Development of a Short Version of the ADHD Rating Scale-IV.es (sADHD-RS-IV.es).

OBJECTIVE: To develop a short version of the Spanish 18-item ADHD-Rating Scale IV.es (sADHD-RS-IV.es) to be used as a potential screening tool in pediatric population. METHODS: We recruited 652 subjects, ages 6 to 18 (mean ± SD = 11.14 ± 3.27): 518 patients with ADHD (per DSM-IV criteria); and 134 healthy controls. We performed a stepwise logistic regression to select the best subset of ADHD-RS-IV.es items to create a short-form. We calculated internal consistency reliability (Cronbach's and ordinal alphas) and diagnostic accuracy using receiver operating characteristic (ROC) curve. RESULTS: Six items were found to enter the stepwise analysis significantly. Internal consistency was high (Cronbach's alpha = 0.86; ordinal alpha = 0.90) and offered a good concordance with clinician diagnosis and a high discriminatory power (AUC = 0.98) with an optimal cut-off at a score of six points. CONCLUSIONS: This shorter questionnaire (six items) was able to discriminate ADHD cases from healthy controls.

Time discrimination and change detection could share a common brain network: findings of a task-based fMRI study.

Introduction: Over the past few years, several studies have described the brain activation pattern related to both time discrimination (TD) and change detection processes. We hypothesize that both processes share a common brain network which may play a significant role in more complex cognitive processes. The main goal of this proof-of-concept study is to describe the pattern of brain activity involved in TD and oddball detection (OD) paradigms, and in processes requiring higher cognitive effort. Methods: We designed an experimental task, including an auditory test tool to assess TD and OD paradigms, which was conducted under functional magnetic resonance imaging (fMRI) in 14 healthy participants. We added a cognitive control component into both paradigms in our test tool. We used the general linear model (GLM) to analyze the individual fMRI data images and the random effects model for group inference. Results: We defined the areas of brain activation related to TD and OD paradigms. We performed a conjunction analysis of contrast TD (task > control) and OD (task > control) patterns, finding both similarities and significant differences between them. Discussion: We conclude that change detection and other cognitive processes requiring an increase in cognitive effort require participation of overlapping functional and neuroanatomical components, suggesting the presence of a common time and change detection network. This is of particular relevance for future research on normal cognitive functioning in the healthy population, as well as for the study of cognitive impairment and clinical manifestations associated with various neuropsychiatric conditions such as schizophrenia.

SARS-CoV-2 transmission in teenagers and young adults in Fútbol Club Barcelona's Multidisciplinary Sports Training Academy.

Most studies, aimed at determining the incidence and transmission of SARS-CoV-2 in children and teenagers, have been developed in school settings. Our study conducted surveillance and inferred attack rates focusing on the practice of sports. Prospective and observational study of those attending the sports facilities of Fútbol Club Barcelona (FCB), in Barcelona, Spain, throughout the 2020-2021 season. Participants were young players (from five different sports) and adult workers, who belonged to stable teams (shared routines and were involved in same quarantine rules). Biweekly health questionnaires and SARS-CoV-2 screening were conducted. From the 234 participants included, 70 (30%) both lived and trained in the FCB facilities (Recruitment Pathway 1;RP1) and 164 (70%) lived at their own household and just came to the facilities to train (RP2). During the study, 38 positive cases were identified; none had severe symptoms or needed hospitalization. The overall weekly incidence in the cohorts did not differ compared to the one expected in the community, except for 2 weeks when an outbreak occurred. The attack rate (AR) was three times higher for the participants from RP1, in comparison to those from RP2 (p < 0.01). A Basketball team showed a significant higher AR.  Conclusion: Physical activities in stable teams are not related to an increased risk of transmission of SARS-CoV-2, since there were the same observed cases than expected in the community. The risk is higher in indoor sports (Basketball vs. Football), and in closed cohort living settings (RP1 vs. RP2). The fulfilment of preventive measures is essential. What is Known: • Despite the low numerical impact caused in paediatric hospitalizations during COVID-19 pandemic, the social impact has been maximum. • The transmission potential in children and teenagers is limited, and it had been widely demonstrated in school settings. What is New: • Group physical activities in children and teenagers are not also related to an increased risk of transmission of SARS-CoV-2, when preventive measures, such as washing hands, and screening protocols are applied. • Routine and semi-professional sports activities seem safe environments to promote during this pandemic.

Implementation of clinical assistants in a pediatric oncology department: An impact analysis.

Bureaucratic and administrative tasks associated with health care provision have historically fallen on health care professionals, which is one among the factors contributing to low job satisfaction and lower productivity. Incorporating new professional roles that help to better respond to the needs of both patients and professionals can increase the quality and efficiency of service provision. This article aims to evaluate the impact of the clinical assistant's introduction in the Sant Joan de Déu Barcelona Children's Hospital's pediatric oncology department, in terms of (i) displacement of activity loads carried out by this new professional role and the consequent time freed up for physicians, (ii) physicians' satisfaction and (iii) efficiency of the new care model. This is an observational and retrospective study using administrative data based on the type of activity performed by clinical assistants and the measurement of the time freed up in favor of the physicians. The potential skill mix productivity increase, survey of physicians' satisfaction, and reduction in costs with the new model was analyzed. During the first year of its implementation in the pediatric oncology department, clinical assistants have performed 13,553 requests (69% of the total), representing a total saving of 266.83 hours or 6.67 workweeks of 40 hours. They performed 74% of outpatient surgical requests in the oncology department, 87% of day hospital requests and 54% of total requests in the outpatient consultations area. Physicians are overall satisfied with the new role and think they can use the time gained to do other things such as research or improving the quality of care. The role change allows reducing the cost per request by 56% in relation to the conventional model. In conclusion, the introduction of clinical assistants in the oncology department could be efficient to the extent that it displaces a significant part of the bureaucratic and administrative tasks previously performed by health care professionals and thus enables to reduce the cost of these processes. This delegation allows them to work more closely to the maximum of their competences and the physicians to have more time for higher added value clinical tasks and increase professional satisfaction.

Transmission of Severe Acute Respiratory Syndrome Coronavirus 2 Infection Among Children in Summer Schools Applying Stringent Control Measures in Barcelona, Spain.

BACKGROUND: Understanding the role of children in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission is critical to guide decision-making for schools in the pandemic. We aimed to describe the transmission of SARS-CoV-2 among children and adult staff in summer schools. METHODS: During July 2020, we prospectively recruited children and adult staff attending summer schools in Barcelona who had SARS-CoV-2 infection. Primary SARS-CoV-2 infections were identified through (1) a surveillance program in 22 summer schools of 1905 participants, involving weekly saliva sampling for SARS-CoV-2 reverse-transcription polymerase chain reaction (RT-PCR) during 2-5 weeks; and (2) cases identified through the Catalonian Health Surveillance System of children diagnosed with SARS-CoV-2 infection by nasopharyngeal RT-PCR. All centers followed prevention protocols: bubble groups, handwashing, face masks, and conducting activities mostly outdoors. Contacts of a primary case within the same bubble were evaluated by nasopharyngeal RT-PCR. Secondary attack rates and the effective reproduction number in summer schools (Re*) were calculated. RESULTS: Among the >2000 repeatedly screened participants, 30 children and 9 adults were identified as primary cases. A total of 253 close contacts of these primary cases were studied (median, 9 [interquartile range, 5-10] for each primary case), among which 12 new cases (4.7%) were positive for SARS-CoV-2. The Re* was 0.3, whereas the contemporary rate in the general population from the same areas in Barcelona was 1.9. CONCLUSIONS: The transmission rate of SARS-CoV-2 infection among children attending school-like facilities under strict prevention measures was lower than that reported for the general population. This suggests that under preventive measures schools are unlikely amplifiers of SARS-CoV-2 transmission, supporting current recommendations for school opening.

Análisis poblacional del gasto en servicios sanitarios en Cataluña (España): ¿qué y quién consume más recursos? / Population-based analysis of the Healthcare expenditure in Catalonia (Spain): what and who consumes more resources?

Objetivo: Analizar la distribución del gasto sanitario según el ámbito asistencial y las características de los pacientes, utilizando microdatos del uso de servicios sanitarios del total de la población de Cataluña (España). Método: Se ha aplicado una tarifa o un gasto indirecto a todos los actos sanitarios financiados por CatSalut durante 2014, computando el gasto sanitario realizado por cada persona y sumando para todos los habitantes de Cataluña. Resultados: La suma del gasto sanitario realizado por todos los habitantes de Cataluña representa el 97,0% del presupuesto de CatSalut. La mitad de la población origina el 3,6% del gasto sanitario total (71 Euros por persona); un 1% de la población gastó el 23% del gasto (22.852 Euros por persona). El gasto medio más elevado, tanto en mujeres como en hombres, se da entre los 80 y los 89 años de edad. La población con una enfermedad crónica tiene un gasto medio anual de 413 Euros; con cinco, de 2413 Euros; y con 10, de 9626 Euros. El gasto medio varía según patologías, desde los 2854 Euros en los pacientes con depresión grave a los 8097 Euros de los pacientes con infección por el virus de la inmunodeficiencia humana/sida. Conclusiones: Los resultados son sumamente útiles para la planificación de los servicios sanitarios y para la priorización de intervenciones de política sanitaria en los colectivos con más necesidades

Objective: To analyse the distribution of the expenditure according to the healthcare services and characteristics of patients, using the microdata of the Catalan population's use of healthcare services. Methods: A fee or an indirect cost has been applied to all healthcare activities financed by CatSalut during 2014, computing the health expenditure made up by each person and adding it all up for the inhabitants of Catalonia (Spain). Results: The sum of the healthcare expenditure made by all the inhabitants of Catalonia represents 97.0% of the CatSalut budget. Half of the population accounts for 3.6% of total healthcare expenditure (71Euros per person); 1% of the population spends 23% of the expenditure (22,852 Euros per person). The highest average expenditure, in both women and men, occurs between the age of 80 and 89. The population with a chronic disease has an average annual expenditure of 413 Euros, with 5 of 2,413 Euros, and 10 of 9,626 Euros. The average cost varies according to pathologies, from 2,854 Euros in patients with severe depression to 8,097 Euros in patients with HIV-AIDS. Conclusions: The results are extremely useful for healthcare planning and for the prioritization of health policy interventions in groups with most needs

[Population-based analysis of the Healthcare expenditure in Catalonia (Spain): what and who consumes more resources?] / Análisis poblacional del gasto en servicios sanitarios en Cataluña (España): ¿qué y quién consume más recursos?

OBJECTIVE: To analyse the distribution of the expenditure according to the healthcare services and characteristics of patients, using the microdata of the Catalan population's use of healthcare services. METHODS: A fee or an indirect cost has been applied to all healthcare activities financed by CatSalut during 2014, computing the health expenditure made up by each person and adding it all up for the inhabitants of Catalonia (Spain). RESULTS: The sum of the healthcare expenditure made by all the inhabitants of Catalonia represents 97.0% of the CatSalut budget. Half of the population accounts for 3.6% of total healthcare expenditure (71€ per person); 1% of the population spends 23% of the expenditure (22,852€ per person). The highest average expenditure, in both women and men, occurs between the age of 80 and 89. The population with a chronic disease has an average annual expenditure of 413€, with 5 of 2,413€, and 10 of 9,626€. The average cost varies according to pathologies, from 2,854€ in patients with severe depression to 8,097€ in patients with HIV-AIDS. CONCLUSIONS: The results are extremely useful for healthcare planning and for the prioritization of health policy interventions in groups with most needs.