Ozge Karadag Caman

Determinants of pre-lacteal feeding practices in urban and rural Nigeria; a population-based cross-sectional study using the 2013 Nigeria demographic and health survey data

Background Prelacteal feeding (PLF) is a barrier to exclusive breast feeding. Objective To determine factors associated with PLF in rural and urban Nigeria. Methods We utilized data from the 2013 Nigerian Demographic and Health Survey. Bivariate and multivariate analyses were used to test for association between PLF and related factors. Results Prevalence of PLF in urban Nigeria was 49.8%, while in rural Nigeria it was 66.4%. Sugar or glucose water was given more in urban Nigeria (9.7% vs 2.9%), plain water was given more in rural Nigeria (59.9% vs 40.8%). The multivariate analysis revealed that urban and rural Nigeria shared similarities with respect to factors like mothers education, place of delivery, and size of child at birth being significant predictors of PLF. Mode of delivery and type of birth were significant predictors of PLF only in urban Nigeria, whereas, mothers age at birth was a significant predictor of PLF only in rural Nigeria. Zones also showed variations in the odds of PLF according to place of residence. Conclusion Interventions aimed at decreasing PLF rate should be through a tailored approach, and should target at risk sub-groups based on place of residence.

Health Warnings, Smoking Rules, and Smoking Status: A Cross-National Comparison of Turkey and the United States

ABSTRACT Objectives: This study aimed to compare the prevalence of smoking status (i.e., current, former and never) between the United States and Turkey in terms of age and gender, and examine how smoking rules and health warnings are associated with smoking status within and between the two countries. Methods: The study used data from the 2012–2013 National Adult Tobacco Survey (U.S. sample, N = 60,196) and the 2012 Global Adult Tobacco Survey (Turkey sample, N = 9,581). SAS PROC SURVEYLOGISTIC with a weighted variable was used to examine the associations between demographics (age, gender and education), smoking rules, health warnings, and smoking status within and between the two countries. Results: There was an 18% current smoking prevalence among U.S. sample, compared to 27% of the Turkey sample. The U.S. sample had a higher rate of former smoking compared to the Turkey sample (25% vs. 22%). In both countries, being older and male gender predicted former smoking while being younger and female gender predicted never smoking. Having seen a health warning, and not allowing smoking in the vehicle and home positively predicted former and never smoking status. Higher education predicted both smoking statuses in the U.S. only. Conclusions: It is important to work with partners particularly in low- and middle-income countries (e.g., Turkey) to combat the global tobacco epidemic. In both counties, cessation endeavors should emphasize a comprehensive understanding of smoking status in terms of smoking rules in personal spaces and health warnings.

Barriers and best practices for participation in urban life for people with disabilities: a qualitative photovoice study

Abstract Background In many parts of the world, people with disabilities do not have equal opportunities in access to health care, education, and participation in social life. We assessed main barriers and best practices for people with disabilities with respect to the accessibility of public services and participation in urban life. Methods We did this qualitative study in Ankara, Turkey. We included 42 people aged 18–35 years with physical or visual disabilities. We selected participants by snowball sampling through contacting non-governmental organisations working with people with disabilities. Participants were given cameras to take photographs of main barriers and good practices from their own perspective (photovoice). We then did facilitated group discussions, in which participants discussed their photographs, developing narratives for each photo, and recommending solutions to overcome barriers and disseminate good practices. Findings The main barriers were difficulties in access to public transport services, pedestrian roads, sidewalks, overbridges, parks, sports fields, and public institutions including health care and educational facilities, which decreased opportunities for people with disabilities to participate in urban life. Although fewer in number, several good practices were also identified, such as the use of lifts, wheelchair lifts, ramps, lowered curbs, tactile paving, audible signals, and Braille signs. Interpretation Municipalities should deliver more evidence-based and needs-based services to improve urban environments for people with disabilities. Community participation in decision-making processes could help advocacy, and consequently the improvement of public policies and services. Funding Hacettepe University Scientific Research Projects Coordination Unit.