Vitamin D status among adults in the Aegean region of Turkey.

BACKGROUND: Vitamin D is a lipid-soluble hormone found in certain foods and synthesized from precursors in the skin when exposed to ultraviolet light. Vitamin D plays a critical role in bone metabolism and many cellular and immunological processes and low levels have been associated with several chronic and infectious diseases. Vitamin D status is assessed by measuring the concentration of serum 25-hydroxyvitamin D [25(OH)D]. Vitamin D deficiency is reported to be common worldwide, but little has been reported about the vitamin D status of adults in Turkey. In this cross-sectional study, we determined the prevalence of 25(OH)D deficiency in adults residing in a city in the Aegean region of Turkey. METHODS: A survey was conducted on a representative sample of adults over 20 years old in a non-coastal city at the end of the winter season. Of the 209 households selected by random sampling, 8.6% (n = 18) were unoccupied and 21.5% (n = 45) refused to participate. Blood samples were taken and questions about medical history, vitamin supplementation, sunlight exposure, and dietary calcium and vitamin D intake were asked in face-to-face interviews of 391 adults living in the remaining households. RESULTS: The mean serum 25(OH)D concentration was 16.9 ± 13.09 ng/mL, with 74.9% of the subjects having 25(OH)D deficiency (<20 ng/mL), 13.8% having insufficiency (20-29.99 ng/mL), and 11.3% of the subjects having sufficient 25(OH)D (≥ 30 ng/mL) levels. 25(OH)D deficiency was more common among females (78.7%) than males (66.4%, p < 0.05). CONCLUSION: Adults living in an urban, non-coastal setting in Turkey have a high prevalence of vitamin D deficiency.

Psychometric properties and responsiveness of the Turkish version of the Diabetes Treatment Satisfaction Questionnaire (s) on a sample of diabetics of three consecutive monitoring periods.

The aim of this study is to test the psychometric properties and the responsiveness of the original (status) version of Turkish DTSQ. The study sample included 88 patients with diabetes mellitus who were evaluated in three consecutive time points. The first data collection time point was during their initial contact to the clinic, and the two following (3rd month and 6th month) were during the monitoring visits to the Celal Bayar University Endocrinology Department in 2007. After the adaptation of the DTSQ to Turkish language by following standard procedures, this instrument was applied to the patients along with WBQ-12 and World Health Organization Quality of Life Measure (WHOQOL-Bref). The reliability of the DTSQ was evaluated by running internal consistency analysis (Cronbach Alpha) and item analysis. Construct validity of the instrument was evaluated by various tests such as Principal Components analysis, Confirmatory Factor Analysis, Concurrent validity and "Known Groups" comparisons. Finally the sensitivity (responsiveness to change) of the DTSQ scores to the changes of the metabolic conditions were assessed. 50.0% of the participants were male with a mean age of 51.1 ± 11.4 (min 22, max 78). Majority of them had type 2 diabetes (86.4%) and 72.7% of these patients had at least one co-morbid chronic conditions. While 53.4% of the patients had been treated by insulin the remaining 46.6% had been taking oral anti-diabetic agents. The results revealed satisfactory alpha values for DTSQ (α > 0.70). All of the three metabolic measures (i.e., FBG, PBG, and HbA1c) had significant correlations with the DTSQ scores. The criterion and construct validity of the scale were found to be very satisfactory. The Turkish version of the DTSQ showed acceptable fit indices (RMSEA = 0.03, CFI > 0.90) with the original (hypothetic) construct. Almost all of the sub-dimensions of the WBQ and WHOQOL were correlated with the DTSQ as expected, indicating a good concurrent validity. DTSQ status version was found to be a reliable and valid instrument for the assessment of treatment satisfaction in Turkish diabetes mellitus patients.

Fertility preferences, contraceptive behaviors and unmet needs: a gap between urban and suburban parts of a city.

OBJECTIVES: To explore the differences in unwanted fertility in different parts of a city. METHODS: Data were obtained from the 1999 Manisa Demographic and Health Survey (MDHS) in Turkey. We collected information from a representative sample of 1728 ever-married women aged 15-49 years on fertility, fertility preferences, unmet need for family planning, contraceptive discontinuation, and abortion. Data were analyzed using SPSS 10.0 for Windows. RESULTS: Of the persons studied, 1238 (71.6%) were living in urban settlements and 490 (28.4%) in suburban (gecekondu) settlements. The total fertility rate is higher among gecekondu women (2.42) than among urban women (2.14) although gecekondu women have a lower wanted fertility rate (1.54) than urban women (1.77). Married women in the urban area were currently using a contraceptive method more frequently (75.6%) than those living in the gecekondu area (61.7%) (OR 2.5; 95% CI 1.9-3.2; p < 0.001). The unmet need percentage in gecekondu women (17.7%) is higher than in urban women (8.3%; p < 0.001). The induced abortion rate is higher in urban women (14.8 per 1000 pregnancies) than in gecekondu women (7.1 per 1000 pregnancies; OR 2.1; 95% CI 1.4-3.1; p < 0.001). CONCLUSIONS: There are inequalities in the achievement of fertility preferences and in accessibility to family planning services between urban and suburban parts of the city.

Sunscreen use and sun protection practices in students and personnel of Celal Bayar University.

BACKGROUND/PURPOSE: The steady increase in the incidence of melanoma, non-melanoma cutaneous neoplasia and preneoplastic disorders has contributed to the demand for more effective protection from the sun. In this study, we aimed to determine the prevalence of sunscreen use and other sun protection behaviors in a large sample of students and personnel of Celal Bayar University, Manisa, Turkey. METHODS: The study group included 1018 participants of whom 607 work in the Celal Bayar University Hospital and 411 are students from the Medical Faculty and School for Health Professionals. All participants completed a questionnaire composed of 45 items about sun protection and other health behaviors, such as sports activity, use of cigarettes, alcohol and seat-belts. Sun protection factor (SPF) of sunscreen, avoiding sun exposure during peak hours, wearing clothing, a hat and sunglasses were studied. RESULTS: Of the 1018, 403 participants were male and 615 were female. While avoiding sun exposure during peak hours was the most popular preventive behavior for men (42.5%), wearing sunglasses was the most popular one for women (50.7%). Avoiding exposure was the second preventive behavior for women (42.1%). Use of sunscreen with SPF 15+ was the second popular protective measure for men (19.4%) and the third one for women (39.2%). There were no significant relationships between sun protection behaviors and obesity, use of cigarettes and alcohol. We also investigated behavioral changes with sunburn experience in the participants who had sunburn history. Among these behavioral changes, increased use of sunscreen and decreased sun exposure during peak hours with sunburn experience were significant. CONCLUSION: Our study demonstrated that the risk of sun exposure is largely unrecognized in Manisa, Turkey, and we have very incomplete information about protective measures. An efficient policy of education on the effective use of sun protection methods should be developed to prevent skin cancer.