Determinants of pre-lacteal feeding practices in urban and rural Nigeria; a population-based cross-sectional study using the 2013 Nigeria demographic and health survey data.

Background: Prelacteal feeding (PLF) is a barrier to exclusive breast feeding. Objective: To determine factors associated with PLF in rural and urban Nigeria. Methods: We utilized data from the 2013 Nigerian Demographic and Health Survey. Bivariate and multivariate analyses were used to test for association between PLF and related factors. Results: Prevalence of PLF in urban Nigeria was 49.8%, while in rural Nigeria it was 66.4%. Sugar or glucose water was given more in urban Nigeria (9.7% vs 2.9%), plain water was given more in rural Nigeria (59.9% vs 40.8% ). The multivariate analysis revealed that urban and rural Nigeria shared similarities with respect to factors like mother\u2019s education, place of delivery, and size of child at birth being significant predictors of PLF. Mode of delivery and type of birth were significant predictors of PLF only in urban Nigeria, whereas, mother\u2019s age at birth was a significant predictor of PLF only in rural Nigeria. Zones also showed variations in the odds of PLF according to place of residence. Conclusion: Interventions aimed at decreasing PLF rate should be through a tailored approach, and should target at risk sub -groups based on place of residence

Health promotion in the “Cancer Early Diagnosis, Screening and Education Centers”in Ankara: Mixed methods research among women/Ankara’daKanser Erken Teşhis Tarama Eğitim Merkezlerinde sağlığı geliştirme:Kadınlar ile yürütülen karma yöntemli bir araştırma

Abstract Objective: Prevention remains the most cost-effective long term strategy for cancer control. This study assessed health services delivered by the “Cancer Early Diagnosis, Screening and Education Centers” (CEDSECs), with a special focus on health promotion. Methods: The study group included 332 women, aged 30-70 years, who had attended any of the three centers in Ankara and had volunteered to participate in the study with a follow-up. A mixed methods design (before and after surveys, medical records and focus groups) was used for data collection. Descriptive statistics, the chi-square test, Fisher’s exact test, McNemar’s chi-square test, Bowker’s test for symmetry and the paired samples t test were used for quantitative data analysis, whereas, manifest content analysis was used for qualitative data. Results: Of the participants surveyed after they had used the services of the centers (n=319), 97.5% were satisfied with the centers’ services. After service delivery, participants’ knowledge on cancer preventive measures was significantly higher (p&lt;0.001). Despite an increase in knowledge, educational activities in the centers were not associated with any improvement in health behaviors (p&gt;0.05), except for an increase in breast self-examination (p&lt;0.001). Conclusion: Most women were satisfied with the CEDSEC services and did not encounter problems with cancer screening; however current services seem only to increase cancer awareness without any significant effect on health behaviors. Within the scope of health promotion services, a multidimensional approach is needed including evidence-based educational and behavioral interventions with follow-ups. Key Words: Cancer screening, health promotion, health education, health behavior, preventive health services.Özet Amaç: Kanser kontrolünde korunma, halen en maliyet-etkili ve uzun dönemli strateji olmayı sürdürmektedir. Bu çalışmada, Kanser Erken Teşhis, Tarama ve Eğitim Merkezleri’nin (KETEM) hizmetlerinin, özellikle hizmetlerin sağlığı geliştirme boyutuna odaklanarak değerlendirilmesi amaçlanmıştır.Yöntem: Araştırma grubunu, Ankara’da bulunan KETEM’lere başvuran ve izleme dönemi ile birlikte çalışmaya katılmayı kabul eden 30-70 yaş arası 332 kadın oluşturmaktadır. Çalışmada, karma veri toplama yöntemi (hizmet öncesi ve sonrası anket formları, tıbbi kayıtlar ve odak grup görüşmeleri) kullanılmıştır. Niceliksel verilerin analizinde tanımlayıcı istatistikler, ki-kare testi, Fisher’in kesin ki-kare testi, McNemar`ın ki-kare testi, Bowker’in simetri testi ve bağımlı gruplarda t-testi kullanılmış, niteliksel verilerin analizinde ise görünür/açık içerik analizi yapılmıştır. Bulgular: Hizmet sonrası görüşülen katılımcıların (n=319) %97.5’i KETEM’lerin sunduğu hizmetlerden memnun kalmıştır. Katılımcıların kanserden korunmak için alınabilecek önlemler konusunda bilgi düzeyi, hizmet sonrasında anlamlı düzeyde artmıştır (p&lt;0.001). Merkezlerde verilen eğitimler, kanserden korunmaya yönelik önlemler konusundaki bazı bilgileri artırmakla beraber, kendi kendine meme muayenesi sıklığının artması (p&lt;0.001) dışında, diğer sağlık davranışları ile ilişkili bulunmamıştır (p&gt;0.05). Sonuç: KETEM’lerden hizmet alan kadınların çoğu hizmetlerden memnun kalmış ve kanser taramaları ile ilgili sorun yaşamamıştır; ancak bulgular, merkezlerin mevcut hizmetlerinin, kanser konusunda farkındalığı arttırmakla birlikte sağlık davranışlarını önemli düzeyde etkilemediğini göstermektedir. Sağlığı geliştirme hizmetleri kapsamında; kanıta dayalı eğitim ve davranış müdahaleleri ile bu müdahaleleri izleme dönemlerini de içeren çok boyutlu bir yaklaşıma gereksinim vardır. Anahtar Kelimeler: Kanser taraması, sağlığı geliştirme, sağlık eğitimi, sağlık davranışı, koruyucu sağlık hizmetleri   </p

Evaluation Of Occupational Health Teaching Sessions For Final Year Medical Students

Objectives The study was conducted with the aim of evaluating applied occupational health teaching for final-year medical students at Hacettepe University, Faculty of Medicine. Methods The study included all sixth grade medical students (n=293) during one academic year. Pre- and post-training tests were used to assess the magnitude of change in knowledge and attitude of students on occupational health, whereas the opinion of students on several aspects of the quality of teaching sessions were assessed by using post-training questionnaires. Results Post-training tests revealed that the level of knowledge on all aspects of occupational health increased among medical students. An evaluation of the teaching sessions showed favorable results for the overall quality of the sessions: 81.3% of the students stated that the sessions were well organized, 81.7% remarked the workplace/factory visit was a valuable experience, and 91.0% stated feeling more competent on occupational health issues. Conclusion There was a greater increase in students' knowledge on technical precautions than their knowledge on issues related to medical practice in the workplace. Visiting a workplace was found to contribute to the overall aim of knowledge and attitude change on occupational health issues. The scope of undergraduate medical education should be extended by improving occupational health education with respect to educational content, duration, and methods.PubMedScopu

[Rational Use of Antibiotics Among Turkish Migrants In Germany: Knowledge, Attitudes and Interaction With Physicians and Pharmacists].

Erdsiek F, Aksakal T, Ozcebe H, et al. Antibiotikanutzung bei Menschen mit türkischem Migrationshintergrund – Wissen, Einstellungen und Interaktion mit ÄrztInnen und ApothekerInnen. Gesundheitswesen (Bundesverband der Arzte des Offentlichen Gesundheitsdienstes (Germany)). 2019;(01):5-71.ZIEL DER ARBEIT: Kulturelle Aspekte der Medikamentennutzung in der Türkei können aufgrund ausgeprägter transnationaler Beziehungen das Nachfrageverhalten von Menschen mit türkischem Migrationshintergrund in Deutschland beeinflussen. Über die Antibiotikanutzung in dieser Bevölkerungsgruppe ist allerdings wenig bekannt. Die Studie untersucht, wie sich das Nachfrageverhalten von Menschen mit türkischem Migrationshintergrund und die Interaktion mit dem Gesundheitssystem im Zusammenhang mit der Antibiotikanutzung gestalten, welche Einstellungen zugrunde liegen und wie diese mit vorhandenem Hintergrundwissen zusammenhängen. METHODIK: Mit einem qualitativen Ansatz wurden Handlungslogiken und das Verhalten von türkeistämmigen Erwachsenen in Deutschland untersucht. Dazu wurden leitfadengestützte Fokusgruppeninterviews mit türkeistämmigen Erwachsenen und Experteninterviews mit HausärztInnen und ApothekerInnen durchgeführt und inhaltsanalytisch ausgewertet. ERGEBNISSE: Während bei jüngeren Menschen eine positive, aber vorsichtige Haltung gegenüber der Einnahme von Antibiotika vorliegt, finden sich bei Älteren teilweise übersteigerte Erwartungen an die Wirksamkeit, die auf fehlendes Faktenwissen zurückgehen. Insgesamt nehmen die TeilnehmerInnen eine passive Patientenrolle in der Interaktion mit HausärztInnen ein, wodurch bestehende Informationslücken teils nicht geschlossen werden. SCHLUSSFOLGERUNGEN: Ältere Menschen mit türkischem Migrationshintergrund haben teils unrealistische Erwartungen an die Wirksamkeit von Antibiotika. In Zusammenhang mit einer passiven Patientenrolle werden Informationsbedarfe und -bedürfnisse nicht befriedigt, was die Arzt-Patient-Beziehung belasten kann. Eine Anpassung der Kommunikation und eine migrationssensible Informationsvermittlung sind daher notwendig

Promoting rational antibiotic use in Turkey and among Turkish migrants in Europe - implications of a qualitative study in four countries.

Background: Antimicrobial resistance is considered one of the major threats to global health. The emergence of resistant microorganisms is a consequence of irrational use of antibiotics. In Turkey, the consumption of antibiotics is relatively high and antibiotics are among the most commonly used drugs. However, Turkey has adopted new, more restrictive policies and regulations on antibiotics. In addition, Turkish migrants to EU countries, such as Germany, the Netherlands and Sweden, may encounter health systems that promote a more restrictive and rational antibiotic use. The objective of this paper was to explore the variation in implemented policies related to rational antibiotic use that citizens in Turkey and Turkish migrants in Germany, the Netherlands and Sweden are subjected to and to discuss the implications for the promotion of rational antibiotic use. Data were collected through focus groups and individual interviews with citizens, physicians and pharmacists in the four countries. In total, 130 respondents were interviewed. Content analysis was used. Results: Three relevant themes were identified: Implementation of regulations and recommendations, Access to antibiotics and Need for health communication. Irrational use of antibiotics was reported mainly in Turkey. While it had become less likely to get antibiotics without a prescription, non-prescribed antibiotics remained a problem in Turkey. In the three EU countries, there were also alternative ways of getting antibiotics. Low levels of knowledge about the rational antibiotic use were reported in Turkey, while there were several sources of information on this in the EU countries. Communication with and trust in physicians were considered to be important. There were also system barriers, such as lacking opportunities for physicians to manage care in accordance with current evidence in Turkey and factors limiting access to care in EU countries

Promoting rational antibiotic use in Turkey and among Turkish migrants in Europe - implications of a qualitative study in four countries.

Background: Antimicrobial resistance is considered one of the major threats to global health. The emergence of resistant microorganisms is a consequence of irrational use of antibiotics. In Turkey, the consumption of antibiotics is relatively high and antibiotics are among the most commonly used drugs. However, Turkey has adopted new, more restrictive policies and regulations on antibiotics. In addition, Turkish migrants to EU countries, such as Germany, the Netherlands and Sweden, may encounter health systems that promote a more restrictive and rational antibiotic use. The objective of this paper was to explore the variation in implemented policies related to rational antibiotic use that citizens in Turkey and Turkish migrants in Germany, the Netherlands and Sweden are subjected to and to discuss the implications for the promotion of rational antibiotic use. Data were collected through focus groups and individual interviews with citizens, physicians and pharmacists in the four countries. In total, 130 respondents were interviewed. Content analysis was used. Results: Three relevant themes were identified: Implementation of regulations and recommendations, Access to antibiotics and Need for health communication. Irrational use of antibiotics was reported mainly in Turkey. While it had become less likely to get antibiotics without a prescription, non-prescribed antibiotics remained a problem in Turkey. In the three EU countries, there were also alternative ways of getting antibiotics. Low levels of knowledge about the rational antibiotic use were reported in Turkey, while there were several sources of information on this in the EU countries. Communication with and trust in physicians were considered to be important. There were also system barriers, such as lacking opportunities for physicians to manage care in accordance with current evidence in Turkey and factors limiting access to care in EU countries