Eren Yildiz

The present study examined the effects of the Psychotraining-Based Communication Workshop Program on family functioning and psychological resilience among parents of children with special needs. This randomized controlled study investigated the effects of communication training therapy for parents of children with special needs. Participants were assigned to intervention (N = 21) and control (N = 21) groups. The workshop was delivered to parents of children with developmental delays over 6 weeks, consisting of two sessions per week lasting 45–60 min each, and was conducted by health and education professionals using a family-centered multidisciplinary approach. The Turkish versions of the Perceived Family Functioning Scale (PFFS) and Adult Psychological Resilience Scale (APRS) were administered in the pre- and post-tests. Following the workshop delivered by psychiatric nursing staff, the intervention group demonstrated significant improvements in family communication and positive affect (4.365 compared with 3.902, effect size = 1.02, p < 0.001), Conflicts and negative affect (1.881 compared with 2.470, effect size = 0.78, p = 0.002), and the total adult psychological resilience score (4.389 compared with 3.921, effect size = 0.74, p = 0.003). Significant increases were also observed in relational resources (4.357 compared with 4.064, effect size = 0.46, p = 0.047), cultural and contextual resources (4.429 compared with 3.743, effect size = 0.76, p = 0.002), and family resources (4.514 compared with 3.886, effect size = 0.85, p = 0.001). Conclusions: The psychoeducation-based communication workshop program was effective in improving family communication and psychological resilience among parents of children with special needs. The findings of this study suggest that family-centered psychoeducational programs may be beneficial and could contribute to nursing practice. What is Known: • Parents of children with special needs frequently experience challenges in family functioning and reduced psychological resilience because of long-term caregiving responsibilities. • Psychoeducational interventions may improve psychosocial outcomes; however, evidence regarding communication-based programs targeting both family functioning and psychological resilience remains limited. What is New: • This psychotraining-based communication workshop significantly improved family communication and positive affect while reducing conflicts and negative emotions among parents of children with special needs. • The intervention strengthened overall psychological resilience, particularly relational, cultural-contextual, and family resources, supporting the integration of communication-based psychoeducation into family-centered nursing practice.

In the present study, cardiovascular risk indices (Atherogenic Index of Plasma [AIP], Atherogenic Coefficient [AC], Castelli Risk Index-1 [CRI-1], and Castelli Risk Index-2 [CRI-2]) and bone mineral density (BMD SDS) were evaluated in patients with Familial Mediterranean Fever (FMF), and the association of these parameters with disease severity and MEFV gene mutations was investigated. A total of 126 participants (96 FMF patients and 30 healthy controls) were included in the study. FMF patients were classified as mild, moderate, or severe according to the PRAS severity score. Cardiovascular risk indices, biochemical parameters of bone metabolism, and BMD SDS values were compared among the groups. The relationship between BMD SDS and atherogenic indices was assessed by Spearman correlation analysis. The results were also analyzed according to MEFV gene mutations. No significant difference was detected among the groups in terms of sex or age (p > 0.05). FMF patients were found to have substantially higher cardiovascular risk indices than the control group, and these indices increased in parallel with disease severity (p < 0.05). The BMD SDS value of the severe FMF group was significantly lower than that of the other groups (p = 0.025). No difference was detected among the groups with respect to bone metabolism parameters (p > 0.05). No significant correlation was observed between BMD SDS and cardiovascular risk indices (p > 0.05). M694V was the most frequently detected mutation, and the BMD SDS value was lower in patients carrying mutations other than M694V (p = 0.011). The increased cardiovascular risk in FMF patients is associated with disease severity. Severe disease is accompanied by a reduction in bone mineral density. The lack of an association between cardiovascular risk and bone mineral density suggests that these systems may be affected through different mechanisms. It is important that FMF patients are monitored with respect to cardiovascular and bone health.

Objectives: The diagnosis of pediatric acute appendicitis remains challenging due to clinical findings that overlap with nonspecific abdominal pain (NSAP). In this study, the value of fibrinogen in the diagnosis of pediatric acute appendicitis and in the classification of disease severity was investigated. Methods: In a single-center, retrospective cohort study, 145 patients aged 1 month to 18 years who underwent contrast-enhanced abdominal computed tomography were divided into three groups: NSAP (n = 62), uncomplicated appendicitis (n = 44), and complicated appendicitis (n = 39). Hemogram parameters, CRP, procalcitonin, albumin, and fibrinogen levels were compared. Diagnostic performance was assessed using ROC analysis, and independent predictors were evaluated via multivariate logistic regression. Results: Fibrinogen levels showed a gradual and statistically significant increase from NSAP to uncomplicated appendicitis and then to complicated appendicitis (p < 0.001 for all pairwise comparisons). In distinguishing appendicitis from NSAP, fibrinogen achieved the highest diagnostic accuracy among the biomarkers examined (AUC = 0.95); CRP, WBC, ANC, and NLR demonstrated lower discriminatory performance. In multivariate logistic regression analysis, fibrinogen was validated as an independent predictor of appendicitis (p < 0.001). Conclusions: Fibrinogen demonstrates high discriminatory performance in the diagnosis of pediatric acute appendicitis and shows a graded relationship with disease severity. These findings suggest that fibrinogen may be a promising biomarker for the evaluation of pediatric acute appendicitis. However, larger prospective multicenter studies are required before its routine integration into diagnostic algorithms can be recommended.

Aluminum phosphide (AlP) is a highly lethal pesticide that releases phosphine gas upon contact with moisture, leading to marked impairment of mitochondrial function, severe oxidative stress, and multiorgan failure. A fifteen-year-old male patient was brought to the emergency department due to loss of consciousness following accidental ingestion of a tablet containing AlP. Severe metabolic acidosis and refractory cardiogenic shock developed within a short time; despite intensive fluid resuscitation, high-dose vasopressor support, and comprehensive treatment approaches including mechanical ventilation, hemodynamic stability could not be achieved, and the patient died due to progressive circulatory failure. The absence of a specific antidote makes the treatment of AlP poisoning extremely challenging and significantly limits management options, particularly in severe cases. In the literature, the pathophysiological mechanisms of phosphine toxicity have been described in detail, and vasopressor therapies in shock management, antioxidant approaches aimed at reducing oxidative injury, and extracorporeal membrane oxygenation (ECMO) as a potential rescue treatment option in refractory cardiogenic shock come to the forefront. This case is presented to highlight the clinical features and management challenges of fatal AlP poisoning.

Aims: This study aims to investigate the association between maternal social media addiction and childhood obesity. Specifically, it explores how maternal problematic social media use may contribute to childhood obesity by influencing parenting practices and the nutritional environment at home. By addressing this relationship, the study seeks to provide insight into psychosocial and digital factors that may underlie obesity risk in children, beyond traditional lifestyle-related determinants. Methods: This cross-sectional study included 161 mother-child dyads (ages 4–11) recruited from a pediatric outpatient clinic. Standardized measures were used to assess maternal social media addiction (BSMAS), psychological symptoms (DASS-21), feeding styles (CFQ), and children's eating behaviors (CEBQ). Children’s BMI-for-age z-scores were calculated using WHO standards. Correlational and multiple linear regression analyses were conducted using SPSS 29. Results: Children with obesity (n=65) had significantly lower mean age (p=0.007) and higher maternal BMI (p=0.009) than their normal-weight peers. Mothers in the obese group reported significantly higher social media addiction scores (p=0.019), anxiety (p=0.044), and stress levels (p=0.015). Children in the obesity group exhibited higher levels of emotional overeating (p=0.027), food enjoyment (p=0.002), and emotional undereating (p<0.001). Maternal social media addiction was positively correlated with child BMI (r=0.164, p=0.038) and problematic media use in children (r=0.330, p<0.001). Regression analysis revealed that child age, maternal BMI, and maternal social media addiction significantly predicted child BMI (R²=0.308, p<0.001). Conclusion: The findings suggest that maternal social media addiction may be a relevant psychosocial risk factor for childhood obesity, influencing both maternal functioning and child media use. Preventive strategies should address family-based digital media habits alongside traditional dietary and lifestyle interventions.

Aim: This study aimed to evaluate the knowledge and attitudes of family physicians and family health personnel who are responsible for childhood vaccination services in primary care regarding meningococcal, rotavirus, and human papillomavirus vaccines. Methods: This cross-sectional study was conducted between October 2021 and January 2022. A total of 700 healthcare professionals from all geographical regions in Turkey were included in the study. The participants filled out an online questionnaire consisting of 39 questions created with Google Forms. Results: Of the participants, 340 (48.6%) are family physicians, and 360 (51.4%) are family health personnel. Most participants are from the Marmara region, Turkey’s most densely populated region. The most recommended vaccine among the participants was rotavirus (84.3%), while the least recommended vaccine was human papilloma virus (47.6%). The number of family physicians recommending meningococcal and human papilloma virus vaccines was significantly higher than that of family health personnel (p < 0.001). Furthermore, there was a statistically significant correlation between seeing a patient with these viruses in one’s professional life or considering the severity of these three diseases to be severe and recommending these vaccines (p < 0.001 for both). However, lack of knowledge about vaccines and doses, the high cost of vaccines, and concerns about side effects were among the reasons for not recommending vaccines. Conclusions: Healthcare professionals involved in childhood immunization should be trained to increase their knowledge and awareness on this issue. The training plan and curriculum should take into account the issues raised in our research, such as age, occupation, region of residence, and professional experience. In general, knowledge about the efficacy and safety of vaccines will help healthcare professionals develop their confidence in vaccines and willingness to recommend childhood vaccines to others.

This study aimed to compare parents' knowledge and attitudes of children with special needs and normally developing children about child sexual abuse. The study was cross-sectional, descriptive, and correlational design, and the sample consisted of 228 parents, including 153 parents of normal children and 75 parents of children with special needs. Personal Information Form and Child Abuse Knowledge/Attitude Scale for Parents were used to collect the data. The only independent variable with explanatory power on the level of Child Abuse Knowledge and Attitude was found to be educational status. In the model created with this variable, educational status explained 2.9% of the variation on the total score of the Child Abuse Knowledge and Attitude Scale. Ninety-four point eight percent of the parents had no previous education about sexual abuse against children but were informed about it. Parents' knowledge and attitudes towards sexual abuse were significantly affected by the educational status of the parents. In this context, awareness should be increased through school-based programs organized by mental health professionals.

Aims: Immature granulocyte (IG) is an easily accessible and inexpensive test that can be measured in hemogram parameters without additional analysis. It can be used in differentiation because of its practical applicability. This study aimed to investigate the role of IG count and inflammation-related complete blood count (CBC) parameters in differentiating between cystitis (CYS) and pyelonephritis (PYL) in pediatric patients. Methods: This retrospective cross-sectional study analyzed data from 79 pediatric patients (40 with PYL and 39 with CYS) who presented at a hospital pediatric outpatient clinic between January 2020 - February 2021. In addition to clinical symptoms and signs, laboratory and urinalysis results were evaluated. Laboratory analyses focused on IG count, IG percentage, and all hemogram parameters. Results: No significant demographic differences were observed between the PYL and CYS groups (p>0.05). IG counts, and C-reactive protein levels significantly differed between the two conditions (p<0.001). IG count was identified as an independent factor for distinguishing between PYL and CYS, with a sensitivity of 89.5% and a specificity of 92.6% (p<0.0001). Conclusion: The IG count, an easily accessible and cost-effective test, is valuable in differentiating PYL and CYS (p<0.001). This finding holds promising implications for the prompt and accurate diagnosis of these conditions in pediatric patients.

To examine the effects of individual education given to Turkish adolescents with Familial Mediterranean fever (FMF) on anxiety, depression, and quality of life. The randomized controlled experimental study was performed on 70 adolescents aged 12–18 years who were diagnosed as having FMF between October 2021 and April 2022 in Turkey. The disease management education was offered individually to adolescents in the intervention group with a booklet entitled “FMF is under my control;” no intervention was applied to adolescents in the control group. The training booklet was prepared by the researchers in a multidisciplinary team and was finalized by taking expert opinions. In the data collection process, a personal information form, the State-Trait Anxiety Inventory for Children (STAI-CH), the children’s depression inventory (CDI), and the Pediatric Quality of Life Inventory (PedsQL) were used. After applying the scales specified in the pretest, individual training was given and the posttest was performed 2 months later using the same scales. After the education, there was a statistically significant decrease in the mean CDI score of the intervention group (p < 0.05), whereas there were statistically significant increases in mean scores obtained on PedsQL and its sub-scales (p < 0.05). However, the decrease in the mean STAI-CH score of the intervention group was not statistically significant (p > 0.05). There was no statistically significant difference in the mean STAI-CH, CDI, and PedsQL scores of the control group after the education (p > 0.05).   Conclusion: The effectiveness of the individual education program for adolescents with FMF in improving quality of life and reducing levels of depression within the scope of disease management has been confirmed. It is recommended that all health professionals working with children with FMF regularly provide individual or group-planned education programs. What is Known: • The unpredictability of FMF attacks has a very negative effect on adolescents. • Individual education programs on FMF focus on children with a holistic approach. What is New: • To the best of our knowledge, this study is the first study to evaluate disease management education given to adolescents with FMF. • This is a pioneering study of the use of nurses in the education of adolescents with FMF and in fulfilling their educational roles.

Amaç: Pnömoni, tüm dünyada çocuk ölümlerinin önde gelen sebeplerinden biridir. Çalışmamızda pnömonili çocukların prognozunu tahmin etmede tam kan sayımı [complete blood count (CBC)] parametrelerinin etkisini araştırmak amaçlanmıştır. Gereç ve Yöntemler: Hastanemizde pnömoni tanısı almış 162 çocuk hasta retrospektif olarak incelendi. Hastalar; yoğun bakımda tedavi görenler (Grup I: ağır şiddette pnömoni, n=57), serviste tedavi görenler (Grup II: orta şiddette pnömoni, n=56) ve ayaktan tedavi ile iyileşenler (Grup III: hafif şiddette pnömoni, n=49) olarak 3 gruba ayrıldı ve hastaların herhangi bir tedavi almadan önce, ilk başvuru anındaki CBC parametreleri karşılaştırıldı. Bulgular: Grup I'deki hastaların eritrosit dağılım genişliği [red cell distribution width (RDW)], nötrofil/lenfosit oranı [neutrophil/lymphocyte ratio (NLR)] ve C-reaktif proteini (CRP) Grup II ve Grup III'teki hastalardan anlamlı şekilde yüksekti, hemoglobin/RDW oranı [hemoglobin/RDW ratio (HRR)] ise anlamlı şekilde düşüktü (p<0,001). Grup I'deki hastalarda RDW ve NLR'nin CRP ile pozitif korelasyon gösterdiği (sırasıyla r=0,637; p<0,001, r=0,705; p<0,001), HRR'nin ise CRP ile negatif korelasyon gösterdiği (r=0,562; p<0,001) saptandı. RDW, NLR, CRP ve bu değerlerin kombinasyonunun şiddetli pnömoni varlığını öngörmede yüksek duyarlılık (sırasıyla %89,5, %91,2, %86,0 ve %87,7) ve özgüllüğe (sırasıyla %86,7, %90,5, %86,7 ve %87,6) sahip oldukları saptandı, eğri altında kalan alanlar değerleri sırasıyla 0,944, 0,945, 0,938 ve 0,953 bulundu. Sonuç: Pnömoni tanısı alan çocuklarda RDW, NLR, HRR ve CRP prognozu tahmin etmede etkili parametrelerdir ve yoğun bakıma yatışı öngörmede yüksek duyarlılık ve özgüllüğe sahiptirler.