Güleser Güney Yılmaz

Background: This study aimed to examine parents’ awareness of health promotion and preventive care in childhood cancer and to investigate whether children’s HR-QoL (Health-Related Quality of Life) differs according to parental awareness items. Methods: This prospective cross-sectional study included 76 parents of children aged 0 to 18 years diagnosed with cancer and followed at a pediatric hematology/oncology clinic. Parents completed a Demographic Information Form, the Barratt Measure of Social Status, the Pediatric Quality of Life Inventory™ (PedsQL™) 3.0 Cancer Module, and a researcher-developed Health Promotion and Preventive Care Awareness Questionnaire. Differences in PedsQL total scores and socioeconomic status across awareness categories were analyzed using Mann–Whitney U and Kruskal–Wallis tests. Results: While most parents believed that cancer-related problems can be treated (92.1%) and prevented (76.3%), awareness of practical preventive care components was limited. Only 27.6% of parents reported knowing childhood cancer risk factors, 22.4% knew recommended physical activity levels, and 6.6% were aware of their child’s appropriate body mass index. Higher PedsQL total scores were observed among parents who believed cancer is preventable or treatable, knew recommended physical activity levels, and perceived their child as physically active ( P < 0.05). Socioeconomic status differed only for awareness of appropriate body mass index and physical activity recommendations. Discussion: These findings highlight the importance of behavior-oriented health promotion alongside disease-related education in pediatric oncology.

Background: School participation is frequency and involvement from person–environment transactions, not diagnosis, per the International Classification of Functioning, Disability and Health (ICF) and the family of participation‐related constructs (fPRC). In this framework, the environmental and child determinants of school participation (e.g., school routines and peer/teacher context; self‐regulation, activity competence and preferences) interact bidirectionally to shape everyday participation. However, many interventions still target isolated impairments, overlooking coordinated changes in capacities and context. Grounded in this contemporary view, this study aimed to investigate the impact of an immersive virtual reality (IVR) intervention on school participation–related constructs in children with ADHD. Methods: The study included 92 children aged between 7 and 12 years diagnosed with ADHD. Participants were randomly assigned into intervention ( n = 46) and control ( n = 46) groups. Both groups completed the School Participation Questionnaire (SPQ) and Bruininks–Oseretsky Test of Motor Proficiency Test 2 Brief Form (BOT2‐BF) assessment prior to the intervention. The intervention group received an IVR intervention program twice a week for 8 weeks. During this period, the control group did not receive additional therapy. At the end of the 8 weeks, the SPQ was readministered to both groups. Results: Baseline characteristics showed no significant differences in SPQ and BOT2‐BF results between groups, confirming homogeneity prior to intervention. Following the intervention, the study group demonstrated significant improvements across all domains of the SPQ (doing, being, symptoms and environment), with large effect sizes for SPQ total score ( d = 0.978) and subdomains ( d = 0.452–0.910). In contrast, the control group showed no improvements and even declines in subdomains. Post‐intervention, between‐group comparisons revealed significant differences favouring the study group across all domains ( p < 0.001), with large effect sizes ( d = 0.878–1.165). Conclusions: Findings suggest that the IVR program was associated with improvements in teacher‐rated environmental and child determinants of school participation (SPQ domains) in children with ADHD.

Introduction: Children with attention‐deficit/hyperactivity disorder (ADHD) often experience difficulties in academic performance, completing classroom tasks, engaging in social and emotional interactions, which can lead to limited participation. These challenges are most evident in everyday environments such as home and school, where children spend much of their time. Given the critical role of the school environment, evaluating participation in this context is essential. The School Participation Questionnaire (SPQ) assesses school participation, and this study aims to adapt the SPQ for Turkish children and investigate its validity and reliability in children with ADHD. Participants and Methods: The study included 250 children diagnosed with ADHD (study group) receiving treatment in the occupational therapy department and 100 undiagnosed children (control group). Participants were aged 7–12 years. The SPQ was administered to both groups to assess school participation. Assessments were completed by 12 classroom teachers, each with a minimum of 5 years of professional experience. To evaluate test–retest reliability, 100 children from the ADHD group completed the SPQ again 2 weeks after the first assessment. Results: The control group demonstrated significantly higher school participation scores across all SPQ subscales compared with the ADHD group ( p < 0.001). Internal consistency of the Turkish SPQ was high, with Cronbach's α values ranging from 0.82 to 0.91 and McDonald's ω values ranging from 0.83 to 0.92 across subscales. Test–retest reliability was strong, with ICC ranging from 0.84 to 0.92. Receiver operating characteristic (ROC) analysis indicated acceptable to good discriminative ability across subscales (AUC = 0.705–0.808). Conclusion: The Turkish version of the School Participation Questionnaire is a valid and reliable tool for assessing school participation in children with ADHD, offering valuable insights for interventions aimed at improving their school engagement.

To evaluate physical activity and balance in children with OBPP (Obstetric Brachial Plexus Palsy) and investigate the relationship between these variables. The study included 58 children with OBPP and 58 healthy controls aged 7-12 years. Physical activity was measured using the Physical Activity Questionnaire for Children (PAQ-C). Dynamic balance was evaluated with the Y Balance Test (YBT), and static balance was assessed using the One-Leg Standing (OLS) test. Outcome measures included scores from these assessments and group comparisons. Children with OBPP showed significant deficits in dynamic balance, particularly in the posterolateral direction (p < 0.05), while static balance and physical activity levels did not differ significantly between groups (p > 0.05). Logistic regression identified the left posterolateral balance score as a significant positive predictor for group classification (p < 0.001). Children with OBPP experience significant impairments in dynamic balance, emphasizing the need for targeted interventions to address postural control and lateral stability. Comprehensive assessments incorporating physical activity and balance measures are crucial for developing effective rehabilitation strategies.

Individuals with advanced cancer face profound daily disruptions, yet research specifically focusing on their personal participation experiences remains limited. This study aimed to explore the daily life experiences and participation perceptions of advanced-stage cancer patients receiving palliative care. Semi-structured interviews were conducted with eight patients, and data were analyzed using reflexive thematic analysis. Four themes were identified: (1) dependence in activities of daily living and loss of function, (2) altered occupational identity and social participation restrictions, (3) occupational disruption and longing for the past (4) the role of support systems and care services. Participants emphasized that social isolation, unmet rehabilitation needs, and the loss of meaningful roles affected them as much as physical symptoms. The findings suggest that maintaining occupational identity is a vital need, distinct from mere functional ability. Consequently, there is an urgent need for patient-centered rehabilitation services within palliative care settings to address these fundamental humanistic needs.

Amaç: Bu tanımlayıcı çalışmada, kanser tanısı almış çocuk ve adölesanların aktivite performansını etkileyen katılım kısıtlılıklarının incelenmesi amaçlandı.Yöntem: Çalışmaya kanser tanısı almış ve bir yıldan uzun süredir tedavi gören 62 (yaş ortalaması 10,07± 3,83 yıl) ve sağlıklı 54 (yaş ortalaması 9,29±3,43 yıl) çocuk ve adölesan katıldı. Aktivite performansını etkileyen katılım kısıtlılıklarının incelenmesi için Pediatrik Veri Toplama Aracı (PVTA) kullanıldı. Kanser tanısı almış ve sağlıklı çocukların ve adölesanların katılım düzeyleri arasındaki fark düzeyini karşılaştırmak için Mann-Whitney U testi kullanıldı. Kanser tanısına göre katılım düzeylerini karşılaştırmak için ise Kruskal Wallis kullanıldı.Bulgular: Çalışmaya katılan çocukların %14,5’i akut lenfoblastik lösemi, %21’i lenfoma ve %64,5’i beyin tümörü tanısı almıştı. Kanser tanısı alan ve sağlıklı adölesanlar arasında PVTA testinin tüm alt parametreleri arasında anlamlı fark bulundu (p=0,001). Kanser türlerine göre global fonksiyon ve rahatlık (p=0,020), üst ekstremite fonksiyonu(p=0,001) ve fiziksel fonksiyon/spor parametreleri arasında anlamlı fark bulundu (p=0,006) özellikle beyin tümörü tanılı çocukların en fazla fonksiyonel sınırlılığa sahip olduğu bulundu. Transfer & mobilite(p=0,847), rahatlık /ağrısızlık (p=0,020) ve mutluluk & memnuniyet (p=0,061) parametrelerinde anlamlı fark bulunamadı. Sonuç: Kanser tanısı alan çocuklarda tanı ve tedavi süreçlerine bağlı olarak uzun dönemde katılım kısıtlılıkları ortaya çıkmaktadır. Bu kısıtlılıklar özellikle fiziksel boyutta olmakla birlikte kanserin türüne göre değişkenlik göstermektedir. Bu süreçte çocukların ve adölesanların katılım kısıtlılıkları ve ilişkili nedenler detaylıca inceleyen ileri çalışmalar önerilmektedir.

Host factors may affect immune-related adverse events (irAE) during immune checkpoint inhibitor (ICI) therapy. We systematically reviewed studies on body composition (BMI, CT/DXA-defined sarcopenia, sarcopenic obesity) and physical activity (PA) in relation to irAE incidence and severity in ICI-treated adults. PubMed, Embase, Scopus, and Web of Science were searched from inception to 15 December 2024. Eligible studies assessed baseline body composition and/or PA in relation to irAE. Risk of bias was evaluated using the NIH tool and QUIPS. Findings were synthesized using structured narrative methods. Seven studies (2,590 patients) were included. Two large cohorts found overweight/obese patients had higher odds of any-grade irAE (OR = 1.4-1.5); one disease-specific cohort found no association. One CT-based study showed higher irAE risk with sarcopenia (OR = 2.64) and more with sarcopenic obesity (OR = 5.50). Two studies on PA were conflicting: one found higher PA reduced severe irAE risk (OR = 0.19), another found no association. Body composition and PA may help predict irAE in ICI-treated patients. Evidence is low to very low certainty: overweight/obesity may increase toxicity risk, higher PA may lower risk, and evidence for sarcopenia is limited. Standardized prospective studies are needed to confirm these associations. : https://www.crd.york.ac.uk/PROSPERO identifier is CRD420251084119.

This study aimed to adapt the Social Participation Restrictions Questionnaire (SPaRQ) into Turkish (SPaRQ-T) and assess its validity and reliability for evaluating participation restrictions in adults with hearing loss. A cross-sectional, multicenter study was conducted with 278 individuals with hearing loss who had used hearing aids for at least one year. The adaptation process followed international guidelines, including back-translation and expert evaluation. Rasch analysis, test-retest reliability, and concurrent validity assessments were performed.The SPaRQ-T demonstrated strong internal consistency (Cronbach’s α = 0.926 for Social Behaviors and 0.871 for Social Perceptions) and test-retest reliability (ICC = 0.928 and 0.773, respectively). Rasch analysis confirmed the unidimensionality of both subscales and supported good model fit. The SPaRQ-T is a reliable and valid instrument for assessing social participation restrictions in Turkish-speaking adults with hearing loss. It provides a comprehensive evaluation of the social and emotional dimensions of participation and can be used in clinical and research settings.

Introduction Occupational imbalance and its effects in adolescents have not been adequately investigated. Objectives This study aimed to examine exam anxiety levels in adolescents according to different education levels and the relationship between occupational balance and participation levels. Methods Students' levels of exam anxiety were assessed using the Multidimensional Exam Anxiety Scale (MTAS); occupational balance was evaluated using the Adolescent Occupational Balance Scale (AOB-S); and their levels of participation were measured using the Child and Adolescent Scale of Participation (CASP). Results While there was a significant difference in MTAS and A-OBS scores according to education level (p0.05). There was a negative relationship between students' exam anxiety levels and their professional balance levels, Home Participation, School Participation and Home and Social Activities (p<0.05). Conclusion The balance between daily occupations and participation levels of individuals with high exam anxiety are affected.