Nuevas tecnologías aplicadas al ocio terapéutico: Proyecto activa

3rd International Conference on the Elderly and New Technologies. III Jornadas Internacionales de Mayores y Nuevas Tecnologías.The combination of games and technology opens up new possibilities for entertainment and also enables integral development of individuals by enhancing highly valued skills in a range of contexts (school, work, therapy, etc). Likewise, it provides versatility in generating contents and accessing them in a natural way, which is particularly favourable for games of all ages. From aiju, in particular from the Department of Pedagogy (New Technologies and Recreational Therapy Area), work is carried out on recreational development activities to aid e-inclusion, as well as on improving the different capacities/skills (cognitive, physical, socio-emotional, etc.) for communities that are most excluded from the new technologies. Our team works using this media to bring the benefits of games, toys and new technologies closer to new users. An example of this is the activa research project: The development of a system of active therapy based on physical exercise that enables muscular strengthening in patients with Parkinson’s through recreation and the latest Information and Communication Technologies. The main aim of the activa project is to provide the base for development of an interactive game of highly recreational and therapeutic value based on a combination of physical exercise and advanced visual and communication technologies in order to promote socialisation and entertainment and to improve motor skills and muscular dexterity for people suffering from Parkinson’s disease.La combinación de juegos y tecnologías ofrece nuevas posibilidades de entretenimiento y permite, a su vez, el desarrollo integral de los individuos mejorando capacidades de gran valor para diferentes tipos de contextos (escolar, profesional, terapéutico, etc.). Así mismo, aporta versatilidad en la generación de contenidos y en el acceso a los mismos de forma natural, lo que favorece especialmente el juego para todas las edades. Desde aiju, y más concretamente desde el Departamento de Pedagogía (Área de Nuevas Tecnologías y Ocio Terapéutico), trabajamos en desarrollos lúdicos que contribuyen a la e-inclusión y a la mejora de diferentes capacidades/habilidades (cognitivas, físicas, socio-afectivas, etc.) de los colectivos más alejados del uso de las nuevas tecnologías. Nuestro equipo trabaja a través de este medio para acercar los beneficios del juego, los juguetes y las nuevas tecnologías a nuevos usuarios. Ejemplo de ello es el proyecto de investigación activa: desarrollo de un sistema de terapia activa basada en el ejercicio físico que permita el fortalecimiento muscular en enfermos de Parkinson a través del ocio y las nuevas tecnologías de la información y la Comunicación. El proyecto activa tiene como principal objetivo establecer la base para el desarrollo de un juego interactivo de alto valor lúdico y terapéutico basado en la combinación del ejercicio físico con tecnologías avanzadas de visualización y comunicación para la promoción de la socialización, el entretenimiento y la mejora de las habilidades motoras y musculares en personas con Parkinson

Evaluation of learning outcomes using an educational iPhone game vs. traditional game

In this paper, we present an initial study to determine the subject preferences for educational computer games for children, in which 150 education professionals participated. From the results of this first study, we have developed an iPhone game for transmitting knowledge as part of multiculturalism, solidarity and tolerance following established learning theories, several design principles, and the objectives and competences of the Spanish law for primary education. We also report on a second study to determine whether the iPhone game has better learning outcomes than a traditional game by analyzing the participation of 84 children ranging in age from 8 to 10 years old. The frequency of playing with consoles or computer games was also taken into account in this second study, and the worldwide trend of previous studies has been corroborated. For learning outcomes, the results did not show significant differences between the two groups. However, 96% of the children indicated that they would like to play with the iPhone game again, and 90% indicated that they preferred the experience with the iPhone game over the traditional one. From these results, we can conclude that the children achieved similar knowledge improvements using both the autonomous game (iPhone game) and the custom, guided game (traditional game). This could facilitate versatility in the learning process since the learning activity could be performed at any place and time without requiring supervision. Therefore, it could be a useful tool in the learning process and help teachers to fulfill students' training needs. 2013 Elsevier Ltd. All rights reserved.This work was funded by the Spanish APRENDRA project (TIN2009-14319-C02).Furió Ferri, D.; González Gancedo, S.; Juan, M.; Seguí, I.; Rando, N. (2013). Evaluation of learning outcomes using an educational iPhone game vs. traditional game. Computers and Education. 64:1-23. https://doi.org/10.1016/j.compedu.2012.12.001S1236

Flexible learning intinerary vs. linear learning itinerary

The latest video game and entertainment technology and other technologies are facilitating the development of new and powerful e-Learning systems. In this paper, we present a computer-based game for learning about five historical ages. The objective of the game is to reinforce the events that mark the transition from one historical age to another and the order of the historical ages. Our game incorporates natural human-computer interaction based on video game technology, Frontal Projection, and personalized learning. For personalized learning, a Flexible Learning Itinerary has been included, where the children can decide how to direct the flow of their own learning process. For comparison, a Linear Learning Itinerary has also been included, where the children follow a determined learning flow. A study to compare the two different learning itineraries was carried out. Twenty nine children from 8 to 9 years old participated in the study. The analysis of the pre-tests and the post-tests determined that children learned the contents of a game about historical ages. The results show that there were no statistically significant differences between the two learning itineraries. Therefore, our study reveals the potential of computer-based learning games as a tool in the learning process for both flexible and linear itinerariesThis work was funded by the Spanish APRENDRA project (TIN2009-14319-C02-01).Martín San José, JF.; Juan Lizandra, MC.; Gil Gómez, JA.; Rando, N. (2014). Flexible learning intinerary vs. linear learning itinerary. Science of Computer Programming. 88:3-21. https://doi.org/10.1016/j.scico.2013.12.009S3218

Effectiveness of the Epley’s maneuver performed in primary care to treat posterior canal benign paroxysmal positional vertigo: study protocol for a randomized controlled trial

BACKGROUND: Vertigo is a common medical condition with a broad spectrum of diagnoses which requires an integrated approach to patients through a structured clinical interview and physical examination. The main cause of vertigo in primary care is benign paroxysmal positional vertigo (BPPV), which should be confirmed by a positive D-H positional test and treated with repositioning maneuvers. The objective of this study is to evaluate the effectiveness of Epley’s maneuver performed by general practitioners (GPs) in the treatment of BPPV. METHODS/DESIGN: This study is a randomized clinical trial conducted in the primary care setting. The study’s scope will include two urban primary care centers which provide care for approximately 49,400 patients. All patients attending these two primary care centers, who are newly diagnosed with benign paroxysmal positional vertigo, will be invited to participate in the study and will be randomly assigned either to the treatment group (Epley’s maneuver) or to the control group (a sham maneuver). Both groups will receive betahistine. Outcome variables will be: response to the D-H test, patients’ report on presence or absence of vertigo during the previous week (dichotomous variable: yes/no), intensity of vertigo symptoms on a Likert-type scale in the previous week, total score on the Dizziness Handicap Inventory (DHI) and quantity of betahistine taken. We will use descriptive statistics of all variables collected. Groups will be compared using the intent-to-treat approach and either parametric or nonparametric tests, depending on the nature and distribution of the variables. Chi-square test or Fisher’s exact test will be conducted to compare categorical measures and Student’s t-test or Mann–Whitney U-test will be used for intergroup comparison variables. DISCUSSION: Positive results from our study will highlight that treatment of benign paroxysmal positional vertigo can be performed by trained general practitioners (GPs) and, therefore, its widespread practice may contribute to improve the quality of life of BPPV patients. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT01969513

Effectiveness of the Epley's maneuver performed in primary care to treat posterior canal benign paroxysmal positional vertigo: study protocol for a randomized controlled trial

Background: Vertigo is a common medical condition with a broad spectrum of diagnoses which requires an integrated approach to patients through a structured clinical interview and physical examination. The main cause of vertigo in primary care is benign paroxysmal positional vertigo (BPPV), which should be confirmed by a positive D-H positional test and treated with repositioning maneuvers. The objective of this study is to evaluate the effectiveness of Epley's maneuver performed by general practitioners (GPs) in the treatment of BPPV. Methods/Design: This study is a randomized clinical trial conducted in the primary care setting. The study's scope will include two urban primary care centers which provide care for approximately 49,400 patients. All patients attending these two primary care centers, who are newly diagnosed with benign paroxysmal positional vertigo, will be invited to participate in the study and will be randomly assigned either to the treatment group (Epley's maneuver) or to the control group (a sham maneuver). Both groups will receive betahistine. Outcome variables will be: response to the D-H test, patients' report on presence or absence of vertigo during the previous week (dichotomous variable: yes/no), intensity of vertigo symptoms on a Likert-type scale in the previous week, total score on the Dizziness Handicap Inventory (DHI) and quantity of betahistine taken. We will use descriptive statistics of all variables collected. Groups will be compared using the intent-to-treat approach and either parametric or nonparametric tests, depending on the nature and distribution of the variables. Chi-square test or Fisher's exact test will be conducted to compare categorical measures and Student's t-test or Mann-Whitney U-test will be used for intergroup comparison variables. Discussion: Positive results from our study will highlight that treatment of benign paroxysmal positional vertigo can be performed by trained general practitioners (GPs) and, therefore, its widespread practice may contribute to improve the quality of life of BPPV patients

Encuesta de hábitos en la demanda de urgencias de pediatría durante el período de desescalada COVID-19

Objective: To understand how population’s adaptation during de-escalation phase after SARS-CoV-2 pandemic and their demands of pediatric emergency services in Hospital Universitario Valle Hebrón. Methodology: Observational, descriptive and transversal study made at the cited hospital between May and June 2020. Data were obtained through a self-administered ad hoc questionnaire. The age of the children, priority levels in caregiving, visit’s motive, alternative assistance resources and opinions about protective measures established were gathered. Results: The demands of assistance decreased during May and June 2020 compared with the same months of the previous year (2019). There is a 3.5% increase in level 3 priority attention patients. The main causes of visits were fever and digestive problems. 85% of surveyed patients received medical attention on several occasions during the year. 80% of respondents needed to attend emergency services but they did not go because fear of contagion. 62% prioritized other resources before attending to the hospital. The most used sanitary resource were centers of Primary Care. More than 80% of the respondents did not perceive any dehumanization in their attention and 40% adopted all safety measures. Discussion: There has been a decrease in Pediatric Emergency assistance during de-escalation period, what has originated an increase in the use of other healthcare resources. Organizational and functional changes adopted as protective measures have not been perceived as reasons for dehumanization in patient’s care.Objetivo: Conocer cómo la población se adapta durante la fase de desescalada, después de la pandemia por SARS-CoV-2 en la demanda del Servicio de Urgencias Pediátricas del Hospital Universitario Valle Hebrón. Métodos: Estudio observacional, descriptivo y transversal realizado en el citado hospital entre mayo y junio de 2020. Se recogieron datos sobre la edad de los pacientes, nivel de prioridad de atención, motivo de consulta, recursos asistenciales alternativos utilizados y opinión sobre medidas de protección adoptadas. La información se recogió mediante una encuesta autoadministrada de elaboración propia. Resultados: Disminuyó la demanda en la asistencia durante los meses de mayo y junio del 2020 respecto a los mismos meses el año anterior (2019). Existe un aumento del 3,5% de pacientes con nivel 3 de prioridad de atención. Los motivos principales de consulta fueron fiebre y problemas digestivos. El 85% de los pacientes encuestados han sido visitados en varias ocasiones durante el último año en el citado hospital. El 80% de los encuestados tuvieron la necesidad de venir a urgencias durante el confinamiento y no lo hicieron por miedo al contagio. El 62% priorizaron otros recursos antes de acudir al hospital. El recurso sanitario más utilizado fue el Centro de Atención Primaria vía telefónica/presencial. Conclusiones: Durante el periodo de desescalada ha habido una disminución de la asistencia a urgencias pediátricas, recurriendo a otros recursos asistenciales. Los cambios organizativos y funcionales adoptados como medidas de protección no han sido percibidos como motivos de deshumanización en la atención

Disability perceived by primary care patients with posterior canal benign paroxysmal positional vertigo

Background: Benign paroxysmal positional vertigo (BPPV) is the most common cause of vertigo. Little is known on how posterior canal BPPV affects health-related quality of life in patients diagnosed and treated at primary care facilities or on whether patients with subjective and objective disease perceive the effects differently. This study was designed to describe how patients diagnosed with posterior canal BPPV in primary care perceive disability. Methods: Cross-sectional descriptive study performed at two urban primary care centers. Participants were patients aged 18 years or older with suspected posterior canal BPPV recruited for baseline evaluation in a clinical trial on the effectiveness of the Epley maneuver in primary care. The recruitment period was from November 2012 to January 2015. Perceived disability was evaluated using the Dizziness Handicap Inventory - Screening version (DHI-S). Other variables collected were age and sex, a history or diagnosis of anxiety or depression, treatment with antidepressants and/or anxiolytics, and results of the Dix-Hallpike (DH) test, which was considered positive when it triggered vertigo with or without nystagmus and negative when it triggered neither. Results: The DH test was positive in 134 patients, 40.30% of whom had objective BPPV (vertigo with nystagmus). The median age of the patients was 52 years (interquartile range [IQR], 39.00-68.50 years) and 76.1% were women. The median total score on the DHI-S was 16 out of 40 (IQR, 8.00-22.00). Scores were higher (greater perceived disability) in women (p < 0.001) and patients with subjective BPPV (vertigo without nystagmus) (p = 0.033). The items perceived as causing the greatest disability were feeling depressed (67.1%) and worsening of the condition on turning over in bed (88%). Conclusions: Patients diagnosed with posterior canal BPPV in primary care perceive their condition as a disability according to DHI-S scores, with higher levels of disability reported by women and patients with subjective BPPV. Feelings of depression and turning over in bed were associated with the greatest perceived difficulties. Trial registration: ClinicalTrials.gov Identifier: NCT01969513. Retrospectively registered. First Posted: October 25, 2013. https://clinicaltrials.gov/ct2/show/NCT0196951