Türkan Günay

Factors affecting adult knowledge of diabetes in Narlidere Health District, Turkey.

The objective was to determine the level of knowledge on diabetes in an adult population in Turkey. In this cross-sectional study, 524 people aged over 30 were selected from the population of Narlıdere Health District, Izmir, Turkey. A questionnaire was performed to determine sociodemographic characteristics and knowledge of diabetes. Each item on the questionnaire was given a score with a possible final total of 100 points. Knowledge level was evaluated in the whole group, DM-positive and -negative groups. “DM-positive” group refers to respondents who either have diabetes themselves or whose relatives have it. “DM-negative” group refers to respondents who do not have diabetes themselves and whose relatives do not. In total, 479 people were included in the study (response rate=87.6%). The mean age of the study group was 50.2±12.8 and 61% of them were women. Mean diabetes knowledge scores were 62.9±17.9 for the study group, 68.3±16.1 for the “DM-positive” group and 60.6±18.2 for the “DM-negative” group. The “DM-negative” group had a significantly lower mean score than the other two groups. Overall, diabetes knowledge was higher in participants with diabetes or who had a relative with diabetes, who were educated for more than 5 years and who had health insurance. The diabetes knowledge of the study group was not satisfactory. Diabetics and people who have relatives with diabetes had a higher knowledge level than the population without diabetes. Detailed information regarding diabetes should be provided to not only diabetics, but also the population as a whole.

Can Spirometry, Pulse Oximetry and Dyspnea Scoring Reflect Respiratory Failure in Patients with Chronic Obstructive Pulmonary Disease Exacerbation?

Objective: To evaluate the extent to which oximetry, spirometry and dyspnea scoring can reflect hypoxemia and hypercapnia among patients admitted to the emergency department (ED) with acute exacerbations of chronic obstructive pulmonary disease. Subjects and Methods: Spirometry, oxygen saturation by pulse oximetry (SpO2), arterial blood gas analysis and dyspnea scoring assessments were made in the ED. Correlations of these parameters were evaluated by means of Pearson’s test. Pulse oximetry cutoff values to express hypoxemia were demonstrated by receiver operating characteristic (ROC) curves. Results: 76 patients with a mean age of 68.0 years were included in the study. Mean spirometric values, expressed as percentages of predicted values, were forced expiratory volume in 1 s (FEV1) = 23.1 ± 9%; forced vital capacity (FVC) = 32.8 ± 11%, and mean FEV1/FVC = 72.4 ± 21.6%. While there was a positive correlation between the SpO2,SaO2 and PaO2 values (r = 0.91 and 0.80, respectively), a negative correlation (r = –0.74) was observed between PaCO2 and SpO2. In determining hypoxemia, both SpO2 and FEV1 were sensitive (83.9 and 90.3%, respectively) while dyspnea scoring was the most sensitive (93.5%). In the evaluation by means of an ROC curve, a saturation of 88.5% for the pulse oximeter was the best cutoff value to reflect hypoxemia (sensitivity 95.6%, specificity 80.6%). Conclusion: SpO2 alone appears to be as highly specific as a combination of other tests in the evaluation of hypoxemia. A cutoff value for SpO2 of ≤88.5% is proposed as a criterion in screening for hypoxemia.

First aid: level of knowledge of relatives and bystanders in emergency situations

Bystanders who are able to provide immediate first aid to patients who require emergency care can make a big difference in the outcome. Thus, first-aid training should be made available to as many people as possible. The aims of this study were to assess the level of first-aid knowledge among bystanders in emergency situations and to identify factors that affected this level of knowledge. At Dokuz Eylul University Emergency Service between February 1 and February 15, 2002, 318 bystanders were given a questionnaire. The first part of the questionnaire was concerned with demographic characteristics and factors that would affect first-aid knowledge level. The second part consisted of 16 multiple choice questions about first aid. Bystanders answered an average of 7.16±3.14 questions correctly. Bystanders who had graduated from a university, were health care personnel, had taken a first-aid course, had a first-aid certificate, or had a driver’s license were considered to be more successful.

High prevalence of cardiovascular risk factors in a Western urban Turkish population: a community-based study.

OBJECTIVE Cardiovascular diseases (CVD) are the largest cause of morbidity and mortality in Turkey and in the World. Heart of Balçova Project is a community- based health promotion project that aims to reduce CVD incidence and prevalence through risk factor modification in the individual and population level. This paper presents results of the baseline survey that aimed to define CVD risk factors and risk of developing coronary heart disease (CHD) in the Balçova population. METHODS The study population included 36,187 people over 30 years of age residing in Balçova in 2007. Individuals were interviewed at their homes. Anthropometrics and blood pressure were measured and in total 12914 fasting blood samples were collected for lipid and glucose analyses. CHD risk was estimated using Framingham risk equation. Students t test, Chi-square for trend test and ANOVA were used to compare mean levels and percentages of risk factors between age groups and gender. RESULTS In total 5552 men and 10528 women participated in the study. Smoking prevalence was 38.6% in men and 26.8% in women. The prevalence of obesity was 29.4% among men and 44.2% among women and obesity prevalence increased until the age group 75 years old. While 14.6% of men and 12.6% of women had diabetes, 39.8% of men and 41.8% of women had hypertension. The prevalence of high total cholesterol was 56.0% in men and 50.6% in women. Men had a higher risk of developing CHD compared to women in the following 10 years (13.4% vs 2.5%). CONCLUSION The prevalence of preventable risk factors for CHD is very high in Balçova population. Community-based interventions should be planned and implemented targeting both the high-risk individuals and whole population.

Prevalence of Metabolic Syndrome and Affecting Factors among Individuals Aged 30 and over in Balçova District of İzmir

BACKGROUND The studies have shown that metabolic syndrome (MetS) leads to an increase twice as much in cardiovascular diseases (CVD) and four times as much in diabetes mellitus (DM) prevalence since the second half of the 20(th) century. AIMS This study aims to determine and discuss the prevalence of the MetS and co- factors among individuals at the age of 30 and over in Balcova district of İzmir province according to the American National Cholesterol Education Program - Adult Treatment Panel III (NCEP ATP III) and InternationalDiabetes Federation (IDF) criteria. STUDY DESIGN Cross-sectional study. METHODS Data obtained from the Balcova Heart Project in İzmir were used in the study. The dependent variable of the study is MetS existence. The independent variables were socio-demographic characteristics (age, gender, education level, and marital status), self-perceived economic status, physical activity, smoking status, healthy nutrition and body mass index (BMI). RESULTS The prevalence of MetS was 36.9% according to the diagnostic criteria of IDF, while it was 27.4% according to ATP III criteria. According to the both criteria, increasing age, low education, poor economic status perception, physical inactivity, and obesity increase the risk of MetS. Apart from the IDF criteria, being female and a current smoker increase the risk of the MetS in the NCEP-ATP III. CONCLUSION Compared to educational studies of MetS as of today, which are community and health-oriented studies, it is challenging that the prevalence of MetS was found to be high for both criteria in our study. Therefore, in particular, primary health care doctors must be prompted to protect the public against DM and CVD in particular.

Evaluation of effectiveness of peer education on smoking behavior among high school students

Objectives: To evaluate the effectiveness of peer education on changing the smoking behavior of high schoolage children’s. Methods: In this interventional study; transtheoretical model, which is one of the cognitive-behavioral models was used for application of the peer education. Study was conducted in Izmir during 2011-2012 education period and included 338 students from 2 high schools The independent variable of the study is peer training. Descriptive variables for a student are age, gender, tendecy of friends to smoke inside and outside the school, the age they have first experienced the habit, reasons for nicotine consumption, levels of addiction, chatting about smoking and related harms. Family descriptive variables are education level of parents and whether their smoking tendency is present or not. Results: Approximately 18.3% of the students were current smoker. A positive behavioral change of smoking quitting among smoker students was observed after peer education. The number of students in precontemplation stage was reduced while the number of students in stages of preparation/determination action and maintenance was increased. Conclusion: Peer education was observed to be an effective method in the behavioral change of smoking teens. Authors strongly suggest peer education to be one of the preferred tools in changing the teen behavior in use of tobacco.

Socioeconomic factors associated with tobacco smoking in Turkey: a cross-sectional, population-based study

Background Gender and lower socioeconomic status are associated with smoking. Aims This study aimed to determine the association between socioeconomic factors and cigarette tobacco smoking in Balcova, Izmir, Turkey, with a focus on gender differences. Methods The study population was all men and women (36 187) aged over 30 years living in Balcova from October 2007 to May 2009. Data were collected in interviews and included smoking status (current, former, never), age, gender, marital status, educational level, occupational class/working status, health insurance and having a chronic disease. Logistic regression analysis was used to evaluate the association between socioeconomic characteristics and smoking status. Results Of the 36 187 study subjects, 16 080 (44%) agreed to participate and 15 174 (42%) with complete data were evaluated. The majority were women (66.2%); mean ages of men and women were 53.1 (SD 13.1) and 51.3 (SD 13.2) respectively. Current smoking was higher in men (41.7% versus 31.2% of women), and more men were ex-smokers (33.1% versus 13.5% of women) but more women had never smoked (55.3% versus 25.2% of men). For women, being married and having low educational level were associated with current smoking and previous smoking (P < 0.05). Current smoking was also more frequent among working women (P < 0.05). For men, low educational level and occupational class were associated with being a current smoker and an ex-smoker (P < 0.05). Conclusions Socially disadvantaged groups, especially those with low education or unemployed men, were more likely to be current smokers and smoking cessation was lower in these groups. Smoking habits were different in men and women. Socioeconomic factors should always be considered when developing smoking cessation policies.