Evaluating the Financial Performances of the Publicly Held Healthcare Companies in Crisis Periods in Türkiye.

The purpose of this study was to evaluate the financial performances of the publicly held healthcare companies in crisis periods in Türkiye. The 2018 economic crisis and the COVID-19 pandemic crisis were included in the study as the crisis periods. We collected the financial data of the publicly held healthcare companies and calculated three liquidity, three turnover, three leverage and three profitability ratios through ratio analysis to use as financial performance indicators. We then conducted Wilcoxon signed-rank tests and we performed separate analyses for the 2018 economic crisis and the COVID-19 pandemic crisis. The results of the analyses showed that there were no statistically significant differences between the publicly held healthcare companies' liquidity, turnover, leverage, profitability ratios and thus their financial performances before the crises and after the crises. While the results are reassuring and give valuable insights to managers and policy makers to determine the areas that needs to be strengthened to be better prepared for possible future crises, our sample was limited. Therefore, this study presents an exploratory foundation for future studies which are needed to make a case for financial stability for the publicly held healthcare companies before and after the crisis periods.

The Associations between Childhood Experiences and Occupational Choice Capability, and the Mediation of Societal Gender Roles.

Experiences in family, school, and social life during childhood are associated with gender roles and occupational choice capability. This study examines how competent individuals are in occupational choice capability and the relationships of childhood experiences and gender roles with their competencies in occupational choice capability. The research is composed of 805 individuals aged 18 and older, who reside in Turkey. In the research, we used the Personal Information Form, Childhood Experiences Scale, Gender Roles Attitude Scale, and The Scale of Occupational Choice Capability. The SPSS 25 program and PROCESS-Macro were used to analyze the variables. The relationship between the scales was investigated using Pearson correlation analysis and multiple regression analysis. According to the findings we obtained, individuals' family and school life were positively correlated with their career choices, and family function sexism harmed their choice of profession. We also found gender roles had a mediating role in the relationship between school life and career choice.

Why Are Turkish University Students Addicted to the Internet? A Moderated Mediation Model.

Internet addiction has become a significant problem that primarily affects young people. It has an essential effect on the individual's self-perception and assessment of their competencies. This study aimed to reveal whether there is a significant relationship between the level of internet addiction of university students and their age and self-esteem. For this purpose, internet addiction and self-esteem scales were used in addition to questions such as age, gender, the purpose of internet use, and internet daily usage time. We used a quantitative research method to obtain cross-sectional data from 400 Turkish young people using online surveys. Correlation, regression, mediation, and moderation analyses were performed using SPSS and the PROCESS macro plugin for data analysis. Internet addiction was significantly associated with self-esteem, gender, age, and daily internet usage. In addition, we discovered that self-esteem and daily usage time played a mediation role in the effect of the age variable on internet addiction. Moreover, the moderation roles of social networks, gender, and location in the impact of self-esteem on internet addiction were determined. With this study, we understood that as age increases, self-esteem triggers the decrease of internet addiction. In this sense, policies should be developed to increase self-esteem among young people to ensure the conscious use of the internet.

The Mediating Role of Gaming Disorder in the Effect of Narcissism on Happiness in Children.

We aimed to determine the relationship between gaming disorder, narcissism, and happiness levels of children between the ages of 9 and 15. This study was based on the compensation theory. The sample consists of 461 boys who continue their education in public schools in Istanbul. In the study, a mixed research design, which nests qualitative data into quantitative, was used. In addition to the scales and sociodemographic form, the Draw-a-Person test was also used to better understand children's inner world. According to the findings, there is a significant relationship between gaming disorder and narcissism and happiness levels in children. Accordingly, as narcissism increases in children, the gaming disorder level increases, and happiness decreases. We also found a mediation effect in the impact of narcissism on happiness through gaming disorder. According to the results, we think that the problem is not caused by the individual but by society. For a solution, we recommend making more macro-level social work interventions within the framework of system theory instead of the current medical model in combating gaming disorder.

The Role of Family Influence and Academic Satisfaction on Career Decision-Making Self-Efficacy and Happiness.

Careers are a reality of life that need to be considered as multi-dimensional in today's modern societies. Choosing a career is a complex process that coincides with high school and university ages, creating psycho-social stress. Considering the literature, the effects of different environmental factors have been revealed in separate studies. This study examines both individual and environmental factors together. By adopting a quantitative research method, we collected cross-sectional data through online questionnaires from 1130 university students. The association of family influence and academic satisfaction with happiness through career decision self-efficacy was meaningful using gender, age, income, and parents' education as control variables. Family influence and academic satisfaction were positively correlated with career decision self-efficacy and happiness. In conclusion, we found that family influence and support, students' work, and academic satisfaction are positively significant in terms of the career process and happiness. It was understood that the career reality should be considered with a holistic view that includes family, school, and work experience.

Investigation of the Effect of Social Media Addiction on Adults with Depression.

This study aimed to investigate the effects of social media addiction on depression in adult individuals. For this purpose, the researchers analyzed whether social media dependence had differing impacts according to various variables (age, gender, the highest level of education, duration of daily use of social media, frequency of social media use, etc.). A sample population of 419 people who live in different provinces in Turkey between 18 and 62 years of age participated in the research. The questionnaire form was developed to obtain the Social Media Dependence Scale (SMDS), Beck Depression Inventory scores, and demographic information from the participants. The research was conducted according to the general screening model. Significant differences were found between depression and social media dependency in variables such as the number of children, age, and income. As a result of the study, when social media addiction was examined in terms of gender among socio-demographic variables, no significant difference was found.

The Psychological Consequences of COVID-19 Fear and the Moderator Effects of Individuals' Underlying Illness and Witnessing Infected Friends and Family.

The COVID-19 virus has become a fearful epidemic for people all over the world. In Turkey, long quarantine periods and curfews have increased both physical and psychological problems. Due to the rapid spread and substantial impact of the COVID-19 virus, different psychological effects were observed among different segments of society, such as among young people, elderly people, and active workers. Because of fear caused by the COVID-19 virus, it is thought that depression, stress, and anxiety levels have increased. It is estimated that there are more psychological issues for people with poor health and others whose friends or family became ill or have died because of COVID-19. To explore and test the situation mentioned above, we conducted a cross-sectional study in Turkey with 3287 participants above 16 years old. We measured COVID-19 fear, along with anxiety, stress, and depression levels (DASS21) and demographics. Firstly, we tested whether COVID-19 fear predicts stress, anxiety, and depression. Secondly, we investigated if the effect of COVID-19 fear is stronger for those who have underlying illness and for those whose friends or family became ill or have died because of COVID-19. The results showed that women and 16-25 years old youths have higher COVID-19-related fear, anxiety, depression, and stress. Furthermore, we found a significant relationship between COVID-19 fear and stress, anxiety, and depression, as well as significant moderation effects of having an underlying illness and having friends or family who were infected or have died. These results show the importance of implementing specific implementations, particularly for vulnerable groups, to minimize the psychological problems that may arise with the pandemic.

Cost-effectiveness of allergic rhinitis treatment: An exploratory study.

Allergic rhinitis is serious public health problems and one of the most common chronic diseases worldwide. We aimed to assess the cost-effectiveness of clinically relevant treatment options for allergic rhinitis using evidence-based literature. In addition, we aimed to develop recommendations for allergic rhinitis treatment based on health economic facts. We searched MEDLINE via PubMed from 2009 to 2014 to identify all therapeutic options described in the current literature and selected randomized controlled trials that used a symptom score, had at least one placebo control group and used adult patients. We analyzed the side effects and the number of cases in which treatment was discontinued for each treatment option. Local antihistamines were the most cost-effective local therapy and are recommended due to the low number of complications. Regarding systemic therapies, although the use of oral steroids is indeed significantly cost-effective, this treatment was found to be associated with strong side effects. Sublingual immunotherapy was identified as the most cost-effective immunotherapy and exhibits a good side-effect profile. Overall, local therapy with antihistamines was found to be the most cost-effective option of all therapies. This study showed that there are only minor differences between sublingual and subcutaneous immunotherapy. Based on our results, we recommend the use of an international, uniform nasal symptom score to facilitate the comparison of clinical trials on allergic rhinitis in the future.

Opinions and attitudes of obstetricians and midwives in Turkey towards caesarean section and vaginal birth following a previous caesarean section.

Aim To determine the opinions and attitudes of Turkish obstetricians and midwives to caesarean section (C-section) and vaginal birth following a C-section. Methods The study involved obstetricians and midwives who were working in a state women's hospital and two private hospitals in Gaziantep, Turkey. Participants were asked to complete questionnaires on sociodemographic data and provide opinions about C-section. Results A total of 88 midwives and 22 obstetricians participated in the study. Approximately one-third of midwives believed caesarean rates were high at their institution and more than 50% thought that the rate should be reduced. In contrast, although approximately 80% of obstetricians thought that caesarean rates in their institutions ranged between 25-50%, only 18% believed the rate was high and 68% believed that the rate of should be reduced. Midwives and obstetricians tended to agree on most suggested reasons for high C-section rates. When asked about interventions that may reduce the C-section rates, midwives and obstetricians had opposing views. However, most participants agreed that prenatal childbirth preparation courses would be beneficial. Conclusions This study showed that most midwives and obstetricians believe the rate of C-section at their institution is high and should be reduced.

Healthcare reform in the Middle East and the USA.

Mustafa Z Younis speaks to Laura Dormer, Commissioning Editor: Dr Mustafa Z Younis is an internationally recognized scholar and was a member of the Executive Committee of the International Society for Research of Healthcare Financial Management. Dr Younis has authored and published over 200 articles, abstracts and presentations in refereed journals and meetings, and has presented at national and international conferences. Dr Younis has administrative experience as Senior Adviser for the President at Zirve University, Turkey and as Chair of the Department of Health Policy and Management at Florida International University (FL, USA) where he led the accreditation efforts for the Healthcare Management Program. Dr Younis has a history of playing visible roles on the editorial boards of journals as Chief Editor, Guest Editor and Editorial board member of leading journals such as Journal of International Medical Research, Journal of Health Care Finance, Inquiry, Journal of Health and Human Services Administration, Journal of Public Budgeting, Accounting and Financial Management. Dr Younis is a frequent speaker for both academic and professional audiences. His talks often feature his latest research and work in progress as well as cross-industry trends and strategy implications. He has provided workshops and presentation for wide organizations. His research and findings applied to for-profit, non-profit settings, and government. Dr Younis has consulted with several organizations on healthcare finance, and economics. Dr Younis is often invited to speak about the challenges in the healthcare industry and other related topics to health economics, finance, and research. He has presented topics such as, healthcare reform, ownership structure, profitability, unit cost, payment system and efficiency in management, at a variety of forums and conferences in Europe, Asia and Middle East.

Hospital-related cost of sepsis: A systematic review.

OBJECTIVES: This article systematically reviews research on the costs of sepsis and, as a secondary aim, evaluates the quality of economic evaluations reported in peer-reviewed journals. METHODS: We systematically searched the MEDLINE, National Health Service (Abstracts of Reviews of Effects, Economic Evaluation and Health Technology Assessment), Cost-effectiveness Analysis Registry and Web of Knowledge databases for studies published between January 2005 and June 2015. We selected original articles that provided cost and cost-effectiveness analyses, defined sepsis and described their cost calculation method. Only studies that considered index admissions and re-admissions in the first 30 days were published in peer-reviewed journals and used standard treatments were considered. All costs were adjusted to 2014 US dollars. Medians and interquartile ranges (IQRs) for various costs of sepsis were calculated. The quality of economic studies was assessed using the Drummond 10-item checklist. RESULTS: Overall, 37 studies met our eligibility criteria. The median of the mean hospital-wide cost of sepsis per patient was $32,421 (IQR $20,745-$40,835), and the median of the mean ICU cost of sepsis per patient was $27,461 (IQR $16,007-$31,251). Overall, the quality of economic studies was low. CONCLUSIONS: Estimates of the hospital-related costs of sepsis varied considerably across the included studies depending on the method used for cost calculation, the type of sepsis and the population that was examined. A standard model for conducting cost improve the quality of studies on the costs of sepsis.

QUANTITATIVE ASSESSMENT OF SOME PREVENTIVE HEALTH SERVICES PROVIDED FOR ADOLESCENT INDIVIDUALS IN DUBAI.

The United Arab Emirate (UAE) of Dubai, faces significant adolescent health problems. In 2009, evidence based clinical guidelines were developed for primary health care professionals in Dubai to help reduce adolescent health problems. This research study explores adolescents' self-reports about health education services received between 2008 and 2010. The sample consisted of 730 public high school students in grades 10 through 12 between the ages of 15 and 19. 357 (48.9%) of the sample were males and 373 (51.1%) were female. The major language spoken in the home was Arabic (77.4%). All students completed a 27-item survey in Arabic that was adapted from the Young Adult Health Care Survey (YAHCS). The YAHCS is a 56-item research instrument traditionally administered in English and Spanish. The sample reported they had received little or no health education from their health care providers. 94.2% reported receiving no information about using a helmet for bicycle and motorbike safety; 88.2% reported receiving no information about drug use; and 81.9% reported that they received no information about smoking. The instrument also explored the health education material students received within the last 12 months. 65.5% of the sample reported seeing and/or hearing safety tips; 84.9% reported hearing and/or seeing health information about healthy diet, physical activity and exercise; and 79.2% reported seeing and/or hearing information about the risks of smoking and substance abuse.

Diabetes education program for people with type 2 diabetes: An international perspective.

BACKGROUND: In the Palestinian community, lifestyle changes, rapid urbanization and socioeconomic development, stress, smoking, and changes in food habits has increased the risk of non-communicable diseases especially diabetes mellitus. Diabetes complications can be prevented if the glycemic status of patients with diabetes is maintained within a nearly normal range. Therefore, patient education is critical in controlling blood glucose levels within the normal range. OBJECTIVE: This study aimed at measuring the effect of diabetes educational intervention program for patients suffering from type 2 diabetes attending the Diabetes Clinic in Tulkarim Directorate of Health. METHODS: A short duration observational study involving pre- and post-test educational intervention program was carried out on a relatively small number of type 2 diabetes patients at the Diabetes Clinic in Tulkarim Directorate of Health. In total, 215 patients attended a group-based 4h educational intervention session about diabetes. The program included explaining diabetes mellitus-symptoms, risk factors, types, treatment and complications and main aspects of self-care of the disease (foot care, eye care, and blood glucose monitoring), main aspects of dietary management, weight reduction, blood pressure, smoking cessation, periodic investigations, home monitoring and importance of physical activity. Knowledge evaluation questionnaire were evaluated pre- and post-study. Anthropometric measurements such as body weight (WT), body mass index (BMI) and laboratory tests such as fasting blood glucose (FBG), hemoglobin A1C (HbA1c), cholesterol (Chol), and triglycerides (TG) were measured both at the beginning and at the end of the study. Significance of the results was assessed by paired t-test at 95% confidence interval. RESULTS: The participant's mean age was 51.07 that ranged between 31 and 70 years. For a total of 215 participants, 41.4% were males and 58.6% were females. The mean weight before educational intervention was 80.81±14.95kg (82.6kg for males and 79.5kg for females) that decreased to 78.9±14.33kg (81.1kg for males and 77.3kg for females) after educational intervention program. The BMI also decreased significantly after educational intervention. The mean fasting blood sugar was 188.65±71.45mg/dL before educational intervention that decreased to 177.7±66.11mg/dL after the educational intervention (p=0.049). The mean glycosylated hemoglobin was 8.57±1.21 before educational intervention that decreased to 7.95±1.42 after educational intervention. The mean value of cholesterol before educational intervention was 183.27±37.74mg/dL that decreased to 169.57±34.23mg/dL after educational intervention. The mean triglycerides value decreased after educational intervention from 209.85±171.04mg/dL to 183.28±152.4mg/dL (p=0.025). The mean score of knowledge questionnaire before educational intervention was 60.6±20.65 that increased to 78.1±13.4 after conducting educational intervention. CONCLUSIONS: Diabetes education was found to be effective on BMI, FBG, HbA1c, Chol, TG, and knowledge. RECOMMENDATIONS: Diabetes education is a cornerstone in the management and care of diabetes and should be an integral part of health planning involving patient's family, diabetes care team, community, and decision makers in the education process.

Effect of GNI on Infant Mortality Rate in Low Income, Lower Middle Income, Upper Middle Income and High Income Countries.

Global disparities in health form a complex issue adversely affecting much of the world's population. What has been found is that national income and other general socio-economic factors are strong determinants of population health (Houweling, 2005 & Schell, 2007). In countries where resources are less, people are much less healthy than people living in rich countries. In wealthier countries that have made immense progress in health indicators, the resulting change in age structure and morbidity and mortality patterns portends even greater financial demands on the health sector. This study noted the trends in several health indicators versus economic indicators and related it to low income, lower middle income, upper middle income and high income countries. We noted that there is improvement in all health indicators along with an increasing GNI per Capita and GDP. In low income regions though, the rate of improvement is slower as opposed to high income countries. However, there is progress, which is leading to an increase in aging population.

Electronic Health Object: Transforming Health Care Systems From Static to Interactive and Extensible.

Electronic health records (EHRs) store health-related patient information in an electronic format, improving the quality of health care management and increasing efficiency of health care processes. However, in existing information systems, health-related records are generated, managed, and controlled by health care organizations. Patients are perceived as recipients of care and normally cannot directly interact with the system that stores their health-related records; their participation in enriching this information is not possible. Many businesses now allow customers to participate in generating information for their systems, strengthening customer relationships. This trend is supported by Web 2.0, which enables interactivity through various means, including social networks. Health care systems should be able to take advantage of this development. This article proposes a novel framework in addressing the emerging need for interactivity while preserving and extending existing electronic medical data. The framework has 3 dimensions of patient health record: personal, social, and medical dimensions. The framework is designed to empower patients, changing their roles from static recipient of health care services to dynamic and active partners in health care processes.

Health insurance reform and the development of health insurance plans: the case of the Emirate of Abu Dhabi, UAE.

INTRODUCTION: The Emirate of Abu Dhabi has taken concrete steps to reform health insurance by improving the access to health providers as well as freedom of choice. The growing cost of health care and the impact of the global financial crisis have meant that countries are no longer able to solely bear the cost. As a result many countries have sought to overhaul their health care system so as to share the burden of provision with the private sector whether it is health care plan providers or employers. OBJECTIVES: This article explores and discusses how the policy issues inherent in private health care schemes have been dealt with by the Emirate of Abu Dhabi. METHODS: Data was collected in early 2013 on health care plans in Abu Dhabi from government sources. RESULTS: The Abu Dhabi model has private sector involvement but the government sets prices and benefits. The Abu Dhabi model adequately deals with the problem of adverse selection through making insurance coverage a mandatory requirement. There are issues with moral hazards, which are a combination of individual and medical practitioner behavior that might affect the efficiency of the system. Over time there is a general increase in the usage of medical services, which may be reflective of greater awareness of the policy and its benefits as well as lifestyle change. CONCLUSION: Although the current health care system level of usage is adequate for the current population, as the level of usage increases, the government may face a financial burden. Therefore, the government needs to place safeguards in order to limit its exposure. The market for medical treatment needs to be made more competitive to reduce monopolistic behavior. The government needs to make individuals aware of a healthier lifestyle and encourage precautionary actions.

Health policies and intervention strategies: a description of current issues and approaches to care of the public health and health care system in the United Arab emirates.

The demographic factors of the United Arab Emirates (UAE) have changed drastically within one generation. This is evident in how quickly it has moved from a developing nation, where fishing was once the main source of income, to a country that is quite developed, competing on a global level. From one perspective, socio-economic progress has brought many benefits to the population. These include improved education, better access to health care, and safe drinking water. However, on the other hand, economic development has been the cause for changes in lifestyles, eating habits, and traditional societal and family structures. Over time, these changes have added up, creating an unprecedented impact on the population's health. This impact has crept up onto the society until suddenly a notable epidemic has become recognized in the country. According to the UAE Ministry of Health, 19.5 percent of the UAE population has diabetes, making it the second highest rate in the world. The structure and responsibilities of the current UAE health care systems along with other cultural factors were investigated in order to determine their impact on the growing epidemic.

The impact of computerized physician order entry on medication errors and adverse drug events.

OBJECTIVES: Medication errors and adverse drug events (ADEs) are common, costly, and clinically important problems. This research was conducted to determine whether computerized physician order entry (CPOE) improves the quality of care by increasing patient safety and decreasing medication errors at the King Fahad Medical City Hospital (KFMCH) of the Kingdom of Saudi Arabia (KSA). METHODS: The study utilized a cross-sectional research design. Questionnaires were distributed to physicians in various departments who used the system for more than six months. The study was conducted in Riyadh at KFMCH, which is the largest medical complex hospital in the Middle East, in the outpatient setting. KEY FINDINGS: Ninety-three physicians participated in the study; the response rate was 31 percent. Only descriptive analyses were conducted. Results showed that 88 percent of the physicians agreed that the use of CPOE improved their performance and 76 percent reported that the use of CPOE increased their productivity. In addition, 56 percent of the participants agreed that CPOE was a simple system and 64 percent reported that it was easy to use. However, 44 percent of the physicians agreed that CPOE lacked a user guide during medication ordering and 55 percent reported that it created new types of errors. Results showed that 234 physicians always changed their order, 179 physicians changed their order often, 175 physicians rarely changed their order, and 74 physicians never changed their order. Furthermore, 72 percent of the physicians agreed that CPOE helped them to decrease ADEs. Finally, 91 percent of the physicians agreed that CPOE reduced errors related to hand-written prescriptions.

Estimation of health care costs and cost recovery: the case of Rafidya Hospital in Palestine.

The purpose of this study is to develop an estimation model for health care costs and cost recovery, and evaluate service sustainability under an uncertain environment. The Palestinian National Authority's recent focus on improving financial accountability supports the need to research health care costs in the Palestinian territories. We examine data from Rafidya Hospital from 2005-2009 and use step-down allocation to distribute overhead costs. We use an ingredient approach to estimate the costs and revenues of health services, and logarithmic estimation to prospectively estimate the demand for 2011. Our results indicate that while cost recovery is generally insufficient for long-term sustainability, some services can recover their costs in the short run. Our results provide information useful for health care policy makers in setting multiple-goal policies related to health care financing in Palestine, and provide an important initiative in the estimation of health service costs.