Geographical Regions Of Turkey Research Articles

Investigation of antibiotic resistance patterns and reduced vancomycin susceptibilities of methicillin-resistant Staphylococcus aureus isolates: a multi-center study

The aims of this study were to determine the minimum inhibitory concentration (MIC) values of vancomycin, teicoplanin, daptomycin, quinupristin/dalfopristin, linezolid, tigecycline, chloramphenicol, rifampicin, ofloxacin and tetracycline and to investigate the reduced vancomycin susceptibility among methicillin-resistant Staphylococcus aureus (MRSA) strains isolated in hospitals located in different geographical regions of Turkey. A total of 100 MRSA strains isolated from patients (of which 50% were from intensive care units) hospitalized in seven centers in Turkey [Istanbul (n= 15), Ankara (n= 15), Izmir (n= 15), Adana (n= 15), Diyarbakir (n=15), Erzincan (n= 15), Van (n= 10)], between August 2013 - August 2014, were included in the study. Fourty-three strains were isolated from blood, whereas 21 were from lower respiratory tract, 17 from wounds, eight from catheters, six from urine, four from nasal swab and one from cerebrospinal fluid samples. Methicillin resistance of the isolates was determined by using cefoxitin (30 µg) disk with standard disk diffusion method, while the MIC values of other antibiotics were determined with E-test in accordance with the recommendations of Clinical and Laboratory Standards Institute (CLSI). MIC results obtained for quinupristin-dalfopristin (Q/D) were evaluated according to the CLSI criteria used for methicillin-susceptible S.aureus and for tigecycline according to the criteria recommended by the Food and Drug Administration for MRSA. Primarily, agar screening method (ASM) was used for determination of vancomycin-intermediate S.aureus (VISA) and heterogeneous VISA (hVISA) strains. Brain heart infusion agar containing 6 µg/ml vancomycin was used in ASM, and the strains with suspicion of VISA/hVISA were screened by standard E-test and macro E-test methods. All MRSA strains were susceptible to vancomycin, teicoplanin, daptomycin, Q/D and linezolid by E-test method; and their rates of susceptibility for tigecycline, chloramphenicol, rifampicin, ofloxacin and tetracycline were detected as 89%, 97%, 40%, 39% and 32%, respectively. MIC50/MIC90 values were 1.5/2 µg/ml for vancomycin, 2/4 µg/ml for teicoplanin, 0.19/0.38 µg/ml for daptomycin, 0.19/0.38 µg/ml for Q/D, 0.75/1 µg/ml for linezolid, 0.19/0.75 µg/ml for tigecycline, 3/6 µg/ml for chloramphenicol, 32/32 µg/ml for rifampicin, 32/32 µg/ml for ofloxacin and 32/64 µg/ml for tetracycline, respectively. For the evaluation of reduced vancomycin susceptibility, 2% (2/100) of MRSA strains were defined as VISA and 5% (5/100) as hVISA with ASM. One of those seven isolates identified as VISA/hVISA with ASM was evaluated as suspected hVISA by using both standard E-test and macro E-test methods. In conclusion, no MRSA resistant strain to vancomycin, teicoplanin, daptomycin, Q/D and linezolid was determined in our study. However tigecycline resistance (11%) was found higher than expected. As the glycopeptide resistance is increasing in the world and because of the intense use of these drugs in Turkey, the rates of vancomycin resistance among MRSA strains should be investigated periodically.

Knowledge, attitudes and behaviors of physicians towards thyroid disorders and iodine requirements in pregnancy.

Thyroid disorders including iodine deficiency during pregnancy are important health problems worldwide. However, considering real life, assessment of knowledge, attitudes, and practice of physicians is lacking. We aim to evaluate knowledge, attitudes and behaviors of physicians towards thyroid disorders and requirements of iodine during pregnancy on a nationwide basis. Clinicians from different medical disciplines most likely to encounter pregnant women in daily practice (i.e., obstetricians, endocrinologists, and family physicians) were included. Family physicians were selected from primary care centers; endocrinologists and gynecologists were selected from state hospitals. Randomly selected 322 physicians from seven geographical regions of Turkey were included. Subjects filled a questionnaire which consisted of three sections about knowledge, attitudes and behaviors towards thyroid disorders and iodine requirements during pregnancy. Physicians had insufficient and/or erroneous knowledge about thyroid disorders during pregnancy. 73.1% of endocrinologists, 32.7% of family physicians, and 17.8% of obstetricians knew the correct level of TSH during pregnancy (p<0.001). 67.1% of physicians thought it is unnecessary to offer iodine supplementation to pregnant women. Endocrinologists achieved the highest scores in each section, and also had the highest total scores (p<0.001). Family physicians achieved higher scores than obstetricians. Physicians who encounter pregnant women in Turkey do not have sufficient information about management of thyroid disorders and providing iodine support during pregnancy and lactation.

Determination of Technopedagogical Content Knowledge Competencies of Preservice Physical Education Teachers: A Turkish Sample

This study examined preservice physical education teachers’ (PPETs’) technopedagogical content knowledge (TPCK) competencies. The participants were 1028 PPETs from 26 major universities representing all seven geographical regions of Turkey. The Technological Pedagogical Content Knowledge Deep- Scale developed by Kabakci Yurdakul et al. (2012) was used to measure TPCK competencies of PPETs. Descriptive statistics, an independent samples t test, and multivariate analysis of variance were used to analyze the data. The results showed that PPETs rated themselves at a high level in self-reported TPCK competencies in terms of the entire scale and its factors (design, exertion, ethics and proficiency). There was no significant main effect for gender (p &lt; .05). Computer/internet-based background (p &gt; .05) and PPETs’ interest in keeping up with the latest PE-related technological developments (p &gt; .05) were significant variables in PPETs’ TPCK competencies. Overall, this study offers some evidence that the use of information and communication technology (ICT) is an important factor affecting PPETs’ TPCK competencies.

Team Leadership: Leadership Role Achievement in Supervision Teams in Turkey

The purpose of this paper is to explore the views of team leaders and team members of supervision teams about the extent that team leaders achieve their team leadership roles in Turkey. This research was conducted as a survey. The population of the study consisted of approximately 2650 supervisors (inspectors) working in 81 provinces distributed to seven geographical regions in Turkey. The sample consisted of 563 supervisors which were selected out by random sampling. The data were gathered by a questionnaire developed by the researchers and it was designed in two forms: one for team leaders and one for team members. In the analysis SPSS package programme was used. The study provides several noteworthy findings. Team leaders in general noted that they achieved their leadership roles affectively. The findings show that team members agreed with the views of their leaders. Team leaders and team members’ views were both consistent in their views regardless of their gender, education, seniority and the time spent working in the same province were the same in regard to total statistical calculation and analysis. In order to have more effective teams there is a need to give place to team leadership in legal arrangements more, the one who is selected by the team members as team leader should be appointed regardless of any approval of upper managers. It can be asserted that the more democracy in the process of leadership positions the more voluntary participation among members of a team directed to effectiveness can be expected.

UYGULAMA ÖĞRETMENLERİNİN PERSPEKTİFİNDEN “UYGULAMA ÖĞRETMENİ” YETERLİKLERİ

This research was conducted to determine the opinions of Classroom Teachers (N = 832), serving at seven geographical regions of Turkey, about the competence of mentors. In the study, Mentor Competence Scale which was developed by some researchers was used. The Scale consisted of nine sub-dimensions; ‘preparation for teaching practice’, ‘vocational guidance’, ‘evaluation’, ‘observation’, ‘adult education’, ‘classroom management’, ‘communication’, ‘feedback’ and ‘personality traits’. Participants of the study stated at the level of ‘strongly agree’ that all the competence domains should be represented by a mentor. It was also revealed that a mentor is mostly required to have the competences of ‘adult education’ sub-dimension

Evaluation of metabolite extraction protocols and determination ofphysiological response to drought stress via reporter metabolites in model plant Brachypodium distachyon

Metabolomics aims to systematically gather (quantitative) information on metabolites in the cell and is commonly viewed as the missing link between genomics, transcriptomics, and physiology. Typical metabolomics platforms consist of two main steps, the quenching and extraction of metabolites from plant material and the (un)targeted quantification of the extracted metabolites. Brachypodium distachyon, a native grass species of the Mediterranean region, is an attractive model plant to study temperate crops. In recent years, despite an increasing interest in genomic and transcriptomic studies, metabolomics studies for B. distachyon are still in their infancy. Drought, an abiotic stress factor, causes severe loss in plant productivity and it is therefore crucial to understand its effect on plant metabolism, in particular its metabolome. The objective of this study is to set up a quantitative plant metabolomics platform for B. distachyon to evaluate and optimize alternative metabolite extraction protocols (methanol and methanol-chloroform extraction). Focusing on three reporter metabolites (ATP, glucose, and starch) for metabolite quantification and two extraction protocols, we compared the drought stress response of 2 different genotypes from different geographical regions of Turkey. Results revealed that there is no one-protocol-fits-all, pointing to significant differences in metabolite recoveries upon different extraction protocols, though methanol extraction generally yielded higher recoveries. Drought stress resulted in higher glucose levels while ATP and starch levels did not show statistically significant or consistent changes. In conclusion, the impact of drought stress on B. distachyon metabolism was significant and this study could be the basis for further metabolomics studies on plant stress response.

Abstract 43: Distribution and frequency of BRCA gene mutations in Turkish population including Balkan Turks

Abstract Background: The distribution of hereditary breast and ovarian cancer in Turkish population has been reported in earlier publications. However, the regional distributions of breast cancer and/or BRCA1/2 gene mutations frequency are not known for Balkan Turks who came to Turkey for the forced migration in 1989 and for general Turkish populations in Turkey. Materials and Method: We recruited 401 patients with a family history of breast and/or ovarian cancers, and 126 early-onset breast cancer cases below age 40 with/without a family history of cancer between 1994-2013. These patients were referred to Cancer Genetics Department of Oncology Institute in University of Istanbul. Families were selected from consecutive referrals to the above-listed hospital meeting specific family-history criteria (either multiple cases of breast and or ovarian cancer in the family or the presence of an individual with a young age at diagnosis). Mean age of patients in the study was 41, 18±10, 24. Results: The distributions of patients participating in the study were evaluated in total 8 groups such as seven geographic regions of Turkey and the Balkan Turks. Overall frequency of BRCA1/2 gene mutations in Turkish population was 10%. The distribution of patients according to 8 groups were 26.6% in the Black Sea Region, 21.5% in the Marmara Region, 17.6% in the Eastern Anatolia Region, 8.6% in Central Anatolia, 3.1% in Aegean Region, 3.9% in the Mediterranean region, 2.7% in South Eastern Anatolia and 16% in Balkan Turks. BRCA1 and BRCA2 positivity was evaluated in the study groups: BRCA1/2 mutations ratio were 20% in the Black Sea Region, 16% in the Marmara Region, 20% in the Eastern Anatolia Region, 12% in Central Anatolia, % 4 in Aegean Region and 28% in the Balkan Turks. None of mutations in both genes were found in the patients participating in the study from South Eastern Anatolia and the Mediterranean regions. The observed BRCA1/2 mutations rate was found almost two-fold according to the expected mutation rate in the group of Balkan Turks. The highest breast cancer rates were seen in the city of Giresun in the Black Sea Region and in the city of Malatya in the Eastern Anatolia Region, respectively. Conclusions: In our study, breast cancer was more frequent in the regions which were the Black Sea, the Marmara, Eastern Anatolia and the Balkan Turks group. Although the Marmara region was industrialized, Bulgaria where Balkan Turks lived before forced-migration and the Black Sea Region are not industrialized areas. However, in 1986, these regions were the most affected by the Chernobyl disaster and these interactions was described with scientific data. Therefore, it might be concluded that the high rates of breast cancer are associated with the Chernobyl disaster in these regions. In the study, BRCA1/2 gene mutation rates were examined in Balkan Turks who came to Turkey by forced-migration after Chernobyl disaster. In the group of Balkan Turks, almost two fold expected incidence for BRCA1/2 gene mutations was observed. The investigated society was a small community living as a minority in Bulgaria. Therefore, it was suggested that the society was isolated as a nature and has been had high BRCA1/2 mutations rate. On the other hand, in the study, BRCA1/2 gene mutations and clinical/pathological data were also compared and survival analysis was performed in the general Turkish population. The diagnosis age for breast cancer was found 10 years earlier when compared to the other populations (p&amp;lt;0,005). BRCA1/2 mutations were not shown in the patients below age of 30. High frequency of the BRCA1 positivity was observed in triple negative patients (P &amp;lt;0.05). Citation Format: Demet Akdeniz, Bugra S. Tuncer, Seda Kilic, Ozge Sukruoglu, Leyla Kilic, Kevser Altundag, Rumeysa Ciftci, Sevda Ozel, Senem Karabulut, Meltem Ekenel, Pinar Saip, Hasan Karanlik, Neslihan Cabioglu, Hulya Yazici. Distribution and frequency of BRCA gene mutations in Turkish population including Balkan Turks. [abstract]. In: Proceedings of the AACR Special Conference: Cancer Susceptibility and Cancer Susceptibility Syndromes; Jan 29-Feb 1, 2014; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2014;74(23 Suppl):Abstract nr 43. doi:10.1158/1538-7445.CANSUSC14-43

The Effect of Organizational Support on Organizational Commitment

This research examines the effect of organizational support for teachers on their organizational commitment. The data was collected from 819 primary school teachers in seven cities from every geographical regions of Turkey. In the research, the two scales administered are Perceived Organizational Support Scale (POSS) and Teachers' Organizational Commitment Scale (TOCS). The results reveal that teachers perceive organizational support and organizational commitment at a moderate level. While teachers' organizational commitment perceptions differentiate in terms of gender, experience, reward and education level variables, their organizational support perceptions differentiate in terms of experience and reward variables. It shows that the more teachers' organizational support perceptions increase, the higher their commitment perceptions are. While organizational support perceptions towards personal development have a low influence on the dependent variable, organizational support perceptions towards work structure have a negative influence on the dependent variable.

Comparison of Physico-chemical Properties of Various Coals as Thermodynamics: First and Second Law Analysis

In energy transformation processes, such as combustion of fossil and renewable fuels, the conservation of energy (first law of thermodynamics) as well as the quality of energy (second law of thermodynamics) is important. The objective of this article is to present a calculation of standard chemical exergy of coal-based fuels. In this regard, the necessity of this study has been based on solid and valid arguments on the advantages of second-law analyses compared to first-law analyses and a correct chemical exergy calculation is presented. A formula has been developed for estimating the chemical exergy of coals from their ultimate analysis values. In order to obtain this formula, 33 samples from different geographical regions in Turkey were analyzed to calculate chemical exergy values by using ultimate analyses and calorific values. Also, chemical exergy values of these coal samples obtained from different Turkish sources were calculated from a formula in the literature. The mean differences between these values range from −0.798 to 0.646%. The formula developed for estimating the chemical exergy of coals from their ultimate analyses and calorific values had a correlation coefficient (R2 = 0.99), and the prediction of this formula is good, as well as expected.

238U, 234U and 226Ra concentrations in mineral waters and their contribution to the annual committed effective dose in Turkey

Activity concentrations of 234U, 238U and 226Ra in mineral waters were determined on the basis of nine water bottling facilities using alpha particle spectrometry. The mineral water samples were collected from three geographic regions of Turkey. The radiochemical separation used in the uranium analysis is based on the isolation of uranium radioisotopes from other radionuclides such as Th, Am, Pu and Np using UTEVA resin. Alpha sources were prepared using electrodeposition method. The activity concentration of 226Ra was determined after deposition on a membrane using BaSO4 co-precipitation method. The activity concentrations (mBq L−1) of 226Ra, 238U and 234U ranged from <0.56 to 165, from <0.42 to 439 and from <0.42 to 464, respectively. The measured activity concentrations were used for the calculation of the average total annual effective ingestion doses for children and adults. The committed effective doses were calculated for three different scenarios according to mineral water consumption rate. In the most extreme scenario (for age group 12–17), all water samples except MW1 and MW2 cause annual committed effective doses below the reference level (0.1 mSv year−1) recommended by World Health Organization (WHO).

The Estimation of Chemical Availability (Exergy) Values for Various Types of Coals in Geographical Regions of Turkey

Anxiety concerning the problems of energy and resources has led to a rapid increase in the interest in describing and understanding the conversion processes of energy and other resources in society. To be able to understand the procedure of these conversion processes, it is important that useful concepts, such as the chemical availability, are available. Exergy was introduced in Turkey long ago but not enough attention has been given to it until recently. The objective of this article is to present a calculation of the chemical availability of coal-based fuels in geographical regions of Turkey. In this regard, it has based the necessity of this study on solid and valid arguments on the advantages of second-law analyses compared to first-law analyses and has presented a correct chemical availability calculation.

Turkish health system reform from the people’s perspective: a cross sectional study

BackgroundSince 2003, Turkey has implemented major health care reforms to develop easily accessible, high-quality, efficient, and effective healthcare services for the population. The purpose of this study was to bring out opinions of the Turkish people on health system reform process, focusing on several aspects of health system and assessing whether the public prefer the current health system or that provided a decade ago.MethodsA cross sectional survey study was carried out in Turkey to collect data on people’s opinions on the healthcare reforms. Data was collected via self administered household’s structured questionnaire. A five-point Likert-type scale was used to score the closed comparative statements. Each statement had response categories ranging from (1) “strongly agree” to (5) “strongly disagree.” A total of 482 heads of households (response rate: 71.7%) with the mean age of (46.60 years) were selected using a multi stage sampling technique from seven geographical regions in Turkey from October 2011 to January 2012. Multiple logistic regressions were performed to identify significant contributing factors in this study.ResultsEmploying descriptive statistics it is observed that among the respondents, more than two third of the population believes that the changes have had positive effects on the health system. A vast majority of respondents (82.0%) believed that there was an increase in accessibility, 73.7% thought more availability of health resources, 72.6% alleged improved quality of care, and 72.6% believed better attitude of politician/mass media due to the changes in the last 10 years. Indeed, the majority of respondents (77.6%) prefer the current health care system than the past. In multivariate analysis, there was a statistically significant relationship between characteristics and opinions of the respondents. The elderly, married females, perceived themselves healthy and those who believe that people are happier now than 10 years ago have a more positive opinion of the changes. While, the single unemployed from rural region who perceived themselves as unhealthy and believe that people are unhappy now compare to ten years ago showed less positive opinions.ConclusionsHence, we conclude that from the people’s perspective overall the health system reforms were most likely successful.

Prevalence of asthmatic smokers: Turkish experience (PASTE Study)

Although both asthma and smoking are major health problems worldwide, smokers are often excluded from asthma studies. It was aimed to verify the prevalence of asthmatic smokers in Turkey and assess the effects of smoking based on clinical parameters, exacerbations and hospitalizations because of lack of national data about the prevalence of smoking among asthmatics. The study protocol was comprised of a retrospective questionnaire. The asthmatic patients were followed in the outpatient clinics of 18 tertiary hospitals selected from seven different geographical regions in Turkey. We evaluated demographic data, smoking habits, asthma-related diseases, respiratory function and emergency visits. The study population included 1385 patients (M/F: 343/1042), and the mean age was 45.1 ± 14.0 years. Current and former smoking prevalence was 11.4% and 15.1%, respectively. Smoker rates were higher in males and younger asthmatics compared with females and older asthmatics (P < 0.01 and P < 0.05, respectively). Smoking history ranged from 0.20 to 90 pack-years (the mean was 12.9), and smokers had a higher level of education compared with nonsmokers (P < 0.01). Socioeconomically, the most developed region had the highest rate of smoker asthmatics (33.9%; P = 0.014). There was an increase in the number of exacerbations in smoker asthmatics during the previous year, but it was not statistically significant (P > 0.05). We showed that the smoking prevalence in Turkey was lower in asthmatics (11.4%) compared with the general population (44.5%). Nevertheless, every effort should be made to encourage asthmatics to stop smoking because smoking is a modifiable risk factor for adverse asthma health outcomes.

Medical courses need to be tailored for dental students

Objective: The purpose of this study was to determine the efficiency of medical education at the dental schools from the perspective of dental students. Methods: A questionnaire was distributed to the fourth and final year students at five different dental schools from different geographical regions in Turkey. The satisfaction of 443 dental students with the quality of medical education together with students’ perspectives on the ways to enhance the quality of curriculum was ascertained. Results: Of the students, 17.4% hold an opinion that they received satisfactory overall biomedical science education. Over half disagreed that biomedical science topics were not integrated with clinical cases. Around one in every three students felt that lecturers were not focused on oral/dental related topics and were underrating dental students. The highest satisfaction was gained on the head and neck anatomy; the least satisfaction was obtained by biochemistry (scores of 5.3 and 3.3 on a 10 point scale, respectively). Over half of the students disagree that the education on the other medical disciplines and on the management of possible emergency conditions were good quality. The most common suggestion given by students for a better education was biomedical science and medicine teaching given in a more relevant way to clinical setting. Conclusion: The findings of this study indicate that biomedical science teaching should be more ‘tailored’ to the needs of dental students who appear to appreciate a curriculum placed in a clinical perspective with an emphasis given to oral health needs.

Updated checklist of harvestmen (Arachnida: Opiliones) in Turkey

In this work, faunistic studies on harvestmen from Turkey are reviewed. A total of 88 species and 7 subspecies from 35 genera belonging to 7 families were determined. The distribution in Turkey and the world of these taxa is given and their distribution in the geographical regions of Turkey are presented.

Amyloidosis and its related factors in Turkish patients with familial Mediterranean fever: a multicentre study

The primary aim of this study was to investigate the prevalence of amyloidosis and its related factors in a large number of FMF patients. Fifteen centres from the different geographical regions of Turkey were included in the study. Detailed demographic and medical data based on a structured questionnaire and medical records were collected. The diagnosis of amyloidosis was based on histological proof of congophilic fibrillar deposits in tissue biopsy specimens. There were 2246 FMF patients. The male/female ratio was 0.87 (1049/1197). The mean age of the patients was 34.5 years (S.D. 11.9). Peritonitis was the most frequent clinical finding and it was present in 94.6% of patients. Genetic testing was available in 1719 patients (76.5%). The most frequently observed genotype was homozygous M694V mutation, which was present in 413 (24%) patients. Amyloidosis was present in 193 patients (8.6%). Male sex, arthritis, delay in diagnosis, M694V genotype, patients with end-stage renal disease (ESRD) and family history of amyloidosis and ESRD were significantly more prevalent in patients with amyloidosis compared with the amyloidosis-negative subjects. Patients with homozygous M694V mutations had a 6-fold higher risk of amyloidosis compared with the other genotypes (95% CI 4.29, 8.7, P < 0.001). In this nationwide study we found that 8.6% of our FMF patients had amyloidosis and homozygosity for M694V was the most common mutation in these patients. The latter finding confirms the association of homozygous M694V mutation with amyloidosis in Turkish FMF patients.

Prevalence of Orthodontic Malocclusion and Evaluation Criteria in 7 Geographic Regions of Turkey

ABSTRACT Objective: The aim of this study was to identify the prevalence of malocclusion and orthodontic evaluation criteria in Turkey and determine differences among the 7 regions. Materials and Method: In our research, extra- and intraoral examination of 1023 randomly selected persons from rural and central parts of different regions (500 female subjects and 523 male subjects; mean age = 13.10 ± 3.11) were performed. To analyze the data, descriptive statistical methods (mean value, prevalence ratio, standard deviation) were carried out. The significance of regional differences of the evaluation criteria and gender distributions were assessed by means of a χ2 test. Results: Comparison of the classification of malocclusion, crossbite, chin deviation asymmetry, smile line, cleft lip and palate, and profile among the regions showed significant differences (p < 0.05). Class I, II, and III malocclusion was most frequently noted in the Marmara, Aegean, and Central Anatolia regions, respectively. Crossbite was ...

T030, Türkiye’deki Hastanelerden İzole Edilen Metisiline Dirençli Staphylococcus aureus İzolatları Arasında En Yaygın spa Tipidir

Staphylococcus aureus is one of the most frequent agents causing hospital infections. S.aureus has a great ability to adapt itself to variety of conditions and successful clones can be epidemic and even pandemic by its ability spread from one continent to another. The aims of this study were to detect spa types of 397 methicillin-resistant S.aureus (MRSA) strains isolated from 12 centers in different geographical regions of Turkey from 2006 to 2008, and to investigate their clonality by PFGE and MLST typing. Additionally, 91 MRSA from four of those 12 centers isolated during 2011 were also studied for their spa types. PFGE profiles indicated the presence of a major pulsotype, namely pulsotype A with a rate of 91.4% (363/397), followed by pulsotype B (n= 18, 4.5%) and pulsotype C (n= 11, 2.8%). Among isolates tested 363 (91.4%) were SCCmec type III, 30 (7.6%) were SCCmec type IV. Sequence analysis of representative isolates revealed that ST239 (85.1%) was the most common MLST type followed by two MLST types ST737 (4%), and ST97 (2.8%), both SCCmec type IV. Two isolates were ST80 with SCCmec type IV. Of 397 isolates, 338 (85.1%) were t030, followed by t005 (2.5%) and t632 (2%). Among MRSA isolated during 2011, 64 (70.3%) of 91 were t030, 4 (4.4%) were t005, 2 (2.2%) were t015, and 2 (2.2%) were t1094. Among centers the t030 prevalence of 2006-2008 isolates ranged from 59-100%. The highest t030 prevalence was found in Ankara (100%) and lowest in Trabzon (59%) provinces which are located at central and northestern Anatolia, respectively. In Istanbul province, the prevalence of t030 was 94.5% among 2006-2008 isolates which decreased to 55.5% among 2011 isolates. Also a decrease in t030 rates was observed among samples from Konya and Trabzon but not from Aydin. Our results showed that the most common MRSA clone in Turkey is ST 239-SCCmec type III, t030 which persisted during the six years of the study period. Presence of PVL toxin gene was tested by PCR and 5 (3%) isolates found to be positive, of them two were SCCmec Type IV-ST80 and three were SCCmec Type III-ST239. This study is the largest epidemiological survey ever done in Turkey which showed presence of a hospital Turkish clone TR09 (ST239-SCCmecIII-t030) and a community clone TR10 (ST737-SCCmecIV-t005) largely disseminated in Turkey.

The Atrial Fibrillation in Turkey: Epidemiologic Registry (AFTER)

AFTER (Atrial Fibrillation in Turkey: Epidemiologic Registry) is a prospective, multicenter study designed with the aim of describing the prevalence and epidemiology of AF practice in Turkey. This study aims to evaluate stroke risk in non-valvular atrial fibrillation (AF) and anticoagulant drug utilization within conformity to AF guidelines. Patients were recruited in 17 referral hospitals reflecting all the population of 7 geographical regions of Turkey. 2242 consecutive patients who had been admitted with AF on ECG were included in the study. 1745 of these patients, who had non-valvular AF, were included in the statistical evaluation. Stroke risk was evaluated with the CHA2DS2-VASc score. The average age of participants was determined to be 69.2 ± 11.5 years (56% female). Persistent-permanent AF was found to be the most common type of non-valvular AF (78%). The most common comorbid disorder was hypertension (73%). It was found that oral anticoagulant therapy was used by 40% of all patients, 37% of whom had effective INR (2.0-3.0). Upon multivariate analysis, age was found to be the only independent predictor of stroke among the variables' effects on thromboembolic events that created CHA2DS2-VASc abbreviations (OR 1.026, p < 0.001). These results suggest that stroke risk scores should be thoroughly heeded based on guidelines, and that anticoagulation must be applied according to their guidance.

Perceptions of Elementary School Teachers Regarding Political Life at School

The basic purpose of this study was to determine political behavior in schools according to the perceptions of elementary teachers and to present the politica l perceptions of tea chers accor ding to miscellaneous variables. The study was carried out using a survey model. The participants in the study consisted of 265 elementary teachers, randomly selected from seven provinces in the seven geographical regions of Turkey. A scale of political perception at school developed by the researcher, was used as the data collection tool. It was determined that teachers from the more developed regions of Turkey, such as the Marmara, Aegean and Mediterranean regions, perceived less political behavior than the teachers from regions considered t o be less developed, such as the Eastern Anatolia and Southeastern Anatolia Regions. The study also determined that married teachers and female teachers perceived more rational behavior than single teachers and male teachers, respectively. It was observed that teachers who were union members perceived more political behavior than those who were not union members.