Cahiers de sociologie et de demographie medicales最新文献

Public health encompasses all health problems and factors related with these problems and with the planning and implementation of activities to improve the health status of communities. Therefore, the public health field is universal as a science, but its implementation (activities) depends on the local problems specific to each community. Public health is afield of many sciences and should be open to people representing a wide variety of scientific backgrounds. Since the factors affecting an individual's health are many and varied, public health professionals should be aware of and equipped to deal with all these factors and possible health risks. Therefore, this wide range of community health problems should appear in the training programs of public health professionals. Health, social and natural sciences are the basic sciences of public health. Upon this knowledge, the trainees learn "epidemiology and biostatistics", which are the main diagnostic sciences of public health, and then the common existing and potential health problems as relates to environmental, occupational, reproductive, and child health, community nutrition, infectious and chronic diseases, geriatrics, mental health, disaster medicine, and accidents, etc. The public health professional, in order to effectively control a community's health problems, should also be educated in health care management and be able to conduct health education programs. Turkish Society of Public Health Specialists has documented the job description and listed what public health specialists should know and be able to do. According to this document: "The tasks of public health specialists are to determine the health status of the people, the existing and potential health problems, their reasons, and the health needs of the community; to develop public policies and strategies for solving these problems; to monitor and assess public health problems; to participate in the implementation of these programs; and to act as managers at all levels of health services. In realizing these tasks, public health specialists locate the sources of information and collect and analyze data. Regarding their managing tasks, they conduct planning, organizing, staffing, directing, supervising, coordinating, reporting, and budgeting activities. A public health specialist is involved directly in research, consultancy, program development, the control of epidemics, public health education, health care management, and provision and supervision of preventive and curative services."

Manpower or human resource planning is a major component of health services planning. In this study, it was aimed to practice an estimation method for midwife demand in a selected region of Ankara, Turkey. In this study, the needs-based approach was used as a method of estimating manpower demand. The study was conducted in one of the central regions in Ankara. Calculations were done separately for 31 primary health care centers in the region. Midwife demand was calculated separately for each of the six specified duties in all health centers. By summing the calculated numbers, midwife demand for each health center was found In order to determine the approximate time required to deliver each service, 10 midwives from 10 different primary health care centers in the region were selected by random sampling and interviewed. According to the sample calculation presented in this study, the number of midwives required (160) was found to be equal to the current number of midwife posts available in the region. Although this finding was favorable, the fact that 29% of those posts were unfilled constituted a significant problem. Lack of human resources can lead to the lack of essential services, lack of quality in service delivery and loss of strength in primary care. In order to facilitate the optimal delivery of health services, an adequate number of personnel have to be allocated in the most appropriate positions.

It is well known that due to long working hours and stressful working conditions, doctors experience burnout more often than other professional groups. Their career burnout begins in the early years, continues to increase and becomes most evident in the internship of medical school. On this wise, the purpose of this study was to investigate the burnout status of intern doctors and the associated factors. Participants in this cross-sectional study were sixth-year medical students (n = 302). Data were collected under observation using a questionnaire including some sociodemographic characteristics and the Maslach Burnout Inventory, SF-36, General Health Questionnaire and COPE Inventory. The mean age of the participants was 24.5 +/- 1.1 years and 53.4% of them were male. Mean scores of emotional exhaustion, depersonalization and personal accomplishment were 25.5 +/- 7.5, 11.3 +/- 3.9 and 24.7 +/- 3.4, respectively and the three sub-dimension scores of the burnout scale showed no association with gender. Students' emotional exhaustion scores significantly differed according to the socioeconomic status (p < 0.05). Participants who had lower scores on the mental and physical dimensions of SF-36 and higher scores on GHQ-12 showed significantly more emotional exhaustion and depersonalization.Positive coping methods showed negative correlation with the subscales of burnout and individuals using problem-focused coping felt more successful (personal accomplishment) confirming the relationship between mental health and burnout. The medical education curricula (both theoretical and practical studies) should be reviewed and appropriate adjustments should be made according to the needs of intern doctors.

At the heart of each health system, the workforce is central to advancing health. The World Health Organization has identified a threshold in workforce density below which high coverage of essential interventions, including those necessary to meet the health-related Millennium Development Goals (MDGs), is very unlikely. The International Labor Organization (ILO) has launched a similar indicator -staff related access deficit- using Thailand's health care professional density as a benchmark. The aim of this study is to assess the staff-related access deficit of the population across the 12 NUTS 1 level regions of Turkey. The main hypothesis is that staff-related access deficit has a correlation with and predicts the gap in antenatal care coverage (percentage of women unable to access to antenatal care) across different regions. Staff-related access deficit, as a threshold indicator, seems to have a linear relationship with the antenatal care coverage gap. The known inequalities in the distribution of the health care workforce among different regions of Turkey were put forward once more in this study using the SRA indicator. The staff-related access deficit indicator can be easily used to monitor the status of distributional inequalities of the health care workforce at different sub-national levels in the future.

This study aims to make an assessment of the current status of human resources for health in Turkey and to bring a new perspective to key issues in the development of human resources for health within the framework of a macro approach. Although a number of issues are covered in human resources for health (HRH) studies which need to be handled carefully, this study focuses on the number of health personnel, health personnel efficiency, geographic distribution, education and financing of health personnel, and migration.

During the history of the Republic of Turkey, there have been two population policies: a pro-natalist policy from 1923 to 1965 and an anti-natalist policy after 1965. This study aims to discuss the population planning activities, including the operation researches, the impact of the population planning laws on maternal health and family planning practices in Turkey, with special emphasis on use of non-physicians in family planning services.

Medicine has always been an appealing profession. However, some studies have shown that the medical profession in Turkey appeared to lose some of its appeal around the 1990s. The purpose of this study was to determine to what extent young people currently prefer the medical profession in Turkey as an example for developing countries. This descriptive study aims to evaluate and compare the selection and preferences of candidates between medical and industrial engineering programs in state universities between 1985 and 2009. The main indicators used in this study was the success rank" of the candidates, that refers to the candidate's placement in the list of student-scores sorted in descending order, and further grouped into 100. The data were analyzed using the Statistical Package for the Social Sciences (SPSS) version 15, and percentage distribution and chi-square tests were applied. There were 21 medical faculties in state universities in 1985; this number reached 53 in 2009. The success rank of registered students decreased between 1985 and 2000 and then increased continuously thereafter. A significant difference between faculties in terms of the registration rate of the students who scored in the top 3% was determined in all years evaluated in this study (p < 0.05). This study clearly shows that although medicine was less popular among university candidates before 2000, it gradually gained in popularity, reaching its highest levels in 2008 and 2009.

This study aimed to examine the burden of neonatal deaths in Denizli province, Turkey, over a 5-year period and to investigate the role of "routine" primary health care (PHC) services provided to mothers and infants by the Ministry of Health in reducing neonatal deaths, while controlling for major confounding factors. A retrospective cohort study was conducted based on the health records of the Provincial Health Directorate of Denizli, Turkey. Data were collected from the 5-year records of a total of 119 PHC units responsible for providing comprehensive PHC services to all residents of the province. A random-effect Poisson panel regression was employed to investigate the association between "monitoring services (for mothers and babies) provided by PHC unit personnel" and the neonatal mortality. According to the results of study the final model revealed that "monitoring", i.e., the joint factor for the average number of regular visits of the mother (during pregnancy and over puerperium) and that of the babies over the neonatal period was found to have a positive impact on decreasing the neonatal infant mortality rate. In the final model, controlling for the total number of live births in the health care service area, neonatal mortality was detected to be negatively associated with total populations per nurse, total populations per midwife, presence of prematurity and presence of low birth weight whereas having deliveries in the hospital setting decreased the risk of neonatal deaths significantly. The findings of the study are important, revealing that the neonatal mortality rates could be decreased significantly by increasing the number of regular health visits of mothers and newborn babies to PHC units, with no need for specialized health personnel or additional costs.

Institute of Public Health of Serbia (IPHS) is developing new function related to better monitoring of alcohol related diseases and injuries, actions focusing on alcohol as a lifestyle related factor using integrated strategic approaches for both population and individual risk reduction. In that regard the long term objective of the IPHS is to study, monitor, promote and safeguard public health--from the point of view of mental health and alcohol abuse--by means of research, development and the provision of expert services. Starting point in the aforementioned need for the capacity building in the area of mental health and alcohol abuse is the Program of education of general practitioners (GPs) in primary health care settings for identification and diagnosis of alcoholism. This is because GPs have the widest contact with the general population. Their education related to recognition of alcohol abuse and appropriate diagnostic tools application is first, but very important step in providing direction of the health service and other sectors for problem solving and would bring the largest benefit for the whole population. In the year 2010 National program against alcohol abuse and alcoholism will be developed. Program of education of GPs is very important complementary activity which outcome will have great impact on the National program implementation.

Unlabelled: This study's aim is to gain the insight on smoking prevalence at the Institutes of Public Health in Serbia.

Method: All Institutes of Public Health in Serbia have participated in the study. All employees have participated in an epidemiology survey, which is used to collect data.

Results: The questionnaire on smoking was completed by 83,2% (2458) of employees in the public-health institutes and institutions in the Republic of Serbia. The questionnaire was filled in by 27,1% males, and 72,95% females, in other words, the gender ratio was 1:2,7 respectively, which corresponds to gender ratio of the total number of employees in these institutes and institutions. Smoking prevalence among the employees according to the Occupation: Of the total number of questioned employees in Serbian public-health institutes and institutions 1078 are smokers (43,8%). Smoking habits among the employees according to occupation are as follows: Physician smokers 31.1% (134), Secondary-school medical staff smokers 48.1% (507), and non-medical staff smokers 45.0% (437).

Conclusion: Even though medical personnel hold a key-role in smoking prevention and quitting smoking, smoking among them is at a high rate. Taking into consideration that institutes and institutions of public health have a promotional anti tobacco and prevention role, the first step in carrying out the National strategy of tobacco control should be the appliance of the Codex of behavior of medical personnel in tobacco control, and the decrease in the number of smokers among the employees in health institutes.