Distance education perception scale for medical students: a validity and reliability study.

BACKGROUND: There are major changes in education strategies as higher education institutions urgently need to adopt distance education tools and practices due to the Covid-19 pandemic. Medical education is also trying to get out of this emergency using distance education. In this study, we aimed to develop a reliable and valid scale in order to evaluate the perceptions of medical students towards distance education. METHODS: The students taking part in the study were in the first five academic years of the medical faculty in Bursa in Turkey. At first, 57 items were determined to evaluate students' perceptions. Content validity was examined according to the assessment of the expert team. Construct validity of these items was examined by exploratory and confirmatory factor analysis. Also, Cronbach's alpha coefficients were calculated for reliability analysis. The medical students' responses were scored using a five-point Likert scale. RESULTS: When the content validity was examined, the number of items was determined to be 38 items. Construct validity of these items was examined by exploratory and confirmatory factor analysis. Because of the exploratory factor analysis performed on the responses of 429 medical students, 22 items were included in four factors. This four-factor model was applied to 286 medical students and validated by confirmatory factor analysis. Also, Cronbach's alpha coefficients were calculated for reliability analysis and values were between 0.713 and 0.930. CONCLUSIONS: This study demonstrated validation and reliability of perceptions of distance education for medical students. We suggest a 22-item model with a four-factorial scale.

A Meta-Analysis and an Evaluation of Trends in Obesity Prevalence among Children and Adolescents in Turkey: 1990 through 2015.

OBJECTIVE: Obesity in childhood and adolescence is one of the most serious public health problems due to a remarkable increase in prevalence in recent years and its close relationship with non-communicable diseases, such as diabetes and hypertension, resulting in increased adult morbidity and mortality. This study aims to quantify the secular trend in different regions of Turkey from 1990 to 2015 by performing a meta-analysis of childhood and adolescent obesity prevalence studies conducted. METHODS: Uludag University Library Database was searched for relevant articles published prior to March 2017. The heterogeneity of the studies in the meta-analysis was tested by the I2 statistic and Cochran's Q test. The obesity trend analyses were examined by chi-square trend analysis with respect to five year periods. The statistical significance level was taken as α=0.05. RESULTS: A total of 76 papers were initially identified addressing childhood and adolescent obesity in Turkey. Fifty-eight papers were selected for analysis. The prevalence of obesity increased from 0.6% to 7.3% with an 11.6-fold increase between the periods 1990-1995 to 2011-2015. The prevalence of obesity increased in both genders. However, boys were more likely to be obese than girls. CONCLUSION: Studies on obesity prevalence in the 5-19 age group in Turkey have gained importance, especially in the 2000s. While a remarkable number of prevalence studies, mostly regional, have been conducted between 2005-2011, a gradual decline was observed thereafter. Further national and population-based surveys on prevalence of obesity in children and adolescents are definitely needed in Turkey.

General Practitioners' intention to prescribe and prescribing patterns in selected European settings: The OTCSOCIOMED project.

The aim of this paper is to explore general practitioners' (GPs) prescribing intentions and patterns across different European regions using the Theory of Planned Behavior (TPB). A cross-sectional study was undertaken in selected geographically defined Primary Health Care areas in Cyprus, Czech Republic (CZ), France, Greece, Malta, Sweden and Turkey. Face-to-face interviews were conducted using a TPB-based questionnaire. The number of GP participants ranged from 39 to 145 per country. Possible associations between TPB direct measures (attitudes, subjective norms (SN) and perceived behavioral control (PBC)) and intention to prescribe were assessed by country. On average, GPs thought positively of, and claimed to be in control of, prescribing. Correlations between TPB explanatory measures and prescribing intention were weak, with TPB direct measures explaining about 25% of the variance in intention to prescribe in Malta and CZ but only between 3% and 5% in Greece, Sweden and Turkey. SN appeared influential in GPs from Malta; attitude and PBC were statistically significant in GPs from CZ. GPs' prescribing intentions and patterns differed across participating countries, indicating that country-specific interventions are likely to be appropriate. Irrational prescribing behaviors were more apparent in the countries where an integrated primary care system has still not been fully developed and policies promoting the rational use of medicines are lacking. Demand-side measures aimed at modifying GPs prescribing behavior are deemed necessary.

How parental attitudes affect the risky computer and Internet usage patterns of adolescents: a population-based study in the Bursa District of Turkey.

BACKGROUND: We aimed to evaluate the computer usage patterns of adolescents and to determine the effects of family life and parental attitude on these patterns. METHODS: This was a descriptive, cross-sectional, population-based survey that included 935 children between 11 and 16 years of age who were students in the second level of primary school and their parents as well. The following instruments were used in the survey: student and parent questionnaires on computer usage patterns and the Parental Attitude Research Instrument (PARI) to assess parental attitudes towards child-rearing and family life. RESULTS: Of the study population, the majority of the students had a computer in their homes and spent a lot of time on the Internet. Parental control over the amount of time spent on the Internet and the websites that were visited had sometimes limited and contradictory effects on computer usage among the students. A democratic parental attitude was the best approach. Using the computer as a reward or punishment had a negative impact on the children's computer usage patterns. CONCLUSIONS: Although parents are confused concerning the benefits and harms of the Internet for their children and not certain how to manage their children's use of the computer and safe navigation of the Internet, a democratic parental attitude appears to be the best approach for reaching the most beneficial computer usage patterns for students.

Diagnosis of acute tonsillopharyngitis in primary care: a new approach for low-resource settings.

BACKGROUND: Diagnosing GABHS (Group A-beta Hemolytic Streptococcus) tonsillopharyngitis by clinical scoring is a recommended approach in developed countries, but there is still much controversy for low resource settings. AIM: We aimed to assess the impact of Centor criteria with the support of practical laboratory tests. METHODS: We prospectively included patients complaining sore throat (N = 282). We evaluated them in terms of Centor scoring and performed white blood cell count (WBC), C-reactive protein (CRP), rapid antigen detecting test, and throat culture. RESULTS: In GABHS cases (N = 32, 11·3%), two of the criteria were observed to be positive in more than half of the cases (N = 19, 59·3%), while 13 (40·7%) cases met three/four criteria. The specificity of having two criteria was found to be 65·5% and increased to 91·5% after including CRP and WBC. CONCLUSION: Centor criteria could be safely used to reduce unnecessary antibiotic usage for tonsillopharyngitis in developing countries.

Getting better or worse? General health status of 9th grade students in Orhangazi, Bursa, Turkey.

Adolescence is a transition phase from childhood to adulthood. In this period, rapid changes and development in their physical, biological, psychological, and social lives take place. While adolescents have to acquire many qualifications, they are faced with many problems, especially those that risk their health. In Turkey, one of the most important issues contributing to risky behaviors is the 1st Phase Nationwide High School Exam. Students must pass this phase in order to be in good high schools and to then pass the 2nd Phase University Exam. Most of their time is spent studying in school or in private teaching institutions, and less time is spent with their families or participating in social activities. In order to examine the effects on 9th grade students after the 1st Phase exams, we conducted this study with 1192 students in Bursa, Orhangazi. Data to evaluate students by socioeconomic status, body mass index (BMI), dietary, smoking, and physical activity behaviors and psychological status were collected via classroom questionnaires. We aimed to determine and evaluate the general characteristics and physical examination findings, to some extent, in a nationally representative sample of 9th grade students a year following the Nationwide High School Exam.

Risk factors for wheezing in primary school children in Bursa, Turkey.

BACKGROUND: Wheezing is the most common symptom of childhood respiratory tract illnesses. It is important not only for its associated acute morbidity, but also for the fact that early childhood wheezing confers a high risk for asthma. Epidemiological studies from various countries show that 10-15% of children <1 year of age and 25% of children <5 years of age have wheezing-associated respiratory tract illness, and one-third of these children develop asthma later in life. METHODS: In this retrospective study, we evaluated the association between a history of wheezing and prenatal, postnatal, familial, and environmental risk factors in 858 7-year-old children, randomly selected from seven primary schools in Bursa, Turkey, by means of an easy-to-understand questionnaire form. Among these children, 12.4% had a history of early transient wheezing, 7.1% had persistent wheezing, and 7.7% had late onset wheezing; 72.8% had no wheezing symptoms and 33.3% of children who experienced wheezing during the first 3 years of life had physician-diagnosed asthma. RESULTS: Notable risk factors associated with wheezing were as follows: male gender, lower socioeconomic status, premature birth, maternal smoking during pregnancy, bottle-feeding before 2 months of age, dampness and mold at home, hospitalization due to any respiratory illness in infancy, history of croup between 6 months and 5 years of age, frequent upper respiratory infections during the first 3 years of life, allergic eczema in the child, and any allergic disease in the mother or siblings. CONCLUSION: This study shows that the high rates of reported wheezing in the 858 primary school children in Bursa are clearly attributable to important risk factors that have long been recognized and discussed by researchers worldwide, and this suggests that all efforts at primary prevention may be insufficient.

The knowledge of "Facts for Life".

OBJECTIVE: "Facts for Life" is an essential tool for saving the lives of children. In this study we wanted to evaluate the knowledge of "Facts for Life" among Turkish women. DESIGN: This is a cross-sectional field study. We used 25 indicator questions to evaluate the knowledge of women in the following main subjects: safe motherhood, childhood immunization, childhood diarrhoea, children's acute respiratory diseases, and household hygiene. We filled out printed questionnaires during face-to-face interviews. For each correct answer we gave 4 points, and the sum of the points was accepted as the knowledge score. SETTING: Bursa metropolitan area in Turkey. SUBJECTS: Married women between 15-44 years of age. We selected 1000 of them from the household cards of the health centers that were located at the Bursa metropolitan area by using a random selection method. RESULTS: Mean knowledge score was 72.0 +/- 0.3. About 3/5 had moderate, 1/5 good + very good, and 1/5 bad knowledge scores. Childhood diarrhoea was better known than acute respiratory diseases. The very well known "Facts for Life" were those concerning food and household hygiene. CONCLUSION: Women's knowledge about "Facts for Life" was at a moderate level. The knowledge level of older women was better than the younger. Some false beliefs still existed. Knowledge about ARI and diarrhoeal diseases in childhood were the least known facts.

Domestic violence: a tragedy behind the doors.

OBJECTIVE: To explore the prevalence, type, frequency and causes of domestic marital violence among Turkish women in a socio-economically developed metropolitan setting. METHODS: A cross-sectional study was performed in 2003. All married women, aged 18 years and over, who were visiting any of the 50 primary health care units for different purposes were asked to participate in the study. Of 1427 asked, 1010 gave consent and completed face-to-face interviews. Multiple correspondence analysis, and logistic regression were used for statistical analyses. RESULTS: Domestic violence was statistically significantly associated with educational level. Illiterate women reported marital abuse 2.6 times more than university or more educated women. No statistically significant relationship was observed between domestic marital violence and women's age or occupation, marital duration or family income. The most frequently reported type of violence was physical, followed by psychological. Among women reporting domestic violence, those with the lowest educational level and income were experiencing all types of domestic violence frequently. CONCLUSION: Placing more importance on educating girls could be a key component of preventing domestic violence.

Domestic violence: a study among a group of Turkish women.

OBJECTIVES: With this study we attempt to explore the reality of domestic violence, its prevalence, type and frequency among a group of Turkish women. METHODS: This study was performed between October 2000 and May 2001 in the fourth largest city in Turkey. All women over the age of 15, who visited any of 50 health centres in different districts for different purposes, were asked to participate in the study. 506 of the participants who gave their consent were taken as a study group, and printed questionnaires were filled in during face-to-face interviews. RESULTS: 297 (58.7%) of the participants had experienced domestic violence at least once in their lifetime. The male partner was the primary violent person (49.5%), followed by mother and/or father (14.1%). The type of violence seen most was a combination of physical and psychological violence (45.5%). More than half of the women (58.6%) were experiencing domestic violence frequently and continuously. Reasons given for this violent behaviour were economic hardship (18.9%), followed by alcohol consumption by the violent person (18.5%), and inadequate family relations (15.8%). Of the victims 43.8% accepted this violence, but 26.6% reacted with violence. Women were not willing to abandon their relationships despite marital violence, because of their children (48.2%). Women's and men's higher educational attainments did indicate a decrease in the prevalence of domestic violence. CONCLUSION: Reasons for continuing the abusive relationship and the effectiveness of the scarce support resources should be evaluated more seriously. The potential role of the primary healthcare provider in eliminating barriers for identification and assessment of domestic violence should not be forgotten. Otherwise, domestic violence will still remain a 'family matter', hidden and neglected.