Hepatitis-B immune status and vaccination in Family Medicine Practice: A retrospective study.

Objective: To examine the relationship between Hepatitis B vaccination status and demographic and hepatitis B markers of individuals receiving healthcare services. Methods: The study designed in a retrospective structure using quantitative research methods was conducted with a total of 1837 individuals including medical school students and other healthcare professionals (975 female, 862 male) aged 19-77 who were registered to the Family Health Center between March 1, 2023, and March 31, 2023. In the study, sociodemographic characteristics, infancy and adult full-dose hepatitis-B vaccines, and marker laboratory measurements of these individuals who were registered to the Family Health Center were examined. SPSS 25.00 program was used for statistical analysis and the level of significance was determined as 0.05. Results: In general, the rate of three doses of vaccination in infancy was 55.1%. Vaccine doses administered to individuals were one with 15.1%, two with 22.9%, and three with 62.1%. In the study, it was determined that anti-HBs levels before and after vaccination differed significantly according to vaccine doses (p=0.01). It was determined that the anti-HBs levels of the three doses vaccine group were 100 and above (p=0.01). Conclusion: Although the Universal Hepatitis-B Vaccination Program was followed in our study, it was determined that antibody levels in healthcare workers decreased or ended over time, and hepatitis-B antibody levels increased significantly with each dose of vaccine administered. For this reason, it is of great importance to determine regular antibody levels and develop standard vaccination programs, especially in healthcare workers.

ABO and RhD blood groups and their relationship with diseases: A retrospective study.

Objective: To retrospectively evaluate the distribution of ABO and RhD blood groups and their relationship with diseases. Methods: The retrospective study was carried out in Bursa Uludag University Family Health Center in Turkey between 1-28 February, 2023. The data of individuals who were registered with the Family Health Center and whose blood types were known were evaluated retrospectively. Blood group type, sociodemographic findings, existing diseases, allergies, and genetic disease conditions were obtained. P-values below 0.05 were considered statistically significant. Analysis were made in the SPSS 25.0 program. Results: A total of 3834 people, 1935 male (50.5%) and 1899 female (49.5%) participated in the study. The mean age of the individuals was 26.45±10.45 years. About 75.8 percent of the participants were university students, 6.3 percent were health workers, and 17.9 percent were from other occupational groups. The rates of blood groups were determined as O Rh D+ at 33.5%, AB Rh D+ at 26.9%, A Rh D+ at 14.9%, AB Rh D- at 7.7%, B Rh D+ at 7%, O Rh D- at 4.6%, B Rh D- at 3.2% and A Rh D- at 2.2%. It was determined that the O Rh D- group had a higher rate of genetic disease than the other groups (p=0.01). Conclusion: It was determined that the O Rh D+ blood group was found more frequently in our region's population than in other groups. This different result depending on the A Rh D+ blood group, which is the most common throughout the country may have reflected the influence of different geographical regions and ethnic characteristics due to the students in our population. In addition, the results regarding the relationships between blood groups and occupation, genetics, existing disease, presence of allergies, and visual defects in the eye are important.

The Effect of Regular Exercise and its Duration on Metabolic Parameters.

Regular exercise is crucial for regulating metabolic parameters. This retrospective study aimed to evaluate the effects of regular exercise duration on glycaemic and metabolic parameters, insulin resistance, and atherogenic indices in individuals attending a single-family health centre. A total of 403 individuals were divided into three groups based on their exercise status as Group A with no regular exercise, Group B with <150 minutes, and Group C with ≥150 minutes of regular excercise per week. The demographic and clinical data were collected from the subjects' records. The median age in Group A was significantly higher than in Group B and C, the median weight of Group A and B was significantly lower than in Group C, and high-density lipoprotein cholesterol level was significantly higher in Group B than in C. Type 2 diabetes percentage was significantly higher in Group C compared to B. Other glycaemic and metabolic parameters, insulin-resistance, and atherogenic indices were similar among the three groups. The results of this study indicated that subjects with higher weight, lower HDL levels, and Type 2 diabetes mellitus were those doing regular exercise in the advised duration per week. Key Words: Exercise, Duration, Lifestyle, Insulin-resistance, Atherogenic index.

Assessment of awareness about COVID-19 disease and vaccine uptake.

OBJECTIVE: To evaluate the awareness of individuals about coronavirus disease-2019 disease and vaccines during the pandemic. METHODS: The descriptive, cross-sectional survey-based study was conducted at family health centres in the Bursa province of Turkiye from July 1 to 7, 2021. The face-to-face survey of registered individuals had 20 items that measured coronavirus disease-2019 and vaccines. The scale was named the Coronavirus Disease-2019 and Vaccine Awareness level. It was carried out by family physicians using an online weblink. The Cronbach alpha coefficient was 0.87. Data was analysed using SPSS 25. RESULTS: Of the 228 subjects, 129(56.6%) were males and 99(43.4%) were females. The overall mean age was 27.82±10.28 years. Awareness levels were high with a mean value of 2.41±0.31. Female participants were more aware than males (p=0.04) and those with monthly income between 2000-10000 Turkish lira had lower awareness level compared to other income groups (p=0.03). Marital status (p=0.32), education level (p=0.49) comorbidities (p=0.23), regular drug usage (p=0.13) and exercise status (p=0.24) did not affect the awareness levels. Non-smokers were more aware than the smokers (p=0.01). CONCLUSIONS: The level of awareness about coronavirus disease-2019 and its vaccine was higher in the female gender and non-smokers, it was lower in the middle-income group.

Does vitamin D level have an effect on COVID-19 positivity and COVID-19 related mortality? A retrospective study.

OBJECTIVE: To explore the possible relationship between vitamin D and coronavirus disease-2019 in an urban population known to have relatively low vitamin D levels. METHODS: The retrospective study was conducted in Bursa, Turkey, and comprised data of 30 family health centers from March 1 to December 15, 2020, related to diagnosed inpatients of coronovairus disease-2019. The diagnosis was based on polymerase chain reaction test for severe acute respiratory syndrome coronavirus-2 infection. Vitamin D levels of these patients were obtained from previous records and compared with those without polymerase chain reaction positivity. Vitamin D levels of positive patients who survived were compared with those who died of coronavirus disease-2019. Data was analysed using SPSS 21. RESULTS: Of the 2,105 patients whose data was retrieved, 212(10%) were positive for coronavirus disease-2019, while 1,893(90%) were negative. Among the positive patients, 89(42%) were men and 123(58%) were women. The overall median age was 45 years (Q1-Q3(Q1: first quartile, Q3: third quartile): 35-56 years). Vitamin D level was not significantly different between the positive and negative patients (p>0.05). Among the positive patients, 2(0.9%) patients did not have new admissions to the designated centers and their data was excluded, 206(97.2%) survived and 4(1.9%) died. There was no significant difference in vitamin D levels between those who survived and those who died (p>0.05). CONCLUSIONS: There was no significant relationship found between vitamin D levels and coronavirus disease-2019 infection and related deaths.

The Göktas definition of family medicine/general practice.

Family medicine is the first gateway to primary health care in health systems. This feature makes the definition of family medicine complex due to its inclusive, holistic and continuous approach. The definition of family medicine should include the professional individual aspect of the family physician as well as its duties, authorities and responsibilities.1 Since the development of family medicine, definitions of the discipline have been frequently modified and updated, continuing to the present day. Family medicine represents the most basic aspect of the health-care system, which makes developing such definitions quite complex, and definitions must be revised and updated as conditions change. The first definition of family medicine, presented in 1974, was followed by a definition by Olesen et al. in 2000, and later by the European Society of General Practice/Family Medicine (WONCA Europe) in 2002. The WONCA Europe definition was then updated in 2011. Although this last definition explains family medicine in the most detailed way, today it needs updating especially in defining the individual characteristics of family medicine and its relations with the environment. There is a need to define the highly intensive role of family physicians while considering, the physicians' spiritual and personal agenda as human beings. The Göktas definition of family medicine/general practice, which was suggested at the WONCA Europe 2018 conference in Krakow, Poland, represents a suitable means of completing the 2011 WONCA Europe definition in this regard.

Knowledge, attitude, and practice towards COVID-19: Research to develop a measuring instrument.

OBJECTIVE: To evaluate the knowledge, attitudes, and behaviors of individuals about COVID-19 and to develop a valid and reliable scale that can measure these items about COVID-19 and other similar pandemic processes. DESIGN: Methodological scale study with a quantitative approach. SITE: Carried out at the Uludag University Family Health Center in Bursa, Turkey. PARTICIPANTS: 415 individuals in the first phase and 367 in the retest phase. INTERVENTIONS: Carried out between March 1, 2021, and April 30, 2021. MAIN MEASUREMENTS: Reliability and factor analyses were performed and validity was evaluated. In factor analysis, a scale with 4 factors and 30 questions was obtained. Confirmatory factor analysis (CFA) was applied to the factor scores of the scale. Factors were named A-General Culture, B-Mask, Distance and Cleanliness, C-Mental Status, and D-Way of Information. A 3-point Likert-type scoring system was created for the responses. RESULTS: Cronbach's alpha value was 0.894. In factor modeling, 3 of the confirmatory factor analysis fit indices were good and 4 of them were acceptable, so our model was found to be appropriate. The scale was highly reliable, according to internal and external consistency coefficients. The scale was named the Turkey COVID-19 Attitude Scale. p values<0.05 were considered statistically significant. CONCLUSIONS: The valid and reliable Turkey COVID-19 Attitude Scale, which we developed to evaluate the knowledge, attitudes, and behaviors of individuals about COVID-19, can be used to guide research during COVID-19 and future pandemics.

Seasonal influenza vaccine awareness and factors affecting vaccination in Turkish Society.

Objective: Influenza vaccine reduces the burden of seasonal influenza and related complications. Potential vaccination barriers need to be identified to raise awareness and increase acceptance. We aimed to investigate the rates of seasonal influenza vaccination and the knowledge, opinions, and behaviours prevalent in Turkish society. Methods: The study among seven regions in Turkey was conducted from October-November 2018 in 28 family health centres, using a cross-sectional, descriptive design. The knowledge, opinions, and behaviours of participants regarding the influenza vaccine were obtained by family physicians through face-to-face interviews with participants. Results: A total of 3,492 people aged 10-97 years age range (median: 50 years) were included in the study. Over half of the participants (59.9%, n = 2093) were female. It was found that the percentage of participants who never received the influenza vaccine was 78.4%; only 13.4% were occasionally vaccinated, and 8.1% received regular annual vaccination. Influenza vaccination rates were higher in married people (p < 0.001), women (p = 0.005), patients with chronic lung and cardiovascular disease (p < 0.001), those over 65 years /nursing home residents (p < 0.001). Awareness of the vaccine's benefit was higher in the group at high risk of influenza (p < 0.001). Conclusion: The rate of regular vaccination against influenza every year was insufficient, at 8.1%. Individuals' insensitivity, insufficient knowledge, and attitudes toward influenza vaccination is a serious health problem for Turkish society. Barriers to influenza vaccination can be reduced by good communication between family physicians and their patients.

Evaluating a physicians' perspective on the use of probiotics and vitamins against coronavirus disease.

OBJECTIVE: To evaluate the perspective of family physicians on probiotics and vitamins against coronavirus disease-2019. METHODS: The cross-sectional study was conducted from June 1 to 30, 2021, after approval from the ethics review committee of Bursa Uludag University, Bursa, Turkey, and comprised family physicians of either gender working at family health centres in the country. Data was collected using an online questionnaire to measure the sociodemographic characteristics, habits, health status related to coronavirus disease-2019, and their knowledge, awareness and behaviour towards the use of probiotics and vitamins during the pandemic. Data was analysed using SPSS 25. RESULTS: Of the 218 family physicians, 130(59.6%) were male and 88(40.4%) were female. The overall mean age was 46.82±5.85 years, mean professional experience was 22.32±8.75 years, and mean experience in family medicine was 10.14±3.51 years. The knowledge and awareness level about coronavirus disease-2019 was high 4.18±0.58, exposure to the disease 3.36±0.83 and their inclination towards the use of vitamins and probiotics 1.68±0.75 was low. Among the participants, 90(41.3%) used probiotic products and 120(55%) used drugs, such as vitamins and minerals. Vitamin C 99(45.4%) was the most commonly used supplement. CONCLUSIONS: Physicians' knowledge and awareness and a realistic scientific approach are important when recommending supplements, such as probiotics, vitamins and minerals, to individuals during the pandemic.

Vitamin D status in the adult population of Bursa-Turkey.

BACKGROUND: Vitamin D, along with parathyroid hormone (PTH) and calcitonin, is an important hormone that affects bone and calcium metabolism. OBJECTIVES: To evaluate the vitamin D status and its seasonal variation in the adult population of Bursa. METHODS: Since there is not enough information about vitamin D levels, 25 OH vitamin D levels were analysed retrospectively from the records of 11,734 adult subjects (9142 women, 2592 men) admitted to 24 family health centres located in different districts of Bursa between 1 December 2017 and 30 November 2018. Some tests that can affect vitamin D levels, demographic features, and accompanying comorbidities were also evaluated. A face-to-face questionnaire was administered to subjects who were willing to answer (n = 2965). RESULTS: The mean serum vitamin D level was 16.6 ± 11.5 ng/mL in the entire population, 15.8 ± 11.7 ng/mL in women and 19.5 ± 9.9 ng/mL in men. The percentage of subjects with a vitamin D level <20 ng/mL was highest in March-May and lowest in the September-November period (80.7% and 69.9% for women, 77.5% and 32.9% for men, respectively). CONCLUSION: Vitamin D levels <20 ng/mL are more prominent in women, and decline in spring, in the adult population of Bursa. These results are meaningful for the population living in Bursa, Turkey and the northern European region.

Factors Affecting Hypertension in the Adult Population of the Marmara Region, Turkey: A Descriptive Field Study.

INTRODUCTION: Hypertension is an increasingly prevalent global public health problem. Nutritional culture and lifestyle are among the factors related to hypertension. The aim of this study was to evaluate the prevalence and influential factors of hypertension in the adult population of the Marmara region, Turkey. METHODS: The study was conducted in 10 provinces in the Marmara region between June 01, 2018, and November 30, 2018. Participants included 2353 patients over 18 years of age diagnosed with hypertension by any of the 30 family physicians working in the Family Health Centers in these provinces. After the participants provided written consent, a survey consisting of 25 questions was administered by their family physicians. SPSS 25.0 (IBM Corporation, Armonk, New York, United States) was used for all statistical analysis calculations. RESULTS: The patients included 1449 females (61.6%) and 904 males (38.4%). Among the respondents, 1555 (73.1%) had primary hypertension etiology and 572 (26.9%) had secondary etiology. While 1614 patients (68.6%) did not exercise at all, 739 patients (31.4%) reported exercising; 1026 patients (43.9%) did not restrict salt in their diet; and 1134 patients (48.2%) had a family history of hypertension. CONCLUSION: Since individual and environmental factors affect the etiology of hypertension, it is recommended that family physicians address these factors first as part of a holistic approach for hypertension prevention, diagnosis, treatment, and follow-up.

General and abdominal obesity prevelances and their relations with metabolic syndrome components.

OBJECTIVE: To evaluate the frequency of obesity and its relation of metabolic syndrome. METHODS: The data from the records of the consecutive adult residents of Bursa province in Turkey who were admitted to the family health centers from the 1st January to the 31st December 2016 were evaluated retrospectively. The population size was 2901396 (N) and the sample size was at least n=17729. A total of 17812 participants (10939 females, 6873 males) were included in this retrospective observational study. Sociodemographic characteristics, diseases, used medication and smoking, height, weight, waist and hip circumferences (WaC and HC) were recorded from the files. RESULTS: The mean age of all subjects was 46.1 years, the mean BMI was 28.1 kg/m2 with a mean WaC of 91.3 cm, HC of 104.7 cm, WHR of 0.87. The prevalence of obesity in Bursa was found to be 32.2% (37.8% in females and 23.3% in males) according to BMI, 63.2% (69.7% in females, 52.9% in males) according to waist and hip circumferences. CONCLUSIONS: Preventive measures should be taken by health authorities to prevent the rapid increase in general and abdominal obesity that may lead to serious comorbidities.

Changes in the management of type 2 diabetic patients in family medicine practices in the Bursa region.

AIM: The aim of the study was to investigate the treatment and monitoring patterns of type 2 diabetes patients in the Bursa region over the last 5 years since the implementation of family practice in Turkey in 2010. METHODS: A total of 216 volunteer family doctors working in family health centers took part in this study. The records of 44,819 diabetic patients who visited these doctors between January 1, 2010 and December 31, 2014 were inspected retrospectively. Apart from the identity of the patients, morphometric data, including the type of medication used for diabetes and the HbA1C, serum creatinine and LDL cholesterol values, were recorded. RESULTS: A total of 38.9% (17,416 patients) of the patients in the study were male and 61.1% (27,403 patients) were female. The average age was 59.7 years with a range of 13.2 years. Although the patients' average body mass index (BMI) did not change over the 5years monitoring, average blood pressure (BP), and serum creatinine and LDL cholesterol levels decreased significantly. The hemoglobin A1c levels were significantly lower after 2010 compared to the 2010 data. Upon examining the medication prescribed for the patients, we determined that the use of metformin and insulin increased, whereas the prescription of thiazolidinedione (glitazone) decreased. There was a significant increase in the amount of patient data recorded over the last 5 years. CONCLUSIONS: Despite the increased level of data entry in these patients with type 2 diabetes, the surveillance of diabetes parameters according to treatment guidelines remains suboptimal. There continues to be a need to engage family practitioners on ongoing education and practice enhancement programs.

A survey of the public attitudes towards organ donation in a Turkish community and of the changes that have taken place in the last 12 years.

In 1990 we carried out a survey on public attitudes toward organ donation in a Turkish community. We repeated this study 12 years later in order to evaluate the changes that had taken place in the meantime. Using the same questionnaire and method, we repeated the study in a different part of the city with similar socio-economic characteristics as in the former area, which had in the meantime ceased to be our research and training area. The 983 participants were chosen by a random stratified method. Of those interviewed, 57.0% were willing to donate, while 18.3% refused and 24.7% were uncertain. A total of 52.6% consented to donation. Twelve years later, some public attitudes toward organ donation had changed. Refusal to donate for religious reasons had diminished (16.1% versus 26.2%); uncertainty whether to donate had risen (24.7% versus 15.8%). Attitudes towards organ donation were clearly related to educational level, age and sex.