The aim of this study is to evaluate the awareness, perception, sources of information, and knowledge of osteoporosis in a sample of rural Turkish women, to examine the factors related to their knowledge, and organize effective education programs. A total of 768 women mean age 53.6 +/- 8.2 (40-70) were randomly selected and interviewed during their visits to primary care centers in three rural towns in West Anatolia. A structured questionnaire was administered by trained nurses. Chi-squared test was performed in age and educational level groups for revealing factors influencing the awareness, perception, and knowledge sources of osteoporosis. One-way analysis of variance (ANOVA) analysis was carried out in calculating the difference of knowledge scores among groups. Of the women, 60.8% had heard of and 44.9% had the correct definition for osteoporosis. Awareness and accurate definition of osteoporosis was high in younger and high educated women (p < 0.001). Television was the main source of knowledge with the rate of 55%, doctors and nurses/midwives were the second and third sources, respectively. Osteoporosis knowledge was low with a mean score of 5.52 out of 20. Younger and more educated women had higher knowledge scores. Low calcium in diet and menopause were the first two risk factors chosen for osteoporosis. Knowledge about osteoporosis among rural Turkish women is low, and majority of women are unaware of the risk factors and consequences of osteoporosis. Therefore, appropriate educational programs should be planned according to community needs, and the target of these programs should be less educated and older women.

Dual-energy X-ray absorptiometry (DXA), the "gold standard" for diagnosis of osteoporosis, is not recommended for population screening, and thus quantitative ultrasound (QUS) of the calcaneus is gaining popularity. The aim of the present study was to evaluate the relationship between QUS values and anthropometric and lifestyle factors, and to assess the diagnostic performance of QUS in predicting DXA-defined osteoporosis. Eight hundred and thirty-two women and 87 men aged 40-88 years were included in the study. Anthropometric measurements, the questionnaire, and QUS and DXA measurements were performed by trained physicians. Both QUS and DXA T-scores were lower for women than for men. Postmenopausal women had significantly lower QUS T-scores compared to premenopausal women (P < 0.001). Age over 50, female sex, sedentary lifestyle, fracture history, presence of chronic disease, and > or =5 years since menopause were associated with QUS T-scores lower than -1.00 by multivariate analysis. Low QUS T-scores were related to lack of direct sun exposure, high parity, fair skin color, and no education by univariate analysis (P < 0.005). A weak correlation was found between calcaneal QUS and DXA T-scores at lumbar spine (r = 0.310, P < 0.001) and femoral neck (r = 0.288, P < 0.001). The sensitivity and specificity of the QUS test were 73.7% and 57.4%, respectively, regarding the identification of osteoporotic patients. Lower QUS T-scores were associated with several osteoporotic risk factors, and the sensitivity and specificity of QUS for predicting DXA-defined osteoporosis were at optimum values at ages between 50 and 59 years. We conclude that, even though the accuracy of QUS for predicting DXA-defined osteoporosis is not remarkably high, it can be applied to identify subjects at risk in this age group in developing countries and rural districts who should be the focus of fracture prevention.

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OP was determined in 1/3 of the women. Advanced age (> 65) and being illiterate were negative factors, while high education levels, being overweight, and being treated with HT had a positive effects on BMD. Habitual tea drinking also may have a positive effect on BMD. However, tea drinking was not found to be a statistically significant factor in the present study.

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Exam anxiety, is defined as an intense anxiety that prevents the effective use of the knowledge learned before the exam and leads to a decrease in succsess. Exam anxiety is an important problem that causes a decrease in performance and is accompanied by serious psychological problems. In studies conducted in different samples, anxiety symptoms and exam related anxiety were examined. In a study conducted on students of the Faculty of Medicine, it was found that 65% of students experience exam anxiety for various reasons and female students experience more exam anxiety than male. In the study conducted to determine the relationship between exam anxiety levels and sleep quality of highschool senior students, it was shown that students have exam anxiety and this situation negatively affects sleep qualty. Again, in another study examining the effects of parents’ expectations on the exam anxiety on high school seniors, factors such as familiy structure, educational status of the parents and income status of the family were examined. It was found that the family structure was effective on examination enxiety and anxiety level was higher in girls than boys. In the study conducted on the test method, which is an examination technique, the effect of various intervention techniques in the treatment of test anxiety was examined and cognitive behavioral methods were found to be the most effective. In this review, it is aimed to review the factors related to exam anxiety in line with the literature.

Aim. Heart murmur is common in children, and it is one of the main reasons for referral among children in primary care. The aim of this study is to evaluate agreement and consistency of normal, innocent, and pathologic murmur decision between academic family physicians and academic pediatric cardiologist. Methods. Seven hundred fifteen primary school children were examined by family physicians and paediatric cardiologist. Auscultatory examination was performed. Intensity, frequency, duration, quality, location, and radiation of the murmur were described if present. Agreement of normal, innocent, and pathologic murmur classification decision between family physician and paediatric cardiologist was analyzed by using kappa statistic. Results. Normal, innocent and pathologic murmurs were reported for 419, 228, and 54 children in family physicians' reports, respectively. Paediatric cardiologist agreed on 383 (91.4%) children as normal, 191 (83.7%) children having innocent murmur, and 19 (35.2%) children having pathologic murmur among family physician's reports. There was good consistency between family physicians and paediatric cardiologist (κ value = 0.679, 95% CI 0.630–0.727, P < .001). They agreed on the majority of normal and innocent murmur decisions. However family physicians reported pathologic murmur more frequently. Conclusion. Cardiac auscultatory skills of academic family physicians may be concordant with paediatric cardiologist.

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