Ergenlerde dikkat eksikliği hiperaktivite bozukluğunun açıklayıcı fenomenolojik analizi

Current research on attention deficit hyperactivity disorder (ADHD) is generally based on quantitative methodology. This indicates a lack of information on how ADHD individuals explain this phenomenon, and what they experience. The aim of this research is to reveal how attention deficit hyperactivity disorder is experienced in adolescents and how adolescents explain this phenomenon. The participants in this study were ten adolescents aged 11-18 who were diagnosed with ADHD and did not have a comorbid diagnosis. Participants were interviewed through a semi-structured interview form. The interviews were conducted and recorded on an online platform, and a transcript of the voice recording of each participant was then created. The texts obtained from the transcripts were analyzed with an interpretative phenomenological analysis. As a result of the analysis, the following themes were found: Academic difficulty, normalizing and affirming the diagnosis, living with undesirable emotions and behaviors, and negative social experiences. The findings reveal that the ADHD-related experiences of adolescents and their explanations for the ADHD diagnosis are not of a single nature. Instead, they were also perceived in a positive light as well as negative. The results reveal that the awareness of professionals and families who have contact with ADHD-diagnosed adolescents should be raised, and interventional and motivational programs directed at ADHD treatment-related negative experiences of adolescents can be organized.Dikkat eksikliği hiperaktivite bozukluğu (DEHB) ile ilgili araştırmaların genellikle nicel metodolojiyle kurgulanmış araştırmalar olduğu görülmektedir. Bu durum DEHB tanılı bireylerin neler deneyimlediklerine ve ilgili fenomeni nasıl açıkladıklarına yönelik bilgi eksikliğine işaret etmektedir. Bu araştırmanın amacı ergenlerde dikkat eksikliği hiperaktivite bozukluğunun nasıl deneyimlendiğini, ergenlerin bu fenomenle ilgili açıklamalarının neler olduğunu ortaya çıkarmaktır. Araştırmaya 11-18 yaşlarında eş bir tanısı olmayan, DEHB tanısı almış 10 ergen katılmıştır. Katılımcılarla yarı yapılandırılmış mülakat formu aracılığıyla görüşülmüştür. Mülakatlar, görüşmelerin yürütüldüğü online platform üzerinden kayıt altına alınmış ve her bir katılımcıya ait ses kaydının yazı dökümü oluşturulmuştur. Yazı dökümlerinden elde edilen metinler Açıklayıcı Fenomenolojik Analiz yöntemiyle analiz edilmiştir. Yapılan analiz sonucunda akademik zorluk, tanıyı normalleştirme ve olumlama, arzu edilmeyen duygular ve davranışlarla yaşama ve olumsuz sosyal yaşantılar temaları bulgulanmıştır. Bulgular DEHB tanılı ergenlerin DEHB ile ilişkili deneyimlerinin ve DEHB tanısına yönelik açıklamalarının sadece bir nitelikte olmayıp karmaşıklaştığını hem olumlu hem olumsuz nitelikte olduğunu göstermektedir. Sonuçlar DEHB tanılı ergenlerle teması olan meslek profesyonellerinin ve ailelerin farkındalıklarının artırılması gerektiğini, tedavi sürecinde ergenlerin DEHB ile ilgili olumsuz deneyimlerine yönelik müdahaleler oluşturulabileceğini ayrıca bu müdahale programlarına ek olarak deneyimlenen duruma özgü, bireylerin ihtiyaçlarına uygun biçimde motivasyonel programlar düzenlenebileceğini ortaya koymaktadır.Publisher's Versio

“Mommy, stay here.” treatment of seperation anxiety disorder case with child-centered play therapy (Case report)

İnsan yaşamının her döneminde ayrılıklar önemli bir yer edinmiştir. Diğer türlere göre dünyaya daha hazırlıksız bir şekilde gelen insan türü için bu çaresizlik durumuna çare annenin varlığıdır. Bu yüzden anneden ayrılma çocuğun sosyoduygusal gelişiminde karşılaşılan en büyük sorunlardan biri olmuştur. Ayrılma kaygısı bozukluğu çocuk ruh sağlığı alanında en sık karşılaşılan bozukluklardandır. Evden veya bağlı olduğu kişilerden ayrılmakta zorlanan çocuk için bu duruma yönelik tedavilerden biri oyun terapisidir. Oyun çocuğun kendisini ifade etmenin en doğal aracı olduğu için çocuk gerginlik, hayal kırıklığı, güvensizlik, saldırganlık, korku, kafa karışıklığı ve şaşkınlık gibi birikmiş duygularını dışa vurma imkanına erişmiş olur. Oyun terapisinin terapötik bir araç olarak çocuk ruh sağlığı alanında kullanımı giderek artmaktadır. Okul öncesi psikolojik sorunlara yönelik geliştirilen tedavi yöntemlerinden biri olan oyun terapisi, kaygı bozukluklarında ve depresyon belirtilerinin azaltılmasında etkili yöntemlerden biridir. Bu çalışmada ayrılma kaygısı bozukluğu tanısı alan 6 yaşında bir çocukla yürütülen 24 çocuk merkezli oyun terapisi seanslarından oluşan bir uygulamanın sonuçları sunulmaktadır. Terapistin gözlemleri, çocuğun oyun davranışlarındaki değişim, ailenin ve psikiyatri uzmanının geri bildirimleri doğrultusunda sürecin sonunda çocuğun kaygılarında önemli düzeyde azalma olduğu ve günlük işlevselliğinin arttığı belirlenmiştir.Seperations have occupied an important place in every stage of human life. Compared to other speices, the humanspacies enters the world in a less prepared manner, and the solution to this situation lies in the presence of the mother. Therefore, the seperation from the mother is one of the most commonly encountered disorders in the field of child mental health. For the child who has difficulty seperating from home or the people to whom she/he is attached to, one of the treatment for this condition is play therapy. Since play is the child’s most natural means of expressing herself/himself, the child has the opportunity to express her accumulated emotions such a tension, frustration, insecurity, aggression, fear, and confusion. The use of play therapy as a therapeutic means in the field of child mental health is increasing. Play therapy, which is one of the treatment methods developed for preschool psychological problems, is one of the effective methods in reducing anxiety disorders and depression symptoms. In this study, the results of an conducted consisting of 24 child-centered play therapy sessions with a 6-year old child-diagnosed with seperation anxiety disorder are presented. At the end of the process, it was determined that patient’s anxiety decreased significantly and his daily functionality increased depend on change of child play behaviors, therapist observation and family and psychiatrist feedback.Publisher's Versio

An interpretative phenomenological analysis of attention deficit hyperactivity disorder in adolescents

Text in Turkish ; Abstract: Turkish and EnglishIncludes bibliographical references (leaves 62-69)xiv, 73 leavesDikkat eksikliği hiperaktivite bozukluğu (DEHB) gelişimsel olarak uygunsuz bir biçimde bozucu dikkatsizlik, motor hiperaktivite ve dürtüsellik ile ayırt edilen, çocuklukta başlayan ve genellikle yetişkinliğe kadar devam eden heterojen ve çok faktörlü nörogelişimsel bir bozukluktur. Son yıllarda yapılan çalışmalar incelendiğinde DEHB ile ilgili yürütülen araştırmaların genellikle nicel metodolojiyle kurgulanmış, kişilerin belirli bir olgudan nasıl etkilendiğiyle ilgilenen ve derleme araştırmalar olduğu görülmektedir. Bu durum DEHB tanılı bireylerin ilgili fenomeni nasıl açıkladıklarına ve neler deneyimlediklerine, bu yaşantıları nasıl tarif ettiklerine yönelik bilgi eksikliğine işaret etmektedir. Uluslararası literatürde benzer sayılabilecek nitelikte bir çalışma olsa da ülkemizde böyle bir çalışmaya rastlanmamıştır. Bu araştırmanın amacı ergenlerde dikkat eksikliği hiperaktivite bozukluğunun nasıl deneyimlendiğini, ergenlerin bu fenomenle ilgili yaşantılarının neler olduğunu ortaya çıkarmaktır. Araştırmaya 11-18 yaşlarında eş bir tanısı olmayan, DEHB tanısı almış 10 ergen katılmıştır. Katılımcılarla yarı yapılandırılmış mülakat formu aracılığıyla görüşülmüştür. Mülakatlar, görüşmelerin yürütüldüğü online platform üzerinden kayıt altına alınmış ve her bir katılımcıya ait ses kaydının yazı dökümü oluşturulmuştur. Yazı dökümlerinden elde edilen metinler Açıklayıcı Fenomenolojik Analiz yöntemiyle analiz edilmiştir. Yapılan analiz sonucunda akademik zorluk, tanıyı normalleştirme ve olumlama, arzu edilmeyen duygular ve davranışlarla yaşama ve olumsuz sosyal yaşantılar temaları bulgulanmıştır. Bulgular DEHB tanılı ergenlerin DEHB ile ilişkili deneyimlerinin ve DEHB tanısına yönelik açıklamalarının sadece bir nitelikte olmayıp karmaşıklaştığını hem olumlu hem olumsuz nitelikte olduğunu göstermektedir. Sonuçlar DEHB tanılı ergenlerle teması olan meslek profesyonellerinin ve ailelerin farkındalıklarının artırılması gerektiğini, tedavi sürecinde ergenlerin DEHB ile ilişkili olumsuz yaşantılarına yönelik müdahale programlarının oluşturulabileceğini ayrıca bu müdahale programlarına ek olarak deneyimlenen duruma özgü, bireylerin ihtiyaçlarına uygun biçimde güdüleyici müdahaleler düzenlenebileceğini ortaya koymaktadır.Attention deficit hyperactivity disorder (ADHD) is a multifactorial neurodevelopmental disorder distinguished by developmentally inappropriate and impairing inattention, motor hyperactivity, and impulsivity. These difficulties develop during childhood, and often continue throughout adulthood. Literature review shows that majority of the research about ADHD are conducted in quantitative methodology. We have found that most of these studies are review articles, mostly concerned with how individuals are affected by ADHD as opposed to how they express it. This reveals a lack of scientific information about how people with ADHD experience this disorder and how they verbalize their experience. Despite the existence of one such study in international literature, we have not found any domestic studies. The aim of this research is to reveal how adolescents experience the phenomenon of attention deficit hyperactivity disorder. The study sample consisted of 10 adolescents aged between 11-18 years who were diagnosed with ADHD without a comorbid disorder. Participants were interviewed through a semi-structured interview form. The interviews were conducted online, and a transcript of the voice recording of each participants was created. The constituent texts from these transcripts were analyzed using Interpretative Phenomenological Analysis. As a result of the analysis, the following themes were found: Academic difficulty, normalizing and affirming the diagnosis, living with undesirable emotions and behaviors, and negative social experiences. The findings reveal that ADHD related experiences and expressions of adolescents are not solely of a single nature. Instead they were also perceived in a positive light as well as negative. The results reveal that the awareness of professionals and families who have contact with ADHD-diagnosed adolescents should be raised, and that interventional and motivational programs directed at ADHD treatment related negative experiences of adolescents can be organized.Dikkat Eksikliği Hiperaktivite Bozukluğu ve TarihçesiDSM ve ICD Tanı Sistemlerinde Dikkat Eksikliği Hiperaktivite BozukluğuDikkat Eksikliği Hiperaktivite Bozukluğunun EpidemiyolojisiDikkat Eksikliği Hiperaktivite Bozukluğunun EtiyolojisiDikkat Eksikliği Hiperaktivite Bozukluğuna Eşlik Eden BozukluklarDikkat Eksikliği Hiperaktivite Bozukluğunda DeğerlendirmeDEHB Tanılı Çocuk ve Ergenlerde Klinik GörünümDikkat Eksikliği Hiperaktivite Bozukluğunda TedaviDEHB Tanılı Çocuk ve Ergenlerde Psikososyal SağlıkNitel Metodoloji Araştırmalarında Dikkat Eksikliği Hiperaktivite Bozukluğ

The Management of Nasal Obstruction During Pregnancy and the Postpartum Period

Nasal congestion affects a large part of the population and is one of the most common symptoms in otolaryngological practice. A detailed history and physical examination are important to reach the diagnosis. Endoscopic examination of the nose is the most valuable examination method in the evaluation of nasal obstruction. In endoscopic examination, nasal mucosa and its features, pathologies of anatomical structures (septal deviation, septal perforation, turbinate hypertrophy etc.), nasal discharge and its characteristics, intranasal masses (polyp, tumor, etc.), and the nasopharynx are evaluated

Heavy metal levels in muscle tissues of some fish species caught from north-east Mediterranean: Evaluation of their effects on human health

Sixteen different fish species were sampled from six sampling stations selected between Taşucu (Mersin)and Samandağ (Hatay)at North-East Mediterranean coasts of Turkey between March and May 2018. Mean muscle levels of Cr, Mn, Fe, Ni, Cu, Zn, As, Sn and Pb for fish species obtained from all sampling stations were 2.15–7.10, <0.0002 – 0.39, <0.001 – 19.02, <0.0006 – 0.50, <0.0006 – 0.74, 3.82–55.05, 1.08–15.06, <0.0004 – 0.92 and <0.0003 – 0.06 mg kg -1 wet weight respectively. Cadmium levels in muscle tissues of all the species studied were below detection limits. Mean muscle level of each metal was calculated for each station by keeping the human consumption in mind, weekly tolerable limits, target hazard quotients and cancer risk assessment of the metals were firstly determined in fish species obtained from North-East Mediterranean. The amount of metal intake by the consumption of analyzed samples was found to be below weekly tolerable limits, however target hazard quotients and cancer risk levels for As were found above the limits stated by United States Environmental Protection Agency. Moreover, 20.93% and 27.91% of 43 fish specimen obtained from Erdemli station had higher Zn levels than those proposed by Turkish Food Codex and World Health Organization respectively. © 2019Mersin University, Scientific Projects Unit, supported this research project. (Project Number: 2018-2-TP2-2918)

The carbapenem-resistant Enterobacteriaceae threat is growing: NDM-1 epidemic at a training hospital in Turkey

Conclusions: Our findings suggest the tendency of NDM-1-producing strains to spread in our country as well. A carbapenem-resistant K. pneumoniae threat may pose a great risk to our country. It is clear that more comprehensive infection control precautions should be implemented in our hospitals

Necessity of Electroencephalography in High-risk Brief Resolved Unexplained Event

Aim: A brief resolved unexplained event (BRUE) is characterized by sudden alterations in an infant’s breathing, color, tone, or responsiveness. the aim of this study was to evaluate the necessity of electroencephalography (EEG) in high-risk BRUE cases. Materials and Methods: Fifty-one patients’ cases were analyzed retrospectively. All of these patients were younger than 1 month so considered to be a high-risk group. the gestational week, the age of the patient, the duration of the event, the conditions related to the event, whether or not any intervention was needed, the type of intervention if done, if the event recurred, the number of recurrences, the state of consciousness during the event, respiratory pattern, muscle tone, sleeping position, suspicion of trauma, use of medication by mother and/ or baby and smoking exposure were evaluated in detail. Results: the mean age of the patients was 15.74±14.96 days, 31 (60.78%) were male and 20 (39.21%) were female. the mean gestational age was 37.64±2.35 weeks. the neurological examinations of the patients were evaluated as normal. EEG was performed in 36 (70.58%) of the 51 patients and only one patient had sharp waves in the left hemisphere central region. in 11 patients hospitalized with a preliminary diagnosis of BRUE, final diagnoses were found as congenital pyloric stenosis, dehydration, fetal myocarditis, patent ductus arteriosus, lower respiratory tract infection and gastroesophageal reflux. Conclusion: It would be more appropriate to plan the tests to be carried out in the high-risk BRUE group by evaluating many factors such as recurrence of the event, family history, and neurological examination findings. As a result, even in the high-risk BRUE group, it would be cost effective to perform an EEG if only the clinical cues are strongly suggestive for the diagnosis of epilepsy

The Score for Allergic Rhinitis study in Turkey, 2020

International audienceObjective: This study aimed to determine how prevalent allergic rhinitis (AR) is in Turkey and to compare the current prevalence with the figures obtained 10 years earlier.Methods: This study included 9,017 participants. The minimum number of participants required from each center was determined via a stratified sampling technique according to regional demographic characteristics as ascertained from the last census. For each region, both men and women were administered the score for allergic rhinitis (SFAR) questionnaire and a score for each participant was calculated based on the responses supplied.Results: A total of 9,017 individuals (55.3% men and 44.7% women) took part in this study. Of these, 94.4% were urban residents and 5.6% lived in a rural setting. Of the men, 38.5% self-reported as suffering from AR. The corresponding figure in women was 40.5%. The overall prevalence of AR, as deduced on the basis of the SFAR, was found to be 36.7%. Comparing the prevalence in different regions, we found that AR was the least prevalent in the Black Sea region with a frequency of 35.8%. The highest prevalence was in the Mediterranean region, where the prevalence was 37.7%. There was no statistical significance in the apparent differences in prevalence between different geographical regions. Despite this, however, there was a clear increase in the frequency of AR over the preceding decade. This increase was most pronounced in the South-Eastern Anatolian region, where the frequency rose from 21.0% to 36.9%.Conclusion: Our results indicate that there has been a marked increase in the prevalence of AR in every region in Turkey over the last 10 years. This could be related to living conditions in urban environments. Alterations in lifestyle, urban living, air pollution causing impairments in immune defense mechanisms, and other aspects of modern lifestyles may account for the increase in AR in Turkey