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Objective: Existing research in action video games has increased in recent years due to the expansion of their use all over the world. Specifically, there is growing evidence about the positive development of the cognitive functions associated with the use of this kind of video game. Therefore, this work aims to explore the relationship between playing action video games and the development of attention span as well as the impact at the brain level from a functional perspective. Methods: Articles were searched in Scopus, Pubmed, and Web of Science. A total of 196 studies were retrieved, among which 13 studies were systematically reviewed. Results: The review has shown that playing action video games can improve cognitive functions, including attention, with reaction time and processing speed being the aspects that would most benefit from such practice, as well as the development of focused, sustained, and divided attention. Also, there are functional brain changes. Conclusion: It is necessary to deepen the understanding of the association between playing action video games and the development of attention.

The main objective is to determine if the infrastructure of critical care units influences the perception of professionals using this handover method.Nursing bedside handover is considered a safe information transfer method that can help reduce communication errors; however, it has some disadvantages expressed by health professionals and patients, related to confidentiality, stress and less rest.Qualitative descriptive study. The perception of nursing professionals who work in a critical care unit with a mixed structure (open and closed boxes) in a tertiary care hospital was evaluated through a semi-structured interview with a battery of common questions (prepared after literature review) and spontaneous questions according to the objectives of the study.Five thematic areas related to the study objectives were observed: patient safety, message content, confidentiality/privacy, intimacy/rest/noise, and patient participation.Nursing bedside handover improves safe communication between professionals, because it avoids errors or distractions by double or triple checking (if we include the patient) as well as empowering the patient and including him in his recovery. Carrying it out in closed boxes increases confidentiality and improves intimacy as there are no other patients or relatives nearby who can hear the message. However, the place or shift where the handover is performed does not interfere with the effectiveness of the communication of the message. The morning shift is the busiest, which could affect the patient's rest, a fact that could be solved if it is carried out in a closed box.Carrying out the handover in individual boxes in intensive care units would provide greater privacy to the patient and reduce the perception of external noise, contributing to the reduction of interruptions and the increase of the patient's rest. It is also a key element in patient safety through verification by double or triple check-up, the structuring of the message and the visualization of devices presented by the patient. In addition, it will allow the professional to start a process of early humanization and participation of the patient in the health process.

Cristina Soria,1– 3 Lola Prieto,2 Esther Lázaro,3 Amalia Ubeda2 1Psicología de la Salud, Suportias, Madrid, Spain; 2Facultad de Medicina, Universidad Francisco de Vitoria, Madrid, Spain; 3Facultad de Ciencias de la Salud, Universidad Internacional de Valencia, Valencia, SpainCorrespondence: Cristina Soria, Suportias. Av. Juan Carlos I, 13. Torre Garena, Madrid, 28806, Spain, Tel +34 910 511 662, Email cristina.soria@suportias.comPurpose: Adherence to disease-modifying therapies (DMTs) in multiple sclerosis (MS) is a complex and multidimensional phenomenon. Identifying the predictors of therapeutic adherence in MS will guide the design of interventions to improve health outcomes. Our aim was to assess the degree of adherence to pharmacological treatments, assess the relationship between patient-related factors and pharmacological adherence and to identify predictors of adherence to pharmacological treatments in patients with MS in Spain.Patients and Methods: A cross-sectional nationwide study was carried out in Spain between December 2020 and September 2021. The web-based evaluation protocol consisted of a self-questionnaire survey designed ad hoc and the application of validated questionnaires to assess adherence, as well as beliefs about medication and quality of life. Predictor variables of adherence to MS treatment were assessed using multivariate analysis.Results: A total of 152 patients with MS participated (mean age: 44 years; 64% were female; and 78% had relapsing-remitting MS). Seventy-three percent of the patients reported being adherent to their pharmacological treatment for MS. Forgetfulness was the most common cause of non-adherence. Necessity beliefs and concerns beliefs were not statistically associated with adherence. The adherent group shows statistically significant better levels of quality of life in the cognitive function subscale than the non-adherent participants (p=0.040). Role limitations-emotional, emotional well-being and overall quality of life were not significantly associated with adherence. Predictors with a statistical association with adherence to treatment were years of education (OR=0.79; 95% CI: 0.65– 0.96; p=0.020) and intravenous treatment (OR=3.17; 95% CI: 1.07– 9.45; p=0.038).Conclusion: We found an adequate adherence to pharmacological treatment. Low education and intravenous treatment were significant predictors of adherence to DMTs.Keywords: adherence, disease-modifying therapy, medication belief, quality of life

Introduction Mucopolysaccharidosis type III (MPS III) or Sanfilippo syndrome is a neurodegenerative disease caused by the accumulation of mucopolysaccharides in the body. As the symptoms are wide ranging, it is a challenge to provide a diagnosis and psychological treatment for affected children. Method The main objective of this study was to describe a form of music therapy treatment applied to three children diagnosed with MPS III. The psychological variables were evaluated by an ad hoc observation recording template, and the physiological variables were measured with a digital meter before and after each session. The perception of the parents was also considered through a semi-structured interview. Results An improvement in the psychological variables was shown in all cases. Changes in the physiological variables were also noted, although they varied according to each child. The parents report some benefit of music therapy and they share difficulty in assessing the extent of benefits of the music therapy. Discussion Findings indicate that music therapy can be a useful form of treatment with multiple benefits for children with conditions such as MPS III or similar conditions. However, further research is needed in this area and in the development of specific ways of evaluating music therapy.

We conducted a systematic review of studies on mobile devices, including tablets, iPads, and smartphones, in teaching programs for young children with autism spectrum disorder (ASD). We conducted a search of the electronic databases (period 2002–2019) supplemented by a search for additional relevant articles by means of cross-referencing. In total, 24 studies were selected, reporting outcomes for 60 participants who ranged from 2 to 5 years old. The study findings were largely positive, suggesting that mobile devices are viable technological aids for preschool children with ASD. The studies reviewed suggest that mobile devices can be successfully utilized in educational programs targeting communication, academic, and social skills. Implications for practice and suggestions for future research are provided.

Objectives The objective was to evaluate the results of valve-in-valve procedures performed with the Allegra device. Background Transcatheter aortic valve implantation to treat degenerated biological aortic valves (valve-in-valve) is an established procedure in most catheterization laboratories, but the results are poorer than procedures done in native aortic stenosis. The Allegra device (Biosensors, Morges, Switzerland) has an excellent design to treat these patients. Methods All patients with severely degenerated biological aortic valve treated with the Allegra device in centers from Spain until December 2020 were included (n = 29). Hemodynamic results and 30-day clinical outcomes were evaluated. The predominant hemodynamic failure was stenosis in 15, regurgitation in 11, and a combination of both in 3 cases. Time from aortic valve replacement to valve-in-valve procedure was 8.4 ± 3.9 years (range 3.3-22.1). Results After the procedure, maximum and mean trans-valvular gradients were 17.4 ± 12.3 and 8.4 ± 6.1 mmHg, respectively. Device success was obtained in 28 patients (96.6%). In one patient with a degenerated 19 mm prosthetic valve, mean gradient after the procedure was 22 mmHg. No patients had a para-valvular leak grade >1. There were no deaths during the hospitalization or at 30 days and one patient suffered a stroke. Conclusions The Allegra trans-catheter aortic valve offers optimal hemodynamic results in patients with severely degenerated biological aortic valve.

El quinto informe del IPCC, recientemente publicado, afirma que el cambio climatico es inequivoco, sin precedentes y antropogenico en origen. El cambio climatico como externalidad global tiene consecuencias para el medio ambiente, la economia, la sociedad y la politica. Dichas consecuencias podrian desencadenar perdidas ‘catastroficas’ de bienestar si se sobrepasan determinados puntos criticos. Es posible argumentar que las acciones para evitar dichos resultados catastroficos deberian asemejarse a las decisiones relativas a la adquisicion de seguros, que evitan las peores consecuencias de eventos catastroficos, mas que a decisiones sobre inversiones. Las recomendaciones historicas de seguir una politica de mitigacion gradual han sido parcialmente desbancadas por llamadas mas contundentes a la accion debido a la existencia de eventos extremos. Los esfuerzos de la comunidad internacional hasta la fecha han sido insuficientes para responder a las llamadas urgentes a la accion. La investigacion de eventos extremos, el desarrollo de tecnologias respetuosas con el entorno y los acuerdos de reparto de carga aceptables para los distintos paises, podrian favorecer una accion climatica efectiva y eficiente.

An 80-year-old male with permanent atrial fibrillation (informed consent obtained) underwent a percutaneous procedure to close the left atrial appendage (LAA). He had required repeated admissions for severe anemia and chronic gastrointestinal bleedings while on different antithrombotic regimens (aspirin alone, clopidogrel alone, apixaban). He had a CHADS-VASC2 score of 6 and a HAS-BLED score of 4. A transesophageal echocardiography (TEE) performed revealed the presence of Windsock morphology and no thrombus in the LAA. The diameters of the landing zone were between 23 mm and 25 mm (figure 1).

(1) Background: The COVID-19 pandemic has created a great impact on mental health in society. Considering the little attention paid by scientific studies to either students or university staff during lockdown, the current study has two aims: (a) to analyze the evolution of mental health and (b) to identify predictors of educational/professional experience and online learning/teaching experience. (2) Methods: 1084 university students and 554 staff in total from four different countries (Spain, Colombia, Chile and Nicaragua) participated in the study, affiliated with nine different universities, four of them Spanish and one of which was online. We used an online survey known as LockedDown, which consists of 82 items, analyzed with classical multiple regression analyses and machine learning techniques. (3) Results: Stress level and feelings of anxiety and depression of students and staff either increased or remained over the weeks. A better online learning experience for university students was associated with the age, perception of the experience as beneficial and support of the university. (4) Conclusions: The study has shown evidence of the emotional impact and quality of life for both students and staff. For students, the evolution of feelings of anxiety and depression, as well as the support offered by the university affected the educational experience and online learning. For staff who experienced a positive professional experience, with access to services and products, the quality-of-life levels were maintained.

This study aims to evaluate the costs of informal care for children with neuromuscular disease and evaluate how physical and psychological health is associated with socio-demographic variables. A cross sectional design was used with a convenience sample of 110 carers that participated in this study. Participants were recruited from Spanish hospitals and rare diseases organizations. Economic costs and sociodemographic aspects were assessed using the economic costs questionnaire and the sociodemographic questionnaire. Physical and psychological health was evaluated using the CarerQol-7D, PHQ-15, Barthel Index, Zarit Overload Scale and Satisfaction with Life Scale. Carers of children with neuromuscular disease spent a large percentage of their annual income in physical therapy, psychological care and speech therapy. Informal costs differed according to the degree of dependency of the child. These were higher in those caregivers whose child under their care presented low functional independence. The loss of work productivity was related to marital status, use of professional services and the child’s dependency. Finally, carers who were female, single or separated and without a job showed worse physical and psychological health. The results highlighted that carers have to face a number of high costs because of the non-existence of social protection and due to the child’s diagnosis.

Rare neuromuscular diseases (RNMDs) are a group of pathologies characterized by a progressive loss of muscular strength, atrophy, fatigue, and other muscle-related symptoms, which affect quality of life (QoL) levels. The low prevalence, high geographical dispersion and disability of these individuals involve difficulties in accessing health and social care services. Teleassistance is presented as a useful tool to perform psychosocial interventions in these situations. The main aim of this research is to assess the effects of a teleassistance psychosocial program on the QoL levels of people with RNMDs who have different levels of disability. A sample of 73 participants was divided into an experimental group (n = 40), which participated in the intervention, and a control wait list group (n = 33). QoL was evaluated through the SIP and the SF-36, and disability through the WHO-DAS II. The participants with a moderate to severe level of disability were those who most benefited from the intervention. The results also revealed that the psychosocial teleassistance program was suitable to improve physical and psychosocial aspects of people suffering from a rare neuromuscular disease with a moderate level of disability, but just psychosocial aspects in those with a severe level of disability.

The number of Hematopoietic Stem Cell Transplantations has risen in the past 20 years. The practice of outpatient Hematopoietic Stem Cell Transplantation programs is increasing in an attempt to improve the quality of patient care and reduce the demand for hospital admission. A systematic review of 29 comparative studies between in-hospital and outpatient treatment of Hematopoietic Stem Cell Transplantation, with no restriction by outpatient regime was conducted. This study aims to analyse the current evidence on the effects of the outpatient model on patient-centred outcomes, comparing both in-hospital and outpatient models for autologous and allogeneic HSCT using the Triple Aim framework: health outcomes, costs and experience of care. We found evidence on improved health outcomes and quality of life, on enhanced safety and effectiveness and on reduced overall costs and hospital stays, with similar results on overall survival rates comparing both models for autologous and allogeneic patients. We also found that the outpatient Hematopoietic Stem Cell Transplantation is a safe practice as well as less costly, it requires fewer days of hospital stay both for autologous and allogeneic transplantations. Under a situation of an increasing number of transplants, rising healthcare costs and shortages of hospital capacity, incorporating outpatient models could improve the quality of care for people requiring Hematopoietic Stem Cell Transplantation programs.

Issue 1: Dispatchable RES and flexibility in high RES penetration scenarios: solutions for further deployment ., We investigate whether political ideology has an observable effect on decarbonization ambition, renewable power aims, and preferences for power system balancing technologies in four European countries. Based on the Energy Logics framework, we identify ideologically different transition strategies (state-centered, market-centered, grassroots-centered) contained in government policies and opposition party programs valid in 2019. We compare these policies and programs with citizen poll data. We find that ideology has a small effect: governments and political parties across the spectrum have similar, and relatively ambitious, decarbonization and renewables targets. This mirrors citizens’ strong support for ambitious action regardless of their ideological self-description. However, whereas political positions on phasing out fossil fuel power are clear across the policy space, positions on phasing in new flexibility options to balance intermittent renewables are vague or non-existent. As parties and citizens agree on strong climate and renewable power aims, the policy ambition is likely to remain high, even if governments change., RT, PdR, CK, LLT, GE and YL have received funding from the European Union’s Horizon 2020 research and innovation programme (Grant agreement 764626, MUSTEC project). JL has received funding from the European Research Council (Grant agreement 715132, TRIPOD project).

Context In recent years, the ketogenic diet has gained special relevance as a possible therapeutic alternative to some neurological and chronic diseases. Objective The aim of this systematic review was to answer the following question: Does a ketogenic diet improve cognitive skills in patients with Alzheimer's disease, Parkinson's disease, refractory epilepsy, and type 1 glucose deficiency syndrome? To define the research question, the PICOS criteria were used, following the guidelines of the PRISMA method. Data sources Medline/PubMed, Elsevier Science Direct, Dialnet, EBSCOhost, Mediagraphic, Sage Journals, ProQuest, and Wiley Online Library databases were used. Data extraction After applying inclusion and exclusion criteria in accordance with the PRISMA method, a total of 63 entries published between 2004 and 2019 were used. Data analysis The records extracted were analyzed from a qualitative approach, so no statistical analysis was carried out. Conclusion Although scientific literature on the subject is scarce and there has tended to be a lack of scientific rigor, the studies reviewed confirmed the effectiveness of this diet in improving the cognitive symptomatology of the aforementioned diseases.

La pandemia del COVID-19 ha alterado las expectativas acerca de la transición energética, acentuando las tendencias subyacentes previas a la misma. La gobernanza climática también se ha visto afectada por el COVID-19 en un año clave para elevar la ambición. Aunque la prioridad de gobiernos y ciudadanos sea la lucha contra el virus, este cambio radical en el contexto a corto plazo no debe distraer de los retos que plantean la transición energética y la gobernanza climática a medio y largo plazo.

Background Wolf-Hirschhorn Syndrome (WHS) is a rare, congenital disease characterized by a distinctive facial phenotype, seizures, intellectual disability and developmental delay, and pre and postnatal growth requiring lifelong care. The psychosocial status of the family caregivers of children diagnosed with WHS is unknown. This study aims to characterize the sociodemographic and psychosocial profile of WHS caregivers and analyze how these variables impact their quality of life (QoL) and well-being. Results The sociodemographic and clinical profile of 22 Spanish caregivers of children with WHS and the characteristics of those affected have been described. Significant relationships were found between sociodemographic and psychosocial characteristics among caregivers. The impact on the parents’ QoL and negative relationship with the symptomatology were assessed. The use of engagement strategies such as problem focused coping was associated with improved psychological QoL and social support. Conclusions WHS caregivers share similarities in their profile and needs with caregivers of children with other rare diseases. Pychosocial support groups involving parents caring for children with the same disease could improve caregivers’ well-being and QoL by strengthening their social support network and using positive coping styles.

Chiari malformation type I (CM-I) is a neurological disorder in which cerebellar tonsils are herniated through the foramen magnum into the spinal canal. A wide spectrum of cognitive deficits underlying this pathology has been reported, but the literature about social cognition is insufficient. Clinical research has pointed out the cerebellar role in Theory of Mind (ToM), indicating that there are several disorders with cerebellar pathology that reveal a poorer performance in social cognition tasks. The main purpose of this study is to compare the performance on ToM tasks between CM-I patients and healthy controls. The protocol includes Faux Pas test, Happe's Strange Stories test, Ice-Cream Van task, the FEEL test, and the Word Accentuation Test. In order to eliminate the possible influence of covariables, physical pain and anxious-depressive symptomatology have been controlled for. According to the results, CM-I patients performed worse than matched healthy controls on ToM tasks, except for facial emotion recognition. These differences remained even after controlling for the neuropsychiatric variables and physical pain. Thus, it can be suggested that patients with CM-I are impaired in their social skills related to their performance on ToM tasks. These findings can be considered to be a preliminary approach to the specific study of social cognition in relation to CM-I since it is similar to other cerebellar pathologies and to previous literature on the cerebellum's role in social cognition.

There are few studies that explore the involvement of the cerebellum in the affective area. This study aims to evaluate the affective component and, specifically, the emotional states of depression and anxiety associated with the Chiari malformation, controlling perceived pain. This study included a Chiari group and two control groups, one healthy, the other suffering from Myasthenia gravis, which exhibits a physical component without cerebellar impairment. Each participant completed the Hospital Anxiety and Depression Scale and the Numeric Pain Rating Scale. Scores were significantly higher for the anxiety variable in the Chiari group, either when compared to the control group or the group affected by Myasthenia gravis-controlling the level of headache. The results obtained support previous studies in which the important contribution of the cerebellum to emotional regulation was emphasized.

espanolLa malformacion de Chiari (MC) es una patologia rara de baja prevalencia y cuya patogenia actualmente sigue siendo objeto de debate. La MC esta dentro del grupo de las malformaciones de la union craneocervical, es una alteracion anatomica de la base craneal. A dia de hoy se considera que hay 6 tipos de MC, siendo la MC tipo I la mas comun. La sintomatologia puede ser muy variada habiendose reportado casos de pacientes totalmente asintomaticos y otros con graves afecciones de tipo neurologicas. Recientes investigaciones manifiestan que las patologias congenitas del cerebelo como la MC, pueden acompanarse de deficits neuropsicologicos. Es de dificil diagnostico debido a la complejidad de la lesion y sintomatologia presente en los pacientes. No obstante, el diagnostico se realiza mediante tecnicas de neuroimagen siendo la tecnica mas utilizada la resonancia magnetica. En cuanto al tratamiento, la cirugia es una de las principales actuaciones a llevar a cabo ante el diagnostico de MC. Esta revision presenta un analisis exhaustivo de la literatura existente sobre las funciones cognitivas afectadas de la MC tipo I. Asimismo, realiza una descripcion de los efectos de los tratamientos quirurgicos en la sintomatologia neuropsicologica. Los resultados evidencian la presencia de deficits cognitivos; sin embargo, no hay acuerdo sobre cuales son exactamente las funciones cognitivas afectadas. EnglishChiari malformation (CM) is a rare pathology with low prevalence. CM is within the group of malformations of the craniocervical junction, it is an anatomical alteration of the cranial base. There are considered to be 6 types of CM, being MC type I the most common one. The symptomatology can be very varied, having been reported cases of totally asymptomatic patients and others with serious neurological affections. Furthermore, recent research shows that congenital pathologies of the cerebellum such as CM can be accompanied by neuropsychological deficits. It is difficult to diagnose it due to the complexity of the lesion and the symptoms present in patients. However, the diagnosis is made by neuroimaging techniques, being the most widely used technique the magnetic resonance. Regarding to treatment, surgery is one of the main actions to be carried out after the diagnosis of CM. This review presents an exhaustive analysis of the existing literature on the cognitive functions affected of type I MC. It also describes the effects of surgical treatments on neuropsychological symptoms. The results show the presence of cognitive deficits; however, there is no agreement about exactly what cognitive functions are affected.

The COVID-19 pandemic has produced alterations in the behaviour and psychological health of people, who have had to learn living under uncertain circumstances escaping their control. This situation has been aggravated in those countries applying strict home confinement rules to try bending their epidemic curve. This is the case of Spain, where the stringent lockdown period was extended over three months. This study aimed at proving a research hypothesis whereby living close to Green Infrastructure (GI) during the confinement period was beneficial for mental health. To this end, La Palma (Canary Islands) and Zaragoza (Peninsular Spain) were taken as case studies, since both locations distributed a questionnaire to address citizenry's self-reported mental health under strict lockdown conditions. A spatial statistical analysis of the responses collected by these questionnaires revealed that variables such as stress, anger, medication use, alcohol consumption or visits to the doctor significantly decreased if citizens were close to GI, whereas people having very high expectations of enjoying the city after the confinement were positively correlated to proximity of green areas. Although these outcomes are limited by the inferential capacity of correlation analysis, they point out to a sense of relief derived from having visual contact with vegetated landscapes and feeling stimulated about using them for recreation, aesthetical or sporting purposes. The joint consideration of these psychological gains with the social and environmental benefits provided by GI emphasizes the importance of approaching urban regeneration through the design and implementation of interconnected green spaces.

Patients’ experience is an acknowledged key factor for the improvement of healthcare delivery quality. This study aims to explore the differences in healthcare experience among patients with chronic conditions according to individual sociodemographic and health-related variables. A population-based and cross-sectional study was conducted. The sample consisted of 3981 respondents of the Basque Health Survey (out of 8036 total respondents to the individual questionnaire), living in the Basque Country, aged 15 or older, self-reporting at least one chronic condition. Patient experience was assessed with the Instrument for Evaluation of the Experience of Chronic Patients questionnaire, which encompasses three major factors: interactions between patients and professionals oriented to improve outcomes (productive interactions), new ways of patient interaction with the health care system (the new relational model), and the ability of individuals to manage their care and improve their wellbeing based on professional-mediated interventions (self-management). We conducted descriptive and regression analyses. We estimated linear regression models with robust variances that allow testing for differences in experience according to sociodemographic characteristics, the number of comorbidities and the condition (for all chronic or for chronic patients’ subgroups). Although no unique inequality patterns by these characteristics can be inferred, females reported worse global results than males and older age was related to poorer experience with the new relational model in health care. Individuals with lower education levels tend to report lower experiences. There is not a clear pattern observed for the type of occupation. Multimorbidity and several specific chronic conditions were associated (positive or negatively) with patients’ experience. Health care experience was better in patients with greater quality of life. Understanding the relations among the patients’ experience and their sociodemographic and health-related characteristics is an essential issue for health care systems to improve quality of assistance.

En este trabajo se presenta una selección de cartas, en su mayoría inéditas, entre Anna Murià y su hija menor, Eli Bartra Murià, donde se puede apreciar la percepción de la exiliada y su hija frente al fenómeno que marcó sus vidas. Se han elegido tres momentos significativos que motivaron la correspondencia entre ambas: el primer viaje a Europa de la pareja Bartra Murià desde que abandonara Francia, el primer viaje de Eli Bartra a la tierra de sus padres en busca de sus raíces y la vuelta a España de Anna Murià y Agustí Bartra. Con la presentación de estos documentos y la paráfrasis de sus contextos familiares se busca señalar cómo los exiliados transmitieron valores republicanos a sus descendientes directos en consonancia con la cultura que tuvieron que dejar atrás, en un claro ejemplo de transnacionalismo. Finalmente, se añade una coda sobre el feminismo de ambas autoras., This paper presents a selection of letters, mostly unpublished, between Anna Murià and her daughter, Eli Bartra Murià, where we can appreciate their perception, regarding the phenomenon that marked their lives. Three specific moments that motivated the correspondence between they have been chosen: the first trip to Europe of the couple Bartra Murià since they left France, the first trip of Eli Bartra to the land of their parents in search of her roots, and the return from exile, the return to Spain, by Anna Murià and Agustí Bartra. With the presentation of these documents and the paraphrasing of their family contexts, the aim is to point out how the exiles transmitted republican values to their direct descendants in line with the culture they had to leave behind, in a clear example of transnationalism. Finally, a coda on the feminism of both authors is added., Este artículo se ha realizado en el marco del Grupo de Estudios del Exilio Literario y del Centre d’Estudis sobre Dictadures i Democràcies.

About 30% of patients with amyotrophic lateral sclerosis (ALS) suffer from cognitive impairment and 10-15% suffer from frontotemporal dementia (FTD). Due to the patients' reduced motor function, a neuropsychological assessment with a low motor demand can be an advantage when evaluating patients, aiding its application. The present work has studied the usefulness of the Faces subtest of the Wechsler Memory Scale in 42 patients with ALS and 42 healthy volunteers applying Holdnack's Two-High Threshold model. The ALS group performed significantly worse in immediate and delayed discriminability. With respect to the presence of cognitive impairment, it seemed to be independent of the indexes proposed by Holdnack and Delis. On the other hand, motor problems were associated with delayed recognition while behavior alterations were linked to problems with delayed discriminability. ALS patients do not express differences in the bias index, in line with other types of previously studied pathologies.

This study aimed to create a valid and reliable instrument to measure people with disabilities' perceptions regarding the extent of application of international standards issued by the Council of Europe, International Labour Organization, and the International Classification of Functioning, Disability and Health in vocational rehabilitation centers in the Basque country, Spain. The instrument items were selected from international recommendations and conventions issued by the International Labour Organization, Council of Europe, International Classification of Functioning, Disability and Health, and a vocational rehabilitation literature review. The instrument was translated from English to Spanish, and the content validity index of an expert panel survey was used to assess content validity. For the Spanish version of the instrument, internal consistency reliability, confirmatory factor analysis and factor analysis were examined with 186 people with disabilities in 10 vocational rehabilitation centers in the Basque country. The coefficient alpha estimate was 0.945, indicating excellent internal consistency. Three factors were identified: job-related services, aims of vocational rehabilitation center, and vocational rehabilitation guidance. The instrument appears to have good validity and reliability but requires further validation. Support is provided for its use in both English and Spanish. Implications for vocational rehabilitation practice and suggestions for future research are provided.

The involvement of the cerebellum in visuospatial abilities has been evidenced in numerous studies, based on the cerebellar-cortical circuitry. This domain has been evaluated in several patients with cerebellar disorders, but the assessment of visuospatial processing in Chiari malformation type I (CM-I) is scarce. The aim of this study is to analyze the visuospatial performance between CM-I adult patients and healthy controls. Participants have been tested using Block Design and Visual Puzzles subtests of the Wechsler Adult Intelligence Scale (WAIS), the Benton Judgment of Line Orientation test, and the Rey-Osterrieth Complex Figure test. The anxious-depressive symptomatology, the physical pain, and the premorbid intelligence have been controlled for, as well. The CM-I patients showed a significantly lower performance; however, after analyzing and controlling for the effect of clinical variables and psychopathological symptomatology, the main effect was maintained for visual puzzles and line orientation tasks. The findings suggest that CM-I patients show a poorer performance in tasks that require an exercise of perceptual reasoning without motor demand, accompanied by visualization and mental imagery of the stimuli. This study contributes towards the reinforcement of the evidence on the cognitive alterations associated to CM-I.

Objective: This study presents the validation of a computerized assessment tool that studies the ability to recognize emotional facial expressions in children between 8 and 11 years of age: the Facially Expressed Emotion Labeling Test (FEEL Test). Method: The two tests composing the protocol were applied using a laptop in the following order: the FEEL Test followed by the Deusto-e-Motion 1.0 Test.The sample consisted of a total of 1,189 schoolchildren aged between 8 and 11 years, 594 boys and 594 girls. A clinical sample of 47 children with ADHD also took part in this study. Results: The Cronbach’s α coefficient for the total scale was .82, showing high levels of reliability. The difficulty index of the items ranged between .4 and .7. The statistical analyses showed a high rate of discrimination between those who obtained low scores compared with those who obtained high scores. The test results reflected differences according to age and gender of participants in many of the variables associated with both response accuracy and response speed. Regarding its predictive validity, the test is able to find statistically significant differences in the total test score among a group of children diagnosed with ADHD and a matched control group. Conclusion: This article presents the validation of an instrument that assesses the ability to recognize facial expressions in children between 8 and 11 years old and can discriminate and detect differences in gender, age, and possible deficits in social skills within the ADHD.

Background Numerous studies have noted the presence of a dysexecutive component of the ALS-FTD. The most widely replicated result refers to the significantly reduced verbal fluency of ALS patients when compared to healthy people. As ALS patients have motor alterations that interfere with production, qualitative studies have the advantage of being independent of the degree of motor disability and revealing patients’ cognitive state. This study examined the production differences between 42 ALS patients who presented with different degrees of dementia and motor impairment and 42 healthy people. Production processes were studied by extending the administration time of a letter fluency task to 2 minutes for the phonemic verbal fluency (PVF) and semantic verbal fluency (SVF) categories. This ensured that the qualitative aspects of verbal fluency were addressed, paying special attention to the new perseverations and intrusions, as well as any clinical correlates that may exist. Results The ALS patients produced a significantly lower number of responses in PVF (p = .017) and SVF (p = .008). The rest of the indicators for frontal lobe alteration also suggested the existence of a dysfunction. The most remarkable results were the number of intrusions on the PVF task, which was much higher in the ALS group (p = .002). However, the number of perseverations did not differ significantly. Conclusions This study highlights the value of intrusions in addressing cognitive deterioration in ALS patients. This deterioration seems to be independent of the degree of motor impairment and of behavioural alterations. Therefore, the value of the intromissions on the verbal fluency task was highlighted as an indicator of a new cognitive alteration, which can be easily evaluated, even retrospectively.