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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]

Objective: In this retrospective study, we analyzed the in vitro fertilization (IVF) clinical and laboratory outcome of cryptozoospermia cases compared to the extremely severe oligospermia cases in a single IVF center. Materials and Methods: All the IVF laboratory and clinical outcomes of cryptozoospermia and extremely severe oligospermia cases were analyzed and compared between January 2014 and December 2019 in Istanbul Florence Nightingale IVF Center. The same reproductive group treated all couples. Virtual azoospermia or cryptozoospermia were diagnosed once the mature sperm cells could be recognized after centrifugation (group 1). Patients without motile sperm were excluded. Extremely severe oligospermia was defined as a sperm count was less than <1 mil/mL (group 2). The study consisted of 33 virtual azoospermic patients with 40 cycles, whereas there were 40 severely oligospermic patients with 45 cycles. All patients underwent the intracytoplasmic sperm injection (ICSI) procedure and all the embryos were let to grow until the blastocyst stage on day 5. Groups were compared for clinical and laboratory reproductive outcome. Results: Both the median maternal and paternal ages were similar. All outcomes including fertilization rates, blastulation rates, clinical pregnancy and delivery rates were comparable. The miscarriage rates did not also show any statistical difference. Conclusion: Reproductive outcomes in cryptozoospermic IVF patients are comparable to those of extremely severe oligospermic patients provided that the ICSI is performed using motile spermatozoa. Our results favor using sperm from fresh ejaculate rather than surgical sperm retrieval when motile sperm is available in cryptozoospermic IVF patients. [ABSTRACT FROM AUTHOR]

Strong primary care does not develop spontaneously but requires a well-developed organizational planning between levels of care. Primary care-oriented health systems are required to effectively tackle unmet health needs of the population, and efficient primary care organization (PCO) is crucial for this aim. Via strong primary care, health delivery, health outcomes, equity, and health security could be improved. There are several theoretical models on how primary care can be organized. In this position paper, the key aspects and benchmarks of PCO will be explored based on previously mentioned frameworks and domains. The aim of this position paper is to assist primary care providers, policymakers, and researchers by discussing the current context of PCO and providing guidance for implementation, development, and evaluation of it in a particular setting. The conceptual map of this paper consists of structural and process (PC service organization) domains and is adapted from frameworks described in literature and World Health Organization resources. Evidence we have gathered for this paper shows that for establishing a strong PCO, it is crucial to ensure accessible, continuous, person-centered, community-oriented, coordinated, and integrated primary care services provided by competent and socially accountable multiprofessional teams working in a setting where clear policy documents exist, adequate funding is available, and primary care is managed by dedicated units. [ABSTRACT FROM AUTHOR]

In this paper, we investigate the effects of various background gases on the formation and sustenance of a plasma jet. A helium plasma is ignited inside a dielectric tube and introduced into a vacuum chamber where the gas composition and pressure can be controlled. The gas composition inside the chamber is altered by separately injecting various background gases, such as air, nitrogen, and argon. Here, we report that, in order to sustain a plasma jet, there needs to be a physical boundary layer around the helium flow. This boundary can be in the form of a solid surface that encapsulates the flow, or a background gas other than helium. If only helium is present inside the chamber, no propagating jet is created; rather a diffuse plasma fills the chamber. If another gas is introduced, then the diffuse plasma reverts into a jet. Additionally, we discovered what can be considered as the signature emission line from a plasma jet operating with helium. This emission line is at 587.4 nm (He). This line appears in the emission profile only in the presence of a plasma jet, and disappears as the plasma transitions to a diffuse state at the same applied power parameters and pressure. [ABSTRACT FROM PUBLISHER]

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]

Background: While bio-medically, menopause could be treated as an illness, from a psychosocial and cultural perspective it could be seen as a "natural" process without requiring medication unless severe symptoms are present. Our objective is to explore the perceptions of Turkish women regarding menopause and Hormone Therapy (HT) to provide health care workers with an insight into the needs and expectations of postmenopausal women. Methods: A qualitative inquiry through semi-structured, in-depth interviews was used to explore the study questions. We used a purposive sampling and included an equal number of participants who complained about the climacteric symptoms and those who visited the outpatient department for a problem other than climacteric symptoms but when asked declared that they had been experiencing climacteric symptoms. The interview questions focused on two areas; 1) knowledge, experiences, attitudes and beliefs about menopause and; 2) menopause-related experiences and ways to cope with menopause and perception of HT. Results: Most of the participants defined menopause as a natural transition process that one should go through. Cleanliness, maturity, comfort of not having a period and positive changes in health behaviour were the concepts positively attributed to menopause, whereas hot flushes, getting old and difficulties in relationships were the negatives. Osteoporosis was an important concern for most of the participants. To deal with the symptoms, the non-pharmacological options were mostly favoured. Conclusion: To our knowledge, this is the first qualitative study which focuses on Turkish women's menopausal experiences. Menopause was thought to be a natural process which was characterised by positive and negative features. Understanding these features and their implications in these women's lives may assist healthcare workers in helping their clients with menopause. [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]

One of the most spectacular shows that nature offers at northern latitudes is what is known as northern lights or Aurora Borealis. The Aurora Borealis is caused by energetic particles of the solar wind, which get trapped in Earth's magnetosphere. To simulate this phenomenon on a table top scale, we ignited a plasma jet and introduced the fast traveling plasma into a chamber, where the pressure can be lowered. A magnetized ball representing Earth was placed in the middle of the chamber. Fig. 1 shows what happens when the plasma jet reaches the ball: the plasma wraps around the ball. [ABSTRACT FROM PUBLISHER]

Plasma bullets have recently been used in novel applications in biology and medicine, which spurred interesting developments in the new interdisciplinary field of “Plasma Medicine.” In this paper, using high speed ICCD camera images we show that during their lifetime, plasma bullets undergo three distinctive phases: a launching phase during which the bullet velocity increases rapidly, a propagation phase during which the bullet velocity is temporarily maintained but later steadily decreases, and an ending phase during which the bullet collapses. [ABSTRACT FROM AUTHOR]

It is challenging nowadays for many authors to write and submit a scientific paper to peer reviewed journals due to strict editorial and reviewer evaluation processes and the competitive environment. For the dissemination of scientific papers (original research, literature review, case presentation, position paper etc.) relevant to Primary Health Care and General Practice it is important that authors understand the perspective of journal editors and their publication policies. This workshop aims to give an insight into the editorial evaluation process of a submitted manuscript and also to discuss the main aspects of preparing a manuscript for successful publication. The workshop will have the format of a highly interactive discussion. It will focus on the preparation and submission of scientific papers with special emphasis on choosing the appropriate journal, understanding the editor's perspective, peer review process, sharing experiences, common errors and how to prevent them. At the end of the workshop, participants will be able to get information about editorial evaluation and gain practical advice on how to successfully prepare a scientific paper for publication in a peer-reviewed journal. [ABSTRACT FROM AUTHOR]

We report the learnings gleaned from a four-country panel (Australia, South Africa, Egypt and Nigeria) sharing their countries' COVID-19 primary healthcare approaches and implementation of policy at the World Organization of Family Doctor's World virtual conference in November. The countries differ considerably with respect to size, national economies, average age, unemployment rates and proportion of people living rurally. South Africa has fared the worst with respect to waves of COVID-19 cases and deaths. All countries introduced strategies such as border closure, COVID-19 testing, physical distancing and face masks. Australia and Nigeria mobilised primary care, but the response was mostly public health and hospital-based in South Africa and Egypt. All countries rapidly adopted telehealth. All countries emphasised the critical importance of an integrated response between primary care and public health to conduct surveillance, diagnose cases through testing, provide community-based care unless hospitalisation is required and vaccinate the population to reduce infection spread. [ABSTRACT FROM AUTHOR]

Introduction: To test the efficacy of a method which can improve compliance of osteoarthtritis patients to exercise treatment. Materials and Method: This is a randomized controlled, intervention study. Sixty-four patients who applied to the Family Medicine outpatient clinic of Marmara University Hospital were enrolled. Half of the paticipants were allocated randomly to the intervention group(IG) and the other half to the control group (CG). The study period was 12 weeks. IG was given leaflets and gradual exercise training by demonstration. CG received leaflet about exercises. We assessed participitans' adherence with patients' diaries and telephone contact. We determined WOMAC scores of the participants at each follow-up visit. Results: Of the participants 98.4% were women. Mean age was 56.8+9.27 in the IG and 52.4+10.0 in the SCG. Adherence to exercise in the IG was high (median 100%). Pain and WOMAC scores improved significantly [chronologically 43.5 (25.7-50.25), 18.5 (10.5-27.75), 16.5 (9.0-25.0), 9.5 (5.0-18.0)(p=0.0001)]. Although exercise adherence of the SCG was good initially, long-term adherence was only moderate (respectively 72.5 (55.0-97.5) and 55 (25.0-85.0)(p=0.036). Improvement of pain and WOMAC score in the SCG was lower than the IG [respectively 36.0 (23.5-42.25), 31.5 (21.25-46.25), 27.0 (15.25-39.0)(p=0.037)]. Conclusion: Gradual exercise education with demonstration might improve adherence. [ABSTRACT FROM AUTHOR]

: Objective:To report the birth of a healthy female infant from a father with nonmosaic Klinefelter syndrome (KS) and document the experience of men with KS undergoing assisted conception.: Design:Retrospective.: Setting:Private IVF center.: Patient(s):Twelve couples with male factor infertility due to Klinefelter syndrome undergoing assisted reproduction treatment.: Intervention(s):Controlled ovarian hyperstimulation, testicular sperm extraction, intracytoplasmic sperm injection (ICSI), round spermatid injection (ROSI), and preimplantation genetic diagnosis.: Main outcome measure(s):Testicular sperm retrieval rate, fertilization rate, and pregnancy outcome.: Result(s):There was a sufficient amount of motile sperm for injection into mature oocytes in 6 of the 11 testicular biopsies (54.5%). Fertilization rates for ICSI and ROSI cases were 54.2% and 41.6%, respectively. The pregnancy rate per ET was 27.2%. None of the ROSI cases resulted in pregnancy. Two patients had spontaneous abortions at 8 and 18 weeks of gestation, respectively. Only one patient delivered a healthy female baby after 36 weeks of an uneventful pregnancy.: Conclusion(s):Men with KS can benefit from assisted reproductive technologies, and the testicular sperm retrieval rate among them is promising. Although sex chromosome aberrations among the embryos from men with KS are not common, couples can be offered preimplantation genetic diagnosis before ET. [Copyright &y& Elsevier]

Background/aim: The predictability of clinical outcomes in hypertension in specific patient groups, especially underrepresented populations is the key to rational treatment. This study aimed to investigate the impact of baseline characteristics of <65-year-old hypertensive women with an increased risk of cardiovascular events, managed with standard- or intensive-approach, on their clinical outcomes and serious adverse events (SAEs). Materials and methods: Baseline characteristics of <65-year-old hypertensive women (n = 1247) in SPRINT, a multicenter randomized trial to compare standard and intensive antihypertensive treatment, were analyzed with Cox-regression method to determine potential predictors of the clinical outcomes and SAEs. The primary outcome was the composite of myocardial infarction (MI), non-MI acute coronary syndrome, stroke, heart failure, or cardiovascular death. Results: The primary outcome occurred in 3.1% and SAEs in 27.6% of the population. The treatment groups were similar in terms of the primary outcome, SAEs, or their individual components. The primary outcome occurred significantly more in current smokers vs. nonsmokers (HR: 2.85, 95% CI: 1.34–6.09). The subjects who were on aspirin in the intensive-group were significantly more likely to develop the primary outcome (HR: 3.17, 95% CI: 1.23-8.19) and MI (HR: 10.15, 95% CI: 1.19-86.88) compared with those not using aspirin. The risk of overall SAEs was significantly higher in blacks vs. nonblacks (HR: 1.27, 95% CI: 1.01-1.58), in current-smokers vs. nonsmokers (HR: 1.59, 95% CI: 1.23-2.05), and those with vs. without chronic kidney disease (CKD), (HR: 1.38, 95% CI: 1.08-1.77). The likelihood of SAEs significantly increased with age (HR: 1.04, 95% CI: 1.01-1.07). Conclusion: Smoking, aspirin, CKD, black race, and age seemed as important baseline characteristics in follow-up of <65-year-old hypertensive women, also depending on therapeutic strategy. Clinicians are expected to consider these critical parameters for effective antihypertensive management that promotes better outcomes in this middle-aged female population. [ABSTRACT FROM AUTHOR]

: ObjectiveTo report a case of cervical heterotopic pregnancy after IVF-ET treatment.: DesignCase report.: SettingPrivate IVF center.: Patient(s)A woman who had undergone controlled ovarian hyperstimulation and intracytoplasmic sperm injection–ET for primary male factor infertility.: Intervention(s)Resection of cervical heterotopic pregnancy by hysteroscopy.: Main outcome measure(s)Successful treatment of heterotopic cervical pregnancy.: Result(s)A successful pregnancy resulting in a term baby.: Conclusion(s)Hysteroscopic resection can be used to treat a cervical heterotopic pregnancy. [Copyright &y& Elsevier]

Objective: To determine the microbiological quality of home meals and salads samples. Methodology: A total of 180 samples were collected between May 2007 and July 2007 in Ankara, Turkey. The samples were analysed for the presence of total aerobic bacteria (TAB), thermotolerant coliform bacteria (TCB), Esherichia coli, Salmonella spp. and Staphylococcus aureus. Results: In the present study, S.aureus, coliforms, E.coli, and Salmonella were not detected in cooked meat meals samples. TAB was detected in 22 (24.4%) meat dishes ranges 102-104. The cooked meat dishes samples were analyzed for the presence of TCB, and detected in 2 (2.2%) meat dishes ranges 103-104. Numbers of the aerobic mesophilic bacteria ranged from 102 to 105 cfu/g and coliforms from 37 to 1400 MPN/g in 17 (18.9%) of salad samples. E.coli was detected at level 102-103 (n=12, 13.3%) and S. aureus was detected in 9 (10.0%) at levels of 103-104 cfu/ g salad samples tested. In 4 (4.4%) of the salads samples S.aureus and E.coli were isolated together. Conclusion: The results indicate that the type of vegetable salads analysed may contain pathogenic bacteria and thereby represent a risk to the consumers in regard to foodborne diseases. Thus, it remains essential to include the significance of effective hygiene practices as an important safety measure in programmes of home hygiene, consumer education, and advice. [ABSTRACT FROM AUTHOR]

Objective: To compare the outcome of day 2 and day 3 embryo transfers in women demonstrating poor ovarian response. Design: Prospective randomized clinical trial. Setting: Private assisted reproductive technology center. Patient(s): Two hundred eighty-one women demonstrating poor ovarian response to controlled ovarian hyperstimulation. Intervention(s): Women who were poor responders were randomly allocated to day 2 or day 3 embryo transfer following oocyte retrieval. Main Outcome Measure(s): Implantation rates and pregnancy rates per oocyte retrieval and embryo transfer. Result(s): The clinical pregnancy rates per oocyte retrieval (37.2% vs. 21.4%, respectively; P<.05) and per embryo transfer (38.9% vs. 24.1%, respectively; P<.05) were significantly higher in the day 2 embryo transfer group compared with day 3. On the other hand, implantation rates were not different between groups (23.9% vs. 17.2%, respectively; P=.08). Conclusion(s): Our results demonstrated that transfering embryos on day 2 could provide an alternative to the management of poor responder patients. [Copyright &y& Elsevier]

Purpose: To evaluate the outcome of women with hypogonadotropic hypogonadism undergoing in-vitro fertilization (IVF). Methods: We retrospectively assessed outcomes in 58 women with hypogonadotropic hypogonadism (HH) and, as matched controls, in 116 women with tubal factor (TF) infertility who underwent assisted reproduction treatment (ART). For ovulation induction, human menopausal gonadotropin (hMG) was used in HH patients and a combination of IIMG and gonadotropin releasing hormone (GnRH) agonist was used in TF patients. Conception and implantation rates, as well as duration of stimulation and number of oocytes retrieved, were the main outcome measures. Results: Of the 58 HH patients, 53 (91.3%) responded adequately to ovulation induction and underwent FT. A larger amount of gonadotropins and a longer duration of ovarian stimulation were needed in HH patients than in TF patients. The mean number of retrieved oocytes and implantation rates did not differ between the groups. In addition, there were no differences between the HH and TF groups in pregnancy (53.8 vs. 48.6%) and multiple pregnancy (63.4 vs. 48.4%) rates. In the HH group, the miscarriage rate was 3.4%, and none of these patients developed severe OHSS. Conclusion: IVF in HH patients, in which there was a background of previous failed ovulation induction, was as successful as in women with TF infertility. [ABSTRACT FROM AUTHOR]