Environmental consciousness of students from secondary and high schools in Bodrum, Turkey.

In this study, it is aimed to determine environmental awareness of secondary and high school students in Bodrum, Turkey. This cross-sectional designed study was conducted on 381 students from secondary school and 335 high school students between 5th and 12th grades in Bodrum. In order to assess the environmental consciousness level, a questionnaire form consisting 58 questions and 17 statements for evaluation of environmental consciousness was developed by researchers. t test was used for the difference between the distribution of percentages and the difference between the averages of environmental consciousness level. The top three environmental health issues that were determined as "very harmful" were "smoking, air pollution resulting from power plants and being in a smoking area" for secondary school students and "smoking, air pollution resulting from power plants and ozone depletion" for high school students. Both in secondary and high school students, the mean environmental consciousness level of female students was higher than that of male students. The mean environmental consciousness level was 12.4 ± 2.7 for secondary school students and 12.1 ± 3.1 for high school students. There was a need of training activities of both the teachers and the students to improve the environmental awareness of the secondary and high school students.

Serologic Investigation of Hantavirus Infection in Patients with Previous Thrombocytopenia, and Elevated Urea and Creatinine Levels in an Epidemic Region of Turkey.

The first cases of Hantavirus infection in Turkey were reported in early 2009 in the Zonguldak and Bartin provinces. The aim of this study was to investigate the presence of Hantavirus antibodies in patients who had clinical and laboratory findings that were potentially associated with Hantavirus infection prior to the epidemic in Bartin in 2009. After screening 314,577 medical records from between 2007 and 2009, the clinical and laboratory data for 442 patients meeting the criteria of coexistent thrombocytopenia, and elevated urea and creatinine levels were transferred to a statistical program. Home visits were made to 170 patients, 84 of whom consented to participate in the study. The participants completed a questionnaire and provided a blood sample. Commercial anti-Hantavirus IgG and IgM ELISA and immunoblotting assays were used, with seropositive samples being confirmed by focus reduction neutralization tests (FRNT). ELISA and/or immunoblotting assays detected 10 positive samples; however, only 7 of these were recorded as positive by FRNT. FRNT positivity was significantly associated with female sex, the presence of a barn near to the house, and working in a forest (P < 0.05). In a Hantavirus endemic region, physicians must keep in mind that thrombocytopenia, and elevated urea and creatinine levels may indicate Hantavirus infection.

Acute flaccid paralysis surveillance in southeastern Turkey, 1999-2010.

The aim of the study was to report the results of acute flaccid paralysis (AFP) surveillance and to evaluate the performance of surveillance in the southeastern region of Turkey in the 12 years from 1999 to 2010. We investigated cases in seven provinces of the southeastern region of Turkey. In the evaluation, AFP Case Report Form, Laboratory Investigation Form and 60-Day Case Investigation Form were used; individuals' demographic characteristics, clinical findings, status of vaccination, sample results, and 60-day follow-up were evaluated. Incidence ranged from 0.60/100,000 in 2008 to 1.60/100,000 in 1999. Dysstasia and loss of strength were the most frequently reported prodromal symptoms. Coxsackievirus and echoviruses were the most frequent viruses detected. One-quarter of the AFP cases could not be followed up in the present surveillance system.

Seroprevalence following the first wave of pandemic influenza A (H1N1) in Turkey, 2009.

In this study, we sought to describe the community seropositivity of pandemic influenza A (H1N1) in order to estimate immunity shortly after the peak of the first pandemic wave in two provinces in Turkey. This cross-sectional study was conducted in the provinces of Diyarbakir and Ankara, after the first wave of H1N1 incidences in 2009. It was designed to evaluate 276 houses in Diyarbakir and 455 houses in Ankara. Everyone living in these houses was included in the study. An antibody titer of ≥1:40 was considered as a positive result for all age groups. Antibody titers of ≤1:20 were considered as 1 while calculating the log titer and geometric mean. The pandemic H1N1 seropositivity was found to be 24.1% for Ankara and 27.7% for Diyarbakir. In Ankara, seropositivity was statistically associated with the 15-24 age group (odds ratio [OR] = 11.47), pandemic influenza A (H1N1) vaccination (OR = 20.95), and influenza-like illness history (OR = 1.60). In Diyarbakir, H1N1 seropositivity was associated with the 15-24 age group (OR = 8.99) and pandemic influenza A (H1N1) vaccination (OR = 9.94). Because individuals less than 25 years old played an important role in the community transmission of infection and were largely protected against the pandemic influenza A (H1N1) virus, these individuals should be given a high priority for pandemic influenza vaccination in the event of the emergence of another novel pandemic strain.

[Pandemic influenza A (H1N1)v vaccination status and factors affecting vaccination: Ankara and Diyarbakir 2009 data from Turkey]. / Pandemik Influenza A (H1N1)v Asilanma Durumu ve Asilanmaya Etki Eden Faktörler: Ankara ve Diyarbakir 2009 Verileri.

In this study, it was aimed to determine the frequency of the symptoms of influenza-like illness during influenza A (H1N1)v pandemic in two provinces where sentinel influenza surveillance was conducted and also to obtain opinions about H1N1 influenza and vaccination, H1N1 vaccination status and factors affecting vaccination. This cross-sectional study was conducted in the provinces of Ankara (capital city, located at Central Anatolia) and Diyarbakir (located at southeastern Anatolia). It was planned to include 455 houses in Ankara and 276 houses in Diyarbakir. The household participation rate in the study was 78.9% and 53.6% for Ankara and Diyarbakir, respectively. Our study was carried out between January-February 2010, with 1164 participants from Ankara and 804 from Diyarbakir, including every household subjects except for infants younger than 11 months and patients with primary/secondary immunodeficiency diseases. Data was collected by site teams consisting of a physician and a healthcare staff with informed consent. Of the participants 45.5% from Ankara and 35.3% from Diyarbakir stated that they had gone through an influenza-like illness. The most frequently indicated clinical symptoms were fatigue/weakness, rhinitis, sore throat and cough. The rates of admission to a physician with influenza like illness complaints were 50.6% and 58.7%; rates of hospitalization due to influenza-like illness were 1% and 1.5%, and rates of antiviral drug use were 3.8% and 1.9%, in Ankara ve Diyarbakir participants, respectively. The rate of personal precautions taken by the subjects for prevention from pandemic influenza were 59% and 53.3%, in Ankara and Diyarbakir, respectively. These precautions most frequently were "hand washing" and "avoiding crowded public areas". H1N1 influenza vaccine was applied in 9.3% of the participants in Ankara and in 3.7% of the participants in Diyarbakir. Vaccination rate was higher in both of the provinces in adults over 25 years old than children and adolescents and in patients with chronic underlying disease. None of the 25 pregnant participants were vaccinated against pandemic influenza. The educational background, employment status and quality of the job have been detected as factors affecting the status of being vaccinated with H1N1 influenza vaccine in both provinces. In addition, the percentage of having H1N1 influenza vaccination was found to be higher in subjects who had seasonal influenza vaccination previously and in 2009, than those who had not, and this difference was statistically significant in both provinces (Ankara p< 0.001, Diyarbakir p< 0.001). The mostly indicated post-vaccination adverse reactions reported by vaccinated participants were local sensitivity, muscle and joint pains, headache and malaise. The most frequent rationale for not being vaccinated against H1N1 were "I do not consider it necessary/I do not want" (Ankara 33.4%, Diyarbakir 27.4%) and "I do not believe/trust its efficacy" (Ankara 25.6%, Diyarbakir 22.6%). Those data emphasized the insufficient awareness of our population about the importance of pandemic influenza and vaccine. It is also believed that possible case definition in H1N1 case management scheme should be revised. In conclusion an important part of pandemic preparation plans is risk communication with the public to increase awareness and to prevent the missed opportunities.

The evaluation of the opinions and attitudes of healthcare personnel of the province Diyarbakir against influenza A (H1N1) and the vaccination.

In this study it was targeted aimed to evaluate the opinions and attitudes of healthcare personnel of the province Diyarbakir against Influenza A(H1N1) and the vaccination and to determine the undesired effects after the vaccination. In this descriptive study, 1691 healthcare personnel participated. The participants were asked about their opinions about being included in the risk group or not, status of advising and having Influenza A(H1N1) vaccination, reasons of having or not having the vaccination, their opinions and attitudes about the pandemic and influenza vaccine and the practices of the press and the Ministry of Health. Of participants, 49.6% stated that they advised pandemic influenza vaccination. Of the healthcare personnel, 35.3% stated that they had pandemic influenza vaccine. Age, sex, profession, having seasonal influenza vaccine , using Media and the Ministry of Health as a source of information were important factors for the status of advising and having Influenza A(H1N1)v vaccine. The healthcare personnel should be informed about the purpose and practices of protection programs. It might be suggested to use press, which is regarded as the most important communication media, in accordance with the conditions in order to achieve suitable risk communication with the society.

Burnout status of interns and associated factors.

It is well known that due to long working hours and stressful working conditions, doctors experience burnout more often than other professional groups. Their career burnout begins in the early years, continues to increase and becomes most evident in the internship of medical school. On this wise, the purpose of this study was to investigate the burnout status of intern doctors and the associated factors. Participants in this cross-sectional study were sixth-year medical students (n = 302). Data were collected under observation using a questionnaire including some sociodemographic characteristics and the Maslach Burnout Inventory, SF-36, General Health Questionnaire and COPE Inventory. The mean age of the participants was 24.5 +/- 1.1 years and 53.4% of them were male. Mean scores of emotional exhaustion, depersonalization and personal accomplishment were 25.5 +/- 7.5, 11.3 +/- 3.9 and 24.7 +/- 3.4, respectively and the three sub-dimension scores of the burnout scale showed no association with gender. Students' emotional exhaustion scores significantly differed according to the socioeconomic status (p < 0.05). Participants who had lower scores on the mental and physical dimensions of SF-36 and higher scores on GHQ-12 showed significantly more emotional exhaustion and depersonalization.Positive coping methods showed negative correlation with the subscales of burnout and individuals using problem-focused coping felt more successful (personal accomplishment) confirming the relationship between mental health and burnout. The medical education curricula (both theoretical and practical studies) should be reviewed and appropriate adjustments should be made according to the needs of intern doctors.