Sibel Sakarya

Determinants of Breast and Cervical Cancer Screening Uptake Among Women in Turkey.

The aim of the study was to assess the influence of sociodemographic characteristics on breast and cervical cancer screening among women 30 years and older in Turkey. We used data from the National Chronic Diseases and Risk Factors Survey conducted by the Ministry of Health in 2011. Multivariate logistic regression analysis was used to assess the association of sociodemographic factors, lifestyle variables, and cancer screening. Overall, 22.0% of women ever had a Pap smear test for cervical cancer screening and 19.0% ever had a mammography for breast cancer screening(n = 6846). Individuals with a university degree, social security, doing moderate physical activity, and consuming 5 portions of fruit or vegetable/day were more likely to receive Pap smear test and mammography. Residing in the eastern region and living in rural area was associated with lower likelihood of receiving both types of screening.

Evaluation of fontanel size variation and closure time in children followed up from birth to 24 months

OBJECTIVE Anterior fontanel size and closure time can be useful clinical signs for the early diagnosis of diseases. Knowing age-related normal variations is important to decide on further investigations. The authors of this study aimed to describe fontanel size variation according to age, determine fontanel closure time, and identify the optimal method for assessing fontanel size. METHODS For this prospective cohort study, 321 healthy term babies who fulfilled the inclusion criteria were consecutively recruited. Percentile charts for the mean anterior fontanel size and oblique measurements from birth to 24 months of age were created. RESULTS The mean fontanel closure time was 9.7 ± 5.0 months (girls 10.3 ± 4.7 months, boys 9.2 ± 5.1 months). No differences were observed between the traditional method and oblique measurements. Early fontanel closure was not associated with microcephaly. CONCLUSIONS Oblique measurements can be used because they are as accurate as the traditional method. Children with fontanels measuring above the 95th percentile should be monitored closely and investigated further for potentially associated diseases.

Family physicians’ views on their role in the management of childhood obesity: a mixed methods study from Turkey

Abstract Background: Childhood obesity (CO) is a high priority issue due to its serious health consequences and its rapid increase. Objectives: To examine the views of primary care physicians (family physicians, FPs) in Turkey regarding their role in the management of CO and the barriers they perceive. Methods: Mixed methods approach. Data was collected in two major counties of Istanbul between February and May 2014. All Family Health Centres (FHCs) in the region were visited, and 180/284 FPs (63.4%) agreed to complete a structured questionnaire (22 questions). Of those, 48 FPs agreed to participate in in-depth interviews that were taken until saturation was 25. Quantitative data were analysed using descriptive statistics. For qualitative data, content analysis was applied to identify the themes. Results: Most of the FPs (93.3%) agreed that they have a role in managing CO. Almost all FPs (98.3%) agreed that for the 0–4-year-olds height and weight measures should be taken. However, only 67.6% recommended this for children aged 5–15 years. The most common barriers in the management of CO were reported as lack of time (68.9%) and FHCs not being utilized for the care of children aged 5–15 years old (53.3%) in Turkey. In-depth interviews showed that FPs tend to limit their role to identifying the problem and making the family aware of it. Conclusion: Although FPs recognize primary healthcare as an appropriate setting for managing CO, they have concerns about being involved in the treatment.

Determinants of prevalence, awareness, treatment and control of high LDL-C in Turkey

Objective: High blood cholesterol is one of the main modifiable risk factors for cardiovascular diseases (CVDs). The aim of the study is to determine the factors associated with the prevalence, awareness, treatment, and control of high “low-density lipoprotein-cholesterol” (LDL-C) among adults aged ≥20 years in Turkey. Methods: We used data from Chronic Diseases and Risk Factors Survey conducted in 2011–2012. The presence of high LDL-C, lipid-lowering treatment eligibility, and achievement of target LDL-C were defined according to the third Adult Treatment Panel guidelines on treatment of high cholesterol. Multivariate logistic regression analyses were performed to determine the associations between participant characteristics and high LDL-C prevalence, awareness, treatment, and control. Results: Framingham risk score categorization was performed for 13121 individuals aged ≥20 years. Approximately, 28% of the participants presented with high LDL-C. Among those with high LDL-C, 55.8% were aware of their situation; among those aware of high LDL-C, 46.9% were receiving lipid-lowering medication, and 50.6% of individuals who were receiving treatment achieved target LDL-C levels on the basis of their coronary heart disease (CHD) risk. Control of high LDL-C was negatively associated with the presence of diabetes mellitus (odds ratio: 0.36, 95% CI: 0.27–0.49, p<0.001). Conclusion: Despite the high awareness rates, there was a high proportion of adults who did not receive treatment or achieve recommended levels of LDL-C during treatment. The low treatment and control levels among individuals based on their CHD risk levels call for a better application of recommendations regarding personal preventive measures and treatments in Turkey.