccine (70.8%); measles, mumps, and rubella (76.6%); varicella (66.8%); and hepatitis A vaccine (76.0%). CONCLUSION: It is important to increase the immunization rates of Syrian children under temporary protection and establish regular vaccination procedures.

Brain Death and Organ Donation in Paediatric Intensive Care Unit.

OBJECTIVE: The purpose of the present study was to retrospectively analyse the brain death (BD) cases that were specified within the last 8 years in the paediatric intensive care unit of our hospital. METHODS: Archive files and computer records of 23 paediatric cases were analysed. Data on age, gender, conditions that caused BD, paediatric risk of mortality (PRISM III) scores, time between suspicion of BD and issuing of BD report, confirmatory tests used, complications that occurred following the diagnosis of BD and time to cardiac arrest development after diagnosis of BD were recorded. RESULTS: The average age of the patients was 6.8±5.5 years. The most frequent cause of BD was intracranial haemorrhage (30.4%). The mean time to diagnosis after BD suspicion was 5.9±6.2 days. Electroencephalography was performed in 61% of the patients in addition to the apnoea test. Radiological imaging methods were used in 39% of the patients (n=9). Of the cases, 34.7% developed hypothermia, and 4.3% developed diabetes insipidus (DI). Among them, 43.4% had both DI and hypothermia. The mean PRISM score was calculated as 22±9.2. The donation rate of the families was 17%. The mean time to cardiac arrest development after diagnosis of BD was 6.9±7.4 days in non-donor cases where medical support had been reduced. CONCLUSION: Any patient with a neurologically poor prognosis in the intensive care unit should be considered to develop BD and diagnosed with BD without delay. The donation rate will increase if family interviews are done by an experienced and educated coordinator.

Effects of vitamin D supplementation on insulin resistance and dyslipidemia in overweight and obese premenopausal women.

INTRODUCTION: Vitamin D deficiency is a common problem, and it is related to increased risk of obesity, metabolic syndrome, atherosclerosis, and cardiovascular disease. Vitamin D has a beneficial effect on dyslipidemia and insulin secretion. We aimed to investigate the impact of vitamin D3 supplementation on anthropometric and laboratory parameters in overweight and obese premenopausal women. MATERIAL AND METHODS: Seventy-two overweight and 50 obese vitamin-D-deficient premenopausal women (mean age: 43.1 ±10.4 years) were included in the study. Baseline mean 25-hydroxyvitamin D [25(OH)D] level was 6.1 (min.-max. = 2.9-15.8) ng/ml in overweight and was 5.6 (min.-max. = 3.0-22.0) ng/ml in obese subjects. At baseline and at the sixth month of supplementation, serum 25(OH)D, intact parathormone (iPTH), calcium, phosphorus, homeostasis model assessment of insulin resistance (HOMA-IR), and lipid profiles were assessed. RESULTS: Following vitamin D3 supplementation in overweight and obese subjects, serum 25(OH)D increased from 6.1 to 34.7 ng/ml and 5.6 to 34.7 ng/ml, respectively (p < 0.001). At the sixth month of supplementation in both overweight and obese subjects, a significant reduction was detected in HOMA-IR (p < 0.001), low-density lipoprotein cholesterol (LDL-C) (p = 0.046, p = 0.044; respectively) and iPTH levels (p ≤ 0.001, p < 0.001; respectively). A negative adjusted correlation was found between changes in 25(OH)D and HOMA-IR (r = -0.581, p < 0.001; r = -0.389, p = 0.005; respectively). A 1 ng/ml increase in serum 25(OH)D level led to a 0.30-fold reduction in HOMA-IR level (p = 0.002). CONCLUSIONS: Our results support the effect of vitamin D3 supplementation in HOMA-IR and LDL-C improvement in both obese and overweight subjects. Further studies focused on low serum 25(OH)D levels with insulin resistance and dyslipidemia are needed.

The relationship of serum vitamin D receptor levels with disease activity and clinical parameters in patients with ankylosing spondylitis.

OBJECTIVES: The aim of this study was to investigate the relationship between serum vitamin D receptor (SVDR) levels and disease activity parameters in patients with ankylosing spondylitis (AS). PATIENTS AND METHODS: Between July 2016 and January 2017, a total of 62 patients (51 males, 11 females; mean age 36.5±12.8 years; range, 23 to 49 years) with AS and 32 healthy volunteers (25 males, 7 females; mean age 41.57±13.6 years; range, 26 to 48 years) were included in the study. The SVDR levels were measured using the enzyme-linked immunosorbent assay. Erythrocyte sedimentation rate (ESR) and serum C-reactive protein (CRP) levels were recorded. The Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) scores were used to assess disease activity. RESULTS: Although there was no significant difference between the patient and control groups (p=0.66), SVDR levels were significantly elevated in patients with active AS (BASDAI score ≥4) (p=0.01). The SVDR levels significantly increased in AS patients with peripheral joint involvement and enthesitis (p=0.01, p=0.05, respectively). The SVDR levels significantly elevated in patients treated with non-steroidal anti- inflammatory drugs, compared to those treated with biological agents and control group (p=0.01, p=0.03, respectively). The SVDR levels were positively correlated with the BASDAI, CRP and ESR in the patient group (p=0.01, r=0.751; p=0.01, r=0.75; p=0.01, r=0.81, respectively). CONCLUSION: Our study results suggest that serum SVDR levels are associated with the disease activity and clinical parameters in patients with AS. Based on these findings, SVDR level may be used as a marker of disease activity in AS.

Knowledge Level, Attitude, and Behaviors of Farmers in Çukurova Region regarding the Use of Pesticides.

INTRODUCTION AND PURPOSE: Farmers are particularly at high risk of pesticide exposure due to added risk from occupational exposure. The aim of this study is to evaluate knowledge level of farmers in the Çukurova region of the effects of pesticides, toxic symptoms, and protective equipment as well as assessing their attitudes and practices regarding pesticides. MATERIAL AND METHOD: A total of 420 seasonal agricultural workers in Karatas District of Adana Province, Turkey, were included in the study. The questionnaire form consisting of 3 sections was administered using face-to-face interview method. RESULTS: The mean age of the participants was 40.2 ± 10.6 years. They were engaged in farming for a mean duration of 18.5 ± 10.6 years. All of them used pesticides, but none of them had been trained on the use of pesticides. Only 26.2% of them stored pesticides in a private depot. The farmers who took empty pesticide containers to special collection bins or centers constituted only 4.3% of them. While 84.0% of them thought that pesticides could have a negative impact on human health, 5.0% of them had experienced a medical problem and 1.0% of them were poisoned after applying pesticides. CONCLUSION: The results show that knowledge level of farmers of safe use of pesticides is very inadequate. This lack of knowledge adversely affects workers' quality of life as well as occupational health and safety. Appropriate training programs should be organized to increase their level of knowledge.

Living Conditions, Access to Healthcare Services, and Occupational Health and Safety Conditions of Migrant Seasonal Agricultural Workers in the Çukurova Region.

OBJECTIVE: Migrant seasonal agricultural workers who are employed in one of the most hazardous occupations in Turkey experience difficulties in accessing health-care services. The aim of this study is to investigate the living conditions, access to health-care services, and occupational health and safety conditions of migrant seasonal agricultural workers in the Çukurova region. METHODS: Four hundred migrant seasonal agricultural workers were contacted in the county of Karatas located in the province of Adana, Turkey. A four-section questionnaire was administered using face-to-face interview techniques. RESULTS: The mean age of the participants was 32.8 ± 12.4 years. One-fourth of the participants did not have any social security coverage. Almost all had a monthly income below minimum wage, and 98% were living in tents. One-fifth experienced health problems in the last year, and 63% of them visited a health-care facility for diagnosis and treatment. About 3.3% of the participants sustained injuries at work, and only 23% of them visited a health-care facility. CONCLUSION: The findings of the study show that migrant seasonal agricultural workers in Turkey have insufficient working conditions, wages, accommodation facilities, nutrition opportunities, health conditions, and occupational health and safety conditions. This insufficiency negatively affects life qualities of the workers, utilization of health-care services, and their occupational health status and safety.

Evaluation of Risk Factors Affecting Substance Use among Tenth-Grade Students.

AIM: The aim of this study is to detect the prevalence of substance use among tenth-grade students; their thoughts, attitudes, behaviors, and tendencies towards substance use; and risk factors of substance use in tenth-grade students in general. METHODS: This study is descriptive and cross-sectional conducted between April and May 2016. Research population consists of tenth-grade students in 2015-2016 school year in the city of Ordu. Since the study involved all tenth-grade students, no sampling was done. Questions on substance use were prepared by Ordu Public Health Directorate and the authors by making use of European School Survey Project on Alcohol and Other Drugs (ESPAD) study questions, AMATEM's "Drugs and Addiction Youth Survey" study conducted on May 1996, and scientific studies conducted previously on similar subjects. RESULTS: 9825 tenth-grade students in 88 schools from 19 counties in the city of Ordu were included in the study. 8714 of the students participated in the survey. Being male, being over the age of 15, mother and father being separated, living with relatives, being in low income, negative feelings about school, perception of being unsuccessful in school, failing a year, absenteeism, and not being content with life are the risk factors for substance use. CONCLUSIONS: The tendency of illegal substance use becoming more and more prevalent especially among youth requires the development of new treatment strategies.

Knowledge, attitudes and behaviors of breast and cervical cancers and screenings of women working in primary health care services.

PURPOSE: Determination of information attitudes, behaviors and related factors on breast and cervical cancer screenings of primary health care workers. METHODS: The population of the study consisted of 1,130 female health workers working in health facilities (Community Health Centers, Family Health Centers) that provided primary health care services in the province of Mersin. The fieldwork was carried out in October 2017-February 2018 period. There were 62 questions in the survey form. There were questions about socio-demographic and living conditions in the first 19 questions and breast and cervical cancer in the next 43 questions. RESULTS: In the study, 87.8% of the target group could be reached, 84.8% of the physicians and 88.2% of the non-physician health professionals. The mean age was 38.93 ± 7.89. Of the group 14% were physicians and the rest were health workers such as midwives, nurses, health officers and medical secretaries, while 47.7% of the group had at least 1 relative who was diagnosed with cancer. More than 90% of the group said that breast and cervical cancer could be diagnosed early and treated if diagnosed early. Of the group 95.3% knew how to do breast self-examination (BSE) and 90.1% of those who knew were doing BSE. The most common response to the question of what should be done for early recognition of breast cancer was BSE and Pap smear test in cervical cancer. The physician group was more advantageous than the other staff in knowing and practicing BSE and in what period it should be done. The most common symptom of breast cancer was the presence of a mass or swelling in the breast. Of the subjects in the target age group, 21.9% of those who think they are at risk had never had a Pap smear test and 14.3% have not had a gynecological examination. CONCLUSIONS: Although these findings indicate that health care professionals are more knowledgable in terms of breast and cervical cancer screening than non-health care workers, it is necessary to motivate healthcare professionals to increase their level of knowledge and practice on cancer screening. The most important means of achieving this is to ensure that in-service trainings, cancer screenings and the risks to be taken in case of non-screening are mentioned seriously.

Prevalence of fibromyalgia in Turkish geriatric population and its impact on quality of life.

OBJECTIVES: The aim of the present study was to examine the presence of fibromyalgia (FM) in elderly adults and to evaluate the impact of the severity of FM on quality of life. METHODS: A total of 100 patients between 65 and 80 years of age were included. The main admission diagnosis of the patients was recorded. Presence of FM was evaluated based on 1990 American College of Rheumatology (ACR) diagnostic criteria. The FM group was comprised of 31 patients fulfilling these criteria, and the remaining 69 patients composed the non-FM group. Tender point count (TPC) and common symptoms were recorded. FM disease severity was assessed using Fibromyalgia Impact Questionnaire (FIQ). Nottingham Health Profile (NHP) was used to evaluate quality of life. Pain severity was measured using Visual Analog Scale (VAS). RESULTS: Rate of FM was found to be 31%. FM patients scored significantly higher on pain, sleep, social isolation, and emotional reactions subgroups of NHP when compared to controls (p<0.05). TPC and FIQ were not affected by gender difference (p>0.05), but reduced with increasing age (p<0.01). FIQ and TPC were found to be correlated with only the pain and emotional reactions subgroups of NHP (p<0.01). There was no statistically significant correlation between FIQ and TPC and the physical mobility, sleep, energy, and social isolation subgroups of NHP (p>0.05). CONCLUSION: Although FM is known as a disease of young and middle-aged women, our study indicates that its prevalence increases with age. FM is associated with poor quality of life in terms of pain, sleep, social, and emotional functions.