Striking at the nation's highly populated industrial heartlands, two massive earthquakes in 1999 killed over 25,000 people in Turkey. The economic cost and the humanitarian magnitude of the disaster were unprecedented in the country's history. The crisis also underscored a major flaw in the organization of mental health services in the provinces that were left out of the 1961 reforms that aimed to make basic health services available nationwide. In describing the chronology of the earthquakes and the ensuing national and international response, this article explains how the public and governmental experience of the earthquakes has created a window of opportunity, and perhaps the political will, for significant reform. There is an urgent need to integrate mental health and general health services, and to strengthen mental health services in the country's 81 disparate provinces. As Turkey continues her rapid transformation in terms of greater urbanization, higher levels of public education, and economic and constitutional reforms associated with its projected entry into the European Union, there have also been growing demands for better, and more equitably distributed, health care. A legacy of the earthquakes is that they exposed the need for Turkey to create a coherent, clearly articulated national mental health policy.

This study investigated the impact of working for public versus private ambulance services in Turkey and elaborated on predictors of mental, physical, and emotional well-being in emergency medical technicians (EMT-Bs). In this observational cross-sectional study, an 81-question self-report survey was used to gather data about employee demographics, socioeconomic status, educational background, working conditions, and occupational health and workplace safety (OHS), followed by the 12-item General Health Questionnaire (GHQ-12), the Work-Related Strain Inventory (WRSI), and the Maslach Burnout Inventory (MBI) with three subscales: Emotional Exhaustion (MBI-EE), Depersonalization (MBI-DP), and Diminished Personal Accomplishment (MBI-PA). In 2011, 1,038 EMT-Bs worked for publicly operated and 483 EMT-Bs worked for privately owned ambulance services in Istanbul, Turkey, of which 606 (58.4%) and 236 (48.9%) participated in the study (overall participation rate = 55.4%), respectively. On all scales, differences between total mean scores in both sectors were statistically insignificant (p > .05). In the public sector, work locations, false accusations, occupational injuries and diseases, work-related permanent disabilities, and organizational support were found to significantly influence self-reported perceptions of well-being (p < .05). In the private sector, commute time to and from work (p < .05), false accusations (p < .05), vocational training and education (p < .05), informed career choices (p < .05), and work-related permanent disabilities (p < .05) were found to significantly influence self-reported perceptions of well-being. EMT-Bs were asked about aspects of their working lives that need improvement; priority expectations in the public and private sectors were higher earnings (17.5%; 16.7%) and better social opportunities (17.4%; 16.8%). Working conditions, vocational training, and OHS emerged as topics that merit priority attention.

Öz Amaç: Çalışmamızda ailelerin çeşitli beyin hasarlarına yol açabilen sarsılmış bebek sendromuna dair bilgi düzeylerini ölçmeyi amaçladık. Gereç ve Yöntemler: Çalışma Ocak-Mart 2016 tarihleri arasında %8,6'sı (n=16) baba, %91,4'ü anne (n=170) olmak üzere toplam 186 ebeveynle gerçekleştirildi. Ebeveynlerin bebeklerini avutma yöntemleri ve sarsılmış bebek sendromu hakkındaki bilgi düzeyi 32 soruluk anketle değerlendirildi. Anketin nominal soruları dışındaki sorular için güvenilirlik analizi Cronbach alfa katsayısı %85 olarak bulundu. Bulgular: Ebeveynlerin sarsılmış bebek sendromu hakkında bilgi sahibi olma oranı %16 olarak belirlendi. "Bebeği sarsmanın bebeğe zararı var mıdır?" sorusuna %87,6 "Evet" yanıtını verirken, annenin eğitim durumunun verilen yanıtlarda istatistiksel açıdan anlamlı fark oluşturduğu görüldü (p=0,019). Annenin eğitim düzeyi ile bebeklerin ayakta sallanması durumu karşılaştırıldığında fark anlamlı bulundu (p=0,001). Aynı karşılaştırmada kız ve erkek bebeği olan ebeveynler arasında anlamlı fark olduğu belirlendi (p=0,045). Tartışma ve Sonuç: Ebeveynlerin sarsılmış bebek sendromuna ve bebek avutma yöntemlerine dair bilgisinin yetersiz olduğu görülmüştür. Bu konularda verilecek eğitim sarsılmış bebek sendromunu önlemede önemli sonuçlar verebilir.

Background Pandemics threaten lives and economies. This article addresses the global threat of the anticipated overlap of COVID-19 with seasonal-influenza. Objectives Scientific evidence based on simulation methodology is presented to reveal the impact of a dual outbreak, with scenarios intended for propagation analysis. This article aims at researchers, clinicians of family medicine, general practice and policy-makers worldwide. The implications for the clinical practice of primary health care are discussed. Current research is an effort to explore new directions in epidemiology and health services delivery. Methods Projections consisted of machine learning, dynamic modelling algorithms and whole simulations. Input data consisted of global indicators of infectious diseases. Four simulations were run for ‘20% versus 60% flu-vaccinated populations’ and ‘10 versus 20 personal contacts’. Outputs consisted of numerical values and mathematical graphs. Outputs consisted of numbers for ‘never infected’, ‘vaccinated’, ‘infected/recovered’, ‘symptomatic/asymptomatic’ and ‘deceased’ individuals. Peaks, percentages, R0, durations are reported. Results The best-case scenario was one with a higher flu-vaccination rate and fewer contacts. The reverse generated the worst outcomes, likely to disrupt the provision of vital community services. Both measures were proven effective; however, results demonstrated that ‘increasing flu-vaccination rates’ is a more powerful strategy than ‘limiting social contacts’. Conclusions Results support two affordable preventive measures: (i) to globally increase influenza-vaccination rates, (ii) to limit the number of personal contacts during outbreaks. The authors endorse changing practices and research incentives towards multidisciplinary collaborations. The urgency of the situation is a call for international health policy to promote interdisciplinary modern technologies in public health engineering.

Turkey has historically been a country of origin, transit and destination for migrants. Following the first entry to Turkey in 2011, the Syrian "influx" arrived in unexpected masses and individually. In June of 2019, Turkey continues to host 3,613,644 registered Syrians under temporary protection, of which 546,296 reside in Istanbul. Turkey is the country with the world's largest population and Istanbul is the city with the highest numbers of Syrians. During a time of unprecedented international migration and unparalleled human suffering, health care administrators of Istanbul as torchbearers, present experiences which will help lead the future of international migration. In this manuscript-effort they present lessonslearned for the world to benefit from. The transformation from "emigration" to "immigration" may transform the host country's demographic structure, from the standpoint that "emigration" defines departing from one's natural home; whereas, "immigration" implies permanent residence. Authors draw attention to policy considerations for integration. The major concern that "universal responsibility should spread more evenly across countries in times of global humanitarian need" is emphasized. Keywords: International migration, public health, international health care management, humanitarian assistance, emergency and disaster medical bütünleşmeye imkân sağlayacak sağlık politikaları değerlendirilmektedir. Küresel çapta insani ihtiyaçlar belirdiğinde, evrensel sorumluluklar ülkeler arasında daha adil şekilde paylaştırılmalıdır. Bu temel kaygı vurgulanmaktadır.