Levels of burnout and their associated factors among physicians working in Northeast Anatolia.

CONTEXT: The concept of burnout is a condition seen in occupational groups working face-to-face with people and resulting in emotional exhaustion, depersonalization, and low professional productivity. AIMS: The purpose of this study was to determine burnout levels and associated factors in physicians practicing in Erzurum, Northeast Anatolia, Turkey. SETTINGS AND DESIGN: This research was designed as a cross-sectional descriptive study. The research sample size was calculated at 663 participants with a 99% confidence interval and a 3% margin of error using Epi Info software. A 10% incomplete or nonresponse rate was added, for a target cohort of 730 individuals. Seven hundred and eleven physicians agreeing to take part were enrolled. SUBJECTS AND METHODS: A questionnaire consisting of questions concerning sociodemographic characteristics and the Maslach Burnout Inventory (MBI) was used as the data collection tool. The questionnaires were distributed by the authors and completed by the physicians in person. STATISTICAL ANALYSIS: Descriptive data were expressed as percentage, mean, median, and standard deviation. Data were analyzed using the Kruskal-Wallis and Mann-Whitney U tests and binary logistic regression analysis. P < 0.05 was regarded as statistically significant. Statistical analyses were performed on SPSS 15.00 software. RESULTS: The mean age of the physicians in the study was 34.4 ± 7.7 years. Mean MBI subdimension scores were 15.6 ± 7.0 for emotional exhaustion, 5.7 ± 3.9 for depersonalization, and 21.0 ± 4.4 for personal accomplishment. Mean emotional exhaustion and depersonalization scores were significantly higher and personal accomplishment scores significantly lower in physicians aged under 25, not taking vacations, working in public hospitals, who were working as research assistants. CONCLUSIONS: Burnout levels among the participants were low (emotional exhaustion in 75%, depersonalization in 76.2%, and low personal accomplishment in 69.6%).

Thalassaemia screening in a non-prevalent region of a prevalent country (Turkey): is it necessary?

OBJECTIVES: Haemoglobinopathies are the most widespread inherited disorders in the world, and are also common in Turkey. Haemoglobinopathies are preventable with control programmes. Therefore, the Ministry of Health initiated a control and prevention programme in 33 provinces in Turkey. The aim of this study was to determine the frequency of haemoglobinopathies in Erzurum as part of the programme mentioned above, and to discuss the need for premarital screening in a non-prevalent region (Erzurum) of a prevalent country (Turkey) as part of a national control programme. STUDY DESIGN: Epidemiological and descriptive survey. METHODS: This study was conducted between May 2005 and February 2006 in Erzurum. Subjects were couples who attended for premarital screening. All blood samples were measured by high-performance liquid chromatography (HPLC) to determine haemoglobinopathies. RESULTS: In total, 1610 individuals were screened. The frequency of beta-thalassaemia trait was 0.68%. Haemoglobin D was the most common (0.12%) abnormal haemoglobin. Haemoglobins S, C and E were not detected. The frequency of beta-thalassaemia trait and other haemoglobinopathies in Erzurum was quite low compared with other provinces in Turkey. CONCLUSIONS: Premarital haemoglobinopathy screening should not be mandatory in a non-prevalent region of a prevalent country as part of a national control programme. If screening is mandatory, it should be performed by total blood count or enzyme-linked immunosorbent assay, which are simple, rapid and less expensive than HPLC.

Hepatitis A seroepidemiology in Eastern Turkey.

BACKGROUND: It has been reported that there are great deal of changes in the epidemiology of hepatitis A at the present. The epidemiologic studies regarding to hepatitis A virus (HAV) infection are not sufficient both in the country and study region. OBJECTIVE: To investigate HAV seroprevalence and association with socio-demographic variables. DESIGN: Cross-sectional and community based study. SETTING: Erzurum Province, Eastern Turkey between April and June 1998. SUBJECTS: Four hundred and fifty persons under the age of 30 years. RESULTS: The rate of the study involvement was 87.1% (392 persons) and ratio for seropositivity 84.2%. Although seropositivity is elevated by age, it has been high within the younger age group. Epidemiological changes could not be interpreted, since the study results were first for the group of people aged under 30 years. Statistical significance was found between hepatitis A seroprevalence and age, the number of households and localisation of toilet within the house. There was no correlation between hepatitis A and sex, jaundice history, family type, tap water availability in the residential area. CONCLUSION: The frequency of hepatitis A infection appearance in the region was found out to be high as compared to other regions of Turkey.

Hepatitis a seroepidemiology in eastern turkey

Background: It has been reported that there are great deal of changes in the epidemiology of hepatitis A at the present. The epidemiologic studies regarding to hepatitis A virus (HAV) infection are not sufficient both in the country and study region. Objective: To investigate HAV seroprevalence and association with socio-demographic variables. Design: Cross-sectional and community based study. Setting: Erzurum Province; Eastern Turkey between April and June 1998. Subjects: Four hundred and fifty persons under the age of 30 years. Results: The rate of the study involvement was 87.1

Seroprevalence of pertussis among children in Eastern Turkey.

The aim of this cross-sectional study was to determine the immunity status of children to pertussis by socio-demographic characteristics in Eastern Turkey. The study sample consisted of 840 randomly selected and healthy children aged 0-71 months. The seroprevalence of pertussis was 30.1%. Age, parent education and economic status were not associated with the geometric mean titers (GMT) of pertussis antibody, while gender, residential area and the application number of diphtheria-tetanus-whole-cell pertussis vaccine were associated with GMT. Most preschool children are susceptible to pertussis and current vaccination efforts do not provide adequate immunization.

Effect of several sociodemographic factors on measles immunization in children of Eastern Turkey.

This study was performed to determine the status of measles immunization and the effect of several sociodemographic factors on immunization in children aged between 10 months and 6 years. Using cluster sampling, 663 healthy children were selected at random from three provinces in Eastern Turkey. The immunization histories of these children were obtained from their immunization cards. With respect to their vaccination status, children were categorized as vaccinated, unvaccinated or unknown. If the child had no immunization card, he or she was classified as unknown. Of these children, 81.6% were vaccinated and 15.1% were unvaccinated. The vaccination status was not known in 3.3% of the children. In children aged 10-12 months, the vaccination rate was 68.6%. For age groups of 1-2, 2-3, 3-4, 4-5 and 5-6 years, the vaccination rates were 84.2, 82.2, 85.3, 82.1 and 76.8%, respectively, but these differences were not significant. The vaccination rates increased in parallel with maternal education level (P = 0.009). Also, vaccination rates were significantly correlated with settlement area (P = 0.036), and were higher in urban regions than suburban and rural regions. There was no difference in vaccination rates with respect to gender, paternal education level, number of siblings and socio-economic status. The results of this study show that the level of immunization necessary for measles elimination has not yet been reached in Eastern Turkey. Priority should be given to increase the immunization levels to 90-95% among children.

Diphtheria seroprevalence in children living in the eastern Turkey.

OBJECTIVES: To determine the seroprevalence of diphtheria in 767 children aged 0-6 years and to identify the relationship between diphtheria seroprevalence and several sociodemographic characteristics of the study subjects in the Erzurum, Erzincan and Kars cities situated in Eastern Turkey. DESIGN: A cross sectional study. SETTING: The subjects were recruited from three cities (Erzurum, Erzincan, Kars). The sampling method of 30 clusters recommended for field studies was used for a predetermined number of selecting subjects in the rural and urban areas in each city. SUBJECTS: Of the 767 children included in this study, 423 were from Erzurum, 187 from Kars and 157 from Erzincan. Diphtheria serology was used to examine the blood samples by ELISA method. RESULTS: Positive diphtheria seroprevalence was detected in 77.9% of 767 subjects in Eastern Turkey. Seroprevalence was 74.5% in children younger than one year of age, increased to 84% at the age of 3-4 years, and reduced to 80% at the age of 4-5 years and 69.8% at the age of 5-6 years. The seroprevalence rates were similar in sex and number of siblings. Seroprevalence of diphtheria increased with educational level of parents in the rural area. CONCLUSION: Positive seroprevalence against diphtheria in eastern Turkey is disturbingly low.

Reproductive health: knowledge and opinions of university students in Erzurum, Turkey.

BACKGROUND: The aim of this study was to assess knowledge of reproductive health and the opinions of university students towards reproductive health education and family planning services. METHODS: A questionnaire about reproductive health knowledge and the opinions of students was submitted to 673 systematically and randomly selected students at Ataturk University. A set of 39 questions was used to determine the level of knowledge of reproductive health. RESULTS: The level of reproductive health knowledge was below the theoretical mean value. An association was found between gender, residential area, parents' education and sibling number with the reproductive health knowledge score. Most of the students approved of formal reproductive health education (88.4%). Approval of family planning services was lower than that of reproductive health education (71.6%). The percentage of men who support family planning services and reproductive health education was lower than that of women. Students who had graduated from Islamic religious schools had more negative opinions towards family planning services. CONCLUSIONS: University students lack knowledge about reproductive health and most of them agree that reproductive health education should be given in schools. Knowledge about reproductive health differs significantly depending on some sociodemographic variables. Some students have negative opinions towards family planning services and reproductive health education.

Prevalence of trachoma in eastern Turkey.

BACKGROUND: This study aims to define the prevalence of trachoma in Erzurum, a town in Eastern Turkey where all types of conjunctivitis are known to be endemic. METHODS: To determine the epidemiological characteristics of the active and residual disease in the area, we chose 20% of the households in 17 residential areas using simple random sampling. RESULTS: We examined 6386 individuals aged < 30 and 2220 aged > 30 years. The active and the residual prevalence of the disease was found to be 3.2% in those aged < 30, and 1.9% for the group aged > or = 30. Risk factors included crowded households with five or more members, infrequent washing of the face, visiting thermal springs and the mutual use of towels by household members. According to the laboratory findings, trachoma with conjunctival smear was found positive in the first and second stages, but seropositivity was quite high in the third and fourth stages. The validity of the methods used for the diagnosis and the positive predictive values showed the sensitivity of the eyelid examinations to be 55.3%, specificity 95.4% and positive predictive value 23.9% which were the highest values in the field survey. CONCLUSIONS: Trachoma continues to be a serious public health threat in Erzurum, and eyelid examination is the most suitable method of diagnosis for surveillance of trachoma.