Fiscal Decentralization in Turkey and Differentiation in Selected Provinces

In this study, fiscal decentralization in Turkey was first considered in terms of the size of local governments within the general government at the macro level, and then the differentiation of fiscal decentralization among the local governments on the basis of selected provinces was examined. The revenue and expenditures of local governments in Turkey have increased as a proportion of GDP, while the level of fiscal decentralization has shown a distinctive structure, especially since the 2000s. Results indicate that there is no efficient calculation methodology for achieving vertical equality. The objective for achieving horizontal equalization in the transfer system remains also limited. Fiscal decentralization rates differ between provinces. Intergovernmental revenue sharing system and differentiation in own-source revenues mainly resulting from the income levels of the regions clearly shows that there has been an inadequate vertical and horizontal imbalances and current sharing system somehow increases inequalities among provinces

Financial Performance and Risk Areas of University Training and Research Hospital Revolving Funds

Döner sermayeli işletmeler mali yönetim sistemimiz ve kurumsal performans üzerindeki etkileri nedeniyle kamu maliyesi açısından önemli kurumsal yapılar haline gelmiştir. Çalışmamızda 42 üniversite döner sermaye hastanesinin gelir, gider, borç yapısı 20092015 dönemi için panel veri analiziyle incelenmektedir. Analiz sonuçları döner sermaye gelir ve gider yapısındaki değişimin, döner sermaye açıkları ve borçları üzerinde anlamlı bir etkisi olduğunu göstermektedir. Üniversite döner sermayelerinde hizmet sunumu sürecinde gelirlerdeki artış yanında harcama yönetimini iyileştirmeye yönelik olmak üzere atılacak somut adımlar mali performansın iyileşmesine neden olacaktır. Mali yönetimin hastanelerde disiplinler arası çalışmalarla etkinlik odaklı olmak üzere iyileştirilmesi ve iç kontrol sisteminin kurumsallaşması mali performansın iyileşmesi ve sürdürülebilirlik açısından kaçınılmaz görülmektedir.Revolving funds have become critical institutions in terms of public finance due to our financial management system and the effects on corporate performance. In our study, the revenue, expenditure and debt structure of 42 university revolving fund hospitals are analyzed by panel data analysis for 2009-2015 period. The results of the analysis show us that change in the structure in income and expenses is a significant on revolving fund deficits and debts. The concrete steps to be taken to improve expenditure management beside increasing revenues in the university revolving funds will result in improving financial performance. The improvement of the fiscal management system based on the efficiency in the hospitals through interdisciplinary studies and the establishment of an effective internal control system are inevitable for ensuring better fiscal performance and financial sustainability

Relationship between endothelial dysfunction and microalbuminuria in familial Mediterranean fever

OBJECTIVE: The aim of our study is to investigate the relationship between microalbuminuria and flow-mediated dilatation in familial Mediterranean fever (FMF) patients. MATERIAL AND METHODS: In our study, there were two groups consisting of 54 patients who were out of the attack period (43 of whom had no microalbuminuria and 11 of whom had microalbuminuria) and 40 healthy controls (M/F: 12/28). RESULTS: There was no statistically difference between patient and control groups’age (25.06±8.07, 22.89±6.00 years, respectively). Flow-mediated dilatation (FMD) percentages were significantly different between the three groups (p=0.01). It was observed that there was a correlation between microalbuminuria and FMD percentage. CONCLUSION: Endothelial dysfunction and renal damage occurred as a result of low-grade chronic inflammation. Microalbuminuria, which is the indicator of renal damage and endothelial dysfunction, and FMD show that endothelial functions can be used in the following of early detection of renal damage and endothelial functions in FMF patients

Cancer Trends and Incidence and Mortality Patterns in Turkey

Cancer incidence and mortality rates have been increasing in Turkey as most of the developing countries. Besides socioeconomic factors, one of the most prominent attributes of developing countries is the dissimilarity of their age-dependent demographic structure. In Turkey, cancer incidence rates rise due to individual and environmental risk factors as well as due to the improvement in the registry system and to increase in access to health services. According to the data retrieved from the Ministry of Health Department of Cancer Control database cancer incidence rates increased between 2002 and 2005. Incidence rates rose from 133.78 per 100 thousand in 2002 to 173.85 per 100 thousand in 2005. Between 2002 and 2005 the average growth rate of increase for men comes about 9.7%, which is higher than 8.6% for women leading to the widening of incidence gap between man and women. First five frequent cancer types in Turkey are lung (30.13), prostate (24.33), skin (18.91), breast (17.96), stomach (9.92) cancer with an incidence of per 100 thousand. Cancer incidence growth rates for men exceed the cancer incidence growth rate for women. This gap is resulting mainly from lung cancer incidence which is much higher for men. Further extension of the nationwide cancer screening and prevention programs will result in improvement of cancer control.WoSScopu

Re-examining the characteristics of pediatric multiple sclerosis in the era of antibody-associated demyelinating syndromes.

Background: The discovery of anti-myelin oligodendrocyte glycoprotein (MOG)-IgG and anti-aquaporin 4 (AQP4)-IgG and the observation on certain patients previously diagnosed with multiple sclerosis (MS) actually have an antibody-mediated disease mandated re-evaluation of pediatric MS series. Aim: To describe the characteristics of recent pediatric MS cases by age groups and compare with the cohort established before 2015. Method: Data of pediatric MS patients diagnosed between 2015 and 2021 were collected from 44 pediatric neurology centers across Turkiye. Clinical and paraclinical features were compared between patients with dis-ease onset before 12 years (earlier onset) and >= 12 years (later onset) as well as between our current (2015-2021) and previous (< 2015) cohorts. Results: A total of 634 children (456 girls) were enrolled, 89 (14%) were of earlier onset. The earlier-onset group had lower female/male ratio, more frequent initial diagnosis of acute disseminated encephalomyelitis (ADEM), more frequent brainstem symptoms, longer interval between the first two attacks, less frequent spinal cord involvement on magnetic resonance imaging (MRI), and lower prevalence of cerebrospinal fluid (CSF)-restricted oligoclonal bands (OCBs). The earlier-onset group was less likely to respond to initial disease-modifying treatments. Compared to our previous cohort, the current series had fewer patients with onset < 12 years, initial presentation with ADEM-like features, brainstem or cerebellar symptoms, seizures, and spinal lesions on MRI. The female/male ratio, the frequency of sensorial symptoms, and CSF-restricted OCBs were higher than reported in our previous cohort. Conclusion: Pediatric MS starting before 12 years was less common than reported previously, likely due to exclusion of patients with antibody-mediated diseases. The results underline the importance of antibody testing and indicate pediatric MS may be a more homogeneous disorder and more similar to adult-onset MS than previously thought