It is known that health care resources and expenditures are limited in middle income countries compared to those with developed countries. However these countries usually compared in terms of health care expenditures with OECD countries. It is mentioned in the literature that, in comparisons to be made based on health expenditures for middle income countries, these countries should be compared within groups to be formed according to similar properties within themselves rather than being compared based on developed countries such as OECD countries. Due to this requirement, in this study it was aimed at making groups in terms of variables considered to be affecting health expenditures using WHO and WB data for middle income countries. As a result of hierarchical cluster analysis, it was seen that two groups representing a total of 95 countries were formed. Analysis results indicated that within middle income countries, countries located in Eastern and Western Asia which were in a higher income group were included in the first cluster and countries in Southern Africa and Southern Asia which were in a lower income group were included in the second cluster. According to study results, it could be said that the formed country clusters were similar to the classification made by World Bank according to the income levels of the countries. Study results provided beneficial information about the comparison of middle income countries indicating heterogeneous characteristics in terms of variables affecting health expenditures.
The idea of Intervention Wheel is originally proposed by Keller, Strohschein, Lia-Hoaberg, and Schaffer in 1998. The Intervention Wheel is a population-based practice model which is evidence-supported. It focuses on entire populations, is grounded in community assessment, considers determinants of health, emphasizes prevention, and intervenes at multiple levels. The model includes three levels of practice and identifies 17 public health interventions. Interventions are the steps taken on behalf of the communities, systems, individuals or families for improvement or protection of health conditions. Individual/family focus modified the knowledge, attitudes, beliefs, practices and behaviors of the individuals and family members, Community Focus modifies norms, attitudes, awareness, practices and behaviors, Systems Focus modifies policies, laws and power structures. 17 Public Health Interventions are: Surveillance, Investigation of Diseases and Other Health Events, Outreach, Screening, Case Finding, Referral and follow-up, Case Management, Delegated Functions, Health teaching, Counseling, Consultation, Collaboration, Coalition building, Community Organizing, Advocacy, Social Marketing, Policy Development and Policy enforcement. The Intervention Wheel is a simple and comprehensive model for directing the health improvement practices and practices of the public health nursing. Because of the structural transformation in the healthcare system in Turkey since 2004, utilization of the intervention wheel in public health education and practice fields will be useful for evaluating data and developing new and measurable common strategies.
Antimicrobial drug resistance is the ability of microorganism to resist against antimicrobial agent to which it was susceptible previously. Today, resistance against antimalarial drugs which are specific antimicrobial drugs against malaria is one of the biggest challenges faced by the malaria control efforts. Drug resistance is held responsible for the malaria spreading to new areas and re-emerging at the eliminated areas. Although there is no drug resistant malaria case was reported in Turkey up to day, -considering the high number of malaria cases imported from malaria prevalent countries- it is probable that some of those imported cases could be drug resistant cases. Considering the drug resistant malaria, chemoprophylaxis alone may not be sufficient for protection against malaria for those who travel to malaria prevalent areas; and prevention of vector contact should be emphasized. Drug resistant malaria should be included in the National Drug Resistance Surveillance System. Solving the resistance problem with new drugs increases cost of treatment, and resistance to these new drugs seems inevitable, sooner or later. Particularly, single use of a new antimalarial drug accelerates this process. While the world of medicine is about to enter an era without antibiotics, new challenges arise in malaria control efforts.
Aim: This study was carried outto determine thecomplementary and alternative treatment methods used for patient care by caregiver to Alzheimer’s disease at home. Material and Method: This study, designed in accordance with descriptive research principles, was applied in a hospital between June 15, 2014 and December 20, 2015 in Samsun. The participants were 177 Alzhemier’s disease caregivers who registered to Home Care Services Centre and who agreed to participate to the study. The data of the study were collected with 'Data Collection Form'. In evaluating the obtained data, number, percentandChi-square (X²) testwere used. Results: In the study, the average age of the caregivers of Alzheimer's patients is 48.8±13.2 and the 83.6's% are women. The frequency of the complementary and alternative treatment methods used for patient care bycaregivers to Alzheimer’s disease at homeis 61.6%. It was found out that 21.5% of the caregivers prefer massage, 30.5% prefer honey as herbal methods, 51.4% prefer religious practices for patient care. It was determined that 59.6% of the participants did not consult to the medical staff before/during their use of complementary and alternative treatment methods. The relationship between the status of achieving to the expected results of the complementary and alternative treatment methods used for patient care by caregiver to Alzheimer’s disease at home and the status of economical support was foundstatistically significant (p
Objective: The best known, most effective and widely used model for chronic illness management is “Chronic Care Model”. Patient Assessment of Care for Chronic Conditions (PACIC) (KBDh) is designed according to this model. The objectives of this study are; 1. To test the sensitivity of PACIC to diverse socio-economic and condition specific variables and 2. To define the quality of care (QOC) and the affecting variables on QOC of the patients in the outpatient wards of CBU hospital. Materials and Methods: In this descriptive study, we enrolled patients from Celal Bayar University Hospital, Departments of Internal Medicine (Endocrinology, Nephrology, Rheumatology, Oncology, and Gastroenterology), Neurology, Dermatology, and Pulmonary Medicine outpatient clinics. Patients were under follow-up care for more than 6 months (n=295) and they were asked to fill the survey containing PACIC scale, socio-demographic variables and other morbidity variables. Type 1 error was adopted as 0.05 and the SPSS 15.0 was used for statistical analysis. Results: The mean age was 51.6±15.2; 18.3% of patients aged 65 and over, and 64.7% were female. 28.8% of patients had type 2diabetes, 29.5% had hypertension, 16.7% had COPD, 15.5% had neurological disease (migraine, epilepsy, MS) and 9.5% had chronic allergic diseases. The mean duration of disease was 9.3±7.9 years, and there was at least one comorbidity in 48.8% of the patients. The overall PACIC scale score was 2.81±0.86. Lower education and income status; the lack of social security and migration to the region negatively affected the quality of follow-up (p<0.05). Patients with hypertension were more negatively affected than the other chronic illness patients in terms of patient activation and goal setting/tailoring dimension scores (p<0.05). Having continuous monitoring by a particular physician and having this physician as primary care physician increased the quality of monitoring (p<0.05). Also, for all chronic diseases and for all dimensions, improvement in quantity of monitoring improved quality of monitoring. Conclusion: Given the PACIC (KBDh) the total score and dimension scores and considering that patients were followed at a university hospital, the scores in this study show that the quality of monitoring is not sufficient level of. Monitoring of the patients in primary care conditions instead of at the second level improves the quality of follow-up.
Purpose: This study was carried out with the aim of exposure college students levels of cyberbullying, application levels of cyberbullying and determine the relationship between these demographic variables. Procedure: The scope of this study which is having identifier type formed 6625 student who is teaching at day school at Erzincan University in the spring semester of the 2013-2014 academic year . The selection from the population has not been examined and 1864 students which are reachable were included in the study. Datas were collected with the questionnaire form and Virtual Bully/Victim Scale by the researchers. The survey forms collected from students installed in the computer with the SPSS 22.0 program and statistical analysis procedures were reviewed. In the analysis of the data, percentage distributions, correlation, Kruskal Wallis, Mann Whitney U and Cronbach Alpha analysis tests were used. Findings: Student's exposure to cyberbullying scores was higher than making cyberbullying. It has been found that student's age and grade variables are effective on exposure to cyberbullying. In addition, it was determined that there is a statistically significant relationship on both exposure to cyberbullying and application of cyberbullying the gender, the level of student achievement, economis status, availability of internet connection at home, the frequently visited place on the internet, anonymous calls and mails, the sending or receiving of messages. Result: It was found that there is cyberbullying not only at the primary stage but also at the college-level students group, exposure to cyberbullying higher than making cyberbullying.
Background: Globally, tuberculosis (TB) has been acknowledged as one of the deadliest infectious disease. The objectives of the study were to assess the level of awareness about TB among the different stakeholders of a medical college and to formulate a comprehensive action plan to strengthen the Advocacy, Communication and Social Mobilization (ACSM) activities. Methods: A cross-sectional descriptive study of five months duration (September 2015 to January 2016) was conducted among the representative section of the various stakeholders of a medical college. A pre-tested, semi-structured schedule was designed after thoroughly studying the national TB training modules. All the study participants were interviewed using the schedule after obtaining their informed consent. In addition, a thorough inspection of the hospital and medical college was done to assess the status of ACSM activities. Results: Among the different stakeholders (doctors, paramedical staff, patients, relatives) who participated in the study, the clinicians 38(24.8%) group accounted for maximum respondents. The knowledge level of medical fraternity (viz. specialists / pre and para-clinical doctors and MBBS doctors) pertaining to the definition of cure, drugs used for multi-drug resistant TB, honorarium for DOT provider, and utility of Mantoux test among adults was quite poor and recorded as only 31.1%, 37.7%, 44.3%, and 42.6% respectively. Conclusion: To conclude, the present study has provided valuable insights about the knowledge of TB among all the stakeholders and the status of the ACSM activities in a medical college. Based on the study findings, a comprehensive action plan has been developed to bridge the existing gaps and strengthen the overall ACSM activities pertaining to TB within the medical college settings.
Congenital adrenal hyperplasia (CAH) is an autosomal recessive disease causing gender differentation disorder. 21-Hydroxylase deficiency comprises more than 90% of patients and leads to cortisol deficiency. Cortisol deficiency causes life threatining adrenal failure. The diagnosis could be missed and the disease may cause to death especially in male neonate and girls with virilised severely. After the CAH diagnosis, the management of disease is possible both medical and surgical. Therefore neonatal CAH screening program is performed in many developed countries. Both male and female infant death can be prevented as well as early medical/surgical intervention correct the problems without grow-up. Europe and American Societies of Pediatric Endocrinology recommend the neonatal CAH screening. Because of all these reason neonatal CAH screening is important and necessary in our country that has high prevalence of consanguineous marriage.
Objectives: Body image dissatisfaction and incorrect body weight perception are raising problems among the adolescents worldwide. They are at increasing level in developing countries undergoing economic and nutritional transition like Nepal. To find out the body image satisfaction, body weight perception and knowledge of obesity among adolescents in Kaski district, Nepal. Methods: A cross sectional study was conducted among 838 adolescents in Kaski district, Nepal from 12 schools selected randomly using multistage cluster sampling. Data collection was done in between October to December, 2013 by using anthropometric assessment and self-administered questionnaire through use of pretested tools. Data was entered and analyzed using WHO anthroplus software v.1.0.4 and SPSS v. 16. Results: Majority of the adolescents, 630(75.2%) were found satisfied with their body image and 208(24.8) weren’t. The body image satisfaction rate was comparatively found higher among adolescents with normal BMI for age, 509(79.3%) and the underweight, 86(67.2%). More than half of the overweight adolescents, 27(55.1%) perceived themselves as normal, 19(38.8%) perceived as overweight and 3(6.1%) perceived as obese. Majority of the adolescents had right knowledge on obesity however no significant association was found. Conclusion: Body image satisfaction among the adolescents was found high. Overweight and obese were found likely to underestimate their body weight. Interventions focusing on behavioral modifications and regular anthropometric assessment are essential.
Cardiovascular diseases (CVD) are located at the beginning of the causes of morbidity and mortality in Turkey and in the World. CVD risk factors are determined and take the necessary precautions and control of the modifiable risk factors are very important in terms of the reduction in mortality. In order to be controlled modifiable risk factors the necessary lifestyle changes need to be made by individuals. Especially, it must be provided individual-specific risk assessment, the opportunistic and systematic screening of the CVD risk factors, consultancy on risky behaviors (diet, smoking, etc.) by Family Health Center’ staff. There are a lot of risk assessment systems to determine the level of individual CVD risk. Which is suited for use at Family Health Centers and one of the recommended risk assessment tools in national and international current guidelines is SCORE (Systematic Coronary Risk Evaluation). SCORE or other risk assessment tools should be used at family health centers which are the most significant way to reach individual and also individuals and society should be made counseling on a healthy diet, smoking cessation and physical activity.
Sexual violence, sexual assault andrapeareperturbationalsubjectsforindividuals, families, andsocieties. Women and men of all ages, all social classes or all professions can exposure to sexual assault. Some groups, however, are under more risk in terms of encounter with sexual assault. Adolescences and those in childhoods, those abused sexually or physically, disabled individuals, individuals with substance-use disorders, those who are homeless and poor, those who live in prison are examples of these groups. Depression, suicide, anxiety or fear, difficulties in fulfillment of daily activities, sexual dysfunction, low self-esteem, and somatic complaints can be effects of sexual assault on aggrieved party. In many countries, furthermore, examination of persons who exposure to sexual assault is performed by persons who are not educated enough about the subject; the aggrieved party exposures to trauma as examination more than one; and protocols related to examination and treatment to be performed are unable to be carried out properly. The objective of this article is to provide to form a guide in plannings of systematic and humanistic nursing approaches to individuals experiencing intensive trauma by sexual violence or assault.
Abstract Objectives: The aim of this study is to estimate the prevalence of fast foods (FFs) consumption among medical students and highlight its circumstances, and to reveal their knowledge about the health effects of fast food. Subjects and methods: A cross sectional descriptive study was conducted in Faculty of Medicine, Mansoura University, Egypt throughout three months in 2014 included 908 medical students chosen through the stratified cluster sampling with proportion allocation. A self-administered questionnaire in Arabic was used to collect data that include socioeconomic characteristics of their families; their habits of fast food intake, and the knowledge on health effects of fast food. Results: More than half of students (51.0%) prefer FF to save time, more tasty and save money. About two-thirds of them ate FF at least once during the last week. The independent factors associated with FF consumption are; being in the clinical years (AOR=1.7), family of rural residence (AOR= 1.99) and belonging to high socioeconomic classes (AOR= 3.0). The majority (64%) of the students took their lunch as fast food meal and most of them drank carbonated beverages (79.8%). The majority (94.3%) of the study participants knew the hazards of fast food on health. Conclusions: The high prevalence of fast/junk food preference and consumption by tomorrow’s doctors is a cause of concern and thus preventive efforts and more nutrition information and provision of nutrition education should be included in medical curricula.
During the second half of the last century; world achieved major success in the prevention and control of communicable diseases. As deaths in early life were successfully prevented and more people could live longer, health problems of the adults and the old age groups emerged. In line with the industrial developments, the life style of the communities changed, namely change of eating habits, exercise and tobacco use. Thus, the non-communicable diseases (NCD) have become the more common health problems of the “modern” societies. Non-communicable diseases have multifactorial etiology and no definitive treatment. Therefore, the needs for prevention of NCD’s have become a major challenge. Although the preventive approaches for the NCD’s are successful at the community level, their benefit for the individuals do not take much attention. This phenomenon is called as “paradox of prevention”. In this article, causes of prevention paradox are discussed at society, health professionals and government levels, which are the main parties to the health services. The major factors at the society level are low health literacy level, invisibility of success in preventing disease, need to change of attitude and behavior, under estimation of prevention by employers and price rates system. Factors at the health professional’s level are inability to identify the needs of the community clearly, lack of knowledge and motivation, inadequacy of incentive mechanisms for preventive health services, shift to therapeutic services and missing inequalities. At the government level, giving attention to the requests of society rather than needs and lack of supervision are important factors.
Aim: The aim of this study is to explore the knowledge and motivations of voluntary blood donors toward allojeneic hematopoietic stem cell donation also, and to determine predictors of hematopoietic stem cell donation motivation among them. Material and methods: The knowledge and motivations of voluntary blood donors toward hematopoietic stem cell donation were evaluated using a questionnaire with 42 items. The sample consisted of 100 voluntary blood donors that admitted to Gulhane Military Medical Faculty Blood Training Center and Blood Bank Department, between May 1st and September 1st, 2015. Results: The mean age of participant was 33.5±6.8 and 83% of them was male. 91% of participant have never get information about hematopoietic stem cell donation and transplantation and 80% of them would like to get information. although 47% of participants keen on for donate ; they haven’t considered such concerns as the deterioration of bodily integrity (75.5%), a negative impact on their health (64.1%) and discomfort (37.7%) before. It was found to be willing for HSC donor both in routine blood donors and in higher education group (respectively values of p,
Purpose: Adoption of an inactive lifestyle and wrong nutritional habits during puberty leads to an increase in the risk of chronic illnesses during adulthood. Purpose of this study is to specify nutritional and physical activity habits of students of Kýrýkkale University Health Sciences Faculty. Method: Students of Kýrýkkale University Medical Sciences Faculty were included in the study. Their socio-demographic data was recorded and their nutritional behaviours/habits were questioned. Their physical activity levels were specified by using the International Physical Activity Questionnaire (IPAQ). Results: Mean age for female students was 20.38±1.69 years and for male students 20.96±2.04 years. Body Mass Index (BMI) was 21.10±3.21 kg/m2 for female students and 23.54±3.39 kg/m2 for male students. 45.8% of the students have their lunches at school or dormitory cafeteria, 49.5% have dinner outside of home or dormitory. 69.7 % have breakfast every day. Having breakfast rate of male students is lower than female students (p0.05). Conclusions: Medical Sciences Faculty students do not have adequate physical activity levels. Regarding their nutritional habits, it is observed that they have some bad habits such as; skipping meals, not drinking enough water and milk, and preferring fast food. Medical professionals particularly have a duty to be role models in healthy life-style which includes both adequate and balanced nutrition and regular exercise. More comprehensive studies are needed to evaluate lifestyles of medical students and to plan corrective measures in our country.
INTRODUCTION AND AIM: Hepatitis B infection which is a life-threatening infection, is a major global health problem. Occupational exposure may be an important route of transmission. The aim of this study was to evaluate Knowledge of Hepatitis B Virus Infection and infection control practices among Faculty of Dentistry Staff, in Aydin province. MATERIAL METHODS: In this cross-sectional study, hepatitis B vaccination status of the participants; knowledge levels, history of work accidents, general infection control practices were questioned. Knowledge levels were assessed with 63 propositions, each correct answer calculated as 1 point to calculate total knowledge score and then subgroup scores such as general information, information level scores for transmission routes, prevention approaches and risk groups, were calculated. RESULTS: 54.4 % of participants told that they had received education about HBV infection, 67.5% told they had been vaccinated with Hepatitis B vaccine. 46.3% of those who stated that they had been vaccinated told that they checked antibody levels after vaccination. 27.8 % of participants stated that they had periodic inspection checks and 18.8 % stated that they had an occupational accident in terms of infection risk in the previous year. The mean total knowledge score over 63 propositions was 42.3±13.3. Total knowledge score were found lower in participants who were younger or dental students, who did not receive education about general infection control precautions and hepatitis B infection, who did not vaccinated with HBV, who did not have a history of contact with HBV-infected patients, who did not had an occupational accident in the previous year and who had less than a year of occupational experience. CONCLUSION: In conclusion oral and dental health workers’ knowledge about hepatitis B infection and infection control practices were not at desired level. It is important to give educational activities regarding causes of infections and standard infection control precautions as earlier as possible in order to prevent horizontal transmission between patients and health workers.
Unexpected circumstances due to the virus or host may emerged in hepatitis B virus (HBV) serology. Atypical serological profiles in HBV infection may cause especially diagnosis and follow-up problems. Isolated positivity of antibodies aganist core antigen (anti-HBc), occult HBV infection, anti-HBc negative chronic HBV infection and concurrent positivity of hepatitis B surface antigen and its antibody can be encountered as an atypical serological profile in the course of HBV infection.
Health literacy have been specified as being an item that enhances years of healthy life and quality, for healthcare professionals ensures acquisition of communication and clinical skills and for individuals involvement decision-mechanism in the health care field. Health literacy based on social and cultural factors in society and serves as a mediator between the individuals with the health system, education system and health issues. For planning health promotion activities, health literacy is considered as an important step and six general themes help to determine why health literacy is important for population health: Affecting the large numbers of people, poor health outcomes, increasing rates of chronic disease, rising health care costs, health information demands and equity. It was stated that supporting evidence of inadequate health literacy effects had incereased on individuals health. These evidences were shown as; using preventive health services in low level, delay to seek health care in symptomatic period, inability of individulas to understand their medical condition, lack adherence on medical advice/instructions, lack of self-care and increased mortality. Assessing of health literacy levels focuses on patient information. However, regardless the development level of countries, it had seen that health literacy levels were low in all over the world. In a report of World Health Organization Commission on Social Determinants of Health, the development of health literacy was accepted as an important tool for reduction of health inequalities. In this respect, proposed approaches were to start in health literacy education in early childhood, health literacy, to focus on the concept of health promotion in school education and to put an emphasis to adult education.
Aim: The present study was aimed at investigating the prevalence of cesarean section among 18-49-year-old women followed by Mezitli Community Health Center and the affecting factors. Materyal and Methods: This descriptive study was performed in January 2015 and February 2015 at Mezitli Community Health Center. The study included 18-49-year-old womenwho gave at least one birth. The population of the study consisted of 22,061 living in the district of Mezitli. The minimum sample size was calculated as 378 people using the prevalence of 50%, the margin of error of ± 5 and 95% confidence interval, and 523 women were reached. To analyze the data, descriptive statistics and the chi-square test were used. Results: The mean age of the women participating in this study was 34.2 ± 7.7 years, and 274 (52.4%) of them delivered a baby by cesarean section at least once. Of the participants, those whose longest place of residence was an urban area gave birth through caesarian section more than did those whose longest place of residence was a rural area.Similarly, thosewho had ahighereducation level, who were employed,who obtained information about birth before delivery gave birth through caesarian section more than did those who had a lowereducation level, who were unemployed and who did notobtain information about birth before delivery. Of the participants who obtained information about birth, those who obtained it from physicians also gave birth through caesarian section more than did those who obtained it frommidwives and nurses. The most common indication in women who gave birth by caesarean section (74 persons, 27.0%) was the mother’s own request, and the most common complications (159 persons, 58.0%) were pain and gas problems. Conclusions: In the area where the present study was conducted, the rate of caesarean sectionis high. Caesarean section was preferred more by those who were in their thirties, whose education level was high, who were employed, whose income was twice as much asthe minimum wage, whose longest place of residence was a city, andwho were provided information especially by a physician.
