Organization of primary care.

Strong primary care does not develop spontaneously but requires a well-developed organizational planning between levels of care. Primary care-oriented health systems are required to effectively tackle unmet health needs of the population, and efficient primary care organization (PCO) is crucial for this aim. Via strong primary care, health delivery, health outcomes, equity, and health security could be improved. There are several theoretical models on how primary care can be organized. In this position paper, the key aspects and benchmarks of PCO will be explored based on previously mentioned frameworks and domains. The aim of this position paper is to assist primary care providers, policymakers, and researchers by discussing the current context of PCO and providing guidance for implementation, development, and evaluation of it in a particular setting. The conceptual map of this paper consists of structural and process (PC service organization) domains and is adapted from frameworks described in literature and World Health Organization resources. Evidence we have gathered for this paper shows that for establishing a strong PCO, it is crucial to ensure accessible, continuous, person-centered, community-oriented, coordinated, and integrated primary care services provided by competent and socially accountable multiprofessional teams working in a setting where clear policy documents exist, adequate funding is available, and primary care is managed by dedicated units.

Assessment of individuals' attitude, knowledge and anxiety towards COVID-19 at the first period of the outbreak in Turkey: A web-based cross-sectional survey.

OBJECTIVE: The aim of this study is to evaluate the attitude, knowledge and anxiety status of individuals about COVID-19 at the first period of the outbreak. METHODS: This was an observational study carried out in Turkey. An online semi-structured questionnaire was developed by using google forms and the link of the questionnaire was sent through emails, WhatsApp and other social media to the contacts of the investigators between 20th March 2020 and 25th March 2020. The questionnaire contained 21 questions and Beck anxiety scale. RESULTS: About 1070 people were included in the study. Approximately one-fifth of the participants had no idea about treatment and immunisation against COVID-19. According to the categorisation of Beck Anxiety Inventory scores 8.6% showed severe anxiety symptoms. Anxiety levels of women, healthcare workers and those with psychiatric illness were higher (P < .05). It was observed that women, healthcare professionals, those with chronic diseases and those with moderate to severe anxiety used the medical facemask more frequently (P < .05). About 73% of the participants thought that they fully implemented the proposed measures; 25.2% of them stated that population did not take any measures for the COVID-19. CONCLUSION: According to the results of the study individuals usually had better awareness and positive attitudes towards COVID-19 pandemic, but there were also things that needed improvement. The most important measure to be taken in order to prevent anxiety from increasing is to ensure the correct access of information and to establish psychological support lines.

Quality assessment of clinical practice guidelines for management of type 2 diabetes mellitus: Assessment of type 2 diabetes mellitus guidelines.

AIMS: Diabetes mellitus is one of the most significant global health emergencies of the 21st century. Every year, an increasing number of people succumb to the condition and therefore suffer life-changing complications. So management of this disease has an important role to prevent complications. In this study, our objective is to assess the quality of guidelines related to the significant public health problem diabetes that have been developed by international and national organizations using the AGREE II tool. METHODS: This observational study assesses the quality of clinical practice guidelines used in the management of diabetes with AGREE II tool. Statistical analysis was performed using the SPSS 20 program package. RESULTS: The overall quality score of the guidelines ranges between 3 and 6.25. While NICE's guidelines scored the highest, the guidelines of the National Diabetes Foundation scored the lowest. CONCLUSION: More comprehensive studies are needed for assessing the quality of guidelines in every subject.

Quality Assessment of Clinical Practice Guidelines Developed by Professional Societies in Turkey.

BACKGROUND: Clinical practice guidelines (CPGs) are systematically developed statements to assist practitioner and patient decisions about appropriate healthcare for specific clinical circumstances. There is a limited number of studies on guidelines in Turkey. The quality of Ministry of Health guidelines have formerly been assessed whereas there is no information on the other guidelines developed in the country. AIM: This study aims to assess the quality of CPGs that are developed by professional societies that work for the health sector in Turkey, and compare the findings with international guidelines. METHODOLOGY: Professional societies that work for the health sector were determined by using the data obtained from the Ministry of Internal Affairs. Inclusion and exclusion criteria were defined for selecting the CPGs. Guidelines containing recommendations about disease management to the doctors, accessible online, developed within the past 5 years, citing references for recommendations, about the diseases over 1% prevalence according to the "Statistical Yearbook of Turkey 2012" were included in the study. The quality of CPGs were assessed with the AGREE II instrument, which is an internationally recognized tool for this purpose. Four independent reviewers, who did not participate in the development of the selected guidelines and were trained in CPG appraisal, used the AGREE instrument for assessment of the selected guidelines. FINDINGS: 47 professional societies were defined which provided access to CPGs in their websites; 3 of them were only open to members so these could not be reached. 8 CPGs from 7 societies were selected from a total of 401 CPGs from 44 societies. The mean scores of the domains of the guidelines which were assessed by the AGREE II tool were; SCOPE AND PURPOSE: 64%, stakeholder involvement: 37.9%, rigour of development: 35.3%, clarity and presentation: 77.9%, applicability: 49.0% and editorial independence: 46.0%. CONCLUSION: This is the first study in Turkey regarding quality appraisal of guidelines developed by the local professional societies. It adds to the limited amount of information in the literature that comes from Turkey as well as other developing countries.