Predicting the Resilience of the Health Care System to New Arrivals: The Case of the Public Health System of Turkey

Purpose/Objectives: Since the start of the Syrian war, a significant population has moved out of the Syrian Republic into its neighborhood environs. Turkey has had a significant effect on its health system and society, as a significant new number has entered the Turkish society, increasingly using the Turkish healthcare system. Our aim is not only to numerically identify the size of the effect to the Turkish system, but to identify the domestic resources that allow the Turkish healthcare system and society to build up resilience against the significant health demand shock. The main objectives of this study is 1) To understand whether there is a complementarity between the earlier efforts in the Turkish health system and the current capabilities that is necessary to meet the Syrian Populations Health Needs. 2) To understand if the newly revamped Turkish Primary Healthcare System Provide a crucial buffer for the negative congestion effects that could have been caused by such a significant and relatively unhealthy refugee population being integrated into the health system, at a relatively rapid pace. Research method: The main two outcomes that the analysis plans to predict are the changing efficiency and the changing user satisfaction of the Turkish health system. Using multi-level regression models (MLO) we (i) Start by looking at the effect of the Syrian effect on the crucial Turkish health parameters, following this by (ii) Looking at the factors of family health program introduction, and family health system utilization to look at how the functionality of the health system, and the satisfaction that it brings to the Turkish population is being affected. We used fixed effect model to remove unobserved heterogeneity in each province (model specification in Appendix 1). We have controlled for health system variables (public primary physicians per 10,000; public hospital specialists per 10,000; public hospitals per 10,000; public PHC centres per 10,000; and the presence of a university hospital in the province) as well as population characteristics (rural population (%); population aged 65 and over (%); population aged 14 and under (%); and the province population). Because demographic data was available only for the years 2007-12, it was linearly extrapolated for the years 2002-6 and 13. The penetration of family medicine model in each province was measured by an indicator variable (0,1) for whether the MLO model was introduced, and the number of years since the introduction of the MLO model. The Syrian effect was measured through the proportion of Syrians under temporary protection status to the domestic province population. Main results: The health system status of the Turkish population is unaffected in the large period from 2011-2016. The significant effect in the initial period was significantly alleviated in the intervening years. The main sources of resilience were found to be the changing importance of the alternative primary health system that allowed Turks to receive a new option to the secondary part of the Turkish health system that was increasingly congested. Increasing use of the immunization for the same goal is also substantiated for the Turkish population. Recommendations: Turkey’s experience is instructive for a lot of the middle income countries, which can face similar refugee and migrant pressure in the next 50 years. The health systems priority to UHC and to (relative) open access that it offered to its citizen population and its outside populations alike, has served its efficacy in good stead. The health system must create enough elasticity to limit a drop in health system satisfaction and health system utilization in either of these critical populations

A STUDY ON CLASSROOM TEACHER CANDIDATES’ CONCERN FOR NON-APPOINTMENT AND THEIR TEACHING MOTIVATION

One of the important elements of the education system is teacher and success of the education system is mainly based on the fact that teachers who will run the system have expected competencies. While the process of bringing teachers in competencies expected from them is seen important in the 21st century world, it is also important to run the appointment process of teachers in a healthy way. It is thought that current teacher appointment system of Turkey causes teachers to get concerned and this affects their motivation for teaching adversely. The purpose of this study is to evaluate the concern of teachers for non-appointment and their motivation for teaching. This study was designed in the screening model. Target population of the study is fourth-grade teacher candidates studying Classroom Teaching Department of five different Faculties of Education in Aegean, Black Sea and Marmara Region of Turkey in 2017-2018 academic year. The sample of the study consists of 370 teacher candidates selected by simple random sampling method. In the study, the "Non-Appointment Concern of Classroom Teacher Candidates’" was measured by "Teacher Candidates Non-Appointment Concern scale" developed by Eskici (2016) and the teaching motivation was measured by "Teaching Motivation Scale" adapted to Turkish by Candan and Evin Gencel (2015). Analysis of the research data was done by SPSS v.22 packaged software, and ANOVA and t-test techniques were used. According to the results of the study, non-appointment concern of classroom teacher candidates has been found to be at a moderate level and significant differences have been determined by universities. Although the concern is above moderate level, it has been determined that teacher candidates do not lose their teaching motivation and their teaching motivation points are still above moderate level. In addition, it has been determined that the motivation of teacher candidates varies significantly by universities. There has been no significant difference between genders in both variables. It is believed that this study will contribute to improvement of the 21st century teachers’ competencies and will create an environment of data driven thinking and discussion based on the related variables.  Article visualizations

Historical Alfalfa Landraces Perform Higher Yield Under Dry Farming in Turkey

AbstractDrought is a serious abiotic stress affecting crop yield and is an increasingly significant challenge to crop production with the climate change. Cultivars that perform well under limited water are the key for the global food security. One of the main problems for plant breeders is the availability of plant germplasm that could perform well under water limited conditions. There is wealth of wild germplasm adapted to water limited environments but they yield poorly in agricultural systems. However, historical landraces could be the key to counterbalance the yield loses due to increased drought caused by climate change. Alfalfa is a forge legume cultivated throughout the world and affected from drought significantly. USDA Germplasm Resources Information Network (GRIN) has a collection of Turkish alfalfa landraces gathered in second half of the last century. In this study, we evaluated the agronomic performance of a total of 100 historical landraces, wild accessions and modern cultivars in a replicated field trial in two locations in Kars Province of Turkey in order to evaluate the field performance of the accessions under non-irrigated conditions and to compare yield performance of landraces with modern cultivars.The results revealed that when all 100 entries were evaluated, the historical landraces on average perform as high as modern cultivars for the agronomic traits such as total biomass yield and plant height. When the accessions and entries considered separately, the top 20 high yielding accessions were all landraces with a few high performing wild accessions outperforming modern cultivars. The results conclude that historical landraces could directly be used in dry agriculture possess significant alleles for water use efficiency. The outcome of the current study suggests that the evaluation of plant genetic resources, especially historical landraces, under different climate conditions is vital for effective breeding strategies

Familial Mediterranean fever: Health-related quality of life and associated variables in a national cohort

Objectives: This study aims to evaluate the effectivity of Familial Mediterranean Fever Quality of Life (FMF-QoL) Scale for the measurement of QoL in patients with FMF and to perform correlations between related clinical variables in Turkish patients. Patients and methods: This multicenter prospective study performed between December 2017 and November 2018 included 974 FMF patients (334 males, 640 females; median age: 35; range, 26 to 45 years). Sociodemographic characteristics and clinical features were recorded. All participants were asked to complete the FMF-QoL Scale, Short Form-36 (SF-36), Hospital Anxiety and Depression Scale (HADS), Health Assessment Questionnaire (HAQ), and Functional Assessment of Chronic Illness Therapy (FACIT) Scale. Results: The median FMF-QoL Scale score was 26. Higher FMF-QoL Scale scores were shown to be related to female sex, illiteracy or primary education, monthly low-income (US$20 years), a higher number of attacks per month (>1/month), and severe disease. FMF-QoL Scale scores were correlated negatively with subscales of SF-36, and positively with HADS-anxiety and HADS-depression scores, HAQ and FACIT. Conclusion: Female sex, smoking, lower educational status, more severe disease, fatigue, and functional impairment were associated with poor QoL. FMF-QoL Scale was noted as a valid and simple patient-reported outcome instrument and correlated with the SF-36 scale

Immunohistochemical expression of ghrelin in mouse testes fed with a diet containing capsaicin on postnatal development

Acı kırmızı biber, botanik biliminde Solanacea familyasına ait bir bitki olup, Capsicum annuum olarak bilinmektedir. Capsaicin, acı kırmızı biberin etken maddesidir. Ghrelin, öncelikli olarak midedeki endokrin X/A hücreleri tarafından üretilen polipeptid yapıda bir hormondur. Görelin, büyüme hormonunun salınımı, enerji dengesi, besin alımı ve vücut ağırlığının ayarlanmasında görev alır.Çalışma materyalini 21 günlük 40 adet Swiss albino soyu erkek fareler oluşturdu. Fareler anneden ayrıldıkları 21'nci günden itibaren deney grubu (n: 20) % 0,02 oranında capsaicin içeren yem ile, kontrol grubu (n: 20) ise standart fare yemi ile beslendi. Gruplardaki tüm farelere dietileter anestezisi altında puberte (40 günlük) ve erişkin (75 günlük) dönemlerinde, servikal dislokasyon uygulandı. Testisleri çıkartılarak rutin doku takibine alındı. Capsaicin ilavesi yapılmış yemle beslenen farelerin testisleri puberte ve erişkin dönemlerde ghrelin peptidinin lokalizasyonu histolojik ve immunohistokimyasal analizler ile değerlendirildi.Araştırmanın, puberte ve erişkin dönemlerinde özellikle deney grubunda seminifer kanal duvarında spermatogenik hücre serisinde artış saptandı. Ghrelin antikoru ile yapılan immunohistokimyasal boyama sonucunda fare testisinde çalışmamızda tüm gruplardaki Leydig ve Sertoli hücrelerinde immunpozitif reaksiyon ilk olarak gösterilerek literatür bilgisine katkı sağlandı. Spermatogenik seriyi oluşturan hücrelerde reaksiyon görülmedi. Ghrelin reaksiyonu hem puberte hem de erişkin dönem deney grubu Leydig hücrelerinde, kontrol gruplarına oranla daha az boyanma yoğunluğunda saptandı.Gerçekleştirilen bu çalışma, yeme düşük doz capsaicin ilavesinin, farelerin testis dokusu gelişimini olumlu yönde uyardığını, gonadlar ve gelişimi üzerinde ghrelinin de etkin rol oynadığını göstermektedir.Red hot pepper, known as Capsicum annuum, belongs to Solanacea family in botany. Capsaicin is the pungent extract of red hot pepper. Ghrelin is an acylated polypeptide hormone secreted predominantly by endocrine X/A cells of the stomach. Ghrelin acts as a regulator for GH release, energy balance, food intake and body weight.Swiss albino male mice (n: 40), at the age of 21 days old, were used. After weaning at day 21, treatment group (n: 20) fed with diet containing 0.02 % capsaicin and control group (n: 20) fed with standard diet. In pubertal (day 40) and adult (day 75) periods, mice sacrificed by cervical dislocation under diethyl ether inhalation anesthesia. Testes from both groups removed and applied routine histological process.Ghrelin peptid evaluated in testes of mice fed with capsaicin containing diet by histological and immunohistochemical methods in pubertal and adult periods. In this research, we determined that there was an increasing on the number of spermatogenic cells in tubules, in both pubertal and adult periods, specially for treatment group. At the end of the immunohistochemical staining, we confirmed that there was a positive reaction on Leydig and Sertoli cells of mouse testes but no reaction on spermatogenic cells. Immunohistochemical expression of ghrelin for mouse testes was first on lectures. Intensity of ghrelin reaction was less for treatment group compared to control group in both pubertal and adult periods. These results show that low dose capsaicin has a positive effect with ghrelin on testicular development.This project shows that, low dose capsaicin containing diet stimulates the development of testes of mouse and ghrelin has an effective role on gonads