Workplace Violence in the Health Sector in Turkey: A National Study.

Violence in the workplace is an increasing occupational health concern worldwide. Health care workers are at high risk of assault. To develop, monitor, and manage prevention policies, baseline data should be available. This cross-sectional study was designed to determine the current extent of workplace violence nationwide in Turkey. The study population of 12.944 health care workers was a stratified sample of all health care workers (612,639) in the country. A probabilistic sampling was made on the basis of the "multistage stratified random cluster sampling method." This study was conducted by a structured questionnaire in a face-to-face interview. The questionnaire items were adapted and translated into Turkish based on questionnaires of International Labor Organization, International Council of Nurses, World Health Organization, and Public Services International. The percentage of health care workers who experienced workplace violence in Turkey in the previous 12 months was 44.7%. The types of violence included physical 6.8%, verbal 43.2%, mobbing (bullying) 2.4%, and sexual harassment 1%. Multivariate analysis showed that level of health care system, type of institution, gender, occupation, age, working hours, and shift work were independent risk factors for experiencing workplace violence ( p < .05). Our study indicates that the workplace violence among health care workers is a significant problem. The results of the study can serve as the basis for future analytical studies and for development of appropriate prevention efforts.

The Effect of Marital Violence on Infertility Distress among A Sample of Turkish Women.

BACKGROUND: The aim of this study was to determine the relationship between marital violence and distress level among women with a diagnosis of infertility. MATERIALS AND METHODS: This cross-sectional study consisted of 139 married women diagnosed as primary infertile who applied to an in vitro fertilization (IVF) center in Turkey, between September and December 2009. A descriptive information questionnaire developed by the researcher was used for data collection. In addition, an infertility distress scale (IDS) for determining the severity effect of infertility and the scale for marital violence against women (SDVW) for determining level of marital violence against the women were used. RESULTS: The total IDS score of the study sample was 37.76 ± 10.53. There was no significant relationship between the age and education level of the women and the total IDS score. The total IDS score was higher in women who did not work and those being treated for infertility for more than three years. The total SDVW score of the study sample was 67.0 ± 8.26. The total SDVW score was higher in women who had been trying to have a child for more than six years and had received infertility treatment for longer than three years. The employment status of the women and physical, emotional, and sexual violence scores had a statistically significant relationship with the IDS scores. The emotional violence score was found to have the highest significance among the variables affecting total IDS score. CONCLUSION: Marital violence is a factor increasing the distress of infertile women. Healthcare staff serving infertile couples should consider the possibility of domestic violence against women as a factor affecting the psychological infertility distress level.

Evaluation of some physical hazards which may affect health in primary schools.

AIM: This study was performed with the objective to determine the levels of some physical hazards in primary schools. MATERIAL AND METHODS: This study is a cross-sectional field survey. In this study which was conducted in 31 primary schools selected by appropriate sampling from the district of Keçiören of the province of Ankara, measurements related with temperature, light, electromagnetic field (EMF) and noise levels were done at hundreds of points. Approval was obtained from Gülhane Military Medical Faculty Ethics Committee (2007/97). RESULTS: Only 47.1% of the classes had a temperature value within the recommended limits (20-21°C). It was found that the illumination levels in 96.8% of the schools were above the standard values. However, the levels of illumination were found to be statistically significantly decreased towards the door and the back line (p<0.05). It was found that electromagnetic field levels were significantly higher in the schools who had a source of electromagnetic field nearby compared to the schools who did not have such a source nearby (p<0.001). It was found that the electromagnetic field levels in computer classes were statistically significantly higher compared to the other classes (p<0.001). Noise levels were found to be statistically significantly higher in classes which had 35 and more students (p<0.05). No statistically significant difference was found in schools near intensive vehicle traffic in terms of noise levels (62.8±5.0 (n=72), 62.0±6.4 (n=79), respectively, p>0.05). CONCLUSIONS: It was found that primary schools in the region of Keçiören had aspects which had to be improved in terms of building age, building location, brightness, electromagnetic field and noise levels. School health programs directed to improve negative enviromental factors should be developed.

Indoor air quality in primary schools in Kecioren, Ankara.

AIM: To increase the awareness of environmental risk factors by determining the indoor air quality status of primary schools. MATERIALS AND METHODS: Indoor air quality parameters in 172 classrooms of 31 primary schools in Kecioren, Ankara, were examined for the purpose of assessing the levels of air pollutants (CO, CO2, SO2, NO2, and formaldehyde) within primary schools. RESULTS: Schools near heavy traffic had a statistically significant mean average of CO and SO2 (P < 0.05). The classrooms that had more than 35 students had higher and statistically significant averages of CO2, SO2, NO2, and formaldehyde compared to classrooms that had fewer than 35 students (P < 0.05). Of all classrooms, 29% had 100 CFU/100 mL and higher concentrations of microorganisms, which were not pathogens. CONCLUSION: Indoor air quality management should continually be maintained in primary schools for the prevention and control of acute and chronic diseases, particularly considering biological and chemical pollution.

Health promotion and risk behaviors among adolescents in Turkey.

Adolescents experience the onset and development of several health-related behaviors. The purpose of this study is to determine health risk and promotion behaviors of adolescents between the ages of 11 and 19 who were attending and to test the reliability and validity analysis of the Turkish version of Adolescent Health Promotion Scale (AHPS). The study was a cross-sectional survey and the sample consisted of 1,351 participants. A questionnaire that included demographic information, health risk behaviors, and AHPS was used to collect data. In the current study, the Cronbach's α coefficient for the AHPS was calculated as .92. Female students had significantly higher mean total scale scores than males (p < .05). The 11-14 age group had a statistically significant higher scale total mean score than the 15-19 age group (p = .001). International directives highlight the important function nurses fulfill in health promotion. Nurses may play a key role in school health services.

Investigation of vasoactive ion content of herbs used in hemorrhoid treatment in Turkey.

OBJECTIVES: The aim of the present study is to determine anion and cation contents of the herbals used in Turkish folk remedy to explore the rationale of their use in hemorrhoid treatment in the context of the vasoactivity of these elements. DESIGN: Herbs used in the treatment of hemorrhoid were determined by the way of literature search. These herbs were obtained from certified herb sellers. Ground herb samples were placed in individual tubes containing methanol and incubated for 48 hours at 30 degrees C. At the end of the incubation, supernatants were analyzed for their ion concentrations by using ion chromatography. RESULTS: The difference between ion levels between systemic and locally used herbs, was not statistically significant (p>0.05). Anion concentrations (except nitrate) of locally used herbs were slightly higher than systemically used herbs (p>0.05). Cation levels (except magnesium) of systemically used herbs were slightly higher than locally used herbs (p>0.05). It was shown that the concentration of vasoconstrictor effective ions was higher than the concentration of vasodilator effective ions (p<0.001). While vasoconstrictor ion concentration of systemically used herbs was 88.06 +/- 147.42 mg, vasodilator ion concentration of locally used herbs was 90.15 +/- 136.94 mg. The difference between vasodilator concentrations of groups was more evident; 5.39 +/- 9.80 mg and 14.32 +/- 66.48 mg for locally and systemically used herbs respectively. CONCLUSIONS: This study showed that herbal remedies used for the treatment of hemorrhoid in Turkey contain vasoactive and especially vasoconstrictor ions. Vasoconstrictor agents could amplify each others' effects as it has been previously shown, therefore, it is probable that the vasoconstrictor ion contents could contribute to the curative effects of herbals in the treatment of hemorrhoids.

Military medical graduates' perceptions of organizational culture in Turkish military medical school.

Organizational culture is the term used to describe the shared beliefs, perceptions, and expectations of individuals in organizations. In the healthcare environment, organizational culture has been associated with several elements of organizational experience that contribute to quality, such as nursing care, job satisfaction, and patient safety. A range of tools have been designed to measure organizational culture and applied in industrial, educational, and health care settings. This study has been conducted to investigate the perceptions of military medical graduates on organizational culture at Gülhane Military Medical School. A measurement of organizational culture, which was developed by the researchers from Akdeniz University, was applied to all military medical graduates in 2004. This was a Likert type scale that included 31 items. Designers of the measurement grouped all these items into five main dimensions in their previous study. The items were scored on a five-point scale anchored by 1: strongly agree and 5: strongly disagree. Study participants included all military physicians who were in clerkship training period at Gulhane Military Medical Academy in 2004. A total of 106 graduates were accepted to response the questionnaire. The mean age of participants was 25.2 +/- 1.1. At the time of study only 8 (7.5%) graduates were married. The study results have showed that the measurement tool with 31 items had a sufficient reliability with a Cronbach's alpha value of 0.91. Factor analysis has resulted a final measurement tool of 24 items with five factors. Total score and the scores of five subdimensions have been estimated and compared between groups based on living city and marital status. The study has shown the dimension of symbol received positive perceptions while the dimension of organizational structure and efficiency received the most negative perceptions. GMMS has a unique organizational culture with its weak and strong aspects. Conducting this kind of studies contribute to improve organizational culture in order to increase educational and research capability.

Body image satisfaction and anxiety of a Turkish sample of university students with skin diseases.

The aim of this study was to evaluate perception of body image and anxiety of 221 university students presenting to the dermatology outpatient clinic with a skin disease and 205 students without skin disease. Analysis of anxiety and body image scores yielded differences by sex and age in both groups. The group with skin disease had lower scores on body image. Acne vulgaris seems to be the most disturbing among the skin diseases, and this was more prominent in younger patients.

Reproductive health education of conscripts in Turkish Armed Forces: first evaluation of training courses.

BACKGROUND: In the frame of the Reproductive Health Program of Turkish Armed Forces, conscripts have been given 1-day participatory, interactive courses by the field military medical trainers in all military garrisons. METHODS: Pre- and posttest knowledge levels of soldiers were tested by 25 true-false questions. Demographic characteristics and test scores were routinely transferred from the training rooms to the reproductive health database by authorized field trainers using the network of the army. Two hundred forty-eight thousand seven hundred ninety-six soldiers with perfect entrance of data have been selected for descriptive analyses. RESULTS: Of all the soldiers, 39.2% were born in 1984. Primary school graduates have constituted the largest group with 34.4%. Only 7.4% of the soldiers were married. The mean precourse score was 65.7% +/- 15.4%, while the postcourse score was 83.5 +/- 12.73% (SD) (p < 0.001). Those who used to live in the east region of Turkey have obtained significantly lower scores on both pre- and posttests in comparison to scores of those who used to live in other regions (p < 0.001). Groups based on five educational levels have obtained significantly different scores, ascending gradually from uneducated to the higher educational level (p < 0.001). The ratio of increase in knowledge was highest in the groups with the lowest educational level and unmarried (p < 0.001). CONCLUSION: Training courses seem to succeed in increasing the knowledge of conscripts, particularly of those with a low socioeconomic and cultural status. However, it requires time to determine whether this increase in knowledge level with promote behavioral change positively and will improve young males' own and their partners' reproductive health status.

Reliability of the Turkish version of Mach IV scale: results obtained from two previously published studies.

Values of coefficient alpha from previously published studies for men (.55 and .63) and women (.47 and .51) are lower (.54 and .59) than the recommended value (.70).

The frequency and effecting factors of consanguineous marriage in a group of soldiers in Ankara.

This cross-sectional study was carried out to investigate the frequency of consanguineous marriage in a group of army conscripts in Ankara and the factors affecting this. Of 4153 soldiers, 387 were married. The rate of marriage between first cousins was found to be 19.1%, and the overall rate of consanguineous marriage was 24.1%. Consanguineous marriage was found to be significantly prevalent among soldiers who were born in and still living in the Eastern region; among those who lived in villages; among those whose parents as well as themselves had low educational levels; and among those whose marriages were arranged by their families. Neither the payment of bride-price nor the presence of consanguinity between parents was a significant factor for consanguineous marriage. In addition, the age of the soldier and the age at marriage were significantly lower among soldiers married to first cousins than among soldiers whose marriages were not consanguineous.

Association between cigarette smoking and depressive symptoms among military medical students in Turkey.

An association has been documented between two important health concerns, smoking and depression. A cross-sectional study was carried out to explore whether this relationship exists in a sample of Turkish military medical undergraduates. Of a total of 779 military medical undergraduates, 690 agreed to participate in the study. The students completed a self-administered questionnaire including the Turkish adaptation of the Beck Depression Inventory (BDI) and gave a smoking history. It was determined that the smokers among medical students were 2.2 times more likely to have depressive symptoms than nonsmokers. This result extends the significant association between smoking and depressive symptoms in the literature to a sample of Turkish military medical undergraduates.

Relation between Machiavellianism and job satisfaction in a sample of Turkish physicians.

Job satisfaction is affected by many factors. A consistent negative correlation between Machiavellianism and Job satisfaction was shown by many previous studies. To estimate this association in a sample of Turkish people, 361 physicians were selected among the total number of 5,959 working in Ankara City Center. A self-administered questionnaire including the Mach IV scale and Job Satisfaction scale developed by Kasapoglu was applied to the subjects. Student t test and Pearson correlation were used for analysis. The correlation of -.25 between Job Satisfaction and Machiavellianism scores was significant and consistent with the mean scores on Job Satisfaction between the Machiavellian and Nonmachiavellian groups. Although the present association is small, the inverse value is consistent for Mach IV scale scores with job satisfaction in the literature.

Effects of electromagnetic radiation from a cellular telephone on epidermal Merkel cells.

The number of reports on the effects induced by electromagnetic radiation (EMR) from cellular telephones in various cellular systems is still increasing. Until now, no satisfactory mechanism has been proposed to explain the biological effects of this radiation except a role suggested for mast cells. Merkel cells may also play a role in the mechanisms of biological effects of EMR. This study was undertaken to investigate the influence of EMR from a cellular telephone (900 MHz) on Merkel cells in rats. A group of rats was exposed to a cellular telephone in speech position for 30 min. Another group of rats was sham-exposed under the same environmental conditions for 30 min. Exposure led to significantly higher exocytotic activity in Merkel cells compared with the sham exposure group. This finding may indicate the possible role of Merkel cells in the pathophysiology of the effects of EMR.

The quality of groundwater for certain chemicals in military fields in Ankara.

OBJECTIVE: The goal of this study was to determine the quality of groundwater for certain chemicals from all wells for the military units in Ankara (the capital city of Turkey) to evaluate special situations like a nuclear, biological, and chemical attack. METHOD: The quality of underground water has been evaluated chemically by examining 34 different water specimens. Various chemical parameters and heavy metals have been assessed in these samples by using an ion meter and atomic absorption spectrophotometer. RESULTS: Nitrate and chloride have been assessed at a higher rate with the levels exceeding maximum contaminant levels. Mercury, arsenic, aluminum, iron, conductivity, and salinity have also had levels exceeding maximum contaminant levels for each of them according to the levels set by the World Health Organization. CONCLUSION: This study has given us some powerful clues that underground water in Ankara is at a growing risk to be contaminated mainly with nitrate and chloride. Although more detailed investigations are necessary for a better evaluation, it is clear that preventive measures should be implemented or improved.