Effects of a mindfulness-based program on the occupational balance and mental health of university students. Protocol for a randomized controlled trial.

OBJECTIVE: The aim is to examine whether the addition of Virtual Reality (VR) meditation training to a standard 8-week Mindfulness-Based Health Care Program (MBHC-VR) results in a significantly increased improvement in occupational, mental health, and psychological functioning versus MBHC-only in university students. MATERIALS AND METHODS: A randomized controlled clinical trial with three arms (MBHC, MBHC-VR, Control Group), four assessment time points (pre-intervention, inter-session, post-intervention, and 3-month follow-up), and mixed methodology will be proposed. University students (undergraduate, master, or doctoral) interested in participating and who meet the inclusion/exclusion criteria will be included over two years. Data will be collected from different ad hoc questionnaires, several standardized tests, and an Ecological Momentary Assessment. We will use R software to carry out descriptive analyses (univariate and bivariate), multilevel modeling, and structural equation models to respond to the proposed objective. The qualitative analysis will be carried out using the MAXQDA program and the technique of focus groups. DISCUSSION: It is expected that with the proposed intervention university students will learn to relate in a healthier way with their mental processes, so as to improve their occupational balance (OB) and their psychological well-being. TRIAL REGISTRATION: ClinicalTrials.gov Identifier NCT05929430.

Enhancing evidence-based practice into healthcare: Exploring the role of scientific skills in occupational therapists.

BACKGROUND: Research utilization and evidence-based practice (EBP) in occupational therapy rely on essential scientific skills. Despite prior research exploring factors influencing EBP, a gap remains in understanding the specific scientific competencies crucial for effective EBP application. OBJECTIVES: To (1) describe the level of scientific skills for EBP and research application, and (2) investigate the factors influencing higher scientific competence among 1159 Spanish-speaking occupational therapists. MATERIAL AND METHODS: We assessed the scientific skills using the HACTO-Screen online survey. Recruitment was conducted through a non-probability convenience sampling method between April to June 2020, using social networks and email dissemination to education and professional organizations in Spain and Spanish-speaking Latin American countries. RESULTS: Out of a total score of 115 points, participants showed a moderate level of scientific skills (mean: 62.7, SD: 21.6), with literature searching skills ranking the highest and scientific writing skills ranking the lowest. Associations were found between greater scientific competence and advanced degrees, ongoing research training, and on-the-job research. CONCLUSIONS: Continuous research training, higher academic degrees, and active research engagement are essential for enhancing scientific competence among occupational therapists. SIGNIFICANCE: Targeted training to enhance scientific skills and promote research utilization are crucial in advancing EBP in occupational therapy.

Children who sleep more may have longer telomeres: evidence from a longitudinal population study in Spain.

BACKGROUND: Inadequate sleep duration has been suggested as a chronic stressor associated with changes in telomere length (TL). This study aimed to explore the association between sleep duration and TL using the INMA birth cohort study data. METHODS: A total of 1014 children were included in this study (cross-sectional: 686; longitudinal: 872). Sleep duration (h/day) was reported by caregivers at 4 years and classified into tertiles (7-10 h/day; >10-11 h/day; >11-14 h/day). Leucocyte TL at 4 and 7-9 years were measured using quantitative PCR methods. Multiple robust linear regression models, through log-level regression models, were used to report the % of difference among tertiles of sleep duration. RESULTS: In comparison to children who slept between >10 and 11 h/day, those in the highest category (more than 11 h/day) had 8.5% (95% CI: 3.56-13.6) longer telomeres at 4 years. Longitudinal analysis showed no significant association between sleep duration at 4 years and TL at 7-9 years. CONCLUSION: Children who slept more hours per day had longer TL at 4 years independently of a wide range of confounder factors. Environmental conditions, such as sleep duration, might have a major impact on TL during the first years of life. IMPACT: Telomere length was longer in children with longer sleep duration (>11 h/day) independently of a wide range of confounder factors at age 4 and remained consistent by sex. Sleep routines are encouraged to promote positive child development, like the number of hours of sleep duration. Considering the complex biology of telomere length, future studies still need to elucidate which biological pathways might explain the association between sleep duration and telomere length.

Identification and Use of Assessment Tools in Spanish Occupational Therapists: An Exploratory Study.

The use of standardized assessment tools is essential for the occupational therapy intervention process to ensure clinical practice is appropriate and of high quality. This study aimed to explore which assessment tools Spanish occupational therapists use in their clinical practice. An ad hoc online questionnaire of 19 open and closed questions was used to collect information on assessment tools, socio-demographics, and academic background. The assessment tools were classified according to the main domains of occupational therapy using the last edition of the American Occupational Therapy Association framework. The survey was completed by 73 Spanish occupational therapists, of whom 86.3% were women; the median age was 31 years, and more than 60% treated people suffering from neurological and neurodegenerative disorders or worked in geriatric medicine. Of 147 assessment tools identified, those designed to assess activities of daily living, body functions, process skills, and motor skills were the instruments most frequently used. Specifically, the Barthel Index, Lawton Instrumental ADL Scale, Functional Independence Measure, Sensory Profile 2, and Mini-Examen Cognoscitivo were the tools most employed by Spanish occupational therapists. However, more than one third of the participants used assessment tools without knowing whether they were validated in the Spanish context and/or a specific target population. To our knowledge, this is the first time a study has examined the use and type of assessment tools in Spanish occupational therapists. Our results may constitute a positive step forward for developing strategies for enhancing evidence-based assessment in occupational therapy practice.

Reporting Quality in Abstracts of Randomized Controlled Trials Published in High-Impact Occupational Therapy Journals.

IMPORTANCE: Adequate reporting in the abstracts of randomized controlled trials (RCTs) is essential to enable occupational therapy practitioners to critically appraise the validity of findings. OBJECTIVE: To evaluate the reporting quality and characteristics of RCT abstracts published between 2008 and 2018 in the occupational therapy journals with the five highest impact factors in 2018. DESIGN: A descriptive cross-sectional study. DATA SOURCES: The American Journal of Occupational Therapy (AJOT), Australian Occupational Therapy Journal (AOTJ), Canadian Journal of Occupational Therapy (CJOT), Scandinavian Journal of Occupational Therapy (SJOT), and Physical and Occupational Therapy in Pediatrics (POTP) were identified using a Web of Science search. STUDY SELECTION AND DATA COLLECTION: We searched Scopus for abstracts in the five included journals. We used a 17-point scale based on the CONSORT for Abstracts (CONSORT-A) checklist to assess reporting quality. We also identified characteristics of the abstracts. FINDINGS: Seventy-eight RCT abstracts were assessed and showed moderate to low adherence to the CONSORT-A checklist (Mdn = 8, interquartile range = 7-9). Abstracts of articles with authors from a higher number of institutions, European first authors, and >200 words had higher CONSORT-A scores. The most underreported CONSORT-A items were trial design, blinding, numbers analyzed, outcome (results), harms, trial registration, and funding. CONCLUSIONS AND RELEVANCE: Between 2008 and 2018, the reporting quality in RCT abstracts from the five highest impact occupational therapy journals was moderate to low. Inadequate reporting in RCT abstracts raises the risk that occupational therapy practitioners will make ineffective clinical decisions based on misinterpretation of findings. What This Article Adds: Reporting quality in RCT abstracts in occupational therapy journals is moderate to low. Journal editors should require authors of RCTs to use the CONSORT-A checklist to promote optimal reporting and transparency in abstracts.

The ATENción Plena en Enfermedad de Alzheimer (ATENEA-Mindfulness in Alzheimer's Disease) Program for Caregivers: Study Protocol for a Randomized Controlled Trial.

A person affected by Alzheimer's disease (AD) gradually loses the ability to perform activities of daily living and becomes dependent on caregivers, thereby having a negative impact on the caregivers' quality of life. There is evidence that suggests that interventions aimed at caregivers, such as mindfulness, may be effective at reducing this burden and emotional issues, such as depression and anxiety, and improving their quality of life. However, there is a lack of consistency in the findings and conclusions remain tentative. In addition, as neuropsychiatric symptoms (NPSs) of AD are major determinants of the caregiver's burden, these interventions should examine the relationship between these symptoms and caregiver outcomes. Importantly, to improve the design of therapeutic interventions for caregivers and complement the treatment of AD, aspects related to occupational performance and the participation of people with AD and their caregivers should also be considered. Therefore, this study will aim to examine first, the effects of a mindfulness-based program designed for caregivers on NPSs of AD and caregivers' anxiety and depression; second, the effects of this program on patients' functional capacity, cognitive performance, executive functions, and quality of life, and on caregivers' burden, quality of life, occupational balance, executive functions, psychological wellbeing, and self-compassion. We believe that the findings of this study will have significant implications for future healthcare strategies focused on improving the quality of life and wellbeing of caregivers.

Sleep Duration and Quality and Sensory Reactivity in School-Aged Children: The Spanish Cross-Sectional InProS Study.

Background: The relationship between children's sleep and health has been widely examined; however, research focused on the link between sleep and sensory reactivity in children without medical conditions is relatively new and based on studies with small samples. Hence, we aimed at exploring the association between sleep duration and quality and prevalence of sensory reactivity in a population-based sample of children aged 3-7. Methods: We examined data on 579 school-age children from the InProS project, a cross-sectional population-based study. Children's sleep duration was classified as <10 vs. ≥10 h/day, and sleep quality was measured using the Pediatric Sleep Questionnaire, defining poor quality sleep as a score of ≥0.33. The Short Sensory Profile (SSP) was used to classify children with or without sensory reactivity using the cut-off points proposed by W. Dunn for SSP total score and each SSP subscale. Prevalence ratios (PR) using Poisson multiple regression models with robust variance were estimated to examine main associations. Results: Around a third (32.6%; n = 189) slept <10 h/day and 10.4% presented poor sleep quality. The prevalence of sensory reactivity was 29.5% for total SSP (<155), 11.4% for tactile sensitivity (<30), 15% for taste/smell sensitivity (<15), 22.5% for movement sensitivity (<13), 49.1% for under-responsive/seeks sensation (<27), 44.4% for auditory filtering (<23), 12.4% for low energy/weak (<26), and 25.4% for visual/auditory sensitivity (<19). Main findings indicated that poor sleep quality was significantly associated with a greater prevalence of sensory reactivity for SSP total score (PR = 1.27; IC 95%: 1.18; 1.38), tactile sensitivity (PR = 1.09, IC95%: 1.00-1.19), taste/smell sensitivity (PR = 1.18, IC95%: 1.08-1.30), under-responsive/seeks sensation (PR = 1.28, IC95%: 1.20-1.37), auditory filtering (PR = 1.31, IC95%: 1.23-1.39), low energy/weak (PR = 1.14, IC95%: 1.04-1.25) and audiovisual sensitivity (PR = 1.15, IC95%: 1.05-1.26) scores after adjusting for potential confounders. Conclusions: In this study, we observed that poor sleep quality was statistically significantly associated with a higher prevalence of sensory reactivity as measured by the total SSP and almost all SSP subscales. To our knowledge, this is the first time that this association has been explored and reported. Further research from prospective studies is required to confirm these findings.

Screening for Scientific Skills in Spanish-Speaking Occupational Therapists (HACTO-Screen): Study Protocol of a Cross-Sectional Survey.

The acquisition of scientific competencies for the application of evidence-based practice (EBP) is considered an essential part of healthcare education programs in order to improve clinical effectiveness. An examination of scientific skills in occupational therapists may be helpful in understanding their current practice as well as being useful in providing a basis for applying suitable approaches to the development and implementation of EBP. Hence, this study was designed with a double main objective: (1) to describe the level of acquisition of scientific skills and academic achievement in Spanish-speaking occupational therapists; (2) to examine the factors associated with these skills. The screening for Scientific Skills in Occupational Therapists (HAbilidades Científicas en Terapeutas Ocupacionales), the HACTO-Screen, is an online cross-sectional survey divided into five sections: sociodemographic data, academic and professional background; assessment of scientific skills; research training and development needs; experience as a researcher and/or academic. A total sample of 1159 occupational therapists finally participated. Main associations will be analyzed using multiple linear and/or Poisson regression models with/without robust variance. Our findings will provide valuable insights on the research skills and associated factors in a large sample of Spanish-speaking occupational therapists. The results will also be helpful to enhance research training and research career development in occupational therapy in order to promote the use of EBP.

Association between Body Mass Index and Sensory Processing in Childhood: InProS Study.

We assessed the association between body mass index (BMI) and sensory processing in 445 Spanish children aged 3-7 from the InProS project. Child sensory processing was measured using the short sensory profile (SSP); an atypical sensory performance was defined as an SSP total score <155 and scores of tactile sensitivity <30; taste/smell sensitivity <15; movement sensitivity <13; under-responsive/seeks sensation <27; auditory filtering <23; low energy/weak <26; and visual/auditory sensitivity <19. The BMI was calculated according to the cutoffs by the World Health Organization for children aged 0-5 and 5-19 years. We used multiple Poisson regression models with robust variance to obtain prevalence ratios (PR). No associations between children's overweight and obesity and the prevalence of atypical sensory outcomes were observed. A one-point increase in BMI was significantly associated with a higher prevalence of atypical tactile sensitivity (PR = 1.07, 95% CI: 1.02; 1.12). A statistically marginal association was also observed for atypical total SSP (PR = 1.03, 95% CI: 1.00; 1.07) and atypical movement sensitivity (PR = 1.05, 95% CI: 1.00; 1.10). To our knowledge, this is the first time the association between children's BMI and sensory processing has been reported. Our findings suggest that sensory processing issues may play a part in the complex context of childhood obesity. Further research is required to confirm these findings.

The Infancia y Procesamiento Sensorial (InProS-Childhood and Sensory Processing) Project: Study Protocol for a Cross-Sectional Analysis of Parental and Children's Sociodemographic and Lifestyle Features and Children's Sensory Processing.

Sensory processing difficulties may have potential detrimental consequences on the physical, social and intellectual development of children. It includes serious disturbances affecting emotional regulation, motor performance, social behavior and daily life functioning, among others factors. Since these symptoms are more frequent among children with disabilities, most research has been carried out in clinical populations. However, recent studies have suggested that sensory problems may be prevalent in around 20% of children without clinical conditions. To date, epidemiological research on sensory dysfunctions in normally developing children is lacking; therefore, it is unknown whether or not sensory processing difficulties are significant factors that affect child's development. Hence, this study has a double general purpose: (1) to determine the sensory profile of school-aged children; (2) to examine the associations between atypical sensory processing patterns and socio-demographic, health and lifestyle features of these children and their parents. The Infancia y Procesamiento Sensorial (InProS, Childhood and Sensory Processing in English) project is a population-based cross-sectional study of Spanish children aged 3-7 years. Data were gathered from different ad hoc questionnaires and several standardized tests. We propose an objective and reliable methodology using statistical and research procedures to describe and determine associations with sensory processing outcomes. We believe that this project will contribute to filling the gap in epidemiological research on sensory issues by providing more convincing evidence. Nevertheless, the potential results should be corroborated in other larger samples.

Association between Adherence to the Antioxidant-Rich Mediterranean Diet and Sensory Processing Profile in School-Aged Children: The Spanish Cross-Sectional InProS Project.

We assessed the association between adherence to the Mediterranean diet (MD) and sensory processing in 583 Spanish children aged 3-7 years from the InProS project in Alicante, Spain. Child sensory processing was measured using the short sensory profile (SSP); atypical sensory performance was defined as SSP total score <155; tactile sensitivity <30; taste/smell sensitivity <15; movement sensitivity <13; under-responsive/seeks sensation <27; auditory filtering <23; low energy/weak <26; and visual/auditory sensitivity <19 scores. Adherence to the MD was measured using the Mediterranean diet quality index KIDMED. Multiple Poisson regression models with robust variance, based on the Huber sandwich estimate, were used to obtain prevalence ratios (PR). Our findings suggested that a lower prevalence of atypical tactile and taste/smell sensitivity were associated with having medium (PR = 0.50, 95% CI: 0.25; 0.99; PR = 0.57, 95% CI: 0.33; 0.99, respectively) and high adherence to the MD (PR = 0.58, 95% CI: 0.34; 0.99; PR = 0.33, 95% CI: 0.19; 0.60, respectively), and of atypical low energy/weak with having medium adherence to the MD (PR = 0.37, 95% CI: 0.16; 0.83). A two-point increase in adherence to the MD showed a general positive effect against atypical sensory performance, although it was statistically significant on taste/smell sensitivity (PR = 0.71, 95% CI: 0.59; 0.85) and low energy/weak (PR = 0.80, 95% CI: 0.64; 0.99) subscales. To our knowledge, this is the first study that shows a protective effect of adherence to the MD against prevalence of atypical sensory processing in school-aged children. Further research from longitudinal studies is required to confirm these findings.