The aim of this report is to provide information about the practice of family medicine in Italy. Despite the beginning of the practice of family health-care throughout Turkey in 2010, and the growth of family medicine, pre-existing problems continue to be experienced, and new problems are arising.

In developed countries, family health-care is being practised very well, due to the experience gained from years of practice.

There are many important differences in the practice of family medicine in different countries, to do with culture, life-style, economic status and level of education. In this report, information is presented about family medicine and its practice in Italy, a country with a population of about 60 million, and whose population growth is much lower when compared with Turkey, and is, at the same time, a Mediterranean country

At the outset of the practice of family medicine, Italy, which has undergone a long, difficult and varied development, it was fully financed by the country’s Health Ministry.

The practical, economic and organised lifestyle is seen reflected in the practice of family medicine.

Assoc. Prof. Dr. Olgun Gökta? has travelled in person to Italy, looked into this practice and prepared this report. The ultimate aim of this report is to gain ideas about how to solve the problems seen in the practice of family medicine in Turkey, through ideas and contributions from Italy, a European country.

Background: From 2011-2014, 56.9% of African American women in the United States were obese. Poverty and urban neighbourhood environments contribute to the health disparities and prevalence of obesity in African American women. The limited resources, education, and widespread disparities in health risks and disease experience in low-income and minority communities make behaviour change challenging. Understanding which strategies facilitate behaviour change is important for improving the health of women in these communities.

Objective: The objective of this quasi-experimental, staggered start pilot study was to determine the differences in biometric changes, health behaviours, and overall health risk in low-income African-American women using either a self-guided workbook or lay health coaching approach to behaviour change in addition to a healthy lifestyle curriculum.

Methods: Utilizing a CBPR approach, a healthy lifestyles curriculum was designed to address health risks and education needs of women in a Midwest urban community. Thirty-four women received a 6-week, 90-minute pilot-curriculum with biometric screening, a health risk assessment, and 30-minutes of personalized feedback. The coaching group received bi-weekly personalized behaviour change sessions. Height, weight, waist circumference, and fasting glucose, triglycerides and cholesterol were measured. Participants completed a 53-item health risk assessment. Confidence in and readiness for behaviour change were measured. Knowledge scores were obtained for each educational session.

Results: Both groups decreased health risk and increased knowledge related to all topics except relapse prevention. There were significant differences in abdominal circumference changes between the coaching group (M= -2.605, SD= 2.372) and the workbook group (M= -0.433, SD= 3.294; F (1, 31) = 4.997, p= 0.032).

Conclusion: Personalized feedback from the health risk assessment in conjunction with the program immediately following the screening may have led to improvement in both groups. Lack of knowledge and skills in relapse prevention highlight the challenge of behaviour maintenance in communities with limited resources. The coaching and group education provided a social support and encouraging environment for behaviour change.

Objective: To assess the association between adolescent’s eating behaviour and social acceptance among peers.

Design: Quantitative, survey data were used. Key measures included self-reported details of healthy foods eaten and avoidance of fast foods in the past week, and perceived social acceptance among peers. Multiple imputation was used to maintain the maximum number of cases (N= 9,150) and multivariate regression analysis was employed to evaluate the significance (p<0.05) of associations between the eating measures and social acceptance. Linear and non-linear measures of healthy eating were assessed to capture potential curvilinear associations.

Setting: This study was conducted using data from a representative sample of adolescents (8th graders) across the U.S.

Subjects: Study subjects included all participants in the 8th grade wave of the Early Childhood Longitudinal Study, a nationally representative sample of almost 10,000 adolescents.

Results: As adolescents’ eating behaviours become healthier, their perceived social acceptance among peers also increases. There is some evidence, however, of declining social acceptance at very high levels of healthy eating. Results were robust to controlling for BMI, as well as other social, economic and demographic variables.

Conclusion: Past research suggests peer influence is an important correlate of adolescent health behaviours and healthy eating is a key behaviour to understand for reducing adolescent obesity. The results suggest that peers are generally not an obstacle to healthy eating among American adolescents, and may be a positive source of social pressure that could be leveraged to encourage more nutritious eating among adolescents.

Family medicine practice is at the core of health systems in almost all developed and developing countries and determines the quality of health at the individual and community level.

Although it is at the core of the health systems of the countries, family medicine is influenced by the socioeconomic, educational and cultural level of the country where it is applied. Depending on this situation, family medicine practices differ between countries.

Family medicine practice, which has a complex structure between medical and paramedical partners, should be well-defined in this respect. As a result, family medicine is applied by determining laws, regulations and directives according to the structure of the countries. Family medicine legislation of the countries shows similarities in this respect, but also presents important differences.

This article examines the legislation of the European Union, the United Kingdom and the United States and discusses the idea that family medicine is the development of Turkey and similar countries.

Objective: The study determines the association between biomass fuel use and serum nitric oxide (NO) levels among women in villages of Gadap town, Karachi, Pakistan

Materials and methods: A cross sectional study was conducted in Gadap town, Karachi, Pakistan. A total of 83 women between 15-45 years of age were recruited with 43 biomass users and 40 using natural gas as primary cooking fuel. Particulate matter (PM2.5) and Carbon monoxide (CO) was measured in kitchens using an aerosol monitor Sidepak and Monoxor II, respectively. Serum Nitric Oxide (NO) was measured through Griess reaction. Multivariate regression was conducted to determine the association between serum NO levels and biomass.

Results: CO and PM2.5 levels in kitchens among biomass [CO: 20.22 (±12.2), PM 2.5:4.46 (±3.6)] users were significantly higher compared to natural gas users [CO: 1.22 (± 1.22), PM2.5:0.05 (± 0.02)]. Blood serum NO levels among women were significantly (p<0.001) higher in biomass users (280.8±25 µmol/L) compared to natural gas users (230.4±10 µmol/L). Multivariate regression analysis found unit change in biomass use associated with 0.25 unit (p<0.02) change in NO levels, after adjusting for age and socioeconomic status

Conclusion: Women who are using biomass as fuel are exposed to high levels of CO and PM2.5 pollutants. High NO levels in biomass users may indicate enhanced in vivo inflammatory responses. Further studies are needed to identify the role of serum NO levels in causing respiratory and cardiovascular diseases among biomass users