The Effect of Tub Bathing on the Skin and Bilirubin Levels of Babies Receiving Tunnel and Light-Emitting Diode Phototherapies: A Randomized Controlled Trial.

OBJECTIVE: To investigate the effects of tub bathing on the skin and bilirubin levels of newborns receiving tunnel and light-emitting diode phototherapy. METHODS: In this randomized controlled trial, hospitalized newborns diagnosed with hyperbilirubinemia treated with a tunnel or light-emitting diode device were randomly assigned to either the experimental (bath) or control (no bath) groups using a computer program. The skin integrity moisture balance of all groups was recorded using the Newborn Skin Condition Score at 6, 12, and 24 hours after phototherapy, and their total serum bilirubin measurements were evaluated. RESULTS: A statistically significant difference was observed in the babies' total serum bilirubin levels; this decrease was the highest in the experimental groups. Further, the skin integrity-moisture balance was higher in the experimental groups than in the control groups; it was highest in the tunnel-experimental group and lowest in the tunnel control group. CONCLUSIONS: These results show that bathing is effective in reducing total bilirubin levels. This study adds to the evidence on skin integrity and moisture balance in newborns who were bathed during phototherapy.

Prevalence of musculoskeletal system problems in children working in Turkey's automotive industry.

OBJECTIVE: This epidemiology study was conducted to determine the musculoskeletal system problems of children working in the automotive industry and related factors affecting them in the province of Sanliurfa, the Turkish province where the child population is the highest at 44.9%. DESIGN AND METHODS: A cross-sectional descriptive type study of 256 children aged 7-17 years working in Sanliurfa Evren Auto Industry Site and Birecik Firat Auto Industry Site was carried out between April and September 2021. RESULTS: The majority (55.9%) of the children spent most of their time afoot while working and had musculoskeletal symptoms, with a duration of more than one year. The body areas with the most symptoms were the waist, feet, and hands, respectively. These symptoms had not occurred before a child started working and were affected by the posture they worked in, and their daily working and sleep hours. CONCLUSION: Public health nurses are in a position to ensure that tetanus vaccination of working children, employment examinations, routine health checks, and necessary personal protective equipment are available. They can also work to ensure that children work for legal periods, get paid their wages, have health insurance, receive apprenticeship training, and only start working when they reach the age of being an apprentice or apprentice candidate.

The Effect of 3 Methods (Buzzy, ShotBlocker, and DistrACTION Cards) Used While Taking Blood Samples From Children with Pain and Anxiety: A Randomized Controlled Trial.

OBJECTIVES: The aim of this study was to compare the effectiveness of 3 methods (Buzzy, ShotBlocker, and DistrACTION Cards) in reducing pain and anxiety while taking venous blood samples in children. METHODS: The study population consisted of children aged 9 to 12 years admitted to the Child Health and Diseases Department in a Faculty of Medicine in Turkey. The sample of the study consisted of 242 children (Buzzy = 60, ShotBlocker = 61, DistrACTION Cards = 60, control = 61) who met the patient selection criteria and agreed to participate in the study. The data were obtained using an Information Form, the State-Trait Anxiety Inventory for Children, visual analog scale, and the Faces Pain Scale-Revised. DESIGN: This article is an experimental randomized controlled study. RESULTS: During venous blood collection, the scores of visual analog scale were significantly lower in ShotBlocker, Buzzy, and DistrACTION Cards groups than the control group. It was also observed that the control group experienced more anxiety than the other groups. CONCLUSIONS: Methods such as Buzzy, ShotBlocker, and DistrACTION Cards can be used to reduce the anxiety and pain of children during painful procedures such as blood collection and vascular access. Among these methods, "Buzzy" and "DistrACTION Cards" can be preferred as it is equally effective, and then ShotBlocker can be preferred.

Comparison of pain levels developed during intramuscular injections to laterofemoral and ventrogluteal regions in children: a randomized controlled study.

OBJECTIVE: The aim of this study was to compare the levels of pain developed during intramuscular injections to the laterofemoral and ventrogluteal regions in children. METHODS: The study population consisted of all children aged between 7 and 12 years who presented to the pediatric emergency clinic of a hospital. The sample consisted of 62 children who met the inclusion criteria and agreed to participate in the study, and the children were randomly assigned to each group (laterofemoral n=31, ventrogluteal n=31). "Buzzy" and "deep breathing" were applied to children in both groups to relieve pain during the procedure. The data were obtained using an Information Form, a visual analog scale, and the Facial Pain Scale-Revised. RESULTS: It was determined that the children in the ventrogluteal group during the intramuscular injections had lower visual analog scale and faces pain scale-revised scores immediately after the procedure compared with the vastus lateralis group, that is, they experienced less pain, and the difference between the two groups was significant (p<0.001). CONCLUSION: In children, it is recommended to choose the less painful ventrogluteal region for intramuscular injection and to inform health professionals about it.

Comparison of pain levels developed during intramuscular injections to laterofemoral and ventrogluteal regions in children: a randomized controlled study

SUMMARY OBJECTIVE: The aim of this study was to compare the levels of pain developed during intramuscular injections to the laterofemoral and ventrogluteal regions in children. METHODS: The study population consisted of all children aged between 7 and 12 years who presented to the pediatric emergency clinic of a hospital. The sample consisted of 62 children who met the inclusion criteria and agreed to participate in the study, and the children were randomly assigned to each group (laterofemoral n=31, ventrogluteal n=31). "Buzzy" and "deep breathing" were applied to children in both groups to relieve pain during the procedure. The data were obtained using an Information Form, a visual analog scale, and the Facial Pain Scale-Revised. RESULTS: It was determined that the children in the ventrogluteal group during the intramuscular injections had lower visual analog scale and faces pain scale-revised scores immediately after the procedure compared with the vastus lateralis group, that is, they experienced less pain, and the difference between the two groups was significant (p<0.001). CONCLUSION: In children, it is recommended to choose the less painful ventrogluteal region for intramuscular injection and to inform health professionals about it.

The Effect of 2 Humidifier Temperature Settings on Inspired Gas Temperatures and the Physiological Parameters of Preterm Infants Receiving Mechanical Ventilation Therapy.

BACKGROUND: The use of heated and humidified gas during mechanical ventilation is routine care in neonatal intensive care units. Giving gas at inadequate heat and humidity levels can affect neonatal morbidity and mortality. PURPOSE: To compare the effects of 2 humidifier temperature settings on the temperature and humidity of the inspired gas and the physiologic parameters in preterm newborns receiving mechanical ventilation. METHODS: The research was conducted in a single-group quasi-experimental design. Proximal temperature was measured using a humidity heat transmitter. The humidifier temperature was set at 38°C (temperature I) and then at 39°C (temperature II). RESULTS: The mean proximal temperatures were significantly lower than the values set in the humidifier (33.8 ± 1.20°C at temperature I, and 34.06 ± 1.30°C at temperature II, P < .001). However, the difference between the 2 proximal temperatures was not significant (P = .162). The incubator temperature was found to be effective on the proximal gas temperature (P < .05). It was found that only preterm infants in the temperature II group had a higher mean heart rate (P < .05). IMPLICATIONS FOR PRACTICE: Incubator temperatures may have an effect on inspired gas temperature in preterm infants who are mechanically ventilated and caregivers should be aware of these potentially negative effects. IMPLICATIONS FOR RESEARCH: Future studies should focus on how to measure the temperature and humidity of gas reaching infants in order to prevent heat and humidity losses.

The Effect of Acupressure on Acute Pain During Venipuncture in Children: Implications for Evidence-Based Practice.

AIMS: The study was conducted as a randomized controlled trial in order to determine the effects of acupressure on acute pain during venipuncture in children. METHODS: The population of the study consisted of children, aged between 9 and 12 years, who received venipuncture between September 2015 and June 2016 at a university hospital in Istanbul. The sample consisted of a total of 90 children, including 45 children in the acupressure group and 45 children in the control group, who met the sample inclusion criteria. The results of the study were obtained by using an information form, the State Anxiety Inventory for Children (STAIC), the visual analog scale (VAS), and the Faces Pain Scale-Revised (FPS-R). Acupressure was applied to the children in the acupressure group for 10 min before the venipuncture procedure. Pain, heart rate, and oxygen saturation levels of the children in the acupressure and control groups were evaluated both before and after the venipuncture procedure. RESULTS: The children in the acupressure and control groups were found to be similar in terms of age, gender, parents' educational levels and working status, number of venipuncture procedures, and mean anxiety scores. In the evaluation that was conducted before the venipuncture procedure, no statistically significant differences were observed between the heat rates, oxygen saturation levels, and expected pain scores from the venipuncture procedure in the children in the acupressure and control groups. On the other hand, it was observed that the children in the acupressure group (VAS: 19.51 ± 4.98; FPS-R: 2.08 ± 0.41) experienced less pain than the children in the control group (VAS: 47.37 ± 9.89; FPS-R: 4.84 ± 1.08), and there was a significant difference between the two groups (p< .000). LINKING EVIDENCE TO ACTION: Acupressure administration is effective in reducing the pain that is experienced by children during a venipuncture procedure.

The Effect of Earmuffs on Physiological Parameters in Preterm Infants: A Systematic Review.

Noise may cause stress responses such as apnea, hypoxemia, changes in oxygen saturation and augmented oxygen consumption secondary to elevated heart and respiratory rates. Moreover, stress results in increased intracranial pressure, abnormal sleep patterns, hearing impairment, and bronchopulmonary dysplasia, retinopathy of prematurity, intraventricular hemorrhage, periventricular leukomalacia, retardate development and alterations in the neuroendocrine system. Herein, this study aimed to discuss the effects of earmuffs on physiological parameters in preterm infants. The relevant and available peer-reviewed publications from 2012 to 2018 from various databases were analyzed. For the assessment of the studies, the full-text accessible studies were included for analysis. The retrieved documents were analyzed using VOSviewer regarding the geographical distributions of the documents with their numbers and citations, keywords proposed by the researchers. All records with the term "earmuffs OR earmuff" in the "article title, abstract, keywords" were retrieved from different databases. Accordingly, 396 documents containing the word "earmuffs OR earmuff" were recorded. The search was then restricted for publications that contain the words "noise AND nursing AND preterm" in the title and abstracts (TITLE-ABS-KEY (earmuffs OR earmuff)) AND (noise AND nursing AND preterm) (Scopus=390; Web of Science=1, Medline=2; Cochrane=1; Embase=1= Pubmed=1=n=396). After inclusion and exclusion criteria, 7 documents were recorded and then evaluated for the present study. As a conclusion, the effects of earmuffs on physiological parameters of preterm infants have not been clearly understood and reported yet. Along with the present documents, it is not clear that the use of earmuffs reduces stress and provides physiological stability in preterm infants born between approximately 28-32 weeks. The studies with a larger sample size are needed for validation of information reported in the articles analyzed herein.

Impact of the odors of vanilla extract and breast milk on the frequency of apnea in preterm neonates.

AIM: We developed this study using an experimental design to determine the impact of the odors of vanilla extract and breast milk on apnea frequency in preterm neonates. MATERIALS AND METHODS: We obtained the study data from 42 preterm neonates (16 vanilla, 13 breast milk, 13 control group) who had been admitted to the Neonatal Intensive Care Unit of Istanbul University meeting the case selection criteria. All groups were monitored on the first day without any intervention. On the second and third days, breast milk was placed in the incubators of the babies in the breast milk group and the sterile gauze that was vanilla-impregnated was placed in the incubators of the babies in the vanilla group. On the fourth day, the babies were watched without any interference. RESULTS: On the second, third and fourth days of the study, we determined that apnea frequency in the vanilla group neonates was significantly lower (P < .00) as compared to the breast milk and control groups. CONCLUSION: Using vanilla extract in neonates suffering from apnea to reduce its frequency is an effective method.

The Effect on Pain of Buzzy® and ShotBlocker® during the Administration of Intramuscular Injections to Children: A Randomized Controlled Trial.

PURPOSE: To investigate the effect of Buzzy® and ShotBlocker® on reducing pain induced by intramuscular penicillin injections in children. METHODS: This was a randomized controlled study. A total of 150 Turkish children aged 7~12 years who presented to our pediatric emergency clinic and met the inclusion criteria were recruited. The children were randomly assigned to each group (control=50, Buzzy®=50, ShotBlocker®=50). Data were collected using an information form, the State-Trait Anxiety Inventory for Children, Visual Analog Scale, and Faces Pain Scale-Revised. RESULTS: The children in the control group had significantly higher pain scores during the penicillin injection than the children in the ShotBlocker® and Buzzy® groups. The children in the Buzzy® group had significantly less pain than the children in both the ShotBlocker® and control groups (p<.001). CONCLUSION: Buzzy® was more effective compared with ShotBlocker® in this study.

Turkish Validation of the Infiltration Scale in Infants.

PURPOSE: To test the validity and reliability of an infiltration scale in infants that was adapted for the pediatric population. DESIGN AND METHODS: The present study is an observational prospective study. The study was conducted in a NICU of a training and research hospital in Istanbul. Data were obtained from131 infants who were <4 kg. Language validity of the scale was tested by expert linguists. The comments of fourteen experts were taken for content validity. For reliability testing, three observers independently evaluated the scale. RESULTS: Infiltration developed in 28.72% of infants who were examined and grade 2 infiltration was detected at rate of 58%. The content validity index of the scale was 0.93. The Cronbach's alpha was calculated as 0.96 in the agreement of the three observer nurses' evaluations. A highly significant association was detected between the coherence of Cohen's kappa values and Intra-Class Correlation coefficient (ICC) (p < 0.01). CONCLUSIONS: The infiltration scale is a valid and reliable scale in infants. The validity and reliability of the scale has been verified and may be used in the identification of infiltration in infant gestational age between 24 and 39 weeks and weighing <4 kg. PRACTICE IMPLICATIONS: The infiltration scale for infants is a valid and reliable tool for monitoring catheter sites in the prevention of complications such as infiltration due to PIV therapy practices in neonatal intensive care units.

Evaluation of a School-Based Program for Internet Addiction of Adolescents in Turkey.

This study aimed to evaluate a school-based program for Internet addiction, the Healthy Internet Use Program, with adolescents in Turkey. Forty-one students were included in the intervention group, and the control group was composed of 43 students. All students were from two primary schools. Students in the intervention group participated in the Healthy Internet Use Program, which was developed in accordance with the literature. The intervention group was given eight training sessions over a 3-month period, and their parents were given two training and consultancy sessions. Data were collected using a data collection form and the Internet Addiction Scale. The third evaluation of the Internet Addiction Scale scores showed a significant difference between the intervention group and the control group (p < .05). The fourth evaluation of the Internet Addiction Scale points showed a highly significant difference between the two groups (p < .001). The findings suggest that use of the Healthy Internet Use Program decreases the rate of Internet addiction among adolescents.

Assessing Neonatal Pain, Duration of Crying and Procedure Time following Use of Automatic or Manual Heel Lances: A Randomized Controlled Study.

OBJECTIVE: The objective of this study was to compare neonatal pain, duration of crying and procedure time following use of automatic or manual heel lancets. METHODS: This randomized trial was conducted with neonates undergoing heel prick procedures in a neonatal intensive care unit for routine blood bilirubin monitoring. An information form, an observation form and the Neonatal Infant Pain Scale (NIPS) were used. Pain before, during and after (1 and 3 min) was assessed using NIPS scoring. RESULTS: Seventy neonates were included (automatic lancet, n = 35; manual lancet, n = 35); there was no difference between the groups (p > 0.01). Pain scores were significantly lower, with automatic lancets compared with manual lancets (p = 0.001). The duration of crying after the procedure (p = 0.001) and procedure time (p = 0.001) was significantly shorter with automatic lancets compared with manual lancets. CONCLUSION: Automatic heel lancets in neonates are more effective than manual lancets at reducing pain, and shorten the procedure time and duration of post-procedural crying.

The effect of training on noise reduction in neonatal intensive care units.

PURPOSE: Noise, an environmental stimulus, is especially important in the neurobehavioral development of newborns and brain development of infants at high risk. Conditions in the neonatal intensive care units (NICUs) may cause certain sensory stimuli that are not appropriate for the development of newborns, especially preterm infants. This study was conducted in order to determine noise levels in the NICU and to evaluate the effect of training provided for noise control. DESIGN AND METHODS: This study was conducted as a pretest-posttest quasiexperimental design between September and November 2014 in a 30-bed NICU of a tertiary hospital in Istanbul. A sample group consisting of 30 people (26 nurses, 4 care workers). Noise measurement devices were used in the Training Program of Noise Control. RESULTS: Of the health professionals, 96.7% were women, 86.7% were nurses, and 63.3% were university graduates. Some 36.7% of the health professionals had worked within the unit for more than 5 years. Noise measurements of full implementations were made over three 24-h periods. Noise measurements were taken before and after the training on Monday, Friday, and Sunday. Noise levels after training diminished in all three measurements, and the decrease was found statistically significant (P < 0.01). PRACTICE IMPLICATIONS: Planned Noise Control Training for health professionals who work in NICUs is an effective way of reducing noise. We recommend that this training should be given to NICU health professionals and noise levels should be determined through measurements at specific times.

Comparison of risk-taking behaviour and frequency of piercing and tattooing among university students.

OBJECTIVE: To assess the frequency of piercing and tattooing among university students and to determine the extent of risk-taking behaviour in this age group. METHODS: The descriptive cross-sectional study was conducted at a university in Istanbul, Turkey, from December 2009 to February 2010. Data was obtained from students through a questionnaire. SPSS 20 was used for statistical analysis. RESULTS: Of the 1303 subjects, 838(64.3%) were girls. The overall mean age of the sample was 21.7±1.9 years. A total of 107 (8.2%) had piercings and 56(4.3%) had tattoos. It was seen that young people who had piercings and tattoos were significantly more likely (p<0.05) to exhibit certain types of risk behaviour including smoking, alcohol, substance abuse, extreme sports, carrying switchblades/knives, unprotected sexuality and having multiple sex partners. CONCLUSIONS: In the face of the steadily increasing fads of piercing and tattooing among the youth, families, teachers and health professionals need to be constantly on the alert.

Effects of balloon inflation and cough trick methods on easing pain in children during the drawing of venous blood samples: a randomized controlled trial.

PURPOSE: The purpose was to determine the effects of the balloon inflation and cough trick methods on easing pain in children during the drawing of venous blood samples. DESIGN AND METHODS: In this prospective randomized controlled study, 9- to 12-year-old children in the intervention groups were asked to cough or inflate balloons during the venipuncture procedure. The Faces Pain Scale-Revised was used to assess pain intensity. RESULTS: Pain intensity significantly differed between the control (n = 44) and intervention groups (balloon inflation [n = 44] and cough trick [n = 44], p < .001). PRACTICE IMPLICATIONS: Coughing and inflating balloons during venipuncture do not require preparation and are time saving, easy, accessible, and effective in reducing pain.

Test anxiety levels and related factors: students preparing for university exams.

OBJECTIVE: To assess test anxiety levels and related factors among students preparing for university exams. METHODS: The descriptive, cross-sectional study was conducted at Istanbul University, Turkey, and comprised students preparing for exams in two private courses for the 2010-11 academic year. Data was collected via an original questionnaire and the Test Anxiety Inventory. SPSS 20 was used for statistical analyses. RESULTS: Of the 1250 students who qualified for the study, the final sample size was 376 (30%). Of them, 210 (55.9%) were females, and 154 (41%) were 18 years old. Students' mean Test Anxiety Inventory scores were 39.44±11.34. Female students' overall test anxiety scores and mean emotionality subscale score were significantly higher than those of their male counterparts. Students whose mothers had an educational attainment between primary school n=170 (45.2%) and a high school diploma n=184 (48.9%), as well as those with four or more siblings n=49 (15%), had significantly higher mean overall Test Anxiety Inventory scores. CONCLUSION: Among other things, test anxiety is influenced by maternal educational level, type of high school, number of exams, and number of siblings. Preparing a relaxed study environment for students, providing the family monetary or social support, and encouraging participation in social activities are recommendedto decreajb anxiety in students preparing for university exams.

Prevalence of nocturnal enuresis and related factors in children aged 5-13 in istanbul.

OBJECTIVE: Enuresis is a health problem frequently encountered in childhood. This study was carried out in two socio-demographically different districts of the province of Istanbul, for the purpose of determining the relationship between the prevalence of primary nocturnal enuresis and certain demographic characteristics. METHODS: The study design is a cross-sectional carried out on 420 children (5 to 13 yr old) through random sampling. The research was conducted at two health centers in two different districts in the province of Istanbul. Data was collected with a questionnaire created by the researchers. Diagnosis of enuresis considered nocturnal voiding twice a week for at least three consecutive months. FINDINGS: Enuresis was a complaint expressed by 16.2% of the cases in the study group; 8.3% reported intermittent bedwetting. The data collected in the two districts pointed to a significant difference in terms of the frequency of enuresis in favor of the district where socio-demographic features were inferior (P<0.005). When family histories were explored in cases of children with enuresis, it was found that the mothers of 76.2% had the problem of enuresis while 14.9% had enuretic fathers. Thus statistically, the presence of enuresis in the family history was seen to have had a markedly significant impact on the occurrence of enuresis in the child (P<0.001). CONCLUSION: It was concluded that familial predisposition to the condition constituted a more significant risk factor for enuresis compared to socio-demographic or economic characteristics.

Cyberbullying among primary school students in Turkey: self-reported prevalence and associations with home and school life.

The current study examined the self-reported prevalence and nature of cyberbullying and victimization among second, third, and fourth grade students (N=372) and explored associated features of home and school life. Of the children in the current sample, 27 percent had been victims of cyberbullying, 18 percent had been aggressors, and 15 percent had been both cyberbullies and victims. Boys were significantly more likely to carry out cyberbullying than girls. Cyberbullying exposure (as both a bully and a victim) was significantly associated with low levels of self-reported school satisfaction (bullies odds ratio [OR]: 2.45; victims OR: 2.10; p<0.05) and achievement (bullies OR: 3.85; victims OR: 3.47, p<0.05). Paternal unemployment was also associated with a three-fold increase in the likelihood of being a cyberbully. Increased awareness and regulation is now required within schools and within the home to tackle this escalating problem.