Health-Seeking Behaviors and its Determinants: A Facility-Based Cross-Sectional Study in the Turkish Republic of Northern Cyprus

Background: Understanding health-seeking behaviors and determining factors help governments to adequately allocate and manage existing health resources. The aim of the study was to examine the health-seeking behaviors of people in using public and private health facilities and to assess the factors that influence healthcare utilization in Northern Cyprus.Methods: A cross-sectional study was conducted in 2 polyclinics among 507 people using a structured interviewer-administered questionnaire. Health-seeking behaviors were measured using four indicators including routine medical check-ups, preferences of healthcare facilities, admission while having health problems, and refusal of health services while ill. Descriptive statistics and multivariable logistic regression analyses were done to explore factors influencing the use of health services. Results: About 77.3% of the participants reported to have visited health centers while they had any health problems. More than half (51.7%) of them had a routine medical check-up during the previous year, while 12.2% of them had refused to seek healthcare when they felt ill during the last five years. Of all, 39.1% of them reported preferring private health services. Current smokers (adjusted odds ratio [AOR] = 1.92, 95% CI: 1.17-3.14), having chronic diseases (AOR = 2.05, 95% CI: 1.95-2.16), having poor perceptions on health (AOR = 2.33; 95% CI: 1.563.48), and spending less on health during the last three months (AOR = 2.08, 95% CI: 1.43- 3.01) had about twice the odds of having routine checkups. Higher education (AOR = 1.87, 95% CI: 1.38-2.55) was shown to be a positive predictor for the health-seeking behaviors, whereas having self-care problems (AOR = 0.18, 95% CI: 0.08-0.40) and having a moderate-income (AOR = 0.68, 95% CI: 0.57-0.81) were inversely associated with seeking healthcare. Conclusion: The utilization of public and private health sectors revealed evident disparities in the socio-economic characteristics of participants. The health-seeking behaviors were determined by need factors including chronic disease status and having poor health perception and also by enabling factors such as education, income, insurance status and ability to pay by oneself. These findings highlight the need for further nationwide studies and provide evidence for specific strategies to reduce the socioeconomic inequalities in the use of healthcare services

The assessment of early and late gestational termination cases

Objective We aimed to investigate the characteristics of early and late gestational termination cases by evaluating the cases underwent gestational termination in our clinic. Methods All pregnant women who had singleton pregnancy and underwent gestational termination due to fetal indications between January 2017 and December 2019 were included in the study. Results A total of 341 cases, of which 263 were with early gestational termination (Group 1) and 73 were with late gestational termination (Group 2) were included in the study. No difference was observed between the demographic characteristics of the groups. The ultrasonographic structural anomaly was observed in 273 (80.1%) of 341 cases and no structural anomaly was observed in 68 (19.9%) cases. Of the cases with structural anomaly, 200 (73%) had isolated system anomaly and 73 (26.7%) had multiple system anomaly. Karyotype analysis was performed in 68% of the cases, and chromosomal anomaly was found in 52.6% of them. Among the cases with normal karyotype analysis results, 22 cases had single gene disorder, of which mostly had thalassemia. While the incidence of structural anomaly was significantly high in the late termination cases (91% vs. 76.8%), the incidence of isolated cardiovascular anomaly was significantly high in the late termination cases similarly (37.5% vs. 13.8%). The autopsy was performed on 16.7% of the cases after termination and the findings were consistent with the prenatal ultrasonographic results in 86% of the cases, and additional findings were found in 22.4% of the cases in the autopsy. Conclusion When the late gestational terminations performed in our clinic are compared to the early gestational terminations, we believe that conducting ultrasonographic anomaly screening to all pregnant women including echocardiography even at a less rate, and also making screening programs in the early gestational periods such as aneuploidy screening easily accessible for all pregnant women may help to maintain maternal health by decreasing the rates of the cases with late gestationa

Focal Endometrial Adenocarcinoma in Atypical Polypoid Adenomyoma of Low Malignant Potential

Atypical polypoid adenomyoma is a rare and benign polypoid lesion of uterus with proliferation of irregular endometrial glands embedded in a smooth muscle stroma. If the lesion contains glands that are sufficiently complex to satisfy the criteria for adenocarcinoma, it is called as atypical polypoid adenomyoma of low malignant potential. Patients most commonly present with abnormal uterine bleeding and more than 90% of patients are premenopausal. Although the lesion is benign, it may occasionally be found to coexist with or to precede endometrial adenocarcinoma. This necessitates a careful management which involves hysterectomy in perimenopausal or postmenopausal patients and hysteroscopy with multiple biopsies in younger women desiring future fertility. This report describes a perimenopausal woman with atypical polypoid adenomyoma of low malignant potential with focal adenocarcinoma on endometrial biopsy who subsequently underwent hysterectomy in which no residual malignant lesion was found

Mother’s knowledge for environmental risks and self-awareness for the presence of pollutants in her living area in West and Central Anatolia: a cross-sectional survey

Abstract Background Environmental risk awareness is a key concept to raise awareness and plan future programs for environmental protection. A cross-sectional household survey aimed to find out the presence of environmental hazards next to living area and the mother’s knowledge levels about environmental risk factors with their related factors according to district development ranking, and Western and Central Anatolian regions with sampling from rural and urban residence. Method The study was designed with household sampling weighted according to population density in 2008. Data on the demography and health status, dwelling characteristics of the residents are also collected in 2009. In addition, open-ended questions "What does environmental risk/hazard mean?" and "Which environmental risks/hazards are present in your environment?" were asked. The data collected from the survey were analyzed using multivariate binary logistic regression. Results The sample included 3489 mothers living either in urban or rural areas. Of the mothers, 19.3% did not know what an environmental risk is and 75.7% stated that there was at least one environmental pollutant in their environment. The most commonly perceived risk factor was air pollution (23.0%), which was reported to be present in their living areas by 12.4%. Regions, residence, settlement features of the house, and health status of family members were associated with the perception of environmental risk at a statistically significant level. Conclusion The neighborhood conditions and health status of family associated with the mother’s awareness for environmental risk factors. Communication and cooperation between local governments, health institutions, non-governmental organizations and other stakeholders should be strengthened to increase risk awareness