Impact of the COVID-19-pandemic and perception of self-efficacy on the mental health of out-of-hospital emergency healthcare professionals by modality of care.

OBJECTIVE: To analyse the influence of the COVID-19 pandemic and the perception of self-efficacy on the health professionals of the Spanish out-of-hospital emergency services. DESIGN: Observational, cross-sectional and descriptive with a survey methodology of 1710 participants from Spain (1 February-30 April, 2021). METHODS: The mental health of healthcare workers was assesed in terms of stress, anxiety and depression, as well as their self-efficacy. Linear and logistic regression models were fitted to predict these variables. A moderation analysis was conducted to determine the effect of self-efficacy on mental health. RESULTS: The means of the sample for stress, anxiety, depression and self-efficacy were 20.60, 15.74, 13.07 and 70.87, respectively. In the regression models, being a woman was the most significant factor for severe mental health impairment. Female gender was also a relevant factor for self-efficacy. Self-efficacy had a direct effect on the mental health for working in patient care. CONCLUSIONS: Healthcare workers showed moderate stress, severe anxiety, mild depression and good self-efficacy. Direct patient care was associated with more stress and severe anxiety. Age, female gender, job changes and job adjustment were associated with levels of stress, anxiety and depression. Self-efficacy is a determining factor of mental health in the direct care modality. IMPLICATIONS: The mental health of healthcare workers has been of great importance in the aftermath of the pandemic, but out-of-hospital emergency workers have been neglected in research. The levels of stress, anxiety and depression during the pandemic justify the creation of prevention and early diagnosis programmes, as they are essential in a health disaster. Surprisingly, their high level of perceived self-efficacy directly impact on the mental health of patient helthcare workers, so improving it will reduce the psychological risk. REPORTING METHOD: We have followed the STROBE guidelines. It has been partially funded by the Asistencia Sanitanitaria Interprovincial de Seguros - ASISA Foundation (Spain). PATIENT OR PUBLIC CONTRIBUTION: 'No patient or public involvement'.

Experiences of Spanish out-of-hospital emergency workers with high levels of depression during the COVID-19 pandemic: a qualitative study.

BACKGROUND: The COVID-19 pandemic had a major psychological impact on health care workers (HCWs). This study was embedded in a larger quantitative study on the mental health care of out-of-hospital HCWs in Spain. To better understand this, a qualitative study was conducted to explore the experiences, coping strategies, and influencing factors of out-of-hospital HCWs who scored high (> 25 points) on the Depression Anxiety Stress Scale (DASS-21) in a previous quantitative mental health study. METHODS: A qualitative study was conducted using six in-depth interviews with individuals who scored high on the depression scale and agreed to be contacted by email between May and June 2021, using the phenomenological approach. The data were analysed using Brawn and Clare's method. RESULTS: The main results findings related to four themes. The emotional impact of assuming a professional role with high self-demands and responsibilities; Factors influencing the development of negative emotions such as the cruelty of the pandemic, the helplessness in relation to health management and policy, the changing role of the professional and the relationship with society; Personal protection through coping strategies to manage negative emotions such as support from colleagues and family; Good practices for the future looking for different management strategies that can influence individuals and their personal, professional, and social relationships. CONCLUSION: The strong impact of the circumstances experienced points to the need to develop psychological support programmes that can protect people's mental health from depression during a crisis and improve the relationship between workers and their managers.

RESUMEN: ANTECEDENTES: La pandemia de COVID-19 tuvo un gran impacto psicológico en el personal sanitario. Este estudio forma parte de un estudio cuantitativo más amplio sobre la atención a la salud mental de los trabajadores sanitarios extrahospitalarios en España. Para comprenderlo mejor, se llevó a cabo un estudio cualitativo para explorar las experiencias, estrategias de afrontamiento y factores de influencia de los trabajadores extrahospitalarios que obtuvieron puntuaciones altas (> 25 puntos) en la Escala de Depresión, Ansiedad y Estrés (DASS-21) en un estudio cuantitativo previo sobre salud mental. MéTODOS: Se realizó un estudio cualitativo mediante seis entrevistas en profundidad con individuos que puntuaron alto en la escala de depresión y aceptaron ser contactados por correo electrónico entre mayo y junio de 2021, utilizando el enfoque fenomenológico. Los datos se analizaron utilizando el método de Brawn y Clare. RESULTADOS: Los principales hallazgos de los resultados se relacionaron con cuatro temas. El impacto emocional de asumir un rol profesional con altas autoexigencias y responsabilidades; Factores que influyen en el desarrollo de emociones negativas como la crueldad de la pandemia, la impotencia en relación con la gestión y la política sanitaria, el papel cambiante del profesional y la relación con la sociedad; Protección personal a través de estrategias de afrontamiento para gestionar las emociones negativas como el apoyo de los compañeros y la familia; Buenas prácticas para el futuro buscando diferentes estrategias de gestión que puedan influir en los individuos y en sus relaciones personales, profesionales y sociales. CONCLUSIóN: El fuerte impacto de las circunstancias vividas apunta a la necesidad de desarrollar programas de apoyo psicológico que puedan proteger la salud mental de las personas durante una crisis y mejorar la relación entre los trabajadores y sus jefes.

Exploring Disparities in Self-Reported Mental Health Symptoms Across Professional Categories in Spain's Emergency Medical Services: A Nationwide Cross-Sectional Study.

OBJECTIVE: This study aimed to analyze stress, anxiety, depression, and self-efficacy levels among Spanish out-of-hospital emergency medical professionals from February 1, 2021, to April 30, 2021. METHODS: A nationwide survey was completed by 1666 Emergency Medical Services (EMS) workers. The Depression, Anxiety, and Stress Scale (DASS-21) and the General Self-Efficacy Scale (GSE) were used. Data analysis used chi-squared, análisis of variance (ANOVA), and logistic regressions. RESULTS: The sample comprised 833 (50%) men, with an average age of 44.3 ± 9.9 y (range: 19-67 y). Occupational distribution included 453 (27.2%) physicians, 474 (28.4%) nurses, and 739 (44.4%) emergency medical technicians (EMTs). EMTs exhibited higher odds of severe or extremely severe depression compared with physicians (odds ratio [OR]: 1.569; 95% confidenceinterval [95% CI]: 1.213-2.030) and nurses (OR: 1.561; 95% CI: 1.211-2.012). EMTs also displayed higher probabilities of severe or extremely severe anxiety compared with nurses (OR: 1.944; 95% CI: 1.529-2.701). Furthermore, EMTs demonstrated elevated probabilities of severe or extremely severe stress compared with physicians (OR: 1.387; 95% CI: 1.088-1.770). However, no significant differences were found in self-efficacy, with a median value of 73 [20]. CONCLUSIONS: Out-of-hospital EMS workers experienced mental health challenges, showing varying levels of depression, stress, and anxiety across different occupational groups. EMTs were particularly affected.

Impacto de la pandemia COVID-19 en la salud mental de profesionales sanitarios de los servicios de emergencias médicas extrahospitalarios españoles / The impact of the COVID-19 pandemic on the mental health of healthcare professionals from the Spanish outpatient medical emergency services

Objetivo: analizar el nivel de afectación psicológica de los profesionales sanitarios (PS) de servicios de emergencias extrahospitalarias (SEM) españoles en función de la incidencia acumulada de COVID-19 de las comunidades autónomas (CC.AA.) en las que trabajaban, identificando posibles factores predictores de una mayor severidad.Método: estudio descriptivo transversal multicéntrico en el que se incluyeron a todos los PS que se encontrasen trabajando en algún SEM de la geografía española entre el 01/02/2021 y el 30/04/2021. Las variables principales fueron: nivel de estrés, ansiedad y depresión, evaluados mediante la escala DASS-21, recogiéndose también información sociodemográfica, clínica y laboral. Se llevó a cabo un análisis univariante y multivariante de regresión logística.Resultados: la muestra estuvo formada por 1.710 PS. El 37,39%, el 39,36% y el 30,46% de las personas participantes presentaron niveles graves de estrés, ansiedad y depresión, respectivamente. Las mujeres, quienes eran más jóvenes o con menos experiencia laboral en SEM, el personal técnico en emergencias sanitarias, quienes declararon consumo previo de psicoterapia y/o psicofármacos, o quienes modificaron sus condiciones laborales, tuvieron más probabilidades de desarrollar niveles más graves de estrés, ansiedad o depresión, variando estos factores en función del área geográfica (clasificada según la IA de COVID-19) de trabajo.Conclusiones: la IA de casos COVID-19 en las diferentes CC.AA. no ha condicionado la aparición de niveles psicopatológicos de estrés, ansiedad y depresión en los PS del ámbito extrahospitalario español; si bien, en cada una de ellas, se han identificado factores sociodemográficos, clínicos o laborales que predisponen a una mayor afectación psicológica.(AU)

Objective: to analyse the level of psychological impact on healthcare professionals from Spanish outpatient emergency services (OES) based on the cumulative incidence of COVID-19 in the autonomous communities (AA.CC.) where they were working, identifying potential factors to predict higher severity.Method: a multi-center cross-sectional descriptive study, including all healthcare professionals who were working in any OES within the Spanish geography between 02/01/2021 and 04/30/2021. The main variables were: level of stress, anxiety and depression, assessed through the DASS-21 scale. Sociodemographic, clinical and occupational information was also collected. Univariate and multivariate analysis of logistical regression was conducted.Results: the sample included 1,710 healthcare professionals; 37.39%, 39.36% and 30.46% of the participants presented severe levels of stress, anxiety, and depression, respectively. Women, those younger or with less experience of work at OES, the technical staff in healthcare emergencies, those who declared previous use of psychotherapy and/or psychotropic drugs, or those who modified their working conditions, presented higher likelihood of developing more severe levels of stress, anxiety or depression; these factors varied according to the geographical area (classified by the cumulative incidence of COVID-19) where they worked.Conclusions: the cumulative incidence of COVID-19 cases in the different autonomous communities has not determined the development of psychopathological levels of stress, anxiety and depression in healthcare professionals from the outpatient setting; however, sociodemographic, clinical or occupational factors have been detected in each one which predisposed them to a higher psychological impact.(AU)

COVID-19 Pandemic Control Measures and Their Impact on University Students and Family Members in a Central Region of Spain.

The first waves of the COVID-19 pandemic were times of great change in the lives of university students and their families in Spain. The aim of this study was to explore the psychosocial aspects and preventive measures carried out during the COVID-19 pandemic by students and family members of the nursing degree students of the University of Valladolid (Spain). The number of people surveyed was 877, by means of an ad hoc questionnaire. Relationships between variables were established by means of the Chi-square test and Student's t-test. In addition, multivariate logistic regression was generated. The significance level used was 0.05. Students and family members maintained preventive measures= such as hand washing, correct use of masks =in closed places, avoiding crowds and maintaining social distance, but at low rates (close to 20% in all cases). Regarding psychosocial aspects, 41.07% of the participants suffered from anxiety and loneliness, while 5.2% needed to take drugs to reduce anxiety or sleep and 66.07% were dependent on technology. Suicidal behavior is related to stress, anxiety, loneliness, poor family relationships, psychotropic drug use and technology abuse. The pandemic has caused life changes in university students and their families at the psychosocial level, generating high figures of suicidal ideation regardless of age. Preventive measures adopted to control the pandemic have not been followed for the most part.

Influence of Previous Mental State on Psychological Outcomes of Spanish Out-of-Hospital Professionals during the COVID-19 Pandemic.

This study aimed to describe factors relating to the psychological distress of healthcare workers (HCWs) in Spanish out-of-hospital emergency medical services (EMS), according to the previous or non-use of psychotropic drugs or psychotherapy. A multicentre, cross-sectional descriptive study was designed. The study population were all physicians, nurses, and emergency medical technicians (EMTs) working in any Spanish out-of-hospital EMS between February and April 2021. The main outcomes were the levels of stress, anxiety, depression, and self-efficacy, assessed by DASS-21 and G-SES. Differences in levels of stress, anxiety, depression, and self-efficacy, according to sex, age, previous use of psychotropic drug or psychotherapy, work experience, professional category, type of work, and modification of working conditions were measured using the Student's t-test for independent samples, one-way ANOVA, Pearson's correlation, or 2-factor analysis of covariance. A total of 1636 HCWs were included, of whom one in three had severe mental disorders because of the pandemic. The interaction of the previous or non-use of psychotropic drugs or psychotherapy with the rest of the factors considered did not modify the levels of stress, anxiety, depression, and self-efficacy. However, HCWs with a history of psychotropic drug or psychotherapy use had a more intense negative emotional response and lower self-efficacy, regardless of their sex, professional category, type of work, or change in the working conditions. These HCWs are considered particularly vulnerable to the development or recurrence of new disorders or other comorbidities; therefore, the implementation of monitoring and follow-up strategies should be a priority.

Psychometric Properties of the Action Research Arm Test (ARAT) Scale in Post-Stroke Patients-Spanish Population.

The validation of measuring instruments in the field of health is a requirement before they can be used safely and reliably. The action research arm test (ARAT) tool is an instrument validated in numerous countries and languages and for different populations, and its use is widespread. The objective of this research was to determine the psychometric properties of ARAT for a sample composed of post-stroke patients. To achieve this, a psychometric analysis was performed, where internal consistency tests were carried out using Cronbach's alpha, correlations between items and item-total and half-level tests to verify their reliability. Regarding validity, criteria validity tests were performed, taking the motor function dimension of the Fugl-Meyer scale as gold standard, and convergent validity tests were performed by correlation with the FIM-FAM, ECVI-38 and Lawton and Brody scales. The results showed very good internal consistency as well as good criterion and convergent validity. In conclusion, the ARAT can be considered a valid and reliable instrument for the evaluation of upper limb function in post-stroke patients.

Reliability and Validity of the Motor Activity Log (MAL-30) Scale for Post-Stroke Patients in a Spanish Sample.

BACKGROUND: The validation of assessment instruments is of great importance when they are applied in clinical and healthcare settings, since their safe and reliable use is essential for the application of appropriate and high-quality treatments. The motor activity log (MAL-30) is an instrument widely used by professionals in the clinic, which has been validated in different countries, languages and populations. The aim of this study was to determine the reliability and validity of the MAL-30 scale for post-stroke patients in a Spanish sample. METHODS: For this purpose, internal consistency tests were carried out using Cronbach's alpha, item-item and item-total correlations, and a half-and-half test for reliability. For the validation, criterion validity tests were performed using the Fugl-Meyer assessment scale as the gold standard, and the convergent validity tests were carried out by correlation with the action research arm test (ARAT), box and block test (BBT), functional independence measure (FIM)-functional assessment measure (FAM), Lawton and Brody index and stroke quality of life scale (ECVI-38). RESULTS: The results showed good internal consistency, as well as a good criterion and convergent validity. CONCLUSIONS: The MAL-30 instrument can be considered a valid and reliable tool for assessing the quantity and quality of the use of the affected upper limb in the performance of the activities of daily living and the instrumental activities of daily living after stroke in a Spanish sample.

Influence of the Cumulative Incidence of COVID-19 Cases on the Mental Health of the Spanish Out-of-Hospital Professionals.

This study aimed to analyze the psychological affectation of health professionals (HPs) of Spanish Emergency Medical Services (EMSs) according to the cumulative incidence (CI) of COVID-19 cases in the regions in which they worked. A cross-sectional descriptive study was designed, including all HPs working in any EMS of the Spanish geography between 1 February 2021 and 30 April 2021. Their level of stress, anxiety and depression (DASS-21) and the perception of self-efficacy (G-SES) were the study's main results. A 2-factor analysis of covariance was used to determine if the CI regions of COVID-19 cases determined the psychological impact on each of the studied variables. A total of 1710 HPs were included. A third presented psychological impairment classified as severe. The interaction of CI regions with the studied variables did not influence their levels of stress, anxiety, depression or self-efficacy. Women, younger HPs or those with less EMS work experience, emergency medical technicians (EMT), workers who had to modify their working conditions or those who lived with minors or dependents suffered a greater impact from the COVID-19 pandemic in certain regions. These HPs have shown high levels of stress, anxiety, depression and medium levels of self-efficacy, with similar data in the different geographical areas. Psychological support is essential to mitigate their suffering and teach them to react to adverse events.

Psychological Impact of the COVID-19 Pandemic on Out-of-Hospital Health Professionals: A Living Systematic Review.

Health professionals (HPs), especially those working in the front line, have been one of the groups most affected by the COVID-19 pandemic. The objective of this study is to identify the best available scientific evidence on the impact of the COVID-19 pandemic on the mental health of out-of-hospital HPs in terms of stress, anxiety, depression, and self-efficacy. A living systematic review of the literature was designed, consulting the electronic online versions of the CINHAL, Cochrane Library, Cuiden, IBECS, JBI, LILACS, Medline PyscoDoc, PsycoINFO, Scopus, and Web of Science databases in November 2021. Original research was selected, published in either English, Spanish, French, Italian, or Portuguese. In total, 2082 publications were identified, of which 16 were included in this review. The mental health of out-of-hospital HPs was affected. Being a woman or having direct contact with patients showing suspicious signs of COVID-19 or confirmed cases were the factors related to a greater risk of developing high levels of stress and anxiety; in the case of depressive symptoms, it was having a clinical history of illnesses that could weaken their defenses against infection. Stopping unpleasant emotions and thoughts was the coping strategy most frequently used by these HPs.

Mindfulness-Based Program for Anxiety and Depression Treatment in Healthcare Professionals: A Pilot Randomized Controlled Trial.

In primary health care, the work environment can cause high levels of anxiety and depression, triggering relevant expert and individual change. Mindfulness-Based Stress Reduction (MBSR) programs reduce signs of anxiety and depression. The purpose of this sub-analysis of the total project, was to equate the effectiveness of the standard MBSR curriculum with the abbreviated version in minimizing anxiety and depression. This randomized controlled clinical trial enrolled 112 mentors and resident specialists from Family and Community Medicine and Nurses (FCMN), distributed across six teaching units (TU) of the Spanish National Health System (SNHS). Experimental group participants received a MBRS training (abbreviated/standard). Depression and anxiety levels were measured with the Goldberg Anxiety and Depression Scale (GADS) at three different time periods during the analysis: before (pre-test) and after (post-test) participation, as well as 3 months after the completion of intervention. Taking into account the pre-test scores as the covariate, an adjusted analysis of covariance (ANCOVA) showed significant depletion in anxiety and depression in general (F (2.91) = 4.488; p = 0.014; η2 = 0.090) and depression in particular (F (2, 91) = 6.653; p = 0.002; η2 = 0.128 at the post-test visit, maintaining their effects for 3 months (F (2.79) = 3.031; p = 0.050; η2 = 0.071-F (2.79) = 2.874; p = 0.049; η2 = 0.068, respectively), which is associated with the use of a standard training program. The abbreviated training program did not have a significant effect on the level of anxiety and depression. The standard MBSR training program had a positive effect on anxiety and depression and promotes long-lasting effects in tutors and resident practitioners. New research is needed to demonstrate the effectiveness of abbreviated versions of training programs.

Análisis de los factores relacionados con el tiempo prehospitalario en la atención al ictus / Factors related to prehospital time in caring for patients with stroke

Objetivo: Identificar factores que influyen en el tiempo prehospitalario (TPH) en pacientes que presentan un ictus. Método: Se realizó una revisión sistemática de la literatura en 6 bases de datos. Se seleccionaron estudios descriptivos, publicados entre 1995 y 2019, en inglés, portugués o castellano, que identificasen factores que influyen en el TPH en pacientes que han padecido un ictus. Resultados: Se analizaron 101 artículos. Se identificaron factores relacionados con el marco temporal en la atención prehospitalaria del ictus, que se clasificaron en sociodemográficos, clínicos, contextuales, cognitivos y conductuales. El aviso inmediato al sistema de emergencias médicas (SEM) fue el principal factor que redujo el TPH; ser derivado desde otro centro sanitario se relacionó con un mayor TPH. Conclusión: El TPH depende de factores inherentes al paciente y a su entorno. Es necesario el desarrollo de estrategias educativas que incidan sobre dichos factores, especialmente sobre la importancia de reconocer los síntomas iniciales del ictus y del aviso inmediato al SEM. (AU)

Objectives: To identify factors that affect prehospital time (PHT) for patients with stroke. Material and methods: Systematic review. We searched 6 databases to select descriptive studies of factors influencing PHT in stroke. The studies selected were published in English, Portuguese, or Spanish between 1995 and 2019. Results: One hundred one articles were analyzed. Sociodemographic, clinical, contextual, cognitive, and behavioral data related to PHT in patients with stroke were identified. Calling the emergency medical services (EMS) immediately after onset of stroke symptoms was the main factor associated with a shorter PHT. Referral from another hospital was associated with a longer PHT. Conclusion: PHT is affected by factors inherent to patients and the setting for the event. Educational strategies should be developed to address relevant factors, especially regarding the importance of recognizing the onset of a stroke and calling the EMS immediately. (AU)

Factors related to prehospital time in caring for patients with stroke. / Análisis de los factores relacionados con el tiempo prehospitalario en la atención al ictus.

OBJECTIVES: To identify factors that affect prehospital time (PHT) for patients with stroke. MATERIAL AND METHODS: Systematic review. We searched 6 databases to select descriptive studies of factors influencing PHT in stroke. The studies selected were published in English, Portuguese, or Spanish between 1995 and 2019. RESULTS: One hundred one articles were analyzed. Sociodemographic, clinical, contextual, cognitive, and behavioral data related to PHT in patients with stroke were identified. Calling the emergency medical services (EMS) immediately after onset of stroke symptoms was the main factor associated with a shorter PHT. Referral from another hospital was associated with a longer PHT. CONCLUSION: PHT is affected by factors inherent to patients and the setting for the event. Educational strategies should be developed to address relevant factors, especially regarding the importance of recognizing the onset of a stroke and calling the EMS immediately.

OBJETIVO: Identificar factores que influyen en el tiempo prehospitalario (TPH) en pacientes que presentan un ictus. METODO: Se realizó una revisión sistemática de la literatura en 6 bases de datos. Se seleccionaron estudios descriptivos, publicados entre 1995 y 2019, en inglés, portugués o castellano, que identificasen factores que influyen en el TPH en pacientes que han padecido un ictus. RESULTADOS: Se analizaron 101 artículos. Se identificaron factores relacionados con el marco temporal en la atención prehospitalaria del ictus, que se clasificaron en sociodemográficos, clínicos, contextuales, cognitivos y conductuales. El aviso inmediato al sistema de emergencias médicas (SEM) fue el principal factor que redujo el TPH; ser derivado desde otro centro sanitario se relacionó con un mayor TPH. CONCLUSIONES: El TPH depende de factores inherentes al paciente y a su entorno. Es necesario el desarrollo de estrategias educativas que incidan sobre dichos factores, especialmente sobre la importancia de reconocer los síntomas iniciales del ictus y del aviso inmediato al SEM.

Effectiveness of a Mindfulness and Self-Compassion Standard Training Program versus an Abbreviated Training Program on Stress in Tutors and Resident Intern Specialists of Family and Community Medicine and Nursing in Spain.

Stress is one of the most common problems among healthcare professionals, as they are exposed to potentially stressful and emotionally challenging situations in the workplace. Mindfulness-based stress reduction (MBSR) training programs have been shown to decrease stress. The objective of this study was to compare the effectiveness of an abbreviated 4-weeks MBSR training program in relation to a standard 8-weeks one on the stress levels. A controlled and randomized clinical trial was designed, in which 112 tutors and resident intern specialists in Family and Community Medicine and Nursing of six Spanish National Health System teaching units (TUs) participated. Participants included in the experimental groups (EGs) received a MBRS training program (standard or abbreviated), while control group (CG) participants did not receive any intervention. The stress levels were assessed by the Perceived Stress Questionnaire (PSQ) in three different moments during the study: before, immediately after, and 3 months after the intervention. Adjusted covariance analysis (ANCOVA), using pretest scores as the covariate, showed a significant reduction in stress (F(2,91) = 5.165; p = 0.008; η2 = 0.102) in the post-test visit, attributable to the implementation of the standard training program, but without the maintenance of its effects over time. No significant impact of the abbreviated training program on stress levels was observed in the intergroup comparison. A standard 8-weeks MBSR training program aimed at tutors and resident intern specialists in Family and Community Medicine and Nursing produces significant improvements in stress levels compared with the abbreviated intervention and no intervention. New studies about abbreviated training programs are needed to provide effective treatments which improve well-being of these professionals.

The ISJ 3D Brace, a Providence Brace Evolution, as a Surgery Prevention Method in Idiopathic Scoliosis.

BACKGROUND: The high incidence of idiopathic scoliosis worldwide as well as the serious health problems it can cause in adulthood, make it necessary to seek effective treatments to prevent the progression of the disease to more aggressive treatments such as surgery and improve patients' quality of life. The use of night braces, besides a less severe influence on the patient's quality of life, is effective in stopping the progression of the curve in idiopathic scoliosis. METHODS: A longitudinal study was performed with an experimental population of 108 participants who attended orthotic treatment at the University Hospital of Barcelona, with ages between 4 and 15 years old, with a main curvature greater than 25 degrees and a Risser between 0 and 3. The participants received treatment with Providence ISJ-3D night braces until their pubertal change (mean duration of 2.78 years for males and 1.97 years for females). RESULTS: The implementation of night-time orthotic treatment in children with idiopathic scoliosis is effective in slowing the progression of the curve and in the prevention of more aggressive treatments such as surgery, maintaining the patient's quality of life. CONCLUSIONS: The use of night braces is efficacious in the treatment of idiopathic scoliosis, although new studies including more sociodemographic data as well as curves from 20 degrees of progression are necessary.

Psychological Effects of Home Confinement and Social Distancing Derived from COVID-19 in the General Population-A Systematic Review.

(1) Background: Home confinement and social distancing are two of the main public health measures to curb the spread of SARS-Cov-2, which can have harmful consequences on people's mental health. This systematic review aims to identify the best available scientific evidence on the impact that home confinement and social distancing, derived from the SARS-CoV-2 pandemic, have had on the mental health of the general population in terms of depression, stress and anxiety. (2) Methods: A systematic search was conducted on PubMed, Scopus, Web of Science and ScienceDirect between 2 January 2021 and 7 January 2021, in accordance with the recommendations of the PRISMA Declaration. The selection of studies and the evaluation of their methodological quality were performed in pairs, independently and blindly, based on predetermined eligibility criteria. (3) Results: The 26 investigations reviewed were developed in different regions and countries. Factors that are associated with poor mental health were female gender, young ages, having no income and suffering from a previous psychiatric illness. Inadequate management of the pandemic by authorities and a lack or excess of information also contributed to worse mental health. (4) Conclusions: There are groups of people more likely to suffer higher levels of anxiety, depression and stress during the restrictive measures derived from COVID-19.

Exploring the Occupational Balance of Young Adults during Social Distancing Measures in the COVID-19 Pandemic.

(1) Background: A balanced life is related to good health in young people, one of the groups most affected by confinement and social distancing measures during the COVID-19 pandemic. This study aims to explore the occupational balance of young adults during home confinement and its association with different sociodemographic factors. (2) Methods: A cross-sectional study was designed, and an online survey was disseminated to collect sociodemographic and occupational balance data, using the Occupational Balance Questionnaire (OBQ). The statistical analysis was performed using the SPSS statistical software package version 24.0. (3) Results: 965 young adults between 18 and 30 years old participated in the study. A predictive model showed that the main predictors of a lower occupational balance were a negative self-perception (ß= 0.377; p = <0.0001), student status (ß = 0.521; p = 0.001), not receiving enough information (ß = 0.951; p = 0.001) and long periods of quarantine (ß = 0.036; p = 0.007). (4) Conclusions: Considering people's occupational health and related factors could lessen many of the psychosocial consequences of isolation and contribute to the well-being of young people.

Explanatory Factors for Periprosthetic Infection in Total Knee Arthroplasty.

There are many studies whose results reveal possible risk factors for developing an infection after a total knee arthroplasty (TKA). The objective of this study is to analyse the risk factors that depend on the hospital and, especially, if the patellar replacement influences the appearance of periprosthetic infection. A retrospective study was performed, where data from the electronic registry of patients of people over 18 and who had undergone TKA, between the years 2015 and 2018, were reviewed. Dependent variables on the patients and the health care system were collected. The possible associations between the factors and the appearance of infection after TKA were studied using univariate and multivariate regression analyses. A total of 907 primary knee arthroplasties were included in the study. Those patients who had their patella replaced had a significantly higher risk of developing an infection (OR 2.07; 95% confidence interval 1.01-6.31). Likewise, patients who underwent surgery by surgeons with more than 10 years of experience were more than twice as likely to become infected than those operated on by younger surgeons (OR 2.64; 95%CI 1.01-6.97). Male patients were also found to be three times more likely to be infected than women (OR 2.99; 95%CI 1.32-5.74). Those interventions that were longer had a higher risk of infection. The same happened with patients who stayed in the hospital for a longer period of time. The rest of the variables did not show statistically significant results. In this study, it was found that the replacement of the patella may be a factor of infection, but it should be corroborated with randomized clinical trials. Furthermore, patients who underwent longer surgeries or those with prolonged hospital stays should be closely monitored to detect infection as soon as possible and establish the most appropriate treatment.

Long-Term V-EEG in Epilepsy: Chronological Distribution of Recorded Events Focused on the Differential Diagnosis of Epileptic Seizures and Psychogenic Non-Epileptic Seizures.

Differential diagnosis in epilepsy is sometimes challenging. Video-electroencephalography (V-EEG) is an essential tool in the diagnosis and management of epilepsy. The prolonged duration of V-EEG recording increases the diagnostic yield of a conventional V-EEG. The right length of monitoring for different indications is still to be established. We present a retrospective descriptive study with a sample of 50 patients with long-term V-EEG monitoring, with a mean age of 36.1 years, monitored from 2013 to 2019 at the Burgos University Hospital. The mean monitoring time was 3.6 days. Events were obtained in 76% of the patients, corresponding to epileptic seizures (ES) in 57.9% of them, with psychogenic non-epileptic seizures (PNES) in 39.5%, and with episodes of both pathologies in 2.6% of the patients. We found that the first event was highly representative, and it correlated with the rest of the events that would be recorded. Moreover, 92% of the first PNES had been captured at the end of the second day, and 89% of the first ES by the end of the third day. V-EEG for differential diagnosis between ES and PNES can be performed in hospitals without specialized epilepsy surgery units. For this indication, the duration of long-term V-EEG can be adjusted individually depending on the nature of the first event.

Effectiveness of Community Occupational Therapy Intervention in, with and from the Community in People with Disabilities in Azrou (Morocco).

In Morocco, the social and environmental context influences the volition and development of meaningful activities, creating physical, personal and social barriers to the occupational performance of people with disabilities. This study develops a community Occupational Therapy program in order to verify its effectiveness in the volition, quality of life and perceived self-stigma of people with disabilities in the Moroccan city of Azrou, and to reduce the stigma of the community towards people with disabilities in the city. Data were collected from people with disabilities who participated in the program (N = 52), using the Volitional Questionnaire (VQ), The World Health Organization Quality of Life scale (WHOQOL-BREF), the Stigma Awareness Questionnaire (SCQ) and an ad hoc interview. In addition, community stigma was assessed by the Attribution Questionnaire (AQ-27) in citizens without disabilities (N = 42). Results confirmed that this intervention favors the inclusion of people with disabilities in their closest environment, improving volition and quality of life and reducing self-stigma. Furthermore, the community's stigma towards people with disabilities was also significantly reduced after the intervention.