This review aims to evaluate the effectiveness of virtual reality-based interventions (VR-based interventions) on cognitive deficits in children with attention deficit hyperactivity disorder (ADHD). A systematic review and meta-analysis were performed according to the PRISMA statement and the Cochrane Handbook guidelines for conducting meta-analyses. The Grading of Recommendations, Assessment, Development and Evaluation (GRADE) was used to assess the quality of the evidence. Clinical trials published up to 29 October 2020, were included. The meta-analysis included four studies, with a population of 125 participants with ADHD. The magnitude of the effect was large for omissions (SMD = −1.38; p = 0.009), correct hits (SMD = −1.50; p = 0.004), and perceptual sensitivity (SMD = −1.07; p = 0.01); and moderate for commissions (SMD = −0.62; p = 0.002) and reaction time (SMD = −0.67; p = 0.03). The use of VR-based interventions for cognitive rehabilitation in children with ADHD is limited. The results showed that VR-based interventions are more effective in improving sustained attention. Improvements were observed in attentional vigilance measures, increasing the number of correct responses and decreasing the number of errors of omission. No improvements were observed in impulsivity responses.

(1) This review aims to evaluate the effectiveness of treatments with virtual reality systems (VRSs) on the functional autonomy of older adults versus conventional treatment. (3) Methods: Systematic review and meta-analysis. An electronic data search was carried out, following the PRISMA statement, up to February 2020. We combined results from clinical trials using VRSs for the improvement of basic and instrumental activities of daily living. The guidelines of the Cochrane Handbook for Systematic Reviews of Interventions were followed for calculations and risk of bias. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) was used to assess the quality of evidence. (4) Results: The final analysis included 23 studies with a population of 1595 participants. A moderate, but clinically significant, effect was found for basic activities of daily living (BADLs), (Standard Medium Deviation, SMD 0.61; 95% CI: −0.15–1.37; P < 0.001). A small effect was found for instrumental ADLs (Instrumental Activities of daily living, IADLs) (SMD −0.34; 95% CI: −0.82–0.15; P < 0.001). Functional ambulation was the BADL which improved the most (SMD −0.63; 95% CI: −0.86, −0.40; P < 0.001). (5) Conclusion: The use of VRSs is an innovative and feasible technique to support and improve the functional autonomy of community-dwelling older adults. Due to the very low quality of the evidence for our main outcomes, the effects of a VRS on the BADLs and IADLs are uncertain. Clinical trials of a higher methodological quality are necessary to increase the level of knowledge of its actual effectiveness.

The aims were to determine Spanish women’s expectations about exclusive breastfeeding (EB) and the effect of expectations and other factors on EB during the first 6 months. A prospective cohort study was conducted with 236 participants. Variables were maternal age, marital status, occupation, expectations about breastfeeding, knowledge about breastfeeding, type of delivery, type of feeding, and duration of EB. Data were collected through three personal interviews, at the hospital (before delivery) and in two telephone calls in the first and sixth months postpartum. Average age was 32.3 years (SD = 5.3); average duration of EB was 2.73 months (SD = 2.49). Of 236 women who had decided to breastfeed before birth, 201 (85.2%) offered EB after delivery. Achievement of expectations was most influenced by the decision to continue breastfeeding ‘as long as I can’ (OR: 5.4; CI: 2.0–14.6) and previous experience (OR: 3.2; CI: 1.2–8.5). Knowledge of breastfeeding acquired from relatives (OR: 9.2; CI: 3.0–27.9), caesarean delivery (OR: 4.6; CI: 1.7–12.8) and maternal age (36–40 years old) (OR: 7.5; CI: 1.8–30.9) were associated with failure to achieve EB. Achievement of EB may depend on a woman’s confidence in her ability to do so and on knowledge obtained in the social environment.

The objective of this study was to assess the potential levels of burnout syndrome in occupational therapists in Spain, as well as the risk factors involved in its prevalence. The data were obtained through an online survey. The tool utilised for this purpose was the Maslach Burnout Inventory General Survey (MBI-GS) that takes into consideration the following dimensions: emotional fatigue, depersonalisation and reduction of personal satisfaction. A sociodemographic questionnaire was also utilised. The sample of the study included 758 occupational therapists, 90.8% of whom were women and 9.2% of whom were men. For identifying the variables associated to the presence of burnout, the prevalence was compared through the chi-squared test, and the odds ratios by age were calculated through the binary logistic regression model. We found that 69.4% of the occupational therapists presented burnout syndrome and especially emotional fatigue (63.5%). Likewise, relevant and significant differences in the prevalence of burnout syndrome were observed depending on the age, marital status, number of children, work field and type of workday. We can conclude that burnout syndrome poses a clear risk for the health of occupational therapists that could have direct consequences on the work environment, affecting the way the interventions are performed with patients. This study could help to raise awareness on this reality and the factors implied. We suggest the implementation of measures (individual, labour and political) both for the prevention of burnout in occupational therapists as well as for reducing the levels of those who suffer from it.

(1) Objective: to explore and describe the relationship between the occupational balance of university students taking a Degree in Occupational Therapy and the problematic use of the Internet and how these, in turn, favour or not the appearance of phubbing behaviour which involves “a behaviour that happens when an individual looks at his mobile phone during a conversation with other individuals, escaping from interpersonal communication”. (2) Methods: this is a quantitative descriptive study of an observational and cross-sectional nature, not experimental. The Spanish version of the Occupational Balance Questionnaire (OBQ-E), the Internet Addiction Test and the Phubbing Scale were used for data collection. 192 university students taking the Degree in Occupational Therapy of the University of Castilla–La Mancha participated (168 women and 24 men). (3) Results: the average score obtained in the OBQ-E was 38.7, indicating a moderate occupational balance; and (4) Conclusions: occupational therapy students from the Faculty of Health Sciences of the University of Castilla–La Mancha have a moderate occupational balance. Furthermore, this is negatively related to both problematic Internet use and phubbing, so a higher occupational balance indicates less Internet addiction and less phubbing.

The role of uric acid levels in the cardiovascular continuum is not clear. Our objective is to analyze the prevalence of hyperuricemia (HU) and its association with cardiovascular risk factors (CVRF), subclinical target organ damage (sTOD), and cardiovascular diseases (CVD). We evaluated the prevalence of HU in 6.927 patients included in the baseline visit of the IBERICAN study. HU was defined as uric acid levels above 6 mg/dL in women, and 7 mg/dL in men. Using adjusted logistic regression models, the odds ratios were estimated according to CVRF, sTOD, and CVD. The prevalence of HU was 16.3%. The risk of HU was higher in patients with pathological glomerular filtration rate (aOR: 2.92), heart failure (HF) (aOR: 1.91), abdominal obesity (aOR: 1.80), hypertension (HTN) (aOR: 1.65), use of thiazides (aOR: 1.54), left ventricular hypertrophy (LVH) (aOR: 1.36), atrial fibrillation (AFIB) (aOR: 1.29), and albuminuria (aOR: 1.27). On the other hand, being female (aOR: 0.82) showed a reduced risk. The prevalence of HU was higher in men, in patients presenting CVRF such as HTN and abdominal obesity, and with co-existence of LVH, atrial fibrillation (AFIB), HF, and any form of kidney injury. These associations raise the possibility that HU forms part of the early stages of the cardiovascular continuum. This may influence its management in Primary Healthcare because the presence of HU could mean an increased CV risk in the patients.