Determination of the effect of preoperative knee joint function on postoperative quality of life in patients with total knee arthroplasty.

Primary total knee arthroplasty (TKA) is one of the most successful procedures for end-stage knee osteoarthritis. To determine the effect of preoperative knee joint function on postoperative quality of life in patients undergoing primary TKA. This descriptive cross-sectional study was conducted with a total of 208 patients in the orthopedics and traumatology clinic. Data were gathered with a personal information form, the Oxford Knee Score (OKS), and the EQ-5D-5L Quality Of Life Scale in the preoperative period, at postoperative 6th week, and at postoperative 3rd month. The data were analyzed using descriptive statistics, one-way analysis of variance (ANOVA), correlation analysis, and simple linear regression analysis. The mean age of the patients was 65.65 ± 7.01 years. Most patients (86.1%) were women, and 51.4% underwent left TKA. OKS scores indicated poor knee function preoperatively and gradually increased at postoperative 6th week and 3rd month. Preoperative OKS was a significant predictor of postoperative knee joint function and quality of life. This study shows that preoperative knee joint function significantly affects postoperative knee joint function and quality of life. These results demonstrate the importance of the surgery timing and suggest that performing surgery earlier in functional decline may be associated with a better outcome.

Challenges and needs of epilepsy management in primary care (from the perspective of family physicians/general practitioners): A cross-sectional study.

OBJECTIVE: Family physicians are expected to have sufficient knowledge and skills in epilepsy management due to frequent encountering with epileptic patients for prescribing antiepileptics, providing preventive services such as vaccination, pre-conceptional counseling, or managing acute health problems of the patients. This study aimed to determine family physicians' challenges and needs regarding managing epilepsy in primary care. METHODS: This cross-sectional study was carried out with the family physicians working in Family Health Centers representing the four districts of Istanbul in 2020. After enrolling sociodemographic characteristics, epilepsy knowledge, and self-efficacy questionnaire were filled out by the physicians themselves, and the difficulties and needs in the follow-up of the patients with epilepsy were evaluated with open-ended questions. RESULTS: Two hundred and twenty-eight physicians participated in the study (48.7% F; mean age: 43.06 ± 8.82). Most of the physicians reported that they feel incompetent and hesitated while providing health reports (driving [83.3%], sport [95.5%] or work [70.2%]), and prescribing antiepileptics, especially during pregnancy (38.2%) and breastfeeding (31.2%). Despite their high awareness of psychosocial problems in epileptic patients, only 25% of physicians stated that they could make psychosocial assessments. There was no correlation between Epilepsy Knowledge and Self-efficacy scores and physicians' age, graduation period, and family medicine experience (p > .05). Most frequently encountered difficulties were reported as epilepsy-specific (follow-up of pregnant or pediatric patients, lack of information about epilepsy and antiepileptics). Most physicians (82.6%) wanted training in epilepsy management. SIGNIFICANCE: The findings of our study suggest that family physicians need knowledge and training in epilepsy management. The main limitation of the present study is its cross-sectional design, which does not allow for causal or directional inferences.

Investigation of the Protective Function of a Lignin Coating of Natural Fiber Geotextiles against Biodegradation.

Natural fibers do not have a long life in soil; therefore, they cannot replace synthetic textiles in many applications. However, in order to solve ever-increasing global environmental problems due to microplastics, more and more natural polymers must be used, creating a need for research into the sustainable life extension of natural fibers. Lignin is, along with cellulose, a main component of wood, and is produced in large quantities as waste during paper production. With appropriate processing, lignin can be exploited/used as a textile auxiliary to combine the strength-enhancing properties of textiles made from natural fibers with the protective properties of a lignin coating. However, there is not yet sufficient research on how to integrate lignin into textile applications. For this purpose, in this study, we have investigated whether thermoplastic lignin can be processed as a surface protective coating. We tested lignin as a yarn coating to extend the service life of cellulosic textiles. Cotton yarns have been coated with lignin in variations of coating mass, characterized and investigated by means of soil burial tests. As the soil burial tests conducted in climate chamber and outdoor field environments showed, the lifespan of textiles made from natural fibers can be significantly extended with a lignin coating. Long-term resilience has been demonstrated in standard burial tests. In the outdoor tests, the lignin coating was still fully intact, even after about 160 days of burial. The textile materials coated in this way enable sustainable applications, especially for geotextiles. They have an adjustable, sufficiently long service life; however, they are still biodegradable, and can therefore replace some applications, such as vegetating trench/brook slopes, with synthetic materials. Lignin-coated textiles have the potential to significantly reduce the carbon footprint, reduce not only the dependence on petroleum-based products but also the amount of microplastics entering the environment. Further research can be conducted to improve lignin compounding in terms of other interesting properties for specific textile applications. Process optimization could increase the protective effect and further extend the life of useful textiles in soil.

Determining knowledge and attitudes related to pressure injury prevention among operating room nurses and associated factors.

AIM: To determine attitudes and levels of knowledge related to pressure injury (PI) prevention among operating room nurses and identify associated factors. METHODS: This descriptive, cross-sectional study was conducted in Turkey with a sample of 112 operating room nurses recruited by the snowball method of convenience sampling. Data were collected online via Google Forms using a nurse data collection form, the Knowledge of Operating Room Nurses about Pressure Injuries Form, and the Attitude Towards Pressure Ulcer Prevention Instrument (APuP). RESULTS: The operating room nurses' mean score for PI knowledge was 52.19 ± 17.01 out of 100, and their mean total APuP score was 42.28 ± 5.19 out of 52. Knowledge about PIs was negatively associated with being male (ß = -0.287, p < 0.001) and positively associated with intervening to prevent PIs during surgery (ß = 0.214, p = 0.008), using international PI guidelines as a reference in the operating room (ß = -0.225, p = 0.005), and APuP score (ß=.415, p < 0.001). Intervening to prevent PIs during surgery (ß = 0.294, p = 0.003) was a significant predictor of attitude toward PI prevention. CONCLUSION: Our results indicate that overall, operating room nurses have insufficient knowledge but positive attitudes about PI prevention. Female gender, using international PI reference guides in the operating room, and positive attitude toward PI prevention were identified as factors associated with higher PI knowledge level, while intervening to prevent PIs during surgery was positively associated with both knowledge level and attitude toward PI prevention.

Developing a post-stroke home care checklist for primary care professionals in Turkey: a modified Delphi study.

AIM: The aim of this study is to develop a post-stroke home care checklist for the use of primary care professionals. BACKGROUND: Home care is an integral part of primary health care. In the literature, several scales are available to help determine elderly individuals' need for home care services; however, there are no standard care criteria or guidelines for the home care of stroke survivors. Therefore, a standardized post-stroke home care tool specific for use by primary care professionals is needed to identify patients' needs and to detect intervention areas. METHODS: This is a checklist development study carried out between December 2017 and September 2018 in Turkey. A modified Delphi technique was used. In the first stage of the study, a literature review was carried out, a workshop was conducted with healthcare specialists in the stroke area, and a 102-item draft checklist was created. In the second stage, two written Delphi rounds were carried out via email with 16 healthcare professionals providing post-stroke home care. In stage three, the agreed items were reviewed, and similar items were grouped together to create the final checklist. FINDINGS: A consensus was achieved in 93 of the 102 items. The final checklist, consisting of four main themes and 15 headings, was created. The four main areas of assessment in post-stroke home care are 'assessment of current status', 'identification of risks', 'evaluation of the care environment and caregiver', and 'planning follow-up care'. The Cronbach alpha reliability coefficient of the checklist was found to be 0.93. In conclusion, the PSHCC-PCP is the first checklist created to be used by primary care professionals in post-stroke home care. However, it needs to be assessed in terms of effectiveness and usefulness with further studies.

Underwater Oleophobic Electrospun Membrane with Spindle-Knotted Structured Fibers for Oil-in-Water Emulsion Separation.

The potential of spider silk as an intriguing biological prototype for collecting water from a humid environment has attracted wide attention, and various materials with suitable structures have been engineered. Here, inspired by this phenomenon, a kind of superwetting poly(vinylidene fluoride) (PVDF) membrane with spindle-knotted structured fibers was prepared by the electrospinning method followed by oxygen plasma etching treatment. The prepared membrane presented a satisfactory separation efficiency for various oil-in-water emulsions. The cooperative effect of the special wettability property and the spindle-knot structure stimulated the emulsified oil droplets to accumulate quickly on the membrane surface. A model that explains the accumulation of emulsified oil droplets has also been developed. Furthermore, an artificial fiber comprising a micron-sized spindle-knot structure was prepared by the dip-coating method to clearly illustrate the aggregation process of the emulsified oil droplets and to verify the theoretical explanation. We hope that this study will provide new inspiration for oil/water emulsion separation techniques.

Stenotrophomonas maltophilia outbreak with a commercial blood gas injector as the culprit and interventions for source and prevention: A possible passage between patient and ECMO water heater device.

BACKGROUND: Despite low virulence of Stenotrophomonas maltophilia, it represents one of the leading drug-resistant bacteria. We report a large outbreak of S. maltophilia infection associated with an unexpected source, which turned out to be a commercial needleless blood gas injector. METHODS: Over a period from January 1 to December10, 2021, 113 patients were identified to have S. maltophilia infection as documented by positive cultures from the clinical samples, extracorporeal membrane oxygenation (ECMO) water heater devices and commercial needleless blood gas injectors. RESULTS: Sixty-seven isolates (59 clinical, 4 ECMO, 4 blood gas injectors) were sent for molecular analysis. Both arbitrarily primed polymerase chain reaction and pulsed-field gel electrophoresis analyses showed 12 distinct genotypes. Of 67 isolates, 58 were clonally related (86.6%), with 52 indistinguishable strains from 4 blood gas needleless injectors, 46 patients' samples (78%), and 2 ECMO samples (50%). Two ECMO samples and 1 clinical sample were clonally identical. CONCLUSIONS: In the event that eradication of infections would not be possible despite taking all environmental disinfection measures including the ECMO devices, unexpected sources, such as a commercial needleless blood gas injector, should not be omitted from the list for surveillance. In addition, obtaining surveillance cultures of ECMO water reservoirs should be placed in the routine clinical practice.

Effect of Counseling on Quality of Life and Self-Care Agency for Patients Who are Scheduled for Total Knee Replacement.

This study aims to determine the effect of counseling on quality of life and self-care agency for patients who are scheduled for total knee replacement (TKR). The study has a quantitative and quasi-experimental design with a control group. The patients in the control group (n = 40) received routine care. Face-to-face and telephone counseling was offered to individuals in the intervention group (n = 39). The data was collected at face-to-face interviews by using a patient characteristics form, Quality of Life Scale, and Self-Care Agency Scale. The scores for quality of life and self-care agency in the 6th to 8th and 14th to 16th weeks after surgery were very significantly higher in the intervention group than in the control group (p < .001). This study shows that counseling given by the nurse increases the quality of life and self-care agency of patients undergoing TKR.

Risk Factors for Mortality in Patients with Stenotrophomonas maltophilia Bloodstream Infections in Immunocompetent Patients.

Objective: This study aimed to evaluate bloodstream infections caused by Stenotrophomonas maltophilia in immunocompetent patients with respect to clinical features and risk factors for mortality. Methods: We reviewed bloodstream infections detected between January 1, 2012, and July 1, 2021, to identify nosocomial S. maltophilia bacteremia in Kosuyolu Research and Training Hospital. Results: We identified a total of 97 patients with S. maltophilia bloodstream infections. Of these, 17 patients were excluded because of community-acquired infections (n=9), contamination with S. maltophilia (n=3), and insufficient data (n=5), with 80 (57.5% males) patients remaining for analysis. The source of infection was the respiratory tract in 28 (35%) patients. A central venous catheter was used in 60 (75%) patients, which required replacement in 23 patients within five days after detecting S. maltophilia bacteremia. On antimicrobial susceptibility testing, 71 strains were found to be susceptible and 9 (11.3%) resistant to trimethoprim-sulfamethoxazole. Thirty-day mortality was 33.8%. Non-survivors differed significantly from survivors with respect to higher rates of central venous catheters ( p=0.020), mechanical ventilation (p=0.006), urinary catheters (p=0.021), septic shock (p=0.001), hypoalbuminemia (p=0.026) and thrombocytopenia (p =0.039). S. maltophilia bacteremia was independently associated with mortality in patients with hypoalbuminemia, and replacement of central venous catheters had a protective role in reducing mortality. Conclusion: As with other bacterial infections, S. maltophilia bacteremia is associated with a considerably high mortality rate in patients with cardiac conditions. The replacement of the catheter seems to play a beneficial role in 30-day survival.

Adaptation and validation of the Turkish version of the vaccine hesitancy 5 point Likert Scale.

The decrease in vaccine acceptance has been recognized as an emerging public health problem and there is therefore a need for reliable and validated tools that identify vaccine hesitancy. The objective of this study was to adapt and validate the Turkish version of the Vaccine Hesitancy 5-point Likert Scale which was originally developed by the WHO Strategic Advisory Group of Experts on Immunization. The study was carried out in a Family Health Center (FHC) in Istanbul over the period June 1-November 30, 2020. The participants were parents who had applied to the FHC for well-child visits and had a child ≤18 months of age. After the process of translation and back-translation, the Turkish version was pilot-tested, and its test-retest reliability was evaluated among 40 parents at a two-week interval. The validation was carried out with 306 parents through exploratory factor analysis. There was no statistical difference between the test-retest scores (p = .17). The intraclass correlation coefficient was 0.98 (p < .001). Cronbach's alpha coefficient was 0.81. Factor analysis yielded two subscales that were named "confidence' and 'risk perception" and explained 63% of total variance. Our results suggest that the Turkish version of the Vaccine Hesitancy 5-point Likert Scale is a reliable and valid instrument.

Outcomes of an acute care surgery model: a 10-year follow-up study.

BACKGROUND: Many hospitals across Australia and New Zealand have implemented acute care surgery (ACS) models over the past decade, often with improved outcomes such as reductions in wait time to surgery, complications and length of stay. The aim of this study was to evaluate the outcomes of patients who underwent non-elective appendicectomy and cholecystectomy and compare these with the results observed shortly after the implementation of an ACS model at our institution 10 years earlier. METHODS: A retrospective review of contemporary patients who underwent non-elective appendicectomy and cholecystectomy compared with historical data was performed. Primary outcomes were wait time to surgery, surgical complications and length of stay. RESULTS: In the contemporary cohort, 263 patients underwent non-elective appendicectomy over a 1-year period compared with 226 patients in the historical cohort. The median wait time to surgery had increased (17.7 versus 9.6 h, P < 0.001). There was no significant difference in a composite end-point of complications and readmissions (8.0% versus 9.3%, P = 0.61). The length of stay was unchanged. There was greater use of preoperative imaging and reduced overnight operating. For non-elective cholecystectomies, 132 patients underwent this procedure in the contemporary cohort over a 2-year period compared with 115 patients in the historical cohort. There were no significant differences in wait time to surgery (2 versus 1 day, P = 0.13) or complications (9.8% versus 8.7%, P = 0.75). The length of stay was unchanged. CONCLUSION: The majority of improvements seen shortly following the implementation of an ACS model have been sustained after 10 years.

Comparison of preventive health service provision before and after reorganization of primary care in Turkey: a community-based study.

AIM: To investigate the changes in the provision of preventive health services in terms of woman and child health after reorganization of the primary health care services. BACKGROUND: The primary care system in Turkey has undergone fundamental changes as a part of Health Transformation Program during last decade. But there was no community-based study to evaluate these changes. METHOD: This community-based and cross-sectional study was conducted in 2010, just before the reorganization of primary care services and in 2015, five year after the reforms. The 30×7 cluster sampling method was used in Zümrütevler quarter of Maltepe District. The socio-demographic characteristics of the participants, the presence of the physician who can be consulted for any health problem, the presence of smokers at home were questioned. The women aged 18 years or older and gave consent provided information about history of pregnancy and birth, the number of follow-ups during pregnancy, family planning method usage, cervical and breast cancer screening, breastfeeding duration, vaccinations, and prophylactic iron and vitamin D supplementation for their children. FINDINGS: After the reorganization of primary care, more people stated that they had physicians to whom they could consult for all kinds of health problems (27.8 versus 44.7%; P<0.001) and that physician was the primary care physician (30.2 versus 64.7%; P<0.001). The reported frequency of at least one smoker at home was decreased after reorganization of primary care (63.6 versus 53.1%; P=0.034). There were no significant differences in terms unplanned pregnancy, the use of family planning method, the number of pregnancy follow-ups and the frequency of Pap smears and mammography. There are no significant differences in terms of healthy children follow-ups, vaccination, vitamin D and iron supplementation (P>0.05). It was found that the duration of total breastfeeding increased after reorganization of primary care (P<0.001).

A bioinspired structured graphene surface with tunable wetting and high wearable properties for efficient fog collection.

Inspired by the fog harvesting ability of the spider net and the interphase wetting surface of Namib desert beetles, we designed a kind of special bioinspired hybrid wetting surface on a Cu mesh by combining polydimethylsiloxane (PDMS) and graphene (G). A surface containing hydrophobic and superhydrophobic areas is prepared by a combination of laser etching and ultrasonic vibration. Thus, this as-prepared hybrid wetting surface can quickly drive tiny water droplets toward more wettable regions, which makes a great contribution to the improvement of collection efficiency. Moreover, the PDMS/G surface not only is tolerant to many stresses such as excellent anti-corrosion ability, anti-UV exposure and oil contamination, but also shows self-healing simply by burning the worn areas, which thus endows the surface with tunable-wettability change between flame treatment and abrasive wear. This study offers a novel insight into the design of burned healed materials with interphase wettability that may enhance the fog collection efficiency in engineering liquid harvesting equipment and realizes renewable materials in situ cheaply and rapidly by processes that can be easily scaled and automated.

Temperature-tunable wettability on a bioinspired structured graphene surface for fog collection and unidirectional transport.

We designed a type of smart bioinspired wettable surface with tip-shaped patterns by combining polydimethylsiloxane (PDMS) and graphene (PDMS/G). The laser etched porous graphene surface can produce an obvious wettability change between 200 °C and 0 °C due to a change in aperture size and chemical components. We demonstrate that the cooperation of the geometrical structure and the controllable wettability play an important role in water gathering, and surfaces with tip-shaped wettability patterns can quickly drive tiny water droplets toward more wettable regions, so making a great contribution to the improvement of water collection efficiency. In addition, due to the effective cooperation between super hydrophobic and hydrophilic regions of the special tip-shaped pattern, unidirectional water transport on the 200 °C heated PDMS/G surface can be realized. This study offers a novel insight into the design of temperature-tunable materials with interphase wettability that may enhance fog collection efficiency in engineering liquid harvesting equipment, and realize unidirectional liquid transport, which could potentially be applied to the realms of microfluidics, medical devices and condenser design.

Three-Dimensional Evaluation of the Effects of Kinesio Taping on Postoperative Swelling and Pain after Surgically Assisted Rapid Palatal Expansion.

OBJECTIVES: The purpose of the present study was to evaluate the effects of kinesio taping on pain and swelling after surgically assisted rapid palatal expansion. MATERIAL AND METHODS: A total of 21 (12 male and 9 female) patients with transverse maxillary deficiency were enrolled in the study. Kinesio taping (KT) was applied unilaterally in each patient, whereby sides of the face with KT application were included into the (a) KT group and the other sides were included into the (b) non-KT group. Changes in facial volume were evaluated on digital images using the 3dMD Face System. Pain scores were assessed at postoperative days 1, 2, 3, 4, 5, 6, and 7 using the visual analog scale (VAS). Two-way repeated measures analysis of variance and Mann Whitney U test were used for statistical analyses. RESULTS: Swelling was significantly lower in the KT group compared to the non-KT group from T0 to T1 (36.42 [SD 19.71] mm3 vs. 183.84 [SD 49.33] mm3) and was significantly greater in the non-KT group compared to the KT group from T0 to T2 (70.88 [SD 15.73] mm3 vs. 21.46 [SD 13.39] mm3) (P < 0.001 for both). The VAS scores were significantly lower in the KT group compared to the non-KT group at all time points (P < 0.05). CONCLUSIONS: The application of kinesio taping after maxillofacial surgery reduced the pain and swelling in the postoperative period. Kinesio taping can be used as an alternative to other methods that are used for the reduction of postoperative complaints.

Bioinspired Fabrication of one dimensional graphene fiber with collection of droplets application.

We designed a kind of smart bioinspired fiber with multi-gradient and multi-scale spindle knots by combining polydimethylsiloxane (PDMS) and graphene oxide (GO). Multilayered graphene structures can produce obvious wettability change after laser etching due to increased roughness. We demonstrate that the cooperation between curvature and the controllable wettability play an important role in water gathering, which regulate effectively the motion of tiny water droplets. In addition, due to the effective cooperation of multi-gradient and multi-scale hydrophilic spindle knots, the length of the three-phase contact line (TCL) can be longer, which makes a great contribution to the improvement of collecting efficiency and water-hanging ability. This study offers a novel insight into the design of smart materials that may control the transport of tiny drops reversibly in directions, which could potentially be extended to the realms of in microfluidics, fog harvesting filtration and condensers designs, and further increase water collection efficiency and hanging ability.

The effect of the BATHE interview technique on the empowerment of diabetic patients in primary care: A cluster randomised controlled study.

AIM: To investigate the effect of the BATHE therapeutic interview technique on the empowerment of diabetes mellitus patients in primary care. METHOD: A cluster randomised controlled study using the BATHE interview technique was conducted on diabetes mellitus patients in primary care. Physicians in the intervention group were trained in the BATHE interview technique and used it with their diabetic patients in addition to the usual care. In the control group physicians delivered only the usual care. A total of 112 diabetes mellitus patients who met the study criteria (57 intervention, 55 control) were included. Three interviews were conducted with the patients in both groups at the beginning, the 3rd and 6th months. The Diabetes Empowerment Scale (DES) was filled up at baseline and in the 6th month. RESULTS: Due to some drop outs, the study finished with 44 patients in the control and 49 in the intervention group. According to an 'Intention to treat analysis' increase in the DES total score for the intervention group was higher than for the control group (Δ=10.56±8.97; Δ=5.64±7.36; p<0.001). Using multiple regression analysis, the BATHE intervention showed a significant predictor of the DES difference (B: 8.861; CI: 6.092-11.629; p<0.001). CONCLUSION: The use of the BATHE technique in primary care has a positive effect on the empowerment of diabetes mellitus patients.

Knowledge and attitudes towards complementary and alternative medicine among medical students in Turkey.

OBJECTIVE: This study aims to examine knowledge and attitudes towards Complementary and Alternative Medicine among medical students in Turkey, and find out whether they want to be trained in Complementary and Alternative Medicine (CAM). METHODS: A cross-sectional study was carried out between October and December 2010 among medical students. Data were collected from a total of seven medical schools. FINDINGS: The study included 943 medical students. The most well known methods among the students were herbal treatment (81.2 %), acupuncture (80.8 %), hypnosis (78.8 %), body-based practices including massage (77 %) and meditation (65.2 %), respectively. Acupuncture, aromatherapy, herbal treatment and meditation were better known among female participants compared to males (p < 0.05). Females and first year students, generally had more positive attitudes. A larger proportion of female students compared to male students reported that a doctor should be knowledgeable about CAM (p = 0.001), and this knowledge would be helpful in their future professional lives (p = 0.015). Positive attitudes towards and willingness to receive training declined as the number of years spent in the faculty of medicine increased. CONCLUSIONS: Majority of the medical students were familiar with the CAM methods widely used in Turkey, while most of them had positive attitudes towards CAM as well as willingness to receive training on the subject, and they were likely to recommend CAM methods to their patients in their future professional lives. With its gradual scientific development and increasing popularity, there appears a need for a coordinated policy in integrating CAM into the medical curriculum, by taking expectations of and feedback from medical students into consideration in setting educational standards.

Factors associated with adolescents' smoking experience and staying tobacco free.

Introduction It is not expected that those who did not smoke during their adolescent years will start to smoke later in life. This study was planned to learn the thoughts of Turkish adolescents about staying tobacco free.Methods A descriptive study was conducted in 2007 with 866 adolescents aged 11 to 14 years. On a self-administered questionnaire, non-smoker students answered both multiple choice and open-ended questions about why they would not smoke in the future. The Chi-square test and logistic regression analysis was used for statistical assessment. For the answers to the open-ended questions, thematic analysis was applied.Results The mean age of the participants was 12.84 ± 1.14 years. The incidence of a smoking experience at least once in the participant's lifetime was 12% and the rate of current smoking was 3.6%. The most listed reasons for staying tobacco free were health problems directly related to smoking (64%), such as 'it can cause diseases' or 'it kills', negative effects of smoking other than health (51%), such as 'it smells bad' or 'it is toxic', and some subjective judgements related only with their self perceptions, such as 'I am happy and healthy' or 'it affects growth negatively' (20%).The most well-known problem related to tobacco use was lung cancer and the least well-known problems were bladder cancer and chronic bronchitis. Most of the smoking students (68%) were not aware that second-hand smoking was harmful (p=0.003). There were significant correlations between smoking experience and male gender, having a smoker in the household and low educational level of the mother or the father (p=0.000, p=0.018, p=0.022, p=0.044 respectively).Conclusion We suggest that the beliefs and perceptions of adolescents about smoking should be given as much consideration as the negative effects of cigarettes in planning smoking free messages.