Opportunity to Use Artificial Intelligence in Medicine.

Over the past period different reports related to the artificial intelligence (AI) and machine learning used in everyday life have been growing intensely. However, the AI in our country is still very limited, especially in the field of medicine. The aim of this article is to give some review about AI in medicine and the related fields based on published articles in PubMed and Psych Net. A research showed more than 9 thousand articles available at the mentioned databases. After providing some historical data, different AI applications in different fields of medicine are discussed. Finally, some limitations and ethical implications are discussed.

Internet/Video Gaming: The Relevance of a New Phenomenon in the Youth.

The high level of technological growth in contemporary society, beside benefits, provokes different kinds of damages, especially among the worldwide youth population. World statistics have recognized that video and internet game addiction is a growing problem. In this context, it is supposed that 0.3 to 1.0 percent of the general population might be qualified as a potential sufferer of internet gaming disorder. However, youth between 18-34 years are the highest risk population. New research has shown the need of early identification of at-risk young people for internet addiction. Adverse experience in children of different forms of stress, negative life circumstances and especially negative, hostile parenting can lead to depression, social and cultural problems, together with significant boredom and loneliness levels. These are all confirmed to be related with addictive behaviour. Some neural correlates are discussed as the possible background of game addiction. Finally, therapeutic possibilities are presented.

Emotional Dysregulation is the Core Problem in Psychopathological Manifestations.

The established opinion is that emotions are the gift given to us by nature in order to help us connect with other people. They are constantly generated, usually by stimuli in our intrapersonal as well as in external world. Problems raised in our relationships initiate emotions to help us to fix those problems. Almost all forms of human psychopathology are associated with dysregulated emotions. The failure to apply appropriate cognitive, attentive, and behavioural regulatory strategies is the core for emotion dysregulation. The brain regulates emotions through a biological mechanism. Emotions rise in intensity, peak, and then go flat once the emotion adaptive action tendency has been expressed. The aim of the therapist is to help clients express, face, and regulate their emotions, and to channel these emotions into healthy actions. The idea of this article is to present contributions from both affective neuroscience and psychotherapy in order to explain the ways how our emotions become dysregulated in life and how they can become regulated through psychotherapy.

Web Platform for Gathering and Analyzing Data from the Neurogame Mobile Application.

Today's cell phones are now smartphones, providing a wide range of possibilities for their use, much more than just simple phones. The custom application for the Android operating system, based on an open-source platform for mobile devices is intended for the examination of cognitive functions: attention, concentration and fine motor skills in children of different age groups. The Neurogame application for mobile devices and web platform development is used for retrieving and analyzing mobile application data, providing relevant indicators for the executive functions of the respondents. Material and methods: The research included 50 children with the developmental disorders ADHD and dyslexia (study group) and 50 healthy children (control group), randomly selected, evenly represented by gender and age. Using the application, we determine attention, concentration and motor skills (reaction speed) as part of the executive functions of the respondents. The web platform has the purpose of gathering and processing the data from the mobile application, as well as their automatic visual representation. Results: The ANOVA test showed that there are no gender differences in all the studied groups. A statistical correlation analysis showed that age does not affect the results in healthy school children. In children with dyslexia, age affects positively for total hits and negatively for total misses. In children with ADHD, there is a positive correlation with age for all variables except total hits (t H). Student's T-test showed that there were significant differences for the variables' total hits (t H) and total reaction time (t h) in milliseconds between healthy school children and children with dyslexia. Additionally, Student's t-test indicated that there were significant differences for the variables' total tries (t T) and total hits (t H) between healthy school children and children with ADHD. Finally, Student's t-test indicated that there were significant differences for the variable total tries (t T) between children with dyslexia and children with ADHD. Multiple Regression Results showed a significant difference between healthy school children, children with ADHD and children with dyslexia for all variables (total tries (t T), total hits (t H), total misses (t M) and total reaction time in milliseconds (t h)). Conclusion: The Neurogame application provides a opportunity to assess the motor skills and concentration level, as well as the focus of the target population by measuring the total number of tries, the total number of hits, the total number of misses and the reaction time expressed in milliseconds which are defined as monitoring variables. The development of the web platform and the connection to the application enabled easier access and distribution of the analyzed results to the stakeholders (parents, teachers, therapists or health professionals) in order to further treat the ascertained condition.

Chronic Diseases in Children as a Challenge for Parenting.

To be a parent or a caregiver in a modern society is a very difficult task, including multiple demands and expectations. Parenting imposes a special role in the life of any couple, especially for the mother, roles which must be learned through personal education, enriched by transgenerational experience. Chronic disease is recognized as a large stressor that affects the current situation of a child and a child's family. In this difficult situation, the family must go through a process of learning how to cope with it. In the family, where a child has a long-term health problem, there are certain behaviours that hinder the normal functioning of family relationships. According to the experience of many researchers, including my own, there is an indication that a child's illness often leads to the divorce of the parents. The fathers of sick children are often the initiators of such decisions. The purpose of this article was to find if there are differences in parenting between mothers and fathers of chronically ill children. The methodology is comprised of a review of published articles in PubMed over the last two decades related to parenting when there is chronic illness in children. More than 500 articles related to the topic were found. Obtained results were discussed.

Perceived Birth Trauma in Macedonian Women.

Although the childbearing is perceived as a normal and happy event, new research shows that psychological birth trauma is, however, a universal and not so rare phenomenon. Traumatic birth experiences can cause postnatal mental health disturbances, fear of childbirth in subsequent pregnancies and disruption to mother-infant bonding, leading to possible impaired child development. The purpose of this research was to evaluate collected data from several obstetric clinics, as well as from primary paediatric settings related to 'Birth Trauma' in order to review women with symptoms of post-traumatic stress disorder (PTSD) following childbirth. The study is prospective, starting from January 2021 and ending in December 2022. The psychological instrument used in this research is the Intersect Questionnaire, composed of 59 questions grouped in 8 parts. The obtained results from our study confirmed that birth trauma is not a rare phenomenon in our country. Symptoms correlated with PTSD were present as follows: unpleasant memories (2.7%), anxiety (38.54%), panic (6.47%), trying not to remember the delivery (4.04%), self-accusation (2.16%), negative emotions (1.89%), alienation (4.31%), irritation/aggression (1.89%), self-destruction (1.89%), impulsiveness (4.31%), problems with concentration (3.23%), and sleeping problems (21.88%). These results are alarming. It is imperative to better understand this vulnerable period in a woman's life. As a general conclusion, we must highlight the importance of perceived birth trauma in women, phenomena which has been confirmed worldwide and which must be overcome as quickly and as successfully as possible.

How Alcohol Damages Brain Development in Children.

The world over, people drink in order to socialize, celebrate, and relax, despite the negative health effects of alcohol. Three periods of dynamic brain changes are evidenced to be particularly sensitive to the harmful effects of alcohol: gestation (from conception to birth), later adolescence (15-19 years), and older adulthood (over 65 years). This article is concentrated only on the negative effects of alcohol in children who have been exposed to alcohol before birth, known as foetal alcohol syndrome (FAS). This is a review based on published data in PubMed over the last two decades and is an analysis of more than 150 published papers. Alcohol use during pregnancy can cause miscarriage, stillbirth, and a range of lifelong physical, behavioural, and intellectual disabilities. The effects of ethanol are expressed on a set of molecules involved in neuroinflammation, myelination, neurotransmission, and neuron function. Modern neuroimaging techniques are able to specify some fine structural changes in the affected areas of the brain: volume reductions in the frontal lobe, including the middle frontal gyri in the prefrontal cortex, hippocampal structure, interhemispheric connectivity, abnormalities in glial cells, white matter deficits etc. Corpus callosum myelination is affected, resulting in a lack of the inter-hemispheric connectivity. This is known to facilitate autism, stroke, schizophrenia, as well as dementia, disrupts cognitive performance, and may lead to neurobehavioral deficits. It was pointed out that many symptoms and neuroimaging characteristics are similar in ADHD and FAS, thus the anamnesis for prenatal alcohol and nicotine exposure must be taken very seriously in order to better understand and interpret clinical symptoms.

An Overview of Pediatric Approaches to Child with Developmental Delay Especially if There is Suspicion of ASD in First Few Years of Life.

To be a pediatrician means that one encounters many serious childhood health problems and one finds many ways to help families cope with these problems. Symptoms in children can be discrete, and the responsibility of the pediatrician to distinguish normal development from pathological. We are facing a new era in the developmental assessment of children. A cluster of neurodevelopmental disorders includes ASD (autism spectrum disorder) and ADHD (attention deficit hyperactivity disorder). Parents often do not recognize the problem on time. Generally, their first concern is speech delay, leading to the suspicion of hearing problems. Therefore, it is very important to obtain objective anamnestic information and for the child to undergo a careful physical examination, a neurophysiological assessment, and metabolic and genetic testing. The etiology usually is multifactorial: genetic, epigenetic, and non-genetic factors act in combination through various paths. Most children seem to have typical neurodevelopment during first their year. It was found that approximately one-third of children with ASD lose some skills during the preschool period, usually speech related, but sometimes also non-verbal communication, social or play skills. In conclusion we must say that it is very important to recognize the early signs of ASD and any kind of other developmental delay and to start with early intervention. Clinical pediatricians tend to correlate clinical manifestations and biological underpinnings related to neurodevelopmental disorder, especially ASD. Therefore, better treatment possibilities are needed.

Young People and Covid-19 Pandemic in Our Country.

The current COVID-19 pandemic has raised significant mental health consequences across the world. Even though healthcare workers provide psychological services, the mental health of the overall population often is cause for concern. Psychosocial stressors of the population play a critical role in impacting both the spread of the disease and the occurrence of emotional distress and psychological disorder, during and after an infectious disease outbreak. The inability to plan, to anticipate future events, and to exert control, at least partially, over external variables inevitably generate stress and tension. Subsequently, this condition can generate more or less discomfort depending on the subjective evaluation of the individual, an evaluation which is influenced by the individual's stable personality traits. In fact, subjective experiences are never unique: stimuli endowed with the same stressful power do not necessarily cause these reactions in different individuals, while stressful conditions of varying degrees can induce the same response in different people. The aim of this research was to evaluate some aspects of mental health using answers related to this pandemic of a group young people, selected by chance. Results showed important changes in quality of life, insecurity, changes in mood and behaviour as well as not optimistic view for the future life. Discussion confirmed similar finding about young people opinions from other counties. Additionally, some mediating measures are proposed.

The Personality Profiles for Contemporary Macedonian Actors.

Theatre is one of the higher cultural activities that characterise us as imaginative, creative and truly human. In general, theatre is an arena in which participants can mentally play, acting out their own fears and fantasies in an experimental way. The purpose of this study is to investigate the psychological personal characteristics, using the MMPI questionnaire, applied in a sample of Macedonian professional actors. MMPI is used as an older form of the questionnaire, standardised in ex-Yugoslavia, and then translated into Macedonian. This is all done with a computer. This research confirms that our (Macedonian) contemporary actors are normal people who function normally in everyday life and generally do not deviate from what in the psychology of personality are denotes as normal/abnormal. Small exceptions are still a rarity! Some indexes of interest are included in this analysis of personal characteristics of actors.

Childbirth-Related Psychological Trauma.

Traumatic childbirth is an international public health problem because it is supposed that currently up to 45% of new mothers have reported such an experience. International rates of PTSD due to birth trauma range between 1.5 and 9 percent of all births. Birth trauma is defined as an event occurring during the labour and delivery process that involves actual or threatened serious injury or death of the mother or her infant. A traumatic event or situation creates psychological trauma when it overwhelms the individual's ability to cope, and leaves that person fearing death, annihilation, mutilation, or psychosis. The individual may feel emotionally, cognitively, and physically overwhelmed. The aim of this article is to present a review of published data for childbirth trauma over various periods of time, as well as in different regions of the world. Studies were identified through a comprehensive search of PubMed, PsycInfo, ProQuest and PILOTS (Published International Literature of Traumatic Stress) over the last 20 years. More than 8000 articles were found. In this article we present and discuss some important findings.

Grief: Aetiology, Symptoms and Management.

Grief is a process provoked as a response to different losses, such as death, loss of job, relationship breakdown, some unexpected life events and changes, etc. The experiences of loss and bereavement are very individual. Even though loss is expected, the person feels traumatized, especially if death is provoked by violence, natural disasters, or war. This pandemic, like other disasters (wars, tsunami, earthquakes, floods, etc.) has provoked intensive reactions of grief, reactions that could persist for years. The core symptoms of grief are described in the ICD-11 and DSM-5 manuals. The term "complicated grief" in the medical sense refers to a superimposed process that alters grief and modifies its course for the worse. Prolonged grief disorder (PGD) is characterized by normal grief symptoms, but these are symptoms that remain too intense for too long of a period. This article is a review of the manifestations and duration of grief in different occasions, and it is based on over 50 published papers, and discoveries in the Medline and Psych-Net databases. Commonly described reactions to grief are: shock, disbelief or denial, a high level of anxiety, distress, anger, sadness, insomnia, and a loss of appetite. As predictors for a high/slow decreasing trajectory of grief process are: female gender, reported symptoms of depression before the traumatic event, and higher scores on avoidance. However, grief is transient, even as we are is in the midst of its clutches. People should expect to fluctuate between moments of sadness and mourning, and moments of acceptance, or even happiness for being alive. Researchers suppose that when a crisis passes; most people will be able to bounce back and move on with their lives.

Does the M-Chat-R Give Important Information for the Diagnosis of the Autism Spectrum Disorder?

Having in mind the rising rates of the incidence for autism worldwide, the early diagnosis of this neuro-developmental disorder is of the high priority. For that purpose, several checklists have been constructed and used. Nevertheless, there are no universal and uniform criteria for assessing and diagnosing autism, and even if there existed, not every country has the resources to manage such an assessment for diagnosis.A recently validated, revised version of the M-CHAT, the M-CHAT-Revised with Follow up (M-CHAT-R/F) has demonstrated strong psychometric properties.The aim of this article is to discuss our results obtained with M-CHAT-R applied in a sample of 131 children aged 31,9 ±9,4 months, recruited for diagnosis and treatment at the University Children's Hospital in Skopje.Our results confirmed that for screening the use of M-CHAT-R/F is currently the very exact instrument which allows the early suspicion, but also possible follow up the symptoms of this disorder. Additionally, we showed the significant negative correlation between age and scores obtained on the checklist.

Is Smartphone Addiction in the Younger Population a Public Health Problem?

Problematic smartphone use and or addiction is defined as a form of behaviour characterized by the compulsive use of a smartphone that results in various forms of physical, psychological, or social harm. Global popularity in the area of the use of smartphones has raised concerns about the negative effects associated with problematic smartphone use, especially in the younger population. Having no consensual definition of smartphone addiction (SA), this behavioural addiction is based on the classic addiction symptomology that was included in DSM-5 criteria for compulsive gambling and substance abuse (APA 2013) This article provides a review of current research related to SA. Articles were found in the PUBMED database using related key words. Statistics confirm the exponential rise of this problem globally, especially in children and adolescents. Therefore, one must make this a high priority among public health issues.

Neuropsychological Correlates of Internet Addiction.

The Internet, mobile phones, and other similar tools are often necessary for the current functioning of both private life and business. During these two years of pandemic (2019-2021), Internet use, especially different games and mobile phones, were indispensable for the global population. Internet addiction is defined as a psychological dependence on the internet, regardless of the type of activity once logged on. Many studies have confirmed the correlation of stress, depression, and anxiety with internet addiction. It has also been proven that internet addiction, per se, increases the risk of depression, anxiety, and stress. Moreover, the COVID-19 pandemic has generated and promoted social isolation along with unmonitored and increased screen time, all of which are the main causes of internet addiction. The aim of this article is to give a short review of internet addiction research, terminology, and symptoms related to brain functioning. The source material was articles cited in the database, PubMed. Our interest was especially oriented towards the personality characteristics of users and addicted persons as well as neuroimage findings among affected people. We selected the newest articles, published in the period of 2012-2021, of which there are more than 2000. The selected obtained results will be presented and discussed.

Electrodermal Activity and Stress Assessment.

Stress, as a kind of emotion, is inevitable in everyday life. In psychosomatic medicine stress represents a powerful link in the pathophysiological chain of disorder. Having evidence about the power of stress on the body, the interest in medicine was how to measure it in appropriate, fast way and with minimal cost. Electrodermal activity seems to be available for this purpose. The galvanic skin response (GSR) is an objective, transient indication of autonomic nervous system arousal in response to a stimulus. It refers to changes in sweat gland activity that are reflective of the intensity of our emotional arousal. In this article we discuss physiological specifics of skin conductance/resistance and how it is measured in practice. The most used application of GSR is in biofeedback methodology. Biofeedback assessment and training exactly uses skin reaction to different stimuli and aims to gain voluntary control over this autonomic response. The aim of this article is to show effectiveness of this method in paediatric practice.

Main Needs and Challenges of Parents of Children with Autism Spectrum Disorder.

Autism spectrum disorder (ASD) comprises a group of complex lifelong neurodevelopmental disorders, characterized with symptoms related to the difficulty of communication and interaction with other people, as well as restricted interests and repetitive behaviors. These symptoms affects the person's ability to function properly in school, work, and other areas of life. For better understanding the needs and challenges of families the survey developed by Autism Speaks in collaboration with the National Coordinators for Autism from nine Balkan countries was established. The aim of this research is to obtain an overview of some important data for children with some form of autistic disorder. The same questionnaire was used in two different periods of time (during 2015 and at the beginning of 2020) including samples of 60 and 140 parents respectively. The questionnaire comprises 57 questions in the following four domains: demographic characteristics, index child characteristics, service encounters and parent/caregiver perceptions. Results are compared and discussed. The survey results underscore that parents and families of children with ASD in our country carry a heavy burden. They face significant financial difficulties and need improved services from the health, educational and social sectors. It was concluded that there is a critical need to strengthen national capacity in caring for children, young people and adults with ASD and other neurodevelopmental disorders.

Neurofeedback - A Method Which Trains the Brain to Obtain Changes in Behaviour.

EEG can determine changes in brain activity that might be useful in diagnosing different brain disorders as well as some mental states. Many advantages of this record have been the reason for resurrect the EEG in current clinical practice and research. More sophisticated form, the Q-EEG comprises a procedure that processes the recorded EEG activity from a multi-electrode recording using a computer, where data is processed with various algorithms, such as the Fourier or Wavelet analysis. Q-EEG data are important as a marker for many psychophysiological disorders. Neurofeedback (NF) is a form of behavioural training aimed at developing skills for self-regulation of brain activity. It is a treatment method for altering brain functioning by the use of signals provided to a patient that reflect the moment-to-moment changes in the patient's electroencephalogram. This article summarizes some of our large experience with neurofeedback training in different groups of disorders in children and adolescents. Positive outcome is promising for more expansive use of this non-pharmacological, cost-benefit methodology in paediatric and general population.

History Information's are Indispensable in Developmental Assessment of Children.

For achieving the good health and wellbeing for all children, the main role of pediatrician and other health care professionals is to follow their development. We implemented developmental monitoring for 465 children at the age of 12 - 60 months, in the period of 4 years (2016 - 2019), using standard algorithm in which start is always with child history. It should be comprehensive, and must include a detailed prenatal, perinatal, and postnatal history. Obtained results showed that 16.13% of participants have some serious illness in family history, and the same percentage (16.13%) manifested serious perinatal problems which imposed the support in intensive care unit. Breastfeed are 49,46 % of children. Only 7,53 % are not completely vaccinated. About the parameters for the development, we obtained that 11,83 % were not walking at the time of the assessment, and 65,81 % were not speaking. Toilet control was negative, and in 75,27 % they still were wearing diapers. Allergic manifestations at the time when the assessment was done is present in 8,60%. Finally, serious illness in child past history was positive in 19.35 % of evaluated sample. We concluded that a good history is needed and indispensable in the assessment process, particularly when exogenous causes are identified as the risk for the developmental delay. Obtained positive answers are directory for further investigation as well to correlate risk-consequences relationship.

Psychosomatic Tendencies, Coping Styles and Locus of Control Among Young Adults.

It is really difficult to live in a society in which the human contact is decreasing each day, and where stressful situations become unavoidable. In order to be healthy and have a healthy lifestyle, the coping style plays a huge role. Witnessing this situation every day, the aim of this research is to investigate the connection among psychosomatic tendencies, different coping styles and locus of control in young adults, aged from 24 to 34 years, in the Republic of North Macedonia. The evaluated sample consists of 187 (M=47; F=140) participants, randomly selected, who accepted to be the part of the research by filling in the on-line questionnaires, delivered through Google forms. The short demographic questionnaire and three psychological instruments were used: Cybernetic Battery of Conjunctive tests KON-6, CISS-21 (Coping Inventory for Stressful Situations), and Internal-External Locus of Control Scale (I-E). Spearman's correlation was used in order to check and approve the connectedness among psychosomatic tendencies, coping styles and locus of control. The obtained results confirm that there is a significant correlation among tendencies towards psychosomatic reaction, coping styles and locus of control among young adults in the Republic of North Macedonia.