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The Anatolian Journal of Family Medicine - anatol j fm: 2 (2)
Volume: 2  Issue: 2 - 2019
1.From the Editor
Mustafa Reşat Dabak
Page I

2.Migration, Public Health, and Low-Threshold Health Services in Italy: A Culturally-Oriented Approach for Roma Communities
Pietro Vulpiani
doi: 10.5505/anatoljfm.2019.36844  Pages 45 - 52
Public health authorities and healthcare providers are often unable to overcome their rigid bureaucratic limits and offer low-threshold health services to vulnerable ethnic minorities, such as the Roma communities. Roma people frequently face institutional, juridical, social, economic, and cultural obstacles in the course of their access to appropriate, effective, and high-quality healthcare. In Italy, Roma people experience difficulties such as cultural constraints and discrimination while accessing health services. For this reason, in recent years, public healthcare institutions have been experimenting with innovative approaches aimed at overcoming inequalities and discriminations associated with the access to health care through cooperation between private and public health and the active involvement of the Roma communities. The implementation of low-threshold services have specific requirements such as; a strong commitment toward public health at the national, regional, and local levels; joint local networks of well-trained healthcare professionals, non-medical personnel, and civil society organizations; tailor-made projects addressing Roma with respect to the public health facilities; monitoring the access to the healthcare facilities of Roma; promoting direct interaction between healthcare providers and Roma; cultural mediation; actively involving Roma communities in overcoming the mistrust of and prejudice toward healthcare providers and medical facilities; promoting a healthy lifestyle in Roma households by fostering routine screenings, immunization, and medical appointments and respecting medical pharmacological therapies. To improve the Roma communities’ health in Italy, we have proposed a culturally-oriented model that offers a methodological approach beyond prejudice to improve access to healthcare.

3.The Earthquake Preparedness Status of Kafkas University Faculty Members
Multehan Evran, Eyüp Eryaman, Mehmet Yusuf Gögebakan, Hacer Ayar, Mehmet Mutlu, Elif Gögüs, Binali Çatak
doi: 10.5505/anatoljfm.2019.08208  Pages 53 - 57
INTRODUCTION: Turkey is home to one of the world's most active seismic belts, the North Anatolian Fault Zone. Severe earthquakes occur in the region, and particularly in areas near the fault line. Education and the establishment of an attitude of earthquake awareness and preparedness can reduce the destructive effect of these natural disasters. The objective of the present study was to determine the earthquake preparedness level of instructors at Kafkas University.
METHODS: Instructors from the Faculty of Medicine, Veterinary Medicine, Educational Sciences, Economics and Administrative Sciences, and Arts and Sciences at Kafkas University were included in this descriptive study. Two questionnaires were used to conduct this research: The first recorded demographic details of the respondents, and the second questionnaire was an Earthquake Preparedness Form based on the Revised and Translated Mulilis–Lippa Earthquake Preparedness Scale.
RESULTS: The mean score of the instructors in the Faculty of Veterinary Medicine was 9.16±3.27, while it was 9.04±3.26 for members of the Faculty of Economics and Administrative Sciences, 7.76±3.33 for the Faculty of Arts and Sciences, 7.48±3.26 for the Faculty of Medicine, and 7.16±3.16 for the Faculty of Educational Sciences.
DISCUSSION AND CONCLUSION: The survey revealed that even well-educated university faculty members are not ready for an earthquake. Additional efforts are needed to prepare the community for a natural disaster.

4.Prevalence of Tobacco Use in University Public Employees and Evaluation of Their Knowledge, Attitudes and Behaviors on This Subject
Kamile Marakoğlu, Gülbahar Ürün Ünal
doi: 10.5505/anatoljfm.2019.47965  Pages 58 - 67
INTRODUCTION: In this study, we aimed to investigate the factors related to tobacco and cigarette smoking status, knowledge, attitudes, and behaviors of public employees of the Selçuk University.
METHODS: This study was planned to determine the frequency of use of tobacco and its products and the attitudes and behaviors of 458 public employees of the Selçuk University between 2017 and 2018. A questionnaire consisting of 39 questions including the factors affecting the use/cessation status of tobacco and its products and the knowledge, attitudes, and opinions of the public employees of the university was applied.
RESULTS: The mean age of the 458 people studied was 39.21±10.26; of them, 64.6% were males and 35.4% were females. In general, the frequency of using tobacco and smoking was 32.1%. Among the university public employees, the frequency of tobacco and cigarette smoking status of medical faculty teaching staff and research staff was 23.2% and that of medical faculty nurses and other health staff was 38.0%. Tobacco and cigarette smoking in males (38.2%) was statistically significantly higher than in females (21.0%) (p=0.000). The smoking rate was 26.6% and the smoking prevalence among medical faculty members (17.9%) was lower compared to those of other health professionals (35.4%) and academic staff (26.0%) (p=0.053). Among the university employees, the smoking rate in males (33.1%) was statistically significantly higher than in females (14.8%) (p=0.000). The frequency of narghile use was 11.1%, hand-rolled tobacco use 7.0%, cigar use 6.1%, pipe use 1.5%, and chewing tobacco use 0.4%.
DISCUSSION AND CONCLUSION: The fact that the frequency of using tobacco and cigarette is 32.1% and the cigarette smoking rate is 26.6% among the university public employees in our study reveals that tobacco and cigarette use is still a great problem.

5.Knowledge, Attitude, Practice, and Associated Factors of Health Extension Professionals with Regard to Mental Illness in West Amhara, Ethiopia
Taye Zeru Tadege, Demeke Endalamawu Alamneh
doi: 10.5505/anatoljfm.2019.08370  Pages 68 - 72
INTRODUCTION: Between 76% and 85% of people with severe mental disorders receive no treatment in low-income and middle-income countries; the corresponding range for high-income countries is high, ranging between 35% and 50%. Approximately 20%–30% of primary care attendees apply primarily due to emotional problems. The majority of these cases often remain unrecognized, misdiagnosed, and inappropriately managed. Currently, mental health is one of the health extension programs. So we aim to examine knowledge, attitude, practice, and associated factors of health extension professionals with regard to mental illness in West Amhara, Ethiopia.
METHODS: This cross sectional study was conducted from March to December 2017 in West Amhara, Ethiopia, on health extension professionals. Data were analyzed using logistic regression, and the level of significance of association was determined as a p-value <0.05.
RESULTS: A total of 650 Health Extension Workers were selected, and the response rate was 623 (96%). A total of 71.9% of health extension professionals had good knowledge with regard to mental illness, and 65.5% had a positive attitude toward mental illness, while 60% have never practiced mental health services. 64.8% of health extension professionals did not refer any case of mental illness in the past 3 months. A basic psychiatric training is significantly associated with good knowledge, positive attitude, and practice.
DISCUSSION AND CONCLUSION: This study showed that the knowledge was satisfactory, that a significant number of health extension professionals had a favorable attitude, and that also only a low number of health extension professionals practiced mental health in their working area. Thus, a basic mental health training should be arranged for health extension professionals.

6.Evaluation of Levels of Serum IgE and Rectal Mucosal Eosinophilia in Irritable Bowel Syndrome
Esra Elif Akkuş, Sabah Tüzün, Kayhan Başak, Kürşat Epöztürk, Mehmet Sayıner, Mustafa Reşat Dabak
doi: 10.5505/anatoljfm.2018.25733  Pages 73 - 77
INTRODUCTION: Irritable bowel syndrome (IBS) and food allergic reactions are common in the community and can cause symptoms similar to each other. In this study, it is aimed to evaluate serum immunglobulin E (IgE) and rectum mucosal eosinophilia levels in IBS.
METHODS: Record of patients who applied between April 2013 and April 2014 were retrospectively screened and patients who were 18–70 years old and previously performed rectal biopsy by colonoscopy and diagnosed with IBS according to Rome III criteria were included in the study. All patients were grouped as diarrheal dominant IBS (IBS-D), constipation dominant IBS (IBS-C), mix type IBS (IBS-M) and unclassified IBS (IBS-U) according to their symptoms. In addition, serum IgE levels and rectal mucosal eosinophilia levels were evaluated from all patients' records.
RESULTS: 39 (56.52%) of total 69 patients with IBS were in the IBS-C group, 19 (27.54%) of them were in the IBS-D, 9 (13.04%) of them were in the IBS-M and 2 (2.90%) of them were in the IBS-U. There were not any significant differences between IBS subgroups in terms of presence of allergic disease and presence of food allergy (p=0.519 and p=0.849, respectively). The median level of rectal eosinophilia in IBS subgroups was found to be 2.00 (0.00 to 88.00) in IBS-C subgroup, 5.00 (0.00–100.00) in IBS-D subgroup and 2.00 (0.00 to 11.00) in IBS-M subgroup. In addition, IgE levels were found high in 7 (19.45%) of IBS-C subgroup, 7 (36.84%) of IBS-D subgroup and 3 (33.33%) of IBS-M group (p=0.348).
DISCUSSION AND CONCLUSION: In this study, relation between serum IgE and rectal eosinophilia levels with IBS subgroups could not not found.

7.Non-ST Elevation Acute Coronary Syndrome With Atypical Symptoms
Güzin Zeren Öztürk, Elif Serap Esen, Dilek Toprak
doi: 10.5505/anatoljfm.2018.63825  Pages 78 - 81
The main cause of death and poor prognosis after acute coronary syndrome (ACS) is the prevalence of longterm myocardial ischemia and necrosis. Early diagnosis and treatment of these patients can reduce morbidity and mortality from the most important factors of survival and rapid treatment. The most important barrier is delayed diagnosis of atypical symptoms. In this article, we present a phenomenon that is overlooked by atypical symptoms of non-ST-ACS.

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