Person: AY, NADİYE PINAR
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AY
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NADİYE PINAR
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Publication Metadata only The Prevalence of Headache and Its Association With Socioeconomic Status Among Schoolchildren in Istanbul, Turkey(WILEY, 2009) TOPUZOĞLU, AHMET; Isik, Ugur; Topuzoglu, Ahmet; Ay, Pinar; Ersu, Refika Hamutcu; Arman, Ayse Rodopman; Onsuz, M. Fatih; Karavus, Melda; Dagli, ElifObjective.-The etiology and pathogenesis of migraine and other types of headache are still under discussion. An interaction of organic, psychological, and psychosocial factors is operative. In this study, we aimed to determine the prevalence of headache and its association with socioeconomic status among schoolchildren. Study Design.-A cross-sectional study was performed on 2669 schoolchildren via a parental questionnaire. Socioeconomic status was determined according to the Turkish socioeconomic status scale. Results.-The mean age of the students was 8.2 +/- 2.4 years. The headache prevalence was 46.2% (95% CI: 44.3-48.1). The prevalence of migraine was 3.4% ( 95% CI: 2.8-4.1), the prevalence of probable migraine was 8.7% (95% CI: 7.6-9.8), and that of non-migraine headache was 34.1% (95% CI: 32.3-35.9). Multivariate analysis revealed that older age, being a girl, having a family history of headache, and exposure to passive smoking at home were independently associated with headache. There was an inverse association between socioeconomic status and all 3 types of headaches after adjusting for age, sex, family history of headache, and presence of passive smoking. When the group with the lowest socioeconomic status was taken as the reference category, the odds ratios for the highest socioeconomic group were 0.33 (95% CI: 0.16-0.69, P = .003) for the migraine, 0.30 (95% CI: 0.11-0.89, P = .029) for the probable migraine, and 0.34 (95% CI: 0.16-0.72, P = 0.005) for the non-migraine headache. Conclusion.-Headache is more common among children with lower socioeconomic groups. Social causation can play a role in the pathogenesis of headache.Publication Open Access The barriers against childhood immunizations: a qualitative research among socio-economically disadvantaged mothers(OXFORD UNIV PRESS, 2007-03-28) TOPUZOĞLU, AHMET; Topuzoglu, Ahmet; Ay, Pinar; Hidiroglu, Seyhan; Gurbuz, YucelBackground: The socio-economically disadvantaged populations are among the most vulnerable groups that are under-vaccinated. Therefore, the aim of this qualitative study was to understand the behaviours of mothers concerning the immunization of their children, the decision-making process, the perceived barriers, and the enabling factors to access the services in a suburban population in Istanbul. Method: Eight focus group discussions and two in-depth interviews were carried out with the mothers who have children younger than five years. Results: While the responsibility of immunization was left totally to the mother, the socially subordinate role of women did not provide the means of getting the immunization services. The women were dependent mostly on social networks for getting the immunization services. Another important barrier to the services was related to the economical constraints and accessibility of the services. In addition, the lack of effective communication and information transfer between the health personnel and the mothers formed an important obstacle. Conclusion: This study underlines a need for an effective counselling tailored to the immunization session, which will maintain a positive relationship between the personnel and the mother.Publication Metadata only Association of sleep duration with socio-economic status and behavioural problems among schoolchildren(WILEY, 2011) TOPUZOĞLU, AHMET; Arman, Ayse Rodopman; Ay, Pinar; Fis, Nese Perdahli; Ersu, Refika; Topuzoglu, Ahmet; Isik, Ugur; Berkem, MeralAim: In this population-based study, we aimed to determine the total sleep duration (TSD), its association with socio-economic status (SES) and behavioural symptoms among schoolchildren. Methods: A cross-sectional study was performed among schoolchildren in Istanbul. A structured questionnaire evaluating the sleep schedule variables was filled out by their parents. SES was determined according to the Turkish SES scale. Results: The mean age of 2669 children was 8.2 +/- 2.4 years, and 51% of the students were girls. The mean TSD was 10.20 +/- 1.04, and the mean bedtime was 21.57 +/- 0.56 (both in hours, minutes +/- SD). Boys tended to go bed later (p = 0.004) and slept less than girls (p = 0.02). The duration of sleep disruptions increased (p < 0.001), whereas TSD decreased with age (p < 0.001). Multiple linear regression revealed that waking time and TSD decreased significantly (p < 0.05) with higher SES among both girls and boys. Sleep fragmentation was associated with habitual snoring, parasomnias, daytime sleepiness and conduct symptoms. Conclusion: Decreased total sleep duration is more prominent in boys, older children and children among higher socio-economic status. Insufficient sleep attributed to shortened total sleep duration by age and higher socio-economic status might have a negative effect on both sleep hygiene and psychological well-being in schoolchildren.Publication Metadata only Do perceived health risks outweigh the benefits of modern contraceptives? A qualitative study in a suburban population in Istanbul, Turkey(TAYLOR & FRANCIS LTD, 2007) TOPUZOĞLU, AHMET; Ay, P.; Hidiroglu, S.; Topuzoglu, A.; Ucar, M. Solakoglu; Kose, O. O.; Save, D.Objectives To evaluate the health concerns and the perceived non-contraceptive benefits of modern contraceptive methods through utilizing qualitative methods. Methods Six focus group discussions were carried out with a total of 53 married women in a socio-economically disadvantaged community in Istanbul, Turkey. Results Women had a vague knowledge of the mechanism of menstruation. Some women believed that the uterus was filled with blood-termed 'dirty blood'-which should be eliminated during menstruation in order to stay healthy. For this reason, amenorrhoea was recognized as the important disadvantage of the progestin-only injectable contraceptives. While the participants mentioned fallacious and exaggerated side effects related to modern methods they did not recognize their non-contraceptive benefits. Most women gained the information concerning side effects through their social networks. Sometimes the information acquired was based on rumours that biased women against the modern contraceptives. Conclusions Women outweighed the risks, some of which were fallacious and exaggerated, against the benefits of modern contraceptives. It is crucial to address health concerns of women and what they 'heard' from their peers during counselling sessions. Also the non-contraceptive health benefits of modern methods should be well emphasized. Since informal sources are prevalent, the effectiveness of peer education should be studied in this community.Publication Metadata only Rubella seroprevalence among first-grade primary school students in a district in Istanbul, Turkey(W B SAUNDERS CO LTD, 2006) TOPUZOĞLU, AHMET; Ay, P; Topuzoglu, A; Korukluoglu, G; Cali, SObjectives Rubella vaccination is not included in the national immunization programme of Turkey. However, it is on the market and is recommended, mainly by the private sector, at the age of 12-15 months. Introduction of the rubella vaccine without achieving high coverage has the risk of shifting the mean age of rubella infection among the unvaccinated population to reproductive ages. The aim of this study was to evaluate the seroprevalance of rubella and the factors associated with seropositivity among primary school students in Umraniye, a district of Istanbul. Methods: Blood samples were collected from 489 students in 70 primary schools of Umraniye. Parents completed a concise questionnaire assessing sociodemographic characteristics and measles, mumps and rubella vaccination status. Results: Among the students screened, 163 (33.3%, 95% confidence intervals 29.2-37.7%) were susceptible to rubella. When sociodemographic variables were evaluated, paternal education was the only variable associated with seronegativity. As the level. of paternal education increased, seronegativity rates decreased. This finding may suggest that rubella vaccination is practiced more commonly among children whose fathers are better educated. Conclusions: Surveillance and control of rubella and congenital rubella syndrome must be set as public health priorities in Turkey, particularly given that rubella vaccination is practiced partially in the country. (c) 2005 The Royal Institute of Public Health. Published by Elsevier Ltd. All rights reserved.Publication Metadata only Resistance to vaccination: The attitudes and practices of primary healthcare workers confronting the H1N1 pandemic(ELSEVIER SCI LTD, 2010) TOPUZOĞLU, AHMET; Hidiroglu, Seyhan; Ay, Pinar; Topuzoglu, Ahmet; Kalafat, Cem; Karavus, MeldaDuring the H1N1 pandemic, most healthcare workers in Turkey were not willing to take up the vaccine. This qualitative study aims to explore the factors that lead to vaccination resistance among a group of primary healthcare workers in Istanbul. Data were collected through focus group discussions. Thematic content analysis was conducted. All participants considered themselves at risk for infection, yet most of them were not vaccinated. Only persons with a poor immune system were considered by the respondents at risk for severe disease and death. Health personnel mostly did not realize their potential role in the transmission of influenza to patients. The decision of vaccination was dependent on the information source. The personnel who depended mainly on the media either did not accept vaccination or was undecided. They believed that the vaccine went through an accelerated authorization procedure. Yet the ones who accepted vaccination relied mostly on evidence-based sources and accessed information from the guidelines of the Ministry of Health, Professional Medical Associations and the World Health Organization. Social networks were also influential factors in the decision-making process. It is important to empower healthcare workers through supporting the skills of acquiring and using evidence-based information. This is particularly important for physicians who also serve as opinion leaders. (c) 2010 Elsevier Ltd. All rights reserved.Publication Metadata only The influence of gender roles on health seeking behaviour during pregnancy in Turkey(TAYLOR & FRANCIS LTD, 2009) TOPUZOĞLU, AHMET; Ay, Pinar; Hayran, Osman; Topuzoglu, Ahmet; Hidiroglu, Seyhan; Coskun, Anahit; Save, Dilsad; Nalbant, Hacer; Ozdemir, Erhan; Eker, LeventObjectives To explore the impact of gender roles in relation to health seeking behaviour during pregnancy and childbirth. Methods The study was conducted in neighbourhoods with low antenatal care rates in three provinces of Turkey. The study population consisted of pregnant women who never got or discontinued antenatal care and their peers, families and community leaders. Sixteen focus group discussions and 125 in-depth interviews were conducted with a total of 239 participants. Results Pregnancy and childbirth are interwoven strongly with gender roles. Since the patriarchal system acknowledges women through the means of childbirth, women are expected to have many children. Hence women experience pregnancy as a burden and are not motivated to seek antenatal care. During pregnancy, only 'serious' conditions are considered as legitimate reasons for accessing care. However, the decision regarding whether a pregnant woman is seriously sick or not belongs to the responsibilities of elder women, which delays service use. Conclusions Providing information regarding the value of antenatal care also to elder women is essential in increasing the demand to the services. Incorporating gender perspectives into daily health practice and maintaining access to high quality reproductive care services are vital in reducing the gender based barriers to care.Publication Metadata only Radionuclide concentrations in soil and lifetime cancer risk due to gamma radioactivity in Kirklareli, Turkey(ELSEVIER SCI LTD, 2009) TOPUZOĞLU, AHMET; Taskin, H.; Karavus, M.; Ay, P.; Topuzoglu, A.; Hidiroglu, S.; Karahan, G.The objective of this study is to ovaluate and map soil radionuclides' activity concentrations and environmental outdoor gamma dose rates (terrestrial and cosmic) in Kirklareli, Turkey. The excess lifetime cancer risks are also calculated. Outdoor gamma dose rates were determined in 230 sampling stations and soil samples were taken from 177 locations. The coordinates of the readings were determined by the Global Positioning System (GPS). The outdoor gamma dose rates were determined by Eberline smart portable device (ESP-2) and measurements were taken in air for two minutes at I m from the ground, The average outdoor gamma close rate was 118 +/- 34 nGy h(-1). Annual effective gamma dose of Kirklareli was 144 mu Sv and the excess lifetime cancer risk of 5.0 x 10(-4). Soil samples were analyzed by gamma spectroscopy. The average Ra-226, U-238, Th-232, Cs-137, and K-40 activities were 37 +/- 18 Bq kg(-1), 28 +/- 13 Bq kg(-1), 40 +/- 18 Bq kg-1, 8 5 Bq kg(-1) and 667 +/- 281 Bq kg(-1), respectively. The average soil radionuclides' concentrations of Kirklareli were within the worldwide range although some extreme values had been determined. Annual effective gamma doses and the excess lifetime risks of cancer were higher than the world's average. (c) 2009 Elsevier Ltd. All rights reserved.