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.

A digital movement in the world of inactive children: favourable outcomes of playing active video games in a pilot randomized trial.

This parallel randomized controlled trial was aimed to evaluate whether parameters as physical fitness, reaction times, self-perception and enjoyment levels, as well as parental and children perspectives, were affected by active video games in inactive and technologically preoccupied children. Data were collected in a laboratory setting from four randomly selected urban public schools. All 1300 children in grades 3-6 were surveyed for the study. Among the 918 responders, 106 children were determined to be inactive and preoccupied with technology. Children in 3 schools (n = 53) allocated to active video game and in one school (n = 53) allocated to control group were compared by univariate covariance analyses for primary outcomes such as weight, body mass index and fat ratios at the end of 12 weeks. Active video game group significantly showed favourable responses for weight, body mass index and corresponding z scores as well as reaction times and self-perception controlling for age and baseline scores. In addition, enjoyment of the children in the game group by qualitative analysis was high indicating a motivational aspect for the continuation of the games. Diverse contributions of games to physical, social, intellectual and personal development were revealed.Conclusion: Active video games by promoting enjoyment levels and physical activity, as well as contributing to agility, alertness, socializing, and striving, led to a reduction in weight gain. They may be used as beneficial tools diverting children from inactivity and subsequent obesity.Trial registration: This study called AVGAME is registered with the number NCT03720938 in Clinicaltrials.gov . The trial protocol can also be retrieved from the archives of Abant Izzet Baysal University. What is Known: • Nowadays, children prefer sedentary video games that are known to induce weight gain and obesity-related comorbidities. • Active video games were shown to decrease weight in overweight and obese children. What is New: • Active video games decrease weight increment and reaction times, thus could be used to prevent obesity in inactive non-obese children. • Active video games raise self-esteem, induce enjoyment, improve the personal and intellectual development of children in addition to socializing and is a safe alternative to indoor sedentary video games.

The analysis of 8-year data (2002-2010) of the tumor cases based on the pathology records of Abant Izzet Baysal University medical faculty department.

AIM: Cancer is one of the most significant health problems throughout the world. An important aspect of measures against cancer is to determinate the extension and prevalence of the cancer. Understanding characteristics and behavior of cancer is the key issue in providing preventive steps and developing proper strategies in the concept of early diagnosis and treatment. The objective of this study was to determine the regional cancer incidence and cancer types based on the pathology records of Department of Pathology, Medical School, Abant Izzet Baysal University. Secondly. The aim was to discuss the properties of these cases with other similar reports both from Turkey and the world. MATERIALS AND METHODS: All pathology records of the cases were evaluated who diagnosed at The Department of Pathology, Medical School, Abant Izzet Baysal University between December 20, 2002 and December 31, 2010. The results were classified according to year, age, sex and organ systems. Statistical analyses were carried out using Open Office version 3.1 and PSPP 0.7.2. The duplication of data was particularly prevented by excluding the multiple records in the case of more than one biopsies of the same cancer in the same patient. RESULTS: Totally 18654 pathology records were analyzed. The ratio of positive cases was 24.18% (4510/18654) of including all benign and malignant tumors. Among them 1984 (43.99%) were male and 2526 (56.01%) were female. On the other hand, malignant tumors constituted 33.35 % (1504/18654) of all cases and the percentage of male and female patients were 67.81 % (1020/1504) and 32.19 % (484/1504) respectively. The occurrence of malignant tumors was mostly seen between 60 and 69 age group, while the predominant age period was between 50 and 59 when considering both benign and malignant patients. Male patients had cancers mostly after 60 age group and the predominant period was between 60 and 69 ages. Considering the female patients only, they had more cancers between 10 and 60 age group than males, and the most prevalent period was between 40 and 49 years. The prevalence of both benign and malignant tumors with respect to their origin were skin( 30.15%), female genital tract (21.57%) and gastrointestinal system (12.92%). Considering only the malignant tumors, the distribution was as skin (21.07%), male genital tract (17.82%) and gastrointestinal tract (14.96%). On the other hand, the order of cancers was skin (31.29%), gastrointestinal tract (17.69%), male genital tract (14.81%) in male patients, while it was as female genital tract (38.50%), skin (29.30%), gastrointestinal tract (9.20%) for the female patients. CONCLUSION: Due to our datas, our results are similar to the results in Turkey and the World. The reason of the lower incidence of some tumors such as lung tumors which are much higher in Turkey and the world may depend on technical inadequacy due to our faculty's being a newly established one.

The association between thyroid malignancy and chronic lymphocytic thyroiditis: should it alter the surgical approach?

BACKGROUND: The relation between thyroid neoplasms and chronic lymphocytic thyroiditis (CLT) is controversial. While it is accepted that focal lymphocytic thyroiditis develops secondarily to malignancy, it is not clear whether diffuse lymphocytic thyroiditis has a tendency to develop into thyroid cancer. The aim of this study was to investigate the relation between CLT and malignant tumours of the thyroid and evaluate the surgical approach to CLT cases. MATERIAL AND METHODS: In this study, 917 patients operated on for thyroid diseases were investigated retrospectively. Seventy-seven (8.4%) patients histopathologically diagnosed as having CLT (either non-specific or Hashimoto's thyroiditis) were investigated for any concurrent malignant neoplasm. Fifteen patients in whom CLT and thyroid malignancy were coexisting were included in the study. RESULTS: In the pathological evaluation of 917 cases, malignancy in the thyroid was found in 97 (10.6%) cases. Seventy-seven cases were categorised as CLT. Of these 77, 16 (20.8%) were Hashimoto's thyroiditis (specific CLT) and the other 61 (79.2%) were non-specific CLT. In 15 cases, thyroid malignancy was found to be concurrent with CLT. Of the malignities, nine (60%) were papillary carcinoma, three (20%) medullar carcinoma, one (6.6%) follicular carcinoma, one (6.6%) Hurthle cell carcinoma, and one (6.6%) lymphoma. In our series, the rate of the development of malignancy against the background of CLT was 19.48%, while the rate in the groups without CLT was 9.76%, with a statistically significant difference between the groups (p = 0.008). CONCLUSIONS: CLT cases should be evaluated more carefully in terms of malignancy. If a nodule is detected on thyroiditis, the minimal surgical intervention should be lobectomy. Total thyroidectomy should be considered as preferable to subtotal thyroidectomy because of its many advantages such as controlling thyroiditis, removing the probability of reoperation, and hormonal stability.

Salivary alpha amylase activity in migraine patients.

OBJECTIVE: Salivary alpha amylase levels were measured to investigate sympathetic nervous system activity in migraine patients during attack, post-attack and interval periods of headache since salivary alpha amylase levels have been suggested as a potential indirect marker of sympatho-adrenal medullary activity in recent studies. METHODS: 50 patients with migraine headache (13 patients in attack, 26 patients in post-attack and 11 patients in interval period) and 60 healthy volunteers were taken into the study. In all participants, the presence of anxiety was measured by using Hamilton Anxiety Rating scale. The visual analog scale scores for pain level estimation were obtained in the attack group. RESULTS: The salivary alpha amylase levels were significantly lower in attack period (p<0.01) and higher in post-attack period (p<0.01) when compared with the control group. There was not any significant difference in salivary alpha amylase levels between interval period and control group (p>0.05). There was a weak negative correlation between the salivary alpha amylase levels and the visual analog scale scores. CONCLUSIONS: This is the first study showing the dynamic nature of sympathetic nervous system activity by evaluating the salivary alpha amylase levels-a noninvasive, reliable and an easy method-in different periods of migraine headache.

Use of GIS in epidemiology: a case study in Istanbul.

In this study, the procedure of using GIS for tracking the distribution of measles in a district of Istanbul was performed. The aim of the study is to present the available questionnaire data, which were collected during the measles epidemic, by means of maps. The designed maps show the relation and the distribution of individual cases on time and spatiality. A database is designed according to the questionnaires. Geo-spatial distribution of measles cases was analyzed. The obtained results were discussed and presented.