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Implementation of guidelines for early detection of cerebral palsy. A single-site study in Spain(Early Human Development, 2026) Hidalgo-Robles, Álvaro; Batista-Guerra, María Del Mar; Gutiérrez-Ortega, Mónica; León-Estrada, Irene; Merino-Andrés, JavierThe 2017 international guidelines for early detection of cerebral palsy (CP) provide a framework for identifying and managing infants at risk. Yet their implementation in clinical practice remains limited in some settings and countries. This study aimed to implement these guidelines in a Spanish tertiary hospital and assess their impact on the timing of CP diagnosis and referral to early intervention. A pre/post observational design was used, structured around a three-phase implementation strategy: (1) planning and preparation, (2) installation, and (3) early implementation of systematic screening of infants with “high-risk” markers. We compared a historical baseline cohort (born 2017–2021, n = 18 children diagnosed with CP) and an implementation cohort (born 2022–2023, n = 57 enrolled, n = 4 children diagnosed with CP). Among infants with CP in the implementation cohort, referral to early intervention occurred at a mean corrected age of 1.9 months, “high-risk” of CP designation at 3.7 months, and CP diagnosis at 9.2 months. In the baseline period, mean age at diagnosis was 17.4 months, yielding a mean reduction of 8.2 months during implementation (95 % CI: −13.8 to −2.6, p < 0.05). Twelve key recommendations were partially (50 %) or consistently (20 %) applied. Findings support the feasibility of implementing the guidelines and suggest improved identification and surveillance outcomes, including earlier diagnosis. Structured implementation pathways are needed to integrate these practices into routine care and promote equitable access across health systems.
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Participation in Everyday Routines: Examining the Latent Structure of the MEISR for Children Aged 3–5 Years(Infant and Child Development, 2026) León-Estrada, Irene; Morales-Murillo, Catalina; Pacheco-Molero, Manuel; Hernández-Soto, Roberto; Gutiérrez-Ortega, MónicaParticipation in everyday routines (e.g., mealtimes, bedtime, dressing) is a key context for early development and a central focus of early childhood intervention. This study examined the internal structure, reliability and construct validity of the Measure of Engagement, Independence and Social Relationships for children aged 3–5 years (MEISR 3–5) within home routines. The sample included 705 children aged 36 to 72 months (M = 51.01, SD = 10.07) receiving early childhood intervention services across Spain. A confirmatory factor analysis based on McWilliam's theoretical functional domains—engagement, independence and social relationships—showed acceptable global model fit and very high internal consistency. However, convergent validity was only partial, and discriminant validity was not supported, indicating substantial overlap amongst domains. To further examine the dimensionality of the instrument, parcel-based analyses were conducted in a subsample (n = 553) and compared correlated three-factor, two-factor, bifactor, second-order and unidimensional models. All models showed equivalent and excellent fit. Bifactor indices (ωh ≈ 0.98; ECV > 0.90) indicated that most reliable and common variance was attributable to a dominant general participation factor, with minimal unique variance remaining for the specific domains. These findings suggest that the MEISR 3–5 functions as an essentially unidimensional measure at the psychometric level. The total score appears to provide the most robust quantitative indicator of children's participation in home routines, whereas domain-level scores are better interpreted as clinically descriptive dimensions that can inform goal setting, intervention planning, and progress monitoring in routine-based practise.- Acceso Abierto
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Diseño de Sistema Renovable Mixto de generación eléctrica Off Grid.(2025-12-15) Rocha-Rodríguez, Fernando GabrielEl Trabajo de Fin de Master (TFM), enfocara el estudio, diseño y dimensionamiento de los sistemas fotovoltaicos y eólicos aislados de la red, destinados a abastecer la demanda energética de una vivienda tipo, ubicada en zona rural del norte de Uruguay. Primeramente, se llevará a cabo una caracterización rigurosa de los recursos solares y eólicos locales, considerando parámetros como Irradiación, Velocidad de Vientos, Temperatura ambiente, Angulo de incidencia y número de horas sol, con el fin de estimar la potencialidad de generación de Energía eléctrica en dicha zona. A continuación, se presentarán las cargas habituales de una vivienda tipo, tomando en cuenta hábitos normales de consumo, así como las características técnicas de cada uno de los artefactos eléctricos a utilizar y se facilitarán los planos técnicos de dicha instalación. Sobre la base obtenida, se dimensionará los principales componentes del sistema fotovoltaico y eólico para que cumplan dicha demanda, así como toda la instalación eléctrica requerida con sus respectivas protecciones, el banco de batería, bomba de agua, el regulador MPPT e inversor necesario. Dicho estudio, utilizara criterios técnicos, que contemplarán pérdidas por temperatura, sombreado, suciedad, a efectos que no se vea comprometido el nivel de acumulación de energía en la batería que en ningún caso podrá ser menor del 90%. Por último, se presentarán los resultados de viabilidad del dimensionamiento utilizado y su respectivo costo económico, con el fin de mostrar la sustentabilidad de este tipo de sistemas Off Grid, para la problemática de autogeneración eléctrica rural.
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