Trastorno Somatosensorial en niños con Trastornos por Déficit de Atención con Hiperactividad.

Introducción: El estudio de los trastornos por déficit de atención (ADHD) se ha centrado en la falta de control inhibitorio como déficit primario, aunque su fisiopatología también se ha relacionado con la corteza somatosensorial. El objetivo de este trabajo fue conocer si existe un trastorno para la discriminación sensorial táctil y praxis en los niños con ADHD y si éste es similar en los subtipos inatento (ADHD-I) y combinado (ADHD-C). Método: los participantes fueron 74 niños entre 7 y 11 años: 43 niños neurotípicos; 31 niños con TDAH . Se utilizaron diferentes pruebas neuropsicológicas para valorar la percepción táctil y praxis: subpruebas del WISC-III-R de aritmética, vocabulario, cubos y rompecabezas; una tarea computarizada EMIC; Cubos de Corsi; subprueba de localización de puntos del VOSP; subprueba de Cierre Visual y Movimiento de Manos de la K-ABC; pruebas de Grafestesias de Luria-Nebraska Neuropychological Battery: Children´s Revision ; pruebas de renocimiento de dedos de Reitan; subpruebas de acción y el Mapa del Zoo del BADS; y la Figura Compleja de Rey . Resultados: Los resultados mostraron diferencias estadísticamente significativas entre ambos grupos en identificación de dedos, gnosis digital, grafestesias y praxis. Conclusiones: Los niños con ADHD realizaron peor las tareas de reconocimiento de dedos, grafestesias, praxis motora, copia de figuras, planificación de la acción y secuenciación de la mismas, que podría afectar al aprendizaje y la realización de tareas que requieren destrezas motoras finas tales como escribir y otras actividades manuales.Universidad de Málaga. Campus de Excelencia Internacional Andalucía Tech

Well-Being, Self-Efficacy and Independence in older adults: A Randomized Trial of Occupational Therapy

Objective: The main objective of the research was to analyze whether there were differences in the effects of individual and group occupational therapy (OT) treatment on psychological well-being, self-efficacy and personal independence. Method: A randomized clinical trial (N = 70; age = 85 years, SD = 4) comparing individual versus group occupational therapy treatment for 6 months was conducted. The evaluation was performed with the Barthel Index (Personal Independence), the Ryff Wellness Index (Well-being), the Global Self-Efficacy Scale (Self-efficacy) and the Geriatric Depression Scale (Affective state Scale). Results: Results showed a decrease in individual treatment scores in the variables autonomy, environmental mastery, personal growth and purpose in life, reflecting worse self-acceptance and negative well-being as well as a lower ability to maintain stable relationships. By contrast, group treatment users maintained more stable social relationships and exhibited a greater ability to resist social pressure, to develop their potential skills and to define their goals in life. There were statistically significant differences in overall self-efficacy (p < 0.001), emotional well-being (p < 0.001) and personal independence (p = 0.013), with better scores in group versus individual treatment. Conclusions: Group occupational therapy interventions in older adults could be the treatment of choice in people with depressed state, improving their emotional well-being, sense of self-efficacy and level of personal independence in basic activities of daily livin

Self-Regulation in Children with Neurodevelopmental Disorders “SR-MRehab: Un Colegio Emocionante”: A Protocol Study

Self-regulation refers to the ability to control and modulate behavior, and it can include both emotional and cognitive modulation. Children with neurodevelopmental disorders may show difficulties in self-regulation. The main objective of this study is to improve self-regulation skills in children between 6 and 11 years of age with neurodevelopmental disorders. Methodology: A randomized controlled trial will be conducted with the use of “SR-MRehab: Un colegio emocionante”, based on a non-immersive virtual reality system where virtual objects can be managed by children in a natural way using their hands. Children will be recruited from several schools of Granada (Spain) and they will be randomly allocated to two groups. An assessment will be conducted before and after the intervention and 24 weeks after the end of the intervention process. The experimental group will receive the intervention using virtual reality. The control group will receive a standard self-regulation program. Both interventions will be performed once a week for a total of 10 sessions. Changes in self-regulation, as well as the acceptability of technology with the use of SR-MRehab, will be evaluated. The results will be published and will provide evidence regarding the use of this type of intervention in children with neurodevelopmental disorders. Trial registration: Registered with code NCT04418921.Programa Estatal de Generacion de Conocimiento y Fortalecimiento Cientifico y Tecnologico del Sistema de I+D+i y del Programa Estatal de I+D+i Orientada a los Retos de la Sociedad, del Plan Estatal de Investigacion Cientifica y Tecnica y de Innovacion 2017 PID2019-108915RB-I00Teaching innovation project of the Degree in Occupational Therapy of the University of Granada about Emotional Skills 19-7

Family Caregivers’ Experiences with Tele-Rehabilitation for Older Adults with Hip Fracture

This research was funded by EIT Health (210752).Background: There is a knowledge gap for implementing tele-rehabilitation (telerehab) after hip fracture. We recently conducted a clinical trial (ClinicalTrials.gov Identifier: NCT02968589) to test a novel online family caregiver-supported rehabilitation program for older adults with hip fracture, called @ctivehip. In this qualitative substudy, our objective was to use semi-structured interviews to explore family caregivers experience with the telerehab program. Methods: Twenty-one family caregivers were interviewed between three and six months after the older adults completed @ctivehip. One occupational therapist with research and clinical experience, but not involved in the main trial, conducted and transcribed the interviews. We conducted a multi-step content analysis, and two authors completed one coding cycle and two recoding cycles. Results: Family caregivers who enrolled in @ctivehip were satisfied with the program, stated it was manageable to use, and perceived benefits for older adults’ functional recovery after hip fracture. They also suggested improvements for the program content, such as more variety with exercises, and increased monitoring by health professionals. Conclusions: This work extends existing literature and generates research hypotheses for future studies to test telerehab content and program implementation.EIT Health 21075

Assessment of Sensory Processing and Executive Functions at the School: Development, Reliability, and Validity of EPYFEI-Escolar

The authors thank the parents and teachers for their participation in this study. Especially to the teachers of the CEIP Ntra. Sra. Del Prado de Talavera de la Reina, Toledo (Spain) and CEIP Parque de las Infantas, Granada (Spain).The aim of this study was to determine the psychometric properties of the Assessment of Sensory Processing and Executive Functions at the School (EPYFEI-Escolar), a questionnaire designed to assess the sensory processing and executive functions as underlying processes for school participation. The total sample consisted of 536 children aged between 3 and 11 years old who lived in Spain. A total of 103 teachers completed the questionnaire. An exploratory factor analysis was conducted, which showed five main factors: (1) initiation, organization, execution, and supervision of the action; (2) inhibitory control; (3) sensory processing; (4) emotional self-regulation and play; and (5) self-competence. Some of these factors were similar to those found in the EPYFEI for parents in the home context. The reliability of the analysis was high, both for the whole questionnaire and for the factors it is composed of. The results provide evidence of the potential usefulness of the EPYFEI-Escolar in school contexts for determining academic needs and difficulties of children; moreover, this tool can also be used to plan intervention programs in the school environment according to the needs of each child and school.This study was supported by University of Málaga

Play in Children with Neurodevelopmental Disorders: Psychometric Properties of a Parent Report Measure ‘My Child’s Play’

Play is essential in childhood, allowing for a positive trend in development and learning. Health professionals need useful tools to assess it, especially in the case of children with neurodevelopmental disorders. The aim of this study was to validate and cross-culturally adapt the My Child’s Play questionnaire and to find out if this instrument allows us to differentiate the play of children with neurodevelopmental disorders from the play of children with neurotypical development. A total of 594 parents completed the questionnaire. A confirmatory factor analysis was conducted, which showed a similar structure to the English version: (1) executive functions; (2) environmental context; (3) play characteristics; and (4) play preferences and interpersonal interactions. The reliability of the analysis was high, both for the whole questionnaire and for the factors it comprises. The results provide evidence of the potential usefulness of the My Child’s Play questionnaire for determining play needs and difficulties of children; moreover, this tool can also be used to plan intervention programs according to the needs of each child and family

Development, reliability, and validity of EPYFEI-Escolar

The aim of this study was to determine the psychometric properties of the Assessment of Sensory Processing and Executive Functions at the School (EPYFEI-Escolar), a questionnaire designed to assess the sensory processing and executive functions as underlying processes for school participation. The total sample consisted of 536 children aged between 3 and 11 years old who lived in Spain. A total of 103 teachers completed the questionnaire. An exploratory factor analysis was conducted, which showed five main factors: (1) initiation, organization, execution, and supervision of the action; (2) inhibitory control; (3) sensory processing; (4) emotional self-regulation and play; and (5) self-competence. Some of these factors were similar to those found in the EPYFEI for parents in the home context. The reliability of the analysis was high, both for the whole questionnaire and for the factors it is composed of. The results provide evidence of the potential usefulness of the EPYFEI-Escolar in school contexts for determining academic needs and difficulties of children; moreover, this tool can also be used to plan intervention programs in the school environment according to the needs of each child and school

A New Tool for Assessment of Professional Skills of Occupational Therapy Students

The assessment of the acquisition of professional skills is an essential process in occupational therapy students. Until now, there has been no standardized and validated instrument for evaluating these skills in Spanish occupational therapy students. This study reports the development and testing of the psychometric properties of the professional skills in students of occupational therapy during their practical training. Methods: A new instrument was developed to assess the professional skills of occupational therapy students, called CPTO. A total of 69 occupational therapists participated in evaluating 295 occupational therapy students from the University of Granada, between the 2018 and 2021 academic years. Results: Of a total of 79 items, the factor analysis yielded a final solution of 33 items, which explains 70.22% of the variance with the following three dimensions: (1) self-appraisal and professional responsibility (α = 0.951); (2) communication skills and delivering intervention (α = 0.944); and (3) clinical reasoning for assessing and planning the intervention (α = 0.947). The instrument allows students with low, medium, high and excellent clinical skills to be differentiated according to the cutting points established by the quartiles. Conclusion: the instrument has good psychometric properties, and is a useful tool to assess professional competencies in occupational therapy students during their practice placement education.Unidad de Calidad Docente from University of Granad

Errors of prescription, transcription and administration according to pharmacological group at hospital

Fundamentos: La mayoría de los estudios sobre errores de medicación se centran sólo en hallar prevalencias globales por pacientes, por fases del proceso o según un determinado grupo de fármacos, por lo que se da una visión parcial. El objetivo de este trabajo fue analizar y comparar la prevalencia de errores en prescripción, trascripción y administración y sus repercusiones clínicas en los principales grupos farmacológicos en un hospital de tercer nivel. Métodos: Estudio de inclusión prospectiva con observación directa disfrazada de la administración de medicamentos y comparación con prescripciones médicas y trascripciones presentes en la historia clínica. Los errores de medicación y sus efectos fueron clasificados por consenso de expertos. Se calcularon las diferentes tasas de errores y sus repercusiones con sus intervalos de confianza al 95% y se compararon utilizando la prueba de Chi cuadrado. Resultados: Se estudiaron 5578 fármacos prescritos, aunque se observó sólo la administración de 1879 dosis. Se encontraron un total de 117 grupos farmacológicos, donde el 50,1% (2795) de las prescripciones pertenecían sólo a 9 tipos. La prevalencia de errores de prescripción global fue de 4,79%, de trascripción de 14,61% y de administración 9,32%. Por grupos, las Heparinas tuvieron una menor prevalencia de errores en la fase de prescripción y en la de trascripción. Se obtuvo mayor número de errores en trascripción de los Analgésicos como el Paracetamol y el Metamizol y de los Laxantes, y una prevalencia de errores en administración superior al resto en Analgésicos como el Paracetamol y en los Inhibidores de la Bomba de Protones. Las repercusiones clínicas de los errores de medicación en la fase de prescripción fueron parecidas entre grupos farmacológicos. En trascripción Heparinas y Corticoides presentaron errores más graves, mientras que en la administración fueron los IECAS y las Estatinas (p<0,05). Conclusiones: Los fármacos considerados clásicamente como de alto riesgo presentaron menos errores (Heparinas, Corticoides), pero más graves. Los fármacos con mayor prevalencia de errores fueron los Analgésicos (Paracetamol) y los Inhibidores de la Bomba de Protones, pero tuvieron una menor repercusión clínica.Background: Most studies of medication errors are focused only on finding global prevalence by patients, by phases or according to a certain group of medication. It’s just a partial view of the problem. To analyze and compare the prevalence of errors in prescription, transcription and administration, and their clinical repercussions in different pharmacological groups in a third-level hospital. Methods: Prospective inclusion study with direct observation disguised as medication administration and comparison with prescriptions and transcriptions at history clinical. The ME and its clinical effects were classified by expert consensus. We calculated the different error rates and their repercussions with their confidence intervals at 95%. Then we compared using Chi-square tests. Results: We studied 5,578 prescribed drugs and we observed the administration of 1,879 doses. A total of 117 different pharmacological groups were found, although 50.1% of the prescriptions belonged to only 9 types. We found heparins had a lower prevalence of errors in prescription and transcription and aspirin also had a lower prevalence of prescription errors. On the opposite side, a greater number of errors were obtained in transcription of Paracetamol, Metamizole and Laxatives and a prevalence of errors in the administration phase superior to rest in Paracetamol and in Proton Pump Inhibitors. The impact of medication error increased as medication process progressed, being similar between groups in prescription. In transcription, Heparins and Corticosteroids presented more serious errors. In administration, medication error are more serious for Diuretics and Statins (p <0.05). Conclusions: Drugs considered potentially dangerous present fewer errors (Heparins, Corticoids), but more serious. Drugs with the highest prevalence of errors were Paracetamol and Inhibitors of proton pump but had a lower impact.Este estudio fue objeto de una beca FIS (Fondo de Investigación Sanitaria) con número PI051524, desarrollado durante 2 año

A Systematic Review and Meta-Analysis

Abstract: This review aims to evaluate the effectiveness of virtual reality-based interventions (VRbased interventions) on cognitive deficits in children with attention deficit hyperactivity disorder (ADHD). A systematic review and meta-analysis were performed according to the PRISMA statement and the Cochrane Handbook guidelines for conducting meta-analyses. The Grading of Recommendations, Assessment, Development and Evaluation (GRADE) was used to assess the quality of the evidence. Clinical trials published up to 29 October 2020, were included. The meta-analysis included four studies, with a population of 125 participants with ADHD. The magnitude of the effect was large for omissions (SMD = −1.38; p = 0.009), correct hits (SMD = −1.50; p = 0.004), and perceptual sensitivity (SMD = −1.07; p = 0.01); and moderate for commissions (SMD = −0.62; p = 0.002) and reaction time (SMD = −0.67; p = 0.03). The use of VR-based interventions for cognitive rehabilitation in children with ADHD is limited. The results showed that VR-based interventions are more effective in improving sustained attention. Improvements were observed in attentional vigilance measures, increasing the number of correct responses and decreasing the number of errors of omission. No improvements were observed in impulsivity responses