Push and Pull Factors of Why Medical Students Want to Leave Türkiye: A Countrywide Multicenter Study.

Phenomenon: Physician immigration from other countries is increasing as developed countries continue to be desirable destinations for physicians; however, the determinants of Turkish physicians' migration decisions are still unclear. Despite its wide coverage in the media and among physicians in Türkiye, and being the subject of much debate, there is insufficient data to justify this attention. With this study, we aimed to investigate the tendency of senior medical students in Türkiye to pursue their professional careers abroad and its related factors. Approach: This cross-sectional study involved 9881 senior medical students from 39 different medical schools in Türkiye in 2022. Besides participants' migration decision, we evaluated the push and pull factors related to working, social environment and lifestyle in Türkiye and abroad, medical school education inadequacy, and personal insufficiencies, as well as the socioeconomic variables that may affect the decision to migrate abroad. The analyses were carried out with a participation rate of at least 50%. Findings: Of the medical students, 70.7% had emigration intentions. Approximately 60% of those want to stay abroad permanently, and 61.5% of them took initiatives such as learning a foreign language abroad (54.5%) and taking relevant exams (18.9%). Those who wanted to work in the field of Research & Development were 1.37 (95% CI: 1.22-1.54) times more likely to emigrate. The push factor that was related to emigration intention was the "working conditions in the country" (OR: 1.89, 95% CI: 1.56-2.28) whereas the "social environment/lifestyle abroad" was the mere pull factor for the tendency of emigration (OR: 1.73, 95% CI: 1.45-2.06). In addition, the quality problem in medical schools also had a significant impact on students' decisions (OR: 2.20, 95% CI: 1.83-2.65). Insights: Although the percentage of those who want to emigrate "definitely" was at the same level as in the other developing countries, the tendency to migrate "permanently" was higher in Türkiye. Improving working conditions in the country and increasing the quality of medical faculties seem vital in preventing the migration of physicians.

Turkish Validity-Reliability Study of the Celiac Disease-Specific Pediatric Quality of Life Scale.

BACKGROUND: Celiac disease is an autoimmune enteropathy triggered by the presence of gluten. There are Celiac Disease Dutch-Child Quality of Life Scale, Celiac-Specific Pediatric Quality of Life Scale for children/adolescents patients to measure the quality of life. In this study, due to lack of quality of life scales for children with celiac in Turkey, we aimed at Turkish adaptation of the Celiac-Specific Pediatric Quality of Life Scale. METHODS: This methodological study was conducted in Ankara University Faculty of Medicine, Cebeci Hospital Hospital between July 2019 and July 2020. A total of 192 children were included. Reliability was demonstrated by the Cronbach's alpha coefficient. Structural validity was evaluated using explanatory factor analysis and confirmatory factor analysis. The Statistical Package for Social Sciences (SPSS) 22.0 and Amos were used in analyses. RESULTS: In 8-12 age groups; Cronbach's alpha was 0.92 in negative emotions dimension, 0.88 in school dimension, and 0.74 in enjoyment dimension. In explanatory factor analysis, Kaiser-Meyer-Olkin measure of sampling adequacy value was 0.698, Bartlett's test of sphericity was significant (P < .001). Variance explained was 75.8%. In confirmatory factor analysis, X2/df was 3.26, root mean square error of approximation value was 0.07, comparative fit index value was 0.96. In 13-18 age groups; Cronbach's alpha was 0.87 in social dimension, 0.84 in uncertainty dimension, 0.78 in isolation dimension, and 0.83 in limitations dimension. In explanatory factor analysis, Kaiser-Meyer-Olkin measure of sampling adequacy was 0.684, Bartlett's test of sphericity was significant (P < .001). Variance explained was 68.6%. In confirmatory factor analysis, X2/sd value was 3.78, root mean square error of approximation value was 0.061, and comparative fit index value was 0.961. CONCLUSION: Cronbach's alpha values of the groups were found to be above 0.70. Kaiser-Meyer-Olkin values were above 0.5 in terms of sample size, Bartlett's tests for sphericity were significant in terms of correlations between variables, root mean square error of approximation values were below 0.08, comparative fit index and goodness of fit index values were above 0.95 in terms of model fit. If the scales have been found to be valid and reliable, it is recommended for use in Turkey.

The age at menopause and associated factors at the health center area in Ankara, Turkey.

OBJECTIVES: This study is performed in one health center area in Ankara, Turkey on a women population of 50-65 years in order to demonstrate menopausal status of women, age at menopause and factors related with the age at menopause. METHODS: This is a cross-sectional study which has been performed on a women population of 50-65 years. The local population was 17,153 in this area by 2001. All of the household determining forms are screened in order to detect the all of the women who were in 50-65 years group, then name and addresses of the these women's are listed. There were 1089 women aged 50-65 years who were constituting 7% of the population. After choosing the first name randomly from the list of the women, 1/3 systematic sampling method was used and, the number of the women in the sampling was 363 (95% C.I., +/-5% S.E.). The response rate among those eligible women who were contactable during the study was 99% (360/363). Data were collected by interviews through questionnaires. The questionnaire consisted of a series of questions concerning age at menopause, socioeconomic status, age at menarche, age at first pregnancy, regularity of menstrual cycles, parity, duration of breast feeding, use of OCs, BMI, smoking habit, age at menopause of the mother and the sister. Chi-square and t-test methods were used for statistical analyses. RESULTS: 4.2% of the women were in premenopause, 13.3% were in perimenopause, 72.8% were in natural menopause and 9.7% were in surgical menopause. Average age at natural menopause was 47+/-4.2 years. Education, age at menarche, smoking, age at menopause of the mother and the sister were found to be related with the age at menopause. CONCLUSIONS: Ninety-six percent of the women over age of 50 years, are at menopause or perimenopause. The results of this study suggest that, for factors of genetic and age at menarche, there are not many possibilities for the lifestyle changes that would modify age at menopause with the subsequent reduction in risk for chronic diseases, but daughters or sisters of women with an early menopause and women who smoked or less educated could be counselled with respect to family timing.

Environmental boron contamination in waters of Hisarcik area in the Kutahya Province of Turkey.

Our aim was to determine boron levels in waters of rich boron mine areas in Turkey. There is a naturally occurring high level of boron in the ground waters of some parts of Turkey. Our study area is Hisarcik village in the Kutahya Province of Turkey which has a large number of boron mines. Boron occurs in combined form, usually borax (Na2B4O7 x 10H2O) and colemanite (Ca2B6O11 x 5H2O). Water samples were collected from many springs in order to determine boron concentrations and the amount of boron that is exposed to 88 samples from the drinking water (tap water), 37 from ground water and 257 from stream or pond water (surface water). Urine samples taken from 42 residents in this area were analyzed for boron and compared with its levels in drinking waters. The inductively coupled plasma/mass spectrometry (ICP/MS) method was used for the analysis of boron concentrations. Water boron contents at differing locations of this area ranged from 2.05 to 29.00 mg B/l. Mean value of boron was 10.20+/-4.08 mg B/l. Total urinary boron excretion was ranged from 0.04 to 50.70 mg B/l and mean value was 8.30+/-10.91 mg B/l. Current information on sources, occurrence, pollution potential and toxicity of environmental boron is discussed.

Traditional coronary risk factors in healthy Turkish military personnel between 20 and 50 years old: focus on high-density lipoprotein cholesterol.

OBJECTIVE: Previous studies presented the Turkish population as a typical example of nations with low levels of high-density lipoprotein cholesterol (HDL-c). Nevertheless, some recent studies opposed this suggestion. We aimed to examine the traditional cardiovascular risk factors in young-middle age male military professionals, focusing especially on HDL-c. METHODS: In this observational and cross-sectional study, the data of 820 male military personnel between 20-50 years old (mean age: 35.3±6.9) who applied to the hospital for routine health examination were included. Blood biochemistry, arterial blood pressure and anthropometric measurements were noted. Statistical analysis was performed using Kruskal-Wallis test and ANCOVA. RESULTS: The mean age was 35.3±6.9, body mass index was 25.8±3.4 kg/m2 and waist circumference was 93.1±8.7 cm. HDL-c, low-density cholesterol, triglyceride and fasting blood glucose levels were 47.6±11.3, 120.4±33.2, 150.4±86.4 and 96,6±13.0 mg/dL, respectively. Only 23.2% of the participants had HDL-c level less than 40 mg/dL. The ratio of current smokers was 40.7%. Almost 66% of the participants (n=545) were making regular exercise. Mean systolic and diastolic arterial blood pressures were 124.1±13.0 and 75.7±9.3 mm Hg, respectively. CONCLUSION: The "mean" levels of traditional coronary risk factors were in almost "normal" limits in healthy young-middle age male military professionals that were examined. It must be emphasized that the HDL-c level, which was defined as "genetically low in Turks" in some previous epidemiologic studies, was not really low. This finding may be due to relatively favorable life style of the study population. On the other hand, some recent population studies in Turkey had found HDL-c levels higher than it was thought. This issue needs further clarification in specific age groups without sedentary lifestyle.

Assessment of possible risk indicators for apical periodontitis in root-filled teeth in an adult Turkish population.

OBJECTIVE: The objective of this study was to determine possible independent risk indicators of apical periodontitis (AP) in root-filled teeth in an adult Turkish population. STUDY DESIGN: This study included subjects older than 15 years who had 1 or more root-filled teeth examined at the Baskent University Faculty of Dentistry. A total of 812 root-filled teeth were evaluated in 425 individuals. AP was the dependent variable and age, gender, length and density of root fillings, presence of periodontal problems, posts, localization of tooth, and tooth type were identified as independent variables. Generalized Estimating Equation (GEE) models were used in statistical analysis. RESULTS: AP was detected on 148 teeth (18.2%) in 812 root-filled teeth. According to multiple GEE model, males were more likely to have AP than females. Of the dental variables, length of root fillings, periodontal problems and tooth type were significantly associated with AP. CONCLUSIONS: The present study indicates that to be male and dental variables including length of root fillings, periodontal problems, and molar teeth were significantly associated with AP.

Microalbuminuria: prevalence in hypertensives and diabetics.

BACKGROUND: Microalbuminuria is the mild elevation of urinary albumin excretion and reflects the progression of clinical nephropathy and cardiovascular disease and mortality risks of diabetic and hypertensive patients. The aim of this study was to determine the prevalence of and risk factors for microalbuminuria amongst Turkish people who had diabetes and/or hypertension and were older than 35 years of age. METHODS: In this cross-sectional study, from a pool of 7708 people over 35 years of age living in the Park Health Centre Area of Ankara, Turkey, we randomly selected 550 out of 926 hypertensive and/or diabetic patients. The area is also the research district of Ankara University Medical Faculty's Public Health Department. The results of 493 of those examined for microalbuminuria are represented in the study. An immunospecific dipstick Micral Test II was used for microalbuminuria screening and Medi-test urinary strip for macroalbuminuria. Additionally, blood pressure levels were recorded, fasting blood glucose levels were measured by Glucotrend and questionnaire forms were filled out. Chi square and logistic regression analyses were used for statistical analyses. RESULTS: In the study population, 439 patients were hypertensive, 194 patients were diabetic and of these, 140 were both hypertensive and diabetic. Overall prevalence of microalbuminuria was 19.1% and macroalbuminuria was 4.4% in the study group. Microalbuminuria prevalence was 18.9% in the hypertensive group and 21.7% in the diabetic group. In the hypertensive group, diastolic pressure level, male sex and type of accommodation, in the diabetic group, duration of diabetes, fasting blood glucose levels and type of accommodation were all influential factors for microalbuminuria according to the results of the multiple logistic regression analyses. CONCLUSION: Our study shows a high prevalence of microalbuminuria in both hypertensive and diabetic patients, males being at Special risk. Lowering of diastolic blood pressure and amelioration of living Standards should be the first goal of treatment according to our results.