Board game-based intervention to improve executive functions and academic skills in rural schools: A randomized controlled trial.

INTRODUCTION: This research intends to increase the knowledge about the use of board games in the classroom to train executive functions and academic skills. 99 children from rural schools were assessed in executive functions and academic skills. METHODS: Through a randomized controlled trial, they were assigned to a playing group (n = 51) and an active control group (regular classes without games, n = 48). Play program consisted of 12 sessions for 6 weeks with eight commercial board games. RESULTS: In flexibility, the playing group was significantly faster after the program (p= = .01, d = 0.76), but not the control group (p = .23; d = 0.35). Both groups improved in the academic tasks, but the significance in calculus was greater in the playing group (p = .00; d = 2.19) than in the control group (p = .01; d = 0.97). DISCUSION: The use of board games during school hours could be as good or better methodology for cognitive training and learning academic skills than regular classes.

Chedoke-McMaster attitudes towards children with handicaps scale for traditional sporting games (CATCH-TSG): initial validation in 7 different languages in adult and young populations.

Introduction: Measuring attitudes towards disability is meant to assess which interventions are most likely to create changes in population attitudes. Physical activities, such as Traditional Sports Games, are an excellent methodology to fight against the stigma of disabled people. Thus, the main aim of this study was to validate the Chedoke-McMaster Attitudes towards Children with Handicaps Scale (CATCH) adapted to a physical activity environment. Methods: Additionally, we implemented this process in a combined way, 7 languages and 2 versions (adult and youth) at the same time. Results: The results showed that the CATCH-TSG scale provides the scientific community with a valid and reliable tool for professionals who want to assess the change in attitudes towards people with disabilities after receiving a psychoeducational intervention that includes physical activity (TSG). Discussion: Researchers will compare respective results from different countries and ages using different versions of the scale, jointly validated.

Just Play Cognitive Modern Board and Card Games, It's Going to Be Good for Your Executive Functions: A Randomized Controlled Trial with Children at Risk of Social Exclusion.

Modern board and card games are usually used for leisure. Few studies have focused on the type of game played in vulnerable populations. Therefore, the main aim of this study was to test the effectiveness of playing modern board and card games to enhance updating, inhibition, and flexibility in children at risk of social exclusion using games that activated specific basic executive functions. We developed a quadruple-blind randomized clinical trial during the COVID-19 pandemic. Sixty-eight participants (7-12 years old) were divided into two experimental groups: 35 children played games that directly activated basic executive functions, and 33 played games that directly triggered other cognitive domains. The primary statistical analysis consisted of mixed models. We found significant time effects in cognitive flexibility and inhibition and, to a lesser extent, in working memory in both gaming groups. We analyzed the cognitive profile of the games and found that all the games activated basic executive functions significantly, irrespective of the experimental group. Therefore, it is possible that playing any type of modern board and card game (excluding games with a high incidence of luck) could be beneficial for children at risk of social exclusion.

The Cognitive Processes Behind Commercialized Board Games for Intervening in Mental Health and Education: A Committee of Experts.

Background: The use of modern board games has been growing past years in education, research, and mental health attendance. Often one professional selects games by his/her criteria depending on his/her objective with them. We evaluated the cognitive processes inherent to each modern board game to obtain a consensus of the cognitive profile of each. We explain how to choose the most suitable board games in future interventions. Materials and Methods: Fifteen education, mental health, and neuroscience research professionals with board games experience participated in an online assessment of 27 modern board games. Experts received a virtual neuroeducation formation and played the games selection for further analysis. Participants answered a Likert scale about 12 cognitive processes activated with each game. Results: All modern board games obtained a high level of agreement (intraclass correlation [ICC] > 0.75). Besides, most cognitive processes reached a high agreement, except for cognitive flexibility and problem-solving (moderate range: 0.5 > ICC > 0.75). Differentiated cognitive profiles have been obtained for each game, some of which could work on more than one cognitive domain at a time. Finally, initial evidence about which board game mechanisms activate with cognitive domain was found. Conclusion: To conclude, this expert consensus methodology became a useful tool for assessing the cognitive profile behind modern board and card games. The results obtained may facilitate the choice of games to be used in future studies depending on the objective cognitive domain to be trained under a criterion based on the observations of a group of experts and not just the researcher's individual criteria.

Oral Microbiota, Its Equilibrium and Implications in the Pathophysiology of Human Diseases: A Systematic Review.

Imbalances of the oral microbiota and dysbiosis have traditionally been linked to the occurrence of teeth and oral diseases. However, recent findings indicate that this microbiota exerts relevant influence in systemic health. Dysbiosis of the oral microbiota is implicated in the apparition and progression of cardiovascular, neurodegenerative and other major human diseases. In fact, the oral microbiota are the second most diverse and largely populated microbiota of the human body and its relationships with systemic health, although widely explored, they still lack of proper integration. The purpose of this systematic review is thus to widely examine the implications of oral microbiota in oral, cardiovascular and neurodegenerative diseases to offer integrative and up-to-date interpretations. To achieve that aim, we identified a total of 121 studies curated in PUBMED from the time interval January 2003-April 2022, which after careful screening resulted in 79 studies included. The reviewed scientific literature provides plausible vias of implication of dysbiotic oral microbiota in systemic human diseases, and encourages further research to continue elucidating the highly relevant and still poorly understood implications of this niche microbiota in systemic health. PROSPERO Registration Number: CRD42022299692. This systematic review follows relevant PRISMA guidelines.

Impact on Executive Dysfunctions of Gamification and Nongamification in Playing Board Games in Children at Risk of Social Exclusion.

Objective: Modern board and card game-based cognitive interventions and gamification practices showed effectiveness in boosting executive functions and decreasing behavioral problems in children. However, the combination of both game-based methods has not been tested. Therefore, the main aim of this study was to test the effectiveness of gamification in modern board and card game-based cognitive interventions in Spanish schoolchildren at risk of social exclusion. Materials and Methods: In this multicenter single-blind study with a quasi-experimental design, 176 schoolers (6-13 years old) were assigned to a gamified group (with a narrative context and a rewarding system) and 107 to a nongamified group (with no narrative context or rewarding system). The interventions were implemented in regular classes. Behavioral executive dysfunction was assessed using the Behavior Rating Inventory of Executive Function, Second Revision (BRIEF-2) (Teacher form), pre- and postintervention. Results: We found significant time effects in all BRIEF-2 domains with small and medium effect sizes (d = -0.35 to d = -0.62). The nongamified group showed significantly higher decreases in all measures than those who used gamification. Conclusions: It is possible that playing for the joy of playing in the nongamified group was enough motivation to focus on the task, while adding gamification elements did not favor greater effectiveness of the program.

Traditional Sporting Games as an emotional induction procedure.

Experimental designs to induct emotional states have frequently used still procedures. However, more naturalistic methods of emotional induction by letting participants move and interact freely with other participants should be considered. Traditional Sporting Games (TSG) have the above-mentioned characteristics. The general aim of this study was to determine whether the different roles which allowed executing ambivalent interactions induced different emotional states in college students. We developed three studies with three paradoxical TSG (Sitting Ball Game, Four Corners Game, and Pitcher's Game). Before beginning to play, all the participants answered the Positive and Negative Affect Schedule (PANAS) in a mood version. After playing, participants were asked to report retrospectively the emotional state they were feeling in each role of the game, responding to the Self-Assessment Manikin, PANAS, and Games and Emotion Scale-II. Statistical analyses were performed by ANOVA, calculating corresponding effect sizes. Consistently, but specifically, in each game, roles still induced less positive and more negative emotions. Regarding the active roles, more positive and less negative emotions were kindled when the role allowed catching other players. On the contrary, when developing an active role that implied an increased likelihood of being caught, more negative and less positive emotions were experienced. We found some significant interaction effects between the moods and the role played before playing. To conclude, TSG could be an adequate procedure to induct emotional states and to study emotional conditions in a naturalistic way, showing ecological validity.

Effect of Ball Screen and One-on-One on the Level of Opposition and Effectiveness of Shots in the ACB.

In light of the importance of shots on the final result in basketball matches, this research aims to reveal the predictive ability of variables associated with different game actions (ball screen, one-on-one near the basket and one-on-one far away from the basket), shot zone (near to or far from the basket) and players' position (outside or inside) of the success of shots and of the type of shot, defended or not defended, in three seasons (2014 to 2016) of the Copa del Rey in the ACB (Asociación de Clubes de Baloncesto) League in Spain. Observational methodology was used, and an ad hoc instrument was created using Lince software. The study was conducted on a total of 7695 game actions, of which an analysis of 877 shots was made using CHAID (Chi-squared Automatic Interaction Detection) classification trees. The results obtained in this research have led us to the following conclusions: (a) the most important variable in the success of shots is to find "open shots", regardless of the game action, (b) one-on-one actions outside and inside the zone have a clear connection to the finishes of the plays and end up in defended shots, (c) shots by ball screen lead to more open shots than in one-on-one and (d) play with passes may facilitate to find "open shots". These results can be of interest for coaches to prepare their teams in the best possible way, but they must be interpreted with caution as the sample was very specific (Copa del Rey in the ACB League) and, therefore, it is necessary to continue investigating this topic in other competition contexts.

Cognitive training with modern board and card games in healthy older adults: two randomized controlled trials.

OBJECTIVES: The aim of this study was to assess the effectiveness of a cognitive intervention based on modern board and card games. METHODS: We conducted two two-arm parallel-group, randomized controlled trials. The first one (pilot study) was nonblind. The second one (main study) was a double-blind design. Participants (14 in a pilot study and 35 in the main study) were healthy older adults over 65 years old who were assisting to adult care institutions. In the pilot study, participants in the experimental group (n = 6) played modern board and card games which activated cognitive processes; whereas the control group (n = 6) was in the wait-list condition. In the main study, participants in the experimental group (n = 12) also played modern board and card games; whereas the control group (n = 15) performed standardized paper-and-pencil cognitive tasks. Psychologists specialized in older-people conducted all the interventions. In both studies, intervention sessions were bi-weekly for 5 weeks. The outcomes of both studies were cognitive status and executive functioning, depressive symptomatology, and quality of life measures. All assessment and intervention sessions took place in their habitual centers. RESULTS: In the pilot study, participants in the games intervention showed a significant improvement in semantic verbal fluency. In the main study, both interventions showed significant improvements in phonemic verbal fluency. Whilst board and card games maintained motor impulsivity control, paper-and-pencil tasks improved speed in an inhibition task. CONCLUSIONS: Modern board and card games could be an effective cognitive intervention to maintain some cognitive functions.

Traditional Sporting Games as Emotional Communities: The Case of Alcover and Moll's Catalan-Valencian-Balearic Dictionary.

Learning to live together is the central concern of education everywhere in the world (UNESCO). Traditional sporting games (TSGs) provide interpersonal experiences that shape miniature communities charged with emotional meanings. The objective of this study was to analyze the ethnomotor features of TSG (relationship between the internal characteristics of the TSG and sociocultural variables) in three Catalan-speaking Autonomous Communities and to interpret them for constructing emotional communities. The study followed a phenomenological-interpretative paradigm. The identification of TSG was done by a hermeneutic methodological approach by using an exhaustive exploratory documentary research. We studied 503 games collected in the Dictionary Català-Valencià-Balear de Alcover and Moll (1926-1963). Instruments and procedure: A database was built up with information about the internal and external logic of the games. The validity of the information was confirmed by means of a concordance test between the researchers. Data processing was carried out by means of classification trees (inferential level), identifying the predictive variables of the types of TSG. Most of the TSGs were sociomotor games (n = 405/503; 80.5%). The classification tree identified four explanatory variables. Three variables were internal traits (body contact, material, and score), and one variable corresponded to external logic (age). Features of the TSG of the Catalan-speaking Autonomous Communities build original emotional communities. The ethnomotor regularities triggered emotional experiences associated with pleasure for (a) living together (predominance of sociomotor games); (b) domesticating of aggressiveness over opponents (different motor licit aggressiveness); (c) developing sustainability (presence and absence of objects from the surrounding environment); (d) educating the competition (games with and without final score); and (e) interpersonal well-being based on the community (transmission of ludic culture from children to young TSG).

A Pilot Study of the Efficacy of a Cognitive Training Based on Board Games in Children with Attention-Deficit/Hyperactivity Disorder: A Randomized Controlled Trial.

Objective: The main aim of this study was to prove the efficacy of an intervention based on board games on executive functions (EFs) and clinical symptoms in children with attention-deficit/hyperactivity disorder (ADHD). Materials and Methods: A nonblinded randomized controlled trial was conducted with a sample of children with a diagnosis of ADHD (diagnosed by psychiatrists and clinical psychologists in a mental health center). Children were randomly allocated by matching age and sex, into two groups: experimental EF training group (n = 13; mean [M]age = 9.46, standard deviation [SD] = 1.20; boys = 53.8%) or a wait-list control group (n = 14; Mage = 9.50, SD = 1.09; boys = 71.4%). Measures assessed individually at pretest, posttest, and follow-up intervention included EFs and clinical symptoms. Results: Analysis of covariance repeated measures analysis showed that linguistic short-term memory, F(1,28) = 7.45, p = 0.02, and conduct problems, F(1,28) = 12.51, p = 0.00, significantly improved with larger effects in the board games training group after intervention when compared to the wait-list group. Although nonsignificant effects were reported at the follow-up, large effect sizes were actually found. Conclusion: Although future studies are needed, the results of this study highlight the importance of board games and its efficacy as a possible therapeutic and/or preventive intervention on ADHD.

Predictive variables of emotional intensity and motivational orientation in the sports initiation of basketball / Variables predictivas de intensidad emocional y orientación motivacional en la iniciación deportiva del baloncesto / Variáveis preditivas de intensidade emocional e orientação motivacional na iniciação esportiva do basquete

The sports initiation of basketball has used exercises and games to improve motor performance, forgetting aspects of maximum importance such as the emotional experience and motivational orientation of players. There were 183 students from public secondary and post-compulsory schools, 103 girls (56.2%) and 80 boys (43.7%). The validated Games and Emotions Scale questionnaire: GES-II was applied, together with the motivation questionnaire that the students completed after finishing the game situations. Two sessions were held: a) races bouncing a basketball and, b) by teams, passing between teammates a ball that had to be launched over the rival team. Multivariate analyzes were applied, classification trees, specifically the CHAID growth method (Chi-squared Automatic Interaction Detector, in SPSS v.24). The analysis of the predictive variables of emotional intensity indicated that the first explanatory variable was the type of emotion (p<.001; F= 1178.369; df1, df2= 1833). The positive emotions (e +) (n= 367, M= 4.0) were more intense (p<.001) than the negative ones (e-) (n= 1468, mean 1.4). The second predictive variable for both types of emotions was the result. The predictive maps of emotional and motivational experience confirm that the characteristics of the tasks and of the players are two intertwined realities to take into account in integral basketball training

La iniciación deportiva del baloncesto se ha servido de ejercicios y juegos para mejorar la ejecución motriz, olvidando aspectos de máxima importancia como la vivencia emocional y la orientación motivacional de los jugadores. Intervinieron 183 estudiantes de centros públicos de secundaria y postobligatoria, 103 chicas (56.2%) y 80 chicos (43.7%). Se aplicó el cuestionario validado Games and Emotions Scale: GES-II y el cuestionario de motivación que los alumnos cumplimentaron tras finalizar las situaciones de juego. Se realizaron dos sesiones: a) carreras botando un balón de baloncesto y, b) por equipos, pasarse un balón entre compañeros que debía lanzarse sobre el equipo rival. Se aplicaron análisis multivariantes, árboles de clasificación, concretamente se empleó el método de crecimiento CHAID (Chi-squared Automatic Interaction Detector, en SPSS v.24). El análisis de las variables predictivas de la intensidad emocional indicó que la primera variable explicativa fue el tipo de emoción (p<.001; F= 1178.369; df1, df2= 1833). Las emociones positivas (e+) (n= 367, M= 4.0) fueron más intensas (p< .001) que las negativas (e-) (n = 1468; mean 1.4). La segunda variable predictiva para ambos tipos de emociones fue el resultado. Los mapas predictivos de la experiencia emocional y motivacional confirman que las características de las tareas y de los jugadores son dos realidades entrelazadas a considerar en el entrenamiento integral del baloncesto

A iniciação esportiva do basquete vem utilizando jogos e exercícios para o desenvolvimento da performancetécnica, esquecendo aspectos fundamentais como a experiência emocional e a orientação motivacional dos jogadores.Participaram183estudantes de escolas públicas deensino médio,sendo 103 mulheres (56.2%) e 80 homens (43.7%). Aplicou-se o questionário validado Games and Emotion Scale: GES-IIe o questionário de motivação, que foi preenchido após a finalização das situação de jogo. Foram realizadas duas sessões: a) corridas com dribles com a bola de basquete e, b)jogopor equipes, passando uma bola entre seus companheiros de time que deviam lança-la sobre a equipe rival,tentando eliminá-los. Foram aplicadas análises multivariáveis, árvores de classificação, e aplicado o método de crescimento CHAID (Chi-squared Automatic Interaction Detector, SPSS v.24). Aanálise das variáveis preditivas da intensidade emocional indicou que a primeira variável explicativa foi o tipo de emoção (p <.001;F= 1178.369;df1, df2= 1833). As emoções positivas (e+)(n= 367,M4.0) foram mais intensas (p <.001) que as negativas (e-) (n= 1468;M1.4). A segunda variável preditiva para ambos tipos de emoções foi o resultado. Os mapas preditivos da experiência emocional e motivacional confirmam que as características das tarefas e dos jogadores são duas realidades entrelaçadas para otreinamento integral do basquete

The Assertive Resolution of Conflicts in School With a Gamified Emotion Education Program.

Coexistence in schools inevitably carries a higher risk of conflicts among peers. This fact can be detrimental to the well-being and academic achievement of the students. In many developed countries, about 90% of the pupils in compulsory secondary education report witnessing assaults among peers. In this regard, recognizing, controlling and managing emotions is key to ensure a healthy and effective interaction with others. Negative emotions, such as anger, can trigger conflicts or even episodes of violence if not regulated properly. Interactive tools, such as specialized software's, have shown high rates of efficacy for the training of different kinds of competences like the regulation of emotions. The aim of the present work is to describe the Happy Emotional Education Program and its effects over a sample of secondary school students. This software focuses in the training of emotional competences of the students with the objective of solving conflicts in a more assertive way. The design employed in the present work was a quasiexperimental design with pretest and posttest with a control group. Results show that Happy Emotional Education Program contributes to the management of emotions and the absence of negative affect or anxiety in a significant way. Additionally, the constant use of this interactive tool enhances motivation and the learning process of students. Results also indicate the importance of assessing the effects of the program in the long term. This would enable researchers to further assess the effects of the program over those emotional competences that are more resistant to change given its stable nature.

Validation of games and emotions scale (GES-II) to study emotional motor experiences / Validación de la Escala de Juegos y Emociones (GES-II) para el estudio de experiencias motoras emocionales

Any teacher or coach should have an instrument to study the emotional experiences of a game or sport. The objective of this study was to compare the behavior of the basic emotions in different games, according to the Bisquerra model (MBI) and the internationally agreed biopsychological model (MBPS), through the validated Emotions and Games Scale (GES). We studied 502 university students, who after participating in games of different categories answered the questionnaires GES, PANAS and POMS. the MBPS had a better fit in absolute adjustment indexes, confirmatory factor analysis, parsimony indexes, construct validity and convergent tests. The findings suggest using the GES with the two factors and five basic emotions identiffied by the MBPS: positive emotion (joy), negative emotion (anger, fear, sadness and rejection)

Cualquier profesor o entrenador debería disponer de un instrumento para estudiar las experiencias emocionales que suscita la práctica de un juego o deporte. El objetivo de este estudio fue comparar el comportamiento de las emociones básicas en distintos juegos, según el modelo de Bisquerra (MBI) y el modelo biopsicológico (MBPS) consensuado internacionalmente, a través del cuestionario validado Emotions and Games Scale (GES). Se estudió a 502 estudiantes universitarios, que tras participar en juegos de distintas categorías respondieron los cuestionarios GES, PANAS y POMS. El MBPS tuvo mejor ajuste en los índices de ajuste absoluto, análisis factorial confirmatorio, índices de parsimonia, pruebas de validez de constructo y convergente. Los resultados sugieren utilizar el GES con los dos factores y cinco emociones básicas que identifica el MBPS: emoción positiva (alegría), emoción negativa (ira, miedo, tristeza y rechazo)

Stressful life events during adolescence and risk for externalizing and internalizing psychopathology: a meta-analysis.

The main objective of the present research was to analyze the relations between stressful life events and the externalizing and internalizing spectra of psychopathology using meta-analytical procedures. After removing the duplicates, a total of 373 papers were found in a literature search using several bibliographic databases, such as the PsycINFO, Medline, Scopus, and Web of Science. Twenty-seven studies were selected for the meta-analytical analysis after applying different inclusion and exclusion criteria in different phases. The statistical procedure was performed using a random/mixed-effects model based on the correlations found in the studies. Significant positive correlations were found in cross-sectional and longitudinal studies. A transactional effect was then found in the present study. Stressful life events could be a cause, but also a consequence, of psychopathological spectra. The level of controllability of the life events did not affect the results. Special attention should be given to the usage of stressful life events in gene-environment interaction and correlation studies, and also for clinical purposes.

Influencia de las tareas motrices sobre los estados de ánimo en baloncesto / Influence of motor tasks on the players modos in basketball

El objetivo de la investigación fue analizar la toma de conciencia de los estados de ánimo en dos equipos de baloncesto teniendo en cuenta el tipo de tarea motriz y el resultado. El estudio se realizó con jugadores de la Liga Española de Baloncesto Amateur y jugadoras de una selección autonómica infantil femenina en la temporada 2010-2011. Se realizaron tres registros compuestos cada uno de ellos por cuatro sesiones, una para cada tipo de tarea motriz. Se registraron los estados de ánimo antes del calentamiento, a mitad de la sesión y al final. Para valorarlos se eligió la versión reducida del cuestionario Profile of Mood States. Se aplicó un modelo de ecuaciones de estimación generalizadas obteniendo las siguientes aportaciones: a) los distintos tipos de tareas motrices desencadenan estados de ánimo desiguales; b) se destaca el papel de la derrota como desencadenante de estado de ánimo negativos; c) los duelos entre jugadores y equipos unidos a la derrota suscitan estados de ánimo negativos tanto en chicos como en chicas; d) las tareas motrices sin oposición (psicomotrices y de cooperación) activan estados de ánimo positivos pudiendo ser utilizadas como reguladoras de la afectividad (AU)

The goal of the research was to analyze the awareness of the moods in two basketball teams, taking into account the type of motor task and the result. The research was conducted on players belonging to the Spanish Amateur Basketball League and on players in the female children's selection during the 2010-2011 season. Three registers were carried out, each one consisting of four sessions, one for each type of motor task. Mood states were recorded before warming up, in the middle of the session and at the end. In order to evaluate them, a reduced version of the Profile of Mood States questionnaire was chosen. A generalized estimates equation model was used, obtaining the following results: a) the different types of motor tasks activate differing mood states; b) a defeat's role as a detonator for negative emotional states is emphasized; c) duels between players, when combined with a loss, generate negative mood states both in boys as well as in girls; d) non-opposition motor tasks (psychomotor and cooperative tasks) activate positive mood states, and can thus be used as affectivity regulator (AU)

Prevalencia de la discapacidad en España por Comunidades Autónomas: el papel de los factores individuales y del entorno geográfico en su variabilidad / Prevalence of the disability in Spain for autonomous communities: the paper of the individual factors and the geographical environment in the variability

Fundamento: La prevalencia de discapacidad en la poblacióngeneral presenta una gran variabilidad geográfica, de manera queidentificar aquellos factores que pudieran explicarla será importantepara la planificación de políticas sociales. En este trabajo se analizala variabilidad de la discapacidad por comunidades autónomasdesde una doble vertiente, los factores individuales y del entorno.Métodos: Los datos proceden principalmente de la Encuestade Discapacidad, Deficiencias y Estado de Salud de 1999 y delInebase, ambas del Instituto Nacional de Estadística (INE). Secalculó la prevalencia de discapacidad simple y ajustada por edadde las CCAA. Se analizan los factores individuales asociados a ladiscapacidad mediante una regresión logística y los factores individualesy de la comunidad autónoma conjuntamente con unaregresión logística de dos niveles.Resultados: La prevalencia de discapacidad muestra una diferenciamáxima de 5,75 puntos entre las comunidades autónomas.En la regresión logística la comunidad de residencia fue estadísticamentesignificativa (OR: 3,35 en la de mayor prevalencia respectoa la de menor) junto con otras variables individuales: edad (ORde 40-64= 1,78 OR de 65-79= 1,87 y OR de >79= 3,34), sexo (ORmujer= 0,66), situación laboral (OR sin trabajo=2,25 OR amascasa/estudiante=1,39 y OR otros=2,03), estado de salud (OR regular=1,69 OR malo/muy malo= 2,05) y enfermedades crónicas (OR1-3=1,56 OR4-6=1,82 OR>6=2,59). En la regresión de dos niveleslas variables individuales explican poca varianza (s=0,261) y ningunade las variables relativas a las CCAA mejora el modelo.Conclusiones: Las características individuales no explicansuficientemente la variabilidad de la discapacidad entre CCAA yno se han identificado variables del entorno que sean significativas(AU)

Background: The prevalence of disability shows a highgeographical variability and the identification of factors that couldexplain these variations can be usuful to the heath and socialwelfare planning. Here the analysis of disability variations amongautonomous regions in Spain is made taking into accountindividual and geographical setting factors together.Methods: Data come from the Spanish Disability,Impairment and Health Status survey of 1999 and from Inebaseboth of the National Institute for Statistics. The prevalence ofdisability crude and adjusted by age was calculated for eachautonomous region. Individual factors related to disability areidentified by means of a logistic regression. The analysisaccounting for both, individual and geographical setting factorswas performed by means of a logistic regression of two levels.Results: Disability prevalence showed a maximum differenceof 5.75 points among regions. In a logistic regression the region ofresidence was statistically significant (OR: 3.35 in the highestrated region related to the lowest) beside several individual factors:age (OR 40-64= 1,78 OR 65-79= 1,87 and OR >79= 3,34), sex(OR women= 0,66), working status (OR unemployment=2,25 ORhousewife/student=1,39 y OR other=2,03), health status (ORregular= 1,69 OR bad/very bad= 2,05) and chronic diseases (OR1-3=1,56 OR 4-6=1,82 OR >6=2,59). Individual factors accountedfor a very few variance at the two levels regression model(s=0,261) and none of the regional variables improved the model.Conclusions: Individual factors do not explain enough theobserved disability variations among the regions and none factorrelated to the geographical setting has been identified asstatistically significant(AU)

[Recall and memory after intensive care unit stay. Development of posttraumatic stress disorder]. / Recuerdos y memoria del paciente crítico a largo plazo. Desarrollo de estrés postraumático.

BACKGROUND AND OBJECTIVE: The intensive care unit (ICU) confers a stress on patients and may affect the memory. The aim of the study was to examine the memory after critical care and the relationship with therapy and the development of posttraumatic stress disorder. PATIENTS AND METHOD: Prospectively study conducted between December 2001 and June 2003. Patients were excluded if language difficulties or had a neurologic or psychiatric disease. We collected data on gender and age, length of stay in the ICU, severity of acute illness, diagnoses and medical treatment with mechanical ventilation, propofol, midazolam and dopamine during the ICU stay. 12 months after ICU eligible patients were contacted to assess memory. The ICUM (Intensive Care Memory) tool and IES (Impact Event Scale) were used to assess memory and posttraumatic stress disorder. RESULTS: A total of 169 patients were included. The incidence of memory was 77.6%. 41 patients recalled delusional memories and these patients had higher IES after discharge. The logistic regression suggested a relationship with propofol, dopamine and length of stay. CONCLUSIONS: ICU treatment may be related more to recall of delusions. The delusional memory is associated with posttraumatic stress disorder symptoms after ICU.

Recuerdos y memoria del paciente crítico a largo plazo. Desarrollo de estrés postraumático / Recall and memory after intensive care unit stay. Development of posttraumatic stress disorder

Fundamento y objetivo: Ingresar en una unidad de cuidados intensivos (UCI) provoca estrés que afecta a la memoria del paciente. El objetivo del presente estudio ha sido evaluar la memoria de los pacientes tras su estancia en la UCI y la influencia del tratamiento, además de examinar la relación entre memoria y síntomas de estrés postraumático. Pacientes y método: Se ha realizado un estudio prospectivo, que incluyó consecutivamente a los pacientes ingresados en la UCI del Hospital Universitario Arnau de Vilanova de Lleida entre diciembre de 2001 y junio de 2003. Se excluyó a los pacientes de nacionalidades distintas de la española y a los que presentaban alteraciones neurológicas o psiquiátricas. Se recogieron datos de filiación, estancia en UCI y hospitalaria, gravedad, diagnóstico principal y variables clínicas como ventilación mecánica, uso de dopamina y sedantes. A los 12 meses se realizó una entrevista programada en la que se recogieron las vivencias experimentadas en UCI según la herramienta ICUM (Intensive Care Unit Memory) y la escala de impacto del estresor (EIE) para evaluación de estrés postraumático. Resultados: Se incluyó a 169 pacientes. El 77,6% tenía algún recuerdo. Un total de 41 pacientes refirieron memoria ilusoria con EIE significativamente más alto que el resto de pacientes. El modelo de regresión logística múltiple demostró como factores predictores independientes de memoria ilusoria el tratamiento con propofol o con dopamina y la estancia hospitalaria. Conclusiones: El tratamiento recibido en la UCI puede favorecer la memoria ilusoria. La alteración de los recuerdos con aumento de la memoria ilusoria puede tener consecuencias psicológicas a largo plazo

Background and objective: The intensive care unit (ICU) confers a stress on patients and may affect the memory. The aim of the study was to examine the memory after critical care and the relationship with therapy and the development of posttraumatic stress disorder. Patients and method: Prospectively study conducted between December 2001 and June 2003. Patients were excluded if language difficulties or had a neurologic or psychiatric disease. We collected data on gender and age, length of stay in the ICU, severity of acute illness, diagnoses and medical treatment with mechanical ventilation, propofol, midazolam and dopamine during the ICU stay. 12 months after ICU eligible patients were contacted to assess memory. The ICUM (Intensive Care Memory) tool and IES (Impact Event Scale) were used to assess memory and posttraumatic stress disorder. Results: A total of 169 patients were included. The incidence of memory was 77.6%. 41 patients recalled delusional memories and these patients had higher IES after discharge. The logistic regression suggested a relationship with propofol, dopamine and length of stay. Conclusions: ICU treatment may be related more to recall of delusions. The delusional memory is associated with posttraumatic stress disorder symptoms after ICU