Does Including Facebook Training Improve the Effectiveness of Computerized Cognitive Training? A Randomized Controlled Trial.

OBJECTIVE: To determine whether implementing a Facebook training program improves the effectiveness of computerized cognitive training (CCT) in older adults. DESIGN: Randomized, controlled, double single-blind trial with parallel groups. SETTING: Community centers. SUBJECTS: Eighty-six adults between 60 and 90 years old. INTERVENTIONS: Nine face-to-face 60-min sessions of CCT with VIRTRAEL for all participants. The experimental group received an additional 30 min of Facebook training per session. MAIN MEASURES: Attention (d2 Test of Attention); learning and verbal memory (Hopkins Verbal Learning Test-Revised); working memory (Letter-Number Sequencing test), semantic and abstract reasoning (Similarities and Matrix Reasoning tests); and planning (Key Search test). RESULTS: There was a significant Group*Time interaction in the Hopkins Verbal Learning Test-Revised-Trial 3, Letter-Number sequencing, and Matrix tests. Between groups, post-hoc analyses showed a difference in Matrix reasoning (p < .001; d = 0.893) at post-intervention in favor of the experimental group. Significant main effects of time were found in the CCT group between baseline and 3-month follow-up for Concentration (F = 26.431, p ≤ .001), Letters and Numbers (F = 30.549, p ≤ .001), Learning (F = 38.678, p ≤ .001), Similarities (F = 69.885, p ≤ .001), Matrix (F = 90.342, p ≤ .001), and Key Search (F = 7.904, p = .006) tests. CONCLUSIONS: The utilization of CCT with VIRTRAEL, a freely accessible tool with broad applicability, resulted in enhanced attention, verbal learning, working memory, abstract and semantic reasoning, and planning among older adults. These improvements were sustained for at least three months post-training. Additional training in Facebook did not enhance the effectiveness of CCT.

Concentration Endurance Test (d2): Normative data for Spanish-speaking pediatric population.

OBJECTIVE: To generate normative data for the Concentration Endurance Test (d2) in Spanish-speaking pediatric populations. METHOD: The sample consisted of 4,373 healthy children from nine countries in Latin America (Chile, Cuba, Ecuador, Guatemala, Honduras, Mexico, Paraguay, Peru, and Puerto Rico) and Spain. Each participant was administered the d2 test as part of a larger neuropsychological battery. The Total number of items processed (TN), Total number of correct responses (CR), Total performance (TP), and Concentration performance (CP) scores were normed using multiple linear regressions and standard deviations of residual values. Age, age2, sex, and mean level of parental education (MLPE) were included as predictors in the analyses. RESULTS: The final multiple linear regression models showed main effects for age on all scores, such that scores increased linearly as a function of age. TN scores were affected by age2 for Guatemala and Puerto Rico; CR scores were affected by age2 for Mexico; TP scores were affected by age2 for Chile, Mexico, Puerto Rico, and Spain; and CP scores for Mexico and Spain. Models indicated that children whose parents had a MLPE >12 years obtained higher scores compared to children whose parents had a MLPE≤12 years for Mexico and Spain in all scores, and Puerto Rico for TN, CR, and TP, and Guatemala and Paraguay for CP scores. Sex affect the scores for Ecuador and Honduras (CP scores). CONCLUSIONS: This is the largest Spanish-speaking pediatric normative study in the world, and it will allow neuropsychologists from these countries to have a more accurate approach to interpret the d2 test in pediatric populations.

Planning deficits in polysubstance dependent users: Differential associations with severity of drug use and intelligence.

BACKGROUND: Polysubstance use is associated with alterations in different components of executive functioning such as working memory and response inhibition. Nevertheless, less attention has been given to executive planning skills, which are required to benefit of low structured interventions. This study examines the association between severity of use of cocaine, heroin, alcohol, fluid and crystallized intelligence and planning tasks varying on degree of structure. METHODS: Data were collected from 60 polysubstance users and 30 healthy controls. Cognitive assessment consisted of three planning tasks with different structure levels: Stockings of Cambridge, Zoo Map test, and Multiple Errands Test. RESULTS: Polysubstance users had significant planning deficits across the three tasks compared to healthy controls. Hierarchical regression models showed that severity of drug use and fluid and crystallized intelligence significantly explained performance in all the planning tasks. However, these associations were higher for low-structured real world tasks. These low-structured tasks also showed a unique association with crystallized but not fluid intelligence. CONCLUSION: Drug abuse is negatively associated with planning abilities, and intelligence is positively associated with planning performance in real-world tasks.

Effectiveness of holistic neuropsychological rehabilitation for Spanish population with acquired brain injury measured using Rasch analysis.

INTRODUCTION: The Rasch model is increasingly used in the field of rehabilitation because it improves the accuracy of measurements of patient status and their changes after therapy. OBJECTIVE: To determine the long-term effectiveness of a holistic neuropsychological rehabilitation program for Spanish outpatients with acquired brain injury (ABI) using Rasch analysis. METHODS: Eighteen patients (ten with long evolution - patients who started the program > 6 months after ABI- and eight with short evolution) and their relatives attended the program for 6 months. Patients' and relatives' answers to the European Brain Injury Questionnaire and the Frontal Systems Behavior Scale at 3 time points (pre-intervention. post-intervention and 12 month follow-up) were transformed into linear measures called logits. RESULTS: The linear measures revealed significant improvements with large effects at the follow-up assessment on cognitive and executive functioning, social and emotional self-regulation, apathy and mood. At follow-up, the short evolution group achieved greater improvements in mood and cognitive functioning than the long evolution patients. CONCLUSIONS: The program showed long-term effectiveness for most of the variables, and it was more effective for mood and cognitive functioning when patients were treated early. Relatives played a key role in the effectiveness of the rehabilitation program.

Tratamiento con acupuntura y moxibustión del síndrome poslaminectomía. Caso clínico / Treatment of post-laminectomy syndrome with acupuncture and moxibustion: a clinical case

El síndrome de la cirugía fallida de espalda es una complicación frecuente posquirúrgica que cursa con lumbalgia crónica con gran repercusión clínica y económica. Las posibilidades de tratamiento abarcan una gran variedad de técnicas y fármacos, siendo pese a ello una de las principales causas de dolor lumbar de más difícil tratamiento. Cada vez hay más pruebas sólidas de que la acupuntura puede ser un complemento útil al tratamiento convencional para el tratamiento de la lumbalgia. Se presenta el caso de un paciente de 37 años intervenido hace 2 años de artrodesis L4-L5,con reintervención posterior hace 1 año de retirada del material de osteosíntesis persistiendo con síndrome poslaminectomía no controlado con cicatriz disestésica pese a tratamiento con opiáceos débiles y anticonvulsivantes que se trató adecuadamente con sesiones de acupuntura y moxibustión. Como pruebas complementarias tenía una resonancia magnética en la que se aprecian además de cambios postquirúrgicos en la región lumbar posterior, deshidratación discal en L5-S1 y cambios degenerativos artrósicos de las pequeñas articulaciones interapofisarias a nivel de los últimos niveles lumbares, un estudio electroneurofisiológico en el que se observa una alteración en los potenciales evocados somestésicos realizados en el nervio fémorocutáneo lateral izquierdo, compatible con una neuropatía axonal de dicho nervio. El tratamiento se realizó en 10 sesiones durante 5 semanas, en cada una de las sesiones se hizo un tratamiento bifásico de 40min, tratando en primer lugar la zona cicatricial y a continuación la lumbalgia, en ambos se realizó moxibustión con puro de Artemisa con técnica de picoteo. El dolor fue controlándose pasando de una escala EAV inicial de 8 a una escala EAV al final del tratamiento de 0. Tras pasar revisión a los 6 meses continua con una escala EAV de 0 (AU)

Failed back surgery syndrome is a common post-surgical complication which leads to chronic low back pain with great clinical and financial repercussions. The treatment possibilities include a great variety of techniques and drugs, despite this being one of the main causes of a very difficult to treat lumbar pain. There is increasing solid evidence that acupuncture may be a useful complement to conventional treatment for treating low back pain. A case is presented of a 37 year-old patient surgically intervened 2 years ago for L4-L5 arthrodesis, with subsequent intervention 1 year ago to remove the osteosynthesis material. There was a persistent uncontrolled post-laminectomy syndrome with a dysesthetic scar despite treatment with weak opiates and anticonvulsants, which was treated adequately with sessions of acupuncture and moxibustion. A magnetic resonance imaging scan was performed as a complementary test, in which post-surgical changes could also be seen in the posterior lumbar region, disc dehydration in L5-S1, and degenerative arthrosis of the small interapophyseal lumbar joints. An electro-neurophysiological study showed a change in the somesthetic evoked potentials performed in the left lateral femoral-cutaneous nerve, compatible with an axonal neuropathy of that nerve. Treatment was given in 10 sessions over 5 weeks, in with a biphasic treatment of 40min being performed in each of them. The scar area was treated first and then the low back pain, moxibustion was performed on both with Artemis smoke and a pecking technique. The pain was controlled, going from a initial VAS score of 8 to 0 at the end of treatment. At the follow-up review at 6 months it was still 0 on the VAS scale (AU)

Frontal behavioral and emotional symptoms in Spanish individuals with acquired brain injury and substance use disorders.

INTRODUCTION: Patients with acquired brain injury affecting the frontal cortex and individuals with substance use disorders share a range of behavioral problems, including apathy, poor self-control, and executive dysfunction. The Frontal Systems Behavioral Scale (FrSBe) is a self-report instrument designed to measure behavioral problems resulting from damage to the frontal-striatal neural systems, involved both in brain insult and addiction. The aim of this study was twofold: (1) to compare the scores from the Spanish version of the FrSBe with the norms collected for American, English-speaking population; and (2) to examine the ability of the FrSBe to discriminate between two clinical populations (acquired brain injury (ABI) and addiction) with putative frontal dysfunction, as compared to a group of healthy participants. PATIENTS AND METHODS: A total of 139 volunteers participated including 46 patients with frontal ABI (F-ABI), 57 abstinent substance abusers, and 36 healthy controls from the Spanish population. A Spanish version of the FrSBe was administered to all participants. We conducted multivariate analyses of variance to examine group differences across the three subscales: apathy, disinhibition, and executive dysfunction; and in the FrSBe total score. RESULTS: F-ABI and substance abusers had higher scores (i.e., greater impairment) than controls on the FrSBe total score; F-ABI patients scored significantly higher than substance abusers, and substance abusers significantly higher than controls. For specific subscales, F-ABI patients had higher scores than substance abusers and controls in the subscales of apathy, disinhibition and executive dysfunction, whereas substance abusers had greater executive dysfunction than controls. CONCLUSIONS: The Spanish version of the FrSBe is a useful instrument for the detection of behavioral problems associated with frontal systems dysfunction in two clinical samples of Spanish-speakers.

Resultados de la intervención dietético-educativa en pacientes con obesidad / Aftermath of dietary educational intervention in patients with obesity

Fundamentos: En el presente trabajo se exponen las conclusiones obtenidas de un estudio longitudinal con intervención, analizando los resultados en el tratamiento de la obesidad, mediante educación y seguimiento cada 1-2 semanas en consulta de nutrición privada externa del ámbito hospitalario. Métodos: Durante tres años se han tratado a un total de 249 pacientes, todos ellos mayores de 16 años. Estos pacientes recibían educación alimentaria y se les realizaba un seguimiento individualizado cada 1-2 semanas. Resultados y conclusión: En el momento de corte continuaban en consulta el 18.07% delos pacientes, habían finalizado el tratamiento consiguiendo el objetivo marcado (reducción del peso al menos del 10%) el 72.28%, el19.67% había abandonado el seguimiento. También se ha querido ver la posible relación entre el inicio del tratamiento y el trimestre del año que se comienza dicho programa, siendo el segundo trimestre (36.54%) el más demandando para comenzar dicho programa. Además hemos constatado que la mayoría de los pacientes son mujeres (80.33%) de las cuales el 86.70% ya con anterioridad había intentado perder peso. Pensamos que el programa para tratar la obesidad debe basarse en la reeducación en la forma de comer del paciente, proporcionando una educación alimentaria que contenga los conocimientos necesarios para poder realizar una alimentación equilibrada y saludable más que imponiendo dietas. El seguimiento debe ser periódico, individualizado y frecuente, reforzando así la adherencia al programa y la obtención de los resultados reales marcados y pactados (AU)

Foundations: In the present work there are exposed the conclusions obtained of a longitudinal study with intervention, analyzing the results in the treatment of the obesity, by means of education and follow-up every 1-2 weeks in consultation of private external nutrition of the hospitable area. Methods: For three years they have treated a whole of 249 patients, all of them older than16. These patients were receiving food education and they an individualized follow-up was realized every 1-2 weeks. Results and conclusion: In the moment of cut they were still under study 18.07% of the patients, had finished the treatment obtaining the goals marked (reduction of the weight at least of 10%) 72.28%, 19.67% had left the follow up. Also has wanted to see the possible relation between the beginning of the treatment and the trimester of the year that begins the above mentioned program, being the second trimester(36.54%) more demanding to begin the abovementioned program. Besides we have stated that the majority of the patients are women (80.33%) of which86.70% already previously had tried to lose weight. We think that the program to treat the obesity must be based on the reeducation on the way of eating of the patient, providing a food education that contains the knowledges necessary to be able to realize a balanced and healthy nourishment more that imposing diets. The follow-up must be periodic, individualized and frequent, reinforcing this way the adherence to the program and the obtaining of the royal (real) marked and agreed results (AU)

La calidad de vida de ios acompañantes de pacientes hospitalizados de media y larga estancia / Quality of life of the companion to hospitalized patients in medium and long-term stay

OBJETIVO: conocer la calidad de vida del acompañante del enfermo hospitalizado de media y larga estancia. DISEÑO: estudio cualitativo. AMBITO: unidades de hospitalización de adultos del Hospital Universitario San Cecilio de Granada. SUJETOS: acompañantes de enfermos que permanezcan constantemente junto a ellos durante un periodo superior a ocho días. METODOLOGÍA: entrevistas semi estructuradas en profundidad y análisis de contenido. RESULTADOS: el perfil del acompañante es: mujer, esposa, entre 50 y 60 años. La mayoría hace tres comidas al día; para el desayuno y el almuerzo toman comida caliente en bares y para la cena alimentos fríos en la propia habitación del enfermo. Las enfermeras proporcionan dietas completas a los que más lo necesitan y un suplemento nocturno para casi todos. Para el aseo encuentran poca intimidad. La calidad del sueño no es satisfactoria. Consideran buena la información que reciben, siendo la de los médicos la más formal; la de los cuidados del enfermo y la información general sobre el hospital es escasa. Participan en los cuidados básicos del enfermo y se sienten útiles con la labor que desempeñan. Los sentimientos más frecuentes son la soledad y la preocupación por el enfermo, la familia y la repercusión económica. Sus sugerencias son: la mejora de la alimentación, del aseo y del descanso. CONCLUSIONES: encontramos tres factores que influyen en la calidad de vida del acompañante: a) relación enfermera-paciente-acompañante, establecida de forma idiosincrática y sin unos instrumentos formales protocolizados que garanticen el mantenimiento de una calidad de vida lo más óptima posible para el acompañante por parte de la institución. b) la adaptación al medio que se desarrolla desde la premisa del conformismo con las circunstancias que le toca vivir. c) la gravedad del enfermo, que suele ser directamente proporcional a la mejora en las condiciones materiales para el acompañante y a los efectos derivados de su preocupación por el enfermo (AU)