Neonatal jaundice is a frequently encountered paediatric problem in Africa that is associated with sickness and death. The research was undertaken to determine the prevalence of critical jaundice values in neonates in Windhoek, Namibia. Although several risk factors and aetiologies may be attributed to neonatal jaundice, the research focused on establishing the number of neonates with critical bilirubin levels in Windhoek, Namibia. Secondary data of bilirubin tests performed on neonates was obtained from the Namibia Institute of Pathology’s (NIP’s) archived patient records for the years 2013 and 2014. Only neonates that were less than 31 days old were included in the study. Data was analysed using the Statistical Package for Social Sciences (SPSS) version 22. The prevalence of critical jaundice values was estimated to be 12.4%. Neonates >3 to ≤6 days of age were noted to be the most affected. It was notable that 9.6% of neonates that were 3 to 6 days old had a potential for developing kernicterus. Males had a higher prevalence of critical values (13.4%) as compared to females (11.5%) and were at greater risk of kernicterus. The critical values and kernicterus cases increased with age. Neonates between 3 to 6 days were most affected as they had bilirubin values depicting risk to kernicterus. The cause of the male preponderance in elevated bilirubin levels is not known. Further studies thus need to be conducted to establish the causes of critical jaundice.

Introduction: The transition from high school to college or university is known to be an especially problematic stage in adult development. In order to adapt and find a way of becoming accepted or popular with their peer group, young women become increasingly concerned about maintaining an attractive and culturally acceptable body shape. To reach their often idealistically low weight goals, many female students engage in regular dieting behaviors which are often unsound and extreme.

Objectives: This study aims to estimate the proportion of Body Image Disturbance among first year Qatari female college students and relate it to their BMI distribution. It also assesses the perceptions towards weight and dieting behaviors among first year Qatari female college students.

Methodology: Data were obtained by cross-sectional study design. Three hundred and thirty two first year Qatari female college students were selected using simple random sample. Participants completed a questionnaire that assessed different concepts including feelings towards body appearance, overweight preoccupation, appearance orientation, body areas satisfaction, and potential risky behaviors and after that their height and weight were measured. Pearson Correlation was used.

Results: Our results indicate that 227(68.4%) of participants desire to lose weight. among them, 58% had body image disturbance (BID) ranging between 0-20% of their current weight. On the other hand, 105 (31.6%) of all participants have BID with a desire to gain weight, of these participants 73.3% have a desire to gain between 0-20% of their actual weight. Strong correlation was found between self reported current weight and actual (measured) weight with r=0.783, p<0.001, 55.1% of students dislike their body shape, 61.4% starve themselves, and 52.7% eat binges for no apparent reasons. About eighty percent weigh themselves at least once a day and 28.6% consider surgery as a way of controlling their weight.

Conclusion & Recommendations: Thinness is linked to social desirability among Qatari female college students. A sizable proportion of females with normal BMI have body dissatisfaction and desire to lose weight and potentially risky behaviors are practiced by the students in order to control their weight. The alarming findings of these behaviors among underweight students should raise concerns of possible eating disorders among these students.

Balanced health education messages should be delivered to females in schools and colleges about healthy attitudes and practices towards diet, and body weight.

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: Surgical acute abdomen is one of the commonly encountered emergencies in the practice of General surgery. However, there was not much study done regarding the presentation and outcome of acute abdomen in Ethiopia, particularly in this study area.

Objective: This study was aimed to assess the presentation and outcome of surgically treated acute abdomen patients who were managed operatively at Goba Referral Hospital, southeast Ethiopia.

Methods: This was Retrospective study conducted on 299 adult patients admitted with acute abdomen in Goba Referral Hospital from September 1, 2012 to August, 30, 2014. Variables analyzed include demographic data, clinical features, and causes of acute abdomen, immediate complications and outcome of the surgical management of acute abdomen. Data were extracted by trained data collectors using data compilation sheet. The collected data were processed using SPSS version 21 software. Descriptive statistics was done. Chi-square test was calculated to identify associated factors of acute abdomen.

Results: There were 299 patients of which 211 (67.2%) were males and 98 (32.8%) were females. About 58.2% of patients visited the hospital after 2 days of onset of symptoms. Abdominal pain (100%) and vomiting (99.3%) were the most common complaints. Acute appendicitis was the most common cause accounting for 49.2% of the patients, followed by acute intestinal obstruction (39.1%). Wound infection (15.7%) and septicemia (8.0%) were the most common postoperative complications. The overall case fatality rate was 16%. Conclusion: Acute appendicitis was the most common cause for acute abdomen. The overall case fatality rate of acute abdomen found was unacceptably high. Wound infection and sepsis were the most common postoperative complications. Early diagnosis, adequate preoperative and postoperative care may help to reduce the observed high mortality.

Introduction: Pharmacy integration into a Family Medicine Residency (FMR) curriculum is beneficial to the professional development and education of medical residents. While pharmacist involvement in FMR programs is well-documented, the ideal means of incorporating pharmacotherapy education as a standardized component of a residency curriculum is unknown. This study was conducted to determine the need, impact, and best approach to incorporate pharmacy experiences into a FMR curriculum, while secondarily identifying the medication-related content medical residents preferred to be taught by pharmacists.

Materials and Methods: A cross-sectional study was conducted via online survey sent to alumni of the Saint Joseph Regional Medical Center’s (SJRMC) FMR in order to assess their perception of the pharmacy curriculum within the residency program, which has been delivered in a variety of formats since its inception.

Results: Of 113 alumni invited to participate, 51 (41%) completed the survey. Developing a required, longitudinal pharmacy experience was well-received, as most alumni believed that it would improve patient care (98%), increase confidence in medication choices (100%), and increase retention of pharmaceutical knowledge (96%). Seventy-two percent believed pharmacotherapy rotations should be a required component of the FMR curriculum, with 96% preferring longitudinal exposure throughout the residency compared to a single month rotation. Finally, the subjects identified as most preferred for pharmacists to teach were quantified, with diabetes, hypertension, pain management, heart failure and anticoagulation cited most commonly.

Conclusions: The majority of FMR alumni believed a pharmacy experience should be a required component of the residency program and would prefer it be delivered longitudinally throughout the residency.

Introduction Family Medicine is a rapidly growing medical discipline in Turkey. This area of specialism, which is drawing attention in almost every developed country in the world and through training given in European Union (E.U.) countries, is a branch of clinical medicine which is wide-ranging in its scope. In 2002, the European branch of the World Organisation of National Colleges, Academies and Academic Associations of General Practitioners (WONCA Europe) gave the following definition: Family Medicine/General Practice is an academic and scientific discipline with training, investigation, peculiar to itself based on investigation and proof along with clinical application, directed at primary health care.

The conceptual systematization in the speciality of Family Medicine has not matched with practice. As it has been renewed and extended its practice, its conceptual foundation was forgotten. Therefore, it is necessary to achieve more meaningful representations of the fundamental concepts of Family Medicine, and facilitate the transfer of these to clinical practice. But, these concepts can be difficult to understand and explain, even for experienced physicians in the specialty. The fable is an adult education method that can serve to intuitively understand abstract concepts by linking them to specific situations, for facilitating their assimilation. In this book -Fables of Family Medicine: A collection of clinical fables that teach the Principles of Family Medicine-, its short fables present animals, plants, minerals and things that think and speak as if they were human beings; beings or objects that are given the opportunity to think, feel and speak, and they are “patients” who come to the consultation with the family doctor. Each fable is a “great lesson” about “a fundamental concept of Family Medicine”. These concepts, elements or fundamental dimensions of Family Medicine, presented by fables in the book are, among others: comprehensiveness, panoramic view, circular causality, context and contextualization, uncertainty, complexity, coordination, variability, clinic interview, relationship doctor-patient, companion of the patient, empathy-assertiveness, biopsychosocial model, functional vs organic, continuity of care, symptoms of the disease vs experience of the pathology, diagnosis, anticipatory care, prevention, epidemiology, medicalization, technology, resources, family, community, treatment, strategic planning, co-development and co-treatment, multimorbidity, healing, participation, empowerment, focusing on the process, prognosis, terminal care, mental health, health and sickness.

The incidence of female infertility is growing worldwide, reaching rates from 10 to 20%. It has been reported diverse risk factors associated with this medical complication.

Parenting practices play an important role in children’s subjective wellbeing and global mental health.

The study included a sample of 2256 parents of 2256 children from 5th grade (48.8%) and 7th grade (51.2%), mean age 11.58 years old; SD 1.41; ranging from 10-16 (48,4% between 10 and 11 years of age and 51.6% 12 years or older); there were 46.2 % boys and 53.8 % girls.

The results present the descriptive analyses of the principal variables, parenting practices and parent’s perception of child subjective wellbeing. It is presented a Regression Model that illustrates the strong impact of parenting practices in subjective wellbeing, and the gender and age differences in this relation.

The main conclusions are that positive parenting practices (control and acceptance) are related to positive perception of subjective wellbeing. Parents have a more positive perception of their parenting practices in relation to girls and younger children.

Suggestions for intervention are proposed, related to positive parenting practices promotion programs and intervention that involve parents-children activities.

The aim of this report is to present information about academic family practice, which has a significant role in the practice of family medicine in The Nederland. While the practice of family medicine in Turkey has made a beginning, there is as yet no field practice, the real place of learning where the assistant is trained. This is an important lack. This report presents the example of field training and academic practice in the specialism training of family doctors in The Nederland. This is the first time that a report on this matter is being presented. The reason for this report is to support the project entitled, “Family Medicine Specialism Training in Family Health Centre in Bursa Integrated with The University Medical Faculty Department of Family Medicine, in Line with European Union Criteria” This is in itself the first of its kind. The author of the report, family physician specialist Assoc. Prof. Dr. Olgun Gökta? has personally visited The Nederland as a representative example nation for this practice, and has prepared this report. The ultimate aim is to generate ideas regarding the beginning and the widening of academic family medicine practice in Turkey. Along with this, through inspection of family practice under the health system in The Nederland and the various factors affecting this, in some sections of this report, opinions based on this experience have been added.

There is little qualitative data on the impact of Chronic Fatigue Syndrome/Myalgic Encephalopathy (CFS/ ME) on family relationships. Semi-structured interviews and thematic analysis were used to explore 18 parents’ experiences of the impact of a child with CFS/ME on family relationships. Five main themes emerged: “Long and Difficult Journey”, “Uncertainty”, “Isolation and Restriction”, “Focus on the unwell person at the expense of family life” and “Parental roles”. Parents felt the illness could have a destructive force but many also described the beneficial effects on family relationships. Health professionals should be aware that parents of children with CFS/ME may need additional support.

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