Children and adolescents with eating disorders during COVID-19 confinement: Difficulties and future challenges.

OBJECTIVE: To present the adaptations to treatment protocols made in a child and adolescent eating disorders (ED) unit during the eight-week confinement period mandated in response to the COVID-19 pandemic and examine clinical and treatment variables in the outpatient, day hospital, and inpatient care programs. METHOD: Description of the implementation of a combined teletherapy program for outpatient and day-hospital patients and the adaptations made to the inpatient protocol. Retrospective review of medical records and analysis of general and specific variables related to the pandemic and confinement. RESULTS: We held 1,329 (73.10%) telehealth consultations and 489 (26.9%) face-to-face outpatient visits with 365 patients undergoing treatment in the outpatient clinic or day hospital. Twenty-eight (7.67%) were initial evaluations. Twenty-two patients were newly admitted and 68 ED-related emergencies were attended. Almost half of the children and adolescents studied experienced reactivation of ED symptoms despite treatment, and severe patients (25%) presented self-harm and suicide risk. CONCLUSIONS: The implementation of a combined teletherapy program has enabled continuity of care during confinement for children and adolescents with ED. Delivery of treatment to adolescents in the day hospital program posed the biggest challenge due to their greater degrees of severity and higher hospitalization rates. An adapted inpatient program should be maintained throughout confinement, as the need for hospitalization of children and adolescents with ED does not decrease with lockdown.

Spanish validation of the Eating Disorder Examination Questionnaire for Adolescents (EDE-Q-A): confirmatory factor analyses among a clinical sample.

Most studies of eating disorders (ED) among adolescents have relied on the use of self-report questionnaires given its cost-effectiveness compared to interviews approaches. The Eating Disorders Examination Questionnaire (EDE-Q) is one of the most commonly used self-report measures of eating psychopathology, despite issues regarding the underlying latent structure and its validity in this population. Given the lack of validated measures among Hispanic clinical samples, the current study aimed to validate previously suggested models for the adolescent version (EDE-Q-A) among female teenage patients with ED in Spain (Mage = 15.45, SD = 1.59). Results failed to replicate the theoretical 4-factor structure, and a 2-factor model previously validated in a Hispanic-American community sample showed best fit over a 3-factor and a single-factor model. Excellent levels of internal consistency were observed for the two dimensions of the retained model and for the Global Score of the EDE-Q-A. Significant correlations with well-established measures of ED (Eating Disorders Inventory; EDI-2) and self-esteem are presented as evidence for convergent and concurrent validity. Sensitivity analyses showed a similar pattern of association between the retained model of the EDE-Q-A and the EDI-2. Current findings may contribute to development of evidence-based knowledge on ED among Hispanic clinical populations.

[Executive function in early childhood and Generalizability Theory: Typical babies and preterm babies]. / Desarrollo ejecutivo temprano y Teoría de la Generalizabilidad: bebés típicos y prematuros.

In the areas of Social, Health, and Behavioral Sciences, observational designs are used as one of the best ways to study human behavior in natural and quasi-natural settings. Observing and recording a sample of individual patterns of behavior is a feature common to all of them, but a broad sampling error can be implicit, especially at early ages. Sampling errors arise also as a result of the observation of only a fraction of each possible case, and this is part of the problem involved in the estimation of generalizations of data recorded by systematic observation. The sampling process usually takes place at different stages (observers, sessions, tasks, age, etc...) and requires estimating variance components that can be combined with each other to produce one or more estimates of board coefficients. The Generalizability Theory (GT) proposes that there are many (infinite) sources of variation (facets) in any measurement. Our main objective is to identify the variance components that contribute to estimation errors and implement strategies to reduce the influence of these error sources on the measurement. Executive functioning in typical and premature babies is studied at 15 and 24 months. The results show differences between groups, sources of variation, and generalizability.

Analysis of the Variability of the Game Space in High Performance Football: Implementation of the Generalizability Theory.

The analysis of variability in sport has shown significant growth in recent years. Also, the study of space management in the game field has not been object of research yet. The present study pretends to describe the variability in the use of strategic space in high performance football. To do this, the spatial management of the Spanish men's soccer team when it is in possession of the ball has been analyzed, during its participation in the UEFA Euro 2012 championship. Specifically, 6861 events have been collected and analyzed. Different zoning of the field have been used, and the location of the ball has been recorded in each offensive action. Using the observational methodology as a methodological filter, two types of analysis have been carried out: first, a General Linear Model was implemented to know the variability of the strategic space. Models with two, three, four and five variables have been tested. In order to estimate the degree of accuracy and generalization of the data obtained, the Generalizability Theory was implemented. Next, and in order to estimate the degree of accuracy and generalization of the data obtained, the Generalizability Theory was implemented. The results showed that the model that produces greater variability and better explanation is the four-variable model (P = 0.019; r 2 = 0.838), with the inclusion of the variables match half, rival, move initiation zone and move conclusion zone. Next, an optimization plan was implemented to know the degree of generalization with the Rival, Start Zone (SZ) and Conclusion Zone (CZ) facets. The available results indicate that it is based on an adequate research design in terms of the number of observations. The results of the present study could have a double practical application. On the one hand, the inclusion of the game's space management in training sessions will potentially conceal the true tactical intention. On the other hand, knowing the variability of the strategic space will allow to exploit areas of the optimal playing field to attack the rival team.

What families really think about the quality of early intervention centers: a perspective from mixed methods.

BACKGROUND: Families are a fundamental aspect in the current perspective of Early Intervention, and knowing their opinion with quantitative and qualitative research is necessary for its improvement. The objective of this research was to evaluate the quality of the service perceived in Early Intervention Centers and its relationship with satisfaction and future intention, as well as to identify factors that are associated with the perception of users. METHODS: A measurement model of 50 items and an open question to gather qualitative information was used in a sample of 233 participants. A confirmatory factor analysis and a regression analysis were conducted. Regarding the qualitative data, the information was subjected to a thematic content analysis in order to delve into the perception of the participants. RESULTS: The model showed a satisfactory fit and the regression analysis indicated that treatment rooms (ß =  - 0.28) and adaptation of activities (ß = 0.27) have greater weight with respect to satisfaction, whereas for future intention, the factors of greater weight were adaptation of activities (ß = 0.23) and location (ß = 0.20). The qualitative analysis showed three themes: facilitators, barriers and suggestions for improvement. Within facilitators, the participants were satisfied with the Early Intervention professionals, and they made improvement suggestions for the detected barriers to improve the facilities and the follow-up of the child. CONCLUSIONS: The study offers a wide perspective of the perception of the service with an active participation of families in the treatment within the Early Intervention service. This will allow professionals in Early Intervention, service providers and researchers to consider the families as intervention agents capable of providing their opinion and making decisions, and not only as passive elements.

Early intervention and perceived quality: Refinement of the inventory of quality in early intervention centers.

The current perspective on early intervention revolves around consideration of the family as a cornerstone, its opinion being essential in providing a quality service. Early intervention centers require an evaluation of the services they perform. The aim of this study was to examine the psychometric properties of the short version of the Inventory of Quality for Early Intervention Centers (IQEIC) and to obtain evidence of its validity and reliability. The sample consisted of 887 families from 21 early intervention centers in Spain, which were randomly divided into 2 groups to conduct a cross-validity analysis: exploratory factor analysis with the first group (n1 = 440), and confirmatory factor analysis with the second group (n2 = 447). A 8 factor structure was obtained in the confirmatory factor analysis that showed a good fit. Both the internal consistency (composite reliability ranging from 0.84 to 0.90) and the convergent (AVE values ranged from 0.12 to 0.50) and discriminant validity were adequate. Lastly, a multigroup analysis (n1 and n2) showed the invariance factorial through the difference in the CFI index. The IQEIC showed satisfactory reliability and validity in this study confirming the proposed model is a valid tool to assess the quality of the service provided in early intervention centers, therefore recommending its application for both research and management.

The adolescent onset anorexia nervosa study (ANABEL): Design and baseline results.

The anorexia nervosa adolescent longitudinal biomarker assessment study (ANABEL) is a 2-year longitudinal study. OBJECTIVE: Evaluate several clinical, biochemical, immunological, psychological, and family variables and their interactions in adolescent onset eating disorders (EDs) patients and their 2-year clinical and biological outcome. This article illustrates the framework and the methodology behind the research questions, as well as describing general features of the sample. METHODS: A longitudinal study of 114 adolescents with EDs seeking treatment was performed. Only adolescents were selected during 4 years (2009-2013). The variables were collected at different times: baseline, 6, 12, 18, and 24 months of the start of treatment. Diagnoses were completed through the semi-structured Kiddie-Schedule for Affective Disorders and Schizophrenia interview. RESULTS: At baseline, the mean age was 15.11 (SD = 1.36). The mean ED duration was 10 months (SD = 5.75). The mean body mass index was 16.1 (SD = 1.8). The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition diagnosis at baseline for restrictive anorexia nervosa was 69.6%, 17.4% for purgative anorexia nervosa, and 24.3% for other specified feeding disorder. At 12 months, 19.4% were in partial remission, whereas at 24 months, 13.8% had fully recovered and 29.2% had partially recovered. CONCLUSIONS: There was an acceptable physical and psychopathological improvement during the first year of treatment, with recovery being more evident during the first 6 months.

Systematic Observation: Relevance of This Approach in Preschool Executive Function Assessment and Association with Later Academic Skills.

Executive functions (EFs) are high-level cognitive processes that allow us to coordinate our actions, thoughts, and emotions, enabling us to perform complex tasks. An increasing number of studies have highlighted the role of EFs in building a solid foundation for subsequent development and learning and shown that EFs are associated with good adjustment and academic skills. The main objective of this study was to analyze whether EF levels in 44 Spanish children in the last year of preschool were associated with levels of literacy and math skills the following year, that is, in the first year of compulsory education. We used a multi-method design, which consisted of systematic observation to observe preschool children during play and selective methodology to assess their reading, writing, and math skills in the first year of compulsory primary education. General linear modeling was used to estimate the percentage of variability in academic skills in the first year of primary school that was explained by preschool EF abilities. The results showed that preschool EF level, together with participants and the instrument used to assess academic skills, explained 99% of the variance of subsequent academic performance. Another objective was to determine whether our findings were generalizable to the reference population. To make this determination, we estimated the optimal sample size for assessing preschool EFs. To do this, we performed a generalizability analysis. The resulting generalizability coefficient showed that our sample of 44 students was sufficient for assessing preschool EFs. Therefore, our results are generalizable to the reference population. Our results are consistent with previous reports that preschool EF abilities may be associated with subsequent literacy and math skills. Early assessment of EFs may therefore contribute to identifying children who are likely to experience later learning difficulties and guide the design of suitable interventions for the optimization of EFs.

Does resistance training improve the functional capacity and well being of very young anorexic patients? A randomized controlled trial.

PURPOSE: We determined the effects of a 3-month low-moderate-intensity strength training program (2 sessions/week) on functional capacity, muscular strength, body composition, and quality of life (QOL) in 22 young (12-16 yrs) anorexic outpatients. METHODS: Patients were randomly assigned to a training or control group (n=11 [10 females] each). Training sessions were of low intensity (loads for large muscle groups ranging between 20%-30% and 50%-60% of six repetitions maximum [6RM] at the end of the program). We measured functional capacity by the time up and go and the timed up and down stairs tests. Muscular strength was assessed by 6RM measures for seated bench and leg presses. We estimated percent body fat and muscle mass. We assessed patients' QOL with the Short Form-36 items. RESULTS: The intervention was well tolerated and did not have any deleterious effect on patients' health, and did not induce significant losses in their body mass. The only studied variable for which a significant interaction (group x time) effect was found (p=.009) was the 6RM seated lateral row test. CONCLUSIONS: Low-moderate-intensity strength training does not seem to add major benefits to conventional psychotherapy and refeeding treatments in young anorexic patients.

Hidden patterns of play interaction in soccer using SOF-CODER.

Traditional methods for quantifying sport performances are limited in their capacity to describe the complex interactions of events that occur within a performance over time. The following article outlines a new approach to the study of actions between players in team sports--mainly, soccer. Since the observational design is nomothetic, point, and multidimensional, an observational and data-collecting instrument has been developed. The instrument is mixed and combines a field format with a category system for game events, as well as an ad hoc instrument that considers the game actions of one or both teams, each recorded according to the same criteria. The article also outlines a new approach to the analysis of time-based event records--in this case, sports performance--known as T-pattern detection. The relevant elements of the T-pattern detection process are explained, and exemplar data from analyses of soccer matches are presented to highlight the potential of this form of data analysis. The results suggest that it is possible to identify new kinds of profiles for both individuals and teams on the basis of observational criteria and a further analysis of temporal behavioral patterns detected within the performances.

Deficiencia congénita combinada de los factores V y VII de la coagulación en una familia mexicana: deficiencia Toledo-Tehuantepec, un nuevo trastomo / Coagulation factors V and VII combined congenital deficiency in a Mexican family: Toledo-Tehuantepec deficiency, a new pathological entity

Se encontró deficiencia combinada de los factores V y VII de la coagulación de los miembros de una femilia originaria de Espinal, Oxaca, en el Istmo de Tehuantepec. Los padres son consanguíneos, y ambos tienen el apellido Toledo. Hay labio leporino en el padre y un hijo. Ningún familiar tiene hemorragias anormales pero sus estudios de coagulación del tiempo de protrombina y de tromboplastina parcial resultaron prologados. El padre es deficiente en factor V, la madre en factor VII, y sus hijos heredaron ambas deficiencias (V y VII), lo que indica una transmisión autosómica dominante y el patrón del estado heterocigoto. Esta deficiencia no se ha descrito previamente, por lo que cabe reconocerla con el nombre Toledo-Tehuantepec