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.

Home accidents in the community-dwelling elderly in Izmir, Turkey: how do prevalence and risk factors differ between high and low socioeconomic districts?

OBJECTIVE: To determine and compare the prevalence of and risk factors for home accidents in the elderly in two different districts. METHOD: This cross-sectional study involves 497 older participants ages 65 and older. Sociodemographic characteristics of the elderly and characteristics of the houses in two different regions are evaluated. Data are analyzed by chi-square and t test. RESULTS: The prevalence of home accidents was 39.3% in the low socioeconomic region and 13.1% in the high socioeconomic region within the past 6 months (p = .000). The most common type of home accident was fall (61.8%), followed by cut or piercing (22.0%). Home accidents are associated with being female and increasing age in the higher socioeconomic region, whereas being female, being unmarried, and living in a squatter house are associated with home accidents in the low socioeconomic region. DISCUSSION: The prevalence of home accidents in the elderly population who live in low socioeconomic region was higher.

Perinatal outcomes and risk factors of Turkish adolescent mothers.

STUDY OBJECTIVE: Adolescent pregnancy is considered a high risk for both the mother and infant. The aim of this study was to determine obstetric and neonatal outcomes and risk factors in adolescent pregnant women and to compare perinatal outcomes among the teen age groups and between adolescent and adult women. DESIGN: Retrospective study including adolescent pregnant women and adult women. SETTING: A public maternal hospital. MAIN OUTCOME MEASURES: This retrospective cohort study included 945 teenagers who gave birth at year 2004 in a maternity hospital in Izmir. Dependent variables included perinatal and maternal outcomes. Independent variables were miscellanous socio-demographic characteristics and obstetric complications. Chi-square, Fisher exact test, and t-tests were used for the comparison of the adolescent group and adult women. RESULTS: Overall, adolescents accounted for 11.8% of all deliveries in hospital. 99.7% of teenagers were unemployed, and 59.8% of those had no health insurance. 81.5% of the pregnant adolescents were nulliparous. 27.5% of teenagers gave birth by cesarean delivery. The rates of preterm birth and low birthweight of teen mothers were 18.2% and 12.1%, respectively. Twenty-eight percent of women had some obstetric and neonatal complications. The rate of preterm delivery was higher in adolescent mothers; however, cesarean delivery rate was higher in adult women (P = 0.000, P = 0.0002 respectively). Absence of health insurance, less education, and non-official marriage were significantly higher in pregnant women aged 17 years or younger compared with women aged 18-19 years (for all, P = 0.000). However, there was no statistically significant difference between the adolescent age groups regarding perinatal complications. CONCLUSION: The rates of pregnancy and the rates of adverse obstetric and neonatal outcomes were considerably higher in teenagers.

The Relationship Between Sociodemographic Characteristics, Work Conditions, and Level of "Mobbing" of Health Workers in Primary Health Care.

Mobbing is a type of violence which occurs in workplaces and is classified under the community violence subgroup of interpersonal violence. The aim of this study is to examine health care workers who work in primary health care in the city of Mugla and to determine whether there is a relationship between sociodemographic characteristics, work conditions, and their level of mobbing. A cross-sectional analysis has been conducted in which 130 primary health care workers were selected. Of the 130, 119 health workers participated, yielding a response rate of 91.5%; 83.2% of health workers are female, 42.9% are midwives, 27.7% are nurses, and 14.3% are doctors. In all, 31.1% of health workers have faced with "mobbing" in the last 1 year, and the frequency of experiencing "mobbing" of those 48.6% of them is 1 to 3 times per year. A total of 70.3% of those who apply "mobbing" are senior health workers, and 91.9% are female. The frequency of encountering with "mobbing" was found significantly in married health workers, in those 16 years and above according to examined total working time, in those who have psychosocial reactions, and in those who have counterproductive behaviors. It has been discovered that primary health care workers have high prevalence of "mobbing" exposure. To avoid "mobbing" at workplace, authorities and responsibilities of all employees have to be clearly determined.

The prevalence and risk factors of dementia in the elderly population in a low socio-economic region of Izmir, Turkey.

The aim of this study is to determine the prevalence of and risk factors of dementia in the elderly with a low socio-economical status. The study is a cross-sectional and analytic study. Two hundred and four persons aged 65 years and above were selected by using the cluster sampling method. The presence of dementia was determined by Standardized Mini Mental State Examination (SMMSE). Twenty-three and 18 cut-off points were accepted as the existence of dementia in educated and uneducated older individuals, respectively. Chi-square test, Student's t-test, and logistic regression analysis were used for data analysis. The mean age of older subjects was 70.8+/-6.45 (S.D.); 71.5+/-5.9 in males and 70.3+/-6.8 in females (p=0.19). Ninety-one percent of older people had never attended school, 54.6% were living below the poverty level, and 97% of the residences were in squatter settlements. Dementia was determined in 46 older subjects (22.9%). Dementia was found significantly higher in females, in elderly subjects aged 80 years and above, in older subjects who were in a bad or very bad self-health status and in those who had a chronic disease, did not have any occupation, had a lower monthly income, and with a depressive score eight and above (p<0.05). In our study, the prevalence of dementia in older people was higher, in agreement with many reported studies. We assumed that this was due to the fact that the ratio of the uneducated, poor, and advanced aged subjects in this study was considerably higher. The different prevalence rates in studies demonstrate that the adoption of SMMSE for the study population, the validity-reliability analyses of tests and the standardization of diagnostic criteria are necessary.

Relationship Between Socio-Demographic Features, Work-Related Conditions, and Level of Anxiety Among Turkish Primary Health Care Workers.

The purpose of this study was to investigate the relationship among Turkish primary health care workers' socio-demographic characteristics, working conditions, and anxiety. A cross-sectional study was conducted with 88 of 103 (85.4%) eligible health care workers from the city of Mugla participating. The participants' average age was 31 years, 85.2% were university graduates, 30.7% were nurses, and 64.8% had been working between 11 and 20 years at the time of the study; 93.6% worked 8 hours each day or less. State anxiety scores for males (p = .016), health care workers age 31 or older (p = .035), nurse participants (p = .043), and individuals who had worked 11 or more years (p = .044) were significantly higher than the rest of the sample; however, trait anxiety scores for participants who did not work overtime and were not scheduled for shift work were significantly higher (p = .033 and p = .004, respectively) than the rest of the sample. According to the logistic regression analysis, risk factors for anxiety included being male and older than 31 years.