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Öğe Communication skills of residents to families with Down syndrome babies(Soc Argentina Pediatria, 2016) Dogan, Derya G.; Kutluturk, Yesim; Kivilcim, Meltem; Canaloglu, Sinem K.Background. Generally, pediatricians are the first health caregivers to deliver initial diagnosis of Down syndrome (DS) to the families. However, most of the parents are not satisfied with the contents and how they receive information when their child is born with DS. Pediatric residents should target educational interventions to help parents to overcome with these issues and to provide accurate information. The objective is to assess comfort levels and training requirements of pediatric residents to communicate with parents of babies born with Down syndrome. Methods. Diagnostic Situations Inventory (DSI) is a rating scale which included ten questions to assess discomfort level. A survey was sent via mobile, websites and all the social media which were available to all pediatrics residents in the country. Socio-demographic factors including information about training requirement were collected as well. Results. From the 326 participants, total mean discomfort level was 30.22 in DSI out of 50 which was the highest score. Discomfort level was significantly increased in female participants (p=0.033). Being female (p=0.014), having less residency level (p=0.028), examining less number of patients with Down syndrome (p=0.025) and having higher discomfort levels (p=0.001) were found to be related with increased training requirement. From the residents, 84% declared the need for additional training. Conclusions. This study showed that pediatric residents had a high level of discomfort when communicating with parentes of newborn with Down Syndrome. Female residentes had a discomfort level significantly higher than male residentes.Öğe Developmental assessment of children with Down syndrome(2019) Dincer, Serpil; Gumus Dogan, Derya; Kivilcim, Meltem; Kortay Canaloglu, SinemAim: Morbidity and mortality of children with Down syndrome (DS) have decreased and their quality of life has increased with modern medicine. The purpose of this study is to assess the developmental characteristics and activities of children with DS and also their participation to life, the environmental factors, the services they receive and their health and sociodemographic characteristics by using Expanded Guide for Monitoring Child Development (E-GMCD) Material and Methods: Children diagnosed with DS who were admitted to hospital were assessed with E-GMCD. Health information and the family’s sociodemographic features were supplied from families and hospital files. Results: The study included a total of 100 children diagnosed with DS, 41 girls and 59 boys, who were between 2-59 months of age. The mothers of the 63 children stated that they were concerned about their children’s learning, motor skills, communication, relationships with others, and senses (sense of hearing and seeing). Of the 57 (81%) children were found to have delay in expressive language and were older than 1 year old (p<0.05). The delay in gross motor domain seemed to decrease with the increase by age, it was not found to be statistically significant (p>0.05). A majority of children who received specialized education and physiotherapy were between ages of 2 and 4. Conclusion: Children with DS should be monitored regularly beginning from the day they are born. These children should get early education to speed up their cognitive development. Family centered early support programs should start as early as possibleÖğe Diagnostic value of “t sign” on MRCP-MIP imaging in the evaluation of pancreas divisum(2019) Kivilcim, Meltem; Gumus Dogan, Derya; Kortay Canaloglu, Sinem; Varol, Fatma Ilknur; Selimoglu, Mukadder AyseAim: Feeding difficulties are common in typically developing children and the prevalence ranges from 25% to 45%. Although using an assessment tool is the best approach when planning an intervention, assessment of feeding disorders is mostly accomplished by informal parent interviews in clinical practice. This study was designed to assess the mealtime behaviours of young children with ‘Feeding Difficulties’ (FD) by an instrument and to compare the results with ‘Typically Developing’ (TD) children.Material and Methods: A total of 61 children with FDs and 63 TD children aged 6-42 months were included. The Behavioral Pediatric Feeding Assessment Scale (BPFAS) was completed to describe the child’s feeding behaviors and the parents’ mealtime strategies. Results:FD group had higher scores than TD group in all BPFAS subtests’ scores. The mean ‘Total Frequency Score’ was 104.6 in FD group whereas 72.9 in TD group (p=0.0001). The FD group had more problematic feeding behaviours in comparison to TD group. The mean ‘Total Problem Score’ of TD group was 6.1 whereas 20.1 in children with FD (p=0.0001).Conclusion: This study supports the BPFAS to be a useful and practical feeding assessment tool and also has the advantage of incorporating parents’ feelings about child’s feeding behaviors.Öğe The Effectiveness of Cinacalcet as an Adjunctive Therapy for Hereditary 1,25 Dihydroxyvitamin D3-Resistant Rickets(Galenos Yayincilik, 2017) Akinci, Aysehan; Dundar, Ismail; Kivilcim, MeltemHigh doses of oral calcium or long-term calcium infusions are recommended to correct the hypocalcemia and secondary hyperparathyroidism in patients with hereditary 1,25 dihydroxyvitamin D-3-resistant rickets (HVDRR). Preliminary studies revealed that calcimimetics may be a safe and effective therapeutic choice in children with secondary hyperparathyroidism. Our aim was to observe the efficacy of cinacalcet in the normalization of secondary hyperparathyroidism and hypophosphatemia in two siblings aged 2.5 years and 6 months with HVDRR who did not respond to traditional treatment regimes. Both patients were admitted to the hospital with severe hypocalcemia. They were treated with high doses of calcitriol and calcium infusions intravenously. Secondary hyperparathyroidism was normalized temporarily, but did not improve completely. Cinacalcet (0.25 mg/kg) once a day along with the high doses of oral calcium and calcitriol was added to the treatment schedule. After 3 months, biochemical and radiologic findings reverted to normal. Our findings indicate that cinacalcet is effective in normalizing the hyperparathyroidism and hypophosphatemia in these cases and in improving the bone pathology.Öğe Evaluation of the Attitudes of Pediatric Residents and Medical Students Towards Child and Death(Galenos Yayincilik, 2014) Kivilcim, Meltem; Dogan, Derya Gumus; Canaloglu, Sinem Kortay; Serbes, MahirIntroduction: The aim of this study was to determine the experiences and attitudes of pediatric residents and medical students about approaching to child who encounters with death and to the family who have lost their child. Materials and Methods: Totally 50 pediatric residents and medical students from the Department of Pediatrics at Inonui University included in this study. A 5-part evaluation form that was prepared by the authors was applied. These parts consist of questions about frequency of experiences with child death, competency levels related to sharing bad news and explaining death to children and family. Results: The mean age of the participants was 26.9 +/- 4.0 years and 56% of them were males. The percentage of experiencing child death was 92%. Of the respondents 80% reported that they didn't feel adequately trained about sharing bad news. 68% of the residents and 76% of the students stated that they haven't been trained on approaches on death and on fatal disease and all of the participants agreed on necessity of taking education. Of the respondents 46% consider that children begin to perceive death issue at ages of 6-7. Conclusions: In this study, it was detected that with the increase of frequency of experiencing child death, the rate of competency level wasn't rising as well as having difficulty with sharing bad news wasn't decreasing. There are misconceptions in communities about how to explain death concept to child and how to console families who have lost their child. The results of this study showed that experiencing death frequently alone isn't effective in increasing the competency level on sharing bad news but education constitutes a significant part. Physicians should learn the developmental characteristics of death during medical education and should have necessary knowledge and skills to manage the process after loss.Öğe Experience of mothers with Down syndrome children at the time of diagnosis(Soc Argentina Pediatria, 2019) Buyukavci, Mehmet A.; Dogan, Derya G.; Canaloglu, Sinem K.; Kivilcim, MeltemIntroduction. Down's syndrome (DS) is a common genetic disorder. The families of children with DS generally do not receive sufficient information at the time of the diagnosis. They are dissatisfied with the manner of healthcare professionals. The objective was to evaluate the experiences of mothers of children with DS at the time of the diagnosis and the communicative attitudes of healthcare professionals. Population and methods. Mothers who had children with Down syndrome were included. The experiences of the mothers at the time of diagnosis and the attitudes of the healthcare professionals were evaluated by a semi-structured interview. Results. The study sample was 43 mothers. Eight children had been diagnosed with DS prenatally, and 35 had been diagnosed postnatally. Eighteen of the mothers had received the diagnosis in a pediatric clinic, and 16 had been told of the diagnosis in an obstetric clinic. More than half the mothers had received the first information about their child's diagnosis from a pediatrician. Only five of the 43 mothers had received detailed information. Twenty-three of 32 mothers said that they were met with a negative attitude. Generally, the time put aside to inform the families about the diagnosis was less than 5 min. Conclusions. Mothers of DS children want more information about DS from healthcare professionals. Furthermore, they want this information to be delivered in a supportive and sensitive manner. Healthcare professionals, especially pediatricians need to allocate sufficient time to discuss DS and its challenges with the family.Öğe Sleep patterns of young children with newly diagnosed atopic dermatitis(Termedia Publishing House Ltd, 2017) Dogan, Derya Gumus; Canaloglu, Sinem Kortay; Kivilcim, Meltem; Kum, Yunus Emre; Topal, Erdem; Catal, FerhatIntroduction: Even though atopic dermatitis (AD) most often begins in the first year of life, it is not well known whether sleep disturbances occur following the onset of the disease or whether they develop later. Aim: To determine the sleep patterns of young children already diagnosed with AD in comparison to a control group by using a validated questionnaire, the Brief Infant Sleep Questionnaire (BISQ). Material and methods: Forty-six children with a new diagnosis of AD and 60 healthy children, aged 3-36 months, participated in the study. Their sleep behaviors were assessed using the BISQ along with a structured sociodemographic data form. Results: It was found that when compared with healthy children, children with AD did not have decreased daily total sleep duration (p = 0.1); however, it was found that they woke up more frequently at night (52.2% vs. 40%, p = 0.4) and they stayed awake significantly longer than 60 min when they woke up (41.3% vs. 11.7%, p < 0.05). In addition, mothers of children with AD reported that their children had three times as many sleep problems compared to the reports of mothers of healthy children. Conclusions: The findings of this study showed that sleep disturbance was more common in young children with already diagnosed AD, and the BISQ provided a practical way to assess the sleep patterns. The use of a screening tool to enable early identification and treatment of childhood sleep problems among patients with AD should be encouraged.
