Person: BORAN, PERRAN
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BORAN
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PERRAN
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Publication Open Access Delivering the thinking healthy programme as a universal group intervention integrated into routine antenatal care: a randomized-controlled pilot study(2023-12-01) BORAN, PERRAN; DÖNMEZ, MELİKE; BARIŞ, HATİCE EZGİ; ALTAŞ, ZEYNEP MEVA; HIDIROĞLU, SEYHAN; SAVE, DİLŞAD; BORAN P., DÖNMEZ M., Barış E., Us M. C., ALTAŞ Z. M., Nisar A., Atif N., Sikander S., HIDIROĞLU S., SAVE D., et al.© 2023, The Author(s).Background: Women with perinatal depression and their children are at increased risk of poor health outcomes. There is a need to implement non-stigmatizing interventions into existing health systems which reduce psychosocial distress during pregnancy and prevent perinatal depression. We adapted the WHO-endorsed Thinking Healthy Programme (THP) to be delivered universally to all women attending routine online pregnancy schools in Istanbul, Turkey. This study aimed to evaluate the feasibility and acceptability of this intervention. Methods: This mixed-methods study incorporated a two-arm pilot randomized controlled trial and qualitative evaluation of the feasibility and acceptability of the adapted THP – Brief Group version (THP-BGV) to a range of stakeholders. We recruited pregnant women at 12-30 weeks’ gestation through pregnancy schools within the University Hospital’s catchment area. Women in the intervention arm received five online sessions of the THP-BGV delivered by antenatal nurses. The intervention employed principles of cognitive behaviour therapy to provide psychoeducation, behaviour activation, problem-solving strategies and group support to participants. In the control arm, women received usual care consisting of routine online educational pregnancy classes aided by the antenatal nurses. The women were assessed for depressive symptoms with the Edinburgh Postnatal Depression Scale at baseline and 4-6 weeks post-intervention and also evaluated for anxiety, perceived social support, partner relationship, level of disability and sleep quality. In-depth interviews were conducted with women and other key stakeholders. Results: Of the 99 consecutive women referred to the pregnancy schools, 91 (91.9%) were eligible and 88 (88.8%) consented to participate in the study and were randomized. Eighty-two (83%) completed the final assessments. Our main findings were that this preventive group intervention was feasible to be integrated into routine antenatal educational classes and it was valued by the women and delivery-agents. While the study was not powered to detect differences between intervention and control conditions, we found small trends towards reduction in anxiety and depressive symptoms favoring the intervention arm. No serious adverse events were reported. Conclusions: Given the paucity of preventive interventions for perinatal depression in low and middle-income countries, a fully powered definitive randomized controlled trial of this feasible and acceptable intervention should be conducted. Trial registration: The study was registered at Clinical Trails.gov (NCT04819711) (Registration Date: 29/03/2021).Publication Open Access Impact of lockdown and school closure on children's health and well-being during the first wave of COVID-19: a narrative review(BMJ PUBLISHING GROUP, 2021-05) BORAN, PERRAN; Rajmil, Luis; Hjern, Anders; Boran, Perran; Gunnlaugsson, Geir; Kraus de Camargo, Olaf; Raman, ShantiBackground In the context of containment measures against the COVID-19 pandemic, the aims were to examine the impact of lockdown and school closures on childs' and adolescents' health and well-being and social inequalities in health. Methods Literature review by searching five databases until November 2020. We included quantitative peer-reviewed studies reporting health and well-being outcomes in children (0-18 years) related to closure measures' impact due to COVID-19. A pair of authors assessed the risk of bias of included studies. A descriptive and narrative synthesis was carried out. Findings Twenty-two studies, including high-income, middle-income and low-income countries, fulfilled our search criteria and were judged not to have an increased risk of bias. Studies from Australia, Spain and China showed an increase in depressive symptoms and decrease in life satisfaction. A decrease in physical activity and increase in unhealthy food consumption were shown in studies from two countries. There was a decrease in the number of visits to the emergency department in four countries, an increase in child mortality in Cameroon and a decrease by over 50% of immunisations administered in Pakistan. A significant drop of 39% in child protection medical examination referrals during 2020 compared with the previous years was found in the UK, a decrease in allegations of child abuse and neglect by almost one-third due to school closures in Florida, and an increase in the number of children with physical child abuse trauma was found in one centre in the USA. Interpretation From available reports, pandemic school closure and lockdown have adverse effects on child health and well-being in the short and probably long term. We urge governments to take the negative public health consequences into account before adopting restrictive measures in childhood.Publication Open Access Seeing the pandemic through children's eyes: Exploring Turkish children's views on COVID-19 pandemic by focus-group discussions(2023-01-01) BORAN, PERRAN; Senkal E., Kurt O. M., YALÇIN S. S., Koller D., Boran P.BackgroundThe direct and indirect effects of the COVID-19 pandemic on children and youth people are well documented. Little is known about children\"s experiences of the pandemic in their own words. We aimed to explore Turkish children\"s experiences and views about the pandemic, across private and public educational systems. MethodsSix focus group discussions were conducted online with 30 children aged between 7 to 18 years in 2021. Children were enrolled through snowball sampling technique according to developmental age groups. A thematic analysis was conducted. ResultsWe identified five themes: Compliance with public health measures about preventing the spread of COVID-19, changes in daily routines, emotional responses to the pandemic, distance education, and adaptive responses. Overall, children were well informed and receptive to the public health preventive measures with the exception of older children\"s tendency to disregard physical distancing with friends. They reported frustration with those who did not comply with measures and believed that the authorities should strictly enforce public health requirements. Emotional responses comprised fear of family members and themselves being infected, anxiety produced by the uncertainty of the virus, and the loss of social support. There was a perceived disparity between students from public and private schools regarding academic self-competence. Positive aspects of the pandemic included positive interactions with family members and the acquisition of new hobbies. Although most children acknowledged the support of their parents to deal with challenges, children of health workers were particularly isolated in terms of emotional support. ConclusionOur findings offer additional insights and validate previous research on the negative and positive effects of COVID-19 from the child\"s perspective across private and public educational systems. This study contributes to global advocacy efforts aimed at understanding the impact of the pandemic on children.Publication Open Access Emzirme Sorunlarına Kanıta Dayalı_x000D_ Yaklaşım(2020-03-19) BORAN, PERRAN; PERRAN BORANEmzirme sorunları doğum sonrası ilk bir ayda yaklaşık %70 sıklıkla yaygın görülmekte, emzirmenin erkensonlanması, postpartum depresyon gibi olumsuz sonuçlar doğurmaktadır. Annenin emzirme konusunda profesyoneldestek alması ise sadece anne sütüyle emzirme başarısını arttırmaktadır. Bu yazının amacı sadece anne sütüylebeslenmenin önündeki en büyük engellerden, yaygın görülen emzirme sorunlarını kanıta dayalı olarak güncelaraştırmalar eşliğinde tartışmaktır. Bebeğin memeye yerleşme sorunları ve ağrılı meme ucu emzirme ile ilgilikaygıların başında gelmektedir. Bu sorunların erken saptanmaması halinde sütte azalma ve bebekte yetersiz tartı alımıile sonuçlanmaktadır. Son yıllarda yapılan ultrason çalışmaları emzirme konusunda yeni bilgiler ortaya koymaktadır.Başarılı emzirmede anne bebek ikilisinin erken ten tene teması, doğum sonrası 1-2 saatlik pencere dönemininkaçırılmayarak bebeğin primitif reflekslerinin harekete geçirilmesi, annenin güvenini kıran müdahaleci yaklaşımlaryerine, anneye özgüven kazandırılması, rahat bir emzirme için bedenen ve ruhen hazırlanması, uygun memedeyerleşimle, sık emzirme önerilmektedir. Anne sütünü arttırmak için kullanılan bitkisel ürünlerde standardize dozolmaması, olası kirleticiler, alerjik potansiyelleri ve olası ilaç etkileşimleri nedeniyle kullanılması önerilmemektedir.Publication Open Access Prevalence of allergic disorders and risk factors associated with food allergy in Turkish preschoolers(CODON PUBLICATIONS, 2021-01-08) ÖZEN, AHMET OĞUZHAN; Aksoy, Aysen Genc; Boran, Perran; Karakoc-Aydiner, Elif; Gokcay, Gulbin; Tamay, Zeynep Ulker; Devecioglu, Esra; Baris, Safa; Ozen, AhmetBackground: The prevalence of allergic disorders is on the rise, affecting about 10% of the population. In this retrospective cohort, we investigated prevalence of allergic disorders, associated risk factors, and the outcome of food allergies. Material and methods: We analyzed data from birth cohorts of two university hospitals' well-child outpatient clinics. Factors related to onset and type of allergic diseases were assessed from demographic, socioeconomic, and clinical data. Results: Analyses were performed on 949 (431F/518M) infants at a mean current age of 28 +/- 6 months. Any allergic disease was established among 177 cases (22%); atopic dermatitis in 123 (12.8%), respiratory allergies in 55 (5.7%), and food allergy in 41 (4.3%). The risk for allergic disorders was found to be significantly increased for male gender (OR: 2.31, 95% CI; 1.54-3.46), and positive parental atopy (OR: 1.94, 95% CI; 1.31-2.86). The risk of food allergies was significantly higher in the male gender (OR: 2.47, 95% CI; 1.21-5.02), who consumed egg-white between 6 and 12 months (OR: 2.34, 95% CI; 1.22-4.48), and who were formula-fed before 6 months (OR: 2.16, 95% CI; 1.14-4.10). We found no significant association between the rate of food allergy outgrowth or food induced-anaphylaxis with regards to the timing of introducing egg-white into the diet. Conclusions: Although the introduction of egg-white into infant diet at 6-12 months of life appeared as an independent risk for any food allergy, none of the patients developed anaphylaxis. Age at symptom onset and outgrowing food allergy were similar compared to those introduced egg-white after 12 months. We recommend promoting exclusive breast-feeding during the first 6 months of life, and avoidance of prolonged restrictive diets for children with food allergy. (C) 2021 Codon Publications. Published by Codon Publications.Publication Open Access Young children's sleep patterns and problems in paediatric primary healthcare settings: a multicentre cross-sectional study from a nationally representative sample(2022-12-01) BORAN, PERRAN; BORAN P., Ergin A., Us M. C., DİNLEYİCİ M., VELİPAŞAOĞLU S., YALÇIN S. S., BARUTÇU A., GÖKÇAY E. G., Gur E., camurdan Duyan A., et al.Studies describing paediatric sleep patterns are needed by taking culture into consideration. The aim of this study was to identify parent-reported sleep-wake patterns in young children and explore possible factors influencing sleep problems. The mothers of 2,434 young children enrolled from well-child outpatient clinics in Turkey completed an online survey including sociodemographic variables, Brief Infant Sleep Questionnaire, Edinburgh Postnatal Depression Scale and Generalised Anxiety Disorder scales. Overall, young children in Turkey go to bed late (10:00 p.m.), awaken twice per night for 30 min, and obtain 11.5 h of total sleep, showing no sex-specific differences. Distinct night-time sleep patterns emerged after 18 months of age. Importantly, although currently breastfed healthy children were 3.8-times less likely to sleep through the night, total sleep duration and exclusive breastfeeding duration were higher in children who were not sleeping through the night. Overall, bedsharing was identified in 11.5%, and only room sharing was reported in 52.9%. Parental perception of a child\"s sleep as problematic was 35.8%. Mothers with higher educational attainment were more likely to perceive their children\"s sleep as a problem. Maternal depressive and anxious symptoms and a history of excessive infant crying were the determinants predicting the likelihood of both parent-perceived sleep problems and poor sleepers. The present analysis of sleep structure in infancy and toddlerhood provides reference data for well-child visits. These findings highlight the importance of considering maternal anxiety, depression and behaviour management techniques to cope with fussy infants in addressing childhood behavioural sleep problems.Publication Open Access Rates of emergency room visits and hospitalizations among refugee and resident children in a tertiary hospital in Turkey(2022-08-01) BARIŞ, HATİCE EZGİ; BORAN, PERRAN; BARIŞ H. E., Silahli N. Y., Gul N. A., Qutranji L., Goldhagen J., BORAN P.Evaluation of emergency department (ED) presentation by Syrian refugee children might provide important information about their health care needs. For this purpose, we compared ED presentation of refugee and resident children in a tertiary university hospital in Istanbul, Turkey. Electronic medical records of Syrian refugee children≤18 years old presenting to the ED between January 2013 and July 2019 were retrospectively reviewed and compared with resident children. The study population consisted of 7299 refugees and 690,127 resident children admitted to the ED. High-acuity cases were more frequent in Syrian refugees (2.2% vs 1% p<0.001). One-third of Syrian children were under 12 months of age (31% vs 17%, p<0.001). Syrian children were more commonly hospitalized (7.9% vs 3.1% p<0.001). The median age (and interquartile range – IQR) was lower in hospitalized refugee than in resident children [12 (0–83) months vs 41 (8–111) months, p<0.001]. Rate of intensive care unit hospitalization (13% vs 9.4%, p=0.001) and neonatal hospitalization was higher in Syrians compared to resident children (29% vs 12%, p<0.001). The median NICU stay was longer in refugees [6 (IQR 4–17) days vs 3 (IQR 1–9) days, p<0.001]. Conclusion: Refugee children, as compared to resident children, are more likely to present to the ED with high acuity conditions and at a younger age resulting in higher rates of inpatient admissions. Strategies to increase access to preventive health care services for young refugee children should be explored to decrease ED and hospital services and improve health outcomes.Publication Open Access COVID-19 disease characteristics in different pediatric age groups(2022-01-01) ŞENYÜREK, BETÜL; BORAN, PERRAN; KEPENEKLİ KADAYİFCİ, EDA; YAKUT, NURHAYAT; KARAHASAN, AYŞEGÜL; AYDINER, ELİF; MEMİŞOĞLU, ASLI; GÖKDEMİR, YASEMİN; ERDEM ERALP, ELA; KARADAĞ, BÜLENT TANER; KEPENEKLİ KADAYİFCİ E., YAKUT N., Ergenc Z., Aydiner O., Sarinoglu R. C., KARAHASAN A., Karakoc-Aydiner E., MEMİŞOĞLU A., GÖKDEMİR Y., ERDEM ERALP E., et al.Introduction: Little is known about the COVID-19 disease characteristics and differences between different pediatric age groups. This study aimed to investigate the disease characteristics according to age groups. Methodology: We conducted a retrospective, single-center study of pediatric COVID-19 in a tertiary care hospital in Turkey. The patients were divided into three groups: 15 days-24 months old (Group 1), 25-144 months old (Group 2), and 145-210 months old (Group 3) according to age. Results: A total of 139 pediatric patients with COVID-19 were examined. Twenty-nine patients (20.9%) were in Group 1, 52 (37.4%) were in Group 2, 58 (41.7%) were in Group 3. Thirty-nine patients (28.1%) were hospitalized. The most common symptoms were cough (55.4%) and fever (51.8%). The median chest X-ray (CXR) score of hospitalized patients was 1 (min 0-max 7), and the median CXR score of outpatients was 1 (min 0-max 6). Fever was significantly more frequent in Group 1, and chest pain was more frequent in Group 3. Group 1 had significantly higher WBC, lymphocyte, thrombocyte counts, AST, LDH, D-dimer, and Troponin T levels but lower hemoglobin, total protein, and albumin levels. The treatment included antibiotics, oseltamivir, hydroxychloroquine, and supportive therapy. Only one patient (0.7%) received noninvasive mechanical ventilatory support. Conclusions: As we know the clinical course of COVID-19 in children is less severe than in adults. We also found significant differences in both clinical and laboratory findings between different pediatric age groups which supports the theory that disease pathogenesis is highly variable according to age.Publication Open Access Impact of ankyloglossia on the language development of children(MARMARA UNIV, FAC MEDICINE, 2021-10-07) DURMUŞ KOCAASLAN, FATMA NİHAL; Baris, Hatice Ezgi; Gunhan, Hakan; Kucuk, Selda; Durmus Kocaaslan, Fatma Nihal; Boran, OerranObjective: Ankyloglossia is a benign anomaly of the tongue which may cause functional limitation. Evidence regarding the impact of ankyloglossia on children's language development is limited. We aimed to evaluate the language development of children born with ankyloglossia. Patients and Methods: Children diagnosed with ankyloglossia were followed up prospectively. Demographic characteristics, degree of ankyloglossia assessed by Hazelbaker score in infancy and its effects on breastfeeding were evaluated. Language development was tested by the Turkish version of the Test of Early Language Development-Third Edition and the Denver II Test at 3-5 years of age. Results: Out of 53 children diagnosed with ankyloglossia, 38 (71.7%) children had language development testing and were included into the study. Significant ankyloglossia was detected in infancy in 10 of these children (26.3%). Median time of exclusively breastfeeding was not different according to the severity of ankyloglossia. All children evaluated with Denver II Test were developmentally normal in all domains. Scores of Test of Early Language Development-Third Edition were not different between children with and without significant ankyloglossia. Conclusion: Long term language development of children with ankyloglossia was not adversely affected. Parents should be appropriately informed and efforts must be paid to prevent unnecessary surgical interventions concerning language delay.Publication Open Access Screening of postpartum depression among new mothers in Istanbul: a psychometric evaluation of the Turkish Edinburgh Postnatal Depression Scale(SPRINGERNATURE, 2020-12) BORAN, PERRAN; Boran, Perran; Waqas, Ahmed; Askan, Oyku Ozboru; Topcu, Irem; Dogan, Tugay; Rahman, AtifObjective This study is the first concerted effort to ascertain factor structure of EPDS using evidence based analytical techniques. It is the most widely used scale for assessing postpartum depression in Turkey, and yet no investigations have been conducted to assess it factor structure. This study was conducted from April 2012 to April 2018 at the Marmara University Hospital operating under the name of Marmara University Pendik Training and Research Hospital in Istanbul Turkey. Results A total of 1700 women were included in this study, who responded to the EPDS, in addition to demographic characteristics and well-being of their offspring. A total of 1615 mothers provided adequate data for inclusion in analysis. Standardized Chronbach's alpha for EPDS was 0.81 with corrected item-total correlations ranging from 0.35 to 0.62. Parallel analysis, MAP Velicer Test and Hull's method dictated retaining of one factor structure. All the items revealed adequate communalities (> 0.20) except item 2 (enjoyment) and item 10 (self-harm). Their communalities were 0.16 and 0.19, however, these items were not dropped. All of the items yielded moderate to strong factor loadings. Minimum factor loading was for item 2 (0.40) and highest for item 8 (0.71).