Zahide Koşan

The Changing Rate of Suspected Rabies Bites after Begin to Act Animal Shelter in Erzurum City

OBJECTIVE We aimed to evaluate the relationship between establishing an animal shelter in Erzurum and the number of suspected rabies bites between the years 2005 and 2012. MATERIALS AND METHODS A retrospective, repeated cross-sectional study was planned in Erzurum in the year 2013. Records between the years 2005 and 2012 were obtained from the Communicable Diseases Department of the Erzurum Health Directorate. Data for 5789 cases exposed to suspected rabies bites were analyzed. RESULTS 5789 suspected rabies bites were encountered in Erzurum between the years 2005 and 2012. After establishing the animal shelter in 2009, 4239 dogs were collected from the streets within four years and 426 of them were released after immunization. Additionally, the following services were given in the animal shelter between 2009 and 2012: immunization of 2935 dogs, sterilization of 1735 dogs, and release of 2082 dogs back to the street. 4-years before the establishment of the animal shelter, the number of dog-bites had decreased from 3403 cases to 2386 cases; 4-years after the establishment of the shelter, it declined by 29.8%. While there were 1096 suspected rabies cases during the year 2008, this ratio decreased by 40.9% after the establishment of the animal shelter in the year 2009. During the year 2010, where we had the highest number of homeless dog collection to the animal shelter, the decrease in suspected rabies bites reached the maximum decrease, namely 51.0%. Spearman correlation analysis showed a strong negative correlation between the number of collected animals and suspected rabies bites (r = -0,862; p=0.006). CONCLUSION Suspected rabies cases are common in Turkey and some cases of rabies are encountered. The number of suspected rabies bites in Erzurum has decreased significantly after establishing the animal shelter. It is an evident that establishing rehabilitation centers for homeless animals in all cities will have an important role in controlling zoonotic diseases including rabies.

Willingness to Receive the Influenza A(H1N1) Vaccine and its Determinants among University Students during the 2009 Outbreak in Turkey.

OBJECTIVE The study aimed to determine the willingness to receive the Influenza A(H1N1) vaccine and its determinants in a large group of university students. MATERIALS AND METHODS This is a self-administered questionnairre based cross-sectional study. Students being educated at health and non-health faculties were invited to participate in this attitude survey. RESULTS A total of 974 students were included in the study, of whom 51.3% (n=500) were in health related faculties. The rate of willingness to receive the Influenza A(H1N1) vaccine was 11.9 and 7.5% for health and non-health groups, respectively (p<0.05). For the health group, having been vaccined with seasonal influenza was a significant determinant of being willingness to receive the Influenza A(H1N1) vaccine (O.R [95% C.I.]), (O.R: 2.9 [1.5-5.6]) and to believe that the Influenza A(H1N1) vaccine prevents swine flu (O.R: 1.7 [1.09-2.8]). For the non-health group, the only determinant was to believe that Influenza A(H1N1) vaccine prevents from swine flu (O.R: 19.1 [5.7-64.1]) which found to be affected by confusing news in media. CONCLUSION The public health professionals who will organize the efforts to improve the acceptability of Influenza A vaccines during influenza outbreaks should try to increase the vaccination rates of seasonal influenza. Information provided by the media should be organized in order not to cause fear and confusion, which was shown to decrease willingness and belief in the Influenza A(H1N1) vaccine.

Fertility Preferences of Women in a Province Center

Objective Fertility preferences and status are important parameters involved in reproductive health. The aim of the present study was to define some characteristics of the fertility preferences of women aged 15-49 years in our region. Materials and Methods This cross-sectional study was conducted between 2013 and 2015. The study population consisted of 627 married women aged 15-49 years living in a city center. A questionnaire about socio-demographic characteristics, pregnancy and birth traits, and fertility preferences was applied. Chi-square, Mann-Whitney U, and Spearman correlation tests were analyzed using Statistical Package for Social Sciences (SPSS) version 20.00 (IBM, SPSS Corp.; Armonk, NY, USA) software for statistical analyses. A p<0.05 was considered statistically significant. Results The mean age of the women participating in the survey was 33.03±7.1 years. Median age at marriage was 20 years, mean age at first pregnancy was 21 years, and mean number of pregnancies was 3.07 years, with 14.6% having had more than five pregnancies and 34.6% having experienced previous miscarriages. The mean number of live births was 2.2, and 21.5% of women had waited 24 months between pregnancies. Additionally, 77.7% reported using family planning of any kind, with 62.1% using the modern method. Womens ages at first marriage varied significantly depending on education (p<0.001) and working status (p<0.001), whereas ages at first pregnancy varied significantly depending on educational status (p<0.001). The total number of pregnancies varied significantly depending on level of education, working status, and family income (p<0.001). Times between two pregnancies among women with histories of more than two pregnancies differed significantly depending on educational status (p<0.05). Conclusion The most important factors in womens fertility preferences are education, work, and income. Increasing womens educational levels can lead to safe and healthy pregnancies and births.

Levels of burnout and their associated factors among physicians working in Northeast Anatolia

Context: The concept of burnout is a condition seen in occupational groups working face-to-face with people and resulting in emotional exhaustion, depersonalization, and low professional productivity. Aims: The purpose of this study was to determine burnout levels and associated factors in physicians practicing in Erzurum, Northeast Anatolia, Turkey. Settings and Design: This research was designed as a cross-sectional descriptive study. The research sample size was calculated at 663 participants with a 99% confidence interval and a 3% margin of error using Epi Info software. A 10% incomplete or nonresponse rate was added, for a target cohort of 730 individuals. Seven hundred and eleven physicians agreeing to take part were enrolled. Subjects and Methods: A questionnaire consisting of questions concerning sociodemographic characteristics and the Maslach Burnout Inventory (MBI) was used as the data collection tool. The questionnaires were distributed by the authors and completed by the physicians in person. Statistical Analysis: Descriptive data were expressed as percentage, mean, median, and standard deviation. Data were analyzed using the Kruskal–Wallis and Mann–Whitney U tests and binary logistic regression analysis. P < 0.05 was regarded as statistically significant. Statistical analyses were performed on SPSS 15.00 software. Results: The mean age of the physicians in the study was 34.4 ± 7.7 years. Mean MBI subdimension scores were 15.6 ± 7.0 for emotional exhaustion, 5.7 ± 3.9 for depersonalization, and 21.0 ± 4.4 for personal accomplishment. Mean emotional exhaustion and depersonalization scores were significantly higher and personal accomplishment scores significantly lower in physicians aged under 25, not taking vacations, working in public hospitals, who were working as research assistants. Conclusions: Burnout levels among the participants were low (emotional exhaustion in 75%, depersonalization in 76.2%, and low personal accomplishment in 69.6%).

Effectiveness of breathing exercises during the second stage of labor on labor pain and duration: a randomized controlled trial

BACKGROUND Some research exists on the effect of non-pharmacological approaches for labor pain relief. However, there is limited information about effectiveness of breathing exercises in pregnant women to reduce maternal pain during labor. OBJECTIVE To determine whether breathing exercises for pregnant women during the second stage of labor have beneficial effects on maternal pain, duration of labor, and the first-minute Appearance, Pulse, Grimace, Activity and Respiration (APGAR) scores. DESIGN, SETTING, PARTICIPANTS AND INTERVENTIONS This randomized clinical trial involved 250 pregnant women, who were randomly divided into two groups: intervention group (IG; n = 125) and control group (CG; n = 125). IG received one session breathing exercise training and performed breathing exercises during the second stage of labor versus the CG that did not receive any breathing exercise training. MAIN OUTCOME MEASURES The effects of breathing exercises on maternal pain were determined by Visual Analogue Scale (VAS), duration of the second stage of labor, and the first-minute APGAR scores. RESULTS The mean age of the participants was (23.2 ± 4.2) (range: 18 to 42) years. Both IG and CG had similar baseline characteristics in terms of age, education level, occupation, and smoking (P > 0.05). The mean VAS scores of IG and CG were (88.2 ± 6.3) and (90.5 ± 7.0), respectively (P < 0.001). The duration of the second stage of labor was (369.6 ± 92.0) s for IG and (440.7 ± 142.5) s for CG (P < 0.001). The mean first-minute APGAR scores were (8.84 ± 0.50) for IG and (8.73 ± 0.89) for CG (P > 0.05). CONCLUSION Based on this study, breathing exercises with deep inhalation and exhalation in pregnant women are effective in reducing the perception of labor pain and shortening the duration of the second stage of delivery. Therefore, we recommend breathing exercises as an effective modality for labor pain management and shortening the duration of labor. TRIAL REGISTRATION This study is registered on the website of ClinicalTrials.gov (www.clinicaltrials.gov) with the number of NCT03066973.

The Effects of Auricular and Body Acupuncture in Turkish Obese Female Patients: A Randomized Controlled Trial Indicated Both Methods Lost Body Weight But Auricular Acupuncture Was Better Than Body Acupuncture

It was aimed to observe the efficacy of body acupuncture and auricular acupuncture for the management of obesity. Fifty female obese patients were randomized into 2 groups; a Body Acupuncture Group (GBA; n=25) and an Auricular Acupuncture Group (GAA; n=25). All patients were followed up for 12 weeks. Their anthropometric measurements (body weight, body mass index, body fat percentage, waist circumference and hip circumference) were recorded for analysis in every 15 days. Patients were compared in terms of anthropometric measurements. Patients in the GAA received 6 sessions of auricular acupuncture in every 15 days. We used bilateral 2 points namely anti-aggression point and stomach point for auricular acupuncture. Bilateral L14, LIll, ST25, ST36, SP6, SP9, CV12, and CV6 points were selected for two times in a week (totally 24 sessions) in the GBA. Independent samples t test, patients in GAA completed the study. The mean age of patients was 36.2±10.5 years (GBA: 32.7±12.3; GAA: 39.1±7.9). The mean weight was 95.7±11.8 kg before acupuncture, and it decreased to 92.5±14.4 kg after acupuncture in GBA; and it was 95.1±15.6 kg before acupuncture and it decreased to 91.5±11.0 kg after acupuncture in GAA. Change in weight after acupuncture was 2.6±2.4 kg in GBA, and 4.2±3.4 kg in GAA (p<0.05). In both groups, changes in weight, body mass index, body fat percentage, waist circumference, and hip circumference were statistically significant (p<0.05). Only one patient reported side effect related to acupuncture. Body acupuncture and auricular acupuncture have the therapeutic role in the management of obesity. In this study, auricular acupuncture is more effective in reducing body weight than body acupuncture. Thus, auricular may be useful and safe, non-pharmacological treatment.