Türkiye'de reküren iskemik inme üzerine etkili risk faktörleri

Objectives: The aim of the study is to determine the risk factors for recurrent ischemic stroke. Patients and Methods: We compared the risk factors in 186 recurrent ischemic stroke patients (94 males, 92 females; mean age 66.85±11.21 years; range 20-95 years) with 300 first-ever stroke patients (control group) among 1150 ischemic stroke patients who had been treated in Neurology Department of Trakya University Medical Faculty over a period of three years. Results: The recurrence rate was 16.1%. Within the recurrent patients, 89.7% had hypertension, 32.3% had atrial fibrillation, 24.4% had diabetes mellitus, 15.6% had transient ischemic attack, and 57.5% had several types of heart diseases. The most frequent recurrence etiology was embolic according to TOAST criteria (35.5%). Transient ischemic attack (OR= 2.98; 95% CI 1.54-5.76), hypertension (OR= 1.96; 95% CI 1.11-2.64) and atrial fibrillation (OR= 1.74; 95% CI 1.44-2.66) were found as the independent risk factors. The mean of the modified Rankin scores of the study group at their last charge were significantly higher than that of the control group. Conclusion: Our findings emphasize the importance of the consistent anticoagulation therapy for patients with atrial fibrillation and close blood pressure control in patients with hypertension.Amaç: Bu çalışmada reküren iskemik inmede risk faktörleri belirlendi. Hastalar ve Yöntemler: Üç yıllık dönemde Trakya Üniversitesi Tıp Fakültesi Hastanesi Nöroloji Kliniği’ne başvuran toplam 1150 hasta içinden reküren inme geçiren 186 hasta (94 erkek, 92 kadın; ort. yaş 66.85±11.21; dağılım 20-95) ilk iskemik inmesini geçiren 300 hasta ile risk faktörleri açısından karşılaştırıldı. Bulgular: Reküren inme oranı %16.1 idi. Reküren inme grubunda hastaların %89.7’sinde hipertansiyon, %32.3’ünde atrial fibrilasyon, %24.4’ünde diabetes mellitus, %15.6’sında geçici iskemik atak ve %57.5’inde değişik kalp hastalıklarının olduğu gözlendi. Reküren inmenin en sık görülen etyolojik nedeni TOAST sınıflamasına göre kardiyoembolizmdi (%35.5). Geçici iskemik atak (OR= 2.98; %95 CI 1.54-5.76), hipertansiyon (OR= 1.96; %95 CI 1.11-2.64) ve atrial fibrilasyon (OR= 1.74; %95 CI 1.44-2.66) reküren inme için bağımsız risk faktörü olarak bulundu. Hasta grubu ile kontrol grubu modifiye Rankin skoru için karşılaştırıldığında hasta grubunda bu skorun daha kötü olduğu izlendi. Sonuç: Bizim bulgularımız hipertansif hastalarda kan basıncı kontrolünün, atriyal fibrilasyonlu hastalarda ise etkin antikoagülasyonun reküren inmeyi önlemede önemli olduğunu göstermiştir

Violence Tendencies And Attıtudes Towards gender of Trakya University Students Studying in Central Distrıct

Şiddet son yıllarda tüm dünyada artmaktadır. Her yıl bir milyondan fazla insan şiddet nedeniyle ölmekte, on binlerce insan da her gün ölümcül olmayan şiddete maruz kalmaktadır. Toplumsal cinsiyet rolleri hem kadınların hem de erkeklerin yaşamını şekillendirmekte; özellikle kadınların toplumsal statüsünü olumsuz etkileyerek fırsatların kullanılması, kaynakların ayrılması ve kullanımında, hizmetlerin elde edilmesinde kadınlar aleyhine eşitsizliğe neden olmaktadır. Bu çalışmayla 2018-2019 dönemi bahar yarıyılında Trakya Üniversitesi’nin Edirne merkez ilçedeki eğitim birimlerinde öğrenim gören üniversite öğrencilerinin şiddet eğilimleri ve toplumsal cinsiyete ilişkin tutumlarını belirlemek, bunu etkileyen sosyo-demografik değişkenleri ortaya koymak ve çözüm önerilerinde bulunmak amaçlanmıştır. Çalışmamız tanımlayıcı ve kesitsel nitelikte olup, Mart 2019-Haziran 2019 tarihleri arasında Trakya Üniversitesi’nin Edirne İl merkezinde bulunan fakülte, yüksekokul ve meslek yüksekokullarında öğrenim gören 751 öğrenci ile gerçekleştirilmiştir. Öğrencilere araştırmacılar tarafından literatürden yararlanılarak geliştirilen 49 soru, Toplumsal Cinsiyet Rolleri Tutum Ölçeği’ne ait 38 soru ve Şiddet Eğilim Ölçeği’ne ait 20 soru olmak üzere toplam 107 sorudan oluşan anket formu uygulanmıştır. Trakya Üniversitesi’nin merkez ilçede eğitim gören öğrencilerin toplumsal cinsiyet tutumu “eşitlikçi”, şiddet eğilimleri ise “az” bulunmuştur. Kadın öğrencilerin, Güzel Sanatlar Fakültesi’nde eğitim görenlerin, Güzel Sanatlar Lisesi ve Devlet Konservatuvarı’ndan mezun olanların, il merkezi ve ilçede doğup büyüyenlerin, anne ve babasının öğrenim düzeyi yüksek olanların, anne babası ayrı öğrencilerin, annesi çalışan ya da emekli olanların, ebeveynleri kendileri tanışıp evlenenlerin, bir kardeşi olanların ve ailesinin ortalama aylık geliri yüksek 80 olanların toplumsal cinsiyet tutumları daha eşitlikçi olduğu saptanmıştır (p<0.05). Erkek öğrencilerin, Edirne Sosyal Bilimler Meslek Yüksekokulu’nda öğrenim görenlerin ve aile içi şiddete veya herhangi bir zamanda şiddete maruz kalanların şiddet eğilimleri daha fazladır (p<0.05). Öğrencilerinin şiddet eğilimleri ile toplumsal cinsiyet rolleri tutumu arasında negatif yönde zayıf düzeyde anlamlı bir ilişki bulunmuş olup, şiddet eğilimi yüksek olan öğrencilerin toplumsal cinsiyet rolleri tutumunun daha düşük olduğu görülmüştür. Geleceğin birer yetişkini olacak olan üniversite öğrencilerinin toplumsal cinsiyette eşitlikçi bir tutuma sahip olmaları ve şiddet konusunda hassas olup şiddet eğilimlerinin az ya da hiç olmaması toplumun sağlığı için önemli bir konudur. Bu nedenle; toplumsal cinsiyet eşitliği ve şiddet konularında öğrencilerin farkındalığı arttırılmalı ve alanda yapılacak başka çalışmalar ile konunun önemi vurgulanmalıdır.Violence has been increasing all over the world in recent years. More than a million people die every year due to violence, and tens of thousands of people are exposed to non-lethal violence every day. Gender roles shape the lives of both women and men; they cause inequality against women especially in the use of opportunities, allocation and use of resources and obtaining services by negatively affecting women's social status. With this study, it was aimed to determine the violence trends and gender-related attitudes of the university students studying in the educational units of Trakya University in Edirne central district in spring semester of 2018-2019 period, to reveal the socio-demographic variables affecting them and to offer solutions. Our study was descriptive and cross-sectional.It was conducted with 751 students studying in faculties, colleges and vocational high schools of Trakya University located in the city center of Edirne between March 2019 and June 2019. A questionnaire form consisting of 107 questions (49 questions developed by the researchers using the literature, 38 questions of Gender Roles Attitude Scale and 20 questions of Violence Tendency Scale) were applied to the students. It was found that the gender attitude of Trakya University students studying in central district was “egalitarian” and violent tendencies were “low”. Gender attitudes of women 82 students, those studying at the Faculty of Fine Arts, graduates of the Fine Arts High School and State Conservatory, those who were born and raised in the provincial center and district, those with a high education level of parents, those whose parents were separated, those whose mothers are working or retired, those whose parents were met and married themselves, those had a sibling and whose family had a higher average monthly income were more egalitarian (p <0.05). Violence tendencies of male students, those who study at Edirne Vocational High School of Social Sciences and those who were exposed to domestic violence or violence at any time were higher (p <0.05). It was found that there was a significant weak negative relationship between the students' violence tendencies and their attitudes towards gender roles, and it was observed that students with high violence tendency had lower attitudes towards gender roles. It is an important issue for community health that university students, who will become adults of the future, to have egalitarian attitude towards gender and to be sensitive about violence and to have little or no violence tendencies. Therefore; students' awareness of gender equality and violence should be increased and the importance of the subject should be emphasized with other studies in the subject area

Associations Between Violence Related Behaviors and Self Perceived Health Among Trakya University Students

Objective: This study was carried out to determine the association between violence related behaviors and self-reported health among university students. Material and Methods: This is a cross-sectional study, which included a representative sample of all students of Trakya University. The sample of 1620 students enrolled at Trakya University was stratified according to sex and actual student number of faculties and colleges and selected by systematic sampling. In addition to descriptive statistics, Chi Square analysis and Logistic Regression analysis were used for statistical evaluation.Results: 6.3% of the respondents reported that they were exposed to violence, 33.5% of them stated they were involved in a physical fight during the past 12 months, 4.9% of them stated they did not go to school at least one day during the past 30 days because they felt unsafe and 4.4% of the students reported they had attempted suicide during the past 12 months. The analyses have shown that violence related behaviors were significantly associated with poor health after controlling the potential confounders. Conclusion: There is a need for more prospective studies for exploring the effects of violence related behaviors to health. Interventions targeting youths who engage in violence should consider that violence related behaviors may be markers for poor health

R-R Interval Variability Analysis With Electromyography Detects Early Autonomic Neuropathy In Diabetic Children

ABSTRACT Purpose: Autonomic neuropathy may exist together with peripheral neuropathy, especially in diabetic patients and it is important to diagnose early autonomic neuropathy especially cardiac one because of their serious effects on mortality and morbidity rates. A decrement of R-R interval variability (RRIV) is a good marker for cardiac autonomic neuropathy. We analyzed RRIV with an alternative method using electromyography machine, and assessed the RRIV in diabetic children who have no clinical sign of cardiac autonomic neuropathy. Method: 64 healthy (mean age 9.5±1.8) and 33 type 1 diabetic (mean age 10.2±2.8) children who have no peripheral neuropathy were included. Recording was made on EMG machine and RRIV was obtained during quiet and deep breathing. Two surface electrodes were placed on the chest, and using triggering mode and delay line, two QRS complexes displayed on the screen. Since the first QRS complex was triggering potential, variation in timing of the second QRS complex represented variation in the R-R interval. RRIV was expressed as a percentage of the average R-R interval. Results: In healthy children, RRIV was 23.9±9.5% in rest and 25.6±10.2% in hyperventilation. In diabetic children, RRIV was 17,4±6.6% in rest, 22±8.9% in hyperventilation. Resting RRIV was lower in diabetic children than healthy children (p=0.001), but there was no difference between groups in hyperventilation (p=0.4). Discussion: Our findings suggest that RRIV may have value to determine cardiac autonomic neuropathy in diabetic children who have no clinical sign of cardiac autonomic neuropathy. Conclusion: The technique, we used is a non time consuming procedure, easily performed in EMG laboratory, and is a simple way of reflecting autonomic dysfunction of the heart

Validity and reliability of the Turkish version of the central sensitization inventory

OBJECTIVES: The aim of this study was to translate the Central Sensitization Inventory (CSI) into the Turkish language, to perform a psychometric validation, and to investigate its reliability in patients with chronic spinal pain with an organic origin, patients with fibromyalgia, and pain-free control individuals. PATIENTS AND METHODS: Between April 2016 and February 2017, the translation of the original English version of the CSI into Turkish was performed using the forward-backward translation method. A total of 100 fibromyalgia patients (6 males, 94 females; mean age: 45.0±8.4 years; range, 25 to 60 years), 100 patients with chronic spinal pain with an identified organic origin (CSPO), (10 males, 90 females; mean age: 43.8±9.7 years; range, 21 to 60 years), and 100 healthy controls (8 males, 92 females; mean age: 35.8±10.1 years; range, 25 to 55 years) were included in the study. Demographic characteristics were collected. Test-retest reliability was determined by re-administering the CSI-Turkish (CSI-Turk) two weeks after the first application. RESULTS: The internal consistency (Cronbach's alpha) was found to be 0.92 and the intraclass correlation coefficient was 0.93. Patients with fibromyalgia, a very common central sensitivity syndrome (CSS), had the highest mean CSI-Turk scores, and healthy controls had the lowest. Using the recommended cut-off score of 40 resulted in 87% sensitivity and 90% specificity in distinguishing between fibromyalgia and control individuals. CONCLUSION: This study suggests that the CSI-Turk can be effectively used as a screening tool to elucidate CS-related symptomology among patients with chronic pain with a high internal consistency, test-retest reliability, sensitivity, and specificity

The Effect of COVID-19 Rapid Antigen Testing in Education on Early Detection and Prevention of Epidemics: A Faculty Example from Trakya University

Introduction: To ensure the safe continuation of face-to-face education, there is ongoing discussion regarding the routine use of easily applicable tests. This study aimed to determine the effectiveness of the COVID-19 rapid antigen tests in the early diagnosis of COVID19 cases among university students studying face-to-face. Materials and Methods: Our study spanned a duration of eight weeks and included students from three different departments within a faculty. The first group of students underwent rapid antigen tests twice a week, with positive results confirmed by PCR testing. The second group was visited twice a week, and students displaying symptoms underwent both rapid antigen and PCR tests. The third group was monitored solely through the use of “Hayat Eve Sığar (Life Fits Into Home)” codes. To identify asymptomatic cases and students who did not report their symptoms in the second group, all volunteers on the final day of the study underwent screening using rapid antigen tests. The groups were compared based on the obtained results, and a questionnaire was administered to the students during each visit. This approach allowed for the investigation of factors associated with positive cases. Results: A total of 274 students participated in our study, with 114 (41.6%) in the first group, 96 (35.0%) in the second group, and 64 (23.4%) in the third group. The rate of detecting the cases in the first group was significantly higher than in the second and third groups. Conclusion: The obtained findings indicate that COVID-19 rapid antigen tests, as mentioned, can serve as a screening tool for the early detection of cases and prevention of further spread among students during face-to-face education. These results align with the criteria established by international organizations and epidemiological standards. By screening all participating students, the potential for bias is minimized, enabling the identification of asymptomatic individuals who may unknowingly transmit the virus

Psychological Determinants of Turkish Farmers’ Health and Safety Behaviors: An Application of the Extended Theory of Planned Behavior

Background: Structural and behavioral factors are among the causes of occupational accidents in agriculture. The SACURIMA Cost network developed a questionnaire to measure the determinants of farmers’ safety behavior based on the extended theory of planned behavior (TPB). Extended TPB adds subjective norms, subjective control, physical barriers and safety culture to TPB. Objective: The aim of this study is to test the psychometric properties of the “Farmers Safety Behaviors questionnaire” developed by the SACURIMA Cost network. Methods: A Turkish version of the questionnaire was applied to 305 farmers producing six different agricultural products in Turkey. The tool consists of 64 items measuring the determinants of four risk-related behaviors (fall prevention, machine handling, chemical-pesticide use, and animal handling) in a single extended TPB model. Results: The alpha values for the six dimensions ranged from 0.69 to 0.89. The confirmatory factor analysis results for all dimensions were at acceptable levels (CFI range = 0.93–0.99; RMSEA range = 0.03–0.09). Four path models were used to test the behaviors and their predictors, and the results were found to be predictive. The criterion and known groups’ validity analyses results were sufficient. Conclusion: The “Farmers Safety Behaviors Questionnaire” is a valid and reliable tool to measure the determinants of occupational safety behaviors in Turkish farmers

Push and Pull Factors of Why Medical Students Want to Leave Türkiye: A Countrywide Multicenter Study

Phenomenon: Physician immigration from other countries is increasing as developed countries continue to be desirable destinations for physicians; however, the determinants of Turkish physicians’ migration decisions are still unclear. Despite its wide coverage in the media and among physicians in Türkiye, and being the subject of much debate, there is insufficient data to justify this attention. With this study, we aimed to investigate the tendency of senior medical students in Türkiye to pursue their professional careers abroad and its related factors. Approach: This cross-sectional study involved 9881 senior medical students from 39 different medical schools in Türkiye in 2022. Besides participants’ migration decision, we evaluated the push and pull factors related to working, social environment and lifestyle in Türkiye and abroad, medical school education inadequacy, and personal insufficiencies, as well as the socioeconomic variables that may affect the decision to migrate abroad. The analyses were carried out with a participation rate of at least 50%. Findings: Of the medical students, 70.7% had emigration intentions. Approximately 60% of those want to stay abroad permanently, and 61.5% of them took initiatives such as learning a foreign language abroad (54.5%) and taking relevant exams (18.9%). Those who wanted to work in the field of Research & Development were 1.37 (95% CI: 1.22–1.54) times more likely to emigrate. The push factor that was related to emigration intention was the “working conditions in the country” (OR: 1.89, 95% CI: 1.56–2.28) whereas the “social environment/lifestyle abroad” was the mere pull factor for the tendency of emigration (OR: 1.73, 95% CI: 1.45–2.06). In addition, the quality problem in medical schools also had a significant impact on students’ decisions (OR: 2.20, 95% CI: 1.83–2.65). Insights: Although the percentage of those who want to emigrate “definitely” was at the same level as in the other developing countries, the tendency to migrate “permanently” was higher in Türkiye. Improving working conditions in the country and increasing the quality of medical faculties seem vital in preventing the migration of physicians