The relation between digital literacy, cyberchondria, and parents' attitudes to childhood vaccines.

PURPOSE: This study aimed to examine the relationship between digital literacy, cyberchondria and parents' hesitancy about childhood vaccines. DESIGN AND METHODS: The study was cross-sectional, and parents with children aged 3-5 years who had access to the questionnaire were sent online and volunteered to participate. RESULTS: The total mean score of the Parents' Attitude to Childhood Vaccines Scale was 44.89 ± 14.99, 31.3% of the parents were hesitant about childhood vaccines. Parental hesitancy about childhood vaccinations was 3.26 times (95% CI, 1.56-6.81) for single participants and 2.77 times (95% CI, 1.33-5.74) for the participants with a high school diploma than primary school graduates, 4.69 times for the participants who did not have a healthcare professional in their family (95% CI, 2.08-10.59), 16.02 times (95% CI, 6.61-10.80) for the participants who did not have a full round of vaccines, 1.81 times higher (95% CI, 1.13-2.88) than the participants who did not have enough information about vaccines. Hesitancy increased as the cyberchondria severity score increased (95% CI, 1.02-1.09), and digital literacy decreased (95% CI, 0.34-0.87). CONCLUSIONS: One-third of the parents had hesitations about childhood vaccines. Vaccine hesitancy is affected negatively by digital literacy and positively by cyberchondria. PRACTICE IMPLICATION: Meeting parents' accurate and reliable vaccine information will positively affect their attitudes and behaviours. Therefore, the level of cyberchondria among parents should be reduced, and their digital literacy should be increased.

Validity and Reliability of the COVID-19 Knowledge, Attitude and Behavior Scale.

BACKGROUND: The aim of this research is to develop a scale that will evaluate the knowledge, attitudes and behaviors of employees about COVID-19 and to test its validity and reliability. METHODOLOGY: The methodological type of research was used between August-November 2020, under observation in organized industrial zones. Information was collected from a total of 543 employees. Confirmatory factor analysis and correlation analysis were performed for the value, item-total correlations and construct validity. SPSS 25.0 (IBM Inc., Armonk, NY, USA), Jasp 0.14 (University of Amsterdam) and Lisrel 9.1(Scientific Software International, Inc., Chapel Hill, NC, USA) programs were used in the analysis. RESULTS: 83.1% of the participants in the study are male, the average age is 37.4 ± 8.0, 76.1% are married, and 49.4% are high school graduates. The Cronbach alpha value of the COVID-19 information part is 0.86 in total, the contamination information dimension is 0.71 and the protection information dimension is 0.84. The COVID-19 attitude section consists of four sub-dimensions and 13 items classified within the framework of the health belief model. In summary, the goodness of fit values for the knowledge, attitude and behavior sections, respectively, are: RMSEA values 0.05, 0.03 and 0.04; CFI values 0.98, 0.98 and 0.99; GFI values 0.97, 0.97 and 0.99. CONCLUSIONS: It has been determined that the internal consistency of the COVID-19 knowledge, attitude and behavior scale conducted on employees is high and compatible, and its validity findings are sufficient. The scale is recommended as an applicable tool to measure COVID-19 knowledge, attitudes and behaviors.

How to reduce pesticide exposure in farmers: An interventional study.

BACKGROUND: Pesticide poisoning is a serious public health problem. OBJECTIVE: The aim was to investigate the effect of safe pesticide application training given to farmers on their behaviors towards compliance with protective measures. METHODS: In this interventional study, the target population was 9750 farmers living in Turkey. To achieve a study power of 95%, type I error and the effect size were assumed as 5% and 0.50 respectively. In the study, 61 farmers were selected using the systematic sampling method. Farmers were interviewed twice, before and after the training, and at each interview, they were asked questions about their pesticide use-related behaviors in the last four sprayings. In the analysis, the paired t-test, repeated measures of ANOVA (post hoc: Bonferroni) were used. RESULTS: The scores the participants obtained from the Pesticide Exposure Prevention Behavior Form which questions their compliance with protective measures taken during pesticide applications at the post-interview were significantly higher than were the scores they obtained at the pre-interview (P < 0.001). The analysis of the independent variables demonstrated that the scores obtained from the Pesticide Exposure Prevention Behavior Form at the post-interview were significantly different from those obtained at the pre-interview in almost all of the subgroups in terms of their sociodemographic characteristics. CONCLUSION: It was observed that the training given to the farmers on the safe use of pesticides encouraged the farmers to develop positive behavioral changes. The study emphasizes the importance of implementing ongoing health education programs for farmers.

The Effect of Perceived Stress and Digital Literacy on Student Satisfaction with Distance Education.

OBJECTIVE: To examine the relationship between perceived stress/digital literacy and student satisfaction in health science college students in the distance education process. METHOD: The cross-sectional study was conducted by collecting data from 842 students. The dependent variable was student satisfaction in distance education. For the analyses, t-test, ANOVA (post hoc: Bonferroni), and linear regression methods were used. RESULTS: Distance education student satisfaction was 178.21 ± 48.64. Student satisfaction was low among those who think that distance education is not more effective than face-to-face education, live in villages/towns, and have high perceived stress. Student satisfaction was high among those who do not have limited internet access, can access the internet via computer, follow the lessons regularly every week, think distance education is applicable in the health domain, can acquire instant feedback from the instructor, and have increased digital literacy. CONCLUSION: Distance education student satisfaction was found to be moderate. Student satisfaction in distance education increases as perceived stress levels decrease and digital literacy levels increase.

Health literacy and quality of life among people in semi-urban and urban areas.

OBJECTIVE: to investigate health literacy level, quality of life and related factors in semi-urban and urban areas. METHOD: this cross-sectional study was carried out between December 2018 and February 2019 with 595 participants. The variables found significant in the bivariate regression analysis were included in the multivariate regression analysis. RESULTS: according to the scores obtained from the Health Literacy Scale, participants' health literacy 76.5% levels were adequate. The factors affecting the Health Literacy Scale score in semi-urban areas were educational status, income status, presence of a chronic disease, perceived health, and understanding the health information provided. The factors affecting the Health Literacy Scale score in urban areas were age, marital status, reading habits, presence of a chronic disease, and understanding the health information provided (p < .05). There was a statistically significant difference between participants living in semi-urban and urban areas in terms of their health literacy and quality of life levels (p < .001). CONCLUSION: the health literacy level was inadequate in three out of ten participants, and it was even lower in semi-urban areas.

Health literacy and quality of life among people in semi-urban and urban areas / Letramento em saúde e qualidade de vida entre pessoas em áreas semiurbanas e urbanas / Alfabetización en salud y calidad de vida entre personas en áreas semiurbanas y urbanas

Abstract Objective: to investigate health literacy level, quality of life and related factors in semi-urban and urban areas. Method: this cross-sectional study was carried out between December 2018 and February 2019 with 595 participants. The variables found significant in the bivariate regression analysis were included in the multivariate regression analysis. Results: according to the scores obtained from the Health Literacy Scale, participants' health literacy 76.5% levels were adequate. The factors affecting the Health Literacy Scale score in semi-urban areas were educational status, income status, presence of a chronic disease, perceived health, and understanding the health information provided. The factors affecting the Health Literacy Scale score in urban areas were age, marital status, reading habits, presence of a chronic disease, and understanding the health information provided (p < .05). There was a statistically significant difference between participants living in semi-urban and urban areas in terms of their health literacy and quality of life levels (p < .001). Conclusion: the health literacy level was inadequate in three out of ten participants, and it was even lower in semi-urban areas.

RESUMO Objetivo: investigar o nível de letramento em saúde, qualidade de vida e fatores relacionados em áreas semiurbanas e urbanas. Método: este estudo transversal foi realizado entre dezembro de 2018 e fevereiro de 2019 com 595 participantes. As variáveis encontradas significativas na análise de regressão bivariada foram incluídas na análise de regressão multivariada. Resultados: de acordo com os escores obtidos na Health Literacy Scale, os níveis de letramento em saúde dos participantes de 76,5% estavam adequados. Os fatores que afetaram a pontuação da Health Literacy Scale em áreas semiurbanas foram escolaridade, renda, presença de doença crônica, percepção de saúde e compreender as informações de saúde fornecidas. Os fatores que afetaram a pontuação da Health Literacy Scale em áreas urbanas foram idade, estado civil, hábitos de leitura, presença de doença crônica e compreender as informações de saúde fornecidas (p < 0,05). Houve uma diferença estatisticamente significativa entre os participantes que vivem em áreas semiurbanas e urbanas em termos de letramento em saúde e níveis de qualidade de vida (p < 0,001). Conclusão: o nível de letramento em saúde foi inadequado em três dos dez participantes, sendo ainda menor nas áreas semiurbanas.

RESUMEN Objetivo: investigar el nivel de alfabetización en salud, calidad de vida y factores relacionados en áreas semiurbanas y urbanas. Método: este estudio transversal se realizó entre diciembre de 2018 y febrero de 2019 con 595 participantes. Las variables que se encontraron significativas en el análisis de regresión bivariante se incluyeron en el análisis de regresión multivariante. Resultados: según los puntajes obtenidos en la Health Literacy Scale, los niveles de alfabetización en salud de los participantes del 76,5% fueron adecuados. Los factores que afectaron los puntajes de la Health Literacy Scale en áreas semiurbanas fueron la educación, los ingresos, la presencia de enfermedades crónicas, la salud percibida y comprender la información de salud proporcionada. Los factores que afectaron el puntaje de la Health Literacy Scale en áreas urbanas fueron la edad, el estado civil, los hábitos de lectura, la presencia de una enfermedad crónica y comprender la información de salud proporcionada (p < 0,05). Hubo una diferencia estadísticamente significativa entre los participantes que vivían en áreas urbanas y semiurbanas en términos de alfabetización en salud y niveles de calidad de vida (p < 0,001). Conclusión: el nivel de alfabetización en salud fue inadecuado en tres de cada diez participantes, y fue aún más bajo en las áreas semiurbanas.

The Effect of Perceived Stress and Digital Literacy on Student Satisfaction with Distance Education / O efeito do estresse percebido e do letramento digital na satisfação do aluno quanto à educação a distância / El efecto del estrés percibido y la alfabetización digital en la satisfacción de los estudiantes en educación a distancia

ABSTRACT Objective: To examine the relationship between perceived stress/digital literacy and student satisfaction in health science college students in the distance education process. Method: The cross-sectional study was conducted by collecting data from 842 students. The dependent variable was student satisfaction in distance education. For the analyses, t-test, ANOVA (post hoc: Bonferroni), and linear regression methods were used. Results: Distance education student satisfaction was 178.21 ± 48.64. Student satisfaction was low among those who think that distance education is not more effective than face-to-face education, live in villages/towns, and have high perceived stress. Student satisfaction was high among those who do not have limited internet access, can access the internet via computer, follow the lessons regularly every week, think distance education is applicable in the health domain, can acquire instant feedback from the instructor, and have increased digital literacy. Conclusion: Distance education student satisfaction was found to be moderate. Student satisfaction in distance education increases as perceived stress levels decrease and digital literacy levels increase.

RESUMO Objetivo: Examinar a relação entre estresse percebido e letramento digital com a satisfação de alunos de faculdades de ciências da saúde no processo de educação a distância. Método: O estudo transversal foi realizado por meio da coleta de dados de 842 alunos. A variável dependente foi a satisfação dos alunos na educação a distância. Para as análises, foram utilizados os métodos de teste t, ANOVA (post hoc: Bonferroni) e regressão linear. Resultados: A satisfação dos alunos de educação a distância foi de 178,21 ± 48,64. A satisfação dos alunos foi baixa entre aqueles que pensam que a educação a distância não é mais eficaz do que a educação presencial, que moram em vilas/cidades e apresentam alto estresse percebido. A satisfação dos alunos foi alta entre aqueles que não têm acesso limitado à internet, podem acessar a internet pelo computador, acompanhar as aulas regularmente toda semana, acham que a educação a distância é aplicável no domínio da saúde, podem adquirir feedback instantâneo do instrutor e têm maior letramento digital. Conclusão A satisfação dos alunos de educação a distância foi considerada moderada. A satisfação dos alunos na educação a distância aumenta à medida que os níveis de estresse percebido diminuem e os níveis de letramento digital aumentam.

RESUMEN Objetivo: Examinar la relación entre el estrés percibido y la alfabetización digital con la satisfacción de los estudiantes de la facultad de ciencias de la salud en el proceso de educación a distancia. Método: El estudio transversal se realizó mediante la recopilación de datos de 842 estudiantes. La variable dependiente fue la satisfacción de los estudiantes en educación a distancia. Para los análisis, se utilizaron métodos de prueba t, ANOVA (post hoc: Bonferroni) y regresión lineal. Resultados: La satisfacción de los estudiantes de educación a distancia fue de 178,21 ± 48,64. La satisfacción de los estudiantes fue baja entre aquellos que piensan que la educación a distancia no es más efectiva que la educación presencial, los que viven en aldeas/pueblos y con un alto nivel de estrés percibido. La satisfacción de los estudiantes fue alta entre aquellos que no tienen acceso limitado a Internet, pueden acceder a Internet a través de una computadora, siguen las lecciones con regularidad todas las semanas, piensan que la educación a distancia es aplicable en el ámbito de la salud, pueden obtener retroalimentación instantánea del instructor y tienen un mayor conocimiento de alfabetización digital. Conclusión: Se encontró que la satisfacción de los estudiantes de educación a distancia es moderada. La satisfacción de los estudiantes en la educación a distancia aumenta a medida que disminuyen los niveles de estrés percibido y aumentan los niveles de alfabetización digital.

Relationship between farmers' knowledge and attitudes towards pesticide use and their sociodemographic characteristics: a cross-sectional study from north-western Turkey.

BACKGROUND: The determination of farmers' knowledge and attitudes towards pesticide use is very important in terms of preventing pesticide use-related short- and long-term damages. OBJECTIVE: This study was aimed at investigating the relationship between the sociodemographic characteristics of farmers in Karacabey District of Bursa, a province in northwest Turkey, and their knowledge and attitudes towards pesticide use. MATERIAL AND METHODS: This cross-sectional study was conducted in Karacabey district between December 2018 and April 2019. The sample size was calculated as 1924 using the Epi info program by assuming the prevalence as 50%, type I error as 5%, standard deviation as 3% and design effect as 2. The dependent variable of the study was the farmers' knowledge of and attitudes towards pesticide use whereas the independent variables were their sociodemographic characteristics. The relationship between the dependent and independent variables was analyzed using the chi-square test and binary logistic regression model. RESULTS: The mean score the participants obtained from the Knowledge and Attitude Index was 12.8±2.8 and the median value was 13. While 49.5% of the participating farmers obtained a score lower than the median, 51.5% of them obtained a score equal to or above the median. While advanced age increased the possibility of getting a low score from the Knowledge and Attitude Index 2.7 times, not being married increased it 35.7 times, not getting formal education increased it 30.1 times, living in a non-crowded household increased it 2.1 times, and low income (2000 Turkish liras equal to ≤$310 according to April 2019 exchange rates) increased it 3.1 times. CONCLUSION: The study indicated that the participating farmers' knowledge and attitudes towards the proper use of pesticides were inadequate, and that there was a strong relationship between their Knowledge and Attitude Index scores and their sociodemographic characteristics.

Occupational acute pesticide poisoning: a cross-sectional study of Turkish vegetable and fruit farmers based on self-reported symptoms and job characteristics.

BACKGROUND: Occupational pesticide poisoning is an important public health concern worldwide, especially in developing countries. OBJECTIVES: This study was aimed at determining the prevalence and risk factors of acute pesticide poisoning (APP) among the vegetable and fruit farmers in Karacabey District in northwest Turkey. METHODS: The study group consisted of 565 farmers. The dependent variable of the study is APP defined according to the World Health Organization's APP case definition matrix. The study's independent variables are the farmers' sociodemographic characteristics and the preventive measures they use when they are applying pesticides. The chi-square and logistic regression analysis analyzed the relationship between the dependent and independent variables. RESULTS: A total of 64 (11.3%) farmers reported APP and 75% of them presented to a health institution due to symptoms. The factors associated with increased risk of APP were: illiteracy (odds ratio (OR)=2.5), 14 years and less farming experience (OR=3.3), not reading the pesticide labels (OR=6.4), and contact with liquid pesticides (OR=2.3). -Conclusions: The study shows that approximately one out of ten farmers experience APP. Training programs should be planned and monitored to improve farmers' awareness of the dangers of pesticides, and they should be encouraged to adopt and implement protective measures.

The Predictive Strength of Students' Self-Efficacy, Problem Solving Skills to Perform Catheter Care.

PURPOSE: The aim of this study was to determine the predictive strength of students' self-efficacy, problem-solving skills, and other characteristics in performing intravenous practices and monitor phlebitis and infiltration. METHODS: This cross-sectional study was carried out with 736 third and fourth-year students studying at the Health Sciences Faculties of Balikesir and Sakarya universities. The data were collected using the Self-Efficacy Scale, Problem-Solving Inventory and Catheter Care and Infiltration Monitoring Questionnaire. RESULTS: The participants' mean Catheter Care and Infiltration Monitoring Questionnaire score significantly and positively correlated with their mean Self-Efficacy Scale score on a moderate level (r=.25; p <.001) but significantly and negatively correlated with their mean Problem-Solving Inventory score on a moderate level (r=-.21; p <.001). In other words, because a low Problem-Solving Inventory score indicates that the person's problem-solving skill is high, the Care and Infiltration Monitoring Questionnaire score increased as the problem-solving skill increased. While the Self-Efficacy Scale predicted the year of study and catheter care and infiltration monitoring variables positively, the Problem-Solving Inventory predicted the satisfaction with the profession variable negatively. CONCLUSION: Self-efficacy, problem-solving, liking the profession, and year of study predict success in catheter care and infiltration monitoring. For this reason, guidance may be provided in the development of a comprehensive education system toward increasing students' problem-solving skills, self-efficacy, and professional knowledge and skills.

Paraoxonase Activity and Phenotype Distribution in Patients with Chronic Obstructive Pulmonary Disease.

OBJECTIVE: Paraoxonase 1 (PON1) and arylesterase (ARE) enzymes have an important role in the prevention of oxidative stress which is related to the pathogenesis of chronic obstructive pulmonary disease (COPD). PON1 levels vary widely among individuals and ethnic groups, which is in part associated with polymorphisms. MATERIALS AND METHODS: We investigated PON1 and ARE activity and phenotype distribution in COPD patients and healthy individuals. Sixty six COPD patients and 59 control subjects were involved in the study. Serum PON1 and ARE activities were detected by spectrophotometric method. The ratio of salt-induced PON1 to ARE activity was used to determine phenotypes as QQ, QR, and RR. RESULTS: COPD patients exhibited higher PON1 activity (199.1 vs 129.2, p=0.002) but lower ARE activity compared to control (21.3 vs 33.5, p=0.021). There was a significant difference between COPD and control group with respect to PON1 phenotype characteristics. RR phenotypic distribution was more common in the COPD group than in control (60.6% [95% CI: 48.8 - 72.3] versus 22.0 % [95% CI: 12.0 - 31.9], p=0.001). We also found that smoking (95.0% CI: 0.001-0.036, p<0.001) and RR phenotype (95.0% CI: 0.006 - 0.59, p=0.016) are independent determinants in COPD. CONCLUSION: We found that RR phenotype was more common in COPD patients compared to control. Smoking and RR phenotype may be defined as independent factors associated with COPD.

Use of dietary supplements among nursing students in Turkey in the last 12 months and its relation with orthorexia nervosa.

PURPOSE: This study was aimed at investigating the use of dietary supplements among nursing students in Turkey in the last 12 months and its relation with orthorexia nervosa (ON). DESIGN AND METHODS: This cross-sectional study was conducted in Balikesir, a province in northwestern Turkey, between November and December 2019 included 560 nursing students. FINDINGS: Almost a fifth of the students had used dietary supplements in the last 12 months and the use of dietary supplements was associated with ON. PRACTICE IMPLICATIONS: Students should be screened for ON symptoms and attempts to reduce ON symptoms in students at risk should be implemented.

Association between the ADAMTS proteinases and obstructive sleep apnea.

BACKGROUND: A disintegrin and metalloproteinase with thrombospondin type-1 motifs (ADAMTS) proteinases have important roles in degradation/repairing of extracellular matrix (ECM). They are thought to play a key role in pathogenesis of many diseases. We aimed to investigate the association between ADAMTS 2, 3, and 14 (procollagen) and obstructive sleep apnea (OSA). METHODS: Eighty-six individuals who were suspected of OSA were included. All cases underwent polysomnography. Participants were divided into 3 groups according to apnea-hypopnea index (AHI): control (n = 22), mild-to-moderate OSA (n = 36), and severe OSA (n = 28). ADAMTS proteinases 2, 3, and 14 were analyzed in serum samples. RESULTS: When compared with other groups, patients with severe OSA showed significantly higher body mass index (BMI) (p = 0.001), whereas they showed significantly lower ADAMTS 3 levels (p = 0.016). No difference was found between groups with respect to the levels ADAMTS 2 and 14. There was a negative relation between the levels of ADAMTS 3 and the severity of OSA (Kendall's tau = - 0.19, p = 0.021). The levels of ADAMTS 3 were also found to be positively correlated with minimum SpO2 (r = 0.31, p = 0.004) and negatively correlated with BMI, AHI, oxygen desaturation index (ODI), time duration with oxygen saturation < 90% (T90), and CRP (r = - 0.31 to - 0.49, p < 0.05). Multivariable regression analysis revealed that BMI (p = 0.013) and CRP levels (p = 0.005) were significantly associated with the levels of ADAMTS 3. CONCLUSIONS: ADAMTS 3, one of the procollagen proteinases, was decreased in severe OSA. Lack of ADAMTS 3 proteinase may contribute to process of sleep apnea due to insufficient collagen syntheses.

The Predictive Strength of Students’ Self-Efficacy, Problem Solving Skills to Perform Catheter Care

Purpose@#The aim of this study was to determine the predictive strength of students’ self-efficacy, problem-solving skills, and other characteristicsin performing intravenous practices and monitor phlebitis and infiltration. @*Methods@#This cross-sectional study was carried outwith 736 third and fourth-year students studying at the Health Sciences Faculties of Balikesir and Sakarya universities. The data were collectedusing the Self-Efficacy Scale, Problem-Solving Inventory and Catheter Care and Infiltration Monitoring Questionnaire. @*Results@#Theparticipants’ mean Catheter Care and Infiltration Monitoring Questionnaire score significantly and positively correlated with their meanSelf-Efficacy Scale score on a moderate level (r=.25; p <.001) but significantly and negatively correlated with their mean Problem-SolvingInventory score on a moderate level (r=-.21; p <.001). In other words, because a low Problem-Solving Inventory score indicates that theperson’s problem-solving skill is high, the Care and Infiltration Monitoring Questionnaire score increased as the problem-solving skill increased.While the Self-Efficacy Scale predicted the year of study and catheter care and infiltration monitoring variables positively, theProblem-Solving Inventory predicted the satisfaction with the profession variable negatively. @*Conclusion@#Self-efficacy, problem-solving, likingthe profession, and year of study predict success in catheter care and infiltration monitoring. For this reason, guidance may be providedin the development of a comprehensive education system toward increasing students’ problem-solving skills, self-efficacy, and professionalknowledge and skills.

Unmet needs for family planning among married women aged 15-49 years living in two settlements with different socioeconomic and cultural characteristics: a cross-sectional study from Karabuk Province in Turkey.

AIM: The aim of the study was to investigate levels and related factors of the unmet needs for family planning among married women aged 15-49 years living in two settlements (rural and urban) having different economic, social and cultural structures in Karabuk, a province in north-western Turkey. METHOD: This cross-sectional study was conducted in the rural Cumayani village and the urban Emek neighbourhood between October 2016 and June 2017. The sample size was determined to be 289 married women aged 15-49 years from each settlement according to the effect size of 0.3, alpha error probability of 0.05 and power of 0.95. In the study, 594 currently married women (298 from Cumayani and 296 from Emek) were contacted. The dependent variable was the level of unmet need for family planning. The independent variables included the sociodemographic and reproductive characteristics of the women. The data were collected through face-to-face interviews. The characteristics of the two settlements were compared using the χ2 test. Bivariate and multivariate logistic regression analyses were carried out to examine the factors associated with the dependent variable. RESULTS: The comparison of the participants demonstrated that the education, employment and income levels of the rural women were lower than those of the urban women (p<0.001). The rural women had more pregnancies, miscarriages and stillbirths, and the mortality among their children was higher compared to the urban women (p<0.001). The level of unmet need for family planning in Cumayani village was about twice that of Emek neighbourhood (9.7% v 5.4%). The multivariate analysis was conducted separately for each settlement. Marrying by way of only a religious ceremony increased the level of unmet need for family planning by 4.61 times (95% confidence interval (CI) 1.3-16.1) (p=0.016) in Cumayani. The multivariate analysis of all the women participating in the study revealed that marriage by way of only a religious ceremony increased the level of unmet need by 4.96 times (95%CI 1.4-17.1) (p=0.011). CONCLUSION: The study showed the effects of socioeconomic and cultural factors on women's fertility behaviours and unmet needs for family planning to favour urban women. Not being married by civil marriage was a significant predictor of unmet need. These findings highlight a need for intervention, particularly for the empowerment of rural women, in order to improve reproductive health outcomes.

The role of high sensitive C-reactive protein and histopathological evaluation in chronic gastritis patients with or without Helicobacter pylori infection.

PURPOSE: To evaluate serum levels of high-sensitivity C-reactive protein (hs-CRP) in chronic gastritis patients to predict Helicobacter pylori (HP) infection, inflammatory activity, and precancerous lesions. METHODS: A total of 811 patients with upper gastrointestinal symptoms and histopathological diagnosis of chronic gastritis were enrolled in the study. On endoscopy, five gastric biopsies were taken according to Modified Sydney protocol, which were stained with hematoxylin & eosin and Giemsa. RESULTS: HP infection was found in 28.6% of patients, being significantly more common in specimens with acute and chronic inflammatory activity. Mucosal atrophy, intestinal metaplasia, and dysplasia were found in 20.2%, 18.8% and 2.7% of biopsy specimens. Mean hs-CRP was 1.9±1.6 mg/dl for males and 2.2±1.9 mg/dl for females. hs-CRP average were significantly higher in patients with severe acute inflammation (p:0.049), in patients with severe chronic inflammation (p:0.015) and in those with HP (p: 0.001) . The severity of HP infection increased significantly with the increased degree of acute inflammation, chronic inflammation and hs-CRP level (p=0.001 for both). CONCLUSION: Serum hs-CRP level increases in patients with chronic gastritis, it could be an indicator of severity of acute or chronic mucosal inflammation, and presence of HP infection. Therefore, hs-CRP may aid the diagnosis of chronic gastritis, but it is not associated with pre-cancerous lesions.

Prevalence and Correlates of the Use of Complementary and Alternative Medicine in Adults Living in a Rural Area.

There is growing interest in the use of complementary and alternative medicine (CAM) throughout the world; however, previous research performed in Turkey has not focused on CAM use in rural areas. The present study was aimed at determining CAM use among people aged 18 years or older living in Balikesir, a province in the western part of Turkey, and the correlates of CAM use. This cross-sectional study was conducted in Balikesir between January 2015 and April 2015. The sample group was reached with multistage cluster sampling method. The study included 410 people who agreed to participate. Data were collected with the questionnaire developed by the researchers from the households through face-to-face interviews. The data were analyzed using the descriptive statistics, chi-square test, and logistic regression analysis. Of the participants, 87.3% reported that they had used CAM in the past 12 months. While 39.4% of them preferred herbal products, 25.7% reported that they used CAM due to chronic pain. The results of the logistic regression model demonstrated that CAM use was 4.23 times higher in the age group of those 44 years of age and older, 7.32 times higher among the women, 11.11 times higher among those who had junior high school or lower education, 9.76 times higher among the employed participants and 15.12 times higher among those who had chronic diseases. The results of the study revealed that nearly 9 of every 10 participants used CAM methods and that the most commonly used method was the use of herbal products.

Reliability and validity of the Turkish version of the WHO-5, in adults and older adults for its use in primary care settings.

BACKGROUND: This study aims to determine the psychometric properties of the World Health Organization Well-Being Index (WHO-5) Turkish version in Turkish adults and older adults. METHODS: This is a multicenter cultural adaptation study carried out with 1752 participants. Internal consistency (by Cronbach's alpha); Construct validity (by known groups and confirmatory factor analysis-CFI) and discriminant validity are evaluated stratified by adults and older adults. Cohen's Effect Size is used in known groups and discriminant validity analyses. RESULTS: Distribution properties of the WHO-5 Turkish version are in acceptable limits. Alpha values are 0.81 for adults and 0.86 for older adults. The variances of the 58.5% of the adults sample and 63.9% of the older adults sample are explained in Exploratory FA. Model fits (CFI) are satisfactory ( > 0.95) in both samples; but RMSEA is poor in the older adults sample (0.166) whereas it is acceptable (0.073) in the adults sample. Known groups validity and discriminant analyses are satisfactory in both adults and older adults. CONCLUSION: The WHO-5 Turkish version has a good measurement capacity, internal consistency and good model fits in both samples. The error values in the older adults group suggest that the results when testing older adults should be interpreted with caution.

The role of high sensitive C-reactive protein and histopathological evaluation in chronic gastritis patients with or without Helicobacter pylori infection

Abstract Purpose: To evaluate serum levels of high-sensitivity C-reactive protein (hs-CRP) in chronic gastritis patients to predict Helicobacter pylori (HP) infection, inflammatory activity, and precancerous lesions. Methods: A total of 811 patients with upper gastrointestinal symptoms and histopathological diagnosis of chronic gastritis were enrolled in the study. On endoscopy, five gastric biopsies were taken according to Modified Sydney protocol, which were stained with hematoxylin & eosin and Giemsa Results: HP infection was found in 28.6% of patients, being significantly more common in specimens with acute and chronic inflammatory activity. Mucosal atrophy, intestinal metaplasia, and dysplasia were found in 20.2%, 18.8% and 2.7% of biopsy specimens. Mean hs-CRP was 1.9±1.6 mg/dl for males and 2.2±1.9 mg/dl for females. hs-CRP average were significantly higher in patients with severe acute inflammation (p:0.049), in patients with severe chronic inflammation (p:0.015) and in those with HP (p: 0.001) . The severity of HP infection increased significantly with the increased degree of acute inflammation, chronic inflammation and hs-CRP level (p=0.001 for both). Conclusion: Serum hs-CRP level increases in patients with chronic gastritis, it could be an indicator of severity of acute or chronic mucosal inflammation, and presence of HP infection. Therefore, hs-CRP may aid the diagnosis of chronic gastritis, but it is not associated with pre-cancerous lesions.

Change from health center to family physician period in the Turkish health system: A qualitative study.

INTRODUCTION: Health care reforms in Turkey have been implemented resolutely in the last 12 years. The shift from health center (HC) to a family physician (FP) approach is 1 of the basic interventions of these reforms. The goal of the current study is to evaluate opinions of patients, health care workers, and managers, using qualitative methods. METHODS: In-depth interviews were conducted with patients who received health care services in both the FP and the HC periods, and with health care workers and managers in health care facilities that served in both periods. The interviews were recorded after obtaining permission, and then transcribed. Both health care staff that worked in the 2 periods and the patients that received health care services in the 2 periods reported that FP system was superior to HC system in attention showed by the family physicians, being followed by the same physician, and having confidence in physicians. RESULTS: The current FP period is superior to HC in facilities such as patient records, computer, internet, and phone. The strengths of HC period include home visits, environmental health studies, and family planning services. According to health care workers who worked in the 2 periods, HC was superior to FP in team spirit, public service delivery, and surveillance of communicable diseases. CONCLUSION: Public service delivery and environmental health studies and primary care practice in rural areas must be scrutinized in the context of the FP approach.