Evaluation of risk perception related with environmental noise among residents living in different vicinities of wind turbines.

This cross-sectional study assessed residents' risk perceptions and associated factors in three rural areas by administering a face-to-face questionnaire to 282 subjects. The association between the perception of risk related to wind turbines and related factors such as noise and annoyance was analysed. Outdoor A-weighted sound pressure levels were measured for all. According to regression analysis, age (B: -0.008, 95% CI: -0.015/-0.002), education (B: 0.415, 95% CI: 0.148/-0.682), noise level day (B: -0.040, 95% CI: -0.068/-0. 013), noise annoyance indoors (B: 0.504, 95% CI: 0.227/0.781) and distance (B: 0.000, 95% CI: 0.000/0.000) had a significant effect on high risk perception (p < 0.05). This demonstrates that, in addition to noise, non-acoustic factors also influence risk perception. Ensuring community participation and considering distance before installation could prevent negative risk perceptions and annoyance. .

Health effects of wind turbines: a review of the literature between 2010-2020.

Although wind power is more acceptable in terms of its environmental impact, possible risks to human health are still being discussed. The aim of this study is to systematically evaluate the methodology and the outcomes of the articles that investigate the health effects of wind turbines on humans. Combinations of keywords were entered into the PubMed database. The search resulted in a total of 141 hits, 22 were included. It had been noticed that the most common problems in those living around the wind turbines are noise annoyance(n=18), risk perception and attitude towards wind turbines(n=11), general health symptoms and quality of life(n=11), sleep disturbance(n=10), annoyance(n=7) and shadow flicker effect(n=4). General annoyance is adversely affected by the noise level and sensitivity to noise. We can conclude that the knowledge of and attitude towards wind turbines can turn into annoyance and symptoms if the audio-visual effects of turbines limit daily life activities.

Trends in socioeconomic inequalities in smoking in Turkey from 2008 to 2016.

BACKGROUND: Smoking inequalities in Turkey were previously demonstrated in an early stage of the smoking epidemic model. This paper aimed to assess the trends for socioeconomic inequalities in smoking in Turkey over the years in the context of the smoking epidemic model using data from the Global Adult Tobacco Survey (GATS) Turkey 2008-2012-2016. METHODS: Cross-sectional data were analyzed to calculate the association of smoking with, wealth, education, occupation and place of residence using age-standardized prevalence rates, odds ratios, relative index of inequality (RII) and slope index of inequality (SII). The analysis was performed separately for age groups (younger: 20-39 years/older: 40 and above years) and sex. RESULTS: Younger women with higher wealth and older women with higher wealth and education smoked more. For both age groups, smoking was increased for working class and urban women. Relative wealth inequalities in smoking narrowed and then showed a reversal for younger women (RII2008 = 3.37; 95% CI:1.64-3.40; RII2012 = 2.19; 95% CI:1.48-3.24; RII2016 = 0.80; 95% CI:0.58-1.10, p-for trend < 0.0001). Relative educational inequalities in smoking for older women also showed a narrowing (RII2008 = 21.45; 95% CI:11.74-39.19; RII2012 = 15.25; 95% CI:9.10-25.55; and RII2016 = 5.48; 95% CI:3.86-7.78, p-for trend < 0.0001). For older women, a similar narrowing was observed for wealth (RII2008 = 3.94; 95% CI:2.38-6.53; RII2012 = 2.79; 95% CI:1.80-4.32; and RII2016 = 1.34; 95% CI:0.94-1.91, p-for trend = 0.0001). The only significant trend for absolute inequalities was for younger women by wealth. This trend showed a narrowing and then a reversal (SII2008 = 0.14; 95% CI:0.09-1.20; SII2012 = 0.12; 95% CI:0.06-0.18; and SII2016 = -0.05; 95% CI:-0.12-0.02, p-for trend = 0.0001). Unlike women, smoking in men showed inverse associations for wealth and education, although not statistically confirmed for all years. Smoking was increased in working classes and unemployed men in 2012 and 2016. Inequalities did not show a trend in relative and absolute terms for men. CONCLUSIONS: For smoking inequalities in Turkey, a transition to the next stage was observed, although the previously defined Southern European pattern also existed. Low socioeconomic women deserve special attention as well as stressors at work and drivers of smoking at urban settings.

WhatsApp embedded in routine service delivery for smoking cessation: effects on abstinence rates in a randomized controlled study.

BACKGROUND: The demand for smoking cessation services has risen in Turkey, as smokers planning to quit reached 35% in 2012. Communication technologies are used globally to support quitters, yet their integration to health services is rare. This study aims to evaluate the effect of support messages through WhatsApp application added to the usual care of a university hospital cessation unit, as compared to usual care alone, on abstinence rates at first month. METHODS: A randomized controlled intervention study was conducted with 132 patients applying to Ege University Hospital's Department of Public Health Smoking Cessation Clinic, between March and July 2017. Intervention content was prepared and 60 WhatsApp messages about having a plan of action and preventing relapse were developed through expert panels. These messages lasted for 3 months and follow-ups continued for 6 months. The primary outcome was abstinence rate at 1st month post target quit day. As secondary outcomes; the continuous abstinence rates at 3rd and 6th months, number of follow-ups, change in weight and continuity of medication were evaluated. Intention-to-treat analysis was used. RESULTS: Abstinence rate at 1st month was 65.9% in the intervention group and 40.9% in the control group (p = 0.007); 50.0 and 30.7% at 3rd month and 40.9 and 22.7% at 6th month, consecutively (both p < 0.05). Being in the intervention group increased abstinence rate by 3.50 (OR, 95% CI = 1.30-9.44) times in the 1st month. When controlled for all other factors in the multivariate logistic regression, the intervention was the only variable significantly associated with abstinence. For secondary outcomes, the intervention increased abstinence rate by 2.50 (OR, 95% CI = 1.08-6.40) times in the 3rd and 2.31 (OR, 95% CI = 1.03-5.16) times in the 6th month. In the intervention group, the number of follow-ups and face-to-face follow-ups were higher at 1st and 3rd months and continuity of medication was longer at 3rd month. CONCLUSIONS: WhatsApp support embedded in cessation service delivery increases the abstinence rate and has favorable effects on follow-up. TRIAL REGISTRATION: This trial is retrospectively registered online at ClinicalTrials.gov with the identifier NCT03714971 .

Medical students' risk perceptions on decreased attention, physical and social risks in using mobile phones and the factors related with their risk perceptions.

The aim of this cross-sectional study is to determine the mobile phone use, risk perception and related factors among the medical students. The study population was 1465 medical students. The dependent variable was the risk perception on mobile phones. The risk perception was assessed in three dimensions: decreased attention, physical risks and social risks. The exploratory factor analysis was used for the success of the scale, and the factor loadings were calculated using the varimax rotation method. Logistic Regression Analysis was applied to determine the factors associated with risk perception. The presented results are based on 1079 students (Access rate = 73.7%). In all dimensions of risk perception, more than half of the medical students had high risk perceptions. Female students and lower social classes had high risk perceptions. An understanding of the determinants and mobile phone utilization characteristics might help in developing effective risk communication to these subgroups.

Mobile phone use, school electromagnetic field levels and related symptoms: a cross-sectional survey among 2150 high school students in Izmir.

BACKGROUND: Health outcomes of electromagnetic fields (EMF) from mobile phones and their base stations are of concern. Conducting multidisciplinary research, targeting children and exploring dose-response are recommended. Our objectives were to describe the mobile phone usage characteristics of high school students and to explore the association between mobile phone usage characteristics, high school EMF levels and self-reported symptoms. METHODS: This cross-sectional study's data were collected by a survey questionnaire and by measuring school EMF levels between November 2009 and April 2011. A sample size of 2530 was calculated from a total of 20,493 students in 26 high schools and 2150 (85.0%) were included in the analysis. The frequencies of 23 symptoms were questioned and analysed according to 16 different aspects of mobile phone use and school EMF levels, exploring also dose-response. School EMF levels were measured with Aaronia Spectran HF-4060 device. Chi square and trend tests were used for univariate and logistic regression was used for multivariate analyses. RESULTS: Among participants, 2021 (94.0%) were using mobile phones and 129 (6.0%) were not. Among users, 49.4% were speaking <10 min and 52.2% were sending/receiving 75 or more messages per day. Headache, fatigue and sleep disturbances were observed respectively 1.90 (95% CI 1.30-2.77), 1.78 (1.21-2.63) and 1.53 (1.05-2.21) times more among mobile phone users. Dose-response relationships were observed especially for the number of calls per day, total duration of calls per day, total number of text messages per day, position and status of mobile phone at night and making calls while charging as exposures and headache, concentration difficulties, fatigue and sleep disturbances as general symptoms and warming of the ear and flushing as local symptoms. CONCLUSIONS: We found an association between mobile phone use and especially headache, concentration difficulties, fatigue, sleep disturbances and warming of the ear showing also dose-response. We have found limited associations between vicinity to base stations and some general symptoms; however, we did not find any association with school EMF levels. Decreasing the numbers of calls and messages, decreasing the duration of calls, using earphones, keeping the phone away from the head and body and similar precautions might decrease the frequencies or prevalence of the symptoms.

Smartphone Addiction and Related Factors among Athletes.

Smartphone addiction (SA) is increasing worldwide. The aim of this study is to determine the level of SA in athletes affiliated to the Turkish Handball Federation in Izmir and to examine its relationship with factors such as sociodemographic status, health status, eating attitude, and body perception. This cross-sectional study was conducted in March-April 2021 in Izmir Province. The sample of the study consisted of 212 licensed handball athletes. The short SA scale, three-factor nutrition scale, and body perception scale were used. A chi-square test was used for bivariate comparisons and logistic regression analysis was used for multivariate comparisons. The study was completed with 202 individuals (the coverage rate was 95.3%). The prevalence of SA was found to be 27.7%. The risk of SA increased 2.49-fold (CI: 1.17-5.31, p = 0.018) in female participants, 2.01-fold (CI: 1.01-4.06, p = 0.048) in participants with alcohol use, 2.17-fold (CI: 1.04-4.58, p = 0.042) in participants with low nutritional scores, 2.65-fold (CI: 1.15-6.10, p = 0.022) in individuals with high-income status, and 2.66-fold (CI: 1.07-6.64, p = 0.036) in individuals with high body perception scale score. In total, 27.7% of the athlete sample had scores above the SA threshold. These results point out that a behavioral addiction such as SA can occur even in professionals of an activity such as sports, known for beneficial effects in terms of healthy life.

Adolescents' risk perceptions on mobile phones and their base stations, their trust to authorities and incivility in using mobile phones: a cross-sectional survey on 2240 high school students in Izmir, Turkey.

BACKGROUND: Use of mobile phones has rapidly risen among adolescents despite a lack of scientific certainty on their health risks. Risk perception is an important determinant of behavior, and studies on adolescents' risk perceptions of mobile phones or base stations are very scarce. This study aims to evaluate high school students' risk perceptions on mobile phones and base stations, their trust to authorities, their opinions regarding incivility while using mobile phones and to assess associated factors. METHODS: For this cross-sectional study, 2530 students were chosen with stratified cluster sampling among 20,493 high school students studying in Bornova district of Izmir, Turkey, among whom 2240 (88.5%) participated. Risk perceptions and opinions were questioned with a 5-point Likert scale for 24 statements grouped under four dimensions. The mean responses to the four dimensions were categorized as <3.5 (low) and ≥3.5 (high) and the determinants were analyzed with logistic regression. RESULTS: Mean risk perception scores for the mobile phone, base station, trust to authority and incivility dimensions were 3.69 ± 0.89, 4.34 ± 0.78, 3.77 ± 0.93, 3.16 ± 0.93 and the prevalence of high risk perception was 65.1%, 86.7%, 66.2%, 39.7%, respectively. In the mobile phone dimension; students attending industrial technical high school had lower risk perceptions while female students, lower mothers' education groups and students not using mobile phones (OR = 2.82, 95% CI = 1.80-4.40) had higher risk perceptions. In the base station dimension girls had higher risk perceptions (OR = 1.68, 95% CI = 1.20-2.37). Girls and students attending industrial technical high school had significantly lower risk perception however 11-12th grade group perceived the risk higher (OR = 1.45 95% CI = 1.15-1.84) in the trust to authority dimension. For the incivility dimension, female students (OR = 1.44, 95% CI = 1.14-1.82), illiterate/only literate mothers (OR = 1.79, 95% CI = 1.04-2.75) and students not using mobile phones (OR = 2.50, 95% CI = 1.62-3.87) perceived higher risk. CONCLUSIONS: Understanding the effects of these determinants might aid in developing more effective educational interventions to specific subgroups on this topic. As debates on the health consequences of electromagnetic fields continue, it would be cautious to approach this issue with a preventive perspective. Efforts should be made to equalize the varying level of knowledge and to ensure that students are informed accurately.

Video gaming improves robotic surgery simulator success: a multi-clinic study on robotic skills.

We aimed to investigate the effects of video game habits, duration of experience, and training in different surgical clinics on the success of robotic surgery simulators. In this prospective, observational, comparative, and multi-clinical study, all participants played Temple Run and Piano Tiles 2™ mobile games for 1 month, after answering a questionnaire including their sociodemographic characteristics, surgical experience, and past and current video game experience. At the end of the period, participants experienced four different robotic surgery simulator tasks (Camera Targeting 1, Energy Switching 1, Ring and Rail 2, Vertical Defect Suturing) in da Vinci® Skills Simulator™. Additionally, sociodemographic data were statistically analyzed with mobile game scores and 13 different performance scores obtained from the simulator. All robotic surgery simulator skill applications were carried out at Ege University Hospital in Izmir. All surgical residents in the general surgery, urology, and pediatric surgery clinics were included in the study. Sixty of the sixty-four participants in total completed all the processes. Four participants were excluded from the study. When clinical performances were compared, it was seen that the general surgery clinic performed better than other clinics in two parameters (overall score, time to complete) of the 'Camera Targeting' task (p = 0.01 and p = 0.006). Participants with mobile phone games experience were successful in the 'Energy Switching' task with less misapplied energy time (p = 0.039). Participants with high scores in Piano Tiles 2™ were more successful in the 'Energy Switching' task and completed the 'Ring Rail' task with fewer movements (p < 0.05). Participants with more surgical and laparoscopic surgery experience scored higher in the 'Camera Targeting' and 'Energy Switching' tasks and completed the assignments with less movement. Again, these participants completed the 'Vertical Defect Suturing' task faster and the 'Ring Rail' task with less movement. In addition, participants with more laparoscopy experience scored higher in the 'Ring Rail' task (p < 0.05). In this study, we showed the effect of recent gaming experience on robotic surgery abilities along with previous video game experience. For surgeons and surgeon candidates in robotic surgery training, the importance of video game-based learning techniques will increase when combined with rapidly developing simulation technologies.ClinicalTrials.gov Identifier: NCT05510960.

Relationship between hepatic and pancreatic steatosis and the COVID-19 pneumonia total severity score and prognosis with an emphasis on prognostic strength

PURPOSE: To investigate the relationship between hepatic steatosis (HS), pancreatic steatosis (PS), and coexisting HS and PS and the Coronavirus disease-2019 (COVID-19) pneumonia total severity score (TSS) and prognosis, assessed through computed tomography (CT), and to evaluate the degree of effectiveness of the three steatosis conditions on TSS and prognosis. METHODS: This retrospective study involved 461 patients (255 male and 206 female, median age of 53 years) with COVID-19 who underwent unenhanced chest CT. HS, PS, and coexisting HS and PS, assessed through CT, were compared with patient demographics, comorbidities, TSS, hospitalization and intubation requirements, and mortality rates. The parameters were compared using Mann-Whitney U and chi-square tests. The parameters of three groups of patients with only HS, only PS, and both HS and PS were compared using the Kruskal-Wallis test. RESULTS: Results revealed that TSS (P < 0.001 for all) and hospitalization rates (P < 0.001 for all except for HS [P = 0.004]) were higher in patients with HS, PS, and both than in those without. Intubation (P = 0.003) and mortality rates (P = 0.018) were significantly higher solely in patients with PS. However, TSS, hospitalization, and diabetes mellitus were significantly higher than in age-standardized analyses for PS. In a comparison between only HS, only PS, and coexisting HS and PS in 210 patients, the highest TSS was in the coexistence group (P < 0.001). CONCLUSION: The TSS and hospitalization rates correlate with HS, PS, and coexisting HS and PS, whereas intubation and mortality rates only correlate with PS. However, TSS correlates with coexisting HS and PS at the highest rate.

Evaluation of public's perception of scar cosmesis after thyroidectomy: results of a survey of Turkish versus South Korean individuals.

Purpose: Visible scars on the neck caused by thyroid surgery give rise to significant aesthetic, functional, and psychosocial problems. The objective of this study is to comparatively investigate the public perception of neck scar cosmesis in Turkish and South Korean populations. Methods: This survey was prepared to collect participants' demographic and socioeconomic data and determine their perception of scar cosmesis on the neck and consisted of 15 questions. One thousand thirty-nine individuals who did not undergo thyroid surgery completed the survey. The P-values of <0.05 were deemed to indicate statistical significance. Results: There were 1,039 respondents, of whom 525 (50.5%) were Turkish and 514 (49.5%) were South Korean. South Korean respondents stated that they would be significantly more uncomfortable with the thought of having a scar due to thyroid surgery, compared to the Turkish respondents (P < 0.001). The South Korean respondents stated that they would be significantly more concerned about the scar's length, thickness, and darkening color, compared to the Turkish respondents (P < 0.001 for all cases). Conclusion: Patients' expectations, which are affected by various sociodemographic factors and cultural characteristics, are as important as the medical condition when deciding on the type of thyroid surgery. The study findings clearly indicated that the South Korean population would be significantly more uncomfortable with having a scar on the neck, compared to the Turkish population. Therefore, in selected cases, a scarless thyroidectomy approach, such as transoral endoscopic thyroidectomy, vestibular approach may be preferable for societies like South Korea.

Socio-economic inequalities in overweight among adults in Turkey: a regional evaluation.

OBJECTIVE: Patterns of socio-economic inequalities in obesity and overweight have not been documented for Turkey. The present study aimed to describe educational and wealth-related inequalities for overweight in Turkey, taking a regional perspective. DESIGN: Cross-sectional self-reported data of the World Health Survey 2002 for Turkey were used. BMI ≥ 25·00 kg/m2 was considered as overweight. Respondents were classified according to education years and a wealth score derived from the availability of household assets. Logistic regression analysis was applied to assess the relationship between overweight and socio-economic factors. Analyses were stratified by sex and region (West, Mediterranean, Middle, Black Sea and East). SETTING: Turkey. SUBJECTS: Among the respondents 20 years and older, 3790 women and 4057 men had data on self-reported height and weight. RESULTS: Age-adjusted overweight prevalence was 48·4 % for women and 46·1 % for men. For men, education was not systematically related to overweight while overweight was significantly increased among the highest wealth groups. For women, the prevalence of overweight was highest for low-educated and middle-wealth groups. The size of the inequalities in overweight showed only small regional variations. In the East, however, overweight prevalence was more related to higher socio-economic position than in the other regions. CONCLUSIONS: Socio-economic inequalities for overweight in Turkey are at a similar level as in most European countries, and especially comparable to Southern Europe. The smaller inequalities in the East correspond to the low level of socio-economic development in this part of the country. Prevention of overweight should focus on lower educational groups throughout the entire country and especially on low-educated women.

Computed tomography evaluation of pancreatic steatosis: correlation with COVID-19 prognosis.

Aim: To investigate the relationship between pancreatic steatosis (PS) assessed on computed tomography (CT) and COVID-19 prognosis. Materials & methods: This retrospective study covers 396 patients with COVID-19 (mean age: 52.50 ± 16.86 years), who underwent unenhanced chest CT. PS was compared with clinical findings, comorbidities, requirements for hospitalization, intubation and intensive care unit (ICU), length of hospitalization and death. Results: PS was found to be strongly correlated with the severity of clinical findings and hospitalization rates (p < 0.001). In hospitalized patients, length of hospitalization (p = 0.002) and rates of ICU requirement (p = 0.003) were higher in patients with PS. Conclusion: PS, correlated with clinical severity and hospitalization requirement, is an independent risk factor for COVID-19.

How Does It Feel to Be a Pathologist in Turkey? Results of a Survey on Job Satisfaction and Perception of Pathology.

OBJECTIVE: Job satisfaction affects productivity and professional performance in many aspects; however, there is limited data regarding pathologists' job satisfaction. Hence, in this study, we aimed to evaluate surgical pathologists' job satisfaction in Turkey. MATERIALS AND METHODS: We conducted a 59-item web-based survey questioning respondents' institutional background, history of training, continuing education status/research activities, physical conditions, professional well-being, and job satisfaction level. Likert-type and open/ close ended questions were asked and scored. The participants were also asked to complete the Minnesota Satisfaction Questionnaire-Short Form. RESULTS: Of the 321 respondents, 75% were female, the median age was 41 years (range 28-71 years), experience as a pathologist ranged between 0.12 and 44 years (mean 11.4±9.16 years). Academic pathologists, senior pathologists with ≥20 years of experience, and pathologists working at large institutions and living in developed cities expressed better physical conditions, higher satisfaction with working conditions and, therefore, higher overall job satisfaction (p < 0.05). 98% agreed that pathologists have a critical impact on patient management; however, the majority ( > 80%) thought that patients barely know what pathologists do and other physicians rarely understand the difficulty and limitations in pathology practice. 82% were happy to have chosen pathology but 45% reported to experience the feeling of being "burnt out". CONCLUSIONS: Our findings suggest that younger pathologists are less satisfied with their jobs and a surgical pathologist's job satisfaction increases with the physical and technical quality of the pathology laboratory/institution, and years of experience. Pathologists seem to be aware of their important role in patient management although they think that pathology remains "invisible" to many physicians and patients.

Spin-echo and diffusion-weighted MRI in differentiation between progressive massive fibrosis and lung cancer.

PURPOSE: We aimed to investigate the value of magnetic resonance imaging (MRI)-based parameters in differentiating between progressive massive fibrosis (PMF) and lung cancer. METHODS: This retrospective study included 60 male patients (mean age, 67.0±9.0 years) with a history of more than 10 years working in underground coal mines who underwent 1.5 T MRI of thorax due to a lung nodule/mass suspicious for lung cancer on computed tomography. Thirty patients had PMF, and the remaining ones had lung cancer diagnosed histopathologically. The sequences were as follows: coronal single-shot turbo spin echo (SSH-TSE), axial T1- and T2-weighted spin-echo (SE), balanced turbo field echo, T1-weighted high-resolution isotropic volume excitation, free-breathing and respiratory triggered diffusion-weighted imaging (DWI). The patients' demographics, lesion sizes, and MRI-derived parameters were compared between the patients with PMF and lung cancer. RESULTS: Apparent diffusion coefficient (ADC) values of DWI and respiratory triggered DWI, signal intensities on T1-weighted SE, T2-weighted SE, and SSH-TSE imaging were found to be significantly different between the groups (p < 0.001, for all comparisons). Median ADC values of free-breathing DWI in patients with PMF and cancer were 1.25 (0.93-2.60) and 0.76 (0.53-1.00) (× 10-3 mm2/s), respectively. Most PMF lesions were predominantly iso- or hypointense on T1-weighted SE, T2-weighted SE, and SSH-TSE, while most malignant ones predominantly showed high signal intensity on these sequences. CONCLUSION: MRI study including SE imaging, specially T1-weighted SE imaging and ADC values of DWI can help to distinguish PMF from lung cancer.

Maternal age, education level and migration: socioeconomic determinants for smoking during pregnancy in a field study from Turkey.

BACKGROUND: Smoking during pregnancy has been associated with socioeconomic determinants and it is recognized as the most important preventable risk factor for an unsuccessful pregnancy outcome. Turkey has national data on the prevalance of smoking during pregnancy; however there is no data on the characteristics of the high-risk population. This is a field study that aims to identify socioeconomic determinants for smoking during pregnancy as well as differentiating the daily and occasional smokers. METHOD: Cross sectional study was conducted among women with 0-5 year old children living in the area served by Primary Health Care Center (PHCC) in Burhaniye, Turkey. Face-to-face interviews were conducted by the researchers during January-March 2008 at the home of the participants with 83.7% response rate (n = 256). The relation of "smoking during pregnacy" and "daily smoking during pregnancy" with the independent variables was determined with chi2 tests. Women's age, educational level, number of previous births, place of origin, migration, partner's educational level, poverty, perceived income, social class were evaluated. Statistical significance was achieved when the p value was less than 0.05. The variables in relation with the dependent variables in the chi2 tests were included in the forward-stepwise logistic analysis. RESULTS: Prevalance of smoking during pregnancy was 22.7%. The majority (74.1%) were daily smokers. Young mothers (< 20), low educated women and migrants were at increased risk for smoking during pregnancy. Low education and being a migrant were risk factors for daily consumption (p < 0.05). CONCLUSIONS: Systematic attention should be paid to socioeconomic determinants in smoking for pregnant women, especially in countries like Turkey with high rates of infant and mother mortality and substantial health inequalities. Young mothers (< 20), low educated women and migrants are important groups to focus on.

Gastrointestinal findings in 26 adults with common variable immunodeficiency: The fickle nature of the disease manifests in gastrointestinal biopsies.

BACKGROUND/AIMS: The aim of the present study was to demonstrate the histopathological findings in gastrointestinal (GI) biopsies in adults with common variable immunodeficiency (CVID). MATERIALS AND METHODS: A total of 172 GI biopsies of 26 patients with CVID obtained over a 16-year period were reevaluated. Findings were analyzed using descriptive analyzes and χ2 test. RESULTS: Female-to-male ratio was 1.36. The median age at diagnosis was 36±13.94 (16-72) years. Chronic esophagitis was noted in 3 patients. The absence of plasma cells in the stomach, duodenum, and colon was observed in 16, 14, and 9 patients, respectively. Divergent results for the presence of plasma cells in concurrent stomach and duodenum samples were found in 11 (44%) patients. Nodular lymphoid hyperplasia (NLH) was notable in the duodenum (56%). The mean number of eosinophils in one high-power field was significantly higher in duodenal biopsies with NLH (27.21 vs. 14.37, p=0.002). Active inflammation was more prominent in the colon (91%) than in the stomach (65%) and duodenum (60%). Helicobacter pylori infection was found in 57.6%, including a case with persistent infection by the coccoid form. Celiac-like villous blunting and increased intraepithelial lymphocytes were seen in 40% and 24%, respectively. In addition, 23% had giardiasis associated with acute duodenitis and duodenal NLH (p<0.05). CONCLUSION: CVID gastroenteropathy is a challenging entity, and due to the heterogeneity in the presence and distribution of plasma cells throughout the GI tract and diverse disease course, multiple concurrent biopsies may be needed for tissue diagnosis. Duodenal CVID may present with villous alterations and giardiasis, and NLH appears to be an important clue in the duodenum. The association between duodenal NLH and eosinophil infiltration deserves further investigation.

Public health education in Ege University Medical Faculty: developing a community-oriented model.

BACKGROUND: Ege University Medical Faculty (EUMF) introduced a community-oriented curriculum in 2001. AIMS: To evaluate the new public health education program in EUMF curriculum. METHOD: The study adopted triangulated methods. Quantitatively, a comparison of the students who were exposed to a community-oriented curriculum (Year 4 in 2007) was made with the students who were exposed to the traditional curriculum (Year 4 in 2005) in terms of their assessment of their achievement of our learning objectives. A total of 255 students in 2005 (80.7%) and 243 students in 2007 (81.5%) were surveyed using a questionnaire. Qualitatively, five focus group- and five individual interviews were performed with the 2007 cohort. RESULTS: Except the one related to teamwork (p > 0.05) all learning objectives yielded significantly higher scores in the 2007 cohort than in the 2005 cohort (p < 0.05). The qualitative analysis supported the achievement of objectives in the 2007 cohort. The students appreciated the relevance of public health education with clinical subjects and interactive methods, but criticized didactic lectures and written assignments. CONCLUSIONS: A community-oriented approach is more effective in achieving a holistic approach to health problems. Improving community-based activities and assessment methods would be more successful in integrating population health into medical training.

Risk perception of occupational hazards among dental health care workers in a dental hospital in Turkey.

AIMS: To determine the factors associated with the level of occupational risk perceived by dental health care workers (DHCW), and to define the perceived sources of hazards. DESIGN: Cross-sectional. SETTING: Izmir Dental Hospital in Turkey. PARTICIPANTS: All employees (n = 308) in the hospital. METHODS: Data were collected by a questionnaire in 2007. Respondents rated their degree of individual risk that could be associated with the procedures they perform on a 10-point scale and listed the hazards they faced. Those with a score > or = 9 were classified as a high-risk perception group. We assessed the relation between variables using chi-square test and logistic regression analysis. RESULTS: Response rate was 90.3%. 57.2% of DHCW had a high-risk perception. Having children, job category and management's commitment to safety were related to the risk perception. DHCW who used preventive measures regularly and experienced an occupational accident in the previous year were 2.29 and 2.77 times more likely to have a high-risk perception. The perceived sources of hazards differed by job category. CONCLUSIONS: Risk perception is an initial step in developing procedures to minimise occupational risks and occupation specific risk management approaches should be performed.

How does it feel to be a pathology resident? Results of a survey on experiences and job satisfaction during pathology residency.

Residents' career choices and professional motivation can be affected from perception of their role and recognition within a medical team as well as their educational and workplace experiences. To evaluate pathology trainees' perceptions of their pathology residency, we conducted a 42-item survey via a web-based link questioning respondents' personal and institutional background, workplace, training conditions, and job satisfaction level. For the 208 residents from different European countries who responded, personal expectations in terms of quality of life (53%) and scientific excitement (52%) were the most common reasons why they chose and enjoy pathology. Sixty-six percent were satisfied about their relationship with other people working in their department, although excessive time spent on gross examination appeared less satisfactory. A set residency training program (core curriculum), a set annual scientific curriculum, and a residency program director existed in the program of 58, 60, and 69% respondents, respectively. Most respondents (76%) considered that pathologists have a direct and high impact on patient management, but only 32% agreed that pathologists cooperate with clinicians/surgeons adequately. Most (95%) found that patients barely know what pathologists do. Only 22% considered pathology and pathologists to be adequately positioned in their country's health care system. Almost 84% were happy to have chosen pathology, describing it as "puzzle solving," "a different fascinating world," and "challenging while being crucial for patient management." More than two thirds (72%) considered pathology and pathologists to face a bright future. However, a noticeable number of respondents commented on the need for better physical working conditions, a better organized training program, more interaction with experienced pathologists, and deeper knowledge on molecular pathology.