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Aim: Family health centers (FHCs) are reimbursed for their current expenditures based on a classification of four clusters in Turkey. This study compared the coordination, comprehensiveness, continuity, accessibility, and the first contact of care among different reimbursement FHC groups. Methods: The data were obtained from the Turkish data of the Quality and Costs of Primary Care in Europe study. Data was collected in provinces from six geographical regions. Physicians and patients from Classes A and B FHCs were called the first group, and others were called the second group. Results: A total of 296 physicians and 2623 patients were enrolled. According to the reimbursement groups, 593 (22.6%) patients received services from the first group and 2012 (77.4%) patients from the second group. The first contact with care and the admission frequency of 3 or more in the last six months were higher in the first group (respectively, 99.2% vs. 97.7%, p=0.027; 55.4% vs. 49.6%, p=0.015). Conclusion: The reimbursement classification did not make a difference in coordination, comprehensive care, continuity, accessibility, and being the first contact of care. Therefore, the current classification does not contribute to improving the quality of primary care in terms of service provision. [ABSTRACT FROM AUTHOR]

Background: Adolescence is a crucial period for development of dietary behaviors that continue into adulthood and influence the risk of chronic diseases later in life. The aim of this study was to determine the eating patterns of adolescents' and their compliance with the Food Guide Pyramid. Methods: 625 students, aged between 11-15 years, from an elementary school in Istanbul, Turkey were enrolled in this cross-sectional survey. A questionnaire of eating patterns (QEP) was administered to all participants. QEP is consisted of questions assessing the knowledge and behaviors on healthy eating, factors affecting food choice, physical activity status and demographical variables. Height and weight of all participants were measured. Physical activity status was determined by questioning about participation in regular sport activities, how much time spent watching TV, playing computer games or doing homework. Results: The mean age of the participants was 12.15 ± 1.15 and 50.5% were female. According to body mass index (BMI) percentiles, 8.3% (52) were obese and 10.2% were overweight. 51% had breakfast every day and only 1.9% met all the recommendations of the Food Guide Pyramid. Among the participants, 31% have fast food at least once every day and 60.8% skip meals. When participants were asked to rate the factors effecting their food choice according to a 10 point Likert scale, the highest mean scores (high impact on food choice) were for the factors; family, health, body perception, teachers and friends; 7.5 ± 3.1, 7.4 ± 3.1, 6.1 ± 3.2, 4.8 ± 3.3 and 4.2 ± 3.0 respectively. Total mean time spent on all passive activities (TV, computer, reading homework etc) per day was 9.8 ± 4.7 hours. Conclusions: In this study we have demonstrated that, adolescents do not have healthy eating patterns. Educational interventions should be planned to decrease the health risks attributable to their eating behaviors. [ABSTRACT FROM AUTHOR]

Aim: To explore the knowledge and behaviour of adolescents from a low socio-economic region of Istanbul, regarding smoking and how these variables are affected by their teachers' smoking status. Method: This is a descriptive study carried out between February-March 2007 among 6th-8th grade students of 3 primary schools in Tasdelen region. A questionnaire was filled out by adolescents under supervision about their smoking experience, related factors and whether the students were affected by their teachers' smoking behaviour. After descriptive and comparative analysis of the data, a logistic regression analysis was performed. Results: Among the 560 participants, mean age was 13±1.08 (11-15). The incidence of a smoking experience at least once was 12%. At least one of the teachers was observed while smoking by 83.8% of the students, and 16% of them declared they were negatively affected by their teachers' smoking behaviour. Among the factors related to smoking experience, the teachers' smoking status (being a smoker) increased the risk of smoking significantly, according to the regression analysis (p=0,008;OR 7,476;95% CI 1,703-32,826). Conclusion: Adolescents are influenced by teachers' smoking at school. We think that the extent of this influence will decrease after the legislation (section number 5727, to take effect on July 19th 2009) prohibiting smoking in doors is passed. [ABSTRACT FROM AUTHOR]

In this study, we investigate chemical and isotopic characteristics of low-temperature geothermal waters issuing from carbonate reservoirs in the Çürüksu Graben within the eastern termination of the Büyük Menderes Graben in western Turkey. Temperatures and pH values of geothermal waters vary from 20.1 to 24.6 ºC and 6.62 to 7.11 and those of cold waters are 17.1 to 19.9 ºC and 6.85 to 7.72, respectively. Geothermal waters are of Ca-HCO3 and Ca-SO4 types whereas cold waters are characterized by these two types and Mg-HCO3 as well. δ18O and δD values of samples vary from –9.27‰ to –7.69‰ (VSMOW) and –58.06‰ to –52.2‰ and indicate a meteoric origin with local recharge. Tritium contents are from 0.12 to 2.17 TU for thermal waters and 0.28 to 4.85 TU for the cold waters implying relatively longer residence time for the hot waters. Thermal water samples mostly have positive δ13C values (varying from –0.32‰ to +1.99‰) and carbon in these waters is likely derived from marine limestone or metamorphic CO2 . δ34S and δ18O values of dissolved sulfate in the waters indicate that sulfur originates from dissolution of marine evaporite deposits (e.g., gypsum). Çürüksu waters are generally oversaturated with respect to calcite, dolomite and quartz but undersaturated with respect to gypsum. Common ion effect exerted a strong control for the formation of travertine deposits in the area. Chemical and isotopic evaluations indicated that the diversity in the water chemistry of samples is attributed to a combination of processes including water-rock interaction, ion exchange and mixing of various types of waters. Çürüksu thermal waters are immature and not in chemical equilibrium with the reservoir rock. Among the various geothermometers applied to Çürüksu thermal waters, temperatures computed by chalcedony, quartz and CaMg geothermometers are 21–52 ºC, 49–83 ºC and 73–96 ºC, respectively. HCO3 -SO4 -F and anhydrite-chalcedony (quartz) diagrams estimated a temperature range of 63–86 ºC and δ18O(SO4 -H2O) isotope geothermometer yielded 67–78 ºC. [ABSTRACT FROM AUTHOR]

Objective: Coordination function of primary care (PC) enables continuous, efficient, and cost-effective health care provided to patients with chronic disease and multimorbidity (MM). The aim of this study was to identify the most common chronic diseases and to determine the prevalence of MM in PC registries. Methods: Our study is a cross-sectional study. All the individuals aged 40 and over who were registered to the primary care units (PCUs) of the Uskudar district of Istanbul have formed the population of the study. A systematic cluster sampling was used. The patient list of each family physician in Uskudar district was accepted as a cluster and an equal number of patients from each cluster were enrolled. Only the information on the patients' MM data was requested from the primary care physicians. Results: The 108 physicians of the Uskudar district (response rate: 73.4%) gave consent to participate in the study. The 1187 (40.3%) of registered patients of all PCUs were 40 years old and over. The multimorbid patients were found as 330 (27.8%). Conclusions: Approximately, one of four patients have multimorbidity. So, the policy of primary care services should be redesigned for the management of MM patients including the 'goal-oriented care' approach. [ABSTRACT FROM AUTHOR]

Objective: This study aims to explore the breast-feeding profiles and the factors that affect breast-feeding and weaning attitudes among mothers of 0-12 month old babies in a baby-friendly primary care unit. Material and Method: The study was conducted in a Mother and Child Health Centre in ıstanbul in May-October 2006. All 364 mothers who were registered in the health centre were enrolled. A total of 358 mothers were included in the study. Results: The frequencies of breastfeeding initiation and of breastfeeding within the first hour were 98.9 %and 62.3 %respectively. Among the babies older than 6 months (n=200), 52.5 %were weaned before 6 months. Pacifier use (OR 3.01, 95 %CI: 1.35-6.69), being preterm (OR: 3.36, 95 %CI: 1.04-10.79), having a job (OR: 2.83, 95%CI:1.14-7.04) or smoking (OR: 2.27, 95 %CI: 1.01-5.14) werefound to be risk factors for early weaning. Conclusion: Although the frequency of initiating breastfeeding is very high, the continuation duration is below the World Health Organization (WHO)'s recommendations. Physicians and other health workers should strongly recommend against smoking during, prenatal and postnatal visits. Physicians should not support pacifiers, until we have sufficient data to support its benefits. In order to increase the duration of breast feeding, health professionals should focus on preterm babies, smoking or working mothers. [ABSTRACT FROM AUTHOR]

The article focuses on the evaluation of the reliability of the Turkish version of Pediatric Outcomes Data Collection Instrument (PODCI) for children and adolescents who have orthopedic problems. It mentions that the instrument is used for children and adolescents in a variety of chronic musculoskeletal disorders. It states that the Turkish version was called Bedensel Ë™I¸slevsellik Degerlendirme Aracı (BIDA).