Opinions of high school students in central Elazig about elderliness.

METHODS: Students attending five different types of high schools in central Elazig (a city in Turkey) during the 2009-2010 school year constitute the study population. One class was randomly selected from each high school. Out of 650 students, 640 participated in the study. The data were evaluated by using the SPSS program; percentage, mean, and chi-square analyses were used. FINDINGS: Of all the students, 41.7% defined the elderly as those who are 60 years of age or older. When asked the question "What does elderliness mean to you?", the majority of the students, 27.2%, responded "peace and resting". The second most common answer, given by 23.6% of students, was "sickness/tiredness"; 16.6% responded "wisdom/experience". Many students (30.3%) stated that the most difficult thing about living with the elderly was their interference in everything; 30.6% of students stated that there was no difficulty at all. According to 42.7% of the students, the greatest problem that the elderly face is health. Of all of the students, 58.3% stated that they feared growing old. CONCLUSION: Our study has concluded the following: 1) High school students have a conventional perception of elderliness and 2) They embrace the elderly and think that perspectives on elderliness will change through education.

The knowledge, attitudes and practices of soldiers in a gendarmerie command headquarters about family planning and venereal diseases.

The objective of this study was to determine the knowledge, attitudes and practices of young male soldiers about family planning. This was a cross-sectional study conducted at the Gendarmerie Command Headquarters, Elazig City, eastern Turkey, carried out on 14 April 2004. One hundred ninety-one of 209 soldiers who were present at the Gendarmerie Command Headquarters were included in the study. A questionnaire, developed by the researchers evaluating the goals of the study, was filled out by the subjects prior to the Family Planning Seminar given to the soldiers. Data were assessed using SPSS and the chi-square test was used for statistical analysis. Defining family planning correctly, being familiar with planning methods and a knowledge of sexually transmitted diseases (STD) and their prevention was found to be at low levels among soldiers. A knowledge of family planning, birth control methods, identification and prevention of STD was higher with higher levels of education. The most familiar family planning methods were condom and oral contraceptive use. Soldiers constitute one of the most significant target groups for education programs.

The prevalence of chronic obstructive pulmonary disease in Elazig, Eastern Turkey.

BACKGROUND: To investigate the prevalence of Chronic Obstructive Pulmonary Disease (COPD) in the urban and rural areas of the Elazig Region of Turkey. METHODS: A questionnaire was conducted and spirometric measurements were made, based on the BOLD protocol. A total of 1270 individuals, over 18 years of age, were included in the study, comprising 610 individuals from the city center and 660 from the rural area. The questionnaire included demographics, symptoms and possible risk factors. The description and staging of COPD were in accordance with GOLD (Global Initiative for Chronic Obstructive Lung Disease). RESULTS: Of the 1270 cases, 1206 (94.9%) were able to complete the questionnaire and undergo spirometric analysis. Of these 1206 cases, 1188 (98.5%) were used in the final assessment; the remainder were excluded due to errors in the spirometric analysis. Of the cases included in the study, 43.2% (25.9% female; 56.7% male) were current smokers. The prevalence of COPD at ≥ 18 years old was 4.5% (female 2.5%; male 6%); the prevalence at ≥ 45 years old was 11.5% (female 5.9%; male 15.1%). The majority of the COPD cases were at stages I and II (22.6% and 66%, respectively). The prevalence of COPD was higher among current and former smokers (5.8%) than non-smokers (2.8%). In general, the risk factors for COPD were found to be age, male gender, smoking, living in a rural area, and low income. CONCLUSIONS: The prevalence of COPD in Elazig, Turkey was highest among the elderly and smokers, and constituted primarily stages I and II of the disease.

Comparison of the severity of traumatic brain injuries in pedestrians and occupants of motor vehicles admitted to Firat health center: a five-year series in an Eastern Turkish city.

BACKGROUND: Traumatic brain injury is the leading cause of death of people in motor vehicle (MV) accidents, which have been increasing in number in developing countries. A retrospective study was undertaken to evaluate all cases admitted to the emergency department of the authors' institution with suspected injury after involvement in a MV-related accident between January 2000 and January 2005. MATERIAL/METHODS: During the study period a total of 2014 cases were admitted: 1258 were occupants of motor vehicles and 756 were pedestrians. Cases with traumatic brain injury were evaluated with respect to gender, age, Glasgow Coma Scales (GCS), and death. RESULTS: Five hundred thirty-two of the cases (386 male, 146 female, mean age: 26.8+/-20.3 years) involved in MV accidents experienced traumatic brain injuries, of which 299 were MV occupants and 233 were pedestrians. The pediatric (< or =16 years: 65.4%) and elderly (> or =65 years: 64.7%) groups were frequently involved as pedestrians in MV accidents; adults 17-64 years of age were involved as pedestrians at a lower rate (25.4%, p<0.001). The GCS values of the pedestrian victims were significantly lower than those of the MV occupants on admission (p<0.001). CONCLUSIONS: The results show that improvements in car safety have reduced life-threatening conditions for occupants of motor vehicles, but this does not include pedestrian safety. There is great need for practical strategies to reduce or prevent MV accident-related injuries among pedestrians, especially for the pediatric and elderly groups who are most exposed to these injuries.

Experience of workplace violence during medical speciality training in Turkey.

AIMS: To determine the type, extent and effects of workplace violence among residents during postgraduate speciality training in various departments of medical schools in Turkey. METHODS: A cross-sectional survey was conducted in seven medical schools representing all geographical regions of Turkey. All physicians in speciality training in the selected medical schools were asked to complete a semi-structured 'violence questionnaire' addressing the type (emotional, physical and sexual) and extent of violence experienced, the perpetrators of the violence and the victim's reactions to the experience. RESULTS: A total of 1712 residents out of 2442 completed the questionnaire. In all, 68% indicated they had experienced some form of workplace violence, 67% had experienced verbal violence, 16% had experienced physical violence and 3% had experienced sexual violence. The victims' most prevalent reactions to violence included being deeply disturbed but feeling they had to cope with it for the sake of their career (39%), being distressed (26%) but considering that such events are common in all occupations and discounting it and being confused and bewildered and unsure how to respond (19%). The most frequently named perpetrators of verbal violence were relatives/friends of patients (36%) and academic staff (36%), followed by other residents/senior residents (21%), patients (20%), heads of department (13%) and non-medical hospital staff (6%). CONCLUSIONS: Physicians in speciality training in medical schools in Turkey are subject to significant verbal, physical or sexual violence. Precautions to prevent such exposure are urgently needed.

Prevalence and consultation behavior of self-reported rectal bleeding by face-to-face interview in an Asian community.

BACKGROUND AND AIM: Although rectal bleeding is a common gastrointestinal symptom, there are very few community-based studies, and all of these studies were conducted in the West. So far the epidemiologic characteristics of rectal bleeding have not been defined in an Asian country. We aimed to characterize self-reported rectal bleeding and its association with functional bowel disorders in Turkey. Factors affecting healthcare-seeking behavior were reviewed as well. SUBJECTS AND METHODS: In this study, 760 subjects were chosen randomly. Questionnaires were completed by nurses during face-to-face interviews with each participant. RESULTS: Of the 707 (93%) subjects included in this study, 9.5% had functional dyspepsia, 8.6% had irritable bowel syndrome (IBS), 24.5% had functional constipation, and 13.8% had functional abdominal bloating. The prevalence of rectal bleeding in the previous year was 14.7%. The recent onset of rectal bleeding was 2.7%. Rectal bleeding was more common among subjects younger than 45 years. Subjects who had functional constipation or constipation-dominant IBS reported rectal bleeding more frequently than others. The rate of consultation was only 41.3% among the subjects with rectal bleeding. Subjects aged > or =45 years and who had marked bleeding or bleeding more than twice a day or fear of cancer sought healthcare more frequently than others. CONCLUSION: Rectal bleeding is as common a symptom in Turkey as in Western countries. Advanced age and fear of cancer were independent predictors of consultation behavior in this group.

Prevalence of domestic violence during pregnancy in a Turkish community.

This study was carried out to determine the prevalence and risk factors for domestic violence victimization of women during pregnancy by intimate partner throughout marriage in a Turkish community. Pregnant women living in the servicing area of selected health centers in Elazig were considered for the study and data were obtained through a questionnaire. A total of 249 pregnant women, mean age 26.8 +/- 5.2 years and the mean gravidity 2.6 +/- 1.7, were involved. Of the 249 women, 28.9% were exposed to at least one case of physical violence throughout matrimony, 12.4% being abused during the previous year and 4.8% during the current pregnancy, 30.5% were exposed to verbal insult and 4.4% exposed to sexual abuse during the current pregnancy. In addition, 25.7% were exposed to one or more types of domestic violence during previous pregnancies. There was a significant correlation between the rate of violent victimization and number of children, and the partner's alcohol habits and socioeconomical status of the families (p < 0.05). Results from the self-report of the receiving end of violent behaviors indicate that the rates of any type of intimate partner violence were very high among pregnant women in this studied Turkish population. Efforts to reduce the incidence of this women's rights and public health problem should be given high priority.

Level of knowledge and attitude of primary care physicians in Eastern Anatolian cities in relation to child abuse and neglect.

BACKGROUND: Child abuse and neglect is not a new phenomenon. It has always existed in every nation and culture in one form or another. The aim of this study was to determine the level of knowledge and attitude toward child abuse and neglect of primary care physicians serving in eastern Turkish cities. METHODS: The study was done in four Eastern Turkish cities involving Elazig, Tunceli, Malatya, and Bingol. All the primary care physicians serving in these cities were contacted. Of 266 primary care physicians, 175 replied (65.8% reply rate) and participated in the study. RESULTS: Most of the participated primary care physicians did not have adequate knowledge about physical assessment of suspected child abuse and neglect. Those physicians serving in primary care centers had better knowledge than those serving in Mother-Child Health and Family Planning Centers. CONCLUSIONS: Results from this study indicate that primary care physicians working in the eastern cities of Turkey do not have adequate knowledge and proper attitudes toward the identification and reporting of suspected child abuse. There is a need for educational programs to primary care physicians and other health personals working with child abuse and neglect to increase their knowledge and skills in detection, assessment, reporting, treatment, and prevention of child abuse and neglect.

The measurement of exhaled carbon monoxide in healthy smokers and non-smokers.

The measurement of exhaled carbon monoxide (CO) level may provide an immediate, non-invasive method of assessing smoking status. The aims of this study were to use a portable CO monitor to compare the exhaled CO levels in established smokers and non-smokers. The exhaled CO levels were measured in 322 subjects (243 healthy smokers, 55 healthy non-smokers, 24 passive smokers) who applied to healthy stand during the spring student activity of Firat University in Elazig. Exhaled CO concentration was measured using the EC50 Smokerlyser. The mean exhaled CO level was 17.13+/-8.50 parts per million (ppm) for healthy smokers and 3.61+/-2.15 ppm for healthy non-smokers, and 5.20+/-3.38 ppm for passive smokers. There were significant positive correlation between CO levels and daily cigarette consumption, and CO levels and duration of smoking in healthy smokers (r=+0.550, P<0.001, r=+0.265, P<0.001, respectively. Spearman's test). When smokers and non-smokers were looked at as a whole, a cutoff of 6.5 ppm had a sensitivity of 90% and specificity of 83%. In conclusion, exhaled CO level provides an easy, an immediate way of assessing a subject's smoking status.

Epidemiological features of irritable bowel syndrome in a Turkish urban society.

BACKGROUND AND AIM: Irritable bowel syndrome (IBS) is a widespread functional bowel disorder and its prevalence in Western societies ranges from 3-20%. The present study aimed to determine the prevalence of IBS in eastern Turkey, particularly in urban parts of Elazig where 250 000 people live. METHODS: Of the 18 primary care centers, four were randomly selected for this study. All individuals (aged >17 years) living around the service area of these health centers were included. A total of 1900 subjects were randomly selected using the personal health records from the primary care centers. The total number of subjects that could be contacted was 1766. A questionnaire with multiple choice questions was applied to the subjects by medical students using the face-to-face technique. Prevalence of IBS and distribution of symptoms were evaluated by the Rome II criteria. RESULTS: Of the 1766 subjects, 45.4% were male and 54.6% were female. Prevalence of IBS was 5% in males, 7.4% in females and 6.3% overall. The percentage of subjects with IBS in the 17-30 years age group was 26.2%; 52.3% in the 30-50 years age group and 21.6% in the above 50 years age group. Prevalence of IBS was highest (10.2%) in persons who were illiterate and lowest (3.0%) in university graduates. A positive correlation was determined between low economical status and prevalence of IBS (P < 0.05). CONCLUSION: Although IBS is widely present in Turkey, its prevalence is lower than that reported in Western communities. In the region where this study was carried out, IBS was more prevalent in females and in individuals with low educational and economical status.

[The knowledge, attitude and behavior related to the tuberculosis and approaches of tuberculosis therapy by the physicians providing first step service]. / Birinci Basamak Hekimlerinin Akciger Tüberkülozu Konusunda Bilgi, Tutum ve Davranislari ile Tedavi Yaklasimlari.

Before a performed education of tuberculosis for physicians who give first step treatment in our city center, a questionnaire was applied to the participants to evaluate the knowledge, attitude, behavior and approach to the treatment. The 66 practicing physician having an employment period of 64.88 +/- 39.42 months were coming from tuberculosis eradication dispensers at the rate of 3%, and from heath center at the rate 97%. The percentage of facing with tuberculosis patients in physicians, exclude who work in tuberculosis eradication dispensers, per year was median 7.30 +/- 9.77 (0-50). 21.2%, of the physicians determine that disease could be spread by only with respiratory tract, 77.3% of them consider that other than respiratory tract and 59.1% of them deemed that the most important factor is living in the same place with a tuberculosis patient and 75.8% of them determine that for a certain diagnosis the sputum examination is enough. 80.3% of the participants said that in our country conditions PPD must be done for the diagnosis. When the most important 4 tuberculosis drugs are asked only 16.7% of the physicians include morphozinamide as a first choice tuberculosis therapy. 48.5% of the physicians deemed that the therapy duration must be at least 6 months. 74.2% of them determine that follow up the disease must be made by sputum plus another examination, 93.9% of them indicated that the tuberculosis patients must be reported to tuberculosis eradication dispensers. When the hepatotoxicity is occurred, only 27.3% of the physicians could interfere the necessary implementation. 74.2% of them determine that the most important problem in control of tuberculosis is about diagnosis, therapy and follow up. When the directly observed treatment short course (DOTS) strategy is asked 16.7% of them gave correct answer. 34.9% of the first step physicians think that tuberculosis eradication dispensers is the primary responsible center in the control of tuberculosis but 53% of them think that tuberculosis eradication dispensers is inadequate in this subject. In conclusion, the first step practice physicians who work in Elazig city center have insufficient knowledge and it is needed periodically postgraduate education.