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Background: This study aims to explore sociodemographic and clinical factors affecting medication adherence in adults with attention deficit and hyperactivity disorder and elicit dysfunctional domains and comorbidities with a focus on gender differences. Methods: Patients were recruited from 2 specialty clinics using chart records in a natural treatment design. Adult attention deficit and hyperactivity disorder self-report scale, Diagnostic Interview for attention deficit and hyperactivity disorder in adults, was applied. Adherence is defined if the patient declared >= 80% adherence to medication throughout the last 8-12 weeks. Results: From 205 attention deficit and hyperactivity disorder patients (male =112 female = 93 (age (median) min-max = 29 (18-56)), 29% were non-adherent to attention deficit and hyperactivity disorder medication. In the multivariate analysis, having 2 or more comorbid disorders (P = .009), dysfunctions in academic/work (P= .049), and dysfunctions in family and other relationships (P = .047) increased the likelihood of adherence. Adherence rates did not significantly differ between methylphenidate and atomoxetine (P= .405). Women were more likely to have 2 or more comorbid psychiatric disorders (P = .004) and dysfunctions in social relationships (P= .001), free time activities, hobbies (P < .001), self-confidence, and self-image (P < .001). Results: Nearly one-third of adult patients with attention deficit and hyperactivity disorder did not adhere to medication treatment. Comorbid psychiatric disorders and dysfunctions in life domains appear to increase the likelihood of adherence to attention deficit and hyperactivity disorder medications, possibly through increasing motivation for treatment. The effect of cognitive-behavioral therapy on compliance with attention deficit and hyperactivity disorder medication should further be explored with prospective controlled studies. Conclusion: We suggest that future longitudinal studies use objective measures of adherence and confirm the role of dysfunctional life domains and comorbid psychiatric disorders as correlates of medication adherence.

Bu araştırmanın amacı Müzik ile Tekstil ve Moda Tasarımı Bölümü lisans öğrencilerinin uzaktan eğitim kavramına ilişkin geliştirdikleri metaforları incelemektir. Araştırmanın çalışma grubunu Çankırı Karatekin Üniversitesi, Sanat, Tasarım ve Mimarlık Fakültesi, Müzik ile Tekstil ve Moda Tasarımı Bölümlerinde kayıtlı olan 116 öğrenci oluşturmaktadır. Araştırma verilerinin toplanması için öğrencilerden “Uzaktan eğitim…gibidir; çünkü…” cümlesini tamamlamaları istenmiştir. Araştırmada nitel araştırma yöntemlerinden biri olan olgu bilim modeli kullanılmış, elde edilen verilerin çözümlenmesi içerik analizi yöntemi ile yapılmıştır. Uzaktan eğitimi ele alan olumlu kategoriler 57 metafordan oluşmuştur. Uzaktan eğitimi ele alan olumsuz kategoriler ise 58 metafordan oluşmuştur. Araştırmada uzaktan eğitimin sağlandığı teknolojik altyapının iyileştirilmesi, öğretim araçlarının erişimini sağlayarak öğrenciler arasında eşitliğin yaratılması ve ihtiyaç halinde sosyal becerilerin iyileştirilmesine yönelik alternatiflerin öğrencilerle etkileşim içinde uygulanması önerilmektedir., This research aims to examine the metaphors developed by the undergraduate students of the Department of Music and Fashion and Textile Design regarding the concept of distance learning. The study group of the research consists of 116 students enrolled in Çankırı Karatekin University, Faculty of Art, Design and Architecture, Department of Music and Fashion, and Textile Design. Students participated in the research voluntarily. To collect research data, students were asked to complete the sentence “Distance learning...because...”. The phenomenology model, which is one of the qualitative research methods, was used in the study, and the analysis of the obtained data was done by the content analysis method. In the study, the students produced 109 different and valid metaphors and 115 views on the concept of distance education. Six categories related to positive metaphors created by students for the concept of distance education and nine categories related to negative metaphors were created. The positive categories addressing distance learning consisted of 57 metaphors. Negative categories covering distance education consisted of 58 metaphors. When the positive and negative statements between Music and Textile and Fashion Design Departments are compared, it is seen that the students of the Textile and Fashion Design Department have a more positive approach to the concept of distance education. In the research, it is proposed to improve the technological infrastructure in which Distance Education is provided, to create equality among students by providing access to teaching tools, and to apply alternatives to improve social skills in interaction with students if necessary.

Teknolojinin getirmiş olduğu değişim ve olanaklar yıllardır devam etmiş olanalışkanlıklarımız üzerinde birtakım değişiklikler yaratmıştır. Sadece birey olarakdeğil, kurum olarak da bu değişime ayak uydurma zorunluluğu, bugünün yoğunrekabet ortamında bir mecburiyet haline dönüşmüştür.Bu nedenle rekabetçi davranış yöntemleri işletmeler arası ilişkilerde önceliklikonuma gelmiş ve bununla beraber, işletmeler ürettikleri mal ya da hizmetlereyönelik olarak farklılık yaratabilecek alternatif yol arayışı içerisinde bulunmuşlardır.Günümüz koşullarında sosyal medya bu amaçları yerine getirmek için etkili bir araçolmuştur.Markalar sosyal medya ortamlarında tüketici zihninde; içeriği, görünümü,sunduğu çeşitli farkındalık unsurları ile diğer rakiplerinden ayrışan marka olarak önplana çıkmaya başlamışlardır. Markaların pazar paylarını koruyarak, rekabetortamlarında başarılı olabilmesi, doğru sosyal medya platformlarında, doğrupazarlama stratejileri sunarak, yönetilmesi ile mümkündür.Bunun için marka ve işletmenini geniş kitleler tarafından tercih edilmesigereklidir ki buda sosyal medya mecraları ve buradaki tutundurma faaliyetleri ilegerçekleşir. Sosyal medya; hedef kitle zihnindeki markanın ve kurumun farklılaşarakkonumlandırılmasını sağlayacak uygulamalar ile marka yönetim sürecinde önemliişlevlere sahiptir. Technology has brought change that has created some changes to our habits, andthe amenities which continued for many years. Just, not as an individual but as aninstitution, an obligation to keep pace with this change, it has become a necessity intoday's highly competitive environment.Competitive behavior methods have become a priority in the relations betweenenterprises and, however, businesses have sought alternative ways to create adifference for the goods or services they produce. In today's world, social media hasbecome the best tool to fulfill these goals.Brands in these environments in the consumer mind; content, appearance,presented with various elements of awareness of other competitors have begun tostand out as the brand. It is possible for brands to be successful in competitiveenvironments by protecting their market shares and by creating and managing themin the right social media platforms by providing the right marketing strategies.For this, the brand and the company is required to be preferred by the broadmasses. This is through social media and promotional activities. Social media; it hasimportant functions in the brand management process with applications that willenable differentiating brand and institution in the mind of the target audience. 178

Türklerin bilinen en eski tekstil sanatlarından biri olan keçenin ilk olarak kim tarafından bulunduğu ve keçenin ilk defa nasıl yapıldığı, kullanıldığı hakkında kesin veriler elde edilememiştir. İlk örnekleri Uygurlar döneminde görülmekle birlikte Türk kültürünün ve yaşantısının hemen her döneminde keçe kullanılmıştır. Keçe, keratin yapılı deri ürünü hayvansal liflerin örtü hücrelerinin alkali, nem, ısı, basınç ve hareket etkisinde birbirlerine çözülmeyecek şekilde kenetlenmesiyle elde edilen tekstil yüzeyleridir. Keçe, günümüzde geçmiş yıllara oranla farklı kullanımlarla artış göstermiş, ülkemizde ve dünya ülkelerinde keçe ürün çeşitliliği önemli hale gelmiştir. Araştırmada betimsel ve deneysel araştırma modelleri kullanılmıştır. Araştırmanın ilk aşamasında konunun temellendirilmesi ve yönlendirilmesi için literatür taraması yapılmıştır. Araştırmanın mekanik ve kimyasal bitim işlemlerinin tepme keçe yüzey üzerindeki etkilerinin denenmesinde deneysel araştırma modeli uygulanmıştır. Araştırma sonucunda; uygulanan anket değerlendirmelerinden geleneksel olarak uygulanan yıkama ve kurutma bitim işlemlerinden farklı olarak günümüzde atölyelerde gerçekleştirilen çeşitli bitim işlemlerinin olduğu, keçe ürünlere estetik görünüm kazandırmada çoğunlukla kenar düzgünleştirme bitim işleminin uygulandığı, uygulanan yöntemler açısından jilet ile temizleme ve el ile düzgünleştirme(kenar) işlemlerinin örneklemdeki atölyelerde benzer şekilde gerçekleştirildiği görülmüştür. Bunun yanında pres gibi işlemler için atölyelerin yeterli donanıma sahip olmaması nedeniyle dışarıdan yardım aldıkları tespit edilmiştir. Araştırmada farklı atölyelerden elde edilen bilgilerle, deneysel işlemler görseller ve işlem basamakları ile ayrıntılı olarak incelenmiştir. Keçe üzerinde farklı özellikler kazandırmada uygulanan kimyasal bitim işlemleri(güç tutuşurluk, su-yağ iticilik, güve yemezlik) bakıldığında; testler sonucunda güç tutuşurluk deneysel işleminin kontrol ve deney numuneleri arasında negatif yönde su-yağ iticilik ve güve yemezlik işlemlerindeki kontrol ve deney numuneleri arasında pozitif yönde sonuçlar elde edildiği görülmüştür. One of the oldest known textile arts of the Turks, in relation to felt no definitive data was obtained who was the first find and how the first time the felt was made and used. Although the first examples were seen during the Uighur period, felt was used in almost every period of Turkish culture and experience. Felt is a textile surface obtained by binding keratin-made leather products of animal fibers in such a way that they do not dissolve in the effect of alkaline, moisture, heat, pressure and movement of cover cells. The felt has increased with different uses compared to the past years and felt product variety has become important in our country and world countries.Descriptive and experimental research models were used in this study. In the first stage of the research, the literature search was conducted to establish and direct the subject. Experimental research model has been applied to the effects of the mechanical and chemical finishing operations of the research on the felt surfaces.As a result of the research; according to survey evaluations unlike the traditionally applied washing and drying finishing processes, it is seen that there are various finishing operations carried out in the workshops today. It has been seen that razor-sharpening and manual smoothing (edge) operations are performed similarly in the sample workshops in terms of the applied methods, in which the edge smoothing finishing process is applied in order to give the felt products aesthetic appearance. Besides, it has been found that for operations such as presses, workshops receive outside help because they do not have adequate equipment. In the study, with the information obtained from different workshops the experimental procedures were examined in detail by visuals and processing steps. Considering the chemical finishing processes to applied different properties on the felt (flammability, water-oil repellency, moth-proofing); as a result of the tests, it was seen that between the control and test samples about flammability negative results were obtained, positive results were obtained between the control and test samples about water-oil repelling and moth-proofing. 224

Bu tez çalışmasında, çok sayıda hedef DNA dizisinin erime dereceleri (Tm) ve yüksek çözünürlüklü erime eğrilerinin (HRM) eş zamanlı olarak değerlendirmesine dayanan ve Çok Fragmentli Erime Analizi (MFMA) olarak adlandırılan yeni bir karakterizasyon yöntemi geliştirilmiştir. Tez çalışmasında yoğurt, peynir, kefir, turşu, ekşi hamur, sucuk, silaj, probiyotik gıda takviyesi örneklerinden izole edilen ve NRRL kültür koleksiyonundan temin edilen toplam 357 suş kullanılmıştır. İzolatların MFMA analizi için, 16S ve 23S rRNA genleri üzerinde Lactobacillus türleri arasında değişkenlik gösteren 8 farklı DNA fragmentini çoğaltmak için toplam 8 primer seti kullanılmıştır. Hedef bölgeler, her bir primer seti ile amplifiye edilmiş ve amplifikasyon ürünlerinin MFMA analizi, ayrı ayrı yapılmıştır. Her izolat için elde edilen MFMA sonuçları diğer türlerin sonuçları ile karşılaştırılarak izolatlar gruplandırılmıştır. Her bir grubu temsil eden sayıda izolat, 16S rDNA ve 23S rDNA'nın bir kısmı ile ITS bölgesini kapsayan ve yaklaşık 1600 bç'lik bir bölgenin dizi analizi tanımlanmıştır. Analiz edilen örneklerde Lactobacillus brevis ve L. plantarum türleri baskın türler olmak üzere, toplam 22 farklı Lactobacillus türü tanımlanmıştır. MFMA ile hedef alınan 8 bölgenin MFMA sonuçları eşzamanlı olarak değerlendirildiğinde her bir türün en az iki primer seti ile başarılı bir şekilde ayrıldığı ve bilinen türler ile karşılaştırılarak tanımlanabileceği gösterilmiştir. Çok sayıda hedef bölgenin eş zamanlı erime analizine dayanan MFMA yönteminin, gıda, yem ve benzeri örneklerden izole edilen Lactobacillus türlerinin hızlı, doğru ve tek adımlı tanımlanması için büyük bir potansiyele sahip olduğu sonucuna varılmıştır.Anahtar Kelimeler: Çok Fragmentli Erime Analizi, MFMA, Lactobacillus, Tanımlama In this thesis, a new characterization method called Multi Fragmented Melting Analysis (MFMA) has been developed. MFMA based on the simultaneous analysis of melting temperature (Tm) and high resolution melting curves (HRM) of multiple DNA sequences. A total of 357 strains, isolated from yoghurt, cheese, kefir, pickle, sour dough, sausage, silage, probiotic food supplement besides standard strains, obtained from international culture collections were used in the study. A total of 8 primer sets were used in the MFMA analysis to amplify 8 different DNA fragments, showing high heterogenity between of Lactobacillus species on 16S and 23S rRNA genes. The target regions were amplified with each primer set and the MFMA analysis of the amplification products was performed separately. The isolates were grouped by comparing the MFMA results obtained for each isolate with the results of other strains. A number of representive isolates from each group were identified by sequence analysis of a region of about 1600 bp covering the ITS region with a partial of 16S rDNA and 23S rDNA. A total of 22 different Lactobacillus species were identified in the analyzed samples and Lactobacillus brevis and L. plantarum species were found as predominant species. When the MFMA results of 8 target regions are evaluated simultaneously, it has been shown that each strain can be successfully discriminated with at least two primer sets and identified by comparing with known species. It has been concluded that the MFMA method based on the simultaneous melting analysis of multiple target regions has a great potential for rapid, accurate and single step identification of Lactobacillus species isolated from food, feed and the other samples.Keywords: Multi Fragment Melting Analysis, MFMA, Lactobacillus, Identification 118

Bu çalışmada 1950'li yılların yazarlarından Ferit Edgü'nün romanlarında yabancılaşma kavramı ele alındı. Üç bölümden oluşan tezin ilk bölümünde; yazarın hayatı, sanatı ve eserlerinden bahsedildi. Yazarın sanatının anlatıldığı kısmın alt başlığında, Hakkâri'nin onun hayatında bir dönüm noktası olduğuna dikkat çekildi.Çalışmanın ikinci bölümünde, Ferit Edgü'de yabancılaşma kavramının belirgin olarak işlendiği üç romanı olan Kimse, Hakkâri'de Bir Mevsim, Yaralı Zaman kitaplarının tanıtımları ve özetleri verildi.Üçüncü bölümde ise Edgü'nün edebi hayatında temel nokta olarak gördüğü varoluşçuluk akımı çerçevesinde çalışmanın temelini oluşturan yabancılaşma kavramı ele alındı. Daha sonra bu konu üzerinde yerli ve yabancı bazı yazarların yabancılaşmaya bakışına yer verildi.Tezin temelini oluşturan dördüncü bölümde ise; Ferit Edgü'nün romanlarında yabancılaşmanın bulunduğu beş alt grup oluşturuldu.Böylece çalışmada Ferit Edgü'nün hayatının bir bölümünde bulunduğu Hakkâri kentinin ve o coğrafyanın etkilerinin romanlarındaki yansımaları ortaya konmuş oldu. Ayrıca yazarın varoluş mücadelesi içerisinde benliğinin olgunlaşmasındaki etkisi ve romanlarındaki yabancılaşma olgusunun nasıl işlendiği tespit edildi.Anahtar kelimeler: Türk Edebiyatı, Ferit Edgü, roman, varoluşçuluk, yabancılaşma. In this study, the concept of alienation was addressed in the novels of Ferit Edgü, one of the authors of the 1950s. The first chapter of the thesis with total three chapters, the author's life, art and works is discussed. In the subtitle of the story of the author's art life, it is noted that Hakkâri city is a turning point in his life. In the second chapter, Feride Edgü's three novels, `Kimse`, `Hakkâri'de Bir Mevsim`, `Yaralı Zaman`, in which the concept of alienation is prominently featured, are introduced and summarized. In the third chapter, as the basis of this study, the concept of alienation within the framework of existentialism which Edgü saw as the main point in in his literary life is addressed. Some views on alienation by some local and foreign authors are also mentioned. In the fourth chapter, which constitutes the basis of the thesis, five sub-groups were formed in the novels of Ferit Edgü where alienation is addressed.Thus, the study reveals reflections of effects of Hakkâri city and its geography, where once Ferit Edgü lived, on his novels. The influence of the struggle for existence on the maturation of author's self (personality) and how the phenomenon of alienation in his novels has been addressed is also discussed.Key words: Turkish literature, Ferit Edgu, novel, existentialism, alienation. 188

Bu çalışma, ev tekstili ürünlerinden döşemelik kumaşlar ve nevresimlerde kullanılan geleneksel Türk motiflerini belirlemek amacıyla yapılmıştır. Araştırmada, Denizli’de ev tekstili ürünü ve Bursa’da döşemelik kumaş üreten firmalarda Türk süsleme motifleri kullanılmıştır . Araştırma kapsamında bilgi formlarından elde edilen verilere göre nevresimlerde en çok kullanılan motifler rumi, lale ve bahar dalı motifleri, döşemelik kumaşlarda ise stilize bitkisel motifler ve lale motifleri olarak saptanmıştır. En çok kullanılan yerleşim düzeni, nevresimlerde tam rapor, döşemelik kumaşlarda ise yatay-dikey yönde ulama rapor tekrarlarıdır.

Amaç: Multipl Skleroz (MS) hastalarında depresyon ve anksiyete sıklıkla bildirilmektedir. Pek çok çalışma MS hastaları ile sağlıklı kontroller arasında kişilik farklılıklarını belgelemiş olsa da kişilik boyutlarınn depresyon ve anksiyete ile ilişkisini araştıran çalışmalar çok sınırlıdır. Bu çalışmanın amacı relapsing remitting multipl skleroz (RRMS) tanılı hastaları sağlıklı kontrollerle mizaç ve karakter, depresyon ve anksiyete açısından karşılaştırmak, mizaç ve karakterin depresyon, anksiyete ve klinik özelliklerle ilişkisini incelemektir.Yöntem: Bir üniversite hastanesi ayaktan MS polikliniğine başvuran ve çalışma ölçütlerini karşılayan 71 RRMS tanılı hasta ve yaş ve cinsiyet açısından eşleştirilmiş 50 sağlıklı kontrol çalışmaya alınmıştır. Tüm katılımcılara sosyodemografik ve klinik bilgilere yönelik yarı-yapılandırılmış görüşme formu, Mizaç ve Karakter Envanteri, Beck Depresyon Envanteri ve Beck Anksiyete Envanteri uygulandı. Hastaların Eksen I psikiyatrik tanıları SCID-I ile değerlendirildi.Bulgular: Hasta grubunun Zarardan Kaçınma skorları sağlıklı kontrol grubundan anlamlı derecede yüksek, Yenilik Arayışı, Sebat Etme, Kendini Yönetme skorları anlamlı derecede düşük bulunmuştur. Mizaç ve karakter özelliklerinden Zarardan Kaçınma boyutu ve alt boyutlarının büyük kısmı depresyon ve anksiyete ile pozitif, Kendini Yönetme boyutu ve alt boyutlarının büyük kısmı depresyon ve anksiyete ile negatif korelasyon göstermiştir. Sonuçlar: Erken evre, görece bilişsel olarak korunmuş RRMS hastalarında dahi mizaç ve karakter özellikleri sağlıklı kontrollerden çeşitli boyutlarda farklılık göstermektedir. Erken evre RRMS hastalarında mizaç, karakter; depresyon ve anksiyete; özürlülük, hastalık süresi ve toplam atak sayısından bağımsız görünmektedir. MS hastalarının kişilik profillerinin daha iyi anlaşılması, koruyucu psikiyatrik ve tıbbi tedavilere yön vermek açısından faydalı olabilir.Anahtar kelimeler: Multipl skleroz, relapsing remitting multipl skleroz, kişilik, mizaç, karakter, depresyon, anksiyete Objective: Depression and anxiety are frequently reported by MS patients. Although it was well documented that MS patients differ from healthy controls in terms of personality, studies examining the association between personality and depression, and anxiety is very limited. The aim of this study is to compare temperament and character, depression and anxiety in RRMS patients with healthy controls and inquire into the association of temperament and character with depression and anxiety and the clinical data. Method: Seventy one RRMS patients who admitted to an university outpatient clinic and 50 age and gender matched healthy controls were enrolled in the study. Semi-structured interview form for sociodemographic and clinical data, Temperament and Character Inventory, Beck Depression Inventory and Beck Anxiety Inventory were administered to all participants. Psychiatric diagnosis of patients were assessed by SCID-I.Results: Patients scored significantly higher in Harm Avoidance and lower in Novelty Seeking, Persistence and Self-directedness than the healthy controls. Harm Avoidance and most of the related subscales were positively, Self-directedness and most of the related subscales were negatively correlated with depression and anxiety. Conclusions: Temperament and character differences from controls were evident even in the cognitively unimpared early RRMS. Temperament and character, depression and anxiety seems to be independent of the disability, disease duration and the total number of relapses. An increased understanding of the MS patients personality profiles may aid with preventive psychiatric and medical treatment.Keywords: Multiple sclerosis, relapsing remitting multiple sclerosis, personality, temperament, character, depression, anxiety. 105

Bu araştırmada, Türkiye'de basılmış okul öncesi dönem çocuklarına yönelik hazırlanan resimli öykü kitaplarının coğrafi kavramları içerip içermediğini analiz etmek ve buna ek olarak, okul öncesi dönem öğretmenlerinin, çocuklara coğrafi kavramları öğretmede resimli öykü kitaplarını kullanma durumlarının incelenmesi amaçlanmıştır.Araştırmanın örneklemini, 2005-2011 yılları arasında basılmış olan Edirne il sınırları içerisinde bulunan kütüphanelerden, özel ve devlet anaokullarından, kitapçılardan toplanan seçilmiş örneklem yöntemi ile seçilen 250 okul öncesi dönem resimli öykü kitabı ve Edirne ili ve ilçelerindeki anaokulu, anasınıflarında görev yapan araştırmaya katılmak isteyen okul öncesi öğretmenleri (N=30) oluşturmaktadır.Araştırmada, survey (tarama) modeli kullanılmıştır. Araştırmanın başında çocuk edebiyatı ve coğrafya ile ilgili alanyazın taraması yapılmıştır. Kitaplar, araştırmacı tarafından geliştirilen ve uzman görüşü alınarak hazırlanmış ?Kitap Değerlendirme Formu? ile değerlendirilmiştir. Öykü kitaplarının coğrafi kavramları içerip içermediği ?Kitap Değerlendirme Formu?na göre değerlendirdikten sonra elde edilen verilerin analizinde SPSS 15.0 istatistik paket programı kullanılmıştır. Araştırmada elde edilen bulgular sonucunda; örneklemde yer alan resimli öykü kitaplarında en fazla işlenen kavramın ?yer? olduğu, en az işlenen kavramın ise, ?harita? olduğu saptanmıştır.Coğrafi kavramların okul öncesi dönem resimli öykü kitaplarındaki yeri ve önemi ve bu kitapların ne derece etkin kullanıldığını belirlemek amacıyla 15 açık uçlu sorudan oluşan görüşme formu kullanılarak öğretmenlerle görüşmeler yapılmıştır. Bulgular sonucunda, genel olarak okul öncesi öğretmenlerinin coğrafi kavramları içeren resimli öykü kitaplarını çocuklara coğrafya eğitimi vermek amacıyla kullandıkları anlaşılmıştır. Öğretmenlerin, okul öncesi dönemde coğrafya eğitiminin olması gerektiğini düşündükleri sonucuna varılmıştır.ANAHTAR SÖZCÜKLERÇocuk edebiyatı, okul öncesi dönem, resimli öykü kitapları, coğrafya, coğrafi kavramlar This research study aims to analyze whether picture story books published for preschoolers in Turkey include geographic concepts and to investigate preschool teachers' opinions about the importance of using picture story books and whether they use these books to teach children geographic concepts.As the sample of the research, a total of 250 preschool picture story books selected using the chosen sampling method from the libraries, private and public preschools, and bookstores in Edirne, published between 2005 and 2011, and 30 preschool teachers from Edirne region volunteering to participate in the study have been used.In this research study, the survey method has been used. First, a literature review about children?s literature and geography has been conducted. The story books have been evaluated using the ?Book Evaluation Form? developed by the researcher with the help of expert opinion to see whether they include geographic concepts. Then, the data obtained from this evaluation have been analyzed using the statistical software package SPSS 15.0. Results indicate that ?place? is the most mentioned concept among the picture story books in the sample, while ?map? is the least mentioned one.Teachers have been interviewed using a questionnaire including 15 open-ended questions to determine the place and importance of geographic concepts in preschool picture story books and how efficient these books are being used. Findings suggest that preschool teachers, in general, use picture story books which include geographic concepts to teach children geography and that they think geographic education is essential for preschoolers.KEYWORDSChildren?s literature, preschool, picture story books, geography, geographic concepts 128

In this article, we report a case describing the airway management and anesthetic technique of a 47-year-old male patient undergoing endolaryngeal surgery with extremely limited mouth opening due to previous maxillofacial trauma. An excisional biopsy was planned after laryngoscopic examination for a possible pathological right vocal cord irregularity. Anterior open laryngofissure approach under transtracheal high-frequency jet ventilation was performed after reviewing all possibilities. Neither direct laryngoscopy nor any endolaryngeal instrument placement was possible in this case. This approach was considered the most preferable choice to provide an unobstructed surgical field and safe gas exchange without requiring additional invasive procedure.

Bu araştırmada, Türkiye’de basılmış okul öncesi dönem çocuklarına yönelik hazırlanan resimli öykü kitaplarının coğrafi kavramları içerip içermediğini analiz etmek ve buna ek olarak, okul öncesi dönem öğretmenlerinin, çocuklara coğrafi kavramları öğretmede resimli öykü kitaplarını kullanma durumlarının incelenmesi amaçlanmıştır. Araştırmada elde edilen bulgular sonucunda; örneklemde yer alan resimli öykü kitaplarında en fazla işlenen kavramın “yer” olduğu, en az işlenen kavramın ise, “harita” olduğu saptanmıştır. Coğrafi kavramların okul öncesi dönem resimli öykü kitaplarındaki yeri ve önemi ve bu kitapların ne derece etkin kullanıldığını belirlemek amacıyla 15 açık uçlu sorudan oluşan görüşme formu kullanılarak öğretmenlerle görüşmeler yapılmıştır. Bulgular sonucunda, genel olarak okul öncesi öğretmenlerinin coğrafi kavramları içeren resimli öykü kitaplarını çocuklara coğrafya eğitimi vermek amacıyla kullandıkları anlaşılmıştır., This research study aims to analyze whether picture story books published for preschoolers in Turkey include geographic concepts and to investigate preschool teachers' opinions about the importance of using picture story books and whether they use these books to teach children geographic concepts. Results indicate that “place” is the most mentioned concept among the picture story books in the sample, while “map” is the least mentioned one. Teachers have been interviewed using a questionnaire including 15 openended questions to determine the place and importance of geographic concepts in preschool picture story books and how efficient these books are being used. Findings suggest that preschool teachers, in general, use picture story books which include geographic concepts to teach children geography and that they think geographic education is essential for preschoolers

We investigated the effect of low-intensity focused ultrasound (LIFU) on gene expression related to alcohol dependence and histological effects on brain tissue. We also aimed at determining the miRNA-mRNA relationship and their pathways in alcohol dependence-induced expression changes after focused ultrasound therapy. We designed a case-control study for 100 days of observation to investigate differences in gene expression in the short-term stimulation group (STS) and long-term stimulation group (LTS) compared with the control sham group (SG). The study was performed in our Experimental Research Laboratory. 24 male high alcohol-preferring rats 63 to 79 days old, weighing 270 to 300 g, were included in the experiment. LTS received 50-day LIFU and STS received 10-day LIFU and 40-day sham stimulation, while the SG received 50-day sham stimulation. In miRNA expression analysis, it was found that LIFU caused gene expression differences in NAc. Significant differences were found between the groups for gene expression. Compared to the SG, the expression of 454 genes in the NAc region was changed in the STS while the expression of 382 genes was changed in the LTS. In the LTS, the expression of 32 genes was changed in total compared to STS. Our data suggest that LIFU targeted on NAc may assist in the treatment of alcohol dependence, especially in the long term possibly through altering gene expression. Our immunohistochemical studies verified that LIFU does not cause any tissue damage. These findings may lead to new studies in investigating the efficacy of LIFU for the treatment of alcohol dependence and also for other psychiatric disorders.

Giriş: İmmunoglobulin E aracılı olmayan besin alerjilerinin tedavisi emziren annelere ve çocuklarına besin eliminasyonudur. Bu süreç çocukların klinik durumuna göre aylar sürebilmektedir. Diyetin uzun sürmesi hem annelerin hem de çocukların yaşamını olumsuz yönde etkileyebilmektedir.Amaç: Bu çalışmada besin protein ilişkili proktokolit (BPİAP), enteropati (BPE) ve enterokolit (BPİES) tanısı alan çocukların annelerinin diyet öncesi ve diyet altında depresyon ve duygu durumlarını değerlendirmeyi ve çocuklarının klinik durumu ile annelerinin ruhsal durumlarındaki değişiklikler arasındaki ilişkiyi belirlemeyi amaçladık.Yöntem: Çocuk Gastroenteroloji Hepatoloji ve Beslenme Polikliniğinde besin protein ilişkili BPİAP, BPE ve BPİES tanısı alan 1-12 ay aralığındaki 42 çocuk hasta ve anneleri dahil edildi. Annelere çocukların beslenme durumları ve demografik verileri ile ilgili sorular soruldu. Başvuru anında ve diyet altında hastaların kilo değerlendirmesı, klinik bulguları (huzursuzluk, emmeyi reddetme, gaz sancıları, kusma, mukuslu dışkılama, kanlı dışkılama, yağlı ishal, kilo alamama, kabızlık) sorgulandı, CoMİSS skorlaması yapıldı. Anneler, çocuklarını sadece anne sütü ile besleyenler, hem anne sütü hem de mama ile besleyenler, sadece mama ile besleyen anneler olarak üç gruba ayrıldı. Annelere diyet öncesi tanı anında ve 2 aylık diyet altında iki kez Beck Depresyon Ölçeği ve Beck Anksiyete Ölçeği uygulandı.Bulgular: Hastaların 16’sı BPİAP, 13’ü BPE, 13’ü BPİES tanılıydı. Hastaların 26’sı (%61,9) kız, 16’sı (%38,1) erkekti. Semptomlarının başlama yaş ortalaması 4 aydı. BPİAP tanılı olanlarda yaş ortalaması 3 ay olarak görüldü. BPİAP tanılı hastalarda huzursuzluk, gaz problemleri, kanlı ve mukuslu dışkılama daha sık; BPE VE BPİES tanılı hastalarda ise kusma, yağlı dışkılama ve kilo alamama şikayetleri daha ön planda izlendi. Diyet öncesi ve diyet sonrası tüm gruplarda CoMiSS değerinde diyet öncesine göre anlamlı düşüş izlendi. Gruplar arasında diyet öncesi ve sonrası depresyon ve anksiyete puanı anlamlı farklılık göstermedi. Çocuklarını sadece anne sütü ile besleyen grupta diyet öncesi ve sonrası anksiyete ve depresyon puanlarında anlamlı bir değişiklik görülmedi. Çocuklarını anne sütü ve mama ile besleyen grupta diyet sonrası hem anksiyete hem de depresyon puanları anlamlı olarak yüksek saptandı. Bebeğini sadece mama ile besleyen annelerin diyet sonrası anksiyete ve depresyon puanları diyet öncesine göre anlamlı olarak azaldı. Çoklu besin eliminasyon diyeti yapan grupta diyet sonrası anksiyete ve depresyon skoru sadece süt eliminasyon diyeti yapan gruptan anlamlı (p

ObjectiveWe aim to examine infection risk and vaccine status of COVID-19 in attention deficit and hyperactivity disorder and evaluate the impact of demographic, clinical, and COVID-19-related factors on the infection status and behavioral avoidance of COVID-19.MethodsThis cross-sectional study assessed adults with attention deficit and hyperactivity disorder recruited from an outpatient psychiatry clinic. Patients and healthy controls completed a survey on sociodemographic data, COVID-19 infection status, and vaccine status. COVID-19 Disease Perception Scale, COVID-19 Avoidance Attitudes Scale, Attitudes toward COVID-19 Vaccine Scale, Adult Attention Deficit and Hyperactivity Disorder Self-report Screening Scale for DSM-5, Adult Attention Deficit and Hyperactivity Disorder Self-Report Scale Symptoms Checklist, Patient Health Questionnaire-9, and State-Trait Anxiety Inventory were applied.ResultsNinety patients and 40 healthy controls participated. Patients did not differ from controls in COVID-19 infection and vaccine status, and behavioral avoidance of COVID-19. No demographic and clinical factor significantly affected the COVID-19 infection status. Patients scored higher than controls in the perception of COVID-19 as contagious (p = 0.038), cognitive avoidance of COVID-19 (p = 0.008), and positive attitudes toward the COVID-19 vaccine (p = 0.024). After adjustment of possible factors, a positive perception of the COVID-19 vaccine and a perception of COVID-19 as dangerous were the two factors significantly affecting behavioral avoidance of COVID-19 [R2 = 0. 17, F(2) = 13.189, p < 0.0001].ConclusionInfection and vaccine status of COVID-19 in patients did not significantly differ from controls. No demographic and clinical factor significantly affected the COVID-19 infection status. Approximately four-fifths of the patients were fully vaccinated as recommended by national and global health organizations. This has increased the knowledge base showing that the COVID-19 vaccine is acceptable and receiving the vaccine is endorsed by ADHD patients. Attention deficit and hyperactivity disorder itself may provoke no kind of mental disturbance in sense of perception of the danger of this disease. Our findings have increased the knowledge base showing that the COVID-19 vaccine is acceptable and the actual practice of receiving the vaccine is endorsed in this population. Our message for practice would be to take into account not only the core symptoms and the comorbidities of the disorder but also the perception of the disease while exploring its link with COVID-19.

Objectives: The global crisis of COVID-19 and its consequential strict public health measures placed around the world have impacted mental health. New scales and tools have been developed to measure these mental health effects. This narrative review assesses the psychometric properties of these scales and tools and methodological aspects of their development. Methods: PubMed, PubMed Central, and Google Scholar were searched for articles published from 15 May 2020 to 15 August 2020. This search used three groups of terms (“tool” OR “scale” AND “mental” OR “psychological”; AND “COVID-19” OR “coronavirus”). The identified scales were further evaluated for their psychometric properties and methodological aspects of their development. Results: Though the studies developing these scales ( n = 12) have demonstrated their robust psychometric properties, some methodological concerns are noteworthy. Most of the scales were validated using internet-based surveys, and detailed descriptions of the mode of administration, sampling process, response rates, and augmentation strategies were missing. Conclusions: The heterogeneous and inadequate reporting of methods adopted to evaluate the psychometric properties of the identified scales can limit their utility in clinical and research settings. We suggest developing guidelines and checklists to improve the design and testing, and result in reporting of online-administered scales to assess the mental health effects of the COVID-19 pandemic.

© 2020 Elsevier LtdThe patho-etiology of mental disorders with onset in childhood or adolescence remains largely unknown. We conducted an umbrella review of meta-analyses (MAs) on environmental factors associated with mental disorders with onset in childhood/adolescence. We searched Pubmed-MEDLINE/EMBASE/PsycInfo databases, last search April 29th, 2020. Quality of MAs was measured with AMSTAR-2. Out of 6851 initial references, ten articles met inclusion criteria, providing 23 associations between 12 potential environmental factors and nine disorders (cases: 8884; N = 3,660,670). While almost half of the associations were nominally significant, none of them met criteria from either convincing or highly suggestive evidence. A single association was supported by suggestive evidence (maternal exposure to lithium or antipsychotics with neuromotor deficits), but it was affected by confounding by indication. Ten more associations had weak evidence, and 12 associations were not statistically significant. Quality of meta-analyses was rated as high in two, moderate in one, low in four, critically low in two, and not pertinent in one (individual participant data). Methodologically-sound research is needed in this field.

Objective Anxiety disorders (AD) are known for its comorbidity and negative impact on the course of adult bipolar disorder (BD). However, there is limited research on AD comorbidity in pediatric BD (PBD). Here, we aimed to conduct a meta-analysis and meta-regression study about the comorbidity and covariates of AD and PBD. Method We systematically searched relevant articles published until May 2019, as defined in PRISMA guidelines. Variables for associated features and prevalence of AD were extracted. Results Thirty-seven articles represented data for the analysis. Lifetime any AD comorbidity was 44.7%; panic disorder (PD) was 12.7%; generalized anxiety disorder (GAD) was 27.4%; social phobia was 20.1%; separation anxiety disorder (SAD) was 26.1%; and obsessive-compulsive disorder (OCD) was 16.7%. Childhood-onset studies reported higher GAD and SAD comorbidity, while adolescent-onset studies reported higher PD, OCD, and social phobia. Age of onset, gender, comorbidity of ADHD, substance use, oppositional defiant disorder and conduct disorder affected each anxiety disorders' comorbidity with PBD differently. Conclusion Anxiety disorders are highly comorbid with PBD. Early-onset PBD increases the risk of AD. Biopsychosocial aspects of this comorbidity and its course needs to be evaluated further.

Aim: The well-being of healthcare workers is a critical indicator in the provision of high-quality care. Although researchers have stressed the importance of social interactions and social support, scarce data exist about their effects on healthcare workers’ well-being. In this study, we aim to advance the research on the relationships between social network diversity (SND), social support, and thriving. Methods: In a cross-sectional design, an anonymous online link was shared among healthcare workers in a university hospital. The survey included questions on demographics, medical diseases, items from the social network index, the multidimensional perceived social support scale, and the brief and comprehensive inventories of thriving scales. Results: A total of 103 individuals participated in the study (median age, min-max=33 (18-57); male/female = 33/70). Men and women did not differ in SND, perceived social support, or thriving scores. The brief inventory of thriving demonstrated healthcare workers older than 38 years exhibited higher scores in thriving compared to those younger than 27 years (p=0.001). According to comprehensive inventory of thriving, belonging (p=0.032), skills (p=0.006), self-worth (p=0.048), meaning and purpose (p

Amaç: Komorbid bozukluklar erişkin dönemde dikkat eksikliği ve hiperaktivite bozukluğunun (DEHB) görünümünü etkileyebilir. Klinikçalışmalarda DEHB tanısı konan bireylerde en sık eş tanılar depresif bozukluklar ve anksiyete bozukluklarıdır [1]. Depresyon tanılıhastalarda ise DEHB sıklığı % 9.4 olarak gösterilmiştir [2]. Sürekli anksiyete, DEHB belirti şiddeti ile işlevsel bozulma arasındaki ilişkiyearacılık etmektedir [3]. Bu çalışmanın amacı depresyon hastalarında DEHB’nun durumluk ve sürekli anksiyeteyle ilişkisininincelenmesidir.Metod: Bir üniversite hastanesi psikiyatri polikliniğinde değerlendirilen, Mental Bozuklukların Tanımsal ve Sayısal El Kitabı TanıÖlçütleri 5. Baskısına (DSM-5) göre depresyon tanısı alan, anksiyete bozukluğu eş tanısı olmayan hastalar çalışmaya alındı. Hastalarerişkin dikkat eksikliği ve hiperaktivite bozukluğu özbildirim ölçeği (ASRS v1.1) DSM-5 DEHB tarama ölçeği (ASRS-5), durumluk vesürekli anksiyete (STAI-I, STAI-II) ve Beck depresyon özbildirim ölçeklerini doldurdu. Araştırma için üniversite girişimsel olmayanaraştırmalar etik kurulundan onay alındı. Çalışma Helsinki Deklarasyonu-na uygun şekilde yürütüldü. Tüm katılımcılar, çalışmanın amacıve içeriği anlatıldıktan sonra yazılı ve aydınlatılmış onam verdi.Bulgular: Çalışmaya alınan depresyon tanılı 38 hastanın (29 kadın, 9 erkek) yaş ortalaması 30.2 ± 11.2’ydi. 11’i (%29) evli, 27’si (%71)bekardı. 26’sının (%68.4) eğitim düzeyi üniversite ve üstündeydi. 13’ü (%34.2) öğrenci, 12’si (%31.6) çalışan, 12’si (%31.6) çalışmayanbireylerdi, bir kişi (%2.6) emekliydi. 25 kişinin (%65.8) maddi durumu orta düzeydeydi. 16 kişi (%42) sigara kullanmaktaydı. HemASRS-5 (p=0.047, r=0.33), hem ASRS v1.1 (p=0.004, r=0.46) sürekli anksiyeteyle pozitif yönde ilişkiliydi. ASRS v1.1 durumlukanksiyeteyle pozitif yönde ilişkili bulunmuşken (p=0.002, r=0.48), ASRS-5 ile durumluk anksiyete arasında ilişki bulunamadı (p=0.071 ,r=0.30).Tartışma ve Sonuç: Bu çalışmada depresyon tanılı erişkin hastalarda DEHB taramasında kullanılan iki ölçeğin durumluk ve süreklianksiyete ile ilişkileri incelenmiştir. Hem ASRS-5 hem ASRS v1.1. sürekli anksiyeteyle pozitif yönde ilişkiliyken, ASRS v1.1 durumlukanksiyeteyle pozitif yönde ilişkili bulunmuş, ASRS-5’le durumluk anksiyete arasında ilişki bulunamamıştır. Bulgularımız, depresyonhastalarında anksiyeteli depresyonun, anksiyetesiz depresyona kıyasla ASRS v1.1. puanlarıyla daha fazla ilişkili olduğunu gösterençalışmayla uyumludur [4]. Yeni ve geniş örneklemli bir klinik çalışmada da ASRS v1.1’le ölçülen özbildirim DEHB puanlarının Beckdepresyon puanlarıyla pozitif ilişkili olduğu ortaya konmuş, depresyon puanları düştükçe, DEHB olarak pozitif taranan hasta sayısının dadüştüğü gösterilmiştir [5]. Depresyon tanılı hastalarda ASRS-v1.1’ in DSM-IV’e göre ve klinik görüşme ile konulan tam sendrom DEHBtanısı için % 60 duyarlılık, % 68.6 özgüllük; % 21.4 pozitif tahmin değeri, % 92.3 negatif tahmin değeri ortaya konmuştır. Depresyonhastalarında DEHB tarandığında negatif sonuç alınmasının DEHB’nun bulunmadığını güçlü şekilde ortaya koyabildiği, ancak taramasonucu pozitifse bu pozitifliğin depresyondan mı DEHB’ndan mı kaynaklandığının incelenmesi gerektiği şeklinde yorumlanmıştır [4].Erişkin depresyon hastalarında, DEHB eştanısı araştırılırken durumlarda anksiyetenin de DEHB tarama ölçek puanlarını etkileyebileceğigöz önünde bulundurulmalıdır. Durumluk anksiyetesi yüksek olan depresyon hastalarında DEHB taranması için, ASRS-5 ölçeği ASRSv1.1’e göre daha uygun olabilir.

Objective: Attention deficit hyperactivity disorder (ADHD) has several negative psychosocial outcomes including poor work performance, academic failure, problems in social relationships, and criminality. However, it is among the most treatable mental disorders given the safety and efficacy of stimulants. We aimed to explore compliance levels to methylphenidate and associated sociodemographic factors in adults with ADHD.Methods: Patients with ADHD who have been following up in a single-center outpatient psychiatry clinic of a university hospital were included in the study. Diagnoses were established according to the Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (DSM-5) during a face-to-face clinical interview. Sociodemographic data form and Morisky medication adherence scale were utilized.Results: Among 64 patients (36 males, 28 females) (mean age ± SD = 25.2 ± 6.8) with ADHD, 19 (29.7 %) and 29 (45.3%) patients showed high and medium adherence to methylphenidate respectively. However, 16 (25 %) had low adherence. Men and women did not significantly differ in compliance levels to stimulants (X2 (2) = 1.639, p = 0.441). Compliance was not found to be related to education, marital and economic status, living conditions, smoking. The number of patients who consume alcohol tends to be higher in the low adherent group although not reaching statistical significance.Discussion: One-fourth of adult patients with ADHD had low adherence to methylphenidate. Men and women did not differ in adherence levels. No significant difference has been observed in the mean ages between the three adherence groups. Our results were in line with some earlier studies on treatment adherence in ADHD but not with others that showed adherence was higher in females and younger patients. The reason for these discrepancies could be that the studies with contrary results have recruited both children and adolescents. Longitudinal multicenter studies are needed to draw conclusions on the factors affecting compliance in ADHD.Keywords: attention deficit and hyperactivity disorder, drugs/medication, pharmacology, treatment compliance, treatment adherence, demographic

There is an increasing movement toward international collaboration and global discussion in mental health. If provided with the right opportunities, early career psychiatrists (ECPs) and researchers in mental health can contribute meaningfully to this discussion. However, they often experience multiple barriers when attempting to add their voices via academic publications. We represent a diverse group of ECPs and researchers from all six World Health Organization regions. In this piece, we discuss these barriers, grounded in our first-hand experiences, and put forth a series of recommendations. The most potentially beneficial and immediate way forward is ensuring a much-needed mentorship and support, particularly for low- and middle-income countries. In this regard, international organizations, especially those with a particular focus on education, such as the Section on Education in Psychiatry of the World Psychiatric Association, can play a pivotal role.

Cognitive function (CF) is a core feature related to all psychiatric disorders. However, self-report scales of CF (SRSC) may not always correlate with CF's objective measures and may have different mediators. Tools to select for evaluating CF in diverse psychiatric populations and their determinants need to be studied. In this study, we aimed to assess the association of SRSC (Perceived Deficit Questionnaire-Depression (PDQ-D), and World Health Organization's Adult Attention Deficit Hyperactivity Disorder Self-Report Scale (ASRS) and its inattentiveness subscale) with Letter-N-back as an objective measure of CF, and to analyze their association with psychopathology. Two hundred nine (131 nonclinical, and 78 clinical with a psychiatric diagnosis of ICD10 F31-39 [mood disorders excluding Bipolar I] or F40-F49 [neurotic, stress-related or psychosomatic disorder] categories) participants were evaluated with PDQ-D, ASRS, Beck Depression Inventory (BDI), and Beck's Anxiety Inventory (BAI), and N-back. Both groups' data were included in the analysis. PDQ-D showed a small correlation with N-back scores, whereas ASRS showed no correlation. PDQ-D and ASRS showed a large correlation. Age and BAI scores significantly predicted both PDQ-D and ASRS, whereas the cognitive subscale of BDI predicted PDQ-D, but not ASRS. Only BAI scores predicted N-back results. The mediation model revealed that 2-back scores of N-back task directly affects PDQ-D scores, independent of BDI scores. However, the cognitive subscale of BDI moderated 2-back and PDQ-D association. On the contrary, BAI scores significantly mediated the association of 2-back scores with PDQ-D. The direct effect of 2-back scores in PDQ-D was insignificant in the mediation of BAI scores. Our study validates the discordance between SRSC and an objective measurement of CF. Anxiety may affect both self-report and objective measurement of CF, whereas depressive thought content may lead to higher cognitive dysfunction reports in nondemented participants.

Introduction: We aimed to explore how physicians from different specialties approach the management of functional neurological symptom (conversion) and somatic symptom disorders in the emergency department compared with pulmonary embolism and how physicians' professional and personal characteristics influence their diagnostic preferences. Methods: Using a vignette methodology, and cross-sectional design, three emergency department case vignettes of possible functional neurological symptom, somatic symptom disorder, and pulmonary embolism were presented to physicians from internal medicine, emergency medicine, and psychiatry. A structured survey including questions on diagnosis and management of these cases, and physicians' professional and personal characteristics (childhood trauma, attachment style) was conducted. Results: Physicians from internal medicine and emergency medicine tended to consider functional neurological symptom disorder as 'malingering' while psychiatrists tended to diagnose the pulmonary embolism case as a psychiatric condition. Emergency medicine physicians preferred to manage functional neurological symptom disorder themselves, while other doctors endorsed recommending a psychiatric consultation. In the univariable model, being a physician from psychiatry, emergency medicine, or internal medicine; being a specialist, history of childhood sexual abuse, dismissive, and fearful attachment styles of doctors were significant predictors of diagnosing functional neurological symptom disorder as malingering. Being a psychiatrist stayed as the only significant predictor in the multivariable model. Conclusion: Objectively-aberrant functional neurological symptoms and subjective somatic symptoms may be creating different reactions in physicians. In the emergency department, physicians' diagnostic and treatment preferences of conversion disorder may be influenced by lack of training in conversion disorder, rather than their personal characteristics.

Background With the uncertainties of COVID-19, people infected by coronavirus present with diverse psychiatric presentations. Some centers have had to manage their patients with existing protocols, others have had to come up with innovations. We aim to report the challenges and good practices recorded in the management of psychiatric conditions and delirium coexisting with COVID-19 and during the COVID-19 era across continents. Material and Methods Early Career Psychiatrists (ECPs) from across five continents were approached to provide their perspective on the management of psychiatric conditions in patients with COVID-19 and during the current pandemic. Results We collected information about the experiences from ten countries. Commonalities were similar psychiatric presentations and poor preparedness across countries. Differences were varying innovations and adjustments made in the management of psychiatric conditions coexisting with COVID-19. Good practices which can be adopted by other countries are novel approaches such as telepsychiatry, proactive consultation-liaison units and enhanced community services targeted at circumventing challenges faced yet providing mental health services. Conclusions This publication highlights the need for global preparedness in the mental health sector during outbreaks of infectious diseases. With our results we can conclude that there is the need for concerted efforts targeted at global and locally sensitive adaptation of existing protocols and the development of new guidelines for the management of psychiatric conditions for the present pandemic and subsequent occurrences., Highlights • Twenty-one Early Career Psychiatrists (ECPs) from thirteen countries across five continents, provided their perspective on the management of psychiatric conditions in patients with COVID-19. • We found commonalities such as similar psychiatric presentations, poor preparedness and alterations in the management of psychiatric conditions coexisting with COVID-19. • There are shared similarities and differences, likewise modifications in pre-existing protocols in the management of delirium and other psychiatric conditions in patients with COVID-19 and during the current era across continents. • A common factor is the need for preparedness in the mental health sector; the need for concerted efforts targeted at globally and locally sensitive adaptation of guidelines and protocols for the management of psychiatric conditions for the present pandemic and subsequent occurrences.

Publisher's version (útgefin grein), Background There is evidence to suggest that the broad discrepancy in the ratio of males to females with diagnosed ADHD is due, at least in part, to lack of recognition and/or referral bias in females. Studies suggest that females with ADHD present with differences in their profile of symptoms, comorbidity and associated functioning compared with males. This consensus aims to provide a better understanding of females with ADHD in order to improve recognition and referral. Comprehensive assessment and appropriate treatment is hoped to enhance longer-term clinical outcomes and patient wellbeing for females with ADHD. Methods The United Kingdom ADHD Partnership hosted a meeting of experts to discuss symptom presentation, triggers for referral, assessment, treatment and multi-agency liaison for females with ADHD across the lifespan. Results A consensus was reached offering practical guidance to support medical and mental health practitioners working with females with ADHD. The potential challenges of working with this patient group were identified, as well as specific barriers that may hinder recognition. These included symptomatic differences, gender biases, comorbidities and the compensatory strategies that may mask or overshadow underlying symptoms of ADHD. Furthermore, we determined the broader needs of these patients and considered how multi-agency liaison may provide the support to meet them. Conclusions This practical approach based upon expert consensus will inform effective identification, treatment and support of girls and women with ADHD. It is important to move away from the prevalent perspective that ADHD is a behavioural disorder and attend to the more subtle and/or internalised presentation that is common in females. It is essential to adopt a lifespan model of care to support the complex transitions experienced by females that occur in parallel to change in clinical presentation and social circumstances. Treatment with pharmacological and psychological interventions is expected to have a positive impact leading to increased productivity, decreased resource utilization and most importantly, improved long-term outcomes for girls and women., The meeting was funded by the UK ADHD Partnership (UKAP), who has been in receipt of unrestricted educational donations from Takeda. Takeda had no influence or involvement in determining the topic and arrangements of the day, the consensus process and outcomes, or writing the final manuscript. Other than reimbursement of travel expenses to attend the meeting, none of the authors received any financial compensation for attending the meeting or writing the manuscript, aside from CS who received funds for medical writing assistance., "Peer Reviewed"

Aim: This study aimed to explore loneliness and associated factors in Turkish patients with inflammatory arthritis. Method: Adult patients with rheumatoid arthritis (RA) (n = 58), ankylosing spondylitis (AS) (n = 53), and psoriatic arthritis (PsA) (n = 30), respectively, were included in the study. A single-item visual analog scale (VAS) for loneliness, UCLA Loneliness Scale-8 (ULS-8), Beck depression inventory (BDI), Beck anxiety inventory (BAI), revised multidimensional scale of perceived social support, Health Assessment Questionnaire-Disability Index (HAQ-DI) were used for the psychometric and functional assessments. Multiple regression models were generated for predicting the ULS-8 and HAQ-DI scores. Results: There was no difference between disease groups in terms of the ULS-8 and HAQ-DI scores. Among demographic and clinical parameters, only the education status and number of drugs used had associations with the ULS-8 score. Single-item VAS score for loneliness did not predict the ULS-8 score well. There were significant correlations between the ULS-8 and HAQ-DI, depression, anxiety, social support, and physician global VAS scores. Only the education status significantly predicted (β = -0.208) the ULS-8 score in multiple regression analysis (adjusted R2 = 0.15, P < .001). Beck depression, anxiety, and patient global VAS scores remained significant for predicting the HAQ-DI after multiple regression with the covariates ULS-8, depression, anxiety, social support, patient and physician global VAS scores, and the number of drugs used (adjusted R2 = 0.53, P < .001). Disease activity and the ULS-8 scores were not found to be associated in any disease group. Conclusion: Loneliness is associated with depression, anxiety, lack of social support, disability, higher number of drugs used, and lower education but not with disease activity in Turkish patients with RA, AS, and PsA. Perception and expression of loneliness vary according to the cultural background. Single-item scales for loneliness may lack reliability compared to the more comprehensive ULS-8. Keywords: ankylosing spondylitis; inflammatory arthritis; loneliness; psoriatic arthritis; rheumatoid arthritis; social support.

In the past century, biological, psychological and social sciences have brought significant progresses to psychiatry, building it is a broad medical specialty, closely linked to somatic medicine, psychology and society. Many psychiatrists early in their career have understood that it is easier to face these challenges in a collaborative way, and therefore there has been in the last decades a growth of local and national associations of psychiatric trainees and early career psychiatrists across Europe. In 2007, the European Psychiatric Association (EPA) has integrated in its program the "Young Psychiatrists Committee", an informal network of young psychiatrists. This Committee since 2010 has been known as the Early Career Psychiatrists Committee (ECPC). EPA has been making remarkable efforts towards supporting early career psychiatrists' education and participation in scientific congresses, promoting their professional growth and integration into the international professional community. Likewise, early career psychiatrists contribute to EPA with their motivation, enthusiasm and creative ideas, proving this initiative as an effective win-win cooperation., NA

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Mast cells are considered sensors of environmental and emotional stress, exist in all body parts and are related to the pathway from stress to inflammation. Mastocytosis defines a rare disease characterized by the accumulation of abnormal mast cells in multiple organs. Here, we present a 77-year-old woman with a background of aggressive systemic mastocytosis who developed impaired cognition, depression, anxiety, visual hallucinations, delusions, and insomnia. Symptoms alleviated only after initiating midostaurin, a tyrosine kinase inhibitor. Systemic mastocytosis should be kept in mind when visual hallucinations are concomitant with chronic or recurrent multi-system disturbances and do not benefit from treatment as usual., NA