Browsing by Author "Demir, F"

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    Post-NPM and re-centralisation: current themes in Europe and Turkey
    Demir, F
    Since 1980s, European Union countries have witnessed significant transformations as regards public management reforms. This era can be examined in two periods. Until mid-1990s the reforms were heavily influenced by the principles of new public management (NPM) paradigm whereas the second period of reforms was handled in the midst of intense criticism towards NPM. Today debate on public management reforms is omnipresent in the entire European Union. On the other hand, the EU requests candidate countries to put into practice public management reforms. The potential effectiveness of such demands is far from being clear in an environment where intense debates are ongoing over the path that public management reforms should take. Some studies show that there is increasing confusion on the direction of public management reforms especially after the 2008 economic crisis. In Turkey, reactionary measures were taken against NPM regulations which led to the fragmentation of central authority: independent regulatory agencies were put under tighter control of the government, and prime minister's office and president's office were expanded and reinforced. A closer look at these practices implicates that these steps are beyond fashioning an integrated administration as a response to the fragmentation in the central government.
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    PUBLIC MANAGEMENT REFORMS IN TURKEY
    Demir, F
    This article focuses on public management reforms in Turkey and how the reform trajectory has changed over the past two decades. Reforms in Turkey represent a mixture of ideas and reform elements that are constantly evolving under the influence of foreign actors, especially the European Union, efforts to respond to global reform trends, and domestic political developments. The article is divided into three parts. The first part gives a brief picture of the political-administrative structure of the country. The second part provides a landscape of the reform initiatives in the last two decades. The third part examines the main challenges Turkey might face in the coming years in terms of implementing reforms and provides a discussion on how they can be addressed.
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    Depolitization of Bureaucracy: The Case of Central and Eastern European Countries
    Demir, F
    Political parties worldwide seek to work with bureaucrats who are close to their programs, willing to cooperate, and concerted. On the other hand, there is a huge body of literature which argues that bureaucracy should be separate from politics and that it has to consist of public servants who are technically knowledgeable, expert, and also politically neutral. The countries of Central and Eastern Europe suffered from highly politicized public administrations under one-party regimes, and have struggled to separate their bureaucracies from politics since early 1990s. In view of the relation between politics and bureaucracy from the perspective of (de) politization, this paper looks into the changes that Central and Eastern European countries (CEECs) have gone through after the institutionalization of multi-party regimes and tries to provide some generalizations.
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    Investigation of the role of stray cats for transmission of toxoplasmosis to humans and animals living in Izmir, Turkey
    Karakavuk, M; Can, H; Selim, N; Yesilsiraz, B; Atli, E; Sahar, EA; Demir, F; Gül, A; Özdemir, HG; Alan, N; Yalçin, M; Özkurt, O; Aras, M; Çelik, T; Can, S; Döskaya, AD; Gürüz, AY; Döskaya, M
    Introduction: Toxoplasma gondii is a protozoan parasite that has a widespread distribution among mammalians and birds. One of the reasons for the high prevalence may be due to ingesting oocyst disseminated by stray cats' feces. In Turkey, most of the citizens are closely associated with stray cats and they love to pet and feed them on the streets. In this study, we aimed to determine the prevalence of T. gondii DNA in feces of stray cats living in Izmir, Turkey in order to identify the transmission potential to humans and other animals. Methodology: Feces and blood samples of 465 stray cats were investigated for the presence of T. gondii oocysts by microscopy and for the presence of T. gondii DNA by two real time PCR methods. Furthermore, serum samples were analyzed for anti-T. gondii IgG antibodies using an ELISA. Results: Oocysts were detected in 0.43% of the stray cats by microscopy. T. gondii DNA was detected in 14.37% of the stray cats' feces samples. The seroprevalence rate was 37.84%. In the feces and/or blood PCR positive group, 35.89% of them were seropositive. Among the 176 seropositive cats, T. gondii DNA was detected in feces of 27 cats (15.34%). Conclusions: This study first time showed the inter relation of T. gondii DNA in feces and blood samples and seropositivity. In sum, over 14% of the stray cats living outdoor may have an important role in transmission of toxoplasmosis to humans in Izmir as well as to other animals.
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    Evaluation of 2015-2016 MOTAKK HBV DNA and HCV RNA External Quality Assessment National Program Results
    Karatayli, E; Soydemir, E; Aksoy, ZB; Kizilpinar, M; Altay Koçak, A; Karatayli, SC; Yurdcu, E; Yildirim, U; Güriz, H; Bozdayi, G; Yurdaydin, C; Ilhan, O; Yildirim, Y; Bozdayi, AM; Oguz, AY; Baris, A; Alp, A; Aksözek, A; Sayiner, A; Karagul, A; Ordu, A; Istanbullu, A; Otlu, B; Aridogan, B; Aksu, B; Buruk, CK; Karahan, C; Güney, Ç; Toksöz, D; Yildirim, D; Çolak, D; Daglar, DE; Findik, D; Kas, E; Çaliskan, E; Zeyrek, FY; Arslan, F; Demir, F; Milletli, F; Kibar, F; Özdinçer, F; Dündar, G; Arslan, H; Agca, H; Aliskan, HE; Güdücüoglu, H; Fidan, I; Akyar, I; Afsar, I; Kaleli, I; Dönmez, I; Yanik, K; Midilli, K; Çubukçu, K; Özdemir, M; Acar, M; Yalinay, M; Kuskucu, MA; Bakici, MZ; Aydin, N; Yilmaz, N; Çeken, N; Ziyade, N; Yilmaz, N; Özgümüs, OB; Gitmisoglu, Ö; Demirgan, R; Kesli, R; Güçkan, R; Sertöz, R; Akgün, S; Aksaray, S; Tezcan, S; Kaygusuz, S; Gökahmetoglu, S; Mese, S; Bayik, SA; Akçali, S; Gürcan, S; Karsligil, T; Us, T; Özekinci, T; Pilgir, T; Aslan, U; Dinç, U; Coskun, USS; Çetinkol, Y; Keskin, Y; Ayaydin, Z; Toraman, ZA
    MOTAKK, as a national external quality control program has been launched to evaluate the molecular detection of viral infections including HBV DNA and HCV RNA in molecular microbiology diagnostic laboratories in Turkey. This program is prepared in compliance with ISO 17043:2010 (Conformity assessment general requirements for proficiency testing) standards, and aims to take the place of external quality control programs from abroad, contributing to standardization and accuracy of molecular diagnostic tests in our country. The aim of this study was to evaluate 2015 and 2016 results of the MOTAKK External Quality Control Program for HBV DNA and HCV RNA viral load. The calls were announced on the web page of MOTAKK (www.motakk.org). The quality control samples were sent to participating laboratories in 2015 and 2016. Main stocks were prepared from patients with chronic hepatitis B and C who had viral load detection with reference methods according to WHO reference materials for viral load studies to improve quality control sera. From these main stocks, samples with different viral loads were prepared from dilutions of plasma with HBV, HCV, HAV, HIV, Parvovirus B19 and CMV negative serologic markers. Quality control samples were sent to the participating laboratories along with the negative samples in the cold chain. The laboratories accomplished the related tests within 2-3 weeks and entered their results on the MOTAKK web page. These results were analysed according to ISO 13528 (Statistical methods for use in proficiency testing by interlaboratory comparison) and scoring reports were created by a software developed by MOTAKK and sent to participating labs. Each laboratory evaluated their own results in comparison with the other laboratory results, reassessed the tests via observing the distance from the mean result and the reference values. The number of laboratories participating in the HBV DNA and HCV RNA external quality control program was 70-73 in 2015-2016. Participants were able to comply with the program tools, registering, entering results and receiving the results reports problem. In HBV panel, 72.6-89.1% and 84.7-90.3% of the participant laboratories were in 1 standard deviation (SD) in 2015-2016, respectively. In HCV panel, 70.8-89.1% and 84.7-90.3% of the participant laboratories were in 1 SD in 2015-2016, respectively. A national external quality control program for HBV DNA and HCV RNA in Turkey has been prepared for the first time with this project and implemented successfully. All the data provided in the MOTAKK external quality control program final report, compensate all the data provided by the quality control program final reports from abroad; additionally, the report allows comparison of used technologies and commercial products.
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    Push and Pull Factors of Why Medical Students Want to Leave Turkiye: A Countrywide Multicenter Study
    Eser, E; Cil, E; Sen Gundogan, NE; Col, M; Ozturk, ENY; Thomas, DT; Sunter, AT; Arslan, HN; Citil, R; Onder, Y; Picakciefe, M; Dede, B; Demirel, C; Aydin, N; Caglayan, C; Aker, AA; Borlu, A; Durmus, H; Can, G; Siddikoglu, E; Sumer, EH; Uygun, T; Alkoy, S; Aycan, KA; Koruk, I; Kuzan, R; Demir, LS; Hacilar, E; Sari, H; Kilinc, Z; Onal, O; Dogan, E; Emek, M; Terzioglu, R; Yapici, G; Erdal, D; Eser, S; Akman, EA; Kosan, Z; Yilmaz, S; Ayoglu, FN; Acikgoz, B; Musal, B; Suner, AF; Erdogan, A; Cilburunoglu, I; Saygun, M; Daymaz, D; Arslantas, D; Onsuz, MF; Beyhun, NE; Ustundag, MG; Ekuklu, G; Tas, FO; Abacigil, F; Oncu, S; Hidiroglu, S; Ozaydin, AN; Pirincci, E; Bulut, I; Tozun, M; Eskiocak, M; Gunel, P; Torun, SD; Yavuz, M; Hasde, M; Camur, D; Gunes, G; Kurt, B; Baysoy, NG; Bakirci, N; Demir, F; Catak, B; Ozyurda, F; Turan, M
    Phenomenon: Physician immigration from other countries is increasing as developed countries continue to be desirable destinations for physicians; however, the determinants of Turkish physicians' migration decisions are still unclear. Despite its wide coverage in the media and among physicians in Turkiye, and being the subject of much debate, there is insufficient data to justify this attention. With this study, we aimed to investigate the tendency of senior medical students in Turkiye to pursue their professional careers abroad and its related factors. Approach: This cross-sectional study involved 9881 senior medical students from 39 different medical schools in Turkiye in 2022. Besides participants' migration decision, we evaluated the push and pull factors related to working, social environment and lifestyle in Turkiye and abroad, medical school education inadequacy, and personal insufficiencies, as well as the socioeconomic variables that may affect the decision to migrate abroad. The analyses were carried out with a participation rate of at least 50%. Findings: Of the medical students, 70.7% had emigration intentions. Approximately 60% of those want to stay abroad permanently, and 61.5% of them took initiatives such as learning a foreign language abroad (54.5%) and taking relevant exams (18.9%). Those who wanted to work in the field of Research & Development were 1.37 (95% CI: 1.22-1.54) times more likely to emigrate. The push factor that was related to emigration intention was the working conditions in the country (OR: 1.89, 95% CI: 1.56-2.28) whereas the social environment/lifestyle abroad was the mere pull factor for the tendency of emigration (OR: 1.73, 95% CI: 1.45-2.06). In addition, the quality problem in medical schools also had a significant impact on students' decisions (OR: 2.20, 95% CI: 1.83-2.65). Insights: Although the percentage of those who want to emigrate definitely was at the same level as in the other developing countries, the tendency to migrate permanently was higher in Turkiye. Improving working conditions in the country and increasing the quality of medical faculties seem vital in preventing the migration of physicians.
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    Push and Pull Factors of Why Medical Students Want to Leave Türkiye: A Countrywide Multicenter Study
    Eser, E; Cil, E; Sen Gundogan, NE; Col, M; Ozturk, ENY; Thomas, DT; Sunter, AT; Arslan, HN; Citil, R; Onder, Y; Picakciefe, M; Dede, B; Demirel, C; Aydin, N; Caglayan, C; Aker, AA; Borlu, A; Durmus, H; Can, G; Siddikoglu, E; Sumer, EH; Uygun, T; Alkoy, S; Aycan, KA; Koruk, I; Kuzan, R; Demir, LS; Hacilar, E; Sari, H; Kilinc, Z; Onal, O; Dogan, E; Emek, M; Terzioglu, R; Yapici, G; Erdal, D; Eser, S; Akman, EA; Kosan, Z; Yilmaz, S; Ayoglu, FN; Acikgoz, B; Musal, B; Suner, AF; Erdogan, A; Cilburunoglu, I; Saygun, M; Daymaz, D; Arslantas, D; Onsuz, MF; Beyhun, NE; Ustundag, MG; Ekuklu, G; Tas, FO; Abacigil, F; Oncu, S; Hidiroglu, S; Ozaydin, AN; Pirincci, E; Bulut, I; Tozun, M; Eskiocak, M; Gunel, P; Torun, SD; Yavuz, M; Hasde, M; Camur, D; Gunes, G; Kurt, B; Baysoy, NG; Bakirci, N; Demir, F; Catak, B; Ozyurda, F; Turan, M
    Phenomenon: Physician immigration from other countries is increasing as developed countries continue to be desirable destinations for physicians; however, the determinants of Turkish physicians' migration decisions are still unclear. Despite its wide coverage in the media and among physicians in T & uuml;rkiye, and being the subject of much debate, there is insufficient data to justify this attention. With this study, we aimed to investigate the tendency of senior medical students in T & uuml;rkiye to pursue their professional careers abroad and its related factors. Approach: This cross-sectional study involved 9881 senior medical students from 39 different medical schools in T & uuml;rkiye in 2022. Besides participants' migration decision, we evaluated the push and pull factors related to working, social environment and lifestyle in T & uuml;rkiye and abroad, medical school education inadequacy, and personal insufficiencies, as well as the socioeconomic variables that may affect the decision to migrate abroad. The analyses were carried out with a participation rate of at least 50%. Findings: Of the medical students, 70.7% had emigration intentions. Approximately 60% of those want to stay abroad permanently, and 61.5% of them took initiatives such as learning a foreign language abroad (54.5%) and taking relevant exams (18.9%). Those who wanted to work in the field of Research & Development were 1.37 (95% CI: 1.22-1.54) times more likely to emigrate. The push factor that was related to emigration intention was the working conditions in the country (OR: 1.89, 95% CI: 1.56-2.28) whereas the social environment/lifestyle abroad was the mere pull factor for the tendency of emigration (OR: 1.73, 95% CI: 1.45-2.06). In addition, the quality problem in medical schools also had a significant impact on students' decisions (OR: 2.20, 95% CI: 1.83-2.65). Insights: Although the percentage of those who want to emigrate definitely was at the same level as in the other developing countries, the tendency to migrate permanently was higher in T & uuml;rkiye. Improving working conditions in the country and increasing the quality of medical faculties seem vital in preventing the migration of physicians.