Когнитивно функционирање и квалитет на живот кај пациенти со шизофренија

Вовед: Шизофренијата претставува хетероген синдром кој се карактеризира со позитивни и негативни симптоми; намалено когнитивно функционирање; сензомоторен дефицит и дефицит во функционалните вештини; со промени во емоционалната и бихевиоралната сфера, секојдневни функционални потешкотии и намален квалитет на живот. Когнитивните потешкотии се моќен индикатор на функционалноста и се од суштинско значење за адаптивна способност во околината, што доведува до низок функционален статус на глобален план кај пациентите со шизофренија и намален квалитет на живот. Раното препознавање и детектирање на доминантната клиничка манифестација и функционалните оштетувања придонесуваат за унапредување и усовршување на третманот и рехабилитацијата во насока на подобрување на секојдневното функционирање во животот на пациентите со шизофренија. Цел: Основна цел на ова истражување беше да ја утврдиме врската меѓу позитивните и негативите симптоми на шизофренијата, когнитивното функционирање и квалитетот на живот кај пациентите со прва епизода на шизофренија и хронична шизофренија. Непосредни цели беа да утврдиме кои домени на когнитивното функционирање влијаат врз квалитетот на живот кај пациентите со шизофренија и дали терапискиот приод влијае врз подобрување на когнитивното функционирање. Метод: Во истражувањето беа вклучени 106 испитаници од машки и женски пол, на возраст од 18 до 60 години, со дијагноза шизофренија, поставена според дијагностичките критериуми на Меѓународната класификација на болестите – МКБ 10, лекувани во ЈЗУ Психијатриска болница Скопје - Скопје, и ЈЗУ Универзитетска Клиника по психијатрија - Скопје во текот на 2021 година. Испитаниците беа поделени во две групи: првата група се пациенти со шизофренија во прва епизода на болеста и втората група се пациенти со хронична шизофренија. Во текот на истражувањето беа применети следниве мерни инструменти: Прашалник за демографските и клиничките карактеристики, PANNS за проценка на позитивниот и негативниот синдром на шизофренијата, SCoRS за проценка на когнитивното функционирање кај шизофренијата и WHOQOL – BREF за проценка на квалитетот на живот. Резултати: Истражувачките резултати ни покажуваат дека квалитетот на живот, даден преку домените: физичко здравје, психичко здравје, социјални релации и животни услови, зависи од сите домени на когнитивното функционирање и негативните симптоми на болеста. Хроничниот тек на шизофренијата придонесува за поизразено редуцирање на квалитетот на живот кај испитаниците со шизофренија. Истовремено, пациентите со акутна шизофренија имаат изразен когнитивен дефицит, во однос на пациентите со хронична шизофренија, но адекватниот третман доведува до подобрување на когнитивното функционирање кај пациентите со шизофренија. Полот, возраста, образовното ниво, брачниот статус и психопатолошките симптоми влијаат врз когнитивното функционирање и квалитетот на живот кај испитуваните субјекти со шизофренија. Заклучок: Когнитивното функционирање претставува една од основните карактеристики на болеста, кое заедно со психопатолошките симптоми, влијае врз квалитетот на живот на пациентите со шизофренија. Врз основа на теоретската анализа и епириските податоци, можеме да кажеме дека ги постигнавме поставените цели, и ова истражување остава простор за практична примена на резултатите во клинички контекст и во секојдневниот живот. Истовремено претставува и стимул за понатамошни нови научни истражувања кои ќе овозможат подобро разбирање на овој комплексен проблем. Клучни зборови: шизофренија, акутна фаза, хронична фаза, когнитивно функционирање, позитивни и негативни симптоми, квалитет на живот

Haematological Profile of Healthy Workers Exposed to Low Dose Radiation

Background: Long-term exposure to low doses of ionizing radiation may affect cells and tissues and result to various adverse health effects. Objective: To compare the haematological profile such as (red blood cell count, haemoglobin or hematocrit levels, white blood cell count and platelet count) of medical imaging and therapeutic technologists and controls selected from medical hospitals in Kumanovo and Skopje. Method: The study was performed on 140 subjects including 70 persons working with X-ray machines as the case group and 70 unexposed individual as the control. Complete blood cell count was performed with a haematology cell counter (Hem count 50L, Deutschland).Data was analyzed using SPSS version 20. Results: Mean values of hematocrit - HCT, mean cell haemoglobin - MCH, red cell distribution width - RDW, white blood cell –WBC, platelets – PLT, plateletcrit – PCT and platelet distribution width - PDW have shown significant difference from the control group. The mean MCH, PLT, PCT and PDW were higher, while HCT, RDW, WBC, granulocytes and neutrophils were lower in the exposed group. Conclusion: The haematopoietic system is highly sensitive to radiation and the peripheral blood count may well serve a biological indication. The rapid recovery of this tissue limits its application as a diagnostic tool to accidental cases of irradiation. Keywords: ionizing radiation, haematological parameters, side effects, occupational health services

Cognitive deficit, positive and negative symptoms in patients with schizophrenia

Objective: The aim of the study was to introduce the relationship between positive and negative symptoms, cognitive deficit, and antipsychotic treatment in acute schizophrenic patients. Methods: The study included 21 acute schizophrenic patients who were selected from the Psychiatric Hospital in Skopje, and were diagnosed according to the ICD-10. All patients were receiving antipsychotic medication treatment at the time of testing and during the time they were clinically stable. At the beginning of the treatment, all subjects received a higher dose of neuroleptics, and before they left the hospital they were given lower drug doses. The Positive and Negative Syndrome Scale (PANSS) was used to assess the severity of positive and negative symptoms respectively. The Schizophrenia Cognition Rating Scale (SCoRS) was used to assess the cognitive function before and after the neuroleptic treatment. Statistical analysis of the results obtained in the research was conducted with SPSS 20.0 for the Windows package program. The results were analyzed by applying Wilcoxon Signed Ranks Test and Pearson correlation coefficient. Results: The results indicated that the acute schizophrenic patients had a higher global rating score in the SCoRS assessment (M=53.667, SD=8.345) in the first weeks after psychosis onset. After 6-8 weeks of treatment with antipsychotic medications, they had a lower global rating score in the SCoRS assessment (M=41.952, SD=6.951). There was a positive relationship between the total SCoRS score and the dose of neuroleptics (Z=-3.925, sig.=0.000, p<.001). The high degree of positive and negative symptoms was a strong predictor of higher cognitive deficits in schizophrenic patients. A positive relationship was observed between the high dose of therapy, PANSS-Positive, and ScoRS level (r=.552, p<.01), and PANSS-Negative and ScoRS level (r=.607, p<.01). In addition, there was a positive relationship between the low dose of therapy, PANSS-Positive and ScoRS level (r=.342, p<.05), and PANSS-Negative and ScoRS level (r=.432, p<.01). Conclusions: During our work, we found that the regular and continued use of antipsychotic medications in schizophrenic disorders and good co-operation with the patients during the therapy could be important for better cognitive function of the person. Keywords: cognitive deficit, positive and negative symptoms, schizophrenia, treatment

The impact of cognitive functioning on the quality of life in patients with schizophrenia

Introduction: Schizophrenia is an endogenous psychotic disorder with a chronic course. The clinical features of schizophrenia is dominated by positive, negative symptoms, as well as cognitive dysfunction, which affects the quality of life. Objective: To determine the relationship between cognitive dysfunction and quality of life in patients with first-episode schizophrenia and a chronic course of the disease. Method: The research involved 37 randomly selected male and female respondents from 18 to 60 years of age who suffer from schizophrenia according to the diagnostic criteria of the International Classification of Diseases - ICD 10. The respondents are divided into two groups. The first group consists of 21 patients with schizophrenia in an acute period of the disease, while the second group consists of 16 patients with chronic schizophrenia treated in the PHI Psychiatric Hospital Skopje-Skopje and the PHI University Clinic of Psychiatry, Skopje. We used the following measuring instruments: the Positive and Negative Syndrome Scale (PANSS), the Schizophrenia Cognition Rating Scale (SCoRS) and the World Health Organization Quality of Life (WHOQOL)-BREF scale. For the statistical data processing, we used the statistical package SPSS version 26 (Statistical Package for the Social Science). Results: By applying ANOVA we found that the quality of life in acute patients is linearly related with at least one predictor, i.e. F (21) =3.570, sig. =.036, p.01 and between the quality of life and the total score of cognitive functioning obtained by the interviewer t(21)=0.096, sig.=0.925, p>.01. Also by using ANOVA, we found that the quality of life in chronic patients is not linearly related to any predictor,i.e. F (16) =0.840, sig. =.498, p>.05. In the regression analysis using the t-test we also found that there is no relationship between the quality of life and the predictors. Conclusion: In the course of our longitudinal prospective study, we found that cognitive dysfunction in schizophrenia affects a person’s quality of life, whereby this is evident in the acute phase of the disease. Rehabilitation is focused on building the required skills for everyday life and work in the community and is based on the principles of recovery and empowerment, it encourages the patient’s autonomy by fostering the ability to work and by reducing incapacity –it improves self-confidence, social functioning, and quality of life

THE RIGHT TO INCLUSIVE EDUCATION FOR CHILDREN WITH DISABILITIES IN THE REPUBLIC OF NORTH MACEDONIA: OPPORTUNITIES AND CHALLENGES

A child is a member of a vulnerable group in societies. Children's rights are equal for all children and they cannot be denied, because they are a birthright. However, throughout the world, children with disabilities and their families constantly experience a barrier in regard to the enjoyment of their basic human rights and to their inclusion in society. Their abilities are overlooked, their capacities are underestimated and their needs are given low priority. The barriers they face are more frequently a result of the environment in which they live rather than a result of their impairment. The situation began to change only when requirements to include disabled children in the education system were introduced in legislation. Following the example of other countries worldwide, the Republic of North Macedonia introduced inclusion of children with disabilities in the mainstream educational process, because the right to education is a right for all children, including the ones with special educational needs. For this purpose, the Republic of North Macedonia implemented a series of changes in the educational system for successful inclusion of children with special educational needs. Hence, the main aim of our paper is to represent the actual situation in Macedonian schools regarding the problem of educational inclusion of students with disabilities in the regular school system. The research methods are based on document studies and case studies about changes in social and educational policies for students with disabilities and special educational needs who are included in primary and secondary education. At the same time we shall present some guidelines for teachers who work with these children and future directions for a proper inclusion system in the Republic of North Macedonia, because every child has a fundamental right to education and must be given the opportunity to achieve and reach an acceptable level of learning. In this frame, school societies try to support full participation of students with disabilities in areas of their lives on equal terms, conditions, social justice and basic human rights