Comparison of Biofeedback Modalities for Better Achievement in High School Students
The aim of this pilot study was to compare three biofeedback methods for enhancement of cognitive abilities (concentration and attention) in high school students. The sample comprises 50 students in high school for nurses, aged 16-18 years, devised in three groups: I - 30 students trained with EEG-Peak Achievement Trainer (EEG-PAT); II - 10 students trained with Electrodermal Response Biofeedback (EDR); and III - 10 students trained with Heart Rate Variability (HRV). The EEG-PAT is supposed to activate the Executive Attention Network, while HRV and EDR were supposed to influence indirectly, through the stabilization of autonomous nervous system. As psychometric tests we used: Trail Making Test (form A and form B) and numbering forward and backward, each one applied prior and after the experiment. The obtained results suggested that EEG-PAT can be successfully used for improving the concentration and attention and to a less extend the Short Term Memory Span. The HRV showed modest improvement (only for numbers), and EDR group did not show significant improvement in the concentration, attention and the Short Term Memory Span. However, all the three methods are highly cost-benefit and very comfortable for application and can be used for stabilization of the homeostasis.
Biofeedback Training for Peak Performance in Sport - Case Study
The use of peripheral biofeedback and neurofeedback is growing rapidly in sport psychology. The aim is to lower competition stress, anxiety, and muscle tension.
We present a case report concerned to biofeedback training in an athlete in preparation to Olympic Game competition. It is the first case in our region to prepare athlete with biofeedback modalities. Obtained results are very encouraging.
Background: Fearful and anxious behaviour is especially common in children, when they come across new situations and experiences. The difference between normal worry and an anxiety disorder is in the severity and in the interference with everyday life and normal developmental steps. Many longitudinal studies in children suggest that anxiety disorders are relatively stable over time and predict anxiety and depressive disorders in adolescence and adulthood. For this reason, the early diagnostic and treatment are needed.
Researchers supposed that anxiety is a result of repeated stress. Additionally, some genetic, neurobiological, developmental factors are also involved in the aetiology.
Methods and subjects: The aim of this article is to summarize and to present our own results obtained with the assessment and treatment of different forms of anxiety disorders in children and adolescents such as: Posttraumatic Stress Disorder (PTSD), Obsessive Compulsive Disorder (OCD), Dental anxiety, General Anxiety Disorder (GAD), and Anxious-phobic syndrome. Some results are published separately in different journals.
a) Post Traumatic Stress Disorder (PTSD) in 10 young children aged 9 ± 2, 05 y. is evaluated and discussed concerning the attachment quality.
b) The group with OCD comprises 20 patients, mean age 14,5 ± 2,2 years, evaluated with Eysenck Personality Questionnaire (EPQ), Child behaviour Checklist (CBCL), K-SADS (Schedule for Affective Disorders and Schizophrenia for School age children), Beck Depression Inventory (BDI), SCWT (Stroop Colour Word task), WCST (Wisconsin Card Scoring test).
c) Dental stress is evaluated in a group of 50 patients; mean age for girls 11,4 ± 2,4 years; for boys 10,7 ± 2,6 years, evaluated with (General Anxiety Scale (GASC), and Eysenck Personality Questionnaire (EPQ).
d) Minnesota Multiphasic Personality Inventory (MMPI) profiles obtained for General Anxiety Disorder in 20 young females and 15 males aged 25,7± 5,35 years, and a group with Panic attack syndrome N=15 aged 19,3±4,9 years are presented and discussed by comparison of the results for healthy people.
e) Heart Rate Variability (HRV) was applied for assessment and treatment in 15 anxious-phobic patients, mean age 12, 5±2,25 years and results are compared with other groups of mental disorder.
Results: Children with PTSD showed a high level of anxiety and stress, somatization and behavioural problems (aggression, impulsivity, non-obedience and nightmares), complemented by hypersensitive and depressed mothers and misattachment in the early period of infancy. Consequently, the explanation of the early predisposition to PTSD was related to be the non-developed Right Orbital Cortex. The later resulted from insecure attachment confirmed in all examined children.
The obtained neuropsychological profile of children with OCD confirmed a clear presence of obsessions and compulsions, average intellectual capacities, but the absence of depressive symptoms. Executive functions were investigated through Event Related Potentials on Go/NoGo tasks. Results showed that no significant clinical manifestations of cognitive dysfunction among children with OCD in the early stage of the disorder are present, but it could be expected to be appearing in the later stage of the disorder if it is no treated.
In a study of 50 children randomly selected, two psychometric instruments were applied for measuring general anxiety and personal characteristics. It was confirmed that there was presence of significant anxiety level (evaluated with GASC) among children undergoing dental intervention. The difference in anxiety scores between girls and boys was also confirmed (girls having higher scores for anxiety). Results obtained with EPQ showed low psychopathological traits, moderate extraversion and neuroticism, but accentuated insincerity (L scale). L scales are lower by increasing of age, but P scores rise with age, which can be related to puberty. No correlation was found between personality traits and anxiety except for neuroticism, which is positively correlated with the level of anxiety.
The obtained profiles for MMPI-201 in a group of patients with general anxiety are presented as a figure. Females showed only Hy peak, but in the normal range. However, statistics confirmed significant difference between scores in anxiety group and control (t= 2, 25164; p= 0, 038749). Males showed Hs-Hy-Pt peaks with higher (pathological) scores, related to hypersensitivity of the autonomic nervous system, as well as with manifested anxiety. Calculation confirmed significant difference between control and anxiety in men (t= 15.13, p=0.000).
Additionally, MMPI profiles for patients with attack panic syndrome are also presented as a figure. Control scales for females showed typical V form (scales 1 and 3) related to conversing tendencies. In addition, females showed peaks on Pt-Sc scales, but in normal ranges. Pathological profile is obtained in males, with Hy-Sc peaks; this profile corresponds to persons with regressive characteristics, emotionally instable and with accentuated social withdraw.
Heart rate variability (HRV) is a measure of the beat to beat variability in heart rate, related to the work of autonomic nervous system. It may serve as a psychophysiological indicator for arousal, emotional state and stress level. We used HRV in both, the assessment and biofeedback training, in a group of anxious-phobic and obsessive-compulsive school children. Results obtained with Eysenck Personality Questionnaire showed significantly higher psychopathological traits, higher neuroticism and lower lie scores. After 15 session HRV training very satisfying results for diminishing stress and anxiety were obtained.
In the field of psychosomatic medicine the relationship between personality characteristics and diseases is supposed to be an important issue.
The aim of this article is to present group’s MMPI profiles obtained for patients with different chronic diseases and to discuss about possible specific features of these different groups.
We summarized results obtained by psychological testing of following groups of patients: adult patients treated with chronic maintenance dialysis, patients with diabetic retinopathy, general anxiety group, attack panic syndrome, parents of children with rheumatoid arthritis, as well as adolescents with mental anorexia, cystic fibrosis, diabetes mellitus and leukemia. Two control groups comprised adults and adolescents, both without any health problems, selected randomly. As a psychometric test MMPI-201 was used. Statistic 10 package is used for statistical analysis.
In our presentation it can be seen some typical personality characteristics for patients with chronic conditions. These findings could be helpful for clinicians concerning treatment planning and followup. In general, the MMPI helps us to obtain a global, factual picture from the self-assessment of the patient, explained in a psycho-technical language. Group’s profile could be used in clinical practice for planning treatment and to suppose the prognosis of the illness.
As a common disorder, depression must be diagnosed not only in psychiatric but also in different medical settings, especially in patients with chronic diseases. Beck Depression Inventory is valuable and sensitive self-report inventory used worldwide for assessment depressive symptoms. In this research we present obtained scores of BDI in different group of disorders and we showed that BDI scores are related to the clinical condition, as well as with the age.
Osteoskeletal Manifestation of Scurvy in a Male Infant (Case Report)
Scurvy, a disease of dietary deficiency of vitamin C, was uncommon in the last century due to improved nutrition and health care. However, in the last decade it was increasingly reported in adult population. In a period of infancy, scurvy appears after the age of five months and is related mainly to malnutrition. The main symptoms are vascular purpura, bleeding and gum abnormalities, but musculoskeletal manifestations could also be prominent. Children experience severe lower limb pain related to subperiosteal bleeding. The misdiagnosis with rickets and arthritis is common. We present a case of scurvy in 8 month boy with osteoskeletal manifestation, very rare seen in contemporary European pediatrics. The diagnosis of our patient is made by clinical presentation (such as haematuria, edema of lower extremities as well as swollen right leg), some biochemical parameters and radiological finding. The therapeutically outcome and follow-up of the boy confirmed the diagnosis and etiology.
Quantitative EEG Characteristics of Attention Deficit Hyperactivity Disorder in Adults
Background. Attention Deficit Hyperactivity Disorder (ADHD) in adults is fairly common, though it often goes unrecognized. The few published studies concerning the EEG assessment in the ADHD adults have demonstrated divergent EEG activity.
Aim. Our aim was to identify whether the dividing the ADHD adults into the four QEEG subtypes (according to the Kropotov's classification by comparing the each individual spectra to the Human Brain Institute (HBI) reference database) corresponds to our findings of electrophysiological measures - spectra absolute power (μV2) for each frequency band (delta, theta, alpha, beta).
Material and Methods. In this study we examined the absolute spectra power of the brain waves through quantitative EEG (QEEG) in two resting conditions (eyes closed and eyes opened) and two neuropsychological tasks (visual and emotional continuous performance tests) from 67 adults diagnosed with ADHD.
Results. Four distinct QEEG subtypes of adults with ADHD were selected according to the Kropotov's classification and then were attested using statistical analysis. These were characterized by (a) increased delta-theta wave activity, (b) increased frontal midline theta, (c) beta excess and (d) alpha excess groups.
Conclusion. We can conclude that the QEEG spectrum power relatively clearly differentiates the ADHD adults into four subtypes. Namely, the obtained results confirmed that the absolute power of all frequency bands depends on the group qualification. These results indicate that adults with ADHD diagnosis constitute a heterogeneous group either with different underlying electrophysiological abnormalities or in clinical expression. These valid subtypes may also have significantly different causes underlying their behaviour, and may respond differentially to medication and neurotherapy, possibilities which merit further investigation.
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.
In their daily practice dentists frequently have patients showing signs of stress-related oral manifestations in different forms. Stress-related aetiology of oral changes are still not investigated enough, and present a subgroup of psychosomatic diseases which had been recognized in medicine a long time ago. Recognition of such psychological or emotional disturbance needs deep evaluation “per exclusionem”, and is beneficial for both the patient and clinician. Psychological management should be taken into consideration when treating patients with these psychosomatic disorders. Therapeutic approach comprises different forms of psychotherapy and medication as well.
Aim: To present a group of young doctors from R. Macedonia who were elected as lecturers at the Faculty of Medicine (FM) in Skopje, R. Macedonia, in the period 1961-63.
Method: A retrospective study based on archive materials, encyclopaedias and jubilee publications of the FM and Faculty of Dentistry in Skopje, other relevant sources of information, and a review of the relevant literature.
Results: The Skopje FM was founded in 1947 and the first meeting of the Teachers’ Council of the Faculty was held on March 17, 1947. The first generation of 153 students was enrolled in the autumn of 1947 and the first lecture was delivered on November 3, 1947.
Besides 15 doctors from R. Macedonia - faculty staff, who had been appointed in the period from 1947-54, and a group of 24 lecturers from R. Macedonia who had been elected assistant professors in the period from 1955-60, an additional group of 17 Macedonian lecturers had been elected for the first time in the period from 1961-63. Those 56 pioneers and coryphaei of medicine in R. Macedonia played important roles in the establishing and/or initial and further development of a number of the faculty departments/chairs, institutes and clinics within the newly established FM in Skopje in 1947 and in the first 15-20 years of its initial development, until 1960s and later.
Conclusion: The Skopje FM, founded in 1947, played a crucial role in the education of medical professionals, in improving the poor health status of the population and the overall further development of the health system and provision of health care to the population of R. Macedonia. The contribution of the third group of 17 lecturers from R. Macedonia in furthering the development of the Skopje FM, during the 1960s and later, was very important.