Changes in parents' attitudes towards childhood vaccines during COVID-19 pandemic.

BACKGROUND: Concerns about the safety and adverse reactions of rapidly-developed vaccines against COVID-19 contributed to parents' vaccine hesitancy and this situation created an opportunity for anti-vaccine campaigners. The aim of this study was to examine the changes in parents' attitudes towards childhood vaccines during COVID-19 pandemic. METHODS: In this cross-sectional study, parents of children who applied to the outpatient clinic of pediatric department of Trakya University Hospital, Edirne, Türkiye, between August 2020 and February 2021 were recruited into two study groups according to COVID-19 peak time in Türkiye. Group 1 included parents of children who applied after first peak of the COVID-19 pandemic and Group 2 included parents of children who applied after second peak. The World Health Organization 10-item Vaccine Hesitancy Scale (WHO-VHS) was applied to each group. RESULTS: A total of 610 parents agreed to participate in the study. Group 1 and 2 consisted of 160 and 450 parents, respectively. While the number of parents who were hesitant about childhood vaccines was 17 (10.6%) in Group 1, it was 90 (20%) in Group 2. A statistically significant difference was found between the two groups (p = 0.008). The (WHO-VHS) mean ± SD score was found to be higher in Group 2 (23.7 ± 6.9) than Group 1 (21.3 ± 7.3) (p < 0.001). The WHO-VHS- mean ± SD scores of parents who experienced COVID-19 infection themselves or their family or acquaintances were significantly lower than those who did not (20.0 ± 6.5 vs. 24.7 ± 6.9) (p < 0.001). CONCLUSIONS: The hesitant attitudes towards childhood and COVID-19 vaccines were low in parents who directly or indirectly experienced COVID-19 or were worried about the devastating effects of this disease. However, it was shown that as the COVID-19 pandemic progressed, parents' hesitations towards childhood vaccines increased.

Melatonin receptor gene polymorphisms as a risk factor in patients with diabetic peripheral neuropathy.

AIMS: Oxidative stress plays an important role in the pathogenesis of diabetic peripheral neuropathy (DPN). Melatonin is one of the most powerful endogenous antioxidants and has anti-inflammatory properties. We investigated how the gene polymorphism of melatonin differs in patients with DPN compared to an healthy control group. MATERIALS AND METHODS: A total of 54 diabetic peripheral neuropathy patients who applied to the Neurology outpatient clinic between 2020 and 2021, and 53 healthy controls comparable with the patient group in terms of age and gender were included in the study. Electromyography was performed and the melatonin gene polymorphism was analysed using the pyrosequencing method. RESULTS: Melatonin gene variants rs2119882, rs13140012, and rs10830963 were analysed in patients and controls. The rs2119882 (G allele) has a protective role, and rs13140012 polymorphism has a related 5-fold higher risk of DPN in the recessive model. CONCLUSIONS: Melatonin gene polymorphisms have been shown to be associated with DPN. This is the first and only study investigating the relationship between melatonin gene polymorphisms and DPN. Ethnicity is very important in genetic studies, and it will give us more information on the role of melatonin gene variants in larger study groups of diabetic patients of other ethnic origin.

Evaluation of Neuropatic Pain Features in COVID-19 Patients.

Background: Pain is a common complaint in COVID-19 disease. Neurotrophic features of the COVID virus are reported. Neuropathic pain is seen during many viral infections and observed during the COVID-19 pandemic part of the clinical presentations. Objective: The aim of this is to evaluate neuroptic pain as presenting symptom in COVID-19 patients. Materials and Methods: In this cross-sectional descriptive study, adult patients (18 years and older) who applied to the COVID Outpatient Clinic completed the demographic data form and the neuropathic pain questionnaire. The patients were divided into positive and negative according to the PCR test results and the presence of neuropathic pain was compared. Results: In total, 440 participants included in the study. Among 301 who stated to had any complaints, 197 (65.4%) had pain. The intensity of their pain was 5.8 ± 2.4 (0 - no pain and 10 - the most severe pain of life). Neuropathic pain component was present in 29.2% of the patients. Among the first admissions, neuropathic pain component was observed significantly higher in those with positive PCR test (55.0%) than negative ones (23.8%), and the Odd's ratio was calculated as 3.911. Conclusions: COVID-19 virus is thought to have neuroinvasion and neurotropic effects. In this study, neuropathic pain specifically was evaluated in COVID-19 patients, and the frequency of neuropathic pain was significantly higher in PCR confirmed COVID-19 patients at the onset of the disease.

Prevalence and associated factors of inappropriate repeat test.

BACKGROUND: The rate of laboratory test utilisation has been increasing unsustainably. Evaluating inappropriately repeated laboratory tests is promising because objective criteria are available to measure the rates while causes can be manipulated easily. In this study, we aimed to evaluate the prevalence, associated factors and financial burden of inappropriate repeat tests. METHODS: A cross-sectional study was conducted on the results of 26 types of laboratory tests recorded in a laboratory database of a tertiary hospital between 1 July 2014 and 30 June 2017. Minimum retest intervals were determined from the literature for each type of tests. If the time interval between the two tests was shorter than the minimum retest interval, then the later test was accepted an inappropriate repeat test. Binary logistic regression was performed after univariate analyses. RESULTS: Of a total of 673 794 tests, 109 370 (16.2%) were inappropriate repeat tests. Male gender, being ≥65 years old, being an inpatient, high-volume test and surgical clinic as the test-requesting clinic were associated with inappropriate repeat tests. Also, it was determined that US$66 761.3 had been wasted on inappropriate repeat tests for 3 years. DISCUSSION: There are several factors that increase the rate of inappropriate repeat tests. They should be considered during health policy making or planning interventions to reduce inappropriate repeat tests.

General health perception, depression and quality of life in geriatric grandmothers providing care for grandchildren.

AIM/BACKGROUND: To investigate levels of depression, quality of life, general health perception, and factors affecting these in grandmothers providing care for their grandchildren. MATERIAL/METHOD: One hundred two family physicians from four cities (Samsun, Amasya, Canakkale, and Izmir) in Turkey investigated 2859 women older than 65 years on their patient lists. Of these, 282 (9.8%) had spent at least 50 h caring for their grandchildren in the previous three months, and these were selected as the study group, while the remaining 2563 (89.6%) were enrolled as the control group. After all participants' demographic variables had been investigated, they completed the Beck Depression Inventory (BDI), Self-Function 12 (Mental and physical component score) (SF-12), and the Visual Analog Scale of EQ-5D (VAS). The participants in the study group also completed a questionnaire investigating features of their grandchild care. RESULTS: The study group (with the exception of custodial grandmothers) scored better on the SF-12 (PSC = 50.60 ± 6.96 vs 48.24 ± 8.12), (MCS = 49.70 ± 7.77 vs 45.48 ± 7.61), VAS (60.44 ± 23.5 vs 54.16 ± 19.5), and BDI (13.97 ± 0.3 vs 19.49 ± 0.2) compared to the control group (p < 0.0001 for all). Age, monthly income, mean length of education, duration of care, mean hours spent caregiving per week, being a custodial grandmother, presence of more than one chronic disease, and caring for more than one grandchild at a time were identified as factors affecting SF-12, VAS and BID in the study group. CONCLUSION: Grandchild care positively affected the grandmothers' quality of life, depression levels, and general health perception, with the exception of custodial grandmothers.

Mental health, suicidality and hopelessness among university students in Turkey.

Psychological symptoms of university students can affect perceptions of physical and mental health and can influence the emergence of suicidal behavior. We investigated the association among psychological symptoms, suicidal thoughts, perceptions of physical and mental health in university students. 4330 students at Onsekiz Mart University completed an internet-based questionnaire. 15.1% of the students reported suicidal thoughts at least once in their lifetime. The severity of mental symptoms was found to increase with a decrease in perceived physical and mental health. 28.2% of the students had depression, 33.1% had anxiety. This research aims to contribute to the extensive body of work done regarding the mental health, suicidal thoughts and hopelessness among university students.

Vision screening in children: Is 7-9 years of age a threshold for visual impairment?

OBJECTIVE: The present study aimed to assess the prevalence of decreased visual acuity, strabismus, and spectacle wear in children aged 5 to 13 years. METHODS: A cross-sectional study was performed in primary education schools. A total of 1938 participants, including 940 females (48.5%) and 998 males (51.5%) with a mean age 8.96 ± 2.31 (5-13 years old), were screened. The comparisons were performed with gender, age, and age groups. The children attended to vision screening were assigned to three age groups as 5-6 years, 7-9 years, and 10-13 years. RESULTS: The prevalence of the parameters was detected as decreased visual acuity 12.4%, strabismus 2.2%, and spectacle wear 6.9%. The prevalence of decreased visual acuity was significantly higher in girls and in children aged 7-9 years old (p = 0.013, p < 0.001). The prevalence of spectacle wear was significantly higher in girls and in children aged 7-9 years old (p = 0.019, p < 0.001). There was a visual acuity decrease in 33 of 106 (31.1%) children despite wearing own spectacle. There was no significant difference among three age groups for strabismus. CONCLUSION: Increased prevalence of decreased visual acuity, as well as the higher frequency of spectacle wear in children at ages of 7-9 years old may point out a threshold for visual impairment.

Prevalence of skin disorders in primary and secondary school age children in Canakkale, Turkey: a community-based survey.

INTRODUCTION: Skin lesions may be of dermatological importance, affect appearance, and cause problems communicating with peers and may be especially more significant in childhood. AIM: Information on the prevalence of pediatric dermatoses in Western Turkey. This study was aimed to define the existing data. MATERIAL AND METHODS: A cross-sectional study was conducted in Canakkale, Turkey, in September-December 2013. It involved 1,957 students from five randomly selected primary and secondary schools. Each student was interviewed for age, gender, and family history, and a dermatologic examination was performed by a dermatologist. Data were coded and analyzed. RESULTS: Of the students, 79.9% revealed at least one dermatosis. The most common disease was benign neoplasms (76%), followed by pigmentary disorders (26.8%), and xerosis (5.8%). In primary schools, the acquired melanocytic nevus, hypopigmented macule, and xerosis; in secondary school the acne was statistically significantly more common. Acne and xerosis was more common in girls, and pityriasis alba was statistically more common in boys. Students who had at least one dermatosis were positively correlated with monthly income. CONCLUSIONS: In Turkish school age children, the prevalence of dermatosis is 79.9%. It may be due to not using preventive means for adequate protection from the sun and other environmental factors. Infectious dermatosis and atopic dermatitis are rare and it may depend on the adequacy of public health work.

Evaluation of nasal airways by objective methods in chronic otitis media.

Otitis media (OM) is a common health problem. Nasal airways play an important role in etiopathogenesis of OM. The aim of this study is to evaluate nasal airways by objective methods in chronic otitis media (COM) cases. The relationship between the course of the disease and nasal parameters is also investigated. Fifty-six patients who had chosen an operation for chronic otitis media were included in the study. The control group was composed of 30 healthy patients. Patients were subjected to acoustic rhinometry and rhinomanometry. Nasal airway resistance and cross-sectional area measurements were taken. The results of the COM group and the control group were compared. Cases were classified by the course of the disease such as suppurative/progressive/active and non-suppurative/inactive and the nasal parameters of these sub-groups were compared. In cases with unilateral COM, nasal cavity results from both sides were compared. The nasal airway resistance of the COM group was statistically significantly higher than the control group (p < 0.05). However, there was no difference in cross-sectional area measurements. There was no significant difference between the suppurative/progressive/active and non-suppurative/inactive groups. However, the suppurative group had higher nasal resistance (p > 0.05). There was no statistical difference between the measurements of each side in unilateral COM cases. This study found that COM cases have greater nasal airway resistance. No significant difference was found in cross-sectional area measurements so the increase in resistance may be linked to mucosal rather than structural changes. There was no evidence for a relationship between the course of the OM and nasal airway parameters.

Relationship between Helicobacter pylori Adenotonsillar Colonization and Frequency of Adenotonsillitis in Children.

BACKGROUND: There are insufficient data in the literature on the presence of Helicobacter pylori in tonsil and adenoid tissue of patients with only airway obstruction. This study examined the presence of H. pylori in surgical cases with airway obstruction or recurrent infection. AIMS: To investigate the relationship between H. pylori adenotonsillar colonisation and the frequency of adenotonsillitis and to compare paediatric and adult patients according to H. pylori tonsillar colonisation. STUDY DESIGN: Prospective clinical trial. METHODS: PATIENTS SCHEDULED FOR ADENOIDECTOMY OR TONSILLECTOMY WERE CLASSIFIED INTO THREE GROUPS BASED ON INDICATIONS: paediatric infection (n=29), paediatric obstruction (n=29) and adult infection (n=12). Tissue samples obtained from patients were examined for the presence of H. pylori by culture, rapid urease test and polymerase chain reaction. RESULTS: Forty-nine tonsil tissues were examined. Positive results were found in two specimens with the rapid urease test (4.1%) and three with polymerase chain reaction examination (6.1%). Only three positive polymerase chain reaction results (5.8%) were identified in 52 adenoid tissue samples. There were no statistically significant differences in the presence of H. pylori between paediatric infection and obstruction groups or between paediatric infection and adult infection groups. CONCLUSION: In our study, there was a low incidence of H. pylori colonisation in tonsil and adenoid tissues. Regarding H. pylori colonisation, there was no significant difference between paediatric infection and obstruction groups. Also, no significant difference was found between adult and paediatric cases.

Depression, anxiety, body image, sexual functioning, and dyadic adjustment associated with dialysis type in chronic renal failure.

OBJECTIVE: Depression is the most widely studied complication in dialysis patients. In patients with chronic renal failure, changes in body image are considered to be associated with invasive treatment interventions. In addition, sexual problems are common in dialysis patients. In this study, hemodialysis and peritoneal dialysis patients are investigated for depression, anxiety, body image, sexual satisfaction, and dyadic adjustment. METHODS: Hemodialysis patients (n = 36), peritoneal dialysis patients (n = 54), and healthy controls (n = 30) were included in the study. All the subjects were assessed with Structured Clinical Interview for DSM-IV, Body Image Scale, Beck Depression Inventory, Beck Anxiety Scale, Golombok-Rust Inventory for Sexual Satisfaction, and Dyadic Adjustment Scale. RESULTS: Depression (20.64 +/- 15.20) and anxiety levels (14.72 +/- 12.36) were significantly higher in hemodialysis group compared to peritoneal dialysis (13.54 +/- 12.51; 12.74 +/- 11.21) and control groups (7.17 +/- 5.58; 9.86 +/- 9.19). In peritoneal dialysis group, as depression and anxiety levels increased, body image was disturbed and sexual satisfaction decreased. In peritoneal dialysis group, body image (86.98 +/- 23.63) was better than hemodialysis group (101.58 +/- 26.51) and was not different from the control group (83.67 +/- 22.11). In hemodialysis group, as depression and anxiety levels increased, body image was disturbed. In both groups, long-term dialysis disturbed body image. CONCLUSION: Patients should be informed about the impacts of dialysis. Clinicians may wish to monitor dialysis-users for anxiety, depression, dyadic adjustment, and body image difficulties at follow-up appointments. Interventions that target intimate partner interventions, appearance-related beliefs, and anxiety depression may be of benefit to this population.

Psychosocial factors affecting various types of intimate partner violence against women.

OBJECTIVE: Intimate partner violence against women is a growing global public health problem that is related to various psychosocial, cultural, mental, and economic factors. In this study, psychosocial factors affecting various types of intimate partner violence against women were investigated based upon affected individuals' statements. METHODS: Demographic data, exposure to various types of partner violence, individual habits, partner habits, family functioning, and social support were inquired about during face to face interviews with 306 women chosen by stratified sampling to represent adult women living in Edirne, Turkey. RESULTS: Among the participants, 54.5% were exposed to psychological violence, 30.4% were exposed to physical violence, 19.3% were exposed to economic violence, and 6.3% were exposed to sexual violence. Partner's age and the duration of marriage had a protective effect on intimate partner violence while worsening of marital relations, marriage by family decision, marriage against family consent, and the presence of a violent history against women in a partner's family had incremental effects on intimate partner violence. The duration of marriage, the worsening of marital relations and a history of violent exposure during childhood increased physical violence. Additionally, a decreasing family income, increasing economic violence, worsening of marital relations, and a decreasing social support network increased sexual violence against women. CONCLUSIONS: Recognizing and defining the effecting factors of intimate partner violence will aid in the understanding of the sources that generate and feed the violent behavior. Risk factors of different types of intimate partner violence vary. Our results indicate that any kind of violent behavior increases intimate partner violence against women.

Physical child abuse and causative factors in Edirne, Turkey.

The aim of this study was to identify the frequency and causative factors of physical child abuse and any correlations with other domestic violence types. In a representative sample of 15-49-year-old married women living in Edirne chosen with stratified cluster sampling, 275 women were interviewed face-to-face in their residence or places of employment. The questionnaire used included any violent behavior of the women or their husbands toward their children as well as demographic features, habits, Marriage Relation Scales, Multidimensional Scale of Perceived Social Support, history of partner abuse, and childhood violence exposition. The physical child abuse rate was 61.1% among the women and 20.7% among the husbands according to the women's declarations. Social support was not associated with child abuse rates. Child abuse rate among the women was increased 2.7 times in the presence of the partner's child abuse, 1.6 times with each additional child, 3.1 times in the presence of a history of physical childhood abuse, and 1.9 times in the presence of a history of partner abuse. Child abuse by the husbands was increased 2.9 times in the presence of physical childhood abuse history and 2.3 times in case of partner abuse. Child abuse is widely seen although morally unacceptable in contemporary society. Violent behaviors spread out horizontally among family members and vertically through generations, although at decreasing rates. Healthcare professionals should behave in a sensitive manner and take responsibility together with those from other related fields to prevent this condition, which can result in several social complications.

Short-term effects of problem-based learning curriculum on students' self-directed skills development.

AIM: To investigate short-term effects of problem-based learning on students' scientific thinking, problem solving, and conflict resolution skills. METHODS: The study was conducted in two medical schools, Ondokuz Mayis University in Samsun and Trakya University in Edirne, Turkey. The two schools used different instructional approaches in educational methods: Ondokuz Mayis University followed a problem-based learning curriculum and Trakya University a traditional didactic curriculum. Three groups of students were included as follows: (a) 83 first-year from Ondokuz Mayis University, who passed an English language proficiency exam; (b) 146 students who failed English language proficiency exam and had to spend a year attending preparatory English language classes before starting their first year at Ondokuz Mayis University (first control group); and (c) 124 students first-year students from Trakya University (second control group). All participants completed the Problem Solving Inventory, Scientific Thinking Skills Questionnaire, and Conflict Resolution Scale at the beginning of the 2003/2004 academic year. The tests were re-administered to same students at the end of the academic year, ie, 10 months later. RESULTS: Analysis of covariance revealed no differences in pre-test scores among the problem-based learning, first, and second control groups in their scientific thinking (9.0+/-71.2, 8.9+/-3.2, and 8.7+/-1.3, respectively; P=0.124), problem solving (132.2+/-15.4, 131.2+/-16.2, and 132.1+/-17.4, respectively; P=0.454), and conflict resolution skills (112.3+/-14.6, 109.7+/-12.8, and 110.2+/-11.4, respectively; P=0.07). The study group in comparison with first and second control group had significantly better post-test results in scientific thinking (13.9+/-3.5, 9.5+/-2.2, and 9.1+/-2.7, respectively), problem solving (125.5+/-12.6, 130.1+/-11.2, and 131.1+/-15.4, respectively), and conflict resolution skills (125.4+/-12.7, 110.9+/-23.7, and 111.6+/-23.6, respectively) (P<0.001 for all). The skills of the two control groups did not improve in this time period and their post-test scores were not significantly different. CONCLUSION: Problem-based learning curricula may positively affect some of the self-directed skills, such as scientific thinking, problem solving, and conflict resolution skills of students, even in a short period of time.

Which anthropometric measurements is most closely related to elevated blood pressure?

BACKGROUND: Epidemiological studies find a progressive increase in the prevalence of elevated blood pressure with increasing adipose tissue. But there is no common opinion about which effectiveness of the anthropometric measurement tools indicating general or android obesity are most important to follow up in patients with elevated blood pressures. OBJECTIVES: To identify which anthropometric measurements are most closely related to blood pressure elevation. METHODS: A cross-sectional descriptive study of 1727 subjects [894 (50.6%) men and 833 (48.2%) women, aged 18-65 years old] was held in Edirne, Turkey. Each subject's weight, height, waist and hip circumference, triceps skin fold and blood pressures was measured; waist to hip ratio and body mass index were calculated. The relations between blood pressure and different anthropometric variables in both genders were investigated in linear regression models. RESULTS: The mean systolic and diastolic blood pressures were 123.49 +/- 17.60 and 78.79 +/- 10.37 mmHg. According to body mass index 23.7% of the subjects were obese (.29.9 kg/m(2)). When waist circumference cut-off points were compared with waist to hip ratio the android obesity ratio was doubled (32.3% versus 16.6%). 119 subjects (6.8%) were not obese according to body mass index but nonetheless had waist circumference measurements above the cut-off points suggesting a high cardiovascular risk. In the linear regression models waist circumference was found to be an independent risk factor for blood pressure in men; however body mass was more important index and waist circumference somewhat less so for women. CONCLUSION: In primary care waist circumference should be a useful tool screening for and following android obesity in patients with elevated blood pressure.

Use of quality circles among first year medical students and impact on student satisfaction.

Quality circles in the classroom setting are composed of students who meet regularly to identify, analyse and solve problems related to a course, and implement solutions. We recently instituted quality circles (QCs) among preclinical medical students and evaluated their impact on quality of learning and student satisfaction. Included in the study were all 135 first-year medical students of Trakya University School of Medicine in the 2000-2001 academic year. Six students were selected randomly out of 26 volunteers as circle members. Circle participants met once a week for 14 45-minute sessions to discuss educational issues, propose solutions and prepare a report for submission to the dean. A questionnaire was administered to all first-year students and the replies provided the problem pool from which the QC chose the problem to be addressed. A total of 22 problems concerned education and 28 were identified in the fields of accommodation, social activities and other issues. To evaluate the change in the perceived quality of learning, circle members prepared a questionnaire designed to compare satisfaction at the beginning and end of the study period. This questionnaire was composed of 26 items and evaluated various aspects of education. There was a significant increase in student satisfaction after the one-year study period (p = 0.001). In addition to enhancing quality of learning, quality circles improved student satisfaction as well. More studies should be conducted to test the impact of QCs on education in different settings and different classes. Our results show that the use of quality circles in first-year medical students improves quality of learning and student satisfaction.