The Effect of Smartphone Use and Nomophobia on Sleep Quality and Daytime Sleepiness in Turkey

Background

Smartphones used unconsciously and in an uncontrolled manner make young people experience sleep problems. This study aimed to investigate the effects of university students’ smartphone addiction and nomophobia levels on sleep quality and excessive daytime sleepiness.

Methods

This study, which had a cross-sectional design, was conducted with 390 people who were first-year and senior students at Inonu University between November and December 2019. The Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale, Nomophobia Scale, and Smartphone Addiction Scale were used in the present study used. For statistical analysis, the chi-squared test, the Student’s t-test, one-way ANOVA, Spearman’s rank correlation coefficient and binomial logistic regression analysis were used. The research has ethics committee approval.The error level was chosen as p = 0.05.

Results

The smartphone use time of the students was finded to be 5.4±2.6 years, daily online time was 4.3±2.6 hours, and daily sleep time was 7.4±1.5 hours. The students received 78.3±25.8 points from the Nomophobia Scale, 90.3±29.7 from the Smartphone Addiction Scale, 7.2±2.8 from the Pittsburgh Sleep Quality Index, and 5.9±4.1 points from the Epworth Sleepiness Scale. A total of 54.4% of students had moderate, and 22.8% had severe nomophobic symptoms; 83.6% of the group had poor sleep quality, and 14.6% had excessive daytime sleepiness. A positive, moderate and significant relation was detected between the mean Nomophobia score and the mean Smartphone Addiction Scale score. It was also determined that those with less than 30 minutes of smartphone use before sleeping had low nomophobia, smartphone addiction and daytime sleepiness scores, and better sleep quality.

Conclusions

Nomophobic symptoms and smartphone addiction were observed to be high in university students. Most students had poor sleep quality. The awareness of students on healthy sleep, and conscious and controlled smartphone use should be increased.

Key messages

• Smartphone addiction increases the level of nomophobia moderately in university students.

• Those who use a smartphone less than 30 minutes before going to sleep have better sleep quality and lower daytime sleepiness.

The effect of Kefir consumption on blood pressure some blood parameters in hypertensive individuals

Aim

In this study is to examine the effect of kefir consumption on blood pressure, some blood parameters and anthropometric measurements in hypertensive individuals.

Methods

The study is a randomized controlled clinical trial. The mean systolic blood pressure in hypertensive individuals was taken as 145.2±19.2. The minimum sample size was determined as 30 for each group with a 95% CI and 80% power. The study was conducted by face-to-face interviews with a total of 100 volunteers, 35 male, 65 female, aged 18 and over, who were hypertensive and volunteered to participate in the study and applied to the internal medicine outpatient clinics of Akçadag Public Hospital between September 2020 and May 2021. The experimental (n = 42) and control (n = 58) groups that the patients are randomly assigned into, the experimental group was ensured to consume 250 ml/day kefir for 28 days. During the study, The study was completed with 56 volunteers. At the beginning of the study and the end of 4 weeks, blood samples, blood pressure, pulse and anthropometric measurements of the individuals were taken.

Results

When the anthropometric measurements were compared, the body weight, body mass index, waist circumference, and hip circumference of the individuals in the experimental group decreased significantly at the end of the study. There was no significant difference between the experimental and control groups in terms of glycemic parameters. While no significant change was observed in the lipid profile in the experimental group, total and LDL cholesterol levels decreased in the control group. There was no statistically significant difference in kidney function parameters in both groups. In addition, at the end of the study, there was no significant change in diastolic blood pressure and pulse in the experimental group, but systolic blood pressure decreased significantly.

Conclusions

Regularly kefir consumption has positive effects on systolic hypertension and weight control.

Key messages

• Regular daily consumption of kefir reduces systolic blood pressure and provides weight control.

• Regular daily consumption of kefir did not lead to an effective result on blood and kidney parameters.

Examining the relationship between inflammation markers and anthropometric values in primary care

Background

In recent studies, adipose tissue appears to be associated with inflammation. In this study, it was aimed to determine the relationship between inflammation markers and anthropometric measurement values and blood lipid values for purpose in primary health units.

Methods

The universe of this study has comprised healthy adults admitted to a community health units' diet clinic in a city of eastern Turkey in the city in 2019. Blood analyzes were done in the family medicine laboratory, those with high leukocyte values were excluded and 274 adults were included in the study. The relationship between blood lipid values, complete blood count, inflammation markers, neutrophil lymphocyte ratio (NLO), platelet lymphocyte ratio (PLO) and lymphocyte monocyte ratio (LMO) and anthropometric measurements of adults were investigated. Spearman correlation test, Kruskal Wallis test, Multiple Linear Regression test were used in the analysis of the data.

Results

The average age of 274 people participating in the study is 34.07 ± 9.92. According to BMI, no significant difference was found between NLO, PLO and MLO ratios. Significantly weak negative correlation between PLO and skeletal muscle, basal metabolic rate, body fluid amount and lean mass; a negative correlation between HDL and BMI, amount of body fat and amount of internal lubrication were found (p < 0,003). The increase in the amount of skeletal muscle causes a decrease in the level of total cholesterol, while the increase in the amount of internal lubrication causes an increase in the level of total cholesterol. A positive weak correlation was found between NLO and LDL(p < 0,001), a very weak positive correlation between NLO and total cholesterol and a very weak positive correlation between LMO and LDL(p < 0,014).

Conclusions

It was observed that there was a very weak correlation between anthropometric values and cholesterol levels and inflammation markers, and moderate levels of blood lipid values in healthy individuals.

Key messages

In primary care, measuring the body composition of healthy people at least once a year appears to be a valuable practice. Exercises that increase skeletal muscle and reduce the amount of internal fat should be recommended to patients with high cholesterol or healthy people at risk.

Health literacy levels and related factors of patients admitted to an outpatient clinic in Malatya

Background

This study was conducted to determine the health literacy levels and related factors of the patients who applied to a health unit.

Methods

The population of this cross-sectional study was the patients who applied to a district outpatient clinic in the center of Malatya. Power 80% and in the 95% confidence interval based on the mean of health literacy scale of Turkey (29.5 ± 5.7) the sample size was determined as 317. In the first three months of 2019 outpatients and 384 randomized patients who agreed to participate in the study, developed by the Ministry of Health Literacy Turkey Health Questionnaire-32 (THLQ) was applied. The score obtained from the scale is considered to be insufficient of 25 and below, limited to > 25-33 points and a score of < 33 and above is sufficient. In the analysis of the data, Kolmogorov Smirnov, Mann Whitney U, Kruskal Wallis and Chi-Kare tests were used and p < 0.05 was chosen as the level of error.

Results

49.9% of the participants were male and 50.1% were female. The average age is 35.94 ± 13.8. While 24% of the participants have secondary or lower education, 40.6% are graduates of higher education. In this study,the health literacy scale mean score of the participants is 15.85 ± 11.07. According to the results of THLQ-32, 78.1% of the participants were in the “insufficient” health literacy category, 14.0% in the “limited” category, only 7.9% in the “sufficient” category. Gender, age, educational background, frequency of applying to the health institution were determined as factors affecting the level of health literacy (p < 0.05). However, the presence of a disease causing regular drug use was not identified as a related factor (p > 0.05).

Conclusions

In this study, although of have a high education level of the participants were found to be inadequate of health literacy levels according to Turkey average value reflects the general.

Key messages

According to these results, it may be difficult for the groups that are insufficient in terms of health literacy to benefit from health services. Raising the health literacy level of the society can be an important component of health promotion.

Health Literacy level and related factors of students in a health vocational high school

Background

Health literacy (HL) is defined as the capacity to acquire, interpret and understand basic health information and services in a way to improve person's health. Population health literacy level was found to be inadequate or limited with 64,4% Ä°n Turkey Health Literacy Research (2015). The aim of this study is to determine the HL levels of students attending health vocational high schools and the related factors.

Methods

The population of this cross-sectional study was students who attended to the vocational school in the center of Malatya. The sample size was determined as 337 by using the power analysis based on Turkish data. Official permission was obtained for the research. In May and June 2019, Turkish Health Literacy Questionnaire-32 (THLQ) developed by the Ministry of Health was applied to the accepting students in this study.The score obtained from the scale is considered to be insufficient of 25 and below, limited to > 25-33 points and a score of < 33 and above is sufficient or excellent. In the analysis of the data, Kolmogorov Smirnov, Mann Whitney U and Kruskal Wallis tests were used and p < 0.05 was chosen as the level of error.

Results

68% of the students is female and 32% is male. The average age of the research group is 16.6 ± 1.1 (min. 14, max. 20). 18.3% of male students stated that 6.6% of female students smoke. The THLQ score of the study group was found to be 33.7 ± 8.9. 53.7% of male students and 39.5% of female students had insufficient or limited HL different from each other significantly (p < 0,025). 56.4% of students in 9th and 10th grades and 37.4% of 11th and 12th grade students were found to have insufficient or limited HL significantly (p < 0,0001). There was no difference between HLL scores and other socio-demographic characteristics(p > 0,05).

Conclusions

The frequency of adequate or excellent HL in the study group is higher among females (60.5%) than males (46.3%). It can be said that female students value health more.

Key messages

The limited level of health literacy of health vocational high school students indicates the insufficiency of health education in schools. Health topic campaigns should be organized frequently for awareness on health education during school education.

Examination of daily water consumption behaviors of individuals living in a semi-rural area

Background

The aim of this study is to investigate water consumption behaviors and related factors in the summer period of the population over the age of 15 who apply to family health centers in the semi-rural region.

Methods

The universe of this cross-sectional study consisted of adult patients who applied to community health centers of a region in Malatya. A questionnaire was applied to random 303 individuals about sociodemographic information and water and other fluid consumption and water use behavior.And also Chrobach alpha coefficient of 0.83, the validity adopted in Turkey Likert type consisting of 16 questions Water Consumption Behavior Scale-16 (WCBS) was used for data collection. Scale score height is considered good. In the analysis of the data; Mann Whitney-U and Kruskal-Wallis tests were used. P < 0.05 was chosen as the level of error.

Results

49.8% of the participants were male and 64.4% were married. The median daily drinking water consumption of the individuals was 2000 ml (320 ml-1000 ml) and the median daily liquid consumption was 3300 ml (718ml-17001ml). There was no significant difference between age groups, marital status and education level and daily water and other fluid consumptions (p > 0,05). 48.8% of individuals stated that they saved water and the most important reason for this was the high level of water consumption prices.In our study, there was no significant difference between gender, place of residence and number of households and total WCBS scale score.(p > 0,05). But the married individuals' scale score were significantly higher than the single individuals (p < 0,05)

Conclusions

Water and fluid consumption of individuals are at moderate levels in the region. Marital status was most important factor influencing the water consumption behaviors has been found in this study.When the most important factors in saving water are examined, the high price water bills were noteworthy.

Key messages

In order to ensure correct water consumption the society should be informed, the necessary sensitivity should be performed to behavioral change and measures should be taken. Adequate daily water consumption is required to protect the health of individuals.

Evaluation of chronic disease follow-up training of family physicians in primary care units

Background

Chronic diseases are a major cause of morbidity and mortality due to late diagnosis and insufficient treatment. This study deals with the training on chronic diseases organized by the Ministry of Health in the provinces. The aim of this study was to measure the effectiveness of training programs for family physicians in a province.

Methods

This semi experimental study was carried out during the training held in Bingöl that is eastern city of Turkey, on 22-26 October 2018 and 19-20 December 2018. The universe of the study consisted of family physicians working in the province. Of the 90 family physicians working in the province, 75 participated in the study. The training was conducted by the researchers and (before-after) 16-question test to the participants were used. The trainings cover the sub-heading Cardiovascular Risk Assessment and Diagnosis and Treatment of Hypertension. The family physicians were divided into 7 groups and were given 7-hour training. SPSS 25 program was used to analyze the data. In the analysis of data, Wilcoxon test, Cochran’s Q test and Bayesian approach samples t test were used.

Results

The average number of correct before training was 7.33 (min: 2 - max: 13), after training 12.64 (min: 7- max: 16; p < 0.001). After the training, participants’ correct answers to 15 questions increased (p < 0.001). Increase rate is 71%. Bayesian factor was found to be < 0.001 according to the results of Bayesian approach t test. There is definite evidence against the H0 hypothesis. According to the results of this quasi-experimental study, training is very effective.

Conclusions

In this study, it was shown that the education of the family physicians about the chronic diseases of the Ministry of Health is effective in increasing the knowledge level of family physicians.

Key messages

The training of the family physicians in charge of the primary health care is important. This study showed that education is very effective accorging to the pre-training.

The relationship between sleep quality and nutrition of medical school students in a city of Turkey

Background

Students need quality sleep and regular feeding during an intensive training proces. The aim of this study was to determine the sleep quality of Faculty of Medicine students and whether there is a relationship between sleep quality and eating attitudes and habits.

Methods

In this cross-sectional study; a face-to-face questionnaire was administered to 352 students who attending Inonu University Medical Faculty between January and March of 2019. The sample group is stratified according to class sizes (total 1665 students. The sleep quality and eating behaviors of students were questioned. For purpose, Pittsburgh Sleep Quality Index (PUKI, developed by Buysse et al,1989), and Eating Attitude Test (EAT,developed by Garner et al 1982) was used to assess quality and disorders. Kolmogorov Smirnov normal distribution test, Mann Whitney U and Kruskal Wallis test were used in analysis of the data.

Results

The mean age of the students was 21.5 ± 2.5 and 54.3% were female and 45.7% were male and 25.0% smoked cigarette. 64.4% of the study group had normal body mass index. The median value of the PUKI (cut of point is 5.0 and under 5 is good) score by gender is similar with 6.0 (1.0-15.0). The median value of the PUKI score was 6.0 (1.0-16.0) in social media / internet users and 5.0 (1.0-13.0) in non-users. According to Internet / social media users before going to sleep, the difference is significant (p: 0.016). The difference between cigarette smoking and median value of PUKI was significant (p: 0.029). there was a difference between classes in favor of upper classes in terms of EAT values (p = 0,046). 12.2% of the students are at risk of Blumia and 10.8% are at risk of Anorexia. There was no significant but positive correlation between the PUKI and EAT (p = 0.074, r = 0.096).

Conclusions

In general, the students’ sleep quality and eating attitudes and habits were found close to the cut-off points accepted by the tests. But blumia and anorexia is significant. This study was supported by the Research Fund of the Inonu University (No. 1792)

Key messages

Social media / internet usage of students before going to sleep affects sleep quality significantly. Although 64.4% of the students have normal body mass index, eating disorders (bulumia and anorexia) risk are noteable.

Smoking and substance abuse prevalence in adolescents in a city of Turkey

Background

The aim of this study was to determine the prevalence of smoking and abuse of substance among young people aged 14-18 in a city of Turkey and to determine the relationship between smoking and substance abuse risk.

Methods

This cross-sectional study was conducted on high school students studying in Bingöl city center. The universe of the study consists of 14000 students studying in 14 high schools. The minimum sample size required to be reached in the sample size analysis with reference to 80% power and 99% confidence interval was found to be 1235. According to the stratified sampling method, the students were randomly reached in schools and questionnaires were conducted under supervision by taking their consent. Chi-square test, Binary Logistic Regression test were used for data analysis.

Results

The mean age of the students was 15.71 ± 1.16 (min-max: 14-18) and 49.5% were male. The prevalence of smoking among all students is 15.8%, addictive substance use / trial frequency 5% except smoking. The prevalence of smoking among male students is 24.1%, in female students 7.7%. The rate of using addictive substance was found to be 8.2% for male students and 1.9% for female students except smoking. According to the results of Logistic Regression; substance abuse increases 8 (95% CI:3,32-19,95) fold in smokers (p = 0,001) and 2.5 (95% CI:1,10-5,38) fold in men (p = 0,027). The risk of substance use increases 1.05 (95% CI:1,02-1,08) fold as the number of cigarettes smoked daily (p = 0,001). Substance abuse risk of 18-year-olds shows increase 1.5 (95% CI:1,06-1,93) fold according to 14 years old (p = 0,021).

Conclusions

Smoking and addictive substance use in adolescents are particularly remarkable in male students (8.2%). This result is higher than the data reflecting Ä°stanbul (7%). This may be due to the fact that the province is located at the crossing point of drug traffic. Smoking increases the risk of other addictive substances (marijuana, heroin, etc.).

Key messages

Smoking and substance abuse is an important health problem in adolescents according to this study. Male students smoke are at risk of substance abuse more than female.

Distribution of Cancer cases and survival analysis results: A retrospective cohort study

Background

Cancer was the second leading cause of death in Turkey. The aim of this study is to examine the changes in the incidence of cancer cases and survival analysis in a region.

Methods

This retrospective cohort study was carried out on data of 977 people had been diagnosed with cancer between the years 2013-2015 in Bingol province located in the east of Turkey. All cancer cases are included in the study. The data of the patients were obtained from the Ministry of Health Cancer Registry System and International Disease Classification Oncology (ICD-O) codes published by World Health Organization were used. Patients were evaluated topographically (tissue originating from the lesion) in 41 categories. Kruskal Wallis, Mann Whitney U test, Chi-square test and Cox regression analysis were used to analyze the data.

Results

The mean age of the patients was 58.73 ± 16.80 (min: 1-max: 107). It was observed that 28.7% of the patients died during the follow-up period and 71.3% of the patients were alive. 30% of the cancer cases digestive system, 11% respiratory system, 23% female breast- genitalia, 15% blood-lymph-thyroid, 11.8% muscle-bone, 15,4% other cancer species. In men, lung, stomach, colon, prostate; breast, thyroid and skin cancers are more common in women respectively. The incidence rate for all age groups was 97 per hundred thousand in 2013, 161 per hundred thousand in 2015. The increase trend did not differ by gender. The mean follow-up period of the patients who died was 388 days and 1541 days for the living patients. The risk of death is increased significantly in patients who cannot be operated (RR = 2.779, HR = 3.048). In patients not receiving chemotherapy, the risk of death is reduced significantly (RR = 0.656, HR = 0.340).

Conclusions

The incidence of cancer increases in the study area. Survival times vary according to treatment efficacy. Broad-based cohort studies evaluating the effects of treatment types on survival may be recommended.

Key messages

Cancer in the study area shows a significant increase from year to year. The average 5-year survival period of cancer patients was found is 71% as a good result.

Production and characterization of chars from cherry pulp via pyrolysis

Pyrolysis is an eco-friendly process to achieve valuable products like bio-oil, char and gases. In the last decades, biochar production from pyrolysis of a wide variety of industrial and agricultural wastes become popular, which can be utilized as adsorbent instead of the expensive activated carbons. In this study, cherry pulp was pyrolyzed in a fixed bed tubular reactor at five different temperatures (400, 500,550, 600 and 700 °C) and three different heating rates (10, 100 and 200 °C/min) to obtain biochar. Proximate, ultimate, nitrogen adsorption/desorption isotherms, scanning electron microscopy, thermogravimetric analysis, x-ray fluorescence, x-ray diffraction, and Fourier transform infrared spectroscopy were performed on cherry pulp and its chars to examine the chemical alterations after the pyrolysis process. Biochar yields were decreased with increasing pyrolysis temperature and heating rate, based on experimental results. Porous biochars are carbon rich and includes high potassium content. The aromaticity of biochars increased and O/C mass ratio reduced with an increase in the pyrolysis temperature as a result of the development of compact aromatic structure in char. Pyrolysis provides a promising conversion procedure for the production of high energy density char which has promising applications in existing coal-fired boilers without any upgrading.

Identifying the determinants of microalbuminuria in obese patients in primary care units: the effects of blood pressure, random plasma glucose and other risk factors

OBJECTIVE

The objective of this study is to evaluate the demographic characteristics, blood pressure and blood glucose and the other related factors that affect the microalbuminuria levels in the obese patients aged 40 and above who applied to the primary care for medical evaluation.

MATERIALS AND METHODS

The population of the research, which was a cross-sectional type, comprised obese patients aged 40 and above who had applied to the community health centers in the center of Malatya. A total of 422 obese patients consisting of 116 males and 306 females were included in the research. The anthropometric measurements of the participants were determined, their blood pressures and their random blood glucoses were evaluated, as well. A microalbuminuria measurement was performed in the urine samples taken from the patients using "Nycocard Reader II" device.

FINDINGS

The incidence of microalbuminuria in patients was found as 31.5%, whereas the incidence of macroalbuminuria was 6.6%. The incidence of microalbuminuria in female patients was 32.7%, while it was 28.4% in male patients; on the other hand, the incidence of macroalbuminuria in female patients was found as 6.8%, whereas this percentage was determined as 7.8 in male patients (p > 0.05). The probability of the incidence of microalbuminuria increased 2.8 times more in those with the diastolic blood pressure of 90 mmHg and above when compared to those without it (GA: 1.79-4.56), whereas the incidence increased 3.2 times more in those with the random blood glucose of 200 mg/l and above (GA: 1.32-7.84) (p < 0.001). In our study, among the variables predicting the microalbuminuria in obese patients; the cutoff values of the diastolic and systolic blood pressures, the waist circumference were found as >85 mmHg; >130 mmHg; >141 mg/dl, respectively, in male patients and found as >85 mmHg, >114 cm, and 109 cm, respectively, in female patients. The sensitivity and specificity of the tests indicating the cutoff values showed significance (p < 0.05). There was no statistically significant relevance between the microalbumin levels of the obese patients via the anthropometric criteria, except for their waist circumference (p > 0.05).

RESULT

In this study, the blood pressure and blood glucose levels of the patients along with their waist circumference that indicated a central obesity were specified as the determinants of microalbuminuria. While the obese patients are being evaluated in terms of proteinuria, the cutoff values of these variables can be taken into consideration.

Sorption of Cr(VI) ions on two Lewatit-anion exchange resins and their quantitative determination using UV-visible spectrophotometer

The sorption of Cr(VI) from aqueous solutions with macroporous resins which contain quarternary amine groups (Lewatit MP 64 and Lewatit MP 500) was studied at varying Cr(VI) concentration, adsorbent dose, pH, contact time and temperature. Batch shaking sorption experiments were carried out to evaluate the performance of Lewatit MP 64 and Lewatit MP 500 anion exchange resins in the removal of Cr(VI) from aqueous solutions. The concentration of Cr(VI) in aqueous solution was determined by UV-visible spectrophotometer. The ion exchange process, which is dependent on pH, showed maximum removal of Cr(VI) in the pH range 3-7 for an initial Cr(VI) concentration of 1x10(-3) M. The optimum pH for Cr(VI) adsorption was found as 5.0 for Lewatit MP 64 and 6.0 for Lewatit MP 500. The maximum Cr(VI) adsorption at pH 5.0 is 0.40 and 0.41 mmol/g resin for Lewatit MP 64 and Lewatit MP 500 anion exchangers, respectively. The maximum chromium sorption occurred at approximately 60 min for Lewatit MP 64 and 75 min for Lewatit MP 500. The suitability of the Freundlich and Langmuir adsorption models was also investigated for each chromium-sorbent system. The uptake of Cr(VI) by the anion exchange resins was reversible and so it has good potential for the removal of Cr(VI) from aqueous solutions. Both ion exchangers had high bonding constants but Lewatit MP 500 showed stronger binding. The rise in the temperature caused a slight decrease in the value of the equilibrium constant (K(c)) for the sorption of Cr(VI) ion.

Uptake of Cr3+ from aqueous solution by lignite-based humic acids

Humic acid (HA) produced from brown coal, a relatively abundant and inexpensive material is currently being investigated as an adsorbent to remove toxic metals from aqueous solution. The influence of five parameters (contact time, solution pH, initial metal concentration, temperature and amount of adsorbent) on the removal at 20+/-1 degrees C was studied. HAs were prepared from lignites by using alkaline extraction, sedimentation and acidic precipitation. Adsorption equilibrium was achieved in about 60 min for Cr3+ ion. The Langmuir adsorption isotherm was used to describe observed sorption phenomena. The maximum adsorption capacity of 0.17 mmol for Ilgin (HA1), 0.29 mmol for Beysehir (HA2) and 0.18 mmol Ermenek (HA3) and 0.17 mmol of Cr3+/g for activated carbon (AC) was achieved, respectively at pH of 4.1. More than 84% of Cr3+ was removed by HA2, 54% by HA3 and 51% by HA1 and 50% by AC from aqueous solution. The adsorption was strongly dependent on pH but independent of ionic strength and metal ions. The adsorption of Cr3+ was higher between pH 4.1 and 5.1 for all HAs and maximum sorption was observed at pH 4.1. The rise in temperature caused a slight decrease in the value of the equilibrium constant (Kc) for the sorption of Cr3+ ion. Complex mechanisms including ion exchange, complexation and adsorption and size exclusion are possible for sorption of Cr3+ ion on HAs.

Equilibrium isotherm studies for the uptake of cadmium and lead ions onto sugar beet pulp

The adsorption of Cd2+ and Pb2+ on sugar beet pulp (SBP), a low-cost material, has been studied. In the present work, the abilities of native (SBP) to remove cadmium (Cd2+) and lead (Pb2+) ions from aqueous solutions were compared. The (SBP) an industrial by product and solid waste of sugar industry were used for the removal of Cd2+ and Pb2+ ions from aqueous water. Batch adsorption studies were carried out to examine the influence of various parameters such as initial pH, adsorbent dose, initial metal ion concentration, and time on uptake. The sorption process was relatively fast and equilibrium was reached after about 70 min of contact. As much as 70-75% removal of Cd2+ and Pb2+ ions for (SBP) are possible in about 70 min, respectively, under the batch test conditions. Uptake of Cd2+ and Pb2+ ions on (SBP) showed a pH-dependent profile. The overall uptake for the (SBP) is at a maximum at pH 5.3 and gives up to 46.1 mg g(-1) for Cd2+ and at pH 5.0 and gives 43.5 mg g(-1) for Pb2+ for (SBP), which seems to be removed exclusively by ion exchange, physical sorption and chelation. A dose of 8 gL(-1) was sufficient for the optimum removal of both the metal ions. The Freundlich represented the sorption data for (SBP). In the presence of 0.1M NaNO3 the level of metal ion uptake was found to reach its maximum value very rapidly with the speed increasing both with the (SPB) concentration and with increasing initial pH of the suspension. The reversibility of the process was investigated. The desorption of Cd2+ and Pb2+ ions which were previously deposited on the (SBP) back into the deionised water was observed only in acidic pH values during one day study period and was generally rather low. The extent of adsorption for both metals increased along with an increase of the (SBP) dosage. (SBP), which is cheap and highly selective, therefore seems to be a promising substrate to entrap heavy metals in aqueous solutions.

Rubella seroprevalence in an unvaccinated pregnant population in Malatya, Turkey

BACKGROUND

Controlling congenital rubella by 2010 is one of the targets of the World Health Organization. Most European countries currently include rubella vaccine in their national immunization programmes, but not yet in Turkey.

OBJECTIVES

To define rubella seroprevalence in pregnancy in Malatya, Turkey.

STUDY DESIGN

A cross-sectional interview survey was conducted among pregnant women living in Malatya province from November 2003 to May 2004, together with a follow-up component.

METHODS

Stratified probability proportional to size sampling methodology. A total of 824 pregnant women from 60 clusters were enrolled. After obtaining informed consent, participants' socio-demographic and fertility characteristics were collected by interview questionnaire. Various blood samples were drawn. After storing serum samples at -20 degrees C for 6 months, anti-rubella IgM and IgG titres were studied by micro ELISA. Only 803 sera were eligible for serological study.

RESULTS

Of the 803 samples tested for rubella antibodies, 753 cases (93.8%) had anti-rubella IgG positivity, indicating past infection. Five of the pregnant women (0.6%) had both anti-rubella IgM and IgG positive results, suggesting a recent infection. The remaining 45 women (5.6%) were seronegative for both antibodies. Seroprevalence was not associated with age or urban/rural residency. All the five anti-rubella IgM positive women were in the second trimester of pregnancy.

CONCLUSIONS

As 5.6% of pregnant women were susceptible to rubella during pregnancy, and five of them had already had a recent infection, immunization efforts should be directed at babies and adolescents.

Comparison of adsorption capacity of young brown coals and humic acids prepared from different coal mines in Anatolia

Binding of Zn2+ and Cd2+ cations to relatively young brown coals YBC (lignite), humic acids (HAs) and commercial humic acid (CHA) were studied in aqueous media at pH 2.7-6 by polarographic method. This study was conducted to evaluate the removal of heavy metals in an aquatic system without prior treatment. The general principles of cation binding to YBC and humic materials are discussed. Sorption of heavy metal ions (Zn2+ and Cd2+) on samples of YBCs from three areas (Ilgin, Beysehir, and Ermenek) in the vicinity of the city of Konya in Anatolia (Turkey) were compared with sorption of these metal ions on HAs, prepared from these YBCs. The ability of both types of sorbent to remove metals from aqueous solutions was studied as a function of pH and concentration of initial metal solutions. Sorption depends strongly on pH, the origin of the YBC and on the nature of the metal ion. Whereas, for YBCs the main ligand groups seem to be carboxylate ions, this is not the case for the HA polymers, prepared from three YBCs, which differ substantially from properties of commercial samples of "HA". The process is very efficient especially in the case of low concentrations of pollutants in water, where common methods are either economically unfavorable or technically complicated. Of the two metal ions examined, Cd2+ was found to form the most stable HA complexes, followed by Zn. Effective removal of metals was demonstrated at pH-values of 5-5.7. The adsorption isotherm was measured at 25 degrees C, using adsorptive solutions at the optimum pH-value to determine the adsorption capacity. An important aspect of the proposed method was that the removal was performed on several metals at a pH-range in which a given metal undergoes an adsorption process making the method useful for wastewater treatment.

Factors affecting survival of hospitalised patients with COPD

Factors determining in-hospital mortality and long-term survival of patients hospitalised with acute exacerbations of chronic obstructive pulmonary disease (AECOPD) are not precisely understood. The aim of the present study was to assess the parameters related to in-hospital mortality and long-term survival after hospitalisation of patients with AECOPD. Clinical and epidemiological parameters on admission in 205 consecutive patients hospitalised with AECOPD were prospectively assessed. Patients were followed-up for 3 yrs. Factors determining short- and long-term mortality were analysed. In total, 17 patients (8.3%) died in hospital. In-hospital mortality was significantly associated with lower arterial oxygen tension (P(a,O2)), higher carbon dioxide arterial tension, lower arterial oxygen saturation and longer hospital stay. The overall 6-month mortality rate was 24%, with 1-, 2- and 3-yr mortality rates of 33%, 39% and 49%, respectively. Cox regression analysis revealed that long-term mortality was associated with longer disease duration (relative risk (RR) = 1.158), lower albumin (RR = 0.411), lower P(a,O2) (RR = 0.871) and lower body mass index (RR = 0.830). When the model was run for the time elapsed since first hospitalisation, it also appeared as statistically significant (RR = 1.195). These findings show that patients hospitalised with acute exacerbations of chronic obstructive pulmonary disease have poor short- and long-term survival. Prediction of survival status may be enhanced by considering arterial oxygen tension, albumin, body mass index, disease duration and time elapsed since the first hospitalisation.

Equilibrium studies for the sorption of zinc and copper from aqueous solutions using sugar beet pulp and fly ash

In the present work, the abilities of native sugar beet pulp (SBP) and fly ash (FA) to remove copper (Cu(2+)) and zinc (Zn(2+)) ions from aqueous solutions were compared. The SBP and FA, an industrial by-product and solid waste of sugar industry, were used for the removal of copper and zinc from aqueous water. Batch adsorption experiments were performed in order to evaluate the removal efficiency of SBP and lignite-based FA. The effect of various operating variables, i.e. initial pH, adsorbent dose, initial metal ion concentration, and time on adsorption of copper and zinc onto the SBP and FA, has been studied. The sorption process was relatively fast and equilibrium was reached after about 60 min of contact. As much as 60-97% removal of copper and zinc for SBP and FA are possible in about 60 min, respectively, under the batch test conditions. Uptake showed a pH-dependent profile. The overall uptake for the SBP is at a maximum at pH 5.5 and gives up to 30.9 mg g(-1) for copper and at pH 6.0 and gives 35.6 mg g(-1) for zinc for SBP, which seems to be removed exclusively by ion exchange and physical sorption. Maximum adsorption of copper and zinc occurred 7.0 and 7.84 mg g(-1) at a pH value of 5.0 and 4.0 for FA, respectively. A dose of 8 g l(-1) of SBP and 8 g l(-1) FA were sufficient for the optimum removal of both the metal ions. The sorption data were represented by the Freundlich for SBP and the Langmuir and Freundlich for FA. The sorption data were better represented by the Langmuir isotherm than by the Freundlich one for FA in the adsorption of zinc ion, suggesting that the monolayer sorption, mainly due to ion exchange. The presence of low ionic strength or low concentration of Na and Cl ions does not have a significant effect on the adsorption of these metals by SBP and FA. The SBP and FA are shown to be effective metal adsorbents for these two metals.

Ceramic encapsulated latex composites

This work reports the encapsulation of latex particles in Al2O3-polystyrene (PS) composite films. These films were prepared from PS particles in Al2O3 dispersion at room temperature in various latex contents. Composite films were annealed at elevated temperatures in 10 min time interval above the glass transition temperature (Tg) of polystyrene. Transmitted photon intensities, I(tr) were monitored after each annealing step. AFM micrographs were also used to observe the physical changes of the composite films during annealing. It was observed that latex particles are encapsulated above a critical Al2O3 content of 33 wt% which corresponds to the critical occupation probability of p(c) = 0.33 at which the film obey the site-percolation model with a critical exponent of 0.45. Below p(c), it was seen that complete latex film formation process took place, where transparency of the film was increased by annealing.

Evaluation of the immune response to hepatitis B vaccination in children aged 1-3 years in Malatya, Turkey

By the end of 1998, Turkey had launched the routine vaccination of infants against hepatitis B. The purpose of the study is to evaluate the immune response in a sample of vaccinated children aged 1-3 years in the city of Malatya. A total of 210 vaccinated children 12 to 48 months old were selected for the study with 30 cluster sampling in the city of Malatya, Turkey. The children were visited at their homes during January-April 2002. The information on demographic characteristics, family's and child's medical history was gathered, childrens' weight and height were measured and blood samples were taken. Anti-HBs, HbsAg and anti-HBc titers were assayed by micro-ELIZA from the sera. The mean age of the children was 26.3 months, 100 (47.6%) were male and 110 (52.4%) were female. Overall, 203 (96.7%) children had protective anti-HBs levels (> or = 10 IU/l), 0.5% showed evidence of natural infection (with positive anti-HBc and anti-HBs titers), 0.5% had acute or chronic infection (with positive HbsAg and anti-HBc titers) and 2.3% were seronegative. Geometric mean titer of anti-HBs among vaccinated children except those who had positive anti-HBc titers was 138.7 mIU/ml (95% CI:124.7-154.2) and seroconversion rates did not differ by age, sex, anthropometric measurements, time after third dose and place of vaccine administered (P > 0.05). The high seroprotection rate over 95% showed that routine infant vaccination program for hepatitis B was successfully carried out in the city Malatya.

A comparative study of two chelating ion-exchange resins for the removal of chromium(III) from aqueous solution

Macroporous resins containing iminodiacetic acid (IDA) groups (Lewatit TP 207 and Chelex-100) were investigated as a function of concentration, temperature and pH for their sorption properties towards chromium(III). The chromium(III) ions sorbed onto the resin and in the equilibrium concentration were determined by inductively coupled plasma spectrophotometer. The maximum sorption for chromium ions was observed at pH 4.5. Solution pH had a strong effect on the equilibrium constant of Cr(III). The equilibrium constants were 320 and 7 at pH value 4.5 for Lewatit TP 207 and Chelex-100 resin, respectively. The Langmuir isotherm was used to describe observed sorption phenomena. Both the sorbents had high bonding constants with Lewatit TP 207 showing stronger binding. The equilibrium related to adsorption capacity and energy of adsorption was obtained by using plots of Langmuir adsorption isotherm. It was observed that the maximum adsorption capacity of 0.288 mmol of Cr(III)/g for Chelex-100 and 0.341 mmol of Cr(III)/g for Lewatit TP 207 was achieved at pH of 4.5. The rise in temperature caused a slight increase in the value of the equilibrium constant (K(c)) for the sorption of chromium(III) ion.

The role of axial length in central and branch retinal vein occlusion

BACKGROUND AND OBJECTIVE

To assess whether the axial length is a local risk factor in central retinal vein occlusion (CRVO) and branch retinal vein occlusion (BRVO).

PATIENTS AND METHODS

The axial lengths of affected and fellow eyes of 19 patients with CRVO and 27 with BRVO and of their controls were measured with A-scan ultrasonography. The control group consisted of 17 individuals for CRVO and 25 for BRVO matched in age, sex and the prevalence of hypertension and diabetes in patient groups. The results of measurements in affected, unaffected and control eyes were compared.

RESULTS

The mean axial length was different among the affected and unaffected eyes in patients with CRVO and their controls (P < .05). The affected eyes had significantly shorter axial length compared to the fellow and control eyes (P < .01 and P < .01, respectively). In the BRVO group, the mean axial length did not differ among affected, unaffected and control eyes (P > .05).

CONCLUSIONS

Our study demonstrates a significantly shorter axial length in eyes with CRVO and not significantly shorter axial length in those with BRVO. The shorter axial length could be an additional risk factor in the pathogenesis of CRVO.

Analysis of polychlorinated dibenzofurans (PCDFs) in fly ash from a waste incineration plant

In this study, a method for the congener-specific analysis of polychlorinated dibenzofurans (PCDFs) in fly ash from a waste incineration plant is described. This method involves extraction, column chromatography, and gas chromatographic-mass spectrometric techniques. Representative fly ash samples are obtained from the waste incinerator. The purpose of this research is to briefly present the findings as they relate to PCDFs. Analyses indicate that PCDFs are consistently found in the municipal incinerator.