Family physicians in an Eastern Turkish City need training on child abuse and neglect: A cross-sectional study.

AIM: The study's purpose was to determine the knowledge, competencies, and approaches of family physicians in recognizing the signs of child neglect and abuse. METHODS: This cross-sectional study was conducted between 1 March and 30 August 2019 in the Erzurum province in Turkey. The population of the study was family physicians working in primary care. The data were collected with an instrument that included the Scale of Diagnosing the Symptoms and Risks of Child Abuse and Neglect (SDRCAN) and a socio-demographic information form. RESULTS: The mean age was 37.40 ± 8.78 years (min. 26, max. 60). Of the participants, 103 (n = 58.5%) were men. The most common types of encountered child abuse/neglect were physical abuse or neglect (each 27.8%, n = 49). Having received education on child abuse/neglect among participants was only 44.9% (n = 79). On the other hand, the rate of having encountered any child abuse/neglect was 40.3% (n = 71). Another result of this study is the proportion of family physicians feeling weak regarding history taking (30.7%, n = 54), physical exam (17.0%, n = 30), and cooperation with the authorities (13.1%, n = 23). Additionally, the different responses among the participants about action in case of encountering child abuse/neglect were remarkable. Being a woman was one prominent factor that increased the SDRCAN score (P < 0.001). CONCLUSION: The awareness and knowledge of family physicians in Erzurum about child maltreatment are inadequate. We recommend focusing on child maltreatment, especially in medical faculties, including this issue in the standard core curriculums, and organizing intermittent in-service training programs during the post-graduate working period.

Smoking among adolescents: relation to school success, socioeconomic status nutrition and self-esteem.

OBJECTIVE: Smoking is a worldwide health problem. This study was designed to evaluate the current status and to examine some potential factors affecting smoking among adolescents. DESIGN: Descriptive, cross-sectional study. SETTING: Community based study. SUBJECTS: Of all middle and high school students in Edirne, Turkey, 883 (6.83%) were randomly sampled. Mean age of the subjects was 15.0 +/- 1.8 years. METHOD: A self-applied questionnaire was used to collect demographic data, smoking status, school success, nutritional behaviour and self-esteem. The influence of different factors on smoking was evaluated with a logistic regression model. RESULTS: There were 89 active smokers (11.1%) with the critical age of 15 years for smoking commitment. 609 students (71.9%) were exposed to environmental tobacco smoke. Nutritional behaviour rich in vegetables (OR = 0.813), high school success (OR = 0.807), longer time reserved for homework (OR = 0.718) and eating breakfast (OR= 0.353) were significantly associated with a lower smoking rate. Having a mother, who smoked (OR = 2.155), increasing age (OR = 1.704), increasing number of siblings (OR = 1.351) and eating fast food (OR = 1.150) were associated with significantly higher smoking rates. CONCLUSION: An educational programme aimed at changing behaviour and attitude to tobacco smoking and including nutritional counselling with high emphasis on the transition age from early to late adolescence may be a successful primary prevention. In addition projects designed to improve school performance may lead to a reduction in smoking rates while providing an investment in the future of the teenagers.

Postpartum maternal levels of hemoglobin A1c and cord C-peptide in macrosomic infants of non-diabetic mothers.

OBJECTIVE: This study was designed to test the hypothesis that macrosomia in infants born to non-diabetic mothers is associated with an increased incidence of hyperinsulinemia and normal maternal glucose regulation in late pregnancy. METHODS: Twenty mothers and their macrosomic infants were chosen as the study group, and 20 mothers with their appropriate-for-gestational-age infants were chosen as the control group. RESULTS: No difference in postpartum mean hemoglobin A1c levels was observed between the mothers of macrosomic infants and those of control infants. Cord plasma C-peptide levels were significantly higher in macrosomic than in control infants. CONCLUSIONS: This study revealed that macrosomic infants of non-diabetic mothers were significantly more likely to have hyperinsulinemia than were normal-sized infants, and this hyperinsulinemia was not caused by dysregulation in glucose metabolism.

Investigation of the relationship between low Apgar scores and early neonatal thyroid function.

BACKGROUND: The aim of the present study was to assess the effects of low Apgar scores on perinatal thyroid function. METHODS: Forty full-term infants delivered by the normal spontaneous vaginal route were enrolled into the study. All babies had 1 and 5 min Apgar scores below 4. The control group consisted of 26 full-term healthy neonates. Cord blood and serum tri-iodothyronine (T3), thyroxine (T4), reverse tri-iodothyronine (rT3), free thyroxine (FT4), thyroid-stimulating hormone (TSH) and thyroid-binding globulin (TBG) determinations were performed by an enzyme immunoassay method. RESULTS: The mean values of FT4 and T4 observed in the cord blood of the study group were significantly lower compared with matched controls, whereas the mean TSH values were significantly higher. There were no differences in concentrations of T3, rT3 and TBG between the two groups. CONCLUSIONS: These results demonstrate the existence of transient hypothyroidism at birth in babies with Apgar scores below 4 delivered by the spontaneous vaginal route.