BackgroundConsidering the fact that, due to recent evidence, many women no longer prefer hormone replacement therapy, it is especially important to develop intervention options to alleviate menopausal symptoms. Although there is conflicting evidence concerning effectiveness, there is an indication that physical activity and weight control may be useful for alleviating symptoms. The aim of this study was to investigate the effect of physical activity and body mass index on menopausal symptoms among menopausal women in Turkey.Methods305 women between the ages of 45 and 60 who visited the health center for various reasons were recruited into this cross-sectional study. Menopausal women, who visited one of five family physicians working in the same area, were included in the analyses. The Menopause Rating Scale, International Physical Activity Questionnaire and a generic medical and socio-demographic information questionnaire were used.ResultsWomen who were physically active had lower total menopausal (p < 0.001), somato-vegetative (p = 0.004), psychological (p = 0.002), and urogenital (p < 0.001) symptom scores than women who were less active. No differences in vasomotor symptoms were recorded related to physical activity level; significant differences were found for most menopausal symptoms, including sleep (p = 0.009) and sexual (p = 0.043) problems, joint and muscular discomfort (p < 0.001) and vaginal dryness (p = 0.016). BMI was not associated with total menopausal symptoms and with the subscales, excluding depressive mood (p = 0.009). A significant increasing trend in the rate of depressive mood was observed from normal through overweight to obese participants. The mean scores of the total menopausal symptoms were lower among the participants who were well educated, currently working and without chronic diseases.ConclusionsPhysical activity may play an important role in alleviating menopausal symptoms. As part of preventive medicine, primary care physicians should also stress lifestyle changes, including physical activity, to manage menopausal symptoms.

We aimed to determine the violence against general practitioners (GPs) through their suggestions on its cause and prevention. This is a descriptive cross-sectional study based on self-administered questionnaire answered by a convenience study population consisting of 522 GPs between November and December 2006. Of the participating GPs, 82.8% reported that they experienced violence. They reported 1,020 events, and verbal form was the most common form (89.3%). Verbal and sexual violence were seen more frequently among women, whereas physical and economic violence were more frequent with men. Perpetrators were patients and/or their relatives in 91.1% of the events. However, they were colleagues and superiors in 67.9% of the economic and sexual violence events. Violence against GPs warrants more attention. For its prevention, there is a need of continuous professional, administrative, and legal support from the government along with systematic, coordinated implementations independent from daily political concerns.

Identifying developmental delay in children earlier by a validated, reliable, parent-completed questionnaire like Ages and Stages Questionnaires and detecting risk factors for delay are crucial for primary care where their growth and development are monitored. Identifying developmental delay and early referral to rehabilitation services may help improve children's quality of life.

BackgroundAs the risks and benefits of early detection and primary prevention strategies for breast cancer are beginning to be quantified, the risk perception of women has become increasingly important as may affect their screening behaviors. This study evaluated the women’s breast cancer risk perception and their accuracy, and determined the factors that can affect their risk perception accuracy.MethodsData was collected in a cross-sectional survey design. Questionnaire, including breast cancer risk factors, risk perceptions and screening behaviors, answered by 624 women visiting primary health care center (PHCC). “Perceived risk” investigated with numeric and verbal measures. Accuracy of risk perception was determined by women’s Gail 5-year risk scores.ResultsThe mean age of the participants was 59.62 ± 1.97 years. Of the women 6.7% had a first-degree relative with breast cancer, 68.9% performed breast self-examination and 62.3% had a mammography, and 82.9% expressed their breast cancer worry as “low”. The numeric measure correlated better with worry and Gail scores. Of the women 65.5% perceived their breast cancer risk accurately. Among the women in “high risk” group 65.7% underestimated, while in “average risk” group 25.4% overestimated their risk.ConclusionsTurkish women visiting PHCC are overtly and overly optimistic. This was especially obvious with the result that nearly one third had had no mammography. There is a need for further studies to understand why and how this optimism is maintained so that better screening strategies can be applied at PHCC. All health workers working at PHCC have to be aware of this optimism to prevent missed opportunities for cancer screening.

DD can be identified early during well-child visits. In such cases, it is critical for the health of the child and community to screen for possible risk factors, eliminate the causes, and refer families to rehabilitation services. What is known: • The causes of DD may be classified into prenatal, perinatal, and postnatal factors. • Early identification may improve later outcomes of DD. Most studies conducted on this topic have focused on prematurity. What is new: • This study focused on maternal, paternal, and sociocultural factors that may be associated with DD in early childhood in this study that was conducted on a community-based sample. • The risk of DD was increased by maternal age ≥ 35 years, maternal education level of primary school or lower, consanguineous marriage and delivery by cesarean section.

Amaç: Dünya Sağlık Örgütü tarafından dünyanın en hızlı yayılan ve en uzun süren salgını olarak tanımlanan sigara içimi hekimler arasında olduğu kadar hekim adayları arasında da oldukça yaygındır. Gereç ve Bulgular:Öğrenciler arasında sigara içme sıklığı %29.1'dir. Günde içilen ortalama sigara sayısı 14.13±6.67 olarak bulunmuştur. Sigaraya başlama yaşı 17.18±2.77 yıldır. Düzenli sigara içen 110 öğrencinin sigaraya başlama nedenleri arasında ilk sırayı "çevre ve arkadaş ortamı" almaktadır. Bu öğrencilerden 63'ü en az bir kez sigarayı bırakmayı denemiş, %10'u yüksek, %32.7'si orta ve %16.4'ü hafif düzeyde bağımlı bulunmuştur. Erkek öğrencilerin sadece bedensel alan puanları kız öğrencilere göre anlamlı (p=0.025) olarak daha yüksektir. Sigara içen öğrencilerin tüm alanlarda puanları düşük bulunurken, bu durum ruhsal (p=0.045) ve çevresel alanlarda (p=0.010 ve p=0.003) anlamlıdır. Nikotin bağımlılığı olan öğrencilerin yaşam kalitesinin tüm alanlarında düşük puan aldıkları tespit edilmiştir. Bu durum ruhsal (p=0.039) ve sosyal (p=0.039) alanlarda istatistiksel olarak anlamlıdır. Material and Method:This was a descriptive, cross-sectional study to determine the tobacco smoking and its effect on the quality of life of medical students in Ondokuz Mayıs University.

BackgroundBreast cancer incidence in women increases with age, while survival rates decrease. Studies interpret this result as meaning higher comorbidity, diagnosis at later stages of the disease, and less effective treatment in the elderly. The aim of this study is to evaluate the diagnosis and treatment characteristics of breast cancer and their effect on the survival of women aged 65 and above.MethodsThe data within the files of 1064 women with breast cancer, who were followed-up in Dokuz Eylul University Medical Faculty Hospital between 2000 and 2006, were reviewed retrospectively. The survival probabilities at years 1 and 5 were calculated by life table analysis. The Kaplan-Meier test was used for calculating mean survival time, and the differences between groups were evaluated by log-rank test. The backward elimination method was used for multivariate analysis, and a −2 log-likelihood ratio was used for comparison of different models.ResultsOf the patients, 25.3% were aged 65 and above at the time of the diagnosis. Patients in this group had more comorbidities and were more likely to be diagnosed at advanced stages than younger patients. Additionally, they had lower rates of surgical treatment, chemotherapy or radiotherapy. One and 5-year survival probabilities among age groups were 96.1% and 84.5%, respectively, for <65 years, 93.5% and 84.8%, respectively, for 65–69, 98.7% and 84.0%, respectively, for 70–74, and 85.5% and 59.6%, respectively, for 75 years and above. In the multivariate model, age, clinical stage, and comorbidity were found to be negatively associated with the survival rate.ConclusionsThe survival of women with breast cancer aged 65 and above was affected negatively by age at diagnosis, clinical stage, and the presence of comorbidity. Early diagnosis also is very important for elderly women. Additionally, because of higher comorbidity, their evaluation and treatment should be planned by an interdisciplinary team.

Health literacy, when the doctor gives a medical information to a patient, it is the ability of the patient to understand, interprete the medical information and act appropriately according to this ability. Patients confront with complicated informations and treatments. Limited health literacy effects diagnosis and treatments in negative way and causes unnecessarily hospitalizations and emergency service usage, unnecessary diagnostic tests, increased hospitalizations. Initially, health literacy seems like a nonphysical concept but then lots of scales have been improved for its measurement.