Sıddıka Songül Yalçın

Factors that affect television viewing time in preschool and primary schoolchildren

Background : Excessive viewing of television (TV) has been linked to aggressive behavior, violence and childhood obesity.

Determinants of Exclusive Breast Feeding in sub-Saharan Africa: A Multilevel Approach.

BACKGROUND The study aimed to provide an overall picture of the general pattern of exclusive breast feeding (EBF) in sub-Saharan Africa (SSA) by examining maternal sociodemographic, antenatal and postnatal factors associated with EBF in the region, as well as explore countries variations in EBF rates. METHODS We utilised cross-sectional data from the Demographic Health Surveys in 27 SSA countries. Our study sample included 25 084 infants under 6 months of age. The key outcome variable was EBF in the last 24 h. Due to the hierarchical structure of the data, a multilevel logistic regression model was used to explore factors associated with EBF. RESULTS The overall prevalence of EBF in SSA was 36.0%, the prevalence was highest in Rwanda and lowest in Gabon. In the multilevel regression model, factors that were associated with increased likelihood of EBF included secondary and above maternal education, mothers within the ages of 25-34 years, rural residence, richer household wealth quantile, 4+ antenatal care visit, delivering in a health facility, singleton births, female infants, early initiation of breast feeding (EIBF), and younger infants. However, countries with higher gross national income per capita had lower EBF rates. CONCLUSIONS To achieve a substantial increase in EBF rates in SSA, breast-feeding interventions and policies should target all women but with more emphasis to mothers with younger age, low educational status, urban residence, poor status, multiple births, and male infants. In addition, there is a need to promote antenatal care utilisation, hospital deliveries, and EIBF.

Determinants of pre-lacteal feeding practices in urban and rural Nigeria; a population-based cross-sectional study using the 2013 Nigeria demographic and health survey data

Background Prelacteal feeding (PLF) is a barrier to exclusive breast feeding. Objective To determine factors associated with PLF in rural and urban Nigeria. Methods We utilized data from the 2013 Nigerian Demographic and Health Survey. Bivariate and multivariate analyses were used to test for association between PLF and related factors. Results Prevalence of PLF in urban Nigeria was 49.8%, while in rural Nigeria it was 66.4%. Sugar or glucose water was given more in urban Nigeria (9.7% vs 2.9%), plain water was given more in rural Nigeria (59.9% vs 40.8%). The multivariate analysis revealed that urban and rural Nigeria shared similarities with respect to factors like mothers education, place of delivery, and size of child at birth being significant predictors of PLF. Mode of delivery and type of birth were significant predictors of PLF only in urban Nigeria, whereas, mothers age at birth was a significant predictor of PLF only in rural Nigeria. Zones also showed variations in the odds of PLF according to place of residence. Conclusion Interventions aimed at decreasing PLF rate should be through a tailored approach, and should target at risk sub-groups based on place of residence.

Urinary bisphenol-A levels in children with type 1 diabetes mellitus.

Abstract Background: Bisphenol-A (BPA) is one of the most abundantly produced chemicals globally. Concerns have been raised about BPA’s possible role in the pathogenesis of type 1 diabetes mellitus (T1DM). The main aim of the current study was to evaluate the possible association between BPA exposure and T1DM. The second aim was to investigate children’s possible BPA exposure routes in Turkey. Methods: A total of 100 children aged between 5 and 18 years including 50 children with T1DM and 50 healthy children were included. Urinary BPA levels of all children were measured using high-performance liquid chromatography. Mothers of children enrolled in the study were also requested to complete a survey that included questions on the sociodemographic characteristics, medical history and possible BPA exposure routes of their children. Results: In the T1DM group, urinary BPA levels were slightly higher compared to the control group, but this difference was not significant (p=0.510). However, there was an inverse relationship between current urinary BPA levels and birth weight. It was found that the use of plastic kettles and the consumption of dairy products in plastic boxes significantly increased the urinary BPA concentrations in all subjects. Conclusions: Although there was no significant association between urinary BPA levels and T1DM, we found an inverse relationship between current urinary BPA levels and birth weight. This finding might be important for prenatal exposure, and further prospective research must be conducted. Also, the use of plastic kettles, which has not been mentioned much in the literature before, was found to be an important exposure route for BPA.

A possible etiological factor in obesity: element status in blood and tooth of overweight versus normal-weight children

ABSTRACT We aimed to assess element status in whole blood and tooth dentin and identify their correlations in overweight or obese children without additional metabolic risk factors. In a case-control study, 40 overweight and 80 normal weight children aged 6–10 years were enrolled. Samples of blood and tooth were collected. While all studied elements were similar in groups in univariate analysis, after adjustment for confounding factors, tooth Mn levels were lower and blood Zn levels were higher in the overweight/obese group (p = 0.049 and p = 0.032, respectively). A significant correlation in blood and tooth dentin levels of Sr and Zn was detected in both groups. In both biological substances, the concentrations of elements did not differ significantly in overweight children without metabolic comorbidities compared to healthy children of normal weight. Presence of low Mn levels in tooth dentin and high Zn levels in blood samples should be explored in further studies.

Agreement Between Integrated Management of Childhood Illness and Final Diagnosis in Acute Respiratory Tract Infections

ObjectiveTo evaluate the agreement between integrated management of childhood illness (IMCI) and final diagnosis in patients presenting with cough at the second and third level health institutions.MethodsThis cross-sectional study included 373 children aged 2–60 mo who presented with cough at the pediatric emergency and outpatient clinics in the Department of Pediatrics. After clinical examination of children, body temperature, respiratory rate, saturation, presence or absence of the chest indrawing, rales, wheezing and laryngeal stridor were recorded. Cases were categorized according to IMCI algorithm regarding the severity using the color code, such as red (urgent treatment), yellow (treatment in the hospital), or green (treatment at home). Final diagnosis after physical examination, laboratory analysis and chest X-ray was compared with the IMCI algorithm.ResultsStudy agreement between IMCI classification and final diagnosis was 74.3% with kappa value 0.55 (moderate agreement). Similar agreement values were detected in both the second and third level health institutions. Health condition and gender did not affect agreement value. Agreement were found to be high in patients <24 mo of age (ĸ = 0.67), presence of fever and cough (ĸ = 0.54), tachypnea (ĸ = 0.93), chest indrawing (ĸ = 1.00) and oxygen saturation of <94%(ĸ = 0.90).ConclusionsAdding saturation level to the IMCI algorithmic diagnosis may increase agreement between IMCI classification and final diagnosis.

Case Management Guidelines on Neurodevelopmental and Psychosocial Problems of Turner Syndrome

Patients with Turner syndrome are referred to doctors because of neurodevelopmental and behavioural problems such as attention deficiency, hyperactivity, special learning disorders, immaturity, peer problems and social adaptation difficulties during their high school period. However the number of references about these issues is limited. Giving priority to the patients’ other problems like short stature, pubertal problems and absence of follow-up procedures providing multidisciplinary team comprehension can lead to the undermining of such neurodevelopmental and behavioural problems. Such negative effects on the lives of patients with Turner syndrome, as well as on those of family members, may be prevented by providing multidisciplinary yearly diagnosis-prevention-intervention programmes.

Breastfeeding status and maternal psychopathologies: in a longitudinal study

The effect of maternal mood on breastfeeding initiation and exclusivity is not clear. Gagliardi et al 1 showed that even low levels of depressive symptoms detected by the Edinburgh Postnatal Depression Scale are negatively associated with breastfeeding. This prompted us to look at our data in Mother–Infant Care Study.2 3 In this comprehensive study, mothers voluntarily enrolled within 3 days post partum between July and October 2006 and followed. In the first interview, 577 mothers completed a questionnaire including maternal, gestational and neonatal characteristics, breastfeeding initiation time and the Brief Symptom Inventory (BSI). Of these women, 298 mothers were available at 4–6 weeks post partum for a telephone interview and were questioned about the feeding …