The Reliability and Validity of The Turkish Form of Berger HIV Stigma Scale.

OBJECTIVE: HIV-related stigma towards people living with HIV/AIDS (PLWHA) creates a barrier in access to quality health care, affects mental health and leads to poor treatment adherence. Assessment of different components of HIV-related stigma is needed to develop appropriate strategies for prevention and intervention. The aim of this study was to translate and adapt Berger HIV Stigma Scale to Turkish and assess its reliability and validity. METHOD: The Turkish version of the 40 item, 4-point Likert-type self-report HIV Stigma Scale, as well as Beck Depression Inventory (BDI), Rosenberg Self-Esteem Scale (RSES) and sociodemographic data form were administered to 95 PLWHA. RESULTS: The items of the scale whose face validity was found to be sufficient, were loaded on four factors in the explanatory factor analysis: Internalised Stigmatization (16 items); Concerns with Public Attitudes (12 items); Negative Self Image (9 items); and Disclosure Concerns (8 items). This structure explained 46.71% of the variance after an item was removed based on the analysis. All subscales had acceptable internal consistency with Cronbach's alpha coefficients .802-.934. BDE scores had moderate positive correlations with Internalized Stigmatization; Concerns with Public Attitudes; Disclosure Concerns subscale scores (rs=0.214, p=0.047; rs=0.295, p=0.006; rs=0.353, p=0.001), and strong positive correlations with Negative Self Image score (rs=0.617, p<0.001). A moderate positive correlation was found between RSES and Negative Self Image subscale score (rs=0.434; p<0.001). CONCLUSION: Our findings showed that the Turkish form of Berger HIV Stigma Scale is a reliable and valid tool for measuring HIV-related stigma in PLWHA.

[Rational Use of Antibiotics Among Turkish Migrants In Germany: Knowledge, Attitudes and Interaction With Physicians and Pharmacists]. / Antibiotikanutzung bei Menschen mit türkischem Migrationshintergrund ­ Wissen, Einstellungen und Interaktion mit ÄrztInnen und ApothekerInnen.

OBJECTIVES: Due to strong transnational ties, the use of and demand for antibiotics among Turkish migrants in Germany may be influenced by cultural aspects of antibiotic use in Turkey. Research on the use of antibiotics among Turkish migrants in Germany, however, is scarce. The aim of this study was to find out how Turkish migrants in Germany use antibiotics, whether and how knowledge, underlying motives and attitudes influence demand and how Turkish migrants interact with medical professionals. MATERIALS AND METHODS: Using a qualitative approach, behavioural patterns and logic of action of adult Turkish migrants were identified. We carried out semi-structured focus group interviews with adults of Turkish origin residing in Germany and expert interviews with family physicians and pharmacists. The interviews were analysed by means of content analysis. RESULTS: While younger migrants had a generally positive, but cautious attitude towards the use of antibiotics, older migrants often showed exaggerated, unrealistic expectations resulting from a lack of factual knowledge. Overall, participants adopted a passive role in the patient-provider relationship. This led to a perpetuation of significant knowledge gaps. CONCLUSIONS: Older Turkish migrants who have less factual knowledge show exaggerated expectations concerning the effectiveness of antibiotics. In conjunction with a passive patient role, resulting in information needs not being satisfied, this can affect the patient-provider relationship. A more active communication by physicians and information materials sensitive to the needs of migrants can positively influence the interaction between migrant patients and medical professionals.

Health Warnings, Smoking Rules, and Smoking Status: A Cross-National Comparison of Turkey and the United States.

OBJECTIVES: This study aimed to compare the prevalence of smoking status (i.e., current, former and never) between the United States and Turkey in terms of age and gender, and examine how smoking rules and health warnings are associated with smoking status within and between the two countries. METHODS: The study used data from the 2012-2013 National Adult Tobacco Survey (U.S. sample, N = 60,196) and the 2012 Global Adult Tobacco Survey (Turkey sample, N = 9,581). SAS PROC SURVEYLOGISTIC with a weighted variable was used to examine the associations between demographics (age, gender and education), smoking rules, health warnings, and smoking status within and between the two countries. RESULTS: There was an 18% current smoking prevalence among U.S. sample, compared to 27% of the Turkey sample. The U.S. sample had a higher rate of former smoking compared to the Turkey sample (25% vs. 22%). In both countries, being older and male gender predicted former smoking while being younger and female gender predicted never smoking. Having seen a health warning, and not allowing smoking in the vehicle and home positively predicted former and never smoking status. Higher education predicted both smoking statuses in the U.S. only. CONCLUSIONS: It is important to work with partners particularly in low- and middle-income countries (e.g., Turkey) to combat the global tobacco epidemic. In both counties, cessation endeavors should emphasize a comprehensive understanding of smoking status in terms of smoking rules in personal spaces and health warnings.

Determinants of pre-lacteal feeding practices in urban and rural Nigeria; a population-based cross-sectional study using the 2013 Nigeria demographic and health survey data.

BACKGROUND: Prelacteal feeding (PLF) is a barrier to exclusive breast feeding. OBJECTIVE: To determine factors associated with PLF in rural and urban Nigeria. METHODS: We utilized data from the 2013 Nigerian Demographic and Health Survey. Bivariate and multivariate analyses were used to test for association between PLF and related factors. RESULTS: Prevalence of PLF in urban Nigeria was 49.8%, while in rural Nigeria it was 66.4%. Sugar or glucose water was given more in urban Nigeria (9.7% vs 2.9%), plain water was given more in rural Nigeria (59.9% vs 40.8%). The multivariate analysis revealed that urban and rural Nigeria shared similarities with respect to factors like mother's education, place of delivery, and size of child at birth being significant predictors of PLF. Mode of delivery and type of birth were significant predictors of PLF only in urban Nigeria, whereas, mother's age at birth was a significant predictor of PLF only in rural Nigeria. Zones also showed variations in the odds of PLF according to place of residence. CONCLUSION: Interventions aimed at decreasing PLF rate should be through a tailored approach, and should target at risk sub-groups based on place of residence.

Global Health Professions Student Survey--Turkey: second-hand smoke exposure and opinions of medical students on anti-tobacco law.

AIM: This study, as a part of "the Global Health Professions Student Survey" (GHPSS), aimed to assess medical students' tobacco use, exposure to second-hand tobacco smoke (SHS), and opinions as well as smoking policies at medical faculties in Turkey. METHODS: The study was conducted in 2010 as a school-based survey of third-year students in 12 medical schools. GHPSS uses a standardised methodology for selecting schools (probability proportional to student enrolment size) and data processing. In total, data from 1,217 of third year medical students were analysed. RESULTS: Prevalence of current tobacco use among participating students was 28.5%. Exposure to SHS in the last seven days was 46.9% at home, and 42.2% in other places. Among smokers, over 7 in 10 students reported smoking on medical school premises during the past 30 days and the past year. CONCLUSION: Medical students' exposure to SHS is common and smoking on medical school premises/buildings constitutes a problem. Turkey passed an anti-tobacco law in 2008, yet enforcement of the law must be stronger. In addition, medical schools must evaluate, and likely revise their education curricula to better prepare medical students to advocate tobacco control.

Longitudinal age-and cohort trends in body mass index in Sweden--a 24-year follow-up study.

BACKGROUND: The aim of this longitudinal study was to analyze whether mean Body Mass Index (BMI), assessed at four occasions, changed within different age groups and birth cohorts over time, i.e., between 1980/81 and 2004/05, after adjustment for possible confounders. METHODS: A sample of 2728 men and 2770 women aged 16-71 years at study start were randomly drawn from the Swedish Total Population Register and followed from 1980/81 to 2004/05. The same sample was assessed on four occasions during the 24-year study period (i.e., every eighth year). The outcome variable, BMI, was based on self-reported height and weight. A mixed model, with random intercept and random slope, was used to estimate annual changes in BMI within the different age groups and birth cohorts. RESULTS: Mean BMI increased from 24.1 to 25.5 for men and from 23.1 to 24.3 for women during the 24-year study period. The annual change by age group was highest in the ages of 32-39, 40-47 and 48-55 years among men, and in the ages of 24-31, 32-39, and 40-47 years among women. The highest annual changes were found in the youngest birth cohorts for both men and women, i.e., those born 1958-65, 1966-73, and 1974-81. For each birth cohort, the annual change in BMI increased compared to the previous, i.e., older, birth cohort. In addition, age-by-cohort interaction tests revealed that the increase in BMI by increasing age was higher in the younger birth cohorts (1966-1989) than in the older ones. CONCLUSIONS: Public health policies should target those age groups and birth cohorts with the highest increases in BMI. For example, younger birth cohorts had higher annual increases in BMI than older birth cohorts, which means that younger cohorts increased their BMI more than older ones during the study period.

Urinary cotinine and breath carbon monoxide levels among bar and restaurant employees in ankara.

INTRODUCTION: Hospitality sector employees constitute one of the key groups with respect to their secondhand tobacco smoke exposure at work. This study aimed to detect urinary cotinine and breath carbon monoxide (CO) levels among bar and restaurant employees in Ankara, as well as the employees' opinions on the new antitobacco law, changes in smoking behavior, and subjective health status before and after the law entered into force. METHODS: This before-after study was conducted in 19 premises, with the participation of 65 employees before implementation and 81 employees 3 months after implementation of the new antitobacco law in the hospitality sector. Data in both phases were collected through face-to-face surveys, breath CO measurements, and urinary cotinine analysis. Descriptive statistics were used to summarize data, whereas chi-square test, paired and unpaired t tests, and analysis of variance were used to compare groups. RESULTS: Most of the restaurant and bar employees were male and below 35 years old. Before-after comparison showed that health complaints of the hospitality sector employees such as watering and itching in the eyes, difficulty in breathing, and cough (p < .001), as well as breath CO (p < .001) and urinary cotinine levels (p < .001) decreased significantly 3 months after implementation of the law. Among the smoking employees, mean number of cigarettes smoked was also found to decrease (p = .012). Majority of the employees (83.8%) were found to support the smoking ban in enclosed public places. CONCLUSIONS: Results of this study provide solid evidence on the positive health effects of smoke-free laws and employees' support for smoke-free workplaces.

Evaluation of occupational health teaching sessions for final year medical students.

OBJECTIVES: The study was conducted with the aim of evaluating applied occupational health teaching for final-year medical students at Hacettepe University, Faculty of Medicine. METHODS: The study included all sixth grade medical students (n=293) during one academic year. Pre- and post-training tests were used to assess the magnitude of change in knowledge and attitude of students on occupational health, whereas the opinion of students on several aspects of the quality of teaching sessions were assessed by using post-training questionnaires. RESULTS: Post-training tests revealed that the level of knowledge on all aspects of occupational health increased among medical students. An evaluation of the teaching sessions showed favorable results for the overall quality of the sessions: 81.3% of the students stated that the sessions were well organized, 81.7% remarked the workplace/factory visit was a valuable experience, and 91.0% stated feeling more competent on occupational health issues. CONCLUSION: There was a greater increase in students' knowledge on technical precautions than their knowledge on issues related to medical practice in the workplace. Visiting a workplace was found to contribute to the overall aim of knowledge and attitude change on occupational health issues. The scope of undergraduate medical education should be extended by improving occupational health education with respect to educational content, duration, and methods.

An estimation method for midwife demand.

Manpower or human resource planning is a major component of health services planning. In this study, it was aimed to practice an estimation method for midwife demand in a selected region of Ankara, Turkey. In this study, the needs-based approach was used as a method of estimating manpower demand. The study was conducted in one of the central regions in Ankara. Calculations were done separately for 31 primary health care centers in the region. Midwife demand was calculated separately for each of the six specified duties in all health centers. By summing the calculated numbers, midwife demand for each health center was found In order to determine the approximate time required to deliver each service, 10 midwives from 10 different primary health care centers in the region were selected by random sampling and interviewed. According to the sample calculation presented in this study, the number of midwives required (160) was found to be equal to the current number of midwife posts available in the region. Although this finding was favorable, the fact that 29% of those posts were unfilled constituted a significant problem. Lack of human resources can lead to the lack of essential services, lack of quality in service delivery and loss of strength in primary care. In order to facilitate the optimal delivery of health services, an adequate number of personnel have to be allocated in the most appropriate positions.