Browsing by Author "Pala, T"

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    Effect of Social Class and Social Security on Access to Healthcare in Manisa: A Research for Inequalities
    Nesanir, N; Dinç, G; Cambaz, S; Baysan, P; Serifhan, M; Deveci, S; Pala, T; Özcan, C
    Objective: In the following study, effect of social class and social security on reaching diagnostic and therapeutic health care services in Manisa is evaluated in both out-patient and in-patient basis. Material and Methods: The households were determined in proportion to targeting populations in health care facilities (health houses) by using cluster sampling method and 11284 people representing the population in Manisa city center (n:232760) was included in the study. The data was collected by pollsters using face to face technique. Crude risks were calculated in different social classes and in those with or without social security for history of health problems and access to diagnostic and therapeutic health care services on outpatient and the inpatient basis. Multivariable risks were revised in accordance with age, sex and chronic health problems. Results: In comparison to unemployed population, the health problems in last 15 days was 1.79 (1.17-2.75) times more common in upper social class and similar figures were also seen in middle social class and lower social class, being 1.51 (1.10 -2.06) and 1.44 (1.04-2.00), respectively. Moreover, reaching to diagnostic\theraupetic health care services in last 15 days was 1.73(1.08-1.46) times more common in upper social class and this value was 1.46 (1.03-2.06) in middle social class and 1.53 (1.07-2.20) in lower social class. The revised risks of having diagnostic and therapeutic health care were similar in different social classes. In comparison to those without any social security, it was found that those with social security reported having health problems 1.58 (1.17-2.13) times more, and this was also true for out-patient diagnostic\therapeutic medical care being 2.57 (1.75-3.78) and inpatient being 3.37 (2.11-5.40) times more. Conclusion: There are inequalities against those being unemployed and those without social securities with respect to accessing to health care services.
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    Vitamin D status among adults in the Aegean region of Turkey
    Hekimsoy, Z; Dinç, G; Kafesçiler, S; Onur, E; Güvenç, Y; Pala, T; Güçlü, F; Özmen, B
    Background: Vitamin D is a lipid-soluble hormone found in certain foods and synthesized from precursors in the skin when exposed to ultraviolet light. Vitamin D plays a critical role in bone metabolism and many cellular and immunological processes and low levels have been associated with several chronic and infectious diseases. Vitamin D status is assessed by measuring the concentration of serum 25-hydroxyvitamin D [25(OH)D]. Vitamin D deficiency is reported to be common worldwide, but little has been reported about the vitamin D status of adults in Turkey. In this cross-sectional study, we determined the prevalence of 25(OH)D deficiency in adults residing in a city in the Aegean region of Turkey. Methods: A survey was conducted on a representative sample of adults over 20 years old in a non-coastal city at the end of the winter season. Of the 209 households selected by random sampling, 8.6% (n = 18) were unoccupied and 21.5% (n = 45) refused to participate. Blood samples were taken and questions about medical history, vitamin supplementation, sunlight exposure, and dietary calcium and vitamin D intake were asked in face-to-face interviews of 391 adults living in the remaining households. Results: The mean serum 25(OH)D concentration was 16.9 +/- 13.09 ng/mL, with 74.9% of the subjects having 25(OH)D deficiency (<20 ng/mL), 13.8% having insufficiency (20-29.99 ng/mL), and 11.3% of the subjects having sufficient 25(OH)D (>= 30 ng/mL) levels. 25(OH)D deficiency was more common among females (78.7%) than males (66.4%, p < 0.05). Conclusion: Adults living in an urban, non-coastal setting in Turkey have a high prevalence of vitamin D deficiency.
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    Fertility preferences, contraceptive behaviors and unmet needs
    Dinç, G; Eser, E; Cihan, UA; Ay, S; Pala, T; Ergör, G; Özcan, C
    Objectives To explore the differences in unwanted fertility in different parts of a city. Methods Data were obtained from the 9999 Manisa Demographic and Health Survey (MDHS) in Turkey. We collected information from a representative sample of 1728 evermarried women aged 15-49 years on fertility, fertility preferences, unmet need for family planning, contraceptive discontinuation, and abortion. Data were analyzed using SPSS 10.0 for Windows's. Results Of the persons studied, 1238 (71.6%) were living in urban settlements and 490 (28.4%) in suburban (gecekondu) settlements. The total fertility rate is higher among gecekondu women (2.42) than among urban women (2.14) although gecekondu women have a lower wanted fertility rate (1.54) than urban women (1.77). Married women in the urban area were currently using a contraceptive method more frequently (75.6%) than those living in the gecekondu area (61.7%) (OR 2.5; 95% CI 1.9-3.2; p < 0.001). The unmet need percentage in gecekondu women (17.7%) is higher than in urban women (8.3%; p < 0.001). The induced abortion rate is higher in urban women (14.8 per 1000 pregnancies) than in gecekondu women (7.1 per 1000 pregnancies; OR 2.1; 95% Cl 1.4-3.1; p < 0.001). Conclusions There are inequalities in the achievement of fertility preferences and in accessibility to family planning services between urban and suburban parts of the city.
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    Sunscreen use and sun protection practices in students and personnel of Celal Bayar University
    Ermertcan, AT; Öztürkcan, S; Dinç, G; Yurtman, D; Pala, T; Sahin, MT
    Background/Purpose: The steady increase in the incidence of melanoma, non-melanoma cutaneous neoplasia and preneoplastic disorders has contributed to the demand for more effective protection from the sun. In this study, we aimed to determine the prevalence of sunscreen use and other sun protection behaviors in a large sample of students and personnel of Celal Bayar University, Manisa, Turkey. Methods: The study group included 1018 participants of whom 607 work in the Celal Bayar University Hospital and 411 are students from the Medical Faculty and School for Health Professionals. All participants completed a questionnaire composed of 45 items about sun protection and other health behaviors, such as sports activity, use of cigarettes, alcohol and seat-belts. Sun protection factor (SPF) of sunscreen, avoiding sun exposure during peak hours, wearing clothing, a hat and sunglasses were studied. Results: Of the 1018, 403 participants were male and 615 were female. While avoiding sun exposure during peak hours was the most popular preventive behavior for men (42.5%), wearing sunglasses was the most popular one for women (50.7%). Avoiding exposure was the second preventive behavior for women (42.1%). Use of sunscreen with SPF 15+ was the second popular protective measure for men (19.4%) and the third one for women (39.2%). There were no significant relationships between sun protection behaviors and obesity, use of cigarettes and alcohol. We also investigated behavioral changes with sunburn experience in the participants who had sunburn history. Among these behavioral changes, increased use of sunscreen and decreased sun exposure during peak hours with sunburn experience were significant. Conclusion: Our study demonstrated that the risk of sun exposure is largely unrecognized in Manisa, Turkey, and we have very incomplete information about protective measures. An efficient policy of education on the effective use of sun protection methods should be developed to prevent skin cancer.
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    Psychometric properties and responsiveness of the Turkish version of the Diabetes Treatment Satisfaction Questionnaire (s) on a sample of diabetics of three consecutive monitoring periods
    Özmen, B; Eser, E; Kafesçiler, SO; Pala, T; Güçlü, F; Hekimsoy, Z
    The aim of this study is to test the psychometric properties and the responsiveness of the original (status) version of Turkish DTSQ. The study sample included 88 patients with diabetes mellitus who were evaluated in three consecutive time points. The first data collection time point was during their initial contact to the clinic, and the two following (3rd month and 6th month) were during the monitoring visits to the Celal Bayar University Endocrinology Department in 2007. After the adaptation of the DTSQ to Turkish language by following standard procedures, this instrument was applied to the patients along with WBQ-12 and World Health Organization Quality of Life Measure (WHOQOL-Bref). The reliability of the DTSQ was evaluated by running internal consistency analysis (Cronbach Alpha) and item analysis. Construct validity of the instrument was evaluated by various tests such as Principal Components analysis, Confirmatory Factor Analysis, Concurrent validity and Known Groups comparisons. Finally the sensitivity (responsiveness to change) of the DTSQ scores to the changes of the metabolic conditions were assessed. 50.0% of the participants were male with a mean age of 51.1 +/- 11.4 (min 22, max 78). Majority of them had type 2 diabetes (86.4%) and 72.7% of these patients had at least one co-morbid chronic conditions. While 53.4% of the patients had been treated by insulin the remaining 46.6% had been taking oral anti-diabetic agents. The results revealed satisfactory alpha values for DTSQ (alpha > 0.70). All of the three metabolic measures (i.e., FBG, PBG, and HbA1c) had significant correlations with the DTSQ scores. The criterion and construct validity of the scale were found to be very satisfactory. The Turkish version of the DTSQ showed acceptable fit indices (RMSEA = 0.03, CFI > 0.90) with the original (hypothetic) construct. Almost all of the sub-dimensions of the WBQ and WHOQOL were correlated with the DTSQ as expected, indicating a good concurrent validity. DTSQ status version was found to be a reliable and valid instrument for the assessment of treatment satisfaction in Turkish diabetes mellitus patients.
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    PSYCHOMETRIC PROPERTIES OF THE TURKISH VERSION (AYTA-TR) OF THE WHO-EUROPE ATTITUDES OF AGING (EAAQ) QUESTIONNAIRE
    Eser, E; Gerçeklioglu, GS; Eser, S; Fidaner, C; Baysan, P; Pala, T; Dündar, P
    Introduction: This study was carried out for psychometric analysis of the Turkish version of the WHO - Atittudes of Aging Questionnaire (AAQ). Materials and Method: AAQ consists of 24 items classified in three domains (Psychosocial Loss-PL; Physical Change-PC and Psychological Growth-PG) with 8 items each (min8 max40). Turkish centre results are presented in this EU FP 5th funded international project (n=833). Internal consistency analysis, Construct validity, Convergent - Divergent validity and Known Groups validity were used. Results: 38.7 % of the sample was male, with a mean age 72.7 +/- 6.1. Alpha values of the domains PL, PC ve PG were 0.75, 0.74 and 0.62 respectively. 7th item of the PC and 4th item of the PG violate the internal consistency. BD was the most affected domain by income and objective health (ES=0.50). PL and PC scores were higher among married and who received support(p>0.05). CFA resulted acceptable fit for PC domain (RMESEA=0.09; CFI=0.93); borderline for PC domain and a poor fit for PG domain. Satisfactory covergent-divergent validity results were obtained between WHOQOL and AAQ scales. Conclusion: Results revealed that psychometric properties of Turkish version of the AAQ can be used for the assessmnet of the attitudes of aging but Psychosocial domain results should be interpreted with caution.
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    QUALITY OF LIFE OF WORKERS AGED 14-16 YEARS IN THE MANISA APPRENTICE TRAINING CENTER
    Dündar, PE; Baydur, H; Eser, E; Bilge, B; Nesanir, N; Pala, T; Ergör, A; Oral, A
    Objective: The literature related to child labor, discusses the causes and socioeconomic factors contributing to child labor but very few studies examine the quality of life among child workers. The purpose of this cross-sectional study was to investigate the quality of life (QoL), socioeconomic and labor related factors in young people aged 14-16 in the city of Manisa. Methods: The study population consisted of 266 students who were attending the Apprentice Training Center in Manisa. The QoL of the subjects was measured by the adolescent version of KINDL-R (Kiddo-Kindl). Odds ratios (95% Confidence Interval) were used in the assessment. Logistic regression analysis was performed in multivariate analysis. Results: Of the 253 adolescent workers, 77.9% were male, with a mean age of 15.6(0.5). According to logistic regression analysis; being female (OR=2.9), lack of family health insurance (OR=2.3), being exposed to family violence (OR=3.7) and absenteeism (OR=2.4) were associated with total Qol. Lack of family health insurance, insufficiency in family income, using alcohol, being exposed to family violence, job dissatisfaction and father illiteracy were associated with poorer QoL of six domains of KINDL-R. Conclusion: The findings of this study concludes that, socioeconomic, family and job related variables are factors associated with QoL in adolescent workers.