Postpartum mood disorders and maternal perceptions of infant patterns in well-child follow-up visits

Aims: The aims of this study were to evaluate the associations between postpartum depressive symptoms and maternal perceptions of infant patterns with 1-year follow-up examinations, and to assess the impacts of treatment on these perceptions. Methods: One hundred three mother-infant pairs were evaluated. Data on maternal reports of infant feeding, sleeping and temperament patterns were collected at each well-child visit. The Edinburgh Postpartum Depression Scale was used to assess depressive symptoms. A psychiatrist interviewed the mothers with depressive symptoms, and psychiatric treatments were administered accordingly. The associations between depressive symptoms and maternal perceptions at each visit were analyzed by taking into account the entire follow-up period. Results: Thirty-five mothers (34%) scored within the clinical range of the EPDS during the follow-up period. Mothers with elevated depressive symptoms were more inclined to report infant cry-fuss, sleeping and temperamental problems through the follow-up. Such complains on infant cry-fuss and temperament problems and maternal sleeping problems improved after treatment in compliant mothers. The dropout rate was high (58.3%) in noncompliant mothers. Conclusion: Postpartum depressive symptoms may lead to negative maternal perceptions of infant patterns. Earlier management of these disorders and maternal compliance to psychiatric suggestions may provide a better care for the mother-infant pairs

Fate of triclosan in laboratory-scale activated sludge reactors - Effect of culture acclimation

Triclosan (TCS); a widely used antimicrobial biocide, exists in several pharmaceutical and personal care products. Due to its wide usage, TCS is detected in wastewater at varying concentrations. Biological treatability of TCS and its effect on chemical oxygen demand (COD) removal efficiency were investigated running laboratory-scale pulse-fed sequencing batch reactors with acclimated and non-acclimated cultures. The culture was acclimatized to TCS by gradually increasing its concentration in the synthetic feed wastewater from 100 ng/L to 100 mg/L. There were no effects of TCS on COD removal efficiency up to the TCS concentration of 500 ng/L for both acclimatized and non-acclimatized cases. However, starting from a concentration of 1 mg/L, TCS affected the COD removal efficiency adversely. This effect was more pronounced with non-acclimatized culture. The decrease in the COD removal efficiency reached to 47% and 42% at the TCS concentration of 100 mg/L, under acclimation and non-acclimation conditions respectively. Adsorption of TCS into biomass was evidenced at higher TCS concentrations especially with non-acclimated cultures. 2,4-dichlorophenol and 2,4-dichloroanisole were identified as biodegradation by-products. The occurrence and distribution of these metabolites in the effluent and sludge matrices were found to be highly variable depending, especially, on the culture acclimation conditions

Triclosan removal from surface water by ozonation - Kinetics and by-products formation

Removal of triclosan from surface water by ozonation was investigated. The results showed that complete elimination of triclosan from a surface water bearing 1-5 mg/L triclosan via continuous ozonation at 5 mg/L, require an ozonation time of 20-30 min depending on pH. Triclosan oxidation followed pseudo-first order kinetics with an apparent reaction rate constant varying from 0.214 min(-1) to 0.964 min(-1) depending on pH, initial triclosan concentration and water composition. Although the effect of pH was complex due to possible existence of different moieties, higher TCS removal efficiencies were obvious at weak-base conditions. Experiments performed to identify degradation by-products showed the formation of four by-products, namely, 2,4-dichlorophenol, 4-chlorocatechol and two unidentified compounds. Additionally, 2,4-dichloroanisole was detected when a methyl moieties exist in water. By-products were found to be eliminated upon further ozonation. The required exposure time varied from 20 to 30 min depending on pH of water. The ozone demand exerted for the complete oxidation of triclosan and its by-products was calculated as 13.04 mg ozone per mg of triclosan. A triclosan degradation pathway, which was found to be highly pH dependent, was proposed

Comparison of tidos with m-chat for screening autism spectrum disorder

OBJECTIVES: Modified Checklist for Autism in Toddlers (M-CHAT) is widely used internationally to screen autism spectrum disorder (ASD). Three-item Direct Observation Screen (TIDOS) is a novel observational tool which may be used by physicians in a short time as a part of routine well-child visit. It includes the following: (a) Joint Attention, (b) Eye Contact, and (c) Response to Name. We aimed to compare the screening performance of TIDOS and M-CHAT for ASD. MATERIAL AND METHODS: A total of 1345 children aged 16–38 months were examined during well-child care visits at Social Pediatrics Department of Ankara University between May 2015 and May 2016. Five hundred and eleven of 1345 children aged 16—38 months whose parents approved informed consent were enrolled in this study to evaluate the performance of two screening tests: TIDOS and M-CHAT for ASD. The children whose screening tests were positive and controls whose tests were negative had undergone clinical evaluation for the diagnosis of ASD. Clinical evaluation was performed within 2 weeks of the initial M-CHAT, M-CHAT/F, or TIDOS screenings for screening positive children and within 3–9 months for screening randomly selected negative children. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of those tests were determined. RESULTS: ASD was diagnosed in 5 of the 511 children in a healthy child clinic of a university hospital with the prevalence of approximately 1%. All the children with ASD were boys. The growth parameters (including body weight, height, head circumference) did not have any properties. There were no consanguineous marriages among the parents of children with ASD. The ages of mothers and fathers of the children with ASD were in a range between 31–39 years and 31–46 years, respectively. The sensitivity for diagnosis of ASD was found to be 0.60 for both M-CHAT and M-CHAT/F tests. The specificity of M-CHAT and M-CHAT/F tests for diagnosis of ASD was found to be 0.96 and 0.97, respectively. PPV were found to be 0.14 and 0.18, respectively. The sensitivity for diagnosis of ASD was found to be 0.80 for TIDOS. Specificity and PPV in the diagnosis of ASD were found to be 0.99 and 0.80, respectively. NPV for all tests were above 0.99. CONCLUSION: The current study has demonstrated that TIDOS was more sensitive and had higher PPV than M-CHAT. TIDOS has required little time and might be easily combined to routine physical examination of toddlers attending 18- to 36-month well-child clinic visits

Evaluation of Child Refugees’ Reasons for Applying to Hospital: Ankara Experience

Aim: The aim of this study was to identify the diagnosis characteristics of the refugees who applied to pediatric emergency and pediatric outpatient policlinics of a major hospital in Ankara. Materials and Methods: Files of patients admitted to the pediatric emergency and pediatric outpatient polyclinics between January and December of 2017 were analyzed retrospectively. Results: There were 12,385 refugee applications to the pediatric emergency polyclinic during this period. The number of refugee applications to the outpatient pediatrics polyclinic was 8,341. The distribution of the nationality of the refugee children who applied to the emergency polyclinic was 46.2% Syrian, 50.6% Iraqi, 1.2% Afghan, and 2% from other countries. The distribution of the nationality of the refugee children who applied to the outpatient polyclinic was 51.9% Syrian, 45.9% Iraqi, 0.9% Afghan, and 1.3% from other countries. The most frequent diagnosis of refugee children admitted to the pediatric emergency polyclinic and outpatient polyclinics were upper respiratory tract infections and lower respiratory tract infections. 21.4% of the refugee patients who applied to the emergency polyclinic were admitted to the pediatric clinic or the pediatric intensive care unit. Of these patients, 1.1% were hospitalized for varicella and 0.8% were hospitalized for hepatitis A. Malnutritionwas observed in 6.2%, anemia of iron deficiency was observed in 23.8%, and vitamin B12 deficiency was observed in 9.6% of the patients. Conclusions: We recommend that every refugee child should be scanned for malnutrition and anemia and nutritional support should be provided to preserve their health

The role of social support on the relationships between internet use and sleep problems in adolescents during COVID-19 pandemic: a multicentre study

BackgroundThis study examines the frequency of problematic internet use and sleep problems in adolescents aged 14-18 years during the COVID-19 pandemic and identifies the impact of factors such as sociodemographic characteristics, internet habits, changes in daily life, and perceived social support on these problems. MethodsThis multicentre study was a questionnaire-based online survey study. The questionnaire included the Young Internet Addiction Scale, the Pittsburgh Sleep Quality Index, and the Multidimensional Scale of Perceived Social Support, as well as questions about demographic information, internet habits, and changes in daily life during pandemic. Several multivariate Backward logistic regression models were run to determine the variables that predicted problematic internet use and poor sleep quality. ResultsIt was determined that the frequency of problematic internet use was 15.5%, and the frequency of poor sleep quality was 47.8%. Poor sleep quality was found 2.5 times higher in problematic internet users. The perceived social support was found insufficient in adolescents with problematic internet use and poor sleep quality. Various factors such as the excessive use of internet and social media, low school success, lack of physical activity, lack of rules for internet use at home, and worsening of relationships with parents were found to be predictive factors for these problems. ConclusionsProblematic internet use during the pandemic is associated with worsening sleep quality in adolescents. It is important to create special interventions for problematic internet use and sleep problems that develop in adolescents as a result of restrictions during the pandemic