Objective: This study aimed to evaluate the effects of impulsivity and emotion dysregulation on trichotillomania (TTM) in adolescents with bipolar disorder (BD). We hypothesized that adolescents with comorbid BD and TTM would exhibit higher impulsivity, more severe emotion dysregulation, and a more complex clinical presentation compared to adolescents with BD alone and healthy controls. Method: In this cross-sectional study, 120 adolescents aged 12-18 were assessed, comprising three groups: BD with a history of TTM (n=40), BD without TTM (n=40), and healthy controls (n=40). Participants were evaluated using standardized measures including the Barratt Impulsivity Scale (BIS-11), the Difficulties in Emotion Regulation Scale (DERS), the Young Mania Rating Scale (YMRS), and the Trichotillomania Global Severity Scale (TGSS). Results: Both clinical groups (BD+TTM and BD-only) displayed significantly higher impulsivity than healthy controls, but there was no statistically significant difference between the two clinical groups in terms of impulsivity. However, a clear gradient was observed in emotion dysregulation; the BD+TTM group had the highest scores, followed by the BD-only group, with both being significantly higher than controls. Multiple regression analysis revealed that emotion dysregulation was the strongest predictor of TTM severity (β = 0.0598, p < 0.001). Furthermore, mania scores were significantly higher in the comorbid group and moderated the relationship between emotion dysregulation and impulsivity. Conclusion: A history of TTM in adolescents with BD is a clinical indicator of profound emotion dysregulation rather than merely elevated impulsivity. These findings suggest that hair-pulling may function as a maladaptive coping mechanism for overwhelming emotional states. Therapeutic interventions should therefore prioritize targeting emotion regulation skills in this high-risk comorbid population.
Background: Pain in children is one of the mostcritical symptoms that occur due to illness, trauma,and medical interventions and should be managedObjectives: This study was planned to develop theChildren's Pain Management Self-Efficacy Scale forPediatric Nurses and examine its Turkishpsychometric properties.Material and methods: The sample of thismethodological study consisted of 292 pediatricnurses. A sociodemographic information form andthe Children's Pain Management Self-Efficacy Scalefor Pediatric Nurses (PNCPM-Self Efficacy) wereused to collect data. Numbers, percentages, andmean scores were used for the descriptive data of thenurses, and content validity was analyzed usingexplanatory and confirmatory factor analyses,Cronbach’s α, item-total correlation, and split-half analysis. The scale consisted of 26 items and threesub-dimensions. Cronbach’s α value of the overallscale and sub-dimensions were 0.96, 0.92, 0.91, and091, respectively.Results:The scale explained 62.3% of the totalvariance. The first sub-dimension explained 24.5%of the total variance, the second 21.9%, and the third15.9%. The Goodness of Fit Indexes was found to begreater than 0.90, RMSEA less than 0.08, and otherfit indexes greater than 0.80.Conclusion:This scale is a valid and reliable tool fordetermining the self-efficacy levels of pediatricnurses regarding pain management in children.Keywords: Pediatric nursing, pain management,self-efficacy, scale development, psychometricproperties.
Introduction: Children with chronic neurological diseases such as spinal muscular atrophy (SMA) are at high risk of incomplete or delayed vaccination. This study aimed to assess the age-appropriate vaccination status of SMA patients and evaluate related factors in case of a mismatch. Methods This multicenter, cross-sectional survey was conducted in 13 pediatric neurology clinics across Türkiye. Clinical characteristics, concomitant diseases, and vaccination status according to the National Immunization Program (NIP) were analyzed. Additionally, the rates of non-NIP vaccines (rotavirus, influenza, meningococcal, and HPV) were investigated, and influenza vaccine recommendations were correlated with vaccination rates. Results A total of 315 SMA patients (54.6% male) with a mean age of 7 ± 5.2 years were included. SMA type distribution was 42.5% type 1, 32.7% type 2, and 24.8% type 3. Nusinersen was administered to 95.8% of patients. Age-appropriate vaccination rates according to the NIP ranged from 81.6% (hepatitis A) to 98.7% (BCG). However, the rates for non-NIP vaccines were significantly lower: rotavirus 8.9%, meningococcal 4.2%, and HPV 0.3%. Although 78.7% of patients were recommended the influenza vaccine, the administration rate was only 7.6%, with a significant decline during the COVID-19 pandemic (p = 0.008). The most common reason for incomplete vaccination was prolonged hospitalization due to intensive treatment, while parental vaccine refusal was 1.8%. Conclusion Vaccination rates were low in this nationwide SMA cohort. Well-structured vaccine programs should be implemented to ensure adherence to the NIP schedule and improve non-NIP vaccine uptake.
Industry 4.0 represents the latest phase of industrial evolution, characterized by the seamless integration of cyber-physical systems, the Internet of Things, big data analytics, artificial intelligence, advanced robotics, and cloud computing, enabling smart, adaptive, and interconnected processes where physical, digital, and biological realms converge. In parallel, healthcare has progressed from the traditional, physician-centered model of Healthcare 1.0 by introducing medical devices and digitized records to Healthcare 4.0, which leverages Industry 4.0 technologies to create personalized, data-driven, and patient-centric systems. In this context, we hereby introduce Pediatrics 4.0 as a new paradigm that adapts these innovations to children's unique developmental, physiological, and ethical considerations and aims to improve diagnostic precision, treatment personalization, and continuous monitoring in pediatric populations. Key applications include AI-driven diagnostic and predictive analytics, IoT-enabled remote monitoring, big data-powered epidemiological insights, robotic assistance in surgery and rehabilitation, and 3D printing for patient-specific devices and pharmaceuticals. However, realizing Pediatrics 4.0 requires addressing significant challenges-data privacy and security, algorithmic bias, interoperability and standardization, equitable access, regulatory alignment, the ethical complexities of consent, and long-term technology exposure. Future research should focus on explainable AI, pediatric-specific device design, robust data governance frameworks, dynamic ethical and legal guidelines, interdisciplinary collaboration, and workforce training to ensure these transformative technologies translate into safer, more effective, and more equitable child healthcare.
Amaç: Bu çalışmada Türkiye’de ebelik bölümü akademisyenlerinin stratejik hedefler doğrultusunda tavsiye edilen faaliyetlerin ülkemizde yürütülme durumu ile ilgili görüşleri değerlendirilmiştir. Yöntem: Tanımlayıcı nitelikteki araştırmaya Türkiye’deki farklı üniversitelerden akademisyenler dahil edilmiştir. Veriler, Google Form üzerinden online anket kullanılarak toplanmıştır. Veri toplama formunda akademisyenlere yönelik tanımlayıcı bilgiler ve Dünya Sağlık Örgütü’nün küresel stratejik hedefler kapsamında ebeliği güçlendirme faaliyetleri ile ilgili toplam 4 alandan oluşan 39 ifade yer almaktadır. Verilerin analizinde, sayı ve yüzde dağılımları alınarak, tanımlayıcı istatistikler uygulanmıştır. Bulgular: Akademisyenler, ulusal akreditasyon standartlarının oluşturulması ve sürdürülmesi (%87), meslekler arası ve meslek içi eğitim uygulamaları için teknik çalışma gruplarının oluşturulması (%63.4), ebelik uygulama standartlarının geliştirilmesi (%77,9) faaliyetlerine devam edildiğini; baş ebelik pozisyonlarının oluşturulması (%76,3), ebelik politikalarının gelişimini desteklemek için multidisipliner grupların oluşturulması (%59,5), ebelik işgücünden tam verimin sağlanabilmesi için finansal yatırımların uyumlu hale getirilmesi (%64,1) faaliyetlerinin ise başlatılmadığını ifade etmişlerdir. Sonuç: Akademisyenler, ülkemizde ebelik mesleğini güçlendirmeye yönelik faaliyetlerin çoğunlukla gelişim aşamasında olduğunu düşünmektedir. Bundan sonraki çalışmalarda küresel stratejik hedefler doğrultusunda ülkemizdeki ebelik mesleğinin gelişimi, yürütülen faaliyetlerin yürütülmesi ile ilgili ebe, öğrenci, akademisyen, yönetici, politika yapıcılar gibi farklı katılımcı gruplar ile sürekli nitel-nicel çalışmalar yapılmalıdır.
