Effect of training about child neglect and abuse to teachers and its effect to awareness.

BACKGROUND: This study aimed to evaluate the effects of child neglect and abuse training on the knowledge and awareness of medical vocational schoolteachers in Turkey. METHODS: This study was conducted based on data taken from a sample of teachers from Kayseri, Turkey, between October 2016 and April 2017. Teachers who agreed to participate in the study received training pertaining to child neglect and abuse. Data were collected through a survey form and the Scale for Identifying the Symptoms and Risks of Child Abuse and Neglect. Data were analyzed using SPSS V.20.0 software. For statistical analyses, Student's t test, analysis of variance and McNemar tests were conducted, with a value of p <  0.05 being considered statistically significant. RESULTS: Of teachers in the sample, 63.7% were female, and 80.5% were married. Teachers' mean age was 40.5 ± 9.9 years. Among teachers, 87.4% reported that the training was sufficient. Teachers' level of knowledge concerning neglect and abuse and the percentage of teachers who reported that they would report such situations to the authorities when faced with such a case increased after training. Female teachers' scores on the neglect and abuse scale increased among teachers without children and those who found the training to be sufficient. CONCLUSIONS: The knowledge level of teachers in the study group was found to be increased compared to their knowledge level prior to training. The subject of child neglect and abuse should be further discussed in the context of teachers' formal training.

Sore throat in primary care project: a clinical score to diagnose viral sore throat.

OBJECTIVE: Viral agents cause the majority of sore throats. However, there is not currently a score to diagnose viral sore throat. The aims of this study were (i) to find the rate of bacterial and viral causes, (ii) to show the seasonal variations and (iii) to form a new scoring system to diagnose viral sore throat. METHODS: A throat culture for group A beta haemolytic streptococci (GABHS) and a nasopharyngeal swab to detect 16 respiratory viruses were obtained from each patient. Over a period of 52 weeks, a total of 624 throat cultures and polymerase chain reaction analyses were performed. Logistic regression analysis was performed to find the clinical score. RESULTS: Viral infection was found in 277 patients (44.3%), and GABHS infection was found in 116 patients (18.5%). An infectious cause was found in 356 patients (57.1%). Rhinovirus was the most commonly detected infectious agent overall (highest in November, 34.5%), and the highest GABHS rate was in November (32.7%). Analysis of data provided a scoring system, called the Mistik Score, to diagnose viral sore throat. The predictive model for positive viral analysis included the following variables: absence of headache, stuffy nose, sneezing, temperature of ≥37.5°C on physical examination, and the absence of tonsillar exudate and/or swelling. The probability of a positive viral analysis for a score of 5 was 82.1%. CONCLUSION: The Mistik Score may be useful to diagnose viral sore throat. We suggest its use either alone or in combination with the Modified Centor Score.

Prevalence and risk factors of tinea capitis and tinea pedis in school children in Turkey.

OBJECTIVE: To evaluate the prevalence and risk factors of tinea capitis and tinea pedis in school children in Turkey. METHODS: The study included 8122 students from 24 schools in the rural and urban areas around Kayseri,Turkey. We asked every student for their personal identification and also for their sanitation in order to get an idea about dermatophytosis. Samples taken from suspicious lesions were collected and inoculated onto Sabouraud dextrose agar slants. For identification of grown fungi, macroscopic appearance of colonies, microscopic examination and biochemical tests were used. RESULTS: There were 41 (0.5%) suspicious lesions in feet and 31 (0.3%) in scalp and 22 (0.2%) students were diagnosed as tinea pedis and 9 (0.1%) as tinea capitis by fungal culture. The predominant etiologic agents in feet were Trichophyton rubrum 8 (36%), Trichophyton mentagrophytes 1 (4%), Rhodotorula 8 (36%), Trichosporon 2 (9%), Candida glabrata 2 (9%), Candida albicans 1 (4%), while Trichophyton verrucosum 8 (88%) and Trichophyton mentagrophytes 1 (12%) were identified in scalp samples. School settlement was found as risk factors on the frequency of tinea pedis and capitis. Age and gender were also found as risk factors on the frequency of tinea pedis. CONCLUSION: The results of this study demonstrate a low prevalence of tinea capitis and tinea pedis in school children of central Anatolia of Turkey. School settlement is a very important factor affecting the prevalence of tinea capitis and pedis in school children in central Anatolia of Turkey.

Pediculosis capitis: prevalence and its associated factors in primary school children living in rural and urban areas in Kayseri, Turkey.

OBJECTIVE: The aim of this study was to investigate the prevalence and risk factors of pediculosis capitis in schoolchildren living in rural and urban areas in Kayseri, a city located in central Anatolia in Turkey. METHODS: This cross-sectional school-based study was performed in 24 randomly selected public schools. A total of 8,122 schoolchildren aged 5-16 years, from kindergarten to eighth grade, were examined for the presence of pediculosis capitis. A child was defined as being infested by the presence of live or dead lice or eggs/nits. The results were analyzed using the chi-squared test and logistic regression analysis. RESULTS: The overall prevalence of head lice infestation was 13.1%. Pediculosis was more frequent in girls (25.2%) than in boys (0.86%) (p < 0.001). The prevalence was lower in children aged 5-8 years than in those aged 9-11 or 12-16 years (p < 0.001). In multiple regression analyses, the variables demonstrating statistically significant association with pediculosis were: being a girl (OR = 40.93; 95% Cl = 29.06-57.66), being 9-11 years old (OR = 1.54; 95% Cl = 1.25-1.89), residing with > or = 3 siblings (OR = 1.98; 95% Cl = 1.57-2.50), having a mother with no education (OR = 1.73; 95% CI = 1.29-2.33), having a father with no education (OR = 1.45; 95% Cl = 1.08-1.94), living in a rural area (OR = 2.34; 95% Cl = 2.02-2.71) and living in a one-room house (OR = 2.39; 95% CI = 1.41-4.08). CONCLUSIONS: Pediculosis capitis remains a health problem in schoolchildren in Kayseri, Turkey. In addition to improvement in socioeconomic status, collaborative and participation efforts among physicians, nurses, teachers, and parents are necessary to maintain effective epidemiological surveillance and provide treatment.

Interpopliteal distance percentiles to diagnose bowleg in 0-84 month-old Turkish children.

The purpose of this study was to determine the percentiles of interpopliteal distance to diagnose bowleg in 0-6 year-old children. Measurement of interpopliteal distance is a simple but valuable indicator in clinical examination to diagnose bowleg. We analyzed data from the anthropometry of Turkish children aged 0-6 years. The primary sampling unit included 21 family health centers (Aile Sagligi Merkezi) located in the city center and suburbs of Kayseri, Turkey. A total of 2,873 children and adolescents (1,419 boys, 1,454 girls), whose parents gave consent were included in the study. The smoothed percentiles and Z-scores were calculated by age and gender in 0-6 year-old children in quarter year intervals except for the 0-28-day newborn period. We found a significant correlation (r: 0.60, p < 0.001) between body weight and interpopliteal distance (after onset of walking). We consider that percentiles of interpopliteal distance can be used in the follow-up of children who may be at risk of bone and growth disorders. The zone between -2 standard deviation (SD) and +2SD values can be used to decide if the child has a normal growth pattern.

Body mass index percentiles for Turkish children aged 0-84 months.

BACKGROUND: Reference body mass index (BMI) percentiles are needed to follow secular changes in Turkish children aged 0-84 months. Obesity prevalence in this age group is also not well documented. AIM: The aim of this study was to determine BMI percentiles and the prevalences of overweight and obesity in Turkish children aged 0-84 months. The authors also tried to compare actual BMI status with World Health Organization (WHO) standards. SUBJECTS AND METHODS: This study used data from the Anthropometry of Turkish Children aged 0-6 years (ATCA-06) study. This cross-sectional study, conducted from September 2009 to May 2010 in Kayseri, Turkey, included 2683 children (1359 girls, 1324 boys) aged 0-84 months. Centile curves were constructed using the LMS method. RESULTS: It was found that BMI percentiles of Turkish children were higher than WHO standards in early childhood. The overweight and obesity prevalences were identical in both genders, 10.0% and 4.9%, respectively. CONCLUSION: This study provides both BMI reference values and prevalence figures for overweight and obesity in children aged 0-84 months, residing in Kayseri city, in Turkey. It is believed that these data can be of use in following secular changes as well as for comparisons with international standards.

Still an unknown topic: child abuse and "shaken baby syndrome".

BACKGROUND: Shaken baby syndrome (SBS) is a severe form of physical child abuse, and can even cause death. In this study, we aimed to investigate whether or not the primary healthcare workers had received any education regarding child abuse and neglect, whether they could diagnose the cases, whether they had sufficient knowledge about SBS as a part of child abuse, and whether they were in need of education on the topic. METHODS: Health workers in the primary healthcare centers in the province of Kayseri were enrolled. A questionnaire was applied. RESULTS: In this study, 35.0% of the study group were physicians. 43.7% of the study group stated that they had not recieved any education regarding child abuse and neglect, and 52.1% stated that they believed that physical abuse was the most prominent form of abuse in society. While 64.1% of the participants stated that they had heard about SBS, 10.4% of these stated that they had heard about it, but did not have adequate knowledge on the topic. CONCLUSION: There is a lack of knowledge and a need for education regarding child abuse and neglect among the personnel working in primary healthcare, especially on the subject of SBS. Undergraduate and postgraduate education regarding child abuse and SBS will help to increase the number of people well-informed and sensitive to this important issue.

Awareness of Migraine Among Primary Care Physicians in Turkey: A Regional Study.

INTRODUCTION: Migraine is a primary headache that involves genetic and environmental factors. In studies conducted in different countries, migraine was shown to be underdiagnosed, treated insufficiently, and highly related to disability. The primary aim of this study was to identify the competence in making a diagnosis of migraine by primary care physicians who provide basic health care to patients. METHODS: Primary care physicians (266 individuals) working in the primary health service centers located within the borders of Kayseri province were included in our study. The research was conducted by using techniques such as face-to-face meetings with the primary care physicians and by participants filling in questionnaires. A neurologist evaluated the questionnaire form. The information provided by the participants was evaluated according to the migraine without aura diagnostic criteria prepared by the International Headache Society (ICHD-3 Beta). RESULTS: Only 10.5% participants were able to give the complete diagnostic criteria of migraine without aura. The most well-known properties were unilateral (53.4%) and pulsating headaches (47%). CONCLUSION: This study showed that educational programs are required regarding migraines for primary care physicians, supported by complete educational material.

Risk factors for overweight and obesity in children aged 2-6 years.

BACKGROUND: Understanding risk factors that may vary culturally can help improve preventive strategies for obesity. This is the first cross-sectional study aimed to determine the risk factors for overweight/obesity in children aged 2-6 years in a central Anatolian city in Turkey. METHODS: A total of 1582 children (1351 healthy, 231 overweight/obese) aged 2-6 years were included from the Anthropometry of Turkish Children aged 0-6 years database. Age, gender, birth weight, birth order, mother's age, mother's body mass index (BMI), weight gain of mothers during pregnancy, presence of gestational diabetes, breastfeeding duration, history of formula feeding, mother's and father's education, mother's job, monthly income, smoking at home and physical activity, sleep duration and duration of television (TV) watching of the children were evaluated as independent risk factors. Logistic regression analyses were performed to investigate risk factors for overweight/obesity. RESULTS: Having a high family income compared to bad [odds ratio (OR)=1.96; 95% confidence interval (CI): 1.237-3.106], increased the time of watching TV during the weekend (OR=1.094; 95% CI: 1.032-1.159), and similar physical activity level according to their peers compared to less (OR=2.957; 95% CI: 1.056-8.282) were found to be significantly associated with a higher risk of overweight/obesity in children aged 2-6 years old. CONCLUSIONS: The early childhood period seems to be important in the establishment of healthy behavioral patterns, especially limitation of TV watching and encouragement of physical activity. Obesogenic environment in families with high incomes need to be revealed.

Risk-Factors and Awareness of HPV in Turkish people with Anogenital Warts in Bagcilar district: a Cross-Sectional Study.

BACKGROUND: Anogenital warts (AGWs) are epithelial tumors which develop as a result of human papilloma virus (HPV) infection. We aimed to assess the sociodemographic, sexual and other possible risk-factors, and awareness of the HPV infection among Turkish people with AGW in the Bagcilar district of Istanbul. METHODS: A cross-sectional study was conducted on 273 patients (183 men, 90 women) with AGW between October 2014 - March 2015. The patients' sociodemographics were recorded along with their possible risk-factors and clinical findings. The patients' answers to questions regarding HPV/AGW were checked for awareness. Data were analyzed by Chi-square test using SPSS (Statistical Package for the Social Sciences) version 15.0. The results were evaluated with P < 0.05 considered significant. RESULTS: The major parameters detected were 26-39 age-range (52.6%), self-employed (54.6%), primary school graduate (44,7%), low/middle income (91.2%), married (59.3%), heterosexual (98.9%), sexually active (93.8%), sex in previous 3 months (87,6%), multi-partners (53.5%), partners without AGW (60.8%), mixed location (32.2%), concomitant verruca on hands (26%), 3-6 month duration (38.8%), non-recurrent lesion (98.2%), tinea cruris [TC](25.3%) and smoking (54.2%). However, self-employed (70.5%), middle-income (47%), polygyny (71.6%), pubic-location (43.2%), long-duration (46.4%), concomitant TC (31.7%) diabetes mellitus (9.8%), and verruca on hands (33.3%) were mostly encountered in males, while housewife (57.7%), low-income (60%), monoandry (67.8%), perianal-location (48.9%), short-duration (58.9%), smoking (64.4%), concomitant candidiasis (15.6%) and  depression (31.1%) were mostly found in females. Awareness of HPV hearing, HPV-AGW and HPV-cancer relationships, transmission-routes, risk-factors (each at 5.5%), and prevention methods (2.2%) was very low. CONCLUSIONS: AGWs are seen in sexually-active, less-educated, married heterosexuals in Bagcilar. Self-employed, middle-income, polygyny, pubic-location, long-duration, concomitant TC and diabetes mellitus, and verruca on hands are mostly seen in males, while housewife, low-income, monoandry, perianal-location, short-duration, smoking, candidiasis and depression are more common in females. Awareness is very low.

Knowledge and Attitudes of Medical and Non-Medical Turkish University Students about Cervical Cancer and HPV Vaccination.

BACKGROUND: This study was conducted to determine knowledge, attitudes and practices about cervical cancer and HPV vaccination of students studying in various faculties of Erciyes University. MATERIALS AND METHODS: The study was performed among the first and fourth grade students of Medicine, Theology, Education and Economics and Administrative Sciences (FEAS) faculties of Erciyes University. It was aimed to reach 1,073 students and 718 were evaluated. A questionnaire consisting of 48 questions related to the socio-demographic characteristics, knowledge, attitude and practices about cervical cancer and HPV vaccination was administered to the students. The chi-square test and logistic regression were used for the statistical analyses. RESULTS: Of the students, 78.3% were aware of cervical cancer, while 36.1% of them were aware of the HPV vaccine. The percentage hearing about cervical cancer and HPV vaccination was significantly higher among the students of the medical faculty than the others and among fourth grade students comparing with the first grade. The marital status and the presence of a health worker in the family had no significant impact on the knowledge level of the students. The acceptability of the HPV vaccination was low among all students. CONCLUSIONS: The knowledge levels of the university students about cervical cancer and HPV vaccination are inadequate. This deficiency is more pronounced among the non-medical students and there is no significant increase during the faculty years. Non-medical students must be provided with information about important public health issues by elective courses. HPV vaccination could provide many benefits for men and women by decreasing the morbidity and mortality of cervical, anal, and penile cancers.

Breast and Cervical Cancer Related Practices of Female Doctors and Nurses Working at a University Hospital in Turkey.

BACKGROUND: Breast and cervical cancers are among the most frequent and most fatal cancers in women. Life span of patients may be increased and quality of life improved through early diagnosis and treatment. This investigation was performed in order to determine knowledge and practices of female health personnel working at a university hospital regarding breast and cervical cancers. MATERIALS AND METHODS: This descriptive investigation was performed in Erciyes University Hospitals in 2014. A total of 524 female health personnel were included in the study. Data were collected through a questionnaire of 36 questions prepared by the researchers. The Chi square test and logistic regression were used for statistical analyses. RESULTS: The mean age of the study group was 32.8±6.9 years, 18.3% being doctors and 81.7% nurses. Of the study group, 60.5% stated that they performed self breast-examination, 4.4% underwent HPV testing, 26.3% thought about taking an HPV test, 34.7% of those who are 40 years and over had mammography regularly and 19.5% of those who were married had a Pap smear conducted regularly. Most important causes of not performing the methods for early diagnosis of breast and cervical cancers are "forget and neglect". CONCLUSIONS: It was concluded that female doctors and nurses do not pay sufficient attention to screening programs for breast and cervical cancers. The importance of early diagnosis and treatment should be emphasized during the undergraduate education and in-service training programs. Health condition of personnel and their utilization of preventive health care should be followed by occupational physicians.

Tularemia outbreaks in Kayseri, Turkey: an evaluation of the effect of climate change and climate variability on tularemia outbreaks.

OBJECTIVES: The aim of this study was to evaluate the epidemiological characteristics of tularemia outbreak and the effect of climate variability on this outbreak in Kayseri. METHODS: The outbreak places, infection dates, source of infection, and the number of cases were recorded and analyzed. This information was obtained from the Regional Public Health Department. Climate data were supplied by the Regional Meteorological Service. RESULTS: The first case in Sariz was recorded in 2005. Thereafter, 2 cases were reported in 2006 and 1 case in 2007. During 2010, 21 cases were recorded in 7 towns, 62 cases in 2011 and 27 cases in 2012. A total number of 110 cases were recorded in 12 out of 16 towns in Kayseri Province between 2010 and 2012. The majority of cases were seen in the north-eastern, east and south-eastern parts of Kayseri Province; located in higher altitudes (over 1000m from sea level). It was accepted that the outbreak was originated from water sources and was confirmed by few number of water samples collected from outbreak areas. Considering climate variations, the outbreak occurred between 1988 and 2009 during a dry, low humid, high temperature period after rainy season. CONCLUSION: A tularemia outbreak was observed between 2010 and 2012 with the initiation of rainy years. High temperature for a long period accompanied by low rainfall and low humidity may affect the vector's biology and initiate a tularemia outbreak in high plateaus in Kayseri Province and around.

Preferences and related factors for postpartum contraception in pregnant women.

BACKGROUND: The postpartum period is a time of transition for a pregnant woman and her new family. In this period many pregnant women are in search about the family planning methods. But contraceptive options differ depending on women's desires such as cultural and religious believes, partner attitudes, previous contraceptive experiences. OBJECTIVE: This study was conducted to identify status of using a contraceptive method before pregnancy and the factors associated with preferences of contraception in postpartum period. MATERIALS AND METHODS: The descriptive research was conducted in a State Hospital March-May 2012 in Turkey. The population of study was formed with 200 pregnant women who applied follow-up pregnant clinics. We took permissions from local authorities and participants. 182 voluntary pregnant women were surveyed. We prepared a 20 item question are form which was asking socio-demographic futures, contraceptives methods before-after delivery and the factors related with using contraceptives after screening literatures related with subject. RESULTS: The 49.5% of women reported that they didn't use any methods before. There was a significant relation between using contraceptives before pregnancy with the idea of using contraceptive during the postpartum period and receiving contraception counseling during pregnancy (p=0.004, p=0.035 respectively). CONCLUSION: The 86.4% of pregnant implied that they would use a contraceptive method in postpartum period. IUD was the most preferred method. Status of using contraceptive before and receiving contraception counseling in pregnancy were the effective variables on thoughts about using a contraceptive method. To achieve desired goals for maternal and child health in our country health professionals should be more focused on postpartum contraception in antenatal care programs.

Prevalence and risk factors of onychomycosis in primary school children living in rural and urban areas in Central Anatolia of Turkey.

BACKGROUND: Onychomycosis is a world-wide public health concern in children, requiring epidemiological data for different regions for control and prevention. AIM: The aim of this study was to evaluate the predominant pathogens and risk factors for onychomycosis in school children living in Kayseri, Turkey. METHODS: This study included 8122 school children, aged 5-16 years, living in the rural and urban areas around Kayseri. Onychomycosis was clinically classified as distal and lateral subungual (DLSO), proximal subungual, superficial white, endonyx and totally dystrophic onychomycosis. Nail samples from children with clinically diagnosed onychomycosis were collected, examined by direct microscopy and inoculated for culture study. The demographic features and possible risk factors were recorded and assessed by logistic regression models. RESULTS: We clinically diagnosed onychomycosis in 152 out of 8,122 (0.18%) school children. DLSO was the most frequent clinical diagnosis (120/152, 78.9%). Culture-positive onychomycosis was detected in 27/152 (17.7%) children. The prevalence of culture-positive onychomycosis was determined as 0.33%. All culture-positive samples were only from toenails. The onychomycosis causative agents were dermatophytes in 17/27 cases (62.9%), including Trichophyton rubrum 12 (44.4%), Trichophyton mentagrophytes 1 (3.7%), Trichophyton tonsurans 1 (3.7%) and Trichophyton spp. 3 (11.1%) and yeasts in 10/27 cases (37.1%), including Candida glabrata 4 (14.8%), Candida parapsilosis 1 (3.7%), Trichosporon 2 (7.4%) and Rhodotorula 3 (11.1%). Age, father's occupation, number of siblings and rooms were statistically associated with the frequency of onychomycosis. CONCLUSIONS: Although to be prevalence of onychomycosis in school children in central Anatolia of Turkey seems very low degree, pediatric onychomycosis is a growing public health concern all over the world. Children having more siblings or unemployed fathers and children living in small house as well as older children should be examined carefully for onychomycosis.

Comparison of life quality of pregnant adolescents with that of pregnant adults in Turkey.

OBJECTIVES: This study aimed to determine the quality of life of pregnant adolescents aged < 20 years and pregnant adults aged between 20-29 years, to evaluate the effects of gestational periods on the quality of life, and to compare the quality of life scores of pregnant adolescents and adults. METHODS: This study was performed in Turkey in 2007. Totally, 147 pregnant adolescents aged < 20 years and 156 pregnant adults aged between 20 and 29 years were included. A questionnaire on socio-demographic and obstetric characteristics was administered by face-to-face interviewing method, and Short Form-36 scale was applied. RESULTS: The mean quality of life scores ranged between 44.2 and 56.1 points for the adolescents and between 44.6 and 59.9 points for the adults. All quality of life scores, except bodily pain, were lower for adolescents than for adults. It was determined that the quality of life scores in pregnancy were generally lower in the first trimester, significantly increased in the second trimester, and decreased to the lowest level in the third trimester. CONCLUSIONS: Quality of life scores of the pregnant adolescents were significantly lower than the pregnant adults. Physical care, support, and education programs may be beneficial to increase the quality of life levels in pregnancy.

[The seroprevalence of Toxoplasma gondii among prisoners in the Kayseri closed prison]. / Kayseri Kapali Cezaevi Mahkumlarinda Toxoplasma gondii Seroprevalansi.

Toxoplasmosis is a zoonosis caused by Toxoplasma gondii and can be found in humans, domestic animals and wild animals almost everywhere around the world. The aim of this study was to investigate the seroprevalence of toxoplasmosis among the 628 prisoners in the Kayseri Closed Prison. Anti-Toxoplasma gondii IgG and IgM antibodies were investigated in the serum specimens with the IFA method. Two hundred and thirty six (37.58%) prisoners were anti-T. gondii IgG seropositive and 11 (1.75%) were both IgG and IgM seropositive. There was no IgM seropositivity in IgG negative serum specimens.