Melda Karavuş

The Prevalence of Headache and Its Association With Socioeconomic Status Among Schoolchildren in Istanbul, Turkey

Objective.— The etiology and pathogenesis of migraine and other types of headache are still under discussion. An interaction of organic, psychological, and psychosocial factors is operative. In this study, we aimed to determine the prevalence of headache and its association with socioeconomic status among schoolchildren.

Resistance against contraception or medical contraceptive methods: a qualitative study on women and men in Istanbul

Objectives This research was carried out to reveal the attitudes of men and women about contraception in the Umraniye district of Istanbul. Methods Focus group discussions were used for data collection. Data from 20 groups of married people (ten groups of men and ten of women) living in Umraniye were analyzed. Results Most people attending the focus groups in the study were against having ‘too many’ children. Economic constraints appear to be a leading influencing factor for limiting the number of children. Urbanization also seems to have a strong influence on peoples knowledge and attitudes about contraception. Culture and religious beliefs were not found to be major barriers to contraception in general, but they would influence the selection of the type of a certain contraceptive method. More specifically, culture and religious beliefs were barriers to use of medical methods, and they were the main reasons for use of the withdrawal method, which is the most common method used in Turkey. Conclusions Men and women are not resistant to contraception, but they are reluctant to use medical methods. The provision of contraceptive services, with special attention to cultural and religious beliefs and values, and the inclusion of appropriate counseling and education sessions during service delivery, may give clients new options and increase the use of medical methods.

Expanding family planning options: offering the Standard Days Method™ to women in Istanbul

Background This study introduced the Standard Days Method™ (SDM), a fertility awareness-based method of family planning, to couples in a region of Istanbul, Turkey who were using a method of low effectiveness or no family planning method. The objective was to determine potential demand for, and satisfaction with, the SDM. Methods A total of 657 couples were selected by systematic sampling and offered the SDM. Those accepting this method were interviewed 1 and 3 months after starting the SDM. Results Some 47% of the participants were satisfied with the method and intended to continue using it. Conclusions Potential demand for the SDM was 80.3% (278/346 eligible women) among couples who were using a method of low effectiveness or no family planning method. Our results suggest that adding the SDM to the contraceptive method mix may benefit Turkish women.

A qualitative study on factors that influence Turkish medical students' decisions to become family physicians after the health transformation programme

Background: In Turkey, general practitioners were authorized to work as family physicians without specialization, within the scope of the Health Transformation Programme, due to inadequate number of family medicine specialists since 2004. With this new implementation Family Medicine specialty became a less preferable option for medical students. Aims: The study was to investigate the perspectives of medical students and understand the issues to choose Family Medicine specialty as a career option. Materials and Methods: This qualitative study was performed with 48 final year medical students using a convenience sample from two medical universities. Results: Three main categories emerged from the data viewing Family Medicine ‘as a specialty’, ‘as an employment’, and finally ‘as a system’. Very few students stated that Family Medicine would be their choice for specialty. Conclusions: Family Medicine does not seem to be an attractive option in career planning by medical students. Several factors that may constrain students from choosing Family Medicine include: not perceiving Family Medicine as a field of expertise, and the adverse conditions at work which may originate from duality in the system.

Knowledge of oral cancer, preventive attitudes, and behaviors of primary care physicians in Turkey.

Oral cancers (OCs) have a high mortality rate because of their typically late diagnosis. Primary care physicians play a vital role in early detection. In this study, we evaluated the family physicians’ (FPs) knowledge, preventive attitudes, and behaviors in terms of OCs. A semistructured questionnaire consisting of 50 questions was prepared and distributed to 200 FPs. Questions were grouped under four main headings: demographic characteristics, general protective attitudes against OCs, risk factors, and daily practices while performing the necessary examinations and referrals. Of 200 FPs, 164 responded to the questionnaire (82% response rate). The mean age of the study participants was 34.8±8.4 years and the mean duration of practice was 10±8.1 years. One-third of the physicians (29.9%, n=49) stated that they did not inquire about the amount of tobacco use. In terms of alcohol use, 45.7% (n=75) and 56.7% (n=93) did not ask about past alcohol consumption or the amount of alcohol consumed, respectively. Moreover, 69.5% (n=114) believed that they did not receive adequate smoking cessation training and 79.9% (n=131) stated that they did not receive any alcohol cessation training. To decrease morbidity and mortality associated with OCs, primary care physicians should be trained to ask their patients about high-risk behaviors, provide counseling and education on tobacco and alcohol-abuse cessation, and provide oral examinations.

Knowledge, Attitudes and Behaviors of Women Over 20 Years Old on Cervix Cancer in Istanbul, Turkey

PURPOSE The aim of the study was to evaluate knowledge, attitudes and behaviors of Turkish women over 20 years old on cervix cancer. MATERIALS AND METHODS This descriptive study was performed at a primary care center covering 246 women using a questionnaire composed of 3 sections and 38 questions. The data were analyzed using descriptive statistics, chi-square test in univariate analysis and multivariate hierarchical logistic regression analysis. RESULTS Of the 93.7% women who knew about cervical cancer, 68.0% of them had heard pap smear test and 46.1% had actually undergone a Pap smear once or more throughout their lives. According to the results of the hierarchical logistic regression analysis about factors affecting the Pap smear test; in Model 1, increase in age and education levels, in Model 2 and Model 3 increase in age and cervical cancer information points were determined. The most important information source for cervical cancer was TV-radio/media (59.9%) and health care workers (62.8%) for pap smear test. CONCLUSIONS Although most women have heard of cervical cancer, knowledge about cervical cancer and also Pap smear screening rate are significantly lower. Having Pap smear test for women was affected by age and knowledge level about cervical cancer. Informing women about cervical cancer would be an important intervention.

A study exploring knowledge, attitudes and behaviours towards autism among adults applying to a Family Health Center in Istanbul.

OBJECTIVE: The aim of this study was to assess knowledge, awareness, behavior and attitudes towards autism among applicants to a Family Health Center (FHC). METHODS: This descriptive study was performed at a Family Health Center (FHC) in Istanbul in August 2013. Data was obtained via face-to-face interviews with participants older than 18 years who were admitted to the FHC. The questionnaire consisted of questions on sociodemographic characteristics, applicants’ knowledge of autism and their approach to autism. RESULTS: 160 applicants participated in our survey of which 38.8% had heard the word ‘autism’. Knowledge and awareness of autism, and attitudes and behaviours towards this disorder differed significantly with the educational level of the study participants (p<0.05) However, these parameters did not change with gender and income level of the participants (p>0.05). CONCLUSION: The most important outcome of our study is that awareness, or even having knowledge of the word autism is significant in breaking down stereotypes. Despite the low level of awareness of the disease, the majority of the participitants had a positive attitude towards autism.

Lead article: The prognostic significance of proliferating cell nuclear antigen (pcna) in laryngeal cancer.

Squamous cell carcinoma arising from upper aerodigestive tract carries with it a significant morbidity and mortality and, over the last few decades, its incidence has steadily increased. The management of patients requires thorough investigation to determine the local, regional, and distant extent of the disease, and treatment options include surgery, radiotherapy, chemotherapy, or combinations of these.Despite the large number of therapeutic and hsitopathologic studies in print, there is currently no morphologic or cytologic feature available which consistenly predicts outcome in patients with laryngeal carcinoma. The use of proliferating cell nuclear antigen (PCNA), a newly available marker of a cell’s proliferative activity ( S-phase fraction), was evaluated in 25 cases of squamous cell carcinoma of the larynx. PCNA scores differed, statistically significantly as far as the localization of the lesion, pathological grade, clinical stage, presence of lymph node metastases and prognosis of the patients were concerned.These data suggest that PCNA is an indicator of the malignant potential of the larynx. PCNA can be used in decision making for treatment and assessing prognosis in carcinoma of the larynx.