Drowning is a significant public health issue, particularly in coastal regions such as Sinop, Turkey, where seasonal variations contribute to a high incidence of cases. However, there is a lack of long-term, population-based studies from the Black Sea region, where distinct environmental factors may influence drowning patterns. This study provides a comprehensive 13-year analysis of seawater drowning cases, including detailed demographic, clinical, and outcome characteristics, to inform prevention strategies and improve emergency response. A retrospective, observational study was conducted on all patients admitted to the regional referral Emergency Department (ED) due to seawater drowning between July 2011 and July 2024. Demographic characteristics, clinical parameters, and outcomes were retrieved from institutional and national health record systems. Descriptive statistical analyses were performed. A total of 198 patients were included, of whom 69.2% were male, with a mean age of 29.6 years. The majority of cases (over 82%) occurred in July and August, and 51% involved tourists. Cardiopulmonary resuscitation (CPR) was performed in 17.7% of patients. Trauma was documented in 7.1% of patients; among these, the most commonly affected regions were the extremities (50.0%) and the head (35.7%). Laboratory analysis showed elevated lactate levels and reduced pH. On admission, most patients had preserved neurological status, while 19.2% presented with severe impairment (GCS ≤8). According to the Szpilman score, 37.9% had mild and 17.7% severe symptoms. The overall mortality was 19.7%, and 22.2% of patients required admission to the intensive care unit (ICU). Notably, 35.9% of all fatal cases (n = 14) involved individuals who drowned while attempting to rescue others. Drowning imposes a substantial burden in coastal regions, disproportionately affecting young males during the summer. Our findings highlight the need for enhanced emergency preparedness and structured clinical response, as well as public education on water safety and safe rescue practices. These findings contribute valuable insight for developing regional and international strategies to mitigate drowning outcomes. Not applicable. This study is a retrospective observational analysis and was not registered as a clinical trial.

Objective: This study examined the relationships between the developmental stages of children aged 6–72 months and their parents’ psychological resilience and psychological well-being. Method: The study was designed as a descriptive and correlational survey. The sample included a total of 184 children aged 6–72 months, as well as their parents, who visited Sinop Atatürk State Hospital. Data were collected face-to-face using the Personal Information Form, the Early Developmental Stages Inventory (EGE), the Psychological Well-being Scale (PWBS), and the Psychological Resilience Scale for Adults (PRS). The data were analyzed using the independent samples t-test, Pearson correlation coefficient, and simple and multiple linear regression analyses. Results: According to the study’s results, most children (92.4%) were found to be at a normal level in terms of overall development; importantly, personal-social skills had the highest rate of developmental delay (19.0%). Comparative analyses showed that the psychological resilience and psychological well-being scores of parents of children with typical development were higher than those of parents of children with developmental delays. Correlation analysis revealed a moderate positive relationship (r = 0.330, p < 0.001) between the Early Developmental Stages Inventory score and the Psychological Well-being Scale, and a weak positive relationship (r = 0.154, p < 0.05) between the Psychological Resilience Scale and the Early Developmental Stages Inventory score. Regression analyses suggest that psychological well-being and resilience are associated with child development outcomes. Discussion and Conclusions: The findings of this study indicate that there are meaningful associations between parents’ psychological well-being and resilience levels and children’s early developmental outcomes. Children whose parents reported higher psychological well-being and resilience tended to demonstrate more favorable developmental profiles in several developmental domains. These results suggest that parental psychological characteristics may be relevant factors associated with early childhood developmental outcomes and should be interpreted within broader ecological and contextual frameworks.

This study aimed to determine the effect of virtual reality (VR) glasses used during inhaler treatment on anxiety, fear and vital signs in children. The study had an experimental, randomized controlled design. Participants were assigned to groups using a lottery method based on simple randomization. The random sequence was generated by physically mixing up 30 red (experimental) and 30 white (control) cards. All the data were collected and finalized by two trained researchers (Yasemin Özyer Güvener, a nurse researcher, and Şeyma Şimşirgil Kara, a pediatrician). Participants were recruited using a convenience sampling method from among individuals who met the inclusion criteria. In terms of baseline measurements, the experimental group had significantly higher mean pulse rate, fear scores, and anxiety scores (130.23 ± 14.64, 2.77 ± 1.25, and 4.60 ± 2.04, respectively) compared to the control group (118.83 ± 17.10, 2.07 ± 1.26, and 2.80 ± 2.07, respectively) ( p = 0.007, p = 0.035, and p = 0.001, respectively). For post-intervention measurements, the experimental group had significantly lower mean fear and anxiety scores (0.443 ± 0.16 and 0.703 ± 0.22, respectively) compared to the control group (2.39 ± 0.16 and 3.197 ± 0.22, respectively) ( p < 0.001 and p = 0.001, respectively). Conclusion : It was determined that VR glasses reduced anxiety and fear, increased oxygen saturation, and reduced respiratory and pulse rates. They can thus be used as an alternative method to reduce fear and anxiety levels and balance vital signs during inhalation therapy in children. What is Known: • Virtual reality (VR) is an effective non-pharmacological method for reducing pain, anxiety, and fear in pediatric patients during various medical procedures. • VR applications create a sense of presence in a virtual world, limiting the impact of anxiety and fear in clinical settings. What is New: • Using VR glasses during the administration of inhaled medication significantly reduces anxiety and fear levels in children compared to traditional methods. • While evidence for VR use during inhalation therapy was previously limited, this study demonstrates its effectiveness as a promising alternative to improve treatment compliance and physiological responses in pediatric patients.

Drowning is a leading cause of preventable mortality worldwide; however, early in-hospital risk stratification remains limited. Although tools such as the Szpilman score assist in early severity assessment, they may not fully capture the evolving clinical status after admission. This study aimed to develop a simplified and objective model based on readily available parameters to predict in-hospital mortality following seawater drowning. This retrospective study was conducted at a referral emergency department (ED) in northern Turkey between July 1, 2011, and December 31, 2024. Of 190 patients initially included, 166 with complete clinical and laboratory data were analyzed. Data were obtained from institutional and national health information systems. Clinical, physiological, and biochemical variables were assessed. Predictors of in-hospital mortality were identified using receiver operating characteristic (ROC) analysis and multivariable logistic regression. Variables with near-perfect discrimination (e.g., GCS, pH, Szpilman score) were excluded to avoid overfitting. Among the 166 patients, 34 (20.5%) died during hospitalization. CPR and endotracheal intubation rates were significantly higher among non-survivors (CPR: 97.1% vs. 0%; intubation: 97.1% vs. 2.3%; both p < 0.001). Non-survivors also presented with lower GCS (median 3 vs. 15), lower arterial pH, and higher Szpilman scores (all p < 0.001). ROC analysis identified four potential predictors with AUC values between 0.90 and 0.95—pCO₂, lactate, SpO₂, and sodium—all showing significant discriminatory capacity (p < 0.001). These variables were entered into a binary logistic regression model, from which serum sodium (OR = 2.110; 95% CI: 1.310–3.401; p = 0.002) and SpO₂ (OR = 0.902; 95% CI: 0.847–0.961; p = 0.001) emerged as independent predictors. These formed the basis of the SNOP score (Saturation and Natremia-based Outcome Predictor), a two-parameter logistic model demonstrating excellent performance: AUC = 0.996, sensitivity = 99.0%, specificity = 96.2%, and overall accuracy = 98.4%. The SNOP score is a simple, ED-specific tool for early prediction of in-hospital mortality in seawater drowning. It complements existing assessment systems by incorporating objective, admission-based parameters. Prospective multicenter validation is warranted to confirm its clinical applicability and support broader implementation.

Objective: To retrospectively evaluate the demographic and clinical characteristics, presentation timing, diagnosis distribution, hospitalization rates, and 72-hour repeat-visit patterns among patients aged 0 to 17 years presenting to a state hospital pediatric emergency department (PED). Methods: A retrospective cohort study was conducted using electronic health record data from Sinop Atatürk State Hospital (Türkiye) PED between January 1, 2020, and December 31, 2024. A total of 133 880 consecutive patient visits were analyzed. Statistical analyses included descriptive statistics and multivariate logistic regression; robust standard errors and a first-visit sensitivity analysis were applied to account for clustering of repeated visits by the same patient. Results: Of the 133 880 visits analyzed, 53.8% involved male patients, and the mean (SD) age was 7.34 (4.98) years. Upper respiratory tract diseases (ICD-10 codes J06.9, J39.9) were the most common diagnoses, accounting for 37.7% of visits. Presentation volume peaked during the summer season (31.1%) and between 4:00 PM and midnight (48.9%). Respiratory infections predominated in winter, whereas gastrointestinal diagnoses predominated in summer (P < .001). The overall hospitalization rate was 2.6%, rising significantly to 15.0% among infants aged <1 year (P < .001). The 72-hour repeat-visit rate was 6.7% overall, which decreased to 4.7% after excluding follow-up codes (Z00.x). After this adjustment, repeat-visit rates for infants approximated those of other age groups. The crude association between repeat visits and subsequent hospitalization was significant in the full sample (P < .001) but did not persist in the clustering-adjusted sensitivity analysis. Conclusions: Most PED visits did not require hospitalization, exhibiting marked seasonal and diurnal variation. Although the hospitalization rate was significantly higher among infants, unplanned repeat-visit rates were similar across age groups after excluding routine follow-up codes. These findings may inform local health care resource allocation, service capacity optimization, and follow-up planning, particularly for infants and young children.