The effect of leap motion controller based exergame therapy on hand function, cognitive function and quality of life in older adults. A randomised trial

Objective. To evaluate the effect of leap motion controller based exergame therapy (LMCBET) on hand function, cognitive function and quality of life (QoL) in older adults. Design. A parallel, double-blind trial with participants allocated (1:1) to one of two groups as the structured exercise (SE) and LMCBET. Setting. The study was conducted in “Barınyurt Nursing Home and Elderly Care Center” in Istanbul. Participants. Thirty-two older adults who had adequate hand function, ability to follow commands, 24 points or more in the mini mental state examination (MMSE) were included and 30 were analyzed. Interventions. SE Group performed a Structured Hand Exercise program while LMCBET group performed “ErgoActive’’ and “HandROM” exercise apps focusing on hand exercises and fine motor skills along 30-45 minute sessions, 2 days a week, over 8 weeks. Main outcome measures. Participants were evaluated with box and block test (BBT), Purdue Pegboard test (PPT), hand dynamometer, Duruöz hand index (DHI), stroop test (ST), digit span test (DST), and World Health Organization QoL instrument-older adults module (WHOQOL-OLD) at the beginning (T0), at 8 (T1), and 16 (T2) weeks after the study started. Results. There were significant differences in BBT, PPT, DHI, and WHOQOL-OLD in the SE group (p 0.05). Conclusions. SE and LMCBET were effective on hand function and QoL in healthy older adults.Nursing Home and Elderly Care Cente

Turner sendromlu ergenlerin multidisipliner yaklaşımla psikometrik ve psikososyal açıdan değerlendirilmesi: Ön çalışma

Introduction: The aim of this study is to compare neurocognitive and psychosocial characteristics in adolescents with Turner Syndrome (TS) and age-matched adolescents with short stature (SS) and normal karyotypes. Materials and Methods: Seven patients with TS and 7 patients with SS and normal karyotypes were included in the study. Their comorbid psychopathologies, cognitive functioning, quality of life, self-esteem, emphatic tendencies, mentalizing abilities and coping strategies were investigated. Results: Although the adolescents with SS had higher levels of anxiety and conduct problems, there were no significant differences between the TS and SS groups in terms of comorbid psychopathologies, social cognition skills, quality of life, self-esteem and coping strategies. However, the cognitive functioning of adolescents with TS was found to be lower than both of the adolescents with SS and community samples. Conclusions: According to this preliminary study, anxiety/conduct problems and cognitive functioning of patients with TS should be evaluated in order to prevent subsequent negative outcomes.Giriş: Bu çalışmanın amacı, TS olan ergenler ile kısa boylu ve normal karyotipi olan benzer yaştaki ergenleri nörobilişsel ve psikososyal olarak karşılaştırmaktır. Gereç ve Yöntem: Çalışmaya TS olan yedi hasta ile kısa boylu ve normal karyotipi olan yedi hasta dahil edilmiştir. Eşlik eden psikopatolojiler, bilişsel işlevsellik, yaşam kalitesi, benlik saygısı, empatik eğilimler, zihinselleştirme becerileri ve baş etme stratejileri araştırılmıştır. Bulgular: Kısa boylu ergenlerde anksiyete ve davranım problemleri daha yüksek olmasına karşın, eşlik eden psikopatolojiler, sosyal biliş becerileri, yaşam kalitesi, benlik saygısı ve başetme stratejileri açısından TS olan ergenler ile kısa boylu ergenler arasında önemli bir fark bulunmamıştır. Bununla birlikte, TS olan ergenlerin bilişsel işlevlerinin hem kısa boylu ergenlere hem de toplum örneklemine göre daha düşük olduğu bulunmuştur. Sonuç: Bu ön çalışmaya göre, ileride gelişebilecek olumsuz sonuçları önlemek için TS’li hastalar anksiyete / davranış sorunları ve bilişsel işlevler açısından değerlendirilmelidir

Neurobiology of Tourette Syndrome

Tourette Sendromu (TS), çocukluk çağında sık görülen, uzun süreli motor ve vokal tiklerle karakterize, nörogelişimsel bir bozukluktur ve etiyolojisi henüz tam olarak aydınlatılamamıştır. Yapılan çalışmalar sonucunda TS olan kişilerin farklı bir nörobiyolojik yapıya sahip olduğu görülmüştür. Bu gözden geçirme yazısında, TS ile ilgili yazın taranarak hastalığın etiyolojisinin ve patofizyolojisinin araştırılmasına yönelik çalışmaların gözden geçirilmesi amaçlanmıştır. Bu amaçla PubMed veri tabanında elektronik arama yapılmıştır. 1985-2015 yılları arasında yayınlanan makalelerden yararlanılmış, özellikle son yıllardaki araştırma ve gözden geçirme çalışmalarının incelenmesine ağırlık verilmiştir. Anahtar sözcükler olarak tik bozuklukları, Tourette Sendromu, nörobiyoloji, genetik, nörogörüntüleme ve hayvan modelleri kullanılmıştır. Çalışmalara göre, TS oluşumunda genetik yatkınlık hipotezinin öncelikli olduğu düşünülse de, TS ile ilişkisi kesinleşmiş bir genetik bozukluk saptanamamıştır. TS'de kortiko-striato-talamo-kortikal (KSTK) devrelerle ilgili olduğu düşünülen bozukluk; postmortem ve beyin görüntüleme çalışmalarıyla heterojen hasta gruplarında ve hayvan çalışmalarıyla gösterilmiştir. Dolayısıyla, patofizyolojide en çok üzerinde durulan hipotez bu devrelerdeki dopaminerjik iletim bozukluğu olmuştur. Bununla birlikte, bulgular bozukluğun nörogelişimsel olduğu yönündeki hipotezi de doğrulamıştır. Sonuç olarak, TS etiyolojisinin anlaşılabilmesi için daha çok çalışma yapılması gerekmektedir. TS nörobiyolojisiyle ilgili elde edilecek veriler, yalnızca TS'ye ışık tutmakla kalmayacak, aynı zamanda hastalığın tedavi seçenekleriyle ilgili çalışmalar için de yol gösterici olacaktır.Tourette Syndrome (TS) is a neurodevelopmental disorder characterized by chronic motor and vocal tics. Although it is a common disorder in childhood, the etiology of Tourette Syndrome has not been fully elucidated yet. Studies, -conducted so far- have revealed differences in neurobiological structures of individuals who suffer from Tourette Syndrome. The objective of this review is to assess etiological and pathophysiological studies in the Tourette Syndrome literature. An electronical search was conducted in PubMed database using the keywords tic disorders, Tourette Syndrome, neurobiology, genetics, neuroimaging and animal models. Research and review studies published between 1985 and 2015, with a selection preference towards recent publications, were reviewed. According to the studies, genetic predisposition hypothesis is considered as a priority. However, a precise genetic disorder associated with Tourette Syndrome has not been found. The evidence from postmortem and neuroimaging studies in heterogenous patient groups and animal studies supports the pathological involvement of cortico-striato-thalamo-cortical (CSTC) circuits in Tourette Syndrome. Consequently, the most emphasized hypothesis in the pathophysiology is the dopaminergic dysfunction in these circuits. Furthermore, these findings of the animal, postmortem and neuroimaging studies have confirmed the neurodevelopmental hypothesis of Tourette Syndrome. In conclusion, more studies are needed to understand the etiology of the disorder. The data obtained from neurobiological studies of the disorder will not only shed light on the way of Tourette Syndrome, but also guide studies on its treatment options

Neurobiology Of Tourette Syndrome

Tourette Syndrome (TS) is a neurodevelopmental disorder characterized by chronic motor and vocal tics. Although it is a common disorder in childhood, the etiology of Tourette Syndrome has not been fully elucidated yet. Studies, -conducted so far-have revealed differences in neurobiological structures of individuals who suffer from Tourette Syndrome. The objective of this review is to assess etiological and pathophysiological studies in the Tourette Syndrome literature. An electronical search was conducted in PubMed database using the keywords tic disorders, Tourette Syndrome, neurobiology, genetics, neuroimaging and animal models. Research and review studies published between 1985 and 2015, with a selection preference towards recent publications, were reviewed. According to the studies, genetic predisposition hypothesis is considered as a priority. However, a precise genetic disorder associated with Tourette Syndrome has not been found. The evidence from postmortem and neuroimaging studies in heterogenous patient groups and animal studies supports the pathological involvement of cortico-striato-thalamo-cortical (CSTC) circuits in Tourette Syndrome. Consequently, the most emphasized hypothesis in the pathophysiology is the dopaminergic dysfunction in these circuits. Furthermore, these findings of the animal, postmortem and neuroimaging studies have confirmed the neurodevelopmental hypothesis of Tourette Syndrome. In conclusion, more studies are needed to understand the etiology of the disorder. The data obtained from neurobiological studies of the disorder will not only shed light on the way of Tourette Syndrome, but also guide studies on its treatment options.WoSScopu

Gender Differences In Defense Mechanisms, Ways Of Coping With Stress And Sense Of Identity In Adolescent Suicide Attempts

The main aim of this study was to investigate the gender differences in defense mechanisms, ways of coping with stress and identity formation in relation to adolescent suicidal behavior. This study involved 64 adolescents between 12-17 years of age, who were admitted to the emergency service with a suicide attempt. They were evaluated with a semi-structured clinical interview (K-SADS), Ways of Coping Inventory (WCI), Defense Mechanisms Inventory (DMI) and Sense of Identity Assessment Form (SIAF). 60.9% (n =39) of the adolescents were female, and 39.1% (n=25) were male. There were no statistically significant differences between the girls and the boys with respect to the clinical characteristics of the suicide attempt and the rate of psychiatric disorders. Of the 64 adolescents with suicide attempt, 47 (73.4%) had at least one, and 26 (40.6%) had more than one psychiatric disorder according to K-SADS. Disruptive behavior disorders were more frequent in males, whereas depression was more frequent in girls. The data indicated the importance of identity confusion, major depression and ADHD in adolescents with suicide attempt in both genders. 43.6% (n=17) of the girls and 36% (n=9) of the boys obtained scores higher than the cut-off point of SIAF indicating identity confusion. Professional help seeking and NSSI behaviors before the suicide attempt were more common in adolescents with identity confusion. While there were differences between genders with respect to the defense mechanisms used, no significant difference was found in terms of ways of coping. Evaluation of DMI scores revealed that the turning against object subscale score was significantly higher in boys compared to girls. While evaluating the adolescents at risk, their defense mechanisms, way of coping and sense of identity, as well as their psychiatric diagnosis should be assessed in detail in order to identify the suicidal thoughts and prevent possible suicide attempts.WoSScopu

Childhood Traumas, Attachment And Alexithymia In Adolescents With Psychogenic Nonepileptic Seizure Type Of Conversion Disorder

Objective: In this cross-sectional study, childhood traumas, attachment security and alexithymia in adolescents with psychogenic nonepileptic seizures (PNES) were compared with those of adolescents without any psychiatric disorder using both semi-structured clinical interviews and self-report scales. Method: This study included 42 adolescents with PNES aged between 12-18 and 38 healthy adolescents who were matched with the study group in respect to socio-demographic variables. All adolescents and their parents were interviewed using Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version in order to evaluate psychiatric disorders. Clinician-Administered Posttraumatic Stress Disorder (PTSD) Scale for Children and Adolescents was used to examine the presence of PTSD symptoms. All adolescents completed the Childhood Trauma Questionnaire-28, Short Form of Inventory of Parent and Peer Attachment, Toronto Alexithymia Scale and Rosenberg Self Esteem Scale. Results: Adolescents with PNES had more emotional and sexual traumatic experiences and PTSD symptoms compared to the control group. PNES group perceived higher “communication” but lower “trust” in attachment relationships with their mothers and fathers. Higher alexithymia and lower self-esteem were determined in the PNES group. Childhood traumas, lifetime PTSD symptoms and alexithymia were found to be significant risk factors for PNES in adolescents. Conclusion: Results indicate that comorbid psychiatric disorders, traumatic experiences, attachment problems and alexithymia need to be evaluated and treated in adolescents with PNES.WoSScopu

The effect of cognitive functions after chemotherapy on activity performance and social participation in breast cancer patients

Amaç: Bilişsel fonksiyon problemleri kemoterapinin en yaygın yan etkileri arasında yer almaktadır. Bireyler tedavi bittikten sonra da bilişsel fonksiyon bozuklukları yaşamaya devam etmektedir. Meme kanseri atlatan bireyler kanser sonucu günlük yaşam problemleri yaşamaktadır. Bu çalışmanın amacı kemoterapisi sonlanan meme kanserli bireylerin bilişsel fonksiyonlarının, bireylerin günlük yaşamdaki aktivite performanslarına ve aktivite katılımlarına etkisinin incelenmesidir. Gereç ve Yöntem: Çalışmaya 18-65 yaş aralığında, kemoterapisi sonlanan, 35 meme kanserli kadın dahil edildi. Bilişsel fonksiyonlarını değerlendirmek için Montreal Bilişsel değerlendirme Ölçeği (MOBİD), aktivite performansı ve problem alanlarının tespit edilmesi için Kanada Aktivite Performans Ölçeği (KAPÖ), katılımda güçlük yaşadıkları aktiviteleri değerlendirmek için Yetiyitimi Değerlendirme Ölçeği (WHODAS-2) kullanıldı. Bulgular: Değerlendirmeler sonucunda kemoterapisi sonlanan meme kanserli bireylerde yürütücü işlevler, adlandırma, dikkat, soyut düşünme, gecikmeli hatırlama ve yönelim alanlarının etkilendiği görülmüştür. Etkilenen bilişsel fonksiyonlar ile bireylerin aktivite performansları ve memnuniyetleri arasında pozitif yönde anlamlı (P < ,05), aktivite katılımları ile negatif yönde ileri düzeyde anlamlı (P < ,01) ilişki bulunmuştur. Sonuç: Kemoterapi sonrası kanser hastalarında yaşam kalitesinin arttırılması, katılımın desteklenmesi ve aktivite performansının iyileştirilmesi için bilişsel rehabilitasyon uygulamaları oldukça önem arz etmektedir.Objective: Cognitive function problems are among the most common side effects of chemotherapy. Individuals continue to experience cognitive dysfunctions after the treatment end. Individuals who survive breast cancer experience daily life problems as a result of cancer. The aim of this study is to investigate the effects of cognitive functions of individuals with breast cancer on chemotherapy, ending on the activity performance, and activity participation of individuals in daily life. Material and Methods: In the study, 35 women with breast cancer between 18 and 65 years of age and whose chemotherapy was terminated, were included. The Montreal cognitive assessment scale (MOBID) was used to evaluate cognitive functions, the Canadian activity performance scale (KAPÖ) was used to determine activity performance and problem areas, and the disability assessment scale (WHODAS-2) was used to evaluate the activities they had difficulty in participating in. Results: As a result of the evaluations, it was observed that the areas of executive functions, naming, attention, abstract thinking, delayed recall, and orientation were affected in breast cancer individuals whose chemotherapy was terminated. A positive and significant (P < ,05) correlation was found between the cognitive functions affected and the activity performances and satisfaction of the individuals, and a negative and significant (P < ,01) correlation with the activity participation. Conclusion: Cognitive rehabilitation practices are very important for improving the quality of life, supporting participation, and improving the performance of cancer patients after chemotherapy

Predictors of Self-Esteem in Adolescents with A Psychiatric Referral

In the literature self-esteem is found to be lower in clinically referred adolescents compared to adolescents without any psychiatric disorder. The aim of this study is to examine self-esteem and associated socio-demographical and psychological factors in clinically referred adolescents in Turkey. Three hundred forty-nine adolescents aged between 12 and 18 years admitted to the Department of Child and Adolescent Psychiatry with a psychiatric complaint were enrolled. Rosenberg Self-Esteem Scale (RSES), Brief Symptom Inventory (BSI), Parenting Style Scale (PSS) and Sense of Identity Assessment Form (SIAF) were used for the evaluation. Self-esteem was lower in: girls, adolescents without siblings, living in non-nuclear families, with a past suicide attempt, and with history of a non-suicidal self-injurious behavior (NSSI). Self-esteem was negatively correlated with identity confusion on SIAF and positively correlated with acceptance/involvement on PSS. Significant predictors of self-esteem were gender, presence of a sibling, history of a NSSI and SIAF scores. Interactions between self-esteem and gender, psychiatric symptoms, parenting and identity development are complex in clinically referred adolescents. Further elucidation of the mechanisms through which these characteristics modify self-esteem will be necessary to guide families and clinicians to help adolescents to maintain high self-esteem levels.WoSScopu