[Evaluation of viral etiology in central nervous system infections from a university hospital point of view in Izmir based on seven years data]. / Santral sinir sistemi enfeksiyonlarinda viral etiyolojinin Izmir'de bir üniversite hastanesinin yedi yillik verileri üzerinden degerlendirilmesi.

The serious diseases of the central nervous system (CNS); encephalitis and meningitis, have high mortality and morbidity rate especially not diagnosed and treated in time. Nucleic acid testing (NAT) is the tool of choice for viral diagnosis in CNS infections. In this study, viral etiological agents found in cerebrospinal fluid (CSF) samples sent to our university hospital virology laboratory for laboratory diagnosis of CNS infections were retrospectively evaluated and results were compared with other reports from our country. Viral etiological agents found in cerebrospinal fluid (CSF) samples sent to Ege University Faculty of Medicine Department of Medical Microbiology Virology Laboratories for laboratory diagnosis of CNS infection between 01.01.2009-31.12.2015 were evaluated retrospectively. A total of 3778 CSF tests were performed for cell culture of enterovirus (EV) in 487 samples and 3291 tests for nucleic acid testing (NAT) by real time polymerase chain reaction (PCR) in herpes simplex virus 1 (HSV1), herpes simplex virus 2 (HSV2), varicella zoster virus (VZV), Epstein-Barr virus (EBV), cytomegalovirus (CMV), human herpes virus 6 (HHV6) and EV. VZV and EV NAT's were performed during the last one and five years period, respectively. NAT positive results for HSV1, HSV2, CMV, EBV, VZV, HHV6 and EV were 1.80% (24/1333), 0.08% (1/1333), 3.28% (19/580), 4.35% (22/506), 0.46% (1/216), 1.05% (5/478) and 3.37% (6/178), respectively. EV was isolated in 30 (6.20%) of 487 CSF samples by viral culture. Positive samples were mainly from pediatric, neurology and infectious diseases clinics as expected. The number of higher positive results were found in samples sentin december (35.3%), july (12.9%) and november (10.6%). Overall 80% of positive samples belonged to patients over 18 years old. When the results of other studies reported from Turkey are examined, although the positivity rates are generally similar, it is seen that the rates specific to certain factors are higher in selected smaller patient groups like HSV1 and EV. Rapid nucleic acid tests like multiplex PCR and microarray will provide more practical and effective laboratory diagnosis approach in CNS infections, since many more microorganisms may be causative agents.

[Stigma of tuberculosis scale: validity and reliability]. / Tüberküloz Damgalanma Ölçegi: Geçerliligi ve güvenilirlik.

INTRODUCTION: In many health conditions, stigma is receiving increasing attention. Public stigmatization toward social illness can affect particularly the patients and family memberships to help seeking behavior and treatment. This study, the aim of this study was to investigate the validity and reliability of the Turkish "Stigma of Tuberculosis Scale " which was developed to evaluate of perception of stigma with tuberkulosis patient. PATIENTS AND METHODS: This methodological study was conducted with 150 with tuberculosis disease people who above 18 age and without known psychological and mental disability. In the study, "Stigma of Tuberculosis Scale" was used as data collection tool. During the study, language equivalence, content validity, reliability and construct validity of the scale was performed. The data was assessed by using mean, median, standard deviation, Spearman Correlation, Cronbach Alpha coefficient and confirmatory factor analysis. RESULTS: The mean age of study participants was 45.6 ± 16.1 (20 - 85). years. Spearman correlation coefficient of the scale for test-retest reliability was 0.853 and the Cronbach Alpha coefficient was 0.95. According to fit indexes of confirmatory factor analysis [x2/SD= 481.38/230= 2.09; RMSEA= 0.087; GFI= 0.776; CFI= 0.776; NNFI= 0.875] it was found that one factors were appropriate for the scale. CONCLUSION: The adoption of the translated "Stigma of Tuberculosis Scale"in Turkey is found reliable and valid to evaluate of perception of stigma with tuberkulosis patient.

The PUFFinCA scale: development of an instrument for evaluating the primary care functions of family physicians in childhood asthma.

AimTo develop the Primary care fUnctions oF Family physicians in Childhood Asthma (PUFFinCA) scale for evaluating the cardinal process functions of primary care services (accessibility, comprehensiveness, continuity and coordination) provided by family physicians (FPs) in the management of childhood asthma. BACKGROUND: In the literature on the functions of primary care, there is no assessment tool focusing on children with asthma. Primary care assessment scales adapted to various languages are not suitable to adequately address the needs of special patient groups, such as children with asthma. METHODS: In this methodological study, the instrument development process was completed in four stages: establishing the pool of items, evaluating the content validity, applying the scale and statistical analysis. The scale was applied to 320 children who had asthma and received care in the clinic of the Department of Pediatrics, Division of Allergy and Pulmonology at Ege University School of Medicine, Turkey. The Cronbach's α and Spearman-Brown coefficient were calculated to determine the reliability of the scale. Principal component analysis was used to determine the construct validity of the scale.FindingsThe PUFFinCA scale was found to have four-factor structure and 25 items. Cronbach's α coefficient was 0.93. It has been determined that the reliability was excellent and the item-total correlation coefficients were >0.30 each. The factors were titled FP's 'functions of accessibility, first contact and continuity', 'functions of coordination and comprehensiveness of health services related to asthma management', 'provision of preventive care related to asthma' and 'provision of services for paid vaccinations'.

The influence of a market-oriented primary care reform on family physicians' working conditions: A qualitative study in Turkey.

BACKGROUND: Turkey has undergone a 'Health transformation programme' putting emphasis on the reorganization of primary care (PC) services towards a more market-oriented system. OBJECTIVES: To obtain a deep understanding of how family physicians (FPs) experienced the process of the reforms by focusing on working conditions. METHODS: This phenomenological and qualitative research used maximum variation sampling and 51 FPs were interviewed in 36 in-depth and four focus-group interviews. RESULTS: Thematic analysis of interviews provided seven themes: (1) change in the professional identity of PC physicians (physician as businessperson); (2) transformation of the physician-patient relationship in PC (into a provider-customer relationship); (3) job description and workload; (4) interpersonal relationships; (5) remuneration of FPs, (6) uncertainty about the future and (7) exhaustion. Most FPs felt that the Family medicine model (FMM) placed more emphasis on the business function of family practice and this conflicted with their professional characteristics as physicians. FPs complained that some of their patients behaved as extremely demanding consumers. Continuously increasing responsibilities and extremely high workload were commonly reported problems. Most participants described the negative incentives in the performance scheme as a degrading method of punishment. The main factor was job insecurity caused by contract-based employment. FPs described the point at which they are with terms such as exhaustion. CONCLUSION: By increasing workload and creating uncertainty about the future and about income, the PC reforms have led to working conditions, which has led to changes in the professional attitudes of physicians and their practice of medicine.