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Super-refractory status epilepticus (SRSE) represents a neurological emergency that is characterized by a lack of response to the third line of antiepileptic treatment, including intravenous general anesthetics. It is a medical challenge with high morbidity and mortality. Electroconvulsive therapy (ECT) has been recommended as a nonpharmacologic option of treatment after other alternatives are unsuccessful. Its effect on the cessation of SRSE has been minimally investigated. The objective of this article is to analyze the effect of ECT on SRSE. For this purpose, a multidisciplinary team created a protocol based on clinical guidelines similar to those described previously by Ray et al. (2017). ECT was applied to six patients with SRSE after the failure of antiepileptic treatment and pharmacologic coma.The objective of each ECT session was to elicit a motor seizure for at least 20 s. SRSE was resolved in all patients after several days of treatment, including ECT as a therapy, without relevant adverse effects. Thus, ECT is an effective and feasible option in the treatment of SRSE, and its place in the algorithm in treatment should be studied due to the uncommon adverse effects and the noninvasive character of the therapy.

Clinical and electroencephalogram (EEG) features in frontal lobe epilepsy (FLE) vary considerably among patients, making the diagnosis a challenge. The objective of this study was to describe interictal and ictal EEG activity, identifying variables that could help to differentiate and diagnose frontal lobe epilepsy cases. A prospective cross-sectional study from patients with frontal interictal epileptiform discharges (IED) referred to the Vall d’Hebron University Hospital (Barcelona, Spain) after a clinical event compatible with epileptic seizures was designed. The interictal and ictal activity were analyzed to provide a detailed EEG description of the cases, using different statistical analyses. The morphological seizure pattern at the ictal onset remained globally unchanged over time in seizures arising from the frontal lobe for each patient. Isolated sharp waves were the most frequent waveforms in the expression of IED. Frontal lobe seizures are frequently short and sometimes appear grouped in clusters within the same recording. Often the ictal expression of the electrical activity in frontal lobe seizure is subtle and challenging to interpret. A description of the main findings is summarized to identify seizures arising from the frontal lobe and avoid false negatives findings in EEG interpretations.

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.

La presente tesis doctoral titulada “Implicaciones reeducativas en la funcionalidad y calidad de vida de las personas con enfermedad de parkinson: implementación de una ortesis de tejido elastomérico dinámica” se realiza según la modalidad de tesis por compendio de artículos científicos. El esquema de trabajo establecido para lograr el objetivo principal planteado se basa en un estudio compuesto por 3 artículos estructurados, un protocolo de estudio y dos ensayos clínicos de tipo longitudinal. La Enfermedad de Parkinson (EP) es un trastorno neurodegenerativo, caracterizado por una pérdida de neuronas de dopamina en la sustancia negra. Los síntomas motores más característicos de la enfermedad son temblor en reposo, bradicinesia, rigidez de las extremidades, problemas de marcha y equilibrio. Con el progreso de la enfermedad los síntomas motores se acentúan, lo que conlleva a una disminución en la funcionalidad de las Actividades de la Vida Diaria (AVD) del paciente. El tratamiento farmacológico actual se basa en tratamientos dopaminérgicos como la levodopa, agonistas dopaminérgicos y reducción de la degradación de la dopamina. La eficacia de este tratamiento disminuye progresivamente y produce otros efectos secundarios como discinesias y fluctuaciones motoras. En la actualidad existen diferentes tipos de tratamientos no farmacológicos que reduce la presencia e intensidad de los síntomas motores, sin embargo, no hay suficiente evidencia científica sobre ellos y los recursos son escasos. Por ello, el objetivo principal de la presente tesis es evaluar los efectos de la implementación de una ortesis de tejido elastomérico dinámico (DEFO) sobre la funcionalidad y calidad de vida de la persona con EP. Las Ortesis Dinámicas de Tejido Elastomérico (DEFO) son dispositivos no farmacológicos y de fácil implementación personalizados para cada paciente que proporcionan una alineación biomecánica y permite la libertad de movimiento del cuerpo al mismo tiempo que envía información s, The present doctoral thesis entitled “Effects of the implementation of a dynamic elastomeric fabric orthosis on the functionality and quality of life of the person with Parkinson's Disease (PD)” is carried out according to the thesis modality by compendium of scientific articles. The work scheme established to achieve the main objective is based on a study composed of 3 structured articles, a study protocol and two longitudinal clinical trials. Parkinson's Disease (PD) is a neurodegenerative disorder, characterized by a loss of dopamine neurons in the substantia nigra. It is characterized by the appearance of different motor and non-motor symptoms. The main motor symptoms of the disease are tremor at rest, bradykinesia, stiffness of the extremities, gait and balance problems. As the disease progresses, motor symptoms become accentuated, which leads to a decrease in the functionality of the patient's Activities of Daily Living (ADL). Current pharmacological treatment is based on dopaminergic treatments such as levodopa, dopamine agonists and reduction of dopamine degradation. The effectiveness of this treatment progressively decreases and produces other side effects such as dyskinesias and motor fluctuations. Currently, there are different types of non-pharmacological treatments that reduce the presence and intensity of motor symptoms; however, there is not enough scientific evidence about them and resources are scarce. Therefore, the main objective of this thesis is to evaluate the effects of the implementation of a dynamic elastomeric fabric orthosis (DEFO) on the functionality and quality of life of the person with PD. DEFO are a non-pharmacological and easily implemented device personalized for each patient that provides biomechanical alignment and allows freedom of movement of the body while sending sensory information to the brain, causing compression localized and stimulation of dermal and proprioceptive receptors that regulate motor activity. Goals To evaluat

Parkinson’s disease (PD) is a chronic, neurodegenerative movement disorder, whose symptoms have a negative impact on quality of life and functionality. Although its main treatment is pharmacological, non-pharmacological aids such as the dynamic elastomeric fabric orthosis (DEFO) merit an evaluation. Our objective is to assess the DEFO in upper limb (UL) functional mobility and in the quality of life of PD patients. A total of 40 patients with PD participated in a randomized controlled crossover study, and were assigned to a control group (CG) and to an experimental group (EG). Both groups used the DEFO for two months, the experimental group the first two months of the study and the control group the last two. Motor variables were measured in the ON and OFF states at the baseline assessment and at two months. Differences from the baseline assessment were observed in some motor items of the Kinesia assessment, such as rest tremor, amplitude, rhythm or alternating movements in the ON and OFF states with and without orthosis. No differences were found in the unified Parkinson’s disease rating scale (UPDRS) or the PD quality-of-life questionnaire. The DEFO improves some motor aspects of the UL in PD patients but this does not translate to the amelioration of the standard of functional and quality-of-life scales., This study was supported by grants for the financing of research projects in biomedicine, health management and social health care approved by the Regional Health Management of the Junta de Castilla y León (No. EXP. GRS2020/A/19). Regional Health Management of Castilla y León–Sacyl GRS/2010/A/19.

La presente tesis doctoral titulada “Estudio de modificadores ambientales epigenéticos asociados a la progresión de la Enfermedad de Huntington, y su relación con la apatía. Aplicaciones prácticas para la terapia ocupacional”, sigue la modalidad de compendio de publicaciones. La enfermedad de Huntington (EH) es una enfermedad neurodegenerativa autosómica dominante, caracterizada por la progresión de los síntomas motores, deterioro cognitivo y aparición de síntomas neuropsiquiátricos. El curso clínico de esta enfermedad presenta un comienzo insidioso en la edad adulta, generalmente en torno a los 40 años, con un diagnóstico curso de 15-20 años hasta la muerte. Cabe señalar que las personas no fallecen como consecuencia directa de la EH, sino por problemas médicos subyacentes. Se conoce que, diferentes factores como son la actividad física, el sueño o la dieta, influyen en la progresión de la enfermedad. Por esto, el objetivo principal es evaluar la influencia de los modificadores ambientales sobre factores intrínsecos en la progresión de la EH y su relación con la apatía., This PhD entitled "Study of epigenetic environmental modifiers associated with the progression of Huntington's disease, and its relationship with apathy. Practical applications for occupational therapy", is a compendium of publications. Huntington's disease (HD) is an autosomal dominant neurodegenerative disease, characterised by the progression of motor symptoms, cognitive impairment and the appearance of neuropsychiatric symptoms. The clinical course of this disease has an insidious onset in adulthood, usually around the age of 40, with a diagnostic course of 15-20 years until death. It should be pointed out that people do not die as a direct consequence of HD, but from underlying medical problems. Different factors, such as physical activity, sleep and diet, are known to influence the progression of the disease. Therefore, the main objective is to assess the influence of environmental modifiers on intrinsic factors in HD progression and their relationship with apathy.

Se ha descrito una nueva afección con efectos a largo plazo, el COVID persistente, que incluye una amplia variedad de problemas crónicos de salud con una duración indeterminada. Sin embargo, aún falta evidencia científica de su influencia sobre la población general y sanitaria. Además, en términos de funcionalidad, el COVID persistente está teniendo un impacto importante en la capacidad de las personas para la realización de sus actividades diarias y mantener un estilo de vida activo, experimentando limitaciones físicas que están repercutiendo sobre su calidad de vida. Esta investigación busca identificar las características sociodemográficas, clínicas, epidemiológicas, el estado funcional y la calidad de vida de la población contagiada por COVID19 y la población con COVID persistente. Para ello se ha contado con un total de 2.349 participantes de toda España. Como resultado de los análisis se ha encontrado que la hospitalización, el ingreso en UCI y los antecedentes de neumonía son factores predictores positivos de algunos síntomas de COVID persistente. Además ha demostrado un peor estado funcional, menor nivel de actividad física, mayor severidad de fatiga y peor calidad de vida en pacientes con COVID persistente. Esta tesis proporciona información útil acerca de las características sociodemográficas, clínicas, epidemiológicas, del estado funcional, nivel de actividad física, fatiga y calidad de vida de pacientes con COVID-19 y COVID persistente tanto en población general como en el personal sanitario de AP., Four scientific articles make up the present doctoral thesis, titled “Sociodemographic, clinical, epidemiological, functional, and quality of life characteristics of patients with COVID-19 and persistent COVID", which follows the modality of compilation of publications. Derived from the acute illness caused by COVID-19, a new condition with long-term effects, known as persistent COVID, has been described. This condition includes a wide variety of chronic health problems of indeterminate duration that affect all bodily organs and systems. However, although new data on clinical and epidemiological characteristics have been incorporated, the majority of these have been on hospitalized cohorts, so there is still a lack of scientific evidence addressing how these may influence the onset of different symptoms in the general population. It should be added that healthcare professionals have been one of the groups most affected by this health condition, and it is necessary to further analyze their clinical and epidemiological profile in-depth. Additionally, in terms of functionality, persistent COVID is having a significant impact on people's ability to carry out their daily activities and maintain an active lifestyle, experiencing physical limitations that are affecting their quality of life. With the aim of identifying the sociodemographic, clinical, epidemiological characteristics, functional status, and quality of life of the population infected with COVID-19 and the population with persistent COVID, two cross-sectional studies were carried out. One focused on the analysis of the clinical and epidemiological profile of the general population and primary care health personnel, as well as the factors that predict persistent COVID. The other study examined the functional status, level of physical activity, fatigue, and quality of life in patients with COVID-19 compared to those with persistent COVID.

Breast cancer (BC) is the most common cancer diagnosis with the highest mortality rate worldwide. The aim of this study was to identify factors related to depression and anxiety in mastectomized women BC survivors. A cross-sectional study was conducted with a sample of 198 women diagnosed with BC aged 30–80 years in Mexico. Depression and anxiety were assessed using the 14-item Hospital Anxiety and Depression Scale (HADS). The results showed that 94.44% and 69.18% of the women scored more than eight points on HADS in the anxiety and depression subscales, respectively; 70.20% and 10.60% were identified as pathological. The following variables were analyzed: age, time elapsed since the start of treatment, received treatment at the time of the evaluation, type of surgery, family history, marital status and employment status. Time elapsed since surgery, having a partner, and employment showed significant results as factors associated to levels of depression and anxiety in these patients. In conclusion, it has been shown that BCSs under 50 years of age receiving some kind of treatment, without family history, without a partner, with a job, with more than secondary education and with more than 5 years since diagnosis could have higher rates of clinical depression. On the other hand, BCSs older than 50 years receiving some kind of treatment, without family history, without a partner, with a job, with more than secondary education and with more than 5 years since diagnosis, could have higher rates of clinical anxiety. In conclusion, the variables studied provide valuable information for the implementation of psychotherapy plans in healthcare systems to reduce the risk of depression and/or anxiety in women with BC who have undergone mastectomy.

Loss of quality of life (QoL) and functional independence are two of the most common consequences of suffering a stroke. The main objective of this research is to study which factors are the greatest determinants of functional capacity and QoL a month after suffering a stroke so that they can be considered in early interventions.

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.

Persistent COVID-19 condition includes a wide variety of symptoms and health problems of indeterminate duration. The present study examined the sociodemographic and clinical characteristics of the population with Long COVID seen in Primary Care using a questionnaire based on the existing scientific literature. It was an observational and descriptive study of the characteristics of the Spanish population with Long COVID over 14 years of age. The responses were analysed by means of a descriptive analysis of the variables recorded, in addition to a bivariate analysis to determine the existence of a relationship between persistent COVID-19 and variables such as gender, age, vaccination status or concomitant pathology. The results obtained clearly describe the sociodemographic characteristics of the population, highlighting the predominance of female gender and the prevalence of tiredness and fatigue. Furthermore, relevant information was obtained on the differences in symptomatology according to gender, age, previous pathologies and alterations derived from infection and/or vaccination. These data are important for better detection, diagnosis and treatment of Long COVID and the improvement of the quality of life of this population.

The consolidation of telerehabilitation for the treatment of many diseases over the last decades is a consequence of its cost-effective results and its ability to offer access to rehabilitation in remote areas. Telerehabilitation operates over a distance, so vulnerable patients are never exposed to unnecessary risks. Despite its low cost, the need for a professional to assess therapeutic exercises and proper corporal movements online should also be mentioned. The focus of this paper is on a telerehabilitation system for patients suffering from Parkinson’s disease in remote villages and other less accessible locations. A full-stack is presented using big data frameworks that facilitate communication between the patient and the occupational therapist, the recording of each session, and real-time skeleton identification using artificial intelligence techniques. Big data technologies are used to process the numerous videos that are generated during the course of treating simultaneous patients. Moreover, the skeleton of each patient can be estimated using deep neural networks for automated evaluation of corporal exercises, which is of immense help to the therapists in charge of the treatment programs., This work was supported by project PI19/00670 of the Ministerio de Ciencia, Innovación y Universidades, Instituto de Salud Carlos III, Spain. The authors gratefully acknowledge the support of the NVIDIA Corporation and its donation of the TITAN Xp GPU used in this research. In addition, this work was partially supported by the European Social Fund, as the authors José Miguel Ramírez-Sanz, José Luis Garrido-Labrador, and Alicia Olivares-Gil are the recipients of a pre-doctoral grant (EDU/875/2021) from the Conserjería de Educación de la Junta de Castilla y León.

This research aimed to validate the Academic Success and Failure Attribution Questionnaire (ASFAQ) and analyze gender and age differences in middle and high school students in Italy. Methods: From the ASFAQ questionnaire validated with Spanish students, an analysis of the psychometric characteristics of the scale was carried out using a Confirmatory Factor Analysis (CFA). To compare ASFAQ scores by gender and school year, the independent samples parametric t-test and Pearson’s coincidence test were used. (3) Results: in total, 976 students participated in the research, of which 515 were middle school students and 461 were high school students. The results showed a validity of the ASFAQ for Italian students, in addition to statistically significant differences between males and females, and school year. (4) Conclusions: The ASFAQ is reliable and valid to assess the attributional styles of academic success and failure in an Italian context. There are significant differences in sex and school year, and a consequence with age.

Artículo de revisión, Gait abnormalities are a hallmark of Parkinson’s disease and contribute to falling risk. As disease symptoms progress, assistive devices are often prescribed. However, there are no guidelines for choosing appropriate ambulatory devices for gait impairment., This work was supported by the project PI19/00670 of the Ministerio de Ciencia, Innovación y Universidades, Instituto de Salud Carlos III, Spain. The authors declare that there are no additional disclosures to report relevant to this work.

Quality of life assessment is a critical aspect of breast cancer patient outcomes, as diagnosis, prognosis and treatment can have a major impact on quality of life. The aim of this study was to describe the characteristics of the sample and to verify the relationship between quality of life (QOL) in women diagnosed with breast cancer (BC) and their age, type or surgery and time since treatment.

Cognitive impairment is known to be very common in patients with hip fractures, but studies are needed to help understand the relationship between both events. Our goal was to determine the relationship between moderate or severe cognitive impairment and hip fractures during the six months following that episode.

The objective of this research was to perform a construct validity, and a psychometric analysis of the Exams-related Emotions Scale (EES), analyze the differences in their scores regarding gender and academic year in primary and secondary education student, as well as study the relationship between emotions and academic performance. During the construction and analysis of the psychometric characteristics of the scale, an Exploratory Factor Analysis (EFA) and a Confirmatory Factor Analysis (CFA) were performed. To test EES scores based on gender and school year, the T-Student test for independent samples and ANOVA were used, respectively. To verify the relationship between the scores of the different types of emotions and academic performance, the Pearson correlation test was performed. A total of 562 students belonging to the 5th (n = 228) and 6th (n = 186) primary school year and the 1st (n = 134) and 2nd (n = 94) secondary school year participated in the research. Age between 10 and 15 years old (mean = 11.66, standard deviation = 1.206) both males (50.5%) and females (49.5%). The results offered support for the three-factor structure. The analysis of invariance with respect to gender showed that the factor structure was invariant. Boys scored higher on the positive emotions factor and lower scores on anxiety than girls. Regarding school year, negative emotions and anxiety related to exams increase in the secondary courses compared to Primary while for positive emotions it is primary school students who obtain higher scores. The correlation coefficient between negative emotions (as well as anxiety) and school performance is negative whereas the correlation coefficient between positive emotions and academic performance is positive. EES scale is an instrument with scientific rigor and with adequate reliability and validity to be able to know the emotions that primary and secondary school students suffer when they are subjected to evaluation processes in the academic

Hip fracture is a pathology with high mortality, but the lack of a universal adaptation of the factors associated with death makes it difficult to predict risk and implement prevention in this group. This study aimed to identify the factors that determine a higher mortality at six months following hip fracture.

The way in which students attribute causes to their successes and failures in school has important implications for their development. The objectives of our research were to validate the Academic Success and Failure Attribution Questionnaire (ASFAQ) and to analyze the gender and grade differences in the ASFAQ data for primary and secondary school students in Spain. For the construction and analysis of the psychometric characteristics of the scale, an exploratory factor analysis (EFA) and a confirmatory factor analysis (CFA) were performed. To compare the ASFAQ scores based on gender and school year, a parametric t-test for independent samples and a one-way analysis of variance (ANOVA) was used. A total of 562 students in the fifth (n = 228) and sixth year (n = 186) of primary studies and the first (n = 134) and second year (n = 94) of secondary studies participated in the research. The results showed the adequate factorial structure, internal consistency, and validity of the ASFAQ, in addition to statistically significant differences by gender and school year. This research provides scientific evidence about the psychometric properties of the ASFAQ to assess and understand attributional style in the educational context, as well as current and consistent empirical evidence related to gender and grade differences in the attributional patterns of academic success and failure for primary and secondary school students.

Autism spectrum disorders are neurodevelopmental disorders characterized by deficits in social and communication functioning. Previous studies suggest that people with autism spectrum disorders have deficits in executive functions, having found a relationship with cognitive flexibility, planning, working memory, inhibition or self-control, but it is especially with respect to cognitive flexibility where the greatest dysfunctions have been found. The objective of this research was to compare the executive functioning of a group of children and adolescents diagnosed with autism spectrum disorders with another with neurotypical development in an educational context.

Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by the presence of difficulties in communication and social interaction, often associated with deficits in executive functions (EF). The EF correct development is related to a more effective functioning in all its daily activities, while being associated with more efficient social relations. The objective of this research is to analyze the level of development of EF in children and adolescents with ASD in school and at home. This is a descriptive, cross-sectional, and multicenter study with 102 participants selected by non-probabilistic sampling, 32 parents of children with ASD, and 70 professionals in the field of education of students with ASD. The study confirms that although children and adolescents with ASD have problems in executive functioning, the perception of informants, parents, and education professionals is similar but not the same in the different contexts: school and home.

School bullying is a phenomenon of unjustified aggression in the school environment that is widespread throughout the world and with serious consequences for both the bully and the bullied. The objectives of this research were to analyze the differences between the different bullying categories by gender and academic year in primary and secondary education students, as well as their relationship with academic performance. To categorize students according to their bullying experiences, the European Bullying Intervention Project (EBIPQ) Questionnaire was used. The Chi-square test was used to compare the scores obtained by the students in the EBIPQ based on gender and academic year, and the one-way ANOVA test was used to analyze its relationship with academic performance. Research participants were 562 students from the 5th (n = 228) and 6th (n = 186) primary school years and the 1st (n = 134) and 2nd (n = 94) secondary school years. They were males (50.5%) and females (49.5%) ranging in ages from 10 to 15 years old (mean = 11.66, standard deviation = 1.206). The results showed statistically significant differences in gender and academic year, indicating a greater number of boys in the role of the bully/victim and girls in that of non-bully/non-victim. The most aggressive students were in the 2nd year of ESO (12–13 years old). Regarding academic performance, statistically significant differences were obtained that confirm the hypothesis that performance or average grade varies according to the category of bullying in which students find themselves. The academic performance of the non-bully/non-victim and those in the victim category was found to be higher than that of bullies and bully/victim students.