At what risk? A research note on interviewer burden.

BACKGROUND: We report on our methodological experiences during an investigation of how institutional racism functions in healthcare. We found tension between balancing methodological rigor with the unanticipated consequence of interviewer burden. METHODS: Semi-structured interviews were conducted with patients. Interviews were recorded, transcribed verbatim, and qualitatively analyzed using thematic content analysis. Interviewers also participated in weekly debriefing sessions and reported experiences with patients. RESULTS: Interviewers repeatedly experienced negative encounters with white patients during interviews. Themes included privilege to avoid racism, denial of racism, non-verbal discomfort, falsely claiming Native identities, and intimidation. These experiences were most pronounced with Black interviewers. DISCUSSION: Interviewer burden may need to be a consideration taken up in a variety of research contexts.

Decolonization and antiracism: intersecting pathways to global health equity.

In this paper, as Black scholars, we address ways that interventions designed to promote equity in health can create pathways for coupling decolonization with antiracism by drawing on the intersection of the health of Africans and African Americans. To frame this intersection, we offer the Public Health Critical Race Praxis (PHCRP) and the PEN-3 Cultural Model as antiracism and decolonization tools that can jointly advance research on colonization and racism globally. We argue that racism is a global reality; PHCRP, an antiracism framework, and PEN-3, a decolonizing framework, can guide interventions to promote equity for Africans and African Americans.

The Impact of Childhood Trauma on Sensory Processing and Connected Motor Planning and Skills: A Scoping Review.

Background: Traumatic experiences during childhood have been suggested to alter the course of sensory and motor development due to the impact on neural connections within the brain at integral periods. This connection has been alluded to in literature and is discussed anecdotally by practitioners suggesting the impact is commonly seen in practice. Previous scoping reviews in this area have focused solely on the process of sensory modulation without exploring the connection to motor planning. Objective: This scoping review considers what is known from the existing literature about the impact of childhood trauma on sensory processing and motor skills. Method: This scoping review followed the JBI methodology for scoping reviews (Peters et al., 2020), searching CINAHL plus, Proquest, Scopus, PsycINFO, EThOS, as well as a search of the reference lists of the articles and citation chaining, to locate both published and unpublished sources. Articles were reviewed by two reviewers independently, with a third reviewer verifying those that met inclusion criteria where there was disagreement. Results: Six articles were identified that met the inclusion criteria for the study. While all included studies suggested the concurrence of sensory processing and motor difficulties in individuals who have experienced childhood trauma they did not conclusively make the link between the two suggesting an overall low level of evidence. Commonalities were identified in relation to the areas of the brain impacted and the nature of difficulties experienced with some suggestion of this varying according to stage of development and the specific nature of the trauma. Conclusions: This study suggests emerging evidence in relation to the connection between trauma, sensory processing and motor development but that further empirical research is needed to verify this and inform practice.

Translation Notes: Heidegger, Derrida, and the Chance for (a) Philosophy.

This paper aims to show that translation is not only a fully-fledged philosophical problem, but also a specific philosophical praxis and a test bed for extracting the core of different philosophical frameworks. For this purpose, I will take into consideration the respective philosophies of Martin Heidegger and Jacques Derrida. Even if Heidegger often practices translation from the Greek in his own works and adds a few remarks towards an original investigation of this activity, he ultimately understands translation as a 'makeshift' or as a 'shipwreck'. Throughout his contestation of Heidegger's position, Derrida shows the trap of the endless appropriation of the experience of the origin structure. He also frees up the discourse by putting the hierarchical polarization between the original and the translation into question. Thus, translation becomes a chance for philosophy, even for Derrida's deconstruction, a chance to generate new paths for investigation and to keep its question open.

Invited Commentary: Race, Ethnicity, and Racism in Epidemiologic Research-Perspectives from Public Health Critical Race Praxis (PHCRP).

In 2023, Martinez et al. examined trends in the inclusion, conceptualization, operationalization and analysis of race and ethnicity among studies published in US epidemiology journals. Based on a random sample of papers (N=1,050) published from 1995-2018, the authors describe the treatment of race, ethnicity, and ethnorace in the analytic sample (N=414, 39% of baseline sample) over time. Between 32% and 19% of studies in each time stratum lacked race data; 61% to 34% lacked ethnicity data. The review supplies stark evidence of the routine omission and variability of measures of race and ethnicity in epidemiologic research. Informed by public health critical race praxis (PHCRP), this commentary discusses the implications of four problems the findings suggest pervade epidemiology: 1) a general lack of clarity about what race and ethnicity are; 2) the limited use of critical race or other theory; 3) an ironic lack of rigor in measuring race and ethnicity; and, 4) the ordinariness of racism and white supremacy in epidemiology. The identified practices reflect neither current publication guidelines nor the state of the knowledge on race, ethnicity and racism; therefore, we conclude by offering recommendations to move epidemiology toward more rigorous research in an increasingly diverse society.

An integrative review of racism in nursing to inform anti-racist nursing praxis in Aotearoa New Zealand.

AIM: To synthesise international literature to identify mechanisms that maintain racism in nursing and understand the factors that contribute to designing and implementing anti-racist praxis to inform nursing in Aotearoa New Zealand. DESIGN: An integrative literature review was undertaken, integrating Indigenous Kaupapa Maori methodologies to ensure a cultural and philosophical lens. METHODS: Peer-reviewed literature published, between January 2011 and July 2023 were sourced. Of 1296 articles, 16 met the inclusion criteria and 4 were identified via citation chaining. In total, 20 articles were included. The Johns Hopkins Research Evidence Tool was applied, findings extracted, and thematic analysis completed utilising Indigenous Kaupapa Maori principles. DATA SOURCES: Databases, including CINAHL, Scopus, PubMed and Aus/NZ Reference Centre, were searched in July 2023. RESULTS: Two key themes were identified: (1) colonial active resistance to change; and (2) transformational, visionary, and proactive nursing. CONCLUSION: Nurses are well-positioned to confront the structures that maintain racism in health and education systems but are often actors in maintaining status quo. Anti-racist praxis can be a mechanism for nurses to reimagine, redefine and transform nursing care, leadership, and nursing education to begin to eradicate racism. REPORTING METHOD: This integrative review adhered to the 2020 Preferred Reporting for Systematic Reviews and Meta-Analyses (PRISMA) method. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution. IMPLICATIONS FOR THE PROFESSION: Racism remains prevalent in nursing and the healthcare system. It is necessary to implement anti-racist praxis and policies that resist, deconstruct, and dismantle power and racism while validating Indigenous values, beliefs and practices. This is vital to deliver equitable health care. IMPACT: This integrative review presents lived realities and knowledge of Indigenous and racially minoritised nurses and scholars, alongside nursing allies to inform anti-racist praxis. This evidence signifies that it is time to walk the walk to challenge the colonising systems and processes that hold racism in place.

Practice and Praxis: Psychoanalysis as an Act of Love.

The concept of praxis in psychoanalysis includes the way clinical practice embodies the values on which psychoanalysis is founded. As psychoanalysis evolved from a medical treatment to a process of open-ended psychic development, its underlying values evolved as well. Free-floating attention has many facets, shown in the variety of names given to it. From being a means to an end clinically, it became an implicit statement about the human value of the person being attended to. Clinical vignettes, contributions from philosophers, and examples from literature converge around the idea that the unreserved openness of free-floating attention amounts to an act of love. It is underpinned by the values, which are also virtues, of hope, and faith in the possibility of good; it can also be seen, in non-religious terms, as a form of prayer.

Folk Knowledge and Perceptions about the Use of Wild Fruits and Vegetables-Cross-Cultural Knowledge in the Pipli Pahar Reserved Forest of Okara, Pakistan.

Wild fruits and vegetables (WFVs) have been vital to local communities for centuries and make an important contribution to daily life and income. However, traditional knowledge of the use of wild fruits is at risk of being lost due to inadequate documentation. This study aimed to secure this knowledge through intermittent field visits and a semi-structured questionnaire. Using various ethnobotanical data analysis tools and SPSS (IBM 25), this study identified 65 WFV species (52 genera and 29 families). These species, mostly consumed as vegetables (49%) or fruits (43%), were predominantly herbaceous (48%) in wild and semi-wild habitats (67%). 20 WFVs were known to local communities (highest RFC), Phoenix sylvestris stood out as the most utilized species (highest UV). Surprisingly, only 23% of the WFVs were sold at markets. The survey identified 21 unique WFVs that are rarely documented for human consumption in Pakistan (e.g., Ehretia obtusifolia, Euploca strigosa, Brassica juncea, Cleome brachycarpa, Gymnosporia royleana, Cucumis maderaspatanus, Croton bonplandianus, Euphorbia prostrata, Vachellia nilotica, Pongamia pinnata, Grewia asiatica, Malvastrum coromandelianum, Morus serrata, Argemone mexicana, Bambusa vulgaris, Echinochloa colonum, Solanum virginianum, Physalis angulata, Withania somnifera, Zygophyllum creticum, and Peganum harmala), as well as 14 novel uses and five novel edible parts. Despite their ecological importance, the use of WFVs has declined because local people are unaware of their cultural and economic value. Preservation of traditional knowledge through education on conservation and utilization could boost economies and livelihoods in this and similar areas worldwide.

Phronesis: Recognising a neglected dimension of knowledge within occupational therapy research.

BACKGROUND: Phronesis is a way of knowing, implying wisdom, experiences, and reflections that guide our judgements. Phronesis, important for learning, is a neglected form of knowledge when applied to research. AIM: To examine how phronesis is conceptualised and practiced in three research projects. METHOD: Data from eight interviews with researchers involved in three research projects was generated. The interview material was analysed. A theoretical matrix of contemporary understanding of phronesis was applied to the material. RESULT: Examples of phronesis from three research projects in occupational therapy are presented according to categories of contemporary phronesis; acknowledging embodiment, embracing humility, using perceptiveness, and practicing reflexivity. SIGNIFICANCE: This unique approach of analysing research projects contributes to the understanding of phronesis and its implications for research, providing valuable insights into the researchers' praxis in their respective projects. CONCLUSION: There is a need for a greater recognition of phronesis as a dimension of knowledge within all types of research, and within the discipline. By not recognising phronesis as a legitimate form of knowledge, the discipline perpetuates a superiority of knowledge from episteme that dominates our ways of learning about the world around us and where the type of knowledge gleaned from phronesis is consequently marginalised.

Hemispheric asymmetry of hand and tool perception in left- and right-handers with known language dominance.

Regions in the brain that are selective for images of hands and tools have been suggested to be lateralised to the left hemisphere of right-handed individuals. In left-handers, many functions related to tool use or tool pantomime may also depend more on the left hemisphere. This result seems surprising, given that the dominant hand of these individuals is controlled by the right hemisphere. One explanation is that the left hemisphere is dominant for speech and language in the majority of left-handers, suggesting a supraordinate control system for complex motor sequencing that is required for skilled tool use, as well as for speech. In the present study, we examine if this left-hemispheric specialisation extends to perception of hands and tools in left- and right-handed individuals. We, crucially, also include a group of left-handers with right-hemispheric language dominance to examine their asymmetry biases. The results suggest that tools lateralise to the left hemisphere in most right-handed individuals with left-hemispheric language dominance. Tools also lateralise to the language dominant hemisphere in right-hemispheric language dominant left-handers, but the result for left-hemispheric language dominant left-handers are more varied, and no clear bias towards one hemisphere is found. Hands did not show a group-level asymmetry pattern in any of the groups. These results suggest a more complex picture regarding hemispheric overlap of hand and tool representations, and that visual appearance of tools may be driven in part by both language dominance and the hemisphere which controls the motor-dominant hand.

Infant and early childhood teleconsultation and training: Program description and feasibility outcomes from a statewide implementation.

To address high rates of mental health and developmental concerns facing young children ages 0-6 in the United States and internationally, providers across professional sectors need Infant and early childhood mental health (IECMH) training and support. The training and teleconsultation program (TTP) is a state-funded program developed in one Mountain West state in the United States to provide free IECMH training and teleconsultation to any provider working with young children. The TTP included access to webinars and individual or group consultation with licensed mental health providers. Webinars focused on increasing awareness and knowledge related to attachment and child development, supporting parents and caregivers, trauma-informed practice, supporting emotional health of staff and providers, and culturally responsive practices with infants, young children, and caregivers. Teleconsultation included case consultation, reflective individual and group supervision, and collaboration supports/referrals. During the 18-month evaluation period, 1568 unique providers engaged in either training or teleconsultation services, an average of 9% growth in new providers each month, with representation from all professional sectors and all state counties. This program demonstrates the feasibility and need for statewide training and teleconsultation programs to help meet the needs of providers who interact with and support young children and caregivers.

Para lidiar con las altas tasas de salud mental y preocupaciones sobre el desarrollo a las que se enfrentan los pequeños niños de edad 0-6 en los Estados Unidos e internacionalmente, quienes proveen el servicio dentro de la gama de todos los sectores profesionales necesitan entrenamiento y apoyo en el campo de la salud mental infantil y la temprana niñez (IECMH). El programa de entrenamiento y teleconsulta (TTP) es un programa con fondos estatales desarrollado en un estado del oeste montañoso en los Estados Unidos para ofrecer entrenamiento y teleconsulta gratis en IECMH a cualquier profesional que trabaja con niños pequeños. El TTP incluye acceso a seminarios web y consulta individual o en grupo con profesionales licenciados de la salud mental. Los seminarios web se enfocaron en incrementar la conciencia y el conocimiento relacionado con la afectividad y el desarrollo del niño, apoyar a progenitores y cuidadores, la práctica con atención informada sobre trauma, apoyar la salud emocional del personal y los proveedores, así como las prácticas culturalmente sensibles con los infantes, niños pequeños y quienes les cuidan. La teleconsulta incluyó consulta de casos, supervisión con reflexión tanto individual como de grupo, así como los apoyos/referencias colaborativas. Durante el período de evaluación de 18 meses, 1,568 proveedores con características particulares recibieron los servicios del entrenamiento o de la teleconsulta, un promedio de 9% de aumento de nuevos proveedores cada mes, con representación de todos los sectores profesionales y todos los condados del estado. Este programa demuestra la posibilidad y necesidad de programas de entrenamiento y teleconsulta a través de todo el estado para ayudar a satisfacer las necesidades de los proveedores que interactúan con y apoyan a los niños pequeños y quienes les cuidan.

Pour faire face aux taux élevés d'inquiétudes en matière de santé mentale et de comportement dont sont témoins les jeunes enfants âgés de 0-6 ans aux Etats-Unis et internationalement, les prestataires au travers des secteurs professionnels ont besoin de formation et de soutien en santé mentale du nourrisson et de la petite enfance (IECMH). Le programme de téléconsultation et de formation (TTP en anglais) est un programme financé au niveau de l'état développé dans un état des montagnes rocheuses aux Etats-Unis afin d'offrir une formation et une téléconsultation IECMH gratuite à tout prestataire travaillant avec de jeunes enfants. Le TTP a incorporé un accès à des webinaires et à une consultation individuelle ou de groupe avec des prestataires de santé mentale agréés. Les webinaires ont porté sur l'accroissement de la sensibilisation et des connaissances liées à l'attachement et au développement de l'enfant, au soutien des parents et des personnes prenant soin des enfants, à une pratique consciente des traumas, et au soutien de la santé émotionnelle des employés et des prestataires, et à des pratiques culturellement adaptées avec les nourrissons, les jeunes enfants et les personnes prenant soin d'eux. La téléconsultation a inclus une consultation de cas, une supervision de réflexion individuelle et de groupe, et des soutiens/références de collaboration. Durant la période d'évaluation de 18 mois, 1568 prestataires uniques se sont engagés soit dans une formation ou des services de téléconsultation, avec une moyenne de 9% de croissance chez les nouveaux prestataires chaque mois, avec une représentation de tous les secteurs professionnels et les comtés de l'état. Ce programme démontre la fiabilité et le besoin de programmes de formation et de téléconsultations au niveau de l'état afin d'aider à remplir les besoins des prestataires qui travaillent et soutiennent les jeunes enfants et les personnes prenant soin d'eux.

The Day Disparities Died.

For many, many years, the public health community has grappled with health disparities. Reducing and/or eliminating health disparities are well-established goals, and have become a fixture in the public health space. The focus on health disparity elimination has permeated policy, resources, institutions of higher learning, and research agendas, to name a few. As a Black female public health professional, I believe that we play a central role in moving the country from a place of disparity to equity. Not only are our professional experiences critical for advancing public health, but our lived experiences can also contribute to the transformation that we all seek. This piece, titled "The Day Disparities Died," reflects this belief. To view the original version of this poem, see the supplemental material section of this article online.

Informed consent in urology.

Appropriate professional practice includes the diagnostic and treatment process of urologic pathology, as well as patient information and respect for patient autonomy in decision making. Informed consent is the gradual process of providing information to the patient and their subsequent decision making. The informed consent document (ICD), when required, demonstrates that information has been provided sufficiently in advance to allow for the patient's deliberation. The dual need for simple yet complete documents make the preparation of adequate ICDs extremely difficult. If the information process is not carried out properly, the professional may incur a medical malpractice liability that is treated as a loss of opportunity. To avoid such situations, the work of scientific societies in the preparation, accessibility, and dissemination of ICD models is fundamental.

Reflective supervision and reflective practice in infant mental health: A scoping review of a diverse body of literature.

Reflective practice is a core component of Infant Mental Health (IMH) training and work in the form of reflective supervision/consultation (RS/C). RS/C supports and facilitates relationship-based practice, and is considered to help prevent burnout and promote work satisfaction. In response to an identified gap in empirical research on RS/C, this scoping review aimed to give an overview of the broad range of study designs and outcomes by systematically charting empirical studies on RS/C in IMH-based work with children and families. Searches of Academic Search Complete, CINAHL, MEDLINE, APA PsychArticles, APA PsycInfo, and Web of Science were supplemented with a Google Scholar search and citation searching. Following title/abstract screening (n = 233) and full-text review (n = 168), 35 reports met criteria for inclusion. Key findings were organized into four categories: Essential components and processes of RS/C; Experiences and outcomes of RS/C; Emerging issues in RS/C literature; and Measuring, researching, and reporting on RS/C. Results describe the components and experience of engaging in quality RS/C, and show that practitioners generally experience RS/C as supportive and beneficial. The existing literature has some methodological limitations and further empirical research is needed on outcomes of RS/C. Practice implications and potential future research directions are discussed.

La práctica con reflexión es un componente central del entrenamiento y trabajo en el campo de Salud Mental Infantil (IMH), en forma de una supervisión/consulta con reflexión (RS/C). RS/C apoya y facilita la práctica que tiene como base la relación y se considera que ayuda a prevenir el agotamiento y a promover la satisfacción en el trabajo. Como respuesta a un identificado vacío en la investigación empírica sobre RS/C, esta revisión de los antecedentes se propuso presentar una visión general de la amplia gama de diseños y resultados de estudios por medio de un trazado sistemático de estudios empíricos sobre RS/C en el trabajo basado en IMH con niños y familias. La búsqueda en Academic Search Complete (Completa Búsqueda Académica), en CINAHL, MEDLINE, APA, PsychArticles, APA PsycInfo y Web of Science (Red de la Ciencia) se suplementó con una búsqueda en Google Scholar y una búsqueda de citas anotadas. Después de seguir la detección de título/resumen (n = 233) y una revisión del texto completo (n = 168), 35 reportes reunieron los criterios para ser incluidos. Los resultados claves se organizaron en 4 categorías: Componentes y procesos esenciales de RS/C; Experiencias y resultados de RS/C; Asuntos incipientes en la literatura sobre RS/C; y Medir, investigar y reportar sobre RS/C. Los resultados describen los componentes y experiencias de participar en RS/C de calidad, y muestran que los profesionales de la práctica generalmente experimentan RS/C como un proceso de apoyo y beneficioso. La literatura existente tiene algunas limitaciones metodológicas y se necesita una mayor investigación empírica sobre los resultados de RS/C. Se discuten las implicaciones en la práctica y las potenciales directrices para la futura investigación.

From the factory model to the classroom-workshop: Learning from practice in the fields of health and education.

In this article, we engage in a dialogue about structural competencies based on the proposal of the classroom-workshop, aimed at educational and work environments in the fields of health and education. Our starting point is the notion that practical experiences do not merely represent a collection of specialised technical knowledge, as they are part of the complexity of the social game. Drawing from the theoretical frameworks of Pierce, Gadamer, Freire, and others, the proposal of the classroom-workshop recovers the power of collective praxis. Learning from and with others becomes central in the social game in order to collectively appropriate knowledge by making the autonomy of learning as horizontal as possible. By centering the relational world of learning and working, the classroom-workshop recovers the circular structure of understanding that enables a reflective appropriation of the territory - understood as the social space where life takes place - while de-instrumentalizing the reading of theoretical traditions and resignifiying the practice of writing. It establishes connections, links, and anchors that enable a dialogue between theory and practice, so often dissociated and fragmented.

USING THE SENSORY INTEGRATION TECHNIQUE FOR PEOPLE WITH AUTISM SPECTRUM DISORDERS DURING TRAINING AT THE CLIMBING SECTION.

OBJECTIVE: Aim: To analyze the practical application of the sensory integration technique for individuals with autism spectrum disorder at a climbing section, and to investigate the impact of physical activity on improving their proprioceptive and vestibular systems. PATIENTS AND METHODS: Materials and Methods: The method of included participant observation at the climbing classes with constant recording the behavior (desirable and undesirable) was used. The sensory screening (developed by J. Ayres) was applied for recording and determining the sensory systems of the people with ASD before the start of training and again after a month. The scale of Sensory Integration and Praxis Tests (SIPT) was used for assessing certain aspects of participants' sensory processing or perception according to the goals set during the climbing classes. RESULTS: Results: The results of the research showed that the application of the sensory integration technique for individuals with ACD at a climbing section promoted the dynamics of changes in their sensory system during training considering the characteristics of their sensory system. The positive changes were observed in the way the people with ACD felt about their own bodies and their involvement in sports activities that in its turn made it possible to be active and develop their sensory system. It has been identified that while planning training for the people with ASD it is necessary to take into account sensory modulation (reading sensory signals) and apply exercises for stimulating sensory sensations that will improve the motor activity of persons with ASD, their social interaction, and safety, as well. CONCLUSION: Conclusions: During training at the climbing section sensory information processing of the individuals with ASD have the impact on their body control, hand-eye coordination, and hand sensitivity during training. The improvement of sensory information processing in its turn enables people with ASD to master climbing.

Los desencadenantes reflejos en la epilepsia mioclónica juvenil / Reflex triggers in juvenile myoclonic epilepsy

Resumen Introducción : La epilepsia mioclónica juvenil (EMJ) es un síndrome epiléptico de inicio en la infancia y ado lescencia con mioclonías, convulsiones tónico-clónicas generalizadas y ausencias. Los estímulos reflejos como la sensibilidad a la luz o fotosensibilidad, la apertura y cierre palpebral y la inducción por praxias producen descargas epileptiformes y crisis. Estos desencadenan tes reflejos no son todos sistemáticamente estudiados. Objetivo : Examinar los rasgos reflejos en pacientes con EMJ. Métodos : Se evaluaron en forma consecutiva 100 adolescentes y adultos con EMJ que recibían diferentes tratamientos anticrisis. Se realizó un electroencefalogra ma standard con un protocolo de estimulación luminosa intermitente (ELI) y otro para la evaluación de las pra xias a través de una actividad neurocognitiva (ANC). El análisis estadístico fue descriptivo y de correlación. Se consideró significativa una p > 0.05. Resultados : La edad actual fue de 28+/-11 (14-67). Las crisis comenzaron a los 15 años +/-3 (Rango 8-25 años). EL 58% presentaron mioclonías y convulsiones tónico clónicas generalizadas. El 50% recibían ácido valproico y el 31% continuaban con crisis. Descargas epileptiformes en reposo 20%; hiperventilación 30%; apertura y cierre palpebral 12%; respuesta fotoparoxística en la ELI 40%; ANC 23%. Mayor porcentaje de descargas y demora en la realización de la ANC en los que presentaban crisis. El ácido valproico comparado con los otros fármacos no demostró superioridad en el control de las crisis. Conclusiones : Estos hallazgos confirman la importan cia del estudio de los rasgos reflejos para el diagnóstico, seguimiento y el control terapéutico.

Abstract Introduction : Juvenile myoclonic epilepsy (JME) is an epileptic syndrome with onset in childhood and adolescence with myoclonus, absences, and generalized tonic-clonic seizures. Reflex stimuli such as sensitivity to light or photosensitivity, eyelid opening and closing, and praxis induction produce epileptiform discharges and seizures. These reflex triggers are not all system atically studied. Objective : Examine reflex features in patients with JME. Methods : One hundred adolescents and adults with JME who received different anti-seizure treatments were evaluated consecutively. A standard electroen cephalogram was performed with an intermittent light stimulation (SLI) protocol and another for the evaluation of praxias through neurocognitive activity (CNA). The statistical analysis was descriptive and of correlation with a p > 0.05. Results : Current age was 28+/-11 (14-67). The seizure began at 15 years +/-3 (Range 8-25 years). They pre sented myoclonus and generalized tonic-clonic seizures in 58%. 50% received valproic acid and 31% continued with seizures. Epileptiform discharges at rest 20%; hy perventilation 30%; eyelid opening and closing 12%; photoparoxysmal response in SLI 40%; CNA 23%. Higher percentage of discharges and delay in performing CNA in those who presented seizures. Valproic acid com pared to other drugs did not demonstrate superiority in seizure control. Conclusions : These findings confirm the importance of studying reflex traits for diagnosis, follow-up, and therapeutic control.

[Reflex triggers in juvenile myoclonic epilepsy]. / Los desencadenantes reflejos en la epilepsia mioclónica juvenil.

INTRODUCTION: Juvenile myoclonic epilepsy (JME) is an epileptic syndrome with onset in childhood and adolescence with myoclonus, absences, and generalized tonic-clonic seizures. Reflex stimuli such as sensitivity to light or photosensitivity, eyelid opening and closing, and praxis induction produce epileptiform discharges and seizures. These reflex triggers are not all systematically studied. OBJECTIVE: Examine reflex features in patients with JME. METHODS: One hundred adolescents and adults with JME who received different anti-seizure treatments were evaluated consecutively. A standard electroencephalogram was performed with an intermittent light stimulation (SLI) protocol and another for the evaluation of praxias through neurocognitive activity (CNA). The statistical analysis was descriptive and of correlation with a p > 0.05. RESULTS: Current age was 28±11 (14-67). The seizure began at 15 years ±3 (Range 8-25 years). They presented myoclonus and generalized tonic-clonic seizures in 58%. 50% received valproic acid and 31% continued with seizures. Epileptiform discharges at rest 20%; hyperventilation 30%; eyelid opening and closing 12%; photoparoxysmal response in SLI 40%; CNA 23%. Higher percentage of discharges and delay in performing CNA in those who presented seizures. Valproic acid compared to other drugs did not demonstrate superiority in seizure control. CONCLUSIONS: These findings confirm the importance of studying reflex traits for diagnosis, follow-up, and therapeutic control.

Introducción: La epilepsia mioclónica juvenil (EMJ) es un síndrome epiléptico de inicio en la infancia y adolescencia con mioclonías, convulsiones tónico-clónicas generalizadas y ausencias. Los estímulos reflejos como la sensibilidad a la luz o fotosensibilidad, la apertura y cierre palpebral y la inducción por praxias producen descargas epileptiformes y crisis. Estos desencadenantes reflejos no son todos sistemáticamente estudiados. OBJETIVO: Examinar los rasgos reflejos en pacientes con EMJ. Métodos: Se evaluaron en forma consecutiva 100 adolescentes y adultos con EMJ que recibían diferentes tratamientos anticrisis. Se realizó un electroencefalograma standard con un protocolo de estimulación luminosa intermitente (ELI) y otro para la evaluación de las praxias a través de una actividad neurocognitiva (ANC). El análisis estadístico fue descriptivo y de correlación. Se consideró significativa una p > 0.05. RESULTADOS: La edad actual fue de 28±11 (14-67). Las crisis comenzaron a los 15 años ±3 (Rango 8-25 años). EL 58% presentaron mioclonías y convulsiones tónico clónicas generalizadas. El 50% recibían ácido valproico y el 31% continuaban con crisis. Descargas epileptiformes en reposo 20%; hiperventilación 30%; apertura y cierre palpebral 12%; respuesta fotoparoxística en la ELI 40%; ANC 23%. Mayor porcentaje de descargas y demora en la realización de la ANC en los que presentaban crisis. El ácido valproico comparado con los otros fármacos no demostró superioridad en el control de las crisis. CONCLUSIONES: Estos hallazgos confirman la importancia del estudio de los rasgos reflejos para el diagnóstico, seguimiento y el control terapéutico.