Nazmi Bilir

Gender differences in students’ health complaints: a survey in seven countries

AimsThis study sought to determine the relationship among gender, quality of life and subjective health complaints in university students from six European countries and Turkey.Subjects and methodsIn surveys conducted between 1998 and 2005, ten health complaints were measured in a sample of 5,317 university students by a symptom checklist with a self-administered questionnaire, which also contained questions on socio-demographic variables and a one-item quality of life measure.ResultsThe gender-standardised prevalence was highest for nervousness and headache followed by back ache or neck/shoulder ache in most of the countries. Overall, students from Turkey and Spain reported the highest level of complaints and students from Denmark and Lithuania the lowest. Female students were significantly more likely to report health complaints. The gender difference was consistent across types of complaints and study sites, but varied in size. It was on average smallest in Turkey and strongest in the Slavic countries, Poland and Bulgaria. Among all health complaints, depressive moods had the strongest negative impact on quality of life.ConclusionAlthough the results cannot be generalized to the general populations of the respective countries, the different profiles of reported complaints and gender differences should give rise to special interventions in these populations of young adults.

Prevalence of lower urinary tract symptoms in a community-based survey of men in Turkey

Aim: The aim of the present study was to determine the frequency of lower urinary tract symptoms (LUTS), assess the impact of LUTS on quality of life (QOL) and compare the results with recent reports from other population‐based studies.

Feasibility and Acceptability of a Text Messaging–Based Smoking Cessation Program in Ankara, Turkey

Data from high-income countries suggest that cell phone–based smoking cessation programs have the potential to affect cessation rates. There is a paucity of research, however, about the feasibility of cell phone–based smoking cessation programs in lower income countries that have higher smoking prevalence rates. A one-arm feasibility and acceptability pilot study of SMS Turkey, a text messaging–based smoking cessation program, was conducted in Ankara, the capital of Turkey. The authors recruited 75 daily smokers who were seriously thinking about quitting in the subsequent 30 days into the 6-week SMS Turkey program. Recruitment was completed in 4 months. Participant retention was high: Almost all (96%) completed the program, and 84% provided 12-week follow-up data. Most (89%) of the respondents who completed the 4-week follow-up measures (n = 38, 51%) said that the text messages were easy to understand and referred to what they were experiencing and feeling during the quitting process (78%). On the basis of intention to treat, 13% of participants (n = 10) reported, at 12-week follow-up, continuous abstinence since their quit date, confirmed by carbon monoxide readings. The cell phone text messaging–based smoking cessation intervention appears feasible and acceptable in Ankara, Turkey.

What is behind smoking among pharmacy students : A quantitative and qualitative study from turkey

This study, performed in two phases, compared the smoking status of first- and last-year pharmacy students and identified underlying factors of smoking using both “quantitative” and “qualitative” research techniques. The quantitative phase was a cross-sectional study with 207 students (of these, 102 were first-year and 105 were last-year students). The mean age at which first-year students tried tobacco/tobacco products was 14.1 ± 3.2 and for last-year students, 16.0 ± 2.4. The students completed an 18-item questionnaire at the end of the spring semester in May 2004. Chi-square and t-test analyses were used for statistical comparisons. Furthermore, focus group discussion techniques were used to find out the underlying factors of smoking in the second phase.

First aid and basic life support training for first year medical students.

We developed 24 and 12-h programs for first aid and basic life support (FA-BLS) training for first-year medical students and evaluated the opinions of both the trainers and trainees on the effectiveness of the programs. The trainees were the first-year students of academic years 2000–2001 (316 students) and 2001–2002 (366 students). The evaluations of the participants were collected from short questionnaires created specifically for the study. For the 24-h training program, most of the students stated that FA-BLS sessions met their expectations (85.9%) and they were satisfied with the training (91.1%). Of the participants, 75.6% stated that they could apply FA confidently in real situations simulating the topics they learned in the FA-BLS sessions. For the 12-h training program, 84.4% of the students felt themselves competent in FA-BLS applications. The trainers considered both of the programs as effective.

Training of ‘first-aid’ trainers: a medical school example in Turkey

Objective A student-oriented basic life support and first-aid training is practical to enlarge the number of qualified people in the field. In this study, we aimed to describe and discuss the training process of a group of medical students at Hacettepe University, School of Medicine and their assessment as basic life support and first-aid trainers. Methods A ‘6-hour’ ‘Training the Trainers’ course was conducted and participants’ demonstration and coaching skills were evaluated by using a 3-point scale (1 – needs improvement; 2 – competently performed; 3 – proficiently performed). In total, 31 students out of 45 volunteers were certified as trainers. Results All of the students proficiently performed ‘explain the aim of the demonstration’, ‘motivate participants to use checklists’, and ‘motivate the participants to ask questions’ for demonstraton skills. Similarly, they all got the maximum grade for ‘answer the questions of the participant’, ‘discuss the coach role of the participant’, ‘apply the skills’, and ‘follow up with the participant by using the checklist’ as steps of coaching skills. None of the skills within the checklists needed improvement for any of the candidates. Conclusion Although there are limitations, we hope that our experience of the Training the Trainers course will be useful for readers to highlight the importance of skill-based peer education on a very important public health concern, especially for the developing countries.

Interest in technology-based and traditional smoking cessation programs among adult smokers in Ankara, Turkey

BackgroundLittle is known about the demand for smoking cessation services in settings with high smoking prevalence rates. Furthermore, acceptability of text messaging and Internet as delivery mechanisms for smoking cessation programs in non-developed countries is under-reported. Given the cost effectiveness of technology-based programs, these may be more feasible to roll out in settings with limited public health resources relative to in-person programs.Findings148 adult smokers took part in a community-based survey in Ankara, Turkey. Two in five (43%) respondents reported typically smoking their first cigarette within 30 minutes of waking. Many participants expressed a desire to quit smoking: 27% reported seriously thinking about quitting in the next 30 days; 53% reported at least one quit attempt in the past year. Two in five smokers wanting to quit reported they were somewhat or extremely like to try a smoking cessation program if it were accessible via text messaging (45%) or online (43%).ConclusionsOpportunities for low-cost, high-reach, technology-based smoking cessation programs are under-utilized. Findings support the development and testing of these types of interventions for adult smokers in Turkey.

Byssinosis and COPD rates among factory workers manufacturing hemp and jute.

OBJECTIVES Prior studies have been performed on cotton textile plants throughout the world. This study was planned to identify the rate of byssinosis and chronic obstructive pulmonary disease (COPD) in hemp and jute workers and those who worked with both of them. MATERIAL AND METHODS The study was realized in a factory which consecutively processed hemp and jute. The study enrollment included 266 people, 164 of whom were active workers and 102 were retired. A questionnaire, plain chest X-rays, physical examination and pulmonary function tests were performed. Dust levels were measured in various sections of the factory during 8 h work shifts. Endotoxin levels of various quality hemp fibers and dusts were measured. RESULTS The rate of byssinosis (28.2%) was higher among the workers that who exposed to both jute and hemp dust. The frequency of chronic bronchitis in retired workers who previously smoked was higher (20%) as compared to currently smoking workers (17%). High dust levels were measured in some parts of the factory (mean (M) = 2.69 mg/m3). Working in dense dust areas, active smoking, being older than 40 years of age, being an ex-smoker, and working in the factory for a period exceeding 15 years were significantly associated with bronchitis and emphysema development. High endotoxin levels were determined for fine hemp dust (605 EU/mg), coarse hemp dust (336 EU/mg) and poor quality hemp fibers (114 EU/mg), whereas in fresh hemp stalks the level of endotoxin was determined to be lower (0.27 EU/mg). CONCLUSIONS Because of high exposures to jute and hemp dusts that are associated with high byssinosis rates, personal protection and environmental hygiene is crucial to prevention of byssinosis.

The opinions of adults about the ban on cigarette sales to minors

BackgroundSelling of tobacco products to minors has been banned since 1996 by the tobacco control law in Turkey. However, it is also important for the public to support practices that prevent the access of tobacco products to minors. In addition, every individual has the responsibility of carrying out society based programs that restrict access to tobacco products especially to children and the youths. Social sensitivity is considered an important factor in the prevention of tobacco use. This study aims to learn about the opinions and attitudes of adults with regards to minors access to tobacco products.MethodsThe study was a descriptive study conducted in nine city centers in Turkey. The total number of participants reached was 3241. The questionnaire was developed by the research team and consisted of 22 questions concerning knowledge and behaviors of adults on restriction of tobacco sales to minors and their observations with regards tobacco sales to minors. Data was collected through face to face interview. Pearson chi-square test was used for the bivariate analysis whereas logistic regression was investigate the relationship between “the participant’s response against tobacco sales to minors” and the following explanatory variables; “age”, “educational status”, “income level”, “working status”, “minors access to cigarettes”, “smoking ratio in high school” and “sales of tobacco to minors”.ResultsMore than half of the participants (60.5%) belonged to the age group 25–44 years, 61.3% graduated from high school or university. Most of the participants were smoker (39.2%) or ex-smoker (19.1%), and 41.7% of the participants was non-smoker. A greater proportion of the participants (76.2%) believed that smoking prevalence was greater than 40% among high school students. One in four (27.8%) adults did not know that tobacco control law bans sell of tobacco products to minors in Turkey. More than half of the participants (57.1%) ever witnessed tobacco sales to minors and 63.6% of them did not act when confronted with the event. Almost all (96.8%) of the respondents thought that access of minors to tobacco products was not difficult. The results of logistic regression of participant’s response against tobacco sales to minor and related factors for current smokers showed that respondents who believed smoking ratio in high school was 4–5 adolescent out of 10 (aOR: 1.59; 95% CI: 1.09–2.34) were more likely to give a warning or informing the police or other people as compared to respondents whose perception on the smoking ratio among high school students was 6–7 adolescents out of 10. The results of logistic regression of non-smokers’ response against tobacco sales to minor were who are from higher educational level, higher economic status, working status and who believed smoking ratio in high school was 4–5 adolescent out of 10 and 2–3 adolescent out of 10 were more likely to give a warning or informing the police or other people as compared to the others.ConclusionsAlthough laws prohibiting the sale of tobacco products to the under age group is very important with regards to accessibility of minors to tobacco products, most of the study participants believed that minors can still easily access tobacco products, and more than half of the participants did not act when confronted with the event. The education, information and monitoring program most especially as it concerns salesman, should be reviewed and strengthened to obey the rules on sales of tobacco products to minors. Education program should be carried out to increase the knowledge and awareness of the community for sale of tobacco to minors. Social sensitivity is important for the prevention of tobacco use and every individual have a responsibility in carrying out this society based program, most especially as it related to prevention of tobacco usage among children and youths.

Assessing the validity and reliability of family factors on physical activity: A case study in Turkey.

Background Childhood obesity rates have been rising rapidly in developing countries. A better understanding of the risk factors and social context is necessary to inform public health interventions and policies. This paper describes the validation of several measurement scales for use in Turkey, which relate to child and parent perceptions of physical activity (PA) and enablers and barriers of physical activity in the home environment. Method The aim of this study was to assess the validity and reliability of several measurement scales in Turkey using a population sample across three socio-economic strata in the Turkish capital, Ankara. Surveys were conducted in Grade 4 children (mean age = 9.7 years for boys; 9.9 years for girls), and their parents, across 6 randomly selected schools, stratified by SES (n = 641 students, 483 parents). Construct validity of the scales was evaluated through exploratory and confirmatory factor analysis. Internal consistency of scales and test-retest reliability were assessed by Cronbach’s alpha and intra-class correlation. Results The scales as a whole were found to have acceptable-to-good model fit statistics (PA Barriers: RMSEA = 0.076, SRMR = 0.0577, AGFI = 0.901; PA Outcome Expectancies: RMSEA = 0.054, SRMR = 0.0545, AGFI = 0.916, and PA Home Environment: RMSEA = 0.038, SRMR = 0.0233, AGFI = 0.976). The PA Barriers subscales showed good internal consistency and poor to fair test-retest reliability (personal α = 0.79, ICC = 0.29, environmental α = 0.73, ICC = 0.59). The PA Outcome Expectancies subscales showed good internal consistency and test-retest reliability (negative α = 0.77, ICC = 0.56; positive α = 0.74, ICC = 0.49). Only the PA Home Environment subscale on support for PA was validated in the final confirmatory model; it showed moderate internal consistency and test-retest reliability (α = 0.61, ICC = 0.48). Discussion This study is the first to validate measures of perceptions of physical activity and the physical activity home environment in Turkey. Our results support the originally hypothesized two-factor structures for Physical Activity Barriers and Physical Activity Outcome Expectancies. However, we found the one-factor rather than two-factor structure for Physical Activity Home Environment had the best model fit. This study provides general support for the use of these scales in Turkey in terms of validity, but test-retest reliability warrants further research.