Cross-cultural adaptation, reliability, and validity of the Turkish Pediatric Quality of Life Inventory-Cognitive Functioning Scale (PedsQLTM-CFS) in children with cancer.

The Pediatric Quality of Life Inventory-Cognitive Functioning Scale (PedsQLTM-CFS) was developed as a brief, general, symptom-specific tool to measure cognitive function. The 6-item PedsQL™ Cognitive Functioning Scale and PedsQL 3.0 Cancer Module answered 369 parents and 330 children with 5-18 years. Parents also completed Behavior Rating Inventory of Executive Function (BRIEF). The PedsQL™ Cognitive Functioning Scale evidenced excellent reliability (parent proxy-report α = 0.980/Fleiss Kappa: 0.794; children self-report α = 0.963/Fleiss Kappa: 0.790). Both child self-report and parent proxy-report PedsQL™ Cognitive Functioning Scale scores exhibited significant correlations with all parent-report BRIEF summary and subscale scores (p < .05). Both child self-report and parent proxy-report PedsQL™ Cognitive Functioning Scale scores exhibited significant correlations with PedsQL 3.0 Cancer Module total score and subscale scores (p < .05). The PedsQLTM-CFS can be used in high-risk populations with substantial to perfect reliability, both in regards to total/subcategory scores as well as in children with cancer.

Effects of a visual perception-based occupational therapy program on reading and motor skills in children with developmental dyslexia: Single blind randomized cross-over study design.

This study aimed to examine the effects of a visual praxis-based occupational therapy (VPOT) program on reading and motor skills for children with developmental dyslexia (DD). Forty-two children were included in the study. Additionally, before VPOT, the Reading-Aloud and Reading-Comprehension Test 2 (ORSRC-2) and the Bruininks-Oseretsky Motor-Proficiency-Test-2-Brief Form (BOT2-BF) were applied to the participants. According to the study design, VPOT was applied to two sessions per week for 8 weeks to group A. During this period, group B was accepted as the control group. At the end of these 8 weeks, evaluation tests were applied to both groups. Then, group A was defined as the control group and Group B as the intervention group, and VPOT was applied to Group B. At the end of another 8 weeks, evaluation tests were applied to both groups for the third time. When the final ORSRC-2 results were examined, VPOT was found to be an effective program for improving reading skills. Additionally, when the final BOT2-BF results were examined, VPOT was determined to be effective in improving motor skills (p < 0.05). We believe that it is important to carry out comprehensive studies such as the VPOT program to solve problems in the physical and learning activities of children with DD.

The effect of CLOSER-computer-based exercise program in older adults with a history of falls: a pilot study.

CLOSER is a computer-based exercise program that aims to improve older adults' health, fitness and social lives. This pilot study aimed to examine the effect of CLOSER, the first computer-based exercise program developed for older adults on a national scale, on those with a history of falls. Forty-eight older adults (71.33 ± 7.47) with a history of falling at least once in the last year were included in the study. Older adults performed CLOSER exercises for (balance maintenance, neck rotation, rhythmic walking, knee flexion and trunk rotation) 2 sessions per week for eight weeks. All individuals were evaluated at baseline and the end of the eighth week. The primary outcome measures were the 30-s Chair-Stand Test (p = 0.002), the Berg Balance Scale (p = 0.002), the Falls Efficacy Scale International (p = 0.003), the Timed Up and Go Test (p = 0.008) and the motivation level (p = 0.007) statistically significant improvements were observed. The results show that a CLOSER-computer-based exercise program effectively increases balance and reduces the risk and fear of falling. In the future, CLOSER could significantly contribute to the healthcare system as an alternative aid for home-based exercise.

Investigation of cognitive functions in children with bone tumours and lymphoma in treatment process.

BACKGROUND: Neurocognitive sequelae are among the most debilitating effects of cancer observed in children. Yet we know very little about the impact on neurocognitive functioning, especially cancer types that develop outside the central nervous system. This study aimed to assess and compare the cognitive functions (CoF) of children with bone tumours and lymphoma in the treatment process. METHODS: The CoF of children with bone tumours (n = 44), lymphoma (n = 42) and their non-cancer peers (n = 55) were assessed with Dynamic Occupational Therapy Assessment for Children. The CoF of children with cancer were compared with their non-cancer peers. Then, children with bone tumours and lymphoma were compared in binary. RESULTS: One-hundred forty-one children aged 6-12 years with a mean age of 9.4 (SD = 1.5) were included in this study. The orientation and visuomotor construction functions of children with bone tumours and orientation, praxis and visuomotor construction functions of children with lymphoma performed worse than their non-cancer peers (pk < 0.001). While orientation, spatial perception, visuomotor construction and thinking operations functions of children with bone tumours and lymphoma were similar (pk > 0.016), praxis functions of children with lymphoma were found to be worse than children with bone tumours (pk < 0.016). CONCLUSIONS: Our findings show that children with bone tumours and lymphoma in the process of treatment are at risk for impairment of their CoF. The findings highlight the importance of assessing CoF in children with bone tumours and lymphoma and considering specific differences between groups. It is essential to assess CoF and develop early intervention plans in these children.

Community Participation, Supports and Barriers of Adolescents with and without Attention Deficit Hyperactivity Disorder.

AIM: To compare participation patterns, environmental supports, and barriers to community activities in adolescents with and without attention deficit hyperactivity disorder (ADHD) in Turkey. METHODS: Participants were 94 adolescents with ADHD and 109 adolescents without ADHD ages 13-17 years (mean age 14.6, S.D 1.49 years) Participation frequency, involvement rate, mothers who desired change, and environmental supports and barriers in a community setting were assessed with the Participation and Environment Measure for Children and Youth (PEM-CY). RESULTS: Adolescents with ADHD participated 20.3% less frequently in socializing with peers in the community than adolescents without ADHD. With moderate to large effect sizes, the mean involvement rate in four community activities, including neighborhood outings, community events, socializing with peers in the community, and religious activities, was significantly lower for adolescents with ADHD than for adolescents without ADHD. CONCLUSION: Adolescents with ADHD participate less frequently and are less involved in socializing with peers in the community. Almost half of all ADHD adolescents never participate in community events. It was seen that cognitive difficulties, sensory qualities, and safety may prevent adolescents with ADHD from socializing with peers in the community.

Occupational performance and participation in children with developmental coordination disorders before and during Covid-19.

INTRODUCTION: Developmental coordination disorder (DCD) is a neurodevelopmental disorder that affects children's occupational performance and participation. It is known that the Covid pandemic has adversely affected the whole world in many areas. We aim to investigate the occupational performance and participation of children with DCD before and during the COVID-19. METHODS: Sixty-five children aged 5-12 years included in the study were assessed by the Canadian Measure of Occupational Performance and the Participation and Environment Measure for Children and Youth. RESULTS: Statistically significant differences were detected in occupational performance and satisfaction scores (p < 0.01). Additionally, except for 'involvement in the home environment' (p > 0.05), there were statistically significant differences in all other areas of participation (p < 0.01). CONCLUSION: The occupational performance and participation of children with DCD are impacted during COVID-19. In addition, it is seen that the desire of families to change regarding participation has increased due to COVID-19. It would be beneficial to include strategies to improve these areas in the rehabilitation processes.

How cognitive and behavioural body-functions of children with ADHD are linked to their participation and environmental supports?

BACKGROUND: Children with chronic conditions face participation restrictions and exclusions. AIMS: To investigate how cognitive and behavioural body-functions are associated with 1) participation patterns and 2) environmental factors among children with attention deficit hyperactivity disorder (ADHD). METHODS AND PROCEDURES: The study included 83 children with ADHD. Cognitive and behavioural body-functions were assessed with Conners' Parent Rating Scale-Revised Long-Version. The participation patterns of children were assessed with Participation and Environment Measure for Children and Youth (PEM-CY). Multiple regression analyses were used to examine the relationships between cognitive and behavioural body-functions and (1) participation patterns at home, school and community settings, and (2) environmental supports and barriers. OUTCOME AND RESULTS: In home setting, inattention and ADHD index which determine ADHD children from typically developing peers, were the strongest factors, explaining 24.9 % of variance in activities that mothers wanted to change. In school setting, presence/level of oppositional behaviours had the strongest effect on environmental barriers, with variation of 29.8 %. In community setting, the strongest factor explaining environmental helpfulness was anxious/shy behaviours (16.1 %). CONCLUSIONS AND IMPLICATIONS: When seeking to improve participation of children with ADHD both the cognitive and behavioural demands of chosen activities should be modified while creating environments that supports these challenges.

Where Exactly Is the Therapist in Virtual Reality and Game-Based Rehabilitation Applications? A Randomized Controlled Trial in Children with Specific Learning Disability.

Objective: Children with specific learning disability (SLD) experience problems in visual perception that influence academical skills and activities of daily living. Virtual reality and game-based rehabilitation applications are becoming increasingly popular in rehabilitation, including visual perception rehabilitation. However, the usage of commercially available and easily accessible games as intervention tools raises the question whether rehabilitation conducted with these games is really rehabilitation, or just casual gameplay. Therefore, we aimed to investigate the effects of a nonactively supervised (game-based intervention program [GIP]) and an actively supervised (therapist guided game-based intervention program [TGGIP]) on the visual perception skills of children with SLD. Materials and Methods: This study was designed as a single-blind randomized, controlled trial of a TGGIP on visual perception skills in children with SLD compared with the self-oriented, nonsupervised program (GIP). A total of 138 children with SLD participated in the study and were randomly divided into two groups (TGGIP and GIP). Children's visual perception skills were assessed with Motor-Free Visual Perception Test-3. Results: Both groups showed significant improvements in visual perception after the intervention programs (P < 0.05). However, the TGGIP (a supervised and structured intervention program) was significantly more effective in improving the visual perception skills compared with the GIP (a standard, nonsupervised, and unstructured intervention program) (P < 0.05). Conclusion: We think that the TGGIP methodology that we designed acts as a facilitator for therapists in using trademarked, commercially available, and easily accessible games for structured and supervised virtual reality and game-based rehabilitation applications.

Investigating the compatibility, interchangeability, and clinical usability of BOT2-BF and BOT2-SF in primary school-aged children with and without developmental dyslexia.

The aim of our study was to determine the sensitivity and specificity levels of BOT2-BF and BOT2-SF tests applied to children with developmental dyslexia and to examine their clinical usability. This study was designed as a case-controlled study. 82 (study group 41, control group 41) 7-12 year children were included. The study occurred three stages. In the first place, the similarities and differences of BOT2-BF and BOT2-SF tests observed in clinical practices were examined by taking the feedback of experts and test correlations. In the second step, BOT2-BF and BOT2-SF tests were examined with reference to the Core Outcome Set (COS) evaluation criteria. In the last step, in order to examine the sensitivity and specificity levels of the tests, assessments were performed in two groups with 1-week intervals. According to the COS results, the BOT2-BF test was examined better than the BOT2-SF test under cross-cultural validity title. The sensitivity and specificity of BOT2-SF were 0.92 and 0.51, and for BOT2-BF were 0.92 and 0.41, respectively. This study will help clinicians working on children with developmental dyslexia to decide the type of test they will use to evaluate and easy access to materials motor proficiency.

The relationship of motor development with sensory processing among infants born very preterm: a prospective case-control study.

BACKGROUND: Little is known about the relationship between sensory processing and motor development in very preterm infants. The purpose of this study was to explore the relationship of motor development with sensory processing among such infants with developmental delay and those who had typical development at the ages of 8 and 12 months. METHODS: This prospective case-control study included 61 preterm infants (31 males, 30 females, mean gestational age: 29.1 weeks). The infants had a gestational age of 32 weeks or less and a current corrected age of 8 months, and they had spent at least 15 days in the neonatal intensive care unit. Motor development was assessed with the Neuro-sensory Motor Developmental Assessment (NSMDA), and sensory processing was evaluated with the Test of Sensory Functions in Infants (TSFI). RESULTS: There were very strong positive correlations between the gross and fine motor scores of the NSMDA and the TSFI`s subdomain scores and total scores (r=0.85-0.93, p < 0.001). There were also very strong negative correlations between the functional level according to the NSMDA and the subdomain scores and total scores of the TSFI (r=-0.89-0.94, p < 0.001). CONCLUSIONS: The results show that sensory processing and motor development are related parts of the development of very preterm infants. In the early rehabilitation process, therapists should comprehensively take motor and sensory development into consideration.

Demographic, clinical and dermoscopic features of melanocytic nevi on the scalp.

BACKGROUND: The scalp is a special anatomical area and dermoscopic findings of this region may significantly differ from other body parts. OBJECTIVE: To investigate and compare the clinical and dermoscopic patterns of scalp melanocytic nevi in patients ≤15 years of age and above, and to analyse their relevance to demographic features, atypical mole syndrome (AMS) and total body nevus count (TBNC). METHODS: In this retrospective cohort study, the clinical data and dermoscopic images of patients with scalp melanocytic nevi were retrieved, reviewed and analysed. Demographic, clinical and dermoscopic features were compared in patients ≤15 years of age and above. RESULTS: A total of 196 scalp melanocytic nevi in 126 patients (female/male:64/62; ≤15/>15 years of age: 49/77) with a median age of 18.5 years (range 0-72) were evaluated. Statistically, the globular pattern was significantly higher in all age groups, and the papillomatous pattern was significantly lower in patients ≤15 years of age (P = 0.008 and P = 0.005, respectively). The eclipse pattern was significantly higher, and the homogenous pattern was significantly lower in patients ≤15 years of age with AMS (P = 0.003 and P = 0.014, respectively). Finally, patients ≤15 years of age with 50 to 100 TBNC had a higher eclipse pattern than those with 0 to 25 TBNC. CONCLUSION: The findings of this retrospective study might implicate that children with eclipse pattern of scalp melanocytic nevi might be 'moley' in the future with an impending risk of AMS. This hypothesis requires confirmation in future prospective studies on a larger cohort of patients.

Home participation, support and barriers among children with attention-deficit/hyperactivity disorder before and during the COVID-19 pandemic.

OBJECTIVES: Few studies have focused on the participation of children with attention-deficit/hyperactivity disorder (ADHD) in daily routine and leisure activities. This study aimed to compare the participation, support and barriers for children with ADHD at home pre-COVID-19 and during the COVID-19 outbreak. METHODS: The study included 55 children with ADHD aged 6-11 years. Participation frequency, involvement, desire for change, supports and barriers at home were assessed using the Participation and Environment Measure for Children and Youth (PEM-CY). RESULTS: During the COVID-19 pandemic compared with the pre-COVID-19 period, the mean frequency of participation of children with ADHD in computer and video games (5.8% vs 5%, respectively), socialising with other people (7% vs 6.2%) and household chores (5.5% vs 4.6%) was shown to be significantly higher (p < 0.05). Mothers of children with ADHD reported higher levels of involvement during the COVID-19 pandemic compared with the pre-COVID-19 period across four areas of home participation, including computer and video games (4.1% vs 3.2%, respectively), arts, crafts, music and hobbies (3.7% vs 3%), household chores (3.6% vs 2.8%) and personal care management (4.2% vs 3.5%) p < 0.05). Mothers of children with ADHD reported that during the pandemic the following two features of the environment made participation easier than pre-COVID-19 (p < 0.05): cognitive demands (36.4% vs 60%, respectively) and social demands (5.5% vs 34.5%). More mothers reported that services (92.7%), supplies (87.3%) and information (85.5%) were available and/or adequate in the COVID-19 period than pre-COVID-19 (p < 0.05). CONCLUSIONS: Mothers of children with ADHD reported that their children were participating more frequently in some of the home-related activities during the COVID-19 pandemic compared to pre-COVID-19. Reduced cognitive and social demands, and more readily available resources in the home environment during the COVID-19 period resulted in increased home participation compared to pre-COVID-19.

Correlation of hand functionality and grip strengths with anthropometric measurements.

BACKGROUND: Using objective anthropometric measurement data and anthropometric ratios, grip strength and hand functionality can be evaluated. OBJECTIVE: The aim of this study was to obtain anthropometric measurements regarding the forearm and hand, to evaluate the hand functionality in addition to hand and finger grip strengths, and to investigate the correlation between these values. METHODS: One-hundred eight-four subjects between 18 and 25 years were included in the study. Forearm and hand anthropometric measurements and ratios were measured. Hand and lateral grip strengths were evaluated. Jebsen Taylor Hand Function Test (JTHFT) was used to assess hand functionality. RESULTS: A statistically weak and consistently negative correlation between the ratios of forearm length to forearm/wrist circumferences and the ratio of hand length to metacarpal head circumference and hand-lateral grip strengths was found. There was a statistically weak and consistently negative correlation between these ratios and the subtests of JTHFT. It was shown that there was a statistically weak-moderate positive correlation between the hand-lateral grip strengths and JTHFT subtests. CONCLUSIONS: In conclusion, when evaluating grip strength and hand functionality, forearm and hand anthropometric measurements and ratios, which could affect the results, should be considered.

Livedoid cutaneous metastasis of signet-ring cell gastric carcinoma.

Cutaneous metastasis of gastric cancer is extremely rare. Nodular forms are more common and inflammatory forms are exceptionally encountered. Herein, we report a case of inflammatory cutaneous metastasis of signet-ring cell gastric cancer (poorly cohesive gastric carcinoma with signet-ring cell component) masquerading as livedo reticularis. To our knowledge, such a clinical presentation of cutaneous metastasis has not been reported for gastric cancer. It is imperative to preserve a high index of clinical suspicion for diagnosing cutaneous metastases. Our case highlights the importance of obtaining a skin biopsy in patients with a known history of internal malignancy. Bizarre, newly erupting, evolving, persistent, or treatment-refractory dermatologic lesions (such as nodules, ulcers, erythematous, reticular, or livedoid patches) might be clues for an underlying internal malignancy and require prompt histopathological sampling. Personal medical history, histopathological examination, and immunohistochemical profiling are equally important in distinguishing primary cutaneous carcinomas from secondary metastatic deposits. Early recognition of a cutaneous metastasis might enable appropriate staging and timely intervention, thereby prolonging survival.

The Effectiveness of a Virtual Reality-Based Intervention on Cognitive Functions in Older Adults with Mild Cognitive Impairment: A Single-Blind, Randomized Controlled Trial.

Objective: Mild cognitive impairment (MCI) is a broad term for people at a stage between normal age-related cognitive decline and dementia, where cognitive problems are present but do not impair activities of daily living. This study aimed at evaluating the effectiveness of a virtual reality (VR)-based rehabilitation program on cognitive functions in MCI. Materials and Methods: Sixty-one older adults (25 men, 36 women) with MCI were randomized to the intervention group (n = 30; 70.12 ± 2.57 years) or control (n = 31; 70.30 ± 2.73 years) group. The intervention group received a VR (computer-generated interactive environments) intervention in addition to a conventional cognitive rehabilitation (CR) intervention, whereas the control group received only the CR intervention. Cognitive functions were assessed in both groups before and after the 12-week interventions by using the Loewenstein Occupational Therapy Cognitive Assessment-Geriatric. Results: Between-group comparisons revealed significantly greater improvements in orientation, visual-spatial perception, visuomotor organization, thinking operation, and attention/concentration functions in the VR group than in the control group (P < 0.001 for all). Conclusion: Our results showed that 12 weeks of VR-based rehabilitation enhanced cognitive functions in older adults with MCI. Using VR applications in CR is recommended to improve cognitive functions of older adults with MCI.

Secretan Syndrome: A Fluctuating Case of Factitious Lymphedema.

Secretan syndrome (SS) is a recurrent or chronic form of factitious lymphedema that usually affects the dorsal aspect of the hand and is accepted as a subtype of Munchausen syndrome. Secretan syndrome usually is induced by compression of the extremity by tourniquets, ligatures, cords, or similar equipment. This unconsciously motivated and consciously produced lymphedema is an expression of underlying psychiatric disease. Herein, we present a fluctuating case of SS involving the hand, with periods of severe lymphedema and those of complete amelioration, parallel to stressful and peaceful periods in the patient's personal life. We briefly review the current literature on SS to increase awareness among dermatologists, and we present information on the clinical portrait, diagnosis, and appropriate management of this peculiar and underreported disorder.

The Bournemouth Questionnaire for Neck Pain: Cross-cultural Adaptation, Reliability, and Validity of the Turkish Version.

OBJECTIVE: The aim of this study was first to translate and culturally adapt the BQN, and then to investigate the validity and reliability of the Turkish version of the BQN in Turkish individuals with chronic neck pain. METHODS: The English version of the BQN was translated into Turkish with permission from its authors. That translation was assessed using 85 participants with a mean age of 46.75 years who had chronic neck pain. At the same time, the participants were assessed sociodemographically and with the Neck Disability Index (NDI) and the Neck Pain and Disability Scale (NPAD). A test-retest procedure was performed with 62 participants who underwent a second assessment with the BQN within 24 hours of the first assessment, to test its reliability. RESULTS: Internal consistency was strong and all Cronbach alpha values were between 0.97 and 0.99. The BQN showed high test-retest reliability (intraclass correlation coefficient ˃ 0.92) for all domains. The total mean (± standard deviation) scores for the 3 questionnaires were as follows: BQN, 30.9 (± 11.18); NPAD, 48.16 (± 12.93); NDI, 17.85 (± 6.29). The results of the Turkish version of the BQN illustrated adequate external construct validity and sensitivity. A Turkish translation of the test has not previously been available for chronic pain. CONCLUSION: The BQN was successfully translated and culturally adapted into Turkish. The reliability and validity were tested against the NPAD and the NDI. The Turkish version of the BQN is multidimensional, short, practical, and suitable for use with individuals with neck pain.