The Validity and Reliability of a New Simple Instrument for the Measurement of First Ray Mobility

Several methods have been described to quantify the first ray mobility. They all have certain disadvantages (great size, sophistication, or lack of validation). The objective of this work was to study the validity and reliability of a new instrument for the measurement of first ray mobility. Anterior-posterior radiographs were obtained from 25 normal feet and 24 hallux valgus feet, with the first ray in a neutral position, maximally dorsiflexed and maximally plantarflexed. The first ray mobility was radiographicaly measured in both groups, and was also manually examined with the new device. A cluster analysis determined whether normal and hallux valgus feet were correctly classified, and a graphic analysis of Bland-Altman was performed to compare the radiographic and manual measurement techniques. Based on the radiographs, the first ray mobility only showed significant differences in dorsiflexion between both groups (P = 0.015). First ray dorsiflexion, plantarflexion and total range of motion measured with the new device were different between both groups (P = 0.040, P = 0.011 and P = 0.006, respectively). The silhouette measure of the cohesion and separation coefficients from the cluster analysis was greater than 0.50 for the dorsiflexion, plantarflexion and total range of motion obtained from the radiographs and from the new device. The Bland-Altman graph suggested that 96% of the data presented agreement between both measurement methods. These results suggested that the new instrument was valid and reliable

Testing the Effect of Relative Pollen Productivity on the REVEALS Model : A Validated Reconstruction of Europe-Wide Holocene Vegetation

Reliable quantitative vegetation reconstructions for Europe during the Holocene are crucial to improving our understanding of landscape dynamics, making it possible to assess the past effects of environmental variables and land-use change on ecosystems and biodiversity, and mitigating their effects in the future. We present here the most spatially extensive and temporally continuous pollen-based reconstructions of plant cover in Europe (at a spatial resolution of 1° × 1°) over the Holocene (last 11.7 ka BP) using the 'Regional Estimates of VEgetation Abundance from Large Sites' (REVEALS) model. This study has three main aims. First, to present the most accurate and reliable generation of REVEALS reconstructions across Europe so far. This has been achieved by including a larger number of pollen records compared to former analyses, in particular from the Mediterranean area. Second, to discuss methodological issues in the quantification of past land cover by using alternative datasets of relative pollen productivities (RPPs), one of the key input parameters of REVEALS, to test model sensitivity. Finally, to validate our reconstructions with the global forest change dataset. The results suggest that the RPPs.st1 (31 taxa) dataset is best suited to producing regional vegetation cover estimates for Europe. These reconstructions offer a long-term perspective providing unique possibilities to explore spatial-temporal changes in past land cover and biodiversity

Plan de emerxencias. Fundación Pública Urxencias Sanitarias de Galicia-061

A Fundación Pública Urxencias Sanitarias de Galicia-061 é a encargada de proporcionar, desde o momento que ocorre a emerxencia, un control da situación, unha primeira avaliación e unha asistencia sanitaria que logre salvar o maior número de vidas e volver á normalidade o antes posible. Para isto, a actuación sanitaria debe seguir unha metodoloxía perfectamente establecida, xa que as actuacións organizadas son as mellores ferramentas de traballo. Así pois, é necesario posibilitar normas de actuación o máis protocolizadas posible, para poder traballar nas mellores condicións de seguridade e manter unhas directrices xerais, onde cada persoa coñeza tanto a súa función como a do resto dos componentes do equipo, procedendo, ademais, á súa identificación funcional mediante signos externos (uniformidade, carteis, identificación, etc.); para facilitar o entendemento e a coordinación de todos os implicados en resolver a situación acaecida. Con este fin, preséntase o Plan de emerxencias que a continuación se expón, nun afán de dar sempre a mellor e máis axeitada resposta; obxectivo primordial desde que a FPUS de Galicia–061 se instaura como responsable da medicina prehospitalaria na nosa comunidade autónoma.La Fundación Pública Urxencias Sanitarias de Galicia-061 es la encargada de proporcionar, desde el momento en que ocurre la emergencia, un control de la situación, una primera evaluación y una asistencia sanitaria que logre salvar el mayor número de vidas y volver a la normalidad lo antes posible. Para esto, la actuación sanitaria debe seguir una metodología perfectamente establecida, ya que las actuaciones organizadas son las mejores herramientas de trabajo. Así pues, es necesario posibilitar normas de actuación lo más protocolizadas posible, para poder trabajar en las mejores condiciones de seguridad y mantener unas directrices generales, donde cada persona conozca tanto su función como la del resto de los componentes del equipo, procediendo, además, a su identificación funcional mediante signos externos (uniformidad, carteles, identificación, etc.); para facilitar el entendimiento y la coordinación de todos los implicados en resolver la situación acaecidad. Con este fin, se presenta el Plan de emergencias que a continuación se expone, en un afán de dar siempre la respuesta mejor y más idónea; objetivo primordial desde que la FPUS de Galicia-061 se instaura como responsable de la medicina prehospitalaria en nuestra comunidad autónoma

Çédille, revista de estudios franceses

Presentació

Range of Motion of the Lower Limb and Its Relationship with the Onset of Posterior Muscle Discomfort in Competitive Swimmers

Objectives: To analyze the relationship between the joint characteristics of the lower limb and the occurrence of muscle discomfort in the lower extremities of competitive swimmers. Methods: This study involved 157 competitive swimmers (86 men and 71 women); 35 in the infant category (14-15 years), 38 in the junior category (16-20 years), 36 in the absolute category (>21 years), and 48 in the master category (>25 years). The following data were recorded: Seat and Reach Test, Straight Leg Raise Test, hip mobility (flexion-extension and rotation), knee flexion-extension, and ankle dorsiflexion with the knee flexed and extended. These variables were compared across different competition categories and styles. Results: Women showed a greater range of motion in most movements analyzed, except for hip extension. The style with the most knee discomfort is breaststroke. Freestyle is the style that presents the most posterior muscle discomfort, particularly in the gastrocnemius. The absolute and master categories reported more discomfort in the gastrocnemius and plantar muscles. Younger swimmers experienced fewer discomforts. A relationship was observed between lumbar and hamstring discomfort with reduced lumbar flexibility. Posterior muscle discomfort was mainly observed in swimmers with short hamstrings. Swimmers with plantar muscle discomfort had less ankle dorsiflexion. Conclusions: Swimmers participating in this study who reported muscle discomfort during swimming showed greater shortening of the hamstring and gastrocnemius muscles along with less ankle dorsiflexion compared to swimmers without discomfort

Morphofunctional characteristics of the foot in competitive swimmers [Dataset]

Objectives: To analyse the articular characteristics of the foot and ankle of two age groups of competitive swimmers (16-18 years and 19-24 years) and their relationship with muscular pain during swimming, mainly in the posterior musculature of the lower limb. Methods: Seventy-four competitive swimmers participated in the study, 38 ‘junior’ (16-18 years) and 36 ‘absolute’ (19-24 years). The following data were recorded: existence of muscular pain in the lower limb during swimming, popliteal angle test, ankle dorsal flexion, rearfoot mobility, dorsal flexion of the first metatarsophalangeal joint, presence of hallux valgus, foot posture, mobility of the first ray, medial arch height, and plantar pressure. These variables were compared between both age groups. A two-stage cluster analysis was carried out using the silhouette measure of cohesion and separation coefficient, with the aim of finding out the values of the variables that differentiate both groups most. Results: The region where muscular pain appeared most frequently was triceps surae, followed by the plantar musculature and hamstrings, without significant differences between age groups. The most relevant articular finding was that ankle dorsal flexion was limited in both age groups, more in adult swimmers (P < 0.001 with knee extended and P < 0.014 with knee flexed). High-arched foot was the most frequent type of foot in both groups. Conclusions: Competitive swimmers who participated in this study showed tightness in hamstrings and gastrocnemius muscles, which caused a limitation in ankle dorsal flexion, and could cause muscular pain in the foot and lower limbv.

Corrective bandages and daily manipulations for treatment of congenital vertical talus: a thirteenyear follow-up

Purpose To analyze the results of a conservative method for treating congenital vertical talus in children with early start and to know in which cases surgical treatment was needed. Methods A retrospective analysis of all children diagnosed with idiopathic vertical talus was carried out during the years 2008–2021. Thirty-two children (46 feet) were fnally included. Children were treated with serial manipulations, muscle stimulation, and corrective bandages. Age at the time of initiation of treatment, duration of treatment, and correction or not of the deformity without surgical intervention were recorded as variables of interest. The talocalcaneal angle, TAMBA, and ankle range of motion were measured before treatment, after treatment, and at the end of the follow-up period. Statistics decision tree was used to determine which variable best discriminated whether the patient needed surgery. To complement the tree diagram, a two-step cluster analysis was carried out. Results After treatment, TAMBA and talocalcaneal angle changed from “vertical” to “oblique” category in 45 and 37 feet, respectively. The pathological dorsal fexion of the ankle changed to normal in 37 feet and ankle plantar fexion was normal in 46 feet. These variables showed signifcant changes between the three measurement moments. The results of the statistics decision tree and cluster analysis indicate that “No surgery” was associated with an age equal to or lower than one week when treatment was started, and with an ankle plantar fexion range of motion lower than 36°. Conclusions The beginning of this conservative treatment in the frst week of life and having a plantar fexion of the ankle lower than 36° were related to the success of the treatment without surgery

Patient-oriented debriefing: Impact of real patients participation during debriefing

©2017. This manuscript version is made available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/ This document is the Published, version of a Published Work that appeared in final form in Clinical simulation in nursing. To access the final edited and published work see https://doi.org/10.1016/j.ecns.2017.04.008Background: This study aims to assess the impact of the participation of real patients during debriefing (using patient as co-debriefer). Method: A mixed study on the perceptions of students (n¼81) and patients as co-debriefers (n¼6) was conducted after performing simulated experiences that were directly related to the health problem. Results: Qualitative results: valuable and enriching learning experience, harmonious and integrated codebriefing, no preference for clinical aspects, compassion and empathy were generated, and the perception of being a therapeutic experience for patients was evident. Questionnaire results: students scored high in learning dimensions M¼14.81 (SD¼0.701), empathy M¼4.57 (SD¼0.96), positive perceptions regarding the debriefing M ¼ 14.56 (SD ¼ 1.09), and satisfaction M ¼ 14.69 (SD ¼ 0.78). Conclusion: This study underlines the benefits and the characteristics perceived by using real patients as co-debriefers

Effectiveness of custom-made foot orthoses in patients with rheumatoid arthritis: a randomized controlled trial

Objective: To determine the effect of custom-made foot orthoses versus placebo insoles on pain, disability, foot functionality, and quality of life. Design: Double-blinded randomized controlled trial. Setting: University Podiatric Clinical Area. Subjects: Patients with rheumatoid arthritis. Interventions: Patients were randomly assigned to either group A, which received custom-made foot orthoses, or group B, which received placebo, flat cushioning insoles, for three months. Main measures: The primary outcome was foot pain, measured by visual analog scale. Foot functionality, foot-related disability, and quality of life were measured using the Foot Function Index, the Manchester Foot Pain and Disability Index, and 12-Item Short Form Health Survey (SF-12) questionnaires, respectively, at the beginning and at days 30, 60, and 90. Results: A total of 53 patients, aged 59.21 ± 11.38 years, received either the custom-made foot orthoses (N = 28) or the placebo (N = 25). For the analysis of the data, only participants who had been measured at the four time points (0, 30, 60, and 90 days) were included. In group A, all variables showed statistically significant differences when comparing the initial and final measurements. Pain showed 6.61 ± 2.33 and 4.11 ± 2.66 in group A, at baseline and at 90 days, respectively, and Group B showed 6.16 ± 1.77 and 5.60 ± 2.71 at baseline and at 90 days, respectively. This was the only variable that showed statistically significant difference between groups (P = 0.048). Conclusion: The custom-made foot orthoses significantly reduced the participants’ foot pain, although they did not have positive effects on disability, foot functionality, and quality of life compared with only cushioning