Ice skating is a community-based sport and a popular leisure activity that can also have benefits for people with disabilities. Ice skating and children with hearing impairment: Self-concept, behavioural and emotional problems, and sleep quality of the children with hearing impairment significantly improved after ice skating. Ice skating programmes may be considered as a rehabilitation alternative for children with hearing impairment. Ice skating and children with visual impairment: Caution must be use when including children with visual impairment in ice skating programmes because of possible negative psychological outcomes. Balance exercises before starting the practices on ice should be considered for preventing some possible negative outcomes in children with visual impairment.

Aims Pandemics can cause substantial psychological distress; however, we do not know the impact of the COVID-19 related lockdown and mental health burden on the parents of school age children. We aimed to comparatively examine the COVID-19 related the stress and psychological burden of the parents with different occupational, locational, and mental health status related backgrounds. Methods A large-scale multicenter online survey was completed by the parents ( n = 3,278) of children aged 6 to 18 years, parents with different occupational (health care workers—HCW [18.2%] vs. others), geographical (İstanbul [38.2%] vs. others), and psychiatric (child with a mental disorder [37.8%]) backgrounds. Results Multivariable logistic regression analysis showed that being a HCW parent (odds ratio 1.79, p < .001), a mother (odds ratio 1.67, p < .001), and a younger parent (odds ratio 0.98, p = .012); living with an adult with a chronic physical illness (odds ratio 1.38, p < .001), having an acquaintance diagnosed with COVID-19 (odds ratio 1.22, p = .043), positive psychiatric history (odds ratio 1.29, p < .001), and living with a child with moderate or high emotional distress (odds ratio 1.29, p < .001; vs. odds ratio 2.61, p < .001) were independently associated with significant parental distress. Conclusions Parents report significant psychological distress associated with COVID-19 pandemic and further research is needed to investigate its wider impact including on the whole family unit.

Objective: The present study aimed to assess the safety of pancreatic anastomosis after pancreaticoduodenectomy (PD) and to compare the results of sutureless pancreatogastrostomy (PG) with those of single-layer duct-to-mucosa pancreatojejunostomy (PJ) after PD in patients with malignant disease of the pancreatic head and of the periampullary region. Materials and Methods:The study included 173 consecutive patients undergoing PD from May 2009 to December 2015 at a single surgical center. Single-layer duct-to-mucosa PJ was performed in 52 patients and sutureless PG in the remaining 123. The primary endpoint was the safety of the procedures, which was assessed as the occurrence of complications during hospitalization. Postoperative pancreatic fistula (POPF) was classified as grade A, B, or C according to the International Study Group of Pancreatic Fistula classification.Results: We found that the incidence of POPF was 11.52%. With regard to POPF, the present study showed no significant difference in the two groups (p=0.043). The incidence of Grade C POPF was significantly higher in the PJ group than in the PG group (p=0.001), which was been reflected in the form of a higher rate of postoperative hemorrhage (p=0.001), intra-abdominal abscess (p=0.012), and septic shock (p=0.012) events in the PJ group. Conclusion:The evaluation of short-term outcomes demonstrates that suturelessPG is a feasible and safe technique, associated with lower life-threatening complications than single-layer duct-to-mucosa PJ. If longterm functional outcomes confirm similar results, sutureless PG could become a valid alternative for pancreatic anastomosis after PD in patients with soft pancreas and high morbidity. Bulgular: Çalışmamızda POPF oranı %11,52 olarak bulundu. İki grup arasında anlamlı bir farklılık görülmedi (p=0,043). Evre C POPF insidansı PJ' de PG grubuna göre anlamlı ölçüde daha yüksekti (p=0,001), Ayrıca PJ grubunda postoperatif hemoraji (p=0,001), intraabdominal apse (p=0,012) ve septik şok (p=0,012) vakalarının oranları da daha yüksek bulundu.Sonuç: Kısa dönem sonuçların değerlendirilmesine göre, tek katlı duct-to-mukozal PJ ile kıyaslandığında dikiş-siz PG daha düşük oranda yaşamı tehdit eden komplikasyonlarından dolayı uygulanabilir ve güvenli bir tekniktir. Uzun dönem fonksiyonel sonuçlarla benzer bulgular doğrulandığı takdirde dikişsiz PG, yumuşak yapılı pankreası ve yüksek morbiditesi olan hastalarda PD sonrası pankreatik anastomoz için geçerli bir alternatif olabilir.

Background: This article presents the results of a comprehensive national model developed for managing maladaptive behaviors (MBs) in children with mental special needs (CMSNs) during the coronavirus disease 2019 (COVID-19) pandemic that combines telehealth-based Applied Behavioral Analyses, psychiatric interventions, and support from local psychosocial teams. This study aims to determine the effectiveness of a system that combined telehealth applications with local psychosocial support teams, allowing services from video calls to emergency interventions. Materials and Methods: The system combines the telehealth applications with the services from local psychosocial intervention teams. In addition to system records covering socio-demographic variables and initial complaints, a telephone survey questioning the effectiveness and satisfaction of the system was used as the main outcome. Results: In total, 347 individuals used the system with mothers constituting the majority of applicants (88.7%, n = 332). The overall satisfaction of the system was 8.8/10. In terms of effectiveness, 63.3% (n = 237) of caregivers reported an improvement in the reason of application. Counselors decided on a need for follow-up visits for 36.6% (n = 137) of applications. A referral to a psychiatrist was asked for 40 patients (10.6%). Discussion: To our best knowledge, this is the first study presenting a model for managing MBs of CMSNs during the COVID-19 outbreak. In general, therefore, it seems that there is a need for unique systems to handle behavioral problems of CMSNs. Conclusions: The findings of this study suggest that it is possible to establish an integrative multistep multidisciplinary telehealth-based approach in a short while.

Objective: In recent years, there has been an increasing interest in the effects of Vitamin D on cognitive development and autism. The aim of this study is to examine the relationship between autism, cognitive developmental delay and behavioral problems. We also aimed to examine the possible mechanisms of interaction between nerve growth factor (NGF) and glial cell line-derived neurotrophic factor (GDNF) levels.Methods: Sixty-four toddlers with developmental delay participated in the study. In the initial assessment, the cases were subjected to a psychiatric examination and developmental tests. Vitamin D, GDNF, and NGF levels were observed. Patients who had low vitamin D levels received replacement treatment. Six months later, the same measures were repeated. Results: Significant progress in autistic symptoms and development scores were determined for the group receiving vitamin D replacement. A negative correlation was found between vitamin D levels and NGF levels. Development scores and GDNF levels were found to be positively correlated in patients who were diagnosed with only cognitive development delay. Conclusions: Measuring vitamin D levels and replacing them if they are low may be beneficial in children with developmental delay, particularly those who also have autistic spectrum disorders. NGF may be more related to autism spectrum disorders, while GDNF seems to be more related with global developmental delay.