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This study determined that critical thinking education improves problem-solving skills.

Background and aimSmoking is still a public health concern in many countries, especially among young adults. Consequently, we determined what factors affect university students’ smoking behavior in Turkey.MethodsThis cross-sectional study was conducted between March and June 2017 using a simple random sampling method. A self-administered questionnaire was used to collect information on participants’ (N = 2,505; mean age = 20.9 ± 2.5 years; 58.9% women) sociodemographic characteristics, cigarette smoking status, and related risk factors. Univariate analysis and multivariate logistic regression analysis were performed with the Backward likelihood-ratio method.ResultsStudents were completing either two- or four-year degrees (45.6% and 54.4%, respectively). Regarding familial smoking behavior, 36.1% had a father who smoked, 10.3% had a mother who smoked, and 15.0% had siblings who smoked. Among participants, 27.9% were current smokers: 46% of the men and 15.3% of the women. Mean smoking onset age was 16.34 ± 2.72 years (15.65 ± 2.67 years for men and 16.34 ± 2.72 for women (p < .05). Mean Fagerströmtest score was 4.43 ± 1.82, and women had lower test scores than did men (p < .05). After controlling for potential confounders in multivariate analyses, five factors were significantly positively associated with current smoking: being a man (odds ratio (OR): 3.43; 95% confidence interval (CI): 2.75–4.28), studying in a two-year program (OR: 1.74; 95% CI: 1.39–2.18), having at least one immediate family member who smoked (OR: 1.63; 95% CI: 1.31–2.04), having all close friends who smoked (OR: 1.81; 95% CI: 1.40–2.33), and alcohol consumption (OR: 4.39; 95% CI: 3.51–5.49).ConclusionThere was a higher smoking rate among our study population, both compared to similar national studies and Turkey’s overall smoking rate. Underlying factors should be evaluated via qualitative studies and preventive strategies should be implemented accordingly.

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Background: Faced with this critical situation and directly involved in the treatment and care of COVID-19 patients, front-line healthcare workers are at high risk in terms of mental health symptoms. Aims and Objectives:To determine the stress, anxiety, depression, and insomnia levels of intensive care nurses during the pandemic with a structural equation model. Design:A multi-site survey study. Methods:The study was performed with 194 nurses working in the intensive care units of five hospitals in Istanbul in July 2020. Data were collected using the Depression Anxiety Stress-21 Scale and Insomnia Severity Index electronically. The data were evaluated with descriptive statistics in SPSS package program. In order to test the structural model and hypotheses of the research, path analysis was performed with LISREL statistical software program. A validation study for the suitability of these scales to the study sample was done by the researchers using the confirmatory factor analysis method. The study conforms to the TREND checklist.Results: In this study, the majority of the intensive care nurses had moderate to extremely severe depression (65.5%), anxiety (58.3%) and stress (72.3%) scores; in addition, 39.7% of the nurses experienced moderate or severe insomnia. Within the framework of a structural model; the effects of stress, anxiety and insomnia on depression, which is the dependent variable, were found to be statistically significant (p < .001). Conclusions:It was found that the majority of the intensive care nurses fighting COVID-19 on the front-line experienced stress, anxiety, depression and insomnia at levels ranging from moderate to extremely severe; in addition, it was determined that there is a positive relationship between stress, anxiety, insomnia and depression. Relevance to clinical practice:This study, in which we have determined the mental health symptoms and insomnia levels of intensive care nurses, who are in the frontline during the COVID-19 pandemic, constitutes the scientific basis for the effective coping strategies that the authorities will take in this subject.