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The main objective of this protocol is to understand the effectiveness of the use of a mobile application (OcupApp) to generate a personal self-analysis about meaningful activities in a population of adults aged between 50 and 70 years with low or moderate depression/anxiety. A randomised study will be carried out comparing the effects of the use of the OcupApp application with a control intervention on health-related quality of life, mental health, frequency of participation on meaningful activities, and perceived occupational balance. This is the first study to use occupational self-analysis in m-health to improve occupational balance, mental health, frequency of participation in meaningful activities and health-related quality of life. The app was co-created with a population whose characteristics are similar to those of the target users, and it was tested in both the intervention itself and the presentation, thus it is expected to be effective. Trial Registration Number: Clinical Trial B1-2020_25 IMPLICATIONS FOR REHABILITATION: This is the first study to evaluate the impact of an app on occupational participation in people older than 50 years with mild-moderate anxiety and/or depression Introducing an occupational self-analysis app that helps people become aware of their occupations can improve health-related quality of life, mental health, frequency of participation on meaningful activities, and perceived occupational balance. OcupApp will allow people to go under occupational self-analysis process from home or any other place, maintaining the principles of the original programme. [ABSTRACT FROM AUTHOR]

Abstract Background The spread of COVID-19 has affected people’s daily lives, and the lockdown may have led to a disruption of daily activities and a decrease of people’s mental health. Aim To identify correlates of adults’ mental health during the COVID-19 lockdown in Belgium and to assess the role of meaningful activities in particular. Methods A cross-sectional web survey for assessing mental health (General Health Questionnaire), resilience (Connor-Davidson Resilience Scale), meaning in activities (Engagement in Meaningful Activities Survey), and demographics was conducted during the first Belgian lockdown between April 24 and May 4, 2020. The lockdown consisted of closing schools, non-essential shops, and recreational settings, employees worked from home or were technically unemployed, and it was forbidden to undertake social activities. Every adult who had access to the internet and lived in Belgium could participate in the survey; respondents were recruited online through social media and e-mails. Hierarchical linear regression was used to identify key correlates. Results Participants (N = 1781) reported low mental health (M = 14.85/36). In total, 42.4% of the variance in mental health could be explained by variables such as gender, having children, living space, marital status, health condition, and resilience (β = −.33). Loss of meaningful activities was strongly related to mental health (β = −.36) and explained 9% incremental variance (R2 change = .092, p

Background. Participation in meaningful activities contributes to individual well-being, so it is essential to have specific evaluation tools that can assess this complex construct Objectives. To create a Spanish version (EDIAS) of the Engagement in Meaningful Activities Survey (EMAS) by following best practices in instrument translation. Methodology. The translation was made according to the Principles of Good Practice for the translation and cultural adaptation of patient-reported outcome measures. Results. The adaptation process involved a meticulous analysis of item equivalence by the expert committee and an expert on the EMAS. Also, harmonization with other translated versions and a cognitive debriefing was carried to assess comprehensibility. Conclusion. Following best practice, this study has developed the EDIAS, a tool for evaluating participation in meaningful activities adapted to the Spanish context.

AbstractIntroduction: To carry out meaningful activities contributes to individual wellbeing, so it is essential to have specific evaluation tools that can assess this difficult construct. The objective of this study was to validate a Spanish version (EDIAS) of the Engagement in Meaningful Activity Survey (EMAS) in health care students.Methods: This study was a validation study using a cross-sectional survey design. The empirical application of the instrument was carried out to obtain quantitative evidence on the internal consistency, the convergent validity and test-retest reliability.Results: The psychometric properties of the EDIAS were assessed in a sample of 98 Spanish college students. The EDIAS demonstrated high internal consistency as well as convergent validity, correlating it with measures of quality of life related to health and presence of meaning in life. The EDIAS showed similar test-retest reliability to the original English version of EMAS in older adults (r = .502; p < .001).Discussion: The results indicate that EDIAS is reliable and valid for assessment of meaningful activities in Spanish-speaking populations. [ABSTRACT FROM AUTHOR]

Cushing disease (CD) is the main cause of endogenous Cushing syndrome (CS) and is produced by an adrenocorticotropic hormone (ACTH)-producing pituitary adenoma. Its relevance in pediatrics is due to the retardation of both growth and developmental processes because of hypercortisolism. In childhood, the main features of CS are facial changes, rapid or exaggerated weight gain, hirsutism, virilization, and acne. Endogenous hypercortisolism should be established after exogenous CS has been ruled out based on 24-hour urinary free cortisol, midnight serum or salivary cortisol, and dexamethasone suppression test; after that, ACTH dependence should be established. The diagnosis should be confirmed by pathology. The goal of treatment is to normalize cortisol level and reverse the signs and symptoms. Treatment options include surgery, medication, radiotherapy, or combined therapy. CD represents a challenge for physicians owing to its multiple associated conditions involving growth and pubertal development; thus, it is important to achieve an early diagnosis and treatment in order to control hypercortisolism and improve the prognosis. Its rarity in pediatric patients has led physicians to have limited experience in its management. The objective of this narrative review is to summarize the current knowledge about the pathophysiology, diagnosis, and treatment of CD in the pediatric population. [ABSTRACT FROM AUTHOR]

Introduction: During the lockdown caused by COVID-19 in Spain, citizens had to stop performing activities in the usual way, which could have had an impact on mental health. 'I'he aim of this study was to determine the contribution of participating in meaningful activities on mental health in the Spanish population during the COVID-19 lockdown. Method: \ cross-sectional online survey was developed and administered, where mental health (General Health Questionnaire), resilience (Connor-Davidson Resilience Scale), participation in meaningful activities (Engagement in Meaningful Activities Survey) and socio-demographic data were assessed. A hierarchical-linear-regression was used to identify key correlations. Results: 'The participants (N = 311) reported low mental health (M -- 16.12/36) and a lower level of resilience (M = 25.48). The results of the regression revealed that 32.6% of the variance of the GI IQ was significantly explained by the living space, including an outdoor space, resilience and participation in meaningful activities. 'I'he loss of meaningful activities was significantly related to mental health, with a significant contribution when controlling for the other variables (β = -.12). Conclusion: Although experimental studies arc needed to determine causality, this study highlights the relationship between participation in meaningful activities and mental health during the lockdown. [ABSTRACT FROM AUTHOR]

Introduction: Occupational participation is a key element to increase the quality of life in the population. One of the effective interventions to increase occupational participation is the "Occupational Self-Analysis" program. The aim of this study was to analyze participant's reported benefits about the "Occupational Self-Analysis" program. Method: This is a qualitative study with 26 participants (12 people with intellectual disability, 7 affected by acquired brain injury, and 7 students) who participated in weekly group sessions and one individual session. The outcomes were measured based on participant diaries and focus group transcriptions. Results: Two main themes emerged: (1) supports for occupational participation and (2) barriers for occupational participation. The thematic analysis of the categories was based on the Model of Human Occupation to increase applicability of the program in occupational therapy practice. Conclusions: The "Occupational Self-Analysis" program allowed participants to increase their knowledge of supports provided for and the barriers against occupational participation. [ABSTRACT FROM AUTHOR]

Introduction: The sequelae of moderate-severe acquired brain injury (ABI) encompass motor, cognitive, sensory, emotional and behavioural areas that affect meaningful occupational participation and quality of life, with a high prevalence of associated mental disorders. When the patient returns to community life after discharge from the hospital, specialised care is generally insufficient due to the lack of consideration of the dual condition of mental disorder and ABI. Since there is a negative impact on competence and thus on occupational participation, occupational therapy represents a convenient way of intervention. On these assumptions, a community-based occupational therapy protocol on mental health for people with moderate/severe acquired brain injury (COT-MHABI) is presented. It is focused on meaningful occupational participation and looks for improvement in the quality of life. Methods and analysis: This study aims: (i) to design a protocol to evaluate the effectiveness of a community occupational therapy intervention based on MOHO for patients with a dual (mental health/ABI) for improving quality of life and self-perceived occupational performance; (ii) to analyse the outcomes of occupational and social variables (occupational balance, participation level, satisfaction with occupation and performed roles and community integration) after the COT-MHABI process; (iii) to analyse the impact of quality of life on satisfaction with occupations performed by this population. A non-randomised controlled clinical trial will be performed. Patients assigned to the experimental group will receive over one year of on-site and telematic occupational therapy sessions, 16 sessions on average. Variables such as quality of life, community integration or satisfaction with occupational performance will be collected at baseline, 6, and 12 months. Discussion: The needs for the dual mental/ABI population in their reintegration into the community are related to the associated deficits and to the absence of specialised services for the complexity of this patient profile. Few studies consider the coexistence of mental health and ABI issues. The COT-MHABI protocol is proposed to provide continuity to the community needs of this population, conceptualised from occupational participation, person-centred and focused on meaningful activities. Clinical trial registration: Trial identifier and registry name ClinicalTrials.gov ID: NCT04586842https://clinicaltrials.gov/ct2/show/NCT04586842?term=252136&draw=2&rank=1; Pre-results; Community-based Occupational Therapy Intervention on Mental Health for People With Acquired Brain Injury (COT-MHABI). [ABSTRACT FROM AUTHOR]

Background. Participation in meaningful activities contributes to individual well-being, so it is essential to have specific evaluation tools that can assess this complex construct Objectives. To create a Spanish version (EDIAS) of the Engagement in Meaningful Activities Survey (EMAS) by following best practices in instrument translation. Methodology. The translation was made according to the Principles of Good Practice for the translation and cultural adaptation of patient-reported outcome measures. Results. The adaptation process involved a meticulous analysis of item equivalence by the expert committee and an expert on the EMAS. Also, harmonization with other translated versions and a cognitive debriefing was carried to assess comprehensibility. Conclusion. Following best practice, this study has developed the EDIAS, a tool for evaluating participation in meaningful activities adapted to the Spanish context. [ABSTRACT FROM AUTHOR]

Background: The spread of COVID-19 has affected people's daily lives, and the lockdown may have led to a disruption of daily activities and a decrease of people's mental health.Aim: To identify correlates of adults' mental health during the COVID-19 lockdown in Belgium and to assess the role of meaningful activities in particular.Methods: A cross-sectional web survey for assessing mental health (General Health Questionnaire), resilience (Connor-Davidson Resilience Scale), meaning in activities (Engagement in Meaningful Activities Survey), and demographics was conducted during the first Belgian lockdown between April 24 and May 4, 2020. The lockdown consisted of closing schools, non-essential shops, and recreational settings, employees worked from home or were technically unemployed, and it was forbidden to undertake social activities. Every adult who had access to the internet and lived in Belgium could participate in the survey; respondents were recruited online through social media and e-mails. Hierarchical linear regression was used to identify key correlates.Results: Participants (N = 1781) reported low mental health (M = 14.85/36). In total, 42.4% of the variance in mental health could be explained by variables such as gender, having children, living space, marital status, health condition, and resilience (β = -.33). Loss of meaningful activities was strongly related to mental health (β = -.36) and explained 9% incremental variance (R2 change = .092, p < .001) above control variables.Conclusions: The extent of performing meaningful activities during the COVID-19 lockdown in Belgium was positively related to adults' mental health. Insights from this study can be taken into account during future lockdown measures in case of pandemics. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to evaluate the benefits of an occupational self-analysis program in people with acquired brain injury (ABI) in the areas of subjective health perception and occupational participation. Material and Method: This study explored the benefits of an occupational self-analysis program in people with ABI. The intervention group comprised 7 participants; the control group included 5 participants. Outcomes were measured using the SF-36 Health Survey and the Role Checklist. The contents of solicited participant diaries and a focus group discussion were also analyzed. Results: Compared to the control group, the intervention group showed statistically significant improvements in the SF-36 energy/fatigue subscale. The qualitative analysis revealed that participants in the intervention group increased their occupational participation in activities of daily living (ADL), social involvement, and leisure. Conclusion: The program helped participants improve their health perception and increase their occupational participation through learning about their supports and barriers for engaging in meaningful activities. [ABSTRACT FROM AUTHOR]

Etoposide-loaded poly(lactic-co-glycolic acid) implants were developed for intravitreal application. Implants were prepared by a solvent-casting method and characterized in terms of content uniformity, morphology, drug-polymer interaction, stability, and sterility. In vitro drug release was investigated and the implant degradation was monitored by the percent of mass loss. Implants were inserted into the vitreous cavity of rabbits’ eye and the in vivo etoposide release profile was determined. Clinical examination and the Hen Egg Test-Chorioallantoic Membrane (HET-CAM) method were performed to evaluate the implant tolerance. The original chemical structure of the etoposide was preserved after incorporation in the polymeric matrix, which the drug was dispersed uniformly. In vitro, implants promoted sustained release of the drug and approximately 57% of the etoposide was released in 50 days. In vivo, devices released approximately 63% of the loaded drug in 42 days. Ophthalmic examination and HET-CAM assay revealed no evidence of toxic effects of implants. These results tend to show that etoposide-loaded implants could be potentially useful as an intraocular etoposide delivery system in the future. [ABSTRACT FROM AUTHOR]

Climate change will have serious repercussions for agriculture, ecosystems, and farmer livelihoods in Central America. Smallholder farmers are particularly vulnerable due to their reliance on agriculture and ecosystem services for their livelihoods. There is an urgent need to develop national and local adaptation responses to reduce these impacts, yet evidence from historical climate change is fragmentary. Modeling efforts help bridge this gap. Here, we review the past decade of research on agricultural and ecological climate change impact models for Central America. The results of this review provide insights into the expected impacts of climate change and suggest policy actions that can help minimize these impacts. Modeling indicates future climate-driven changes, often declines, in suitability for Central American crops. Declines in suitability for coffee, a central crop in the regional economy, are noteworthy. Ecosystem models suggest that climate-driven changes are likely at low- and high-elevation montane forest transitions. Modeling of vulnerability suggests that smallholders in many parts of the region have one or more vulnerability factors that put them at risk. Initial adaptation policies can be guided by these existing modeling results. At the same time, improved modeling is being developed that will allow policy action specifically targeted to vulnerable groups, crops, and locations. We suggest that more robust modeling of ecological responses to climate change, improved representation of the region in climate models, and simulation of climate influences on crop yields and diseases (especially coffee leaf rust) are key priorities for future research. [ABSTRACT FROM AUTHOR]

Occupational therapy programs have been developed in order to promote health in older adults. However, no published studies have yet been identified for the Spanish population. This study explores the benefits of an occupational therapy health promotion program called EnvejeHaciendo (AgeDoing). The study was conducted with 15 elderly Spanish adults, examining health perception and meaningful occupational participation using the Model of Human Occupation, as well as the pedagogical methodology See, Judge, Act. The results showed an increase in the perception of health with reference to social functioning and the number of roles in which the participants wanted to get involved in the future. The participants changed their own negative perception of elderly people, they adapted to the changes provoked by aging, and they got involved in meaningful activities such as physical exercise or social activities. This program allowed participants to engage in meaningful occupations with other people and to increase perceived health status through raising awareness of difficulties. [ABSTRACT FROM AUTHOR]