Low levels of high density lipoprotein cholesterol (HDL-C) are associated with increased risk of coronary heart disease and, in the United States, are often associated with hypertriglyceridemia and obesity. In Turkey, low HDL-C levels are highly prevalent, 53% of men and 26% of women having HDL-C levels Ͻ 35 mg/dl, in the absence of hypertriglyceridemia and obesity. In this study to investigate the cause of low HDL-C levels in Turks, various factors affecting HDL metabolism were assessed in normotriglyceridemic Turkish men and women living in Istanbul and in non-Turkish men and women living in San Francisco. Turkish men and women had significantly lower HDL-C levels than the San Francisco men and women, as well as markedly lower apolipoprotein A-I levels (25 and 39 mg/dl lower, respectively). In both Turkish and non-Turkish subjects, the mean body mass index was Ͻ 27 kg/m 2 , the mean triglyceride level was Ͻ 120 mg/dl, and the mean total cholesterol was 170-180 mg/dl. The mean hepatic triglyceride lipase activity was 21% and 31% higher in Turkish men and women, respectively, than in non-Turkish men and women, and remained higher even after subjects with a body mass index Ͼ 50th percentile for men and women in the United States were excluded from the analysis. As no dietary or behavioral factors have been identified in the Turkish population that account for increased hepatic triglyceride lipase activity, the elevation most likely has a genetic basis.

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In the course of the COVID-19 pandemic, it has become clear that primary healthcare systems play a critical role in clinical care, such as patient screening, triage, physical and psychological support and also in promoting good community advice and awareness in coordination with secondary healthcare and preventive care. Because of the role of social and environmental factors in COVID-19 transmission and burden of disease, it is essential to ensure that there is adequate coordination of population-based health services and public health interventions. The COVID-19 pandemic has shown the primary and community healthcare (P&CHC) system’s weaknesses worldwide. In many instances, P&CHC played only a minor role, the emphasis being on hospital and intensive care beds. This was compounded by political failures, in supporting local community resilience. Placing community building, social cohesion and resilience at the forefront of dealing with the COVID-19 crisis can help align solutions that provide a vision of ‘planetary health’. This can be achieved by involving local well-being and participation in the face of any pervasive health and environmental crisis, including other epidemics and large-scale ecological crises. This paper proposes that P&CHC should take on two critical roles: first, to support local problem-solving efforts and to serve as a partner in innovative approaches to safeguarding community well-being; and second, to understand the local environment and health risks in the context of the global health perspective. We see this as an opportunity of immediate value and broad consequence beyond the control of the COVID-19 pandemic.

Background:In recent years, so many people have left their counties because of the war or social, political and economic reasons. This study aims to evaluate the applications of Syrian refugees to a public health center to describe the health care provided to them. Method:The study is intended as a two-part in regard with the mixed design of the study. The first part planned as single-center, descriptive study to be performed with health records of the Syrian asylum seekers and refugees admitted İzmir-Karabaglar community health center within one year. In the second part semi-structured interviews with three doctors who were working in the same center, taking care of Syrian patients, was planned to understand their experiences and views on this service. For quantitative data SPSS for windows 20 program is used and descriptive analysis are performed. Thematic analysis was used for evaluating interviews. Results: 891 applications were made to Karabaglar community health center within one year and the median of the applicants was 4. The most prevalent reason for application was enfections (519; 58.2%) and the number of refugees who applied for preventive care was very low ( (90; 10.1%). The number of laboratory tests was 41 (4.6%) patients and the most requested test was urinary analysis. 502 (56.3%) application resulted with a prescription, the number of antibiotics and analgesics were the highest. Doctors who provide service were not satisfied with the care they give. They were having very deep communication problems related with both different cultur and language, hard time to understand patient and the disease. They stated that there is a need of different regulations. Conclusions: Refugees and asylum seekers do not receive the necessary health care they need. Physicians in primary care who take care of these people are thinking that they are not competent and not helpful for these patients. ÖZETGiriş: Son yıllarda milyonlarca insan, savaşlar başta olmak üzere siyasi, ekonomik ve sosyal sebeplerle öz vatanlarından ayrılarak yabancı ülkelere sığınmak zorunda kalmıştır. Çalışmamızda, sayıları gittikçe artan Suriyeli sığınmacıların, aldıkları birinci basamak sağlık hizmetlerini tanımlayabilmek amacı ile bir toplum sağlığı merkezine yapılan bir yıllık başvurular değerlendirilmiştir. Yöntem: Çalışma karma desende olup, iki aşamalı olarak tasarlanmıştır. İlk aşamada, İzmir-Karabağlar toplum sağlığı merkezine bir yıl içerisinde başvuran Suriyeli sığınmacı hastalara ait kayıtlardan elde edilen verilerle, tek merkezli, tanımlayıcı bir araştırma olarak planlanmıştır. İkinci bölümde ise, aynı birimde Suriyeli sığınmacılara, poliklinikte hizmet veren üç doktorla yarı yapılandırılmış görüşme yapılarak deneyimlerini ve görüşlerini aktarmaları istenmiştir. Kantitatif veriler, SPSS 20 programında değerlendirilerek tanımlayıcı analizler yapılmış, görüşmeler ise tematik analiz yöntemi ile değerlendirilmiştir. Bulgular: Karabağlar Toplum Sağlığı Merkezi'ne, bir yıl içerisinde yapılan başvuru sayısı 891 olup, ortanca yaş 4 olarak b...

Background:The coronavirus disease 2019 (COVID-19) pandemic has affected every country on earth, and family physicians (FPs) have helped patients at every stage. The first objective of our study was to study the FPs' knowledge about COVID-19 and second objective was to assess their attitudes, stress and death anxiety surrounding the current pandemic. Materials and Methods: An online questionnaire was prepared to collect responses from FPs between March-April 2020. A descriptive and correlational design was utilized. Results: 240 FPs from eight countries were evaluated. The majority reported that they received most information from medical journals (77%). Most of the respondents also noted that the most common symptoms were acute respiratory syndrome and fever -with the most effective treatment in most cases consisting of symptomatic treatment (41%). Although FPs generally had a positive attitude, most of them (68%) were concerned about contacting COVID-19 from patients and as a result, they experienced increased stress (64%). Conclusion:The research was conducted during the COVID-19 outbreak while the FPs were working on the frontline of the pandemic. This research revealed that most of the FPs had good knowledge of, and a positive attitude towards COVID-19 treatment. It was observed that participants who tended towards conscientiousness, emotional stability, and openness to experience, and who had higher life satisfaction, and lower levels of death anxiety also reported more positive attitudes towards COVID-19. While the main target population of COVID-19 disease were the older age groups, FPs' attitudes and fear levels were not associated with age, gender, or years of experience.

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Unmanned aerial vehicle (UAV) is increasingly being used in different sectors, including public health. Common applications of UAVs in public health are delivering logistics in remote areas, transporting biomedical samples, providing community-based health care, and public health surveillance. UAVs have contributed to efficient public health ensuring better health services activities at a lower cost. Across diverse health-care settings, UAVs are used to minimize human labor and physical barriers such as distance or hazards associated with different tasks. This technology has shown notable success in advancing public health in resource-constrained countries. In Rwanda, the use of UAVs has resulted in robust logistic support and improved vaccine coverage. Faster transportation and coordination between points of health services have facilitated the overall health service delivery. Despite these advancements, there are several challenges in using UAVs in public health, which include technical difficulties in operating UAVs, maintenance of devices and systems, regulatory challenges, safety concerns, air traffic congestion, and cost of using UAVs. These challenges should be addressed with empirical research and innovative interventions to leverage UAVs in preventing health-care problems and saving lives around the world.

Despite common use of primary health-care systems, with regard to tertiary hospital presentation, the most important factors for preferring tertiary hospital presentation were caregiver trust in tertiary hospital resources for diagnosis and treatment.