Yildiz Peksen

Antibiotic prescribing and urinary tract infection.

The aim of this study was to evaluate the diagnostic and therapeutic approach to urinary tract infections (UTIs) by primary care physicians, in Samsun, Turkey. Data were obtained from the records of 2083 visits at eight primary care areas. Trained research students were stationed on site at each of the eight primary care centres between 1 June, 1999 and 1 July, 1999. Patients who had acute cystitis, recurrent UTIs, acute pyelonephritis and acute urethritis were included in the study. A total of 2083 office visits were recorded and 419 (20.1%) of the patients had UTIs and acute urethritis. Antibiotics were prescribed for 94.7% of the patients with UTIs and urethritis. Some 74% of prescriptions were consistent with current recommendation, but only 41% of the antibiotic prescriptions were rational according to dosage, dosage interval and duration of therapy. Urinary antiseptic agents were prescribed to 75% of patients with UTIs. These data indicate that polypharmacy is widespread in our region; primary care physicians need to review their knowledge about the diagnosis and treatment of UTIs and acute urethritis.

The reliability and validity of the Turkish version of the brief infant―toddler social emotional assessment (BITSEA)

In this study the reliability and validity of the Turkish version of the brief infant-toddler social emotional assessment (BITSEA) were investigated in a community sample. The sample consisted of 462 children (mean age: 24.60+/-7.93 [12-42] months) who had applied to Turkish health centers for immunization. Both parents completed the BITSEA; mothers completed the child behavior checklist 2/3 (CBCL). Internal consistencies of the BITSEA-problem (P) and competence (C) scales were good to excellent (Cronbachs alpha=0.82 and 0.72, respectively). Interrater reliability between parents and test-retest reliability were good. BITSEA/P scores were significantly correlated with CBCL internalizing, externalizing and total problem scores (p<0.001). Maternal BITSEA/P cutpoint scores revealed that 30.6% of male toddlers and 28.6% of females were in the subclinical range and 13.1% of males and 17.6% of females were in clinical range. Results reveal that the Turkish version of BITSEA is a reliable, valid and simply applicable instrument for screening social, emotional and behavioral problems among toddlers. Clinical validation of the BITSEA/C and BITSEA/P is warranted.

Establishment of interdisciplinary child protection teams in Turkey 2002–2006: Identifying the strongest link can make a difference!

OBJECTIVES The University of Iowa Child Protection Program collaborated with Turkish professionals to develop a training program on child abuse and neglect during 2002-2006 with the goals of increasing professional awareness and number of multidisciplinary teams (MDT), regional collaborations, and assessed cases. This paper summarizes the 5-year outcome. METHODS A team of instructors evaluated needs and held training activities in Turkey annually, and provided consultation when needed. Descriptive analysis was done via Excel and SPSS software. RESULTS Eighteen training activities were held with 3,570 attendees. Over the study period, the number of MDTs increased from 4 to 14. The MDTs got involved in organizing training activities in their institutions and communities. The number of medical curriculum lectures taught by MDTs to medical students/residents, conferences organized by the MDTs, and lectures to non-medical professional audiences increased significantly (R(2)=91.4%, 83.8%, and 69.2%, respectively). The number of abuse cases assessed by the MDTs increased by five times compared to pre-training period. CONCLUSIONS A culturally competent training program had a positive impact on professional attitudes and behaviors toward recognition and management of child abuse and neglect in Turkey. The need to partner with policy makers to revise current law in favor of a greater human services orientation became clear. PRACTICE IMPLICATIONS Pioneers in developing countries may benefit from collaborating with culturally competent instructors from countries with more developed child protection systems to develop training programs so that professional development can improve recognition and management of child abuse and neglect.

Obstetric outcomes of adolescent pregnancies in Turkey

Pregnancy in adolescence has been and continues to be a problem in public health. The purpose of this study was to investigate obstetric outcomes of adolescent pregnancies in Samsun, Turkey. A cross-sectional study was conducted between January 1 and December 31, 2004, at 3 hospitals in Samsun, Turkey. Of the 10,100 women who gave birth during this period, 357 (3.5%) were 18 years of age or younger; these patients were included in the study. Participants with a history of any chronic disease were excluded. Data were provided as median values (minmax) and percentages. In this study, the rate of birth for females 18 years or younger was found to be 35 per 1000. The median age of participants was 18 (14–18) years. The prevalence of cesarean section was calculated at 55.7%. Prevalences of lowbirthweight infants, preterm delivery, and eclampsia/preeclampsia were recorded as 44 (12.3%), 34 (9.5%), and 30 (8.4%) cases, respectively. Although the stillbirth rate was determined to be 1.7%, no congenital deformity was noted in infants, and none of the mothers died. The cephalopelvic disproportion rate was 5.9%, and only 2 adolescents experienced abruptio placentae. To reduce the occurrence of adolescent childbearing, pregnancy intentions must be assessed in multiple ways. Information/education may provide benefit to those female adolescents with inconsistent pregnancy intentions.

Work-related musculoskeletal problems among pharmaceutical sales representatives in Samsun, Turkey

Objectives: Many studies have been performed about work-related musculoskeletal pain (WRMSP) in various groups of professions. However pharmaceutical sales representatives (PSRs) have not been investigated with regard to their musculoskeletal problems related to their works. This study was aimed to investigate the prevalence of work-related musculoskeletal pain (WRMSP) and depression among PSRs; the quality of life in these subjects and to investigate which socio-demographic variables are associated with the presence of complaints, in Turkey. Methods: Among 170 participants, 73.5% completed the survey. A face-to-face questionnaire was given and SF-36 (Short Form-36) and Beck Depression Inventory (BDI) were applied. Results: The highest frequencies of WRMSP were in low back (55.4%) and shoulder (41.1%). The most frequently self-reported complaints of the PSRs were long time standing at work (68.8%) and driving long distances (61.6%). There was significant difference between the groups with and without WRMSP all subgroups of SF-36 test ( p< 0.05). Fourteen of the participants had depression according to BDI. There was a negative correlation between SF-36 and BDI scores ( p< 0.05). Conclusions: WRMSP is common among PSRs in Turkey. Besides; depression, reduced QOL and low back pain are frequently seen. Modifications in ergonomics at work and work conditions may solve these problems.

The effects of temperament and character on the choice of contraceptive methods.

Objectives To identify the effects of temperament and character on the selection of contraceptive methods. Methods Cross-sectional study carried out in June 2005 at the Ondokuz Mayıs University Samsun Health College with the participation of 102 young women. The participants were asked to complete the Contraception Choice Questionnaire devised by the researchers, and the Cloninger Temperament and Character Inventory. Results The mean age of the participants was 22.30 ± 1.27 years; 39 participants (38.2%) mentioned Norplant®, 30 (29.4%) condoms, 17 (16.6%) intrauterine devices (IUDs) and 16 (15.7%) oral contraceptives (OCs) as the method they would consider using in the future. The mean scores of self-directedness and self-transcendence of the groups differed significantly (p < 0.05). Students who indicated they would choose OCs had higher average scores for self-directedness than those choosing IUDs; the mean self-transcendence scores of students choosing IUDs were significantly higher than the scores of those selecting condoms (p < 0.01). Subjects choosing Norplant® cited ease of use; those choosing condoms cited their eliciting fewer side effects; those choosing IUDs cited their high levels of safety; and those choosing OCs cited ease of use and high reliability as the reasons for their choices. Conclusions We think that identifying the roles of temperament and character in the selection process of a contraceptive method will help in achieving a wider application of contraception.

The Search for Non-Medical Treatment by Patients with Psychiatric Disorders

Patients in Turkey frequently seek help from non-physicians such as hodjas and fortune-tellers. The aim of this study is to assess the prevalence, reasons for and results of the search for non-medical help by patients with psychiatric disorders. It was determined that 42.2% of patients consulted a hodja or a fortune-teller, and many (23.1%) were either the subject of prayers or else were advised to pray themselves as treatment. Considering that a significant number of patients seek non-medical treatment, it is thought that people should be informed about psychiatric disorders, therapies, and how to obtain them.

Evaluation of life satisfaction of elderly people according to different life styles

Yaşlanma fiziksel, ruhsal ve sosyal yönden bireyde gerilemeye neden olan doğal bir süreçtir. Dünya Sağlık Örgütü (DSÖ) tarafından yapılan tanımlamada kronolojik yaş dikkate alınmakta ve yaşlılık dönemi “65 yaş ve üzeri” olarak kabul edilmektedir. Ancak farklı yaş kriterleri de kullanılmaktadır. Örneğin, Birleşmiş Milletler yaşlılar üzerine yapılan değerlendirmelerde 60 yaş ve üzerini dikkate almaktadır. Yaşlılık dönemi sınıflaması ise 65-74 yaş arası “genç yaşlı”, 75-84 yaş arası “orta yaşlı” ve 85 yaş üzeri ise “ileri yaşlı (ihtiAbSTrACT