Anticoncepción poscoital. Características de la demanda

ObjetivoConocer el perfil de las mujeres que demandan anticoncepción poscoital (APC).DiseñoDescriptivo transversal. Emplazamiento. Centro de Orientación Familiar (COF), Área 4 del Instituto Madrileño de Salud. Madrid.ParticipantesTodas las mujeres que acudieron en el año 2000 para requerir APC (n = 404).MedicionesSe realizó una encuesta con variables sociodemográficas relacionadas con la APC y con la vida sexual.ResultadosLa edad media fue de 23,9 años (límites, 14–49); el 9,9% era menor de edad. La media de coitos al mes era de 6,7, el número de años de relaciones sexuales era de 4,9 y el primer coito se produjo, de media, a los 18 años. El 90,9% afirmaba tener pareja estable. Tenía estudios secundarios o universitarios un 75%. El 55,7% manifestaba no haber recibido información sobre anticonceptivos. El 19,5% utilizó APC en otra ocasión. El 6,5% había tenido alguna interrupción voluntaria de embarazo y de éstas, el 36% había utilizado APC anteriormente. Los motivos de consulta fueron: rotura de preservativo (69,3%), preservativo retenido (16,9%) y coito sin protección (12%). El 7% tuvo otros coitos de riesgo en el mismo ciclo. Un 33,2% las remitía su equipo de atención primaria, acudió por conocidos el 19% y desde servicios de urgencias el 16%. Conocía el COF un 26,1%. En el 12,2% no se prescribió APC por mínimo riesgo de embarazo. Realizaron la valoración una enfermera (52,6%), médicos residentes (34,4%) y una ginecóloga (13%).ConclusionesFalta información sobre métodos anticonceptivos. La mayoría de las pacientes son derivadas por otros servicios sanitarios.ObjectiveDefine the profile of the women that ask for emergency contraception (EC).DesignTransversal descriptive investigation.SettingFamiliar Planning Center of 4th Area of Instituto Madrileño de Salud. in Madrid. Participants. All the women that went in the year 2000 requiring EC (n=404).MeasurementsWas carried out a survey with sociodemographic variables, related with the EC and with the sexual life.ResultsThe average age was of 23.9 years (age range 14 to 49) were inquired, 9.9 were under 18. They had an average of 6.7 intercourses per month, the first intercourse when they were 18 years old on average, and 4.9 years of sexual relationships. 90.9% stated to have a couple. 75% were graduated from high school or university, and 55.7% said they had never received information about contraceptives. For 19.5% this was not the first time they asked for EC. 6.5% had interrupted on purpose pregnancy and 36% of them had used EC before. The reasons to demand EC were: condom break (69.3%), held condom (16.9%) and intercourse without any protection (12%). 7% acknowledged other risky intercourses during the same period. 33.2% had been sent by a General Practitioner, 26.1% knew the center, 19% were sent by acquaintances and 16% from Emergency Services. EC was not prescribed in 12.2% of the cases because of minimum risk to pregnancy. The evaluation was made by a nurse (52.6%), by a doctor (34.4%) and by a gynecologist (13%).ConclusionsThere is a lack of information about contraceptive methods. Most of the patients are sent from other sanitary services

Criterios para la localización de plantas de gestión de Residuos de Construcción y Demolición (RCD)

Location criteria for a Demolition Waste Processing Center. The recent social worry about ecological duties and conservation of the environment makes indispensable the correct treatment of demolition waste produced by construction sector. This document pretends the appliance of some general keys that could allow the selection of the best possible location for placing a waste processing center and a demolition waste dump. This facility should be able to have a classification and selection level and a treatment level therefore, the facility should be able to put the non-recoverable part on the dump area reserved for it. Later these items would be considered, classified and evaluated being analyzed by the corresponding evaluation matrix

Hacia una Minería Sostenible en el 95 entorno del Parque Natural del Alto Tajo. La escombrera experimental de la mina ‘El Machorro’(Poveda de la Sierra, Guadalajara)

Por su situación en el entorno de un espacio natural protegido, y sobre una ladera de pendiente y longitud elevadas, la restauración de la mina El Machorro constituye un importante reto científico y profesional. La empresa propietaria de esta mina, CAOBAR S.A., tiene entre sus objetivos demostrar la compatibilidad de la actividad minera con la conservación del medio ambiente. Por todo ello está acometiendo sucesivas revisiones de su Plan de Restauración del Espacio Natural (PREN), tratando de incorporar las mejores prácticas internacionales al respecto. Todo ello en colaboración con las universidades Complutense y de Alcalá (Madrid) y bajo la supervisión de la Dirección del Parque Natural del Alto Tajo. Una de las acciones más destacadas a ese respecto ha sido la construcción de una escombrera experimental, específicamente diseñada para mejorar la restauración de los terrenos afectados por la mina. En ella se estudia el comportamiento erosivo que tienen diferentes diseños de escombreras mediante la combinación de: (a) distintas topografías (cóncava y en terrazas); (b) distintos tipos de sustrato (estériles, coluviones y suelos originales); y (c) distintos tipos de revegetación (como hidrosiembras). En la comunicación se describen los detalles de la puesta en funcionamiento de esta escombrera experimental, así como los resultados obtenidos para el periodo 1 de noviembre de 2008 a 31 de marzo de 2009

Does the addition of manual therapy approach to a cervical exercise program improve clinical outcomes for patients with chronic neck pain in short-and mid-term? A randomized controlled trial

Chronic neck pain is one of today’s most prevalent pathologies. The International Classification of Diseases categorizes four subgroups based on patients’ associated symptoms. However, this classification does not encompass upper cervical spine dysfunction. The aim is to compare the short-and mid-term effectiveness of adding a manual therapy approach to a cervical exercise protocol in patients with chronic neck pain and upper cervical spine dysfunction. Fifty-eight subjects with chronic neck pain and upper cervical spine dysfunction were recruited (29 = Manual therapy + Exercise; 29 = Exercise). Each group received four 20-min sessions, one per week during four consecutive weeks, and a home exercise regime. Upper flexion and flexion-rotation test range of motion, neck disability index, craniocervical flexion test, visual analogue scale, pressure pain threshold, global rating of change scale, and adherence to self-treatment were assessed at the beginning, end of the intervention and at 3-and 6-month follow-ups. The Manual therapy + Exercise group statistically improved short-and medium-term in all variables compared to the Exercise group. Four 20-min sessions of Manual therapy + Exercise along with a home-exercise program is more effective in the short-to mid-term than an exercise protocol and a home-exercise program for patients with chronic neck pain and upper cervical dysfunction

Influence of air velocity on indoor environment quality in unidirectional flow operating theatres: A study based on Computational Fluid Dynamics

It is necessary to characterise air-conditioning airflow in omanuscriprder to optimize hospital Indoor Environment Quality in high-performance operating theatres, and also reduce the risk of nosocomial infection due to pathogen contamination. The aim of this article is to study the prevalence of optimal healthy conditions from controlled air flow quality in hospital facilities, and to minimize energy consumption. To this purpose, the indoor air movement was modelled by Computational Fluid Dynamics technology. The optimal results showed that it is necessary to drive ultra-clean air ranging between 0.25 m/s and 0.40 m/s, values which are adequate to perform efficient sweeping and cleaning of the air near the patient, maintaining unidirectional air flow permanently as the air passes through the surgical field. These speeds must be taken into account as calculation parameters in new hospital facility projects, and as control parameters for the existing operating theatres

Procesos geomorfológicos activos en cárcavas del borde del piedemonte norte de la Sierra de Guadarrama (Provincia de Segovia, España)

Dos localizaciones situadas cerca del borde del piedemonte norte de la Sierra de Guadarrama (provincia de Segovia) ofrecen formas erosivas en cárcavas bien desarrolladas: (a) un conjunto de barrancos encajados sobre arenas arcósicas del Mioceno, en un relieve de lomas y vaguadas del suroeste provincial; (b) cárcavas sobre arenas silíceas del Cretácico Superior, en un relieve de laderas de mesas y cuestas de la zona centro sur de la Provincia. En este trabajo se caracteriza la actividad geomorfológica de esos barrancos y cárcavas, y se inicia su cuantificación. El objetivo está encaminado a conocer qué procesos movilizan sedimentos, y a evaluar sus tasas de actuación, intensidad, frecuencia de ocurrencia y conectividad entre los mismos. Los procesos de erosión hídrica por salpicadura, arroyada laminar y concentrada en rills, junto con la actividad gravitacional observada, movilizan materiales desde las cabeceras de las cárcavas hasta los colectores, rellenándolos; éstos son evacuados mediante procesos de encajamiento en los canales efímeros, y sedimentados en pequeños conos aluviales. En los barrancos sobre arcosas, los eventos de precipitación poco intensos y de alta frecuencia tienden a rellenar los lechos arenosos, mientras que la fusión nival y las precipitaciones de alta intensidad y baja frecuencia vacían los canales, sedimentando en zonas apicales de los conos aluviales. En las cárcavas sobre arenas silíceas, los primeros datos obtenidos apuntan a unas tasas de erosión y producción de sedimentos muy elevadas, ya que sobre ellas se produce escorrentía y erosión hídrica de manera casi instantánea; por ello, los eventos de precipitación de baja intensidad son capaces de sedimentar en las zonas apicales de los conos, mientras que los eventos de alta intensidad originan lóbulos telescópicos sobre conos aluviales existentes en pedimentos. [ABSTRACT] Two areas located at the edge of the North piedmont of the Guadarrama Mountains (province of Segovia) show a conspicuous development of gullies. A series of valley side gullies, or ravines, cut on arkosic sand sediments of Miocene age at the Río Chico Valley (southwest of the Segovia province); and slope gullies, cut on silica sand, shale and gravel sediments of Upper Cretaceous age, on the slopes of a set of mesas and cuestas at the río Cega piedmont (Pedraza region, south centre of the Segovia province). This paper characterizes the geomorphic activity of both types of gullies. In addition, the quantification of their current activity is initiated. The objectives are: to know which processes are eroding and mobilizing the sediments within the gullies, and to evaluate their rates, intensity, frequency and connectivity. A detailed field survey shows that weathering processes (sandstone sheeting, and the formation of popcorn structures on shale layers), and splash, sheet and rill erosion, along with sand and mud falls, slides and flows move sediment from the gully slopes and internal divides to the dry washes. These materials are temporary stored in ephemeral stream channels (filled with sandy bed material), evacuated by stream-bed scour and fill processes, and deposited in alluvial cones. In order to get a first approximation of the amount of erosion and sediment movement, a set of field methods have been applied to these areas. These methods include: erosion pins, measurement of pedestals, system of rods and washers, pit traps (box and gabion check-dam types), and topographic surveys after extensive sedimentation on alluvial cones, along with the installation of pluviographs. The results show how on the arkosic valley side gullies, the precipitation events of low intensity and high frequency tend to fill the sandy stream-beds, whereas the snowmelt and the high intensity and low frequency precipitation events scour the sandy stream-beds. The sedimentation occurs here at the apex part of the alluvial cones, which rest directly on the nearby floodplain of the Chico River. On the silica sand slope gullies, the first gathered data point at very high rates of erosion and sedimentation (44.1 tons/ha for a single event), which is interpreted due to the fact that runoff and water erosion occurs here almost instantaneously after precipitation. Here, the precipitation events of low intensity and high frequency produce sedimentation at the apex part of the alluvial cones, whereas the high intensity and low frequency precipitation events sediment in the form of telescopic lobes, on existing alluvial cones, which rest on pediments