A nationwide study of social-emotional problems in young children in Turkey

PubMed ID: 23347970We aimed to assess the prevalence of social-emotional problems of Turkish children in early childhood and to understand their association with various bio-psycho-social risk factors, in order to establish guidelines in planning training programs for parents and professionals. Data from a representative sample of 1507 boys (54.3%) and 1268 girls (45.7%) aged 10-48 months were collected. The primary caregivers (mothers = 91.4%) completed the Brief Infant-Toddler Social and Emotional Assessment (BITSEA), the Brief Symptom Inventory (BSI) and a form designed to gather information about various bio-psycho-social risk factors. Based on the caregiver terms, a total of 1626 children (60.1%) were reported to experience social-emotional problems. However, based on the BITSEA-problem clinical (1.5 SD) cut-off scores, 9.3% (9.1% of boys; 9.5% of girls) of all children were found to experience social-emotional problems. The variables, that showed a significant association with BITSEA-problem scores in pairwise comparisons, were entered in logistic regression analysis to determine the variables that predict the group with scores of above clinical cut-point. Higher total score of BSI of the primary caregiver, being separated from the mother for more than a month, and lower income of the family were found to be significant predictors of social-emotional problems. Caregiver reports highlight that maternal variables of mothers' psychological well-being, education and access to sources of support are closely related to the social-emotional wellbeing of their off-spring. The findings obtained from this study may be used for detection of prioritized domains in terms of management of preventive mental health services. © 2012 Elsevier Inc

Global perspective of familial hypercholesterolaemia: a cross-sectional study from the EAS Familial Hypercholesterolaemia Studies Collaboration (FHSC)

Background The European Atherosclerosis Society Familial Hypercholesterolaemia Studies Collaboration (FHSC) global registry provides a platform for the global surveillance of familial hypercholesterolaemia through harmonisation and pooling of multinational data. In this study, we aimed to characterise the adult population with heterozygous familial hypercholesterolaemia and described how it is detected and managed globally. Methods Using FHSC global registry data, we did a cross-sectional assessment of adults (aged 18 years or older) with a clinical or genetic diagnosis of probable or definite heterozygous familial hypercholesterolaemia at the time they were entered into the registries. Data were assessed overall and by WHO regions, sex, and index versus non-index cases. Findings Of the 61 612 individuals in the registry, 42 167 adults (21 999 [53·6%] women) from 56 countries were included in the study. Of these, 31 798 (75·4%) were diagnosed with the Dutch Lipid Clinic Network criteria, and 35 490 (84·2%) were from the WHO region of Europe. Median age of participants at entry in the registry was 46·2 years (IQR 34·3–58·0); median age at diagnosis of familial hypercholesterolaemia was 44·4 years (32·5–56·5), with 40·2% of participants younger than 40 years when diagnosed. Prevalence of cardiovascular risk factors increased progressively with age and varied by WHO region. Prevalence of coronary disease was 17·4% (2·1% for stroke and 5·2% for peripheral artery disease), increasing with concentrations of untreated LDL cholesterol, and was about two times lower in women than in men. Among patients receiving lipid-lowering medications, 16 803 (81·1%) were receiving statins and 3691 (21·2%) were on combination therapy, with greater use of more potent lipid-lowering medication in men than in women. Median LDL cholesterol was 5·43 mmol/L (IQR 4·32–6·72) among patients not taking lipid-lowering medications and 4·23 mmol/L (3·20–5·66) among those taking them. Among patients taking lipid-lowering medications, 2·7% had LDL cholesterol lower than 1·8 mmol/L; the use of combination therapy, particularly with three drugs and with proprotein convertase subtilisin–kexin type 9 inhibitors, was associated with a higher proportion and greater odds of having LDL cholesterol lower than 1·8 mmol/L. Compared with index cases, patients who were non-index cases were younger, with lower LDL cholesterol and lower prevalence of cardiovascular risk factors and cardiovascular diseases (all p<0·001). Interpretation Familial hypercholesterolaemia is diagnosed late. Guideline-recommended LDL cholesterol concentrations are infrequently achieved with single-drug therapy. Cardiovascular risk factors and presence of coronary disease were lower among non-index cases, who were diagnosed earlier. Earlier detection and greater use of combination therapies are required to reduce the global burden of familial hypercholesterolaemia. Funding Pfizer, Amgen, Merck Sharp & Dohme, Sanofi–Aventis, Daiichi Sankyo, and Regeneron