Exploring developmental trajectories throughout adolescence of children with autism spectrum disorder without intellectual disability.

Characterizing the developmental trajectories of children with autism spectrum disorder (ASD) throughout adolescence and across different domains of functioning offers opportunities to improve long-term outcomes. This prospective study explored, for the first time, the evolution of children with ASD-without intellectual disability (ID) in terms of socio-adaptative skills, learning behaviors, executive functioning (EF), and internalizing/externalizing problems, compared to typically developing (TD) peers. Forty-five children with ASD-without ID and 37 matched TD children (aged 7-11) were assessed at baseline and after 5 years. Parents and teachers completed measures on theory of mind (ToM), socialization, daily living skills, learning style, EF, and emotional/behavioural difficulties at both time points. On all the domains assessed, the ASD group performed significantly worse than the TD group, both in childhood and adolescence. Specific changes were noted between baseline and follow-up assessment on adaptive skills, prosocial behavior, emotional control, inhibit, working memory and monitoring. Group membership (ASD/TD) was influenced by peer relationships and inhibit EF variables. These findings have implications for clinical and school settings.

Cognitive and behavioral profiles in children with autism spectrum disorder with and without Attention-Deficit/hyperactivity disorder.

BACKGROUND: Understanding the developmental trajectories of children with autism spectrum disorder (ASD) with and without comorbid ADHD is relevant to tailor care plans. This prospective study assessed, for the first time, cognitive, emotional, behavioral, and learning outcomes in adolescence of children with ASD-ADHD and in those with ASD+ADHD in childhood. Possible predictors of severity of ASD core symptoms in adolescence were also evaluated. METHODS: Forty-five adolescents without intellectual disability, 26 diagnosed in childhood with ASD-ADHD and 19 with ASD+ADHD, were evaluated at baseline (mean age: 8.6 ± 1.3) and at 5-year follow-up (mean age: 12.9 ± 0.9). Parents and teachers completed questionnaires on executive functions, theory of mind (ToM), emotional/behavioral difficulties (EBD), and learning style at both time points.. RESULTS: Overall different developmental trajectories for the two groups were found. In general, deficits in metacognition processes, ToM skills, EBD, and learning abilities were more pronounced in the ASD+ group. Over time, the ASD+ADHD group, but not the ASD-ADHD, tended to improve in EBD and metacognition but their level of development continued to be lower compared with ASD+ADHD. EBD in childhood were significant predictors of autism core symptoms of adolescents. CONCLUSIONS: Our findings highlight the importance of an early identification of comorbid ADHD symptoms in ASD to offer treatment strategies based on specific developmental trajectories.

Psychometric properties of the Spanish version of the Patient Health Questionnaire-9 in users of the Ecuadorian public health care system

Introduction: Depression is one of the most prevalent public health problems worldwide and remains an underdiagnosed disease, especially in developing countries. The availability of instruments that permit detecting this problem is essential for reducing the burden of this disorder. The aim of this study was to examine the psychometric properties (factor structure, sex invariance, internal consistency, and convergent and divergent validity) of the Spanish version of the PHQ-9 (Patient Health Questionnaire-9). Method: A sample of 366 public hospital users in Ecuador was recruited and accordingly completed a survey that included sociodemographic data, the PHQ-9, and other standards of measurement such as the Beck Depression Inventory-II (BDI-II), the Generalised Anxiety Disorder Scale (GAD-7), the Positive and Negative Affect Scale (PANAS), and the Quality-of-Life Index (QLI). Results: The unidimensional factor model of the PHQ-9 provided the best fit for the data. The PHQ-9 assesses depressive symptoms equivalently in both sexes, and presents high internal consistency, as well as good convergent and divergent validity with the other constructs. Conclusion: The application of the PHQ-9 could aid in the screening of patients with depressive symptomatology in the Ecuadorian public health system (EPHS).

Introducción: La depresión es uno de los problemas de salud pública más prevalentes a nivel mundial, y suele ser subdiagnosticada especialmente en países en vías de desarrollo. Contar con instrumentos que permitan realizar un cribado de este problema es fundamental para reducir el costo de este trastorno. El objetivo de este artículo fue examinar las propiedades psicométricas (estructura factorial, invarianza en función del sexo, consistencia interna, validez convergente y divergente) de la versión española del PHQ-9 (Patient Health Questionnaire-9). Método: Se reclutó una muestra de 366 usuarios de un hospital público en Ecuador, los cuales respondieron una encuesta que incluía datos sociodemográficos, el PHQ-9, el inventario de depresión de Beck-II (BDI-II), la Escala de Trastorno de Ansiedad Generalizada-7 (GAD-7), la Escala de Afecto Positivo y Negativo (PANAS), y el índice de calidad de vida (QLI). Resultados: El modelo unidimensional del PHQ-9 proporcionó mejor ajuste de los datos. El PHQ-9 evalúa síntomas depresivos de forma equivalente en ambos sexos y presenta una elevada consistencia interna, así como una buena validez convergente y divergente con el resto de los constructos. Conclusión: La administración del PHQ-9 podría apoyar el cribado de pacientes con sintomatología depresiva en el sistema público de salud ecuatoriano (SSPE).

Subjective well-being key elements of Successful Aging: A study with Lifelong Learners older adults from Costa Rica and Spain.

Subjective well-being is a major psychological construct in the research tradition. Along with literature, authors have distinguished between hedonic and eudaimonic well-being. The aim of this study is to determine the role of some psychosocial variables plays in the perceived well-being is conceived from a hedonic or a eudaimonic perspective. The sample consisted of 1016 people of 55 years and older in a Spanish sample and 277 people of 55 years old or older from a Costa Rican sample. Both samples were part of the Longitudinal Older Learners (LOL) study. A structural model with latent variables was estimated with Mplus. The results point out that, the traditional variables included on successful aging models are relevant for explaining older adults' well-being in both countries with some differences on the hedonic and eudaimonic approach of successful aging on the Latin cultural context studied.

Offset femoral en los resultados clínicos y funcionales de los pacientes / Femoral offset in the clinical and functional results of patients; Le déport fémoral dans les résultats cliniques et fonctionnels des patients

Introducción: La restauración de las fuerzas biomecánicas a través del ajuste del offset y la longitud de miembros se ha convertido en un objetivo importante cuando el cirujano busca un buen resultado funcional postoperatorio. Sin embargo, las ventajas clínicas de la restauración del offset femoral y las complicaciones del fallo en la restauración no han sido claramente establecidas. Objetivo: Evaluar el efecto del offset o voladizo femoral en los resultados clínicos y funcionales de los pacientes. Adquisición de la evidencia: Se realizó una exploración en la base de datos Pubmed, con las palabras clave: artroplastia de cadera, prótesis de cadera, resultado clínico y resultado funcional.Se buscaron artículos publicados entre 2008 y 2018, basados en humanos y escritos en inglés, español o francés. Se seleccionaron seis artículos que incluían la presencia de una medición radiológica del offset femoral claramente explicada, escalas validadas y análisis comparativo. Resultados: La literatura consultada reflejó resultados heterogéneos. En el grupo de pacientes con offset disminuido, un artículo mostró menos función. En otro estudio se observó mejor puntuación en el grupo de enfermos con offset aumentado. A su vez, en una investigación se comprobó menos dolor en el grupo de offset disminuido. Conclusiones: Debido a la inconsistencia en los resultados y en las metodologías empleadas, no ha sido posible reconocer el beneficio clínico y funcional de la restauración del offset. Algunos autores incluidos en esta revisión, después de no encontrar diferencias estadísticamente significativas, afirmaron que la restauración o el aumento del offset femoral aportó buenos resultados, sin efectos negativos(AU)

Introduction: The restoration of biomechanical forces through offset adjustment and limb length has become an important objective when the surgeon seeks a good postoperative functional result. However, the clinical advantages of femoral offset restoration and complications of restoration failure have not been clearly established. Objective: To evaluate the effect of offset or femoral cantilever on the clinical and functional results of the patients. Acquisition of evidence: An exploration was carried out in the Pubmed database, with the keywords: hip arthroplasty, hip prosthesis, clinical result and functional result. We searched for articles published from 2008 to 2018, based on humans and written in English, Spanish or French. Six articles were selected because they clearly explained the presence of a radiological measurement of the femoral offset, including validated scales and comparative analysis. Results: The literature consulted reflected heterogeneous results. In the group of patients with decreased offset, one article showed less function. In another study, a better score was observed in the group of patients with increased offset. In turn, one investigation reported less pain was found in the reduced offset group. Conclusions: Due to the inconsistency in the results and the methodologies used, it has not been possible to recognize the clinical and functional benefit of offset restoration. Some authors included in this review, after not finding statistically significant differences, stated that the restoration or increase of the femoral offset provided good results, without negative effects(AU)

Clima motivacional, satisfacción, compromiso y éxito académico en estudiantes angoleños y dominicanos / Clima motivacional, satisfação, engajamento e sucesso acadêmico em estudantes angolanos e dominicanos / Motivational climate, satisfaction, engagement, and academic success in Angolan and Dominican students

El objetivo fue triple: validar las versiones portuguesa y española de la Escala de Orientación y Clima Motivacional (MOC), evaluar la invarianza métrica en muestras de estudiantes dominicanos y angoleños, y estudiar las relaciones de las orientaciones y climas motivacionales con aspectos educativos relevantes. Participaron 2302 estudiantes dominicanos y 2028 angoleños de 14 a 18 años. Mediante Análisis Factorial Confirmatorio se comprobó que las cuatro dimensiones hipotetizadas del MOC se ajustaban bien a los datos de ambas muestras. Los resultados más relevantes mostraron que las percepciones de los estudiantes sobre el clima de maestría se relacionaron positivamente con el compromiso escolar y el éxito académico en ambas muestras, mientras que las percepciones del clima de ejecución se relacionaron negativamente con estas variables escolares. Los resultados se discuten en el marco de la teoría de las metas de logro (TML) y en relación con las implicaciones para la práctica educativa.

O objetivo do estudo foi triplo: validar as versões em português e espanhol da Escala de Orientação e Clima Motivacional (MOC); avaliar a sua invariância métrica em amostras de estudantes dominicanos e angolanos; e estudar as relações das orientações e climas motivacionais com os aspectos educacionais relevantes. Participaram 2.302 estudantes dominicanos e 2.028 angolanos, de 14 a 18 anos. A Análise Fatorial Confirmatória mostrou que as quatro dimensões da hipótese do MOC se ajustaram bem aos dados de ambas as amostras. Os resultados mais relevantes mostraram que as percepções dos alunos sobre o clima de ensino estavam positivamente relacionadas ao engajamento escolar e ao sucesso acadêmico em ambas as amostras, enquanto as percepções do clima de desempenho estavam negativamente relacionadas com ditas variáveis. Os resultados são discutidos no âmbito da teoria das metas de realização e com relação às implicações para a prática educacional.

The aim was threefold: to validate the Portuguese and Spanish versions of the Motivational Orientation and Climate Scale (MOC), to test for measurement invariance across large Dominican and Angolan students' samples, and to study the relationships of motivational orientations and climates with relevant educational outcomes. Participants were 2302 Dominican and 2028 Angolan students from 14 to 18 years old. Confirmatory Factor Analyses were used to study factorial structure of the MOC. Main results showed that the hypothesized four dimensions fitted the data from both samples well. Regarding the relationships analyzed, the most relevant results shown that students' perceptions of mastery class climate was positively related with school engagement and academic success in both Dominican and Angolan samples, while perceptions of performance class climate was negatively related to these school variables. Results are discussed within the achievement goal framework and in regard to the implications for educational practices.

Contributions of Psychosocial Factors and Physical Activity to Successful Aging.

The aim of this study was twofold: (a) To validate a successful aging model in a Spanish older adult's sample, and (b) to predict successful aging from psychosocial factors and physical activity. Participants were 725 Spanish older people, of whom 478 were women and 247 men, aged between 55 and 100 years. Of these, 501 were physically active and 197 persons did not practice physical activity. The sample was collected in three areas: Sport centers, day centers and public areas of several Spanish towns. Factorial validity of the Successful Aging Inventory was studied by confirmatory factor analysis, and four multiple regressions to predict each of the dimensions of successful aging (functional performance, intrapsychic factors, gerotranscendence, and spirituality) were estimated. The model of successful aging in Spanish elderly through the Successful Aging Inventory was adequate. The four multiple regressions predicted highly successful aging, with effect sizes of: R2 = .037 for spirituality; .267 for functional performance; .531 for intrapsychic factors; and .356 for gerotrascendece. A main conclusion derived from the results is that older people who do exercise achieve better aging. Another point is that aspects of health and life satisfaction are directly related to better aging while social aspects influence indirectly.

Motives to practice exercise in old age and successful aging: A latent class analysis.

PURPOSE: The aim was to classify motives for exercising trying to find sets of related cases that share common motivations, and to relate these latent classes to markers of successful aging. METHODS: 725 old adult aged 55 to 97 years were sampled in several Spanish towns. INSTRUMENTS: Successful Aging Inventory (SAI), International Physical Activity Questionnaire (IPAQ), Health Survey SF-8, Satisfaction with Life Scale (SWLS), and motives to practice exercise, were used. Latent Class Analyses (LCAs) were estimated. The classes obtained were compared on markers of successful aging. RESULTS: Three latent classes were deemed optimal. Significant differences for several markers of successful aging were found. CONCLUSION: A main conclusion derived from the results is that not all old people do exercise for the same motives, and the class of motives you are in had an impact/relation on markers of successful aging. Motives related to internal rather than external pressures should be promoted in the old age.

Exploring relations among mindfulness facets and various meditation practices: Do they work in different ways?

Several meditation practices are associated with mindfulness-based interventions but little is known about their specific effects on the development of different mindfulness facets. This study aimed to assess the relations among different practice variables, types of meditation, and mindfulness facets. The final sample was composed of 185 participants who completed an on-line survey, including information on the frequency and duration of each meditation practice, lifetime practice, and the Five Facet Mindfulness Questionnaire. A Multiple Indicators Multiple Causes structural model was specified, estimated, and tested. Results showed that the Model's overall fit was adequate: χ2 (1045)=1542.800 (p<0.001), CFI=0.902, RMSEA=0.042. Results revealed that mindfulness facets were uniquely related to the different variables and types of meditation. Our findings showed the importance of specific practices in promoting mindfulness, compared to compassion and informal practices, and they pointed out which one fits each mindfulness facet better.

[Aging and spirituality: Factorial structure and reliability of 2 scales]. / Envejecimiento y espiritualidad: estructura factorial y fiabilidad de dos escalas.

INTRODUCTION: In the field of gerontology, the study of the improvement of health and quality of life, and «successfully aging¼, spirituality plays a key role and, is one of the current research approaches. However, its incorporation into scientific literature is arduous and slow, a fact that is in part due to the absence of developed and validated measurement tools, particularly, in the Spanish speaking area. This work aims to present evidence of the psychometric properties of two tools for the measurement of spirituality: the Functional Assessment of Chronic Illness Therapy Spiritual Well-Being (FACIT-Sp) and the GES Questionnaire. MATERIALS AND METHODS: A sample of 224 elderly persons from Valencia (Spain) was recruited, on which two confirmatory factor analyses were estimated, with the proposed a priori structures for each tool, together with several reliability coefficients. RESULTS: Both models presented an good fit to the data: χ(2)51=104.97 (P<.01); CFI=.973; RMSEA=.076 for the FACIT-Sp, and χ(2)17=31.76 (P>.05); CFI=.996; RMSEA=.050 for the GES Questionnaire. Reliability indices also supported the use of the scales in elderly population, with alphas of .85 and .86, respectively. CONCLUSIONS: These results may be useful as a starting point to include spirituality in works that aim to discover the mechanisms involved in successful aging.

[Cost-consequence analysis of respiratory preventive intervention among institutionalized older people: randomized controlled trial]. / Descripción de los resultados y costes de una intervención preventiva a nivel respiratorio en el anciano institucionalizado: ensayo controlado aleatorizado.

INTRODUCTION: The institutionalized elderly with functional impairment show a greater decline in respiratory muscle (RM) function. The aims of the study are to evaluate outcomes and costs of RM training using Pranayama in institutionalized elderly people with functional impairment. MATERIAL AND METHODS: A randomized controlled trial was conducted on institutionalized elderly people with walking limitation (n=54). The intervention consisted of 6 weeks of Pranayama RM training (5 times/week). The outcomes were measured at 4 time points, and were related to RM function: the maximum respiratory pressures and the maximum voluntary ventilation. Perceived satisfaction in the experimental group (EG) was assessed by means of an ad hoc questionnaire. Direct and indirect costs were estimated from the social perspective. RESULTS: The GE showed a significant improvement related with strength (maximum respiratory pressures) and endurance (maximum voluntary ventilation) of RM. Moreover, 92% of the EG reported a high satisfaction. The total social costs, direct and indirect, amounted to Euro 21,678. CONCLUSIONS: This evaluation reveals that RM function improvement is significant, that intervention is well tolerated and appreciated by patients, and the intervention costs are moderate.

Effects of inspiratory muscle training and yoga breathing exercises on respiratory muscle function in institutionalized frail older adults: a randomized controlled trial.

BACKGROUND: In older adults, respiratory function may be seriously compromised when a marked decrease of respiratory muscle (RM) strength coexists with comorbidity and activity limitation. Respiratory muscle training has been widely studied and recommended as a treatment option for people who are unable to participate in whole-body exercise training (WBET); however, the effects of inspiratory muscle training and yoga breathing exercises on RM function remain unknown, specifically in impaired older adults. PURPOSE: To evaluate the effects of inspiratory threshold training (ITT) and yoga respiratory training (YRT) on RM function in institutionalized frail older adults. METHODS: Eighty-one residents (90% women; mean age, 85 years), who were unable to perform WBET (inability to independently walk more than 10 m), were randomly assigned to a control group or one of the 2 experimental groups (ITT or YRT). Experimental groups performed a supervised interval-based training protocol, either through threshold inspiratory muscle training device or yoga breathing exercises, which lasted 6 weeks (5 days per week). Outcome measures were collected at 4 time points (pretraining, intermediate, posttraining, and follow-up) and included the maximum respiratory pressures (maximum inspiratory pressure [MIP] and maximum expiratory pressure [MEP]) and the maximum voluntary ventilation (MVV). RESULTS: Seventy-one residents completed the study: control (n = 24); ITT (n = 23); YRT (n = 24). The treatment on had a significant effect on MIP YRT (F(6,204) = 6.755, P < .001, η2 = 0.166), MEP (F(6,204) = 4.257, P < .001, η2 = 0.111), and MVV (F(6,204) = 5.322, P < .001, η2 = 0.135). Analyses showed that the YRT group had a greater increase of RM strength (MIP and MEP) and endurance (MVV) than control and/or ITT groups. CONCLUSION: Yoga respiratory training appears to be an effective and well-tolerated exercise regimen in frail older adults and may therefore be a useful alternative to ITT or no training, to improve RM function in older population, when WBET is not possible.

Physiotherapy intervention for preventing the respiratory muscle deterioration in institutionalized older women with functional impairment.

INTRODUCTION: In elderly seniors (>80 years), respiratory function may be compromised when, in addition to the presence of comorbidity and loss of mobility, there is also reduced respiratory muscle (RM) strength. The literature has shown that RM training could be an effective method to improve RM function and prevent clinical deterioration, particularly in population with RM weakness. The main purpose of this paper was to assess the effectiveness of RM training on the respiratory muscle strength and endurance of institutionalized elderly women with functional impairment. METHOD: Fifty-four residents (mean=85 years, SD=6.7) were randomly assigned to either a control (n=27) or training (n=27) group. A supervised training program was developed with Threshold(®)IMT, five times per week for 6-weeks. The main variables of the intervention were: maximum inspiratory pressure (PI(max)), maximum expiratory pressure (PE(max)) and maximal voluntary ventilation (MVV), all of which were measured at weeks 0, 4, 7 and 10. RESULTS: Statistical analysis revealed no significant differences in PI(max) (F(3,114)=1.04, p=0.368, R(2)=0.027), PE(max) (F(3,114)=1.86, p=0.14, R(2)=0.047) and MVV (F(3,114)=1.74, p=0.162, R(2)=0.044) between the two groups after the intervention. However, the workload significantly improved with the training sessions (F(5,100)=72.031, p<0.001, R(2)=0.791). CONCLUSION: In a 6-week interval-based training program, the threshold loading device does not significantly improve parameters related to RM strength and endurance of the study population.

Coping strategies: gender differences and development throughout life span.

Development during life-span implies to cope with stressful events, and this coping may be done with several strategies. It could be useful to know if these coping strategies differ as a consequence of personal characteristics. This work uses the Coping with Stress Questionnaire with this aim using a sample of 400 participants. Specifically, the effects of gender and age group (young people, middle age and elderly), as well as its interaction on coping strategies is studied. With regard to age, on one hand, it is hypothesised a decrement in the use of coping strategies centred in problem solving and social support seeking as age increases. On the other hand, the use of emotional coping is hypothesised to increase with age. With respect to gender, it is hypothesised a larger use of emotional coping and social support seeking within women, and a larger use of problem solving within men. A MANOVA found significant effects for the two main effects (gender and age) as well as several interactions. Separate ANOVAs allowed us to test for potential differences in each of the coping strategies measured in the CAE. These results partially supported the hypotheses. Results are discussed in relation to scientific literature on coping, age and gender.

Predicting perceived health in Angolan elderly: the moderator effect of being oldest old.

The objective of this study was to test the predicting effects of variables measuring social support, dependence/active perceptions, and generativity, on this facet of well-being when controlled for socio-demographic variables (age, gender, marital status, and institutionalization). The research tries to extend previous literature by assessing them in a multivariate context, studying differential effects of these variables in young old and oldest old, and offering evidence of the scarcely studied population of Angola. The sample was formed by 737 young old and 266 oldest old. It was built a hierarchical regression, in which, among the different predictors, interactions effects between age and the psychosocial factors were included. Results provide evidence of the qualitative different perceived health and well-being of the young old and oldest old. When predicting perceived health of the Angolan oldest old, psychosocial factors lose much of its importance, and age itself and the limitations that accompanied it seem to be the key point.

Modelo estructural para predecir el bienestar y las actividades básicas de adultos mayores / A structural model to predict the well-being and basic activities of elderly adults

En España, las personas mayores sumaban un 17.9% del total de la población en 2010 y se espera que alcancen el 31.1% en 2050. Este aumento de la esperanza de vida no necesariamente implica una mejora en las condiciones de salud de las personas mayores. El objetivo del presente estudio es evaluar el impacto de variables sociodemográficas, identificadas en trabajos previos, sobre la dependencia funcional y el bienestar, mediante un modelo estructural de multiples indicadores, múltiples causas. Integraron la muestra 1 208 adultos mayores de la ciudad de Valencia (España), todos ellos jubilados mayores de 65 años, no hospitalizados y sin deterioro cognitivo. Además de los aspectos sociodemográficos se midieron: a) las actividades básicas de la vida diaria (ABVD) mediante el índice de Barthel, y b) el bienestar psicológico mediante las escalas de Ryff. Se obtuvo un modelo estructural con índices de ajustes adecuados que ofrece información relevante en relación con el bienestar y sus variables explicativas en un contexto multivariado. Los resultados revelan: a) entre los aspectos sociodemográficos, los efectos significativos fueron la edad y el nivel de estudios; b) se observa una relación positiva entre las ABVD y el nivel de bienestar; c) las ABVD median parcialmente la relación de los aspectos sociodemográficos con el bienestar.

Resilience and coping as predictors of general well-being in the elderly: a structural equation modeling approach.

OBJECTIVES: The aims of this article are: (a) to test for the validity of the three constructs involved in the structural model; (b) to test for the effects of both coping strategies and resilient coping on well-being in a sample of elderly, by means of a structural model with latent variables; (c) to empirically study whether a brief scale of resilient coping could predict well-being over and above that predicted by the coping resources. METHODS: The research is a survey design. The sample consisted of 225 non-institutionalized elderly people living in the city of Valencia (Spain). The three constructs measured were: well-being, resilient coping, and coping strategies. RESULTS: The analyses consist of a series of alternative structural models with latent variables with resilience, problem-focused coping, and emotion-focused coping as the potential predictors of well-being as measured by Ryff's well-being scales. Due to parsimony reasons, the model retained is that with a single predictor of well-being: resilient coping. CONCLUSION: A latent variable measuring resilient coping is able to predict a significant and large part of the variance in well-being, without the need of including coping strategies. Results impact on well-being literature of the elderly is discussed.

Internal consistency and validity of the Spanish version of the "Quebec Sleep Questionnaire" quality-of-life questionnaire for obstructive sleep apnea.

INTRODUCTION: There is no specific health-related quality of life (HRQL) questionnaire that has been validated in Spanish for its use in patients with sleep apnea-hypopnea syndrome (SAHS). The objective of the present study was to validate the Spanish version of the Quebec Sleep Questionnaire (QSQ). PATIENTS AND METHODS: A multi-center study including a group of patients with SAHS (AHI≥5) referred to the Sleep Unit. All patients completed the following questionnaires: SF-36, FOSQ, QSQ and Epworth scale. Internal consistency, construct validity, concurrent validity, predictive validity, repeatability and responsiveness to change of the QSQ (32 items in five domains: daytime sleepiness, diurnal symptoms, nocturnal symptoms, emotions, and social interactions) were assessed. RESULTS: A hundred twenty one patients were included in the study (mean age: 57 ± 13; mean Epworth: 9 ± 4; mean Body Mass Index (BMI): 28 ± 3 kg·m(-2) and mean AHI: 36 ± 20 hour(-1)). The factorial analysis showed a construct of five factors with similar distribution to the original questionnaire domains. Internal consistency (Cranach's alpha between 0.78 and 0.93 for the different domains), concurrent validity (compared to SF-36, Epworth scale and FOSQ), predictive validity of SAHS severity and test-retest reliability were appropriate. The test showed good responsiveness to change in diurnal (P=.003) and nocturnal symptoms domains (P=.02). CONCLUSIONS: The Spanish version of the QSQ is a valid HRQL measure with appropriate psychometric properties for use in patients with SAHS and is responsive to change in symptoms domains.

Brief report: Association between socio-demographic factors, screen media usage and physical activity by type of day in Spanish adolescents.

This study examined the relationship between socio-demographic factors, screen media time usage, and light, moderate and vigorous activities on weekdays and weekends. Cross-sectional data was collected from 323 Spanish adolescents (mean age 13.59 years) who completed an interview administered recall questionnaire. Structural equation models indicated that male and younger adolescents spent more time on vigorous activities at the weekend, while females and older adolescents showed a greater involvement in light activities both on weekdays and weekends. State school students reported engaging in light and vigorous activities for longer periods than private school students on weekends. TV viewing was negatively linked to vigorous activities during weekdays and to light and moderate activities on weekends. The amount of mobile phone usage, however, was positively linked to light activities during weekdays, but negatively on weekends. The negative relationship between adolescents' use of screen media (TV and mobile phone) and physical activity and its possible displacement, depending on the type of day, added useful comparable knowledge for policies promoting an active lifestyle. Further research is required to provide evidence of the causality in the observed relationships.

[Electrical stimulation in the treatment of the spastic hemiplegic hand after stroke: a randomized study]. / Electroestimulación en el tratamiento de la mano hemipléjica espástica después de un ictus: estudio aleatorizado.

BACKGROUND AND OBJECTIVE: It has been claimed that neuromuscular electrical stimulation (NMES) may enhance hand motor recovery after a stroke. The aim of this study was to examine the effect of an electrostimulation protocol on range of motion and strength of the hand in a group of elderly patients with spastic hemiplegia after a stroke. PATIENTS AND METHOD: 20 elderly patients 60 years old and over with hand impairment due to stroke were randomly assigned to either the experimental group (conventional rehabilitation and NMES) or control group (conventional rehabilitation). NMES was applied on wrist and finger extensors 30 min 3 days/week for 8 weeks. Outcome measurements included goniometry and dynamometry tests. The patients were evaluated at baseline, after 4 and 8 weeks of treatment. RESULTS: After the treatment, the experimental group showed significant improvements (p<0,05) in range of motion: resting wrist angle, active wrist extension, passive wrist extension and resting metacarpophalangeal angle of fingers; and strength of hand: grip and pinch strength. CONCLUSION: The observed changes seem to be associated with the presence of intervention and they suggest that the NMES protocol applied could be a useful complementary rehabilitation treatment to improve hand motor impairment in carefully selected patients after a stroke.