Comparison of the health transformation policies for Turkey and United Kingdom

Amaç- Araştırma, Türkiye ve İngiltere’nin sağlık politikalarının dönemsel olarak karşılaştırılması amacı ile yapılmıştır. İngiltere’nin geçmişten günümüze, AB (Avrupa Birliği)’ye giriş ve çıkış sürecinde, ekonomik ve toplumsal tüm olayların sağlık politikasına etkisi ile Türkiye’nin 2002 yılı itibariyle sağlık dönüşümünün kategorik evrimi ve dönüşüm süreci politikalarının hangi şekillerde etkide bulunduğunu ve hangi dönüşüm süreçlerinin gerçekleştiğinin karşılaştırmasıdır. Yöntem- Araştırmada önce kaynak taraması yapılmıştır. Ulusal ve uluslararası kaynakların üzerinde geniş bir literatür taraması yöntemi ile çalışma ele alınarak sonuçlanmıştır. Çalışma betimsel bir araştırma olup, geçmişten günümüze iki ülkenin belirli dönemlerde uygulanan sağlık politikalarını karşılaştırma yöntemi kullanılmıştır. Bulgular- Araştırma, Türkiye Cumhuriyeti’nin kuruluşundan bugüne kadar çeşitli sağlık politikalarının uygulandığını ve bu dönemlere göre farklılık gösterdiğini çalışmalarında görülmektedir. İngiltere’nin ise geçmişten bugüne siyasi ve ekonomik bulgular açısından olduğu kadar sağlık politikaları ve bu politikaların uygulamaları açısından dünyada önemli bir yere sahip olduğunu, özellikle NHS (Ulusal Sağlık Sistemi) süreçleriyle beraber İngiltere önemli kademelere gelmiştir. NHS’nin geçmişten bugüne Ulusal Sağlık Sistemi’nin yapısal olarak özellikleri, değiştiği yönetimsel ve politikalar yer almaktadır. Sonuç- Bu çalışmada, sağlık kavramları genel olarak ele alınmış ve araştırmanın ana konusu olan Türkiye ve İngiltere’nin sağlık politikaları açısından yapılan değişikliklerin etkisini ve dünyada ki mevcut durum ve gelişmelere göz atılmıştır. Türkiye’nin bu alanda ki mevcut durumu incelenmiş ve kıyaslama yapabilmek adına İngiltere’nin gelişimi incelenmiştir. Çalışmamızda incelediğimiz Türkiye ve İngiltere sağlık hizmetlerinin farklı açılardan birbirlerine üstünlükleri olduğu gibi, farklı dezavantajlı durumları ve riskleri de bulunmaktadır.Purpose- This research was carried out with the aim of comparing the health policies of UK and Turkey periodically. The process of UK entering and leaving the EU from the past until today and the impact of all economic and social events on health policy and the categorical development of health transformation of Turkey from 2002, how the policy of the transformation process was affected and what transformation processes have taken place is the comparison. Methodology- Before the research, a literature review was made. The study has been concluded by dealing with a wide literature review method on national and international sources. The study is descriptive research and the method of comparing the health policies implemented in certain periods of the two countries from the past to the present has been used. Findings- The research shows that various health policies have been implemented since the establishment of the Republic of Turkey and that they differ according to these periods. It is seen that England has an important place in the world in terms of health policies and the implementation of these policies, as well as in terms of political and economic findings from the past to the present, especially with the NHS (National Health System) processes, England has reached important levels. NHS's structural features of the National Health System from the past to the present, the administrative and policies that have changed are included. Conclusion- In this study, the concepts of health were discussed in general and the effect of the changes made in terms of health policies of Turkey and England, which is the main subject of the research, and the current situation and developments in the world were examined. The current situation of Turkey in this field and the development of England has been examined in order to make a comparison. Health services in Turkey and England, which examined in this study, have advantages, disadvantage and risks over each other in different aspects.Publisher's Versio

The Trends of Prevalence of Obesity in Turkey From 2008-2016

Objective: Obesity is one of the major public health problems in Turkey and worldwide. This study was conducted to determine the trends of the obesity prevalence in Turkey from 2008 to 2016 by analysing sociodemographic data. Materials and Methods: This study was cross-sectional. Analysis was performed based on 2008, 2010, 2012, 2014 and 2016 data from Health Survey by Turkish Statistical Institute. Of the 128484 individuals who participated in Turkish Health Research, the body mass index (BMI) of 87205 individuals with aged 15 and older has been calculated. Categorical variables were represented as frequency (%) and continuous variables were represented as mean (±standard deviation) within parentheses. The data were analyzed with SPSS 20 software. Results: Our findings showed that 16.2% of the individuals 15 years and over was obese (18.7% among women and 13.5% among men P-value< 0.001) in 2008, and the prevalence increased to 22 % in 2016 (26% among women and 17% among men P-value< 0.001). The ratios of obesity were higher among the individuals having a low education (P-value< 0.001) and income level (P-value< 0.001; between 2010-2016) compared to other groups. Conclusion: Our study demonstrated alarming rates of obesity, particularly among women, among the population 55 to 64 years of age regardless of gender, which was closely associated with low education and income levels. It is crucial to gain healthy lifestyle behaviors within the society and implement strategies and policies for diverse risk groups

DETERMINATION OF ABSORBED RADIATION DOSE LEVELS OF LENSES THYROID AND ORAL MUCOSA IN COMPUTED TOMOGRAPHY IMAGINING: PHANTOM STUDY

Amaç: Baş ve boyun bilgisayarlı tomografi (BT) görüntülemesi, en sık kullanılan radyolojik incelemelerinden biridir. Birçok hastalığın tanısındaönemli rol oynar. Lens ve tiroid bezi radyasyona karşı en duyarlı organlardandır. Bu çalışmanın amacı, BT görüntülemesi yapıl an hastaların, lens,oral mukoza ve tiroid dokusunun maruz kaldığı radyasyon dozunun belirlenmesidir.Yöntem: Çalışmada, insan eşdeğeri olan Alderson Rando fantomunun tiroid, oral mukoza, lens bölgelerine termolüminesans dozimetreleri (TLD)yerleştirilmiş ve fantomun baş-boyun bölgesinin BT görüntülemesi yapılmıştır. Toplam 18 adet TLD kullanılmıştır. Öncelikle dozimetrelerinkalibrasyon işlemleri yapılmıştır. Bu dozimetrelerden 6 tanesi fantomun tiroid bölgesine, 4 tanesi oral mukozaya, 4 tanesi de lens bölgesineyerleştirilmiştir. 4 tane dozimetre ise arkaplan (background) ölçümleri için kullanılmıştır.Bulgular: Lens merkezine yerleştirilen TLD’lerdeki radyasyon dozu 15,03 ile 23,71 mSv arasında (ortalama 19,83±3,93 mSv), oral mukozada 10,36ile 19,47 mSv arasında (ortalama 15,15±2,96 mSv), tiroid bezinde ise 11,21 ile 16,73 mSv arasında (ortalama 13,97±3,90 mSv) bulunmuştur.Sonuç: Uluslararası Radyolojik Koruma Komisyonu (ICRP)raporlarında tüm vücut ve lensler için müsaade edilen radyasyon dozu, radyasyongörevlilerinde 20 mSv/yıl’dır. Hastalar için kesin bir limit olmamakla beraber, doz düzeyinin minimum tutulması amaçlanır. Bu nedenle referansdozunun bilinmesi çekim planlaması için önemlidirObjective: Head-neck computed tomography (CT) imaging is one of the most common tomography examinations in medical imaging. Lenses and thyroid are among the most sensitive organs to radiation. The aim of this study was to determine the radiation dose levels to which the patient's lens, oral mucosa, and thyroid were during head and neck CT imaging. Methods: Thyroid, oral mucosa and lens areas of human equivalent Alderson rando phantom were placed in thermoluminescence dosimeter (TLD) dosimeters and computerized tomography imaging of head-neck of phantom was performed in this study. A total of 18 TLD dosimetry was used in this study. Firstly, dosimeters were calibrated. 6 of these dosimeters were placed on the thyroid of the phantom and 4 of them were placed in the mouth and 4 of them were in the lens. 4 dosimeters were used for background measurements Results: The radiation dose in TLDs placed at the center of the lens was between 15.03 and 23.71 mSv (mean 19.83±3.93 mSv), the oral mucosa was 10.36 to 19.47 mSv (mean 15.15±2.96 mSv), and the thyroid gland was between 11.21 and 16.73 mSv (mean 13.97±3.90 mSv). Conclusion: The permissible radiation dose for whole body and eye lenses in ICRP reports is 20 mSv/year for radiation officers. Likewise, there is no definite limit for patients, it is aimed to keep the dose level to a minimum. Therefore, knowing the reference dose is important for imaging planning

The importance of ICD-10 applications on daily practice

This study assessed the adequacy of patient data entry in the context of International Statistical Classification of Diseases and Related Health Problems (ICD-10) in the Hospital Information Administration System. It was also aimed to study the adequacy and functionality of the ICD-10 coding in the current Turkish Otorhinolaryngology (ORL) practice in detail. The medical records of 1216 patients who presented to the ORL outpatient clinic between 2012 and 2013 were reviewed. Eight diagnostic codes used by the ORL department were selected from the patient diagnoses report to form patient lists. The accessibility of the ICD-10 codes was analyzed. The data was transferred into the MEdCalc 12.0 software package in a digital medium. The study data was analyzed using frequency tables, Chi-square test, and the two sided likelihood ratio test. Among the ICD-10 codes included in the study, the larynx malignant neoplasm diagnosis (C32.9) was recorded at a rate of 60% and had the greatest ratio of recorded medical history, followed by malignant disorders (C32.3) of the laryngeal cartilage, vertigo (R42) (12.4%) whereas facial asymmetry (Q67.0) (10.5%) had the lowest recorded medical history ratios. There was a significant difference between the recorded and unrecorded patient groups (p [Med-Science 2018; 7(4.000): 873-7

Can we predict patients that will not benefit from invasive mechanical ventilation? A novel scoring system in intensive care: the IMV mortality prediction score (IMPRES)

KUCUK, Ahmet Oguzhan/0000-0002-6993-0519; Kirakli, Cenk/0000-0001-6013-7330; KUCUK, Mehtap PEHLIVANLAR/0000-0003-2247-4074; Aksoy, Iskender/0000-0002-4426-3342WOS: 000504051300010PubMed: 31655511Background/aim: The present study aimed to define the clinical and laboratory criteria for predicting patients that will not benefit from invasive mechanical ventilation (IMV) treatment and determine the prediction of mortality and prognosis of these critical ill patients. Materials and methods: The study was designed as an observational, multicenter, prospective, and cross-sectional clinical study. It was conducted by 75 researchers at 41 centers in intensive care units (ICUs) located in various geographical areas of Turkey. It included a total of 1463 ICU patients who were receiving invasive mechanical ventilation (IMV) treatment. A total of 158 parameters were examined via logistic regression analysis to identify independent risk factors for mortality; using these data, the IMV Mortality Prediction Score (IMPRES) scoring system was developed. Results: The following cut-off scores were used to indicate mortality risk: 8, very high risk. There was a 26.8% mortality rate among the 254 patients who had a total IMPRES score of lower than 2. The mortality rate was 93.3% for patients with total 1M PRES scores of greater than 8 (P < 0.001). Conclusion: The present study included a large number of patients from various geographical areas of the country who were admitted to various types of ICUs, had diverse diagnoses and comorbidities, were intubated with various indications in either urgent or elective settings, and were followed by physicians from various specialties. Therefore, our data are more general and can be applied to a broader population. This study devised a new scoring system for decision-making for critically ill patients as to whether they need to be intubated or not and presents a rapid and accurate prediction of mortality and prognosis prior to ICU admission using simple clinical data