Sleep, academic achievement, and cognitive performance in children with attention-deficit hyperactivity disorder: A polysomnographic study.

The objective of this study was to examine the influence of parent-reported and polysomnography (PSG)-measured sleep patterns on the academic and cognitive performance of children with attention-deficit hyperactivity disorder (ADHD). We assessed 91 children (18 girls) diagnosed with ADHD aged 7-11 years (29 ADHD-Inattentive, 32 ADHD-Hyperactive/Impulsive, and 31 ADHD-Combined). The Paediatric Sleep Questionnaire (PSQ) and Paediatric Daytime Sleepiness Scale (PDSS) were used to assess subjective sleep quality, as perceived by parents, and objective sleep variables were assessed by PSG. Cognitive performance was evaluated using the Wechsler Intelligence Scale for Children (WISC), and the final average grade of the last school year was used as a measure of academic performance. Academic performance was predicted by the following sleep variables: Sleep time, time in bed, night awakenings, and daytime sleepiness. The best predictors of cognitive performance in children with ADHD were rapid eye movement latency, light sleep, periodic limb movements index (PLMs), awakenings, and daytime sleepiness. In conclusion, sleep parameters are closely associated with the academic and cognitive functioning of children with ADHD.

Listening to Relaxing Music Improves Physiological Responses in Premature Infants: A Randomized Controlled Trial.

BACKGROUND: Premature infants are exposed to high levels of noise in the neonatal intensive care unit (NICU). PURPOSE: This study evaluated the effect of a relaxing music therapy intervention composed by artificial intelligence on respiratory rate, systolic and diastolic blood pressure, and heart rate. METHODS: A double-blind, randomized, controlled trial was conducted in the NICUs of 2 general public hospitals in Andalusia, Spain. Participants were 17 healthy premature infants, randomly allocated to the intervention group or the control group (silence) at a 1:1 ratio. To be included in the study, the subjects were to be 32 to 36 weeks of gestation at birth (M= 32.33; SD = 1.79) and passed a hearing screening test satisfactorily. The intervention lasted 20 minutes, 3 times a day for 3 consecutive days, while infants were in the incubator. Infants' heart rate, respiratory rate, and blood pressure were assessed before and after each intervention session. RESULTS: After each session, the respiratory rate decreased in the experimental group (main between-groups effect (F1,13 = 6.73, P = .022, ηpartial = 0.34). Across the sessions, the heart rate increased in the control group (main between-groups effect, F1,11 = 5.09, P = .045, ηpartial = 0.32). IMPLICATIONS FOR RESEARCH: Future studies can use this music intervention to assess its potential effects in premature infants. IMPLICATIONS FOR PRACTICE: Nurses can apply the relaxing music intervention presented in this study to ameliorate the impact of the stressful environment on premature infants.

Occupational health of patients with obstructive sleep apnea syndrome: a systematic review.

PURPOSE: The aim of this systematic literature review was to assess the impact of obstructive sleep apnea syndrome (OSAS) on patients' occupational health. METHODS: We selected 19 studies that dealt with issues related to job performance and productivity, absenteeism, and psychosocial health of patients with OSAS and assessed the risk of bias in their conclusions. RESULTS: Although methodologically rigorous studies are needed to confirm these findings, the results obtained suggest the existence of multiple relationships between OSAS and work limitations of patients (i.e., difficulties maintaining attention, learning new tasks, or performing monotonous tasks). The studies reviewed reached more scientifically consistent conclusions about such patients' risk of taking more days of sick leave or having work disability, particularly if they reported excessive daytime sleepiness. Very few studies have explored the relationship between OSAS and psychosocial occupational health of patients. Thus, there is a need for research to clarify these aspects of occupational medicine. CONCLUSIONS: OSAS has numerous effects on patients' occupational health, yet, in general, results should be confirmed by studies with sufficiently large samples in which OSAS is diagnosed with reliable methods and occupational variables are assessed with standardized and validated questionnaires.

Effect of CPAP therapy on job productivity and psychosocial occupational health in patients with moderate to severe sleep apnea.

PURPOSE: The aim of the present study was to assess the effect of continuous positive airflow pressure (CPAP) therapy on burnout symptoms and job productivity, stress, and satisfaction in patients with obstructive sleep apnea syndrome. METHODS: The sample was composed of 55 patients (mean age 48.5 ± 8.9, BMI 31.1 ± 5.7, AIH 56.8 ± 22.1), diagnosed with obstructive sleep apnea syndrome (OSAS) using polysomnography (PSG) with a therapeutic indication of CPAP. Before and after 6 months of receiving CPAP therapy, participants completed the following questionnaires: the index of the impact of the disease on job productivity (IMPALA), the job content questionnaire(JCQ), the Maslach burnout inventory-general survey (MBI-GS), the Shirom-Melamed burnout questionnaire (SMBQ), the index of job satisfaction, the Epworth sleepiness scale (ESS), and the Pittsburgh sleep quality index (PSQI). We explored the efficacy of CPAP therapy at improving the indices of severity of OSAS using therapeutic PSG. RESULTS: CPAP therapy was associated with a beneficial effect on job productivity (IMPALA) (p = 0.000) and decreasing burnout symptoms such as physical fatigue (SMBQ) (p = 0.000), emotional exhaustion (SMBQ) (p = 0.014), cognitive weariness (SMBQ) (p = 0.004), exhaustion (MBI) (p = 0.000), and cynicism (MBI) (p = 0.002). However, CPAP did not decrease job stress or job dissatisfaction. DISCUSSION: In patients with severe OSAS, CPAP therapy has a beneficial effect on patients' occupational well-being and job productivity.

Cognitive-behavioral therapy for insomnia and sleep hygiene in fibromyalgia: a randomized controlled trial.

Sleep disturbances play an important role in the exacerbation of pain and other troubling symptoms reported by patients with fibromyalgia (FM). The objective of this trial was to analyze the efficacy of a cognitive-behavioral therapy for insomnia (CBT-I) versus a sleep hygiene (SH) education program at improving sleep and other clinical manifestations in FM. Sixty-four FM women with insomnia were randomly assigned to the CBT-I or the SH groups, and 59 completed the treatments (30 in the CBT-I group and 29 in the SH group). Participants completed several self-report questionnaires at pre-, post-treatment and follow-ups. The CBT-I group reported significant improvements at post-treatment in several sleep variables, fatigue, daily functioning, pain catastrophizing, anxiety and depression. The SH group only improved significantly in subjective sleep quality. Patients in the CBT-I group showed significantly greater changes than those in the SH group in most outcome measures. The findings underscore the usefulness of CBT-I in the multidisciplinary management of FM.

Time perception and psychopathology: Influence of time perspective on quality of life of severe mental illness.

INTRODUCTION: The study of time perception and mental illness has given priority to time estimation over time perspective. Considering Zimbardo's theory on five dimensions of time perspective, and balanced time perspective profile, this study has aimed to compare people with severe mental illness (SMI) and healthy people, with measurements of time perspective and time estimation and to assess whether the time perspective profile influences the quality of life in people with SMI. MATERIAL AND METHODS: Using a quasi-experimental design, a clinical group (n=167) corresponding to four samples of severe mental disorders (major depression, bipolar disorder, schizophrenia and personality disorders) and healthy people (n=167) were compared in their performance regarding time perspective and time estimation. After, the clinical sample was grouped according to their deviation from the balanced time perspective profile (DBTP) and negative profile (DNTP). These groups were evaluated with health measures and time estimation tasks. RESULTS AND CONCLUSION: Through the ANOVA, it can be seen that the time perspective profile affects health measurements. There are significant differences between the clinical sample and controls regarding time perspective and time estimation. Within the group of patients, it was observed that those who were closer to the BTP profile had better physical health, and less hopelessness (p<.05). This measurement may favor interventions related to a balanced profile. Results are discussed in relation to contribution of time perspective in the assessment, treatment and quality of life of people with SMI.

[Current epidemiological situation of HIV/AIDS in Latin America: analysis of differences among countries]. / Situación epidemiológica actual del VIH/SIDA en Latinoamérica en la primera década del siglo XXI: Análisis de las diferencias entre países.

BACKGROUND: There is a great regional heterogeneity in the prevalence of HIV/ AIDS. AIM: To analyze the current situation of HIV/AIDS in Latin America by means of a comparative analysis among countries. MATERIAL AND METHODS: In a descriptive study (document analysis), epidemiological data about HIV/AIDS in Latin America as well as population data were used. Prevalence indexes and the distribution of HIV/AIDS cases were compared according to gender, age and transmission mode. RESULTS: Dominican Republic, Panama, El Salvador and Honduras are the countries with the highest prevalence indexes. Colombia is in the first position in percentage of young men with HIV/AIDS and it is in the second position in percentage of children. Costa Rica is the second country for percentage of young men and male adults infected with HIV/AIDS. Paraguay is in the second place for children with HIV/AIDS and it is the third country in young men living with HIV/AIDS. Dominican Republic is in the first position in the percentage of young and adult females living with HIV/AIDS. The main transmission mode in all Latin American countries is sexual intercourse (heterosexual and homo/bisexual). CONCLUSIONS: Latin America is a heterogeneous region in HIV/AIDS which should be considered in the development and establishment of prevention strategies.

Content Validity through Expert Judgment for the Depression Clinical Evaluation Test.

Background/Objective: The evaluation of depression requires valid and reliable measuring instruments, which collect a wide spectrum of symptoms that this disorder displays, in order to carry out an accurate and differential diagnosis. The objective of this work is the construction of the Depression Clinical Evaluation Test (DCET), where affective, somatic, cognitive, behavioral and interpersonal symptoms are considered and also analyze its content validity through an expert judgment. Method: Based on different diagnostic and manual classifications, a specification table for a depression test was established. In its evaluation, 16 experts in Psychological Assessment, Psychometry and/or Psychopathology participated. A total of 300 items were created. The experts had to assess the items according to the criteria of Content, Relevance, Clarity, Comprehension, Sensitivity, and Offensiveness. In addition, 50 adults, evaluated the compression of the items. Results: The degree of understanding for all the items was high and the expert judgment favoured the suppression of 104 items, thus obtaining a shorter measuring instrument with a total of 196 items for ease of application. Conclusions: The content validity of the test is adequate and fits the agreed definition of depression.

Antecedentes: La evaluación de la depresión requiere de instrumentos de medida válidos, fiables y que recojan el amplio espectro de síntomas que este trastorno conlleva, para poder llevar a cabo un diagnóstico certero y diferencial. El objetivo de este trabajo es la construcción del Test de Evaluación Clínica de la Depresión (TECD), que contempla síntomas afectivos, somáticos, cognitivos, conductuales e interpersonales, y analizar su validez de contenido a través de un juicio de expertos. Método: A partir de diferentes clasificaciones diagnósticas y manuales se estableció la tabla de especificación del test para este cuestionario de depresión. En la evaluación de este participaron 16 expertos en Evaluación Psicológica, Psicometría y/o Psicopatología. Se crearon 300 ítems en total, que los expertos tuvieron que valorar atendiendo a los criterios de Contenido, Relevancia, Claridad, Comprensión, Sensitividad y Ofensividad. Además, 50 adultos, valoraron la compresión de los items. Resultados: El grado de comprensión de todos los ítems fue elevado y el juicio de expertos supuso la supresión de 104 ítems, obteniendo así un instrumento de medida más breve, con 196 ítems en total, lo que facilitará su aplicación. Conclusiones: La validez de contenido del test es adecuada y se adapta a la definición de depresión establecida.

Network and Exploratory Factorial Analysis of the Depression Clinical Evaluation Test.

Depression is a highly prevalent disorder with a wide range of symptomatology. Existing instruments for its assessment have only a few items for each factor. The Depression Clinical Evaluation Test (DCET) has been created to cover all depression symptoms at different times (month, year, and always) with several items for each facet. The content validity of this instrument has been judged by experts and, in this paper, we analyse its factorial structure and make a network analysis of it. The test (196 items) was administered to 602 adults without psychological disorders (Mage = 24.7, SD = 8.38, 72% women) both online and on paper. A network was estimated for each time point, using the absolute minimum selection and shrinkage operator. From the factor analysis, 12 factors were established for month, 11 for year, and 10 for always, leaving 94 items. The network analysis showed that the facets of depressive mood, anhedonia, and thoughts of Death, are central to all the estimated networks. The DCET is proposed as a valid and reliable multifactorial instrument to detect the variability of depressive symptoms in adults, guaranteeing its diagnostic usefulness.

Effect of an Interdisciplinary Weight Loss and Lifestyle Intervention on Obstructive Sleep Apnea Severity: The INTERAPNEA Randomized Clinical Trial.

Importance: Obesity is the leading cause of obstructive sleep apnea (OSA); however, the effects of weight loss and lifestyle interventions on OSA and comorbidities remain uncertain. Objective: To evaluate the effect of an interdisciplinary weight loss and lifestyle intervention on OSA and comorbidities among adults with moderate to severe OSA and overweight or obesity. Design, Setting, and Participants: The Interdisciplinary Weight Loss and Lifestyle Intervention for OSA (INTERAPNEA) study was a parallel-group open-label randomized clinical trial conducted at a hospital-based referral center in Granada, Spain, from April 1, 2019, to October 23, 2020. The study enrolled 89 Spanish men aged 18 to 65 years with moderate to severe OSA and a body mass index (calculated as weight in kilograms divided by height in meters squared) of 25 or greater who were receiving continuous positive airway pressure (CPAP) therapy. The sole inclusion of men was based on the higher incidence and prevalence of OSA in this population, the differences in OSA phenotypes between men and women, and the known effectiveness of weight loss interventions among men vs women. Interventions: Participants were randomized to receive usual care (CPAP therapy) or an 8-week weight loss and lifestyle intervention involving nutritional behavior change, aerobic exercise, sleep hygiene, and alcohol and tobacco cessation combined with usual care. Main Outcomes and Measures: The primary end point was the change in the apnea-hypopnea index (AHI) from baseline to the intervention end point (8 weeks) and 6 months after intervention. Secondary end points comprised changes in other OSA sleep-related outcomes, body weight and composition, cardiometabolic risk, and health-related quality of life. Results: Among 89 men (mean [SD] age, 54.1 [8.0] years; all of Spanish ethnicity; mean [SD] AHI, 41.3 [22.2] events/h), 49 were randomized to the control group and 40 were randomized to the intervention group. The intervention group had a greater decrease in AHI (51% reduction; change, -21.2 events/h; 95% CI, -25.4 to -16.9 events/h) than the control group (change, 2.5 events/h; 95% CI, -2.0 to 6.9 events/h) at the intervention end point, with a mean between-group difference of -23.6 events/h (95% CI, -28.7 to -18.5 events/h). At 6 months after intervention, the reduction in AHI was 57% in the intervention group, with a mean between-group difference of -23.8 events/h (95% CI, -28.3 to -19.3 events/h). In the intervention group, 18 of 40 participants (45.0%) no longer required CPAP therapy at the intervention end point, and 6 of 40 participants (15.0%) attained complete OSA remission. At 6 months after intervention, 21 of 34 participants (61.8%) no longer required CPAP therapy, and complete remission of OSA was attained by 10 of 34 participants (29.4%). In the intervention vs control group, greater improvements in body weight (change, -7.1 kg [95% CI, -8.6 to -5.5 kg] vs -0.3 kg [95% CI, -1.9 to 1.4 kg]) and composition (eg, change in fat mass, -2.9 kg [95% CI, -4.5 to -1.3 kg] vs 1.4 kg [95% CI, -0.3 to 3.1 kg]), cardiometabolic risk (eg, change in blood pressure, -6.5 mm Hg [95% CI, -10.3 to -2.6 mm Hg] vs 2.2 mm Hg [95% CI, -2.1 to 6.6 mm Hg]), and health-related quality of life (eg, change in Sleep Apnea Quality of Life Index, 0.8 points [95% CI, 0.5-1.1 points] vs 0.1 points [95% CI, -0.3 to 0.4 points]) were also found at the intervention end point. Conclusions and Relevance: In this study, an interdisciplinary weight loss and lifestyle intervention involving Spanish men with moderate to severe OSA and had overweight or obesity and were receiving CPAP therapy resulted in clinically meaningful and sustainable improvements in OSA severity and comorbidities as well as health-related quality of life. This approach may therefore be considered as a central strategy to address the substantial impact of this increasingly common sleep-disordered breathing condition. Trial Registration: ClinicalTrials.gov Identifier: NCT03851653.

Chilean validation of the Posttraumatic Stress Disorder Checklist-Civilian version (PCL-C) after the earthquake on February 27, 2010.

Posttraumatic stress disorder (PTSD) is an anxiety disorder in which an individual re-experiences a traumatic event, avoids situations related to it, and shows excessive arousal. The disorder appears after experiencing a life-threatening event, such as a war or a natural disaster. Thus, the validation of tests which assess the disorder after the earthquake on February 27, 2010, in Chile is crucial for its evaluation and subsequent intervention. The present study includes psychometric data for the Posttraumatic Stress Disorder Checklist-Civilian version (PCL-C) on a sample of 509 survivors of the disaster. Values indicate good psychometric properties of the questionnaire.

Psychosocial correlates of condom use and their relationship with worry about STI and HIV in native and immigrant adolescents in Spain.

The goal of this study was to analyze how worry about sexually-transmitted infections (STI) and HIV influences attitudes and self-efficacy towards condom use, HIV-related knowledge, HIV-perceived susceptibility and HIV-misconceptions in a multicultural sample in Spain. The sample was composed of 3,051 adolescents aged between 14 and 19 years old who lived in Spain. Of these, 67.7% were native Spaniards and the remaining 32.3% were Latin American immigrants. Results showed that worry about STI and HIV has a direct influence on condom use self-efficacy and HIV-knowledge and HIV-perceived susceptibility. Native Spanish adolescents showed higher positive attitudes towards condom use, greater HIV-knowledge and HIV-perceived susceptibility, and lower negative attitudes towards condoms use and HIV-misconceptions than Latin American adolescents. In the discussion, the importance of worry about STI and HIV is highlighted as a mediator variable that can predict risky sexual behavior and is related to cultural origin.

A systematic archival inquiry on Juan Huarte de San Juan (1529­88).

[[Examen de Ingenios historyJuan HuarteTrial of Men's Wits psychiatrypsychology ]] Juan Huarte de San Juan (1529­88) was a physician of the Spanish Renaissance. He wrote the Examen de Ingenios para las Ciencias, translated as The Trial of Men's Wits (1989[1575­94]), a book that has been acknowledged as a precursor of educational psychology, organizational psychology, behaviorism, neuropsychology and psychiatry. Huarte suggested that before beginning a course of study, students' intellectual capabilities (i.e. ingenio) should be matched up with the professional studies that best suit their aptitudes. His book had a great impact in Europe from the late 16th century to the mid-18th century. The influence of the Trial spread throughout many areas including philosophy, politics, linguistics and literature. Although there has been a growing interest in Huarte's work in recent years, biographical studies have been rare; as a result, the information about Huarte's life is currently incomplete, scattered and sometimes inaccurate. This study presents a systematic archival research on Spanish original sources. We present a reconstruction of Huarte's life-story based on 32 original documents (1549­c.1650), some of them first discovered during the present survey. Documents are described according to the General International Standard of Archival Description, ISAD(G). The documents uncovered allow for a reappraisal of Huarte's biography.

Characteristics of sleep spindles in school-aged children with attention-deficit/hyperactivity disorder.

OBJECTIVE: Attention deficit/hyperactivity disorder (ADHD) is a complex disorder, characterized by different presentations with distinct cognitive and neurobiological characterizations. Here we aimed to investigate whether sleep spindle activity, which has been associated with brain maturation, may be a potential biomarker able to differentiate ADHD presentations in school-aged children (7-11 years). METHOD: Spindle characteristics were extracted from overnight polysomnography in 74 children (27 ADHD-Inattentive [IQ = 96.04], 25 ADHD-hyperactive/impulsive [IQ = 98.9], and 22 ADHD-combined [IQ = 96.1]). We obtained data of the frontal (Fz) and parietal (Pz) derivations using a validated spindle detection algorithm. RESULTS: Children with ADHD showed a higher number and density of slow compared to fast spindles which were more frequent in frontal area. No differences were observed among ADHD presentations for any spindle characteristics. Spindle frequency and density increased with age, indicating an age-dependent maturation of different sleep spindles. However, no associations between IQ and spindle characteristics were observed. CONCLUSIONS: In children with ADHD the spindle characteristics evolve with age but sleep spindle activity does not seem to be a valid biomarker of ADHD phenotypes or general cognitive ability.

Chilean experimental version of the State-Trait Depression Questionnaire (ST-DEP): State subscale (S-DEP).

Depression is the most prevalent mental disorder and one of the most important health problems in Chile. The current study shows data for validity and reliability of the State subscale (S-DEP) of the Chilean experimental version of the State-Trait Depression Questionnaire (ST-DEP). The procedure conducted with the original version of the questionnaire was replicated on a sample of 300 university students. The utilized measures were the State Depression Questionnaire, Beck Depression Inventory, the State-Trait Anxiety Inventory, and neutral depressive, mild depressive, and moderate depressive vignettes. Results indicated that the factor structure was replicable, the internal consistency was good, and the situations were ranked as expected. The scale distinguishes intensities of depression. Clinicians and researchers in Chile are provided with a new measure for state depression.

Analysis of the relationship between the number of citations and the quality evaluated by experts in psychology journals.

The study analyzes the relationship between the number of citations as calculated by the IN-RECS database and the quality evaluated by experts. The articles published in journals of the Spanish Psychological Association between 1996 and 2008 and selected by the Editorial Board of Psychology in Spain were the subject of the study. Psychology in Spain is a journal that includes the best papers published throughout the previous year, chosen by the Editorial Board made up of fifty specialists of acknowledged prestige within Spanish psychology and translated into English. The number of the citations of the 140 original articles republished in Psychology in Spain was compared to the number of the citations of the 140 randomly selected articles. Additionally, the study searched for a relationship between the number of the articles selected from each journal and their mean number of citations. The number of citations received by the best articles as evaluated by experts is significantly higher than the number of citations of the randomly selected articles. Also, the number of citations is higher in the articles from the most frequently selected journals. A statistically significant relation between the quality evaluated by experts and the number of the citations was found.

[Ranking of 2009 in research in Spanish public universities]. / Ranking de 2009 en investigación de las universidades públicas españolas.

In recent years, there has been a growing interest in the development of quality rankings of universities, both nationally and internationally. The lack of clarity in the collection and presentation of information means that many of these classifications are difficult to understand and interpret, so that it is necessary to establish a series of considerations about the name of ranking, selection criteria, the weight indicators, the type and choice of institutions that are evaluated, the size of the institutions, information sources, the one-dimensionality/multi-dimensionality of the rankings, frequency and quality criteria. In addition to providing this information, the aim of this study is to update and improve the research ranking of Spanish public universities of 2009. The same methodology as in the ranking of 2008 is followed, adding a new criterion, which refers to the patents registered and operated, and also enhances the rate of research sections. Results allow the analysis of the strengths and weaknesses of each Spanish public university in the area of research.

[Relationship between productivity and efficiency in research funding for Spanish regions]. / Relación de la productividad y eficiencia en investigación con la financiación de las comunidades autónomas españolas.

Quality is a major current needs and requirements for any university system. The funding that universities receive a relevant influence on the scientific productivity of these. Thus the main objective of this study is to classify the Spanish regions in terms of scientific productivity and economic efficiency of their universities. It followed the same procedure used to prepare the 2009 ranking of research productivity in Spanish universities. The results show that there are differences in the classifications made on the basis of productivity and efficiency in the investigation. The more efficient Spanish regions in managing its resources to obtain research results are Catalonia, Asturias, Aragon, and Cantabria. From the results, each region can compare their situation with the rest and analyze strengths and weaknesses in research in terms of resources.

Factors associated with rape-supportive attitudes: sociodemographic variables, aggressive personality, and sexist attitudes.

The objectives of this study were to determine the influence of various sociodemographic variables and estimate the impact of additional psychological factors (aggressive personality traits and the sexual double standard) on rape-supportive attitudes. A sample of 700 men and 800 women from El Salvador aged between 18 and 40 years completed the Social Desirability Scale, the Double Standard Scale, the Aggression Questionnaire, the State-Trait Anger Expression Inventory-2 and the Rape-Supportive Attitude Scale. Results show gender-based and age-based differences in rape-supportive attitudes, as well as an interaction between gender and age. They also highlight the importance of the sexual double standard and aggressive personality traits in explaining such attitudes.