Satisfacción de las mujeres según el método de inducción al parto por rotura prematura de membranas

La medida de la Satisfacción de las mujeres durante el proceso del parto y nacimiento a través del empleo de cuestionarios permite dar significado a su experiencia e incorporar una mejor evidencia que permita comprender la importancia de las distintas dimensiones del proceso de atención de la gestante. El objetivo del presente estudio fue determinar el nivel de satisfacción de las mujeres inducidas al proceso de parto por rotura prematura de membrana a través de distintos métodos de tal forma que esta se tenga en cuenta en la toma de decisiones por parte de los profesionales sanitarios que atienden a este tipo de mujeres. El diseño fue de tipo descriptivo observacional de corte transversal en dos hospitales de tercer nivel de Tenerife con aprobación del Comité Ético de Investigación Clínica. Previo al alta hospitalaria, las 598 mujeres incluidas en el estudio auto cumplimentaron voluntariamente el cuestionario de satisfacción validado (Mackey Childbirth Satisfaction Rating Scale - MCSRS) y se recogieron las variables a estudio mediante la ulterior entrevista y revisión de la historia clínica. Las puntuaciones de la satisfacción se compararon a través de pruebas no paramétricas a un nivel de significación estadística p<0,05 con un paquete estadístico. No se encontraron diferencias en la satisfacción de las 229 mujeres con rotura prematura de membranas inducidas a través de las distintas intervenciones, así como tampoco entre el manejo espontáneo y el manejo activo del parto. No obstante, en la muestra general, las mujeres inducidas con prostaglandinas presentaron menos satisfacción y una correlación inversa con la duración de la inducción del parto. Aportar la perspectiva de la mujer a través de su satisfacción con las intervenciones obstétricas en el manejo del parto y nacimiento, permite mejorar los cuidados basados en la evidencia aplicada y gestionar de manera más eficiente los recursos de los servicios a través de la evaluación y monitorización de la calidad dentro del actual modelo de atención al parto

Quality of ventilations during infant resuscitation: a simulation study comparing endotracheal tube with face mask

Background: There are few studies that analyze ventilation volume and pressure during CPR carried out on infants. The aim of this study was to evaluate the quality of the ventilations administered using a self-inflating bag with an endotracheal tube and a face mask in manikins. Methods: a quasi-experimental simulation study with a randomized case crossover design [endotracheal tube (ET) vs. face mask (FM)] was performed. Sixty participants who were previously trained nursing students participated in the study. The estimated air volumes breathed, and the pressure generated during each ventilation were assessed and the quality of the chest compressions was recorded. Results: the ET test presented a higher percentage of ventilations that reached the lungs (100% vs. 86%; p < 0.001), with adequate volume (60% vs. 28%; p < 0.001) in comparison to FM. Both tests presented peak pressures generated in the airway greater than 30 cm H2O (ET: 22% vs. FM: 31%; p = 0.03). Conclusions: performing quality CPR ventilations on an infant model is not an easy skill for trained nursing students. Both tests presented a significant incidence of excessive peak pressure during ventilations. Specific training, focused on quality of ventilations guided by a manometer attached to the self-inflating bag, must be considered in life support training for pediatric providers

Exploração da noção de distribuição da variabilidade

This article presents the results of a study aimed at verifying whether the work of variability contributes to developing the notion of statistical distribution. The authors carried out a teaching experiment in which they proposed a sequence of instruction whose purpose was that prospective mathematics teachers reach a wider idea of such concept. From the intuitive exploration of the data collections and the transit through several representation registers with the help of technology, the authors found that students actually note and take into consideration aspects related to the variability which, in turn, are linked to the notion of distribution. In other words, it is clear that, when students informally inquire about variability of data collections, in fact they are developing characteristics of distribution.Este artículo presenta los resultados de una investigación dirigida a comprobar si el trabajo desde la variabilidad contribuye al desarrollo de la noción de distribución estadística. Para ello, se optó por ejecutar un experimento de enseñanza en el que se propuso una secuencia de instrucción orientada a que los candidatos a profesores de matemáticas lleguen a una idea más amplia de este concepto. A partir de la exploración intuitiva de colecciones de datos y del tránsito por varios registros de representación con la ayuda de la tecnología, se encontró que los estudiantes en formación efectivamente notan y consideran diversos aspectos relacionados con la variabilidad que a su vez están ligados a la noción de distribución. En otras palabras, al indagar de manera informal sobre la variabilidad de colecciones de datos, en realidad los estudiantes están develando características de la distribución.Este artigo apresenta os resultados de uma investigação que procurou verificar se o trabalho de variabilidade contribui para raciocinar sobre a noção de distribuição estatística. Assim propomos uma sequência de instrução com estudantes candidatos para professores de matemática que visa alcançar uma ideia de distribuição mais ampla. A partir da exploração intuitiva das coleções de dados e do trânsito através de diversos registros de representação com a ajuda da tecnologia, constata-se que os alunos efetivamente percebem e consideram vários aspectos relacionados à variabilidade que por sua vez estão ligados à noção de distribuição. Em outras palavras, é claro que, quando os estudantes examinam informalmente a variabilidade das coletas de dados, na realidade, estão desenvolvendo características da distribuição

Development of a biosensor protein bullet as a fluorescent method for fast detection of Escherichia coli in drinking water

Drinking water can be exposed to different biological contaminants from the source, through the pipelines, until reaching the final consumer or industry. Some of these are pathogenic bacteria and viruses which may cause important gastrointestinal or systemic diseases. The microbiological quality of drinking water relies mainly in monitoring three indicator bacteria of faecal origin, Escherichia coli, Enterococcus faecalis and Clostridium perfringens, which serve as early sentinels of potential health hazards for the population. Here we describe the analysis of three chimeric fluorescent protein bullets as biosensor candidates for fast detection of E. coli in drinking water. Two of the chimeric proteins (based on GFP-hadrurin and GFP-pb5 chimera proteins) failed with respect to specificity and/or sensitivity, but the GFP-colS4 chimera protein was able to carry out specific detection of E. coli in drinking water samples in a procedure encompassing about 8 min for final result and this biosensor protein was able to detect in a linear way between 20 and 103 CFU of this bacterium. Below 20 CFU, the system cannot differentiate presence or absence of the target bacterium. The fluorescence in this biosensor system is provided by the GFP subunit of the chimeric protein, which, in the case of the better performing sensor bullet, GFP-colS4 chimera, is covalently bound to a flexible peptide bridge and to a bacteriocin binding specifically to E. coli cells. Once bound to the target bacteria, the excitation step with 395 nm LED light causes emission of fluorescence from the GFP domain, which is amplified in a photomultiplier tube, and finally this signal is converted into an output voltage which can be associated with a CFU value and these data distributed along mobile phone networks, for example. This method, and the portable fluorimeter which has been developed for it, may contribute to reduce the analysis time for detecting E. coli presence in drinking water

Are smart glasses feasible for dispatch prehospital assistance during on-boat cardiac arrest? A pilot simulation study with fishermen.

The aim of the study was to explore feasibility of basic life support (BLS) guided through smart glasses (SGs) when assisting fishermen bystanders. Twelve participants assisted a simulated out-of-hospital cardiac arrest on a fishing boat assisted by the dispatcher through the SGs. The SGs were connected to make video calls. Feasibility was assessed whether or not they needed help from the dispatcher. BLS-AED steps, time to first shock/compression, and CPR's quality (hands-only) during 2 consecutive minutes (1st minute without dispatcher feedback, 2nd with dispatcher feedback) were analyzed. Reliability was analyzed by comparing the assessment of variables performed by the dispatcher through SGs with those registered by an on-scene instructor. Assistance through SGs was needed in 72% of the BLS steps, which enabled all participants to perform the ABC approach and use AED correctly. Feasibility was proven that dispatcher's feedback through SGs helped to improve bystanders' performance, as after dispatcher gave feedback via SGs, only 3% of skills were incorrect. Comparison of on-scene instructor vs. SGs assessment by dispatcher differ in 8% of the analyzed skills: greatest difference in the "incorrect hand position during CPR" (on-scene: 33% vs. dispatcher: 0%). When comparing the 1st minute with 2nd minute, there were only significant differences in the percentage of compressions with correct depth (1st:48 ± 42%, 2nd:70 ± 31, p = 0.02). Using SGs in aquatic settings is feasible and improves BLS. CPR quality markers were similar with and without SG. These devices have great potential for communication between dispatchers and laypersons but need more development to be used in real emergencies

Performing simulated basic life support without seeing: blind vs. blindfolded people

Previous pilot experience has shown the ability of visually impaired and blind people (BP) to learn basic life support (BLS), but no studies have compared their abilities with blindfolded people (BFP) after participating in the same instructor-led, real-time feedback training. Twenty-nine BP and 30 BFP participated in this quasi-experimental trial. Training consisted of a 1 h theoretical and practical training session with an additional 30 min afterwards, led by nurses with prior experience in BLS training of various collectives. Quantitative quality of chest compressions (CC), AED use and BLS sequence were evaluated by means of a simulation scenario. BP’s median time to start CC was less than 35 s. Global and specific components of CC quality were similar between groups, except for compression rate (BFP: 123.4 + 15.2 vs. BP: 110.8 + 15.3 CC/min; p = 0.002). Mean compression depth was below the recommended target in both groups, and optimal CC depth was achieved by 27.6% of blind and 23.3% of blindfolded people (p = 0.288). Time to discharge was significantly longer in BFP than BP (86.0 + 24.9 vs. 66.0 + 27.0 s; p = 0.004). Thus, after an adapted and short training program, blind people were revealed to have abilities comparable to those of blindfolded people in learning and performing the BLS sequence and CCS

Training frequency for educating schoolchildren in basic life support: very brief 4-month rolling-refreshers versus annual retraining—a 2-year prospective longitudinal trial

Objective To compare the effectiveness of 4-month rolling-refreshers and annual retraining in basic life support (BLS) on a sample of schoolchildren. Design Prospective longitudinal trial. Setting and participants Four hundred and seventy-two schoolchildren (8–12 years old). Interventions Schoolchildren were instructed in BLS and then split into the following three groups: control group (CG), standard group (SG) and rolling-refresher group (RRG). Their BLS skills were assessed within 1 week (T1) and 2 years later (T2). Moreover, CG did not receive any additional training; SG received one 50 min retraining session 1 year later; RRG participated in very brief (5 min) rolling-refreshers that were carried out every 4 months. Primary and secondary outcomes Hands-on skills of BLS sequence and cardiopulmonary resuscitation. Results BLS sequence performance was similar in all groups at T1, but SG and RRG followed the steps of the protocol in more proportion than CG at T2. When compared at T2, RRG showed higher proficiency than SG in checking safety, checking response, opening the airway and alerting emergency medical services. In addition, although the mean resuscitation quality was low in all groups, RRG participants reached a higher percentage of global quality cardiopulmonary resuscitation (CG: 16.4±24.1; SG: 25.3±28.8; RRG: 29.9%±29.4%), with a higher percentage of correct chest compressions by depth (CG: 3.9±11.8; SG: 10.8±22.7; RRG: 15.5±26.1 mm). Conclusions In 8-to-12-year-old schoolchildren, although annual 50 min retraining sessions help to maintain BLS performance, 4-month very brief rolling-refreshers were shown to be even more effective. Thus, we recommend implementing baseline BLS training at schools, with subsequently brief rolling-refreshers.S

Biomechanical Consequences of the Elastic Properties of Dental Implant Alloys on the Supporting Bone: Finite Element Analysis

The objective of the present study is to evaluate how the elastic properties of the fabrication material of dental implants influence peri-implant bone load transfer in terms of the magnitude and distribution of stress and deformation. A three-dimensional (3D) finite element analysis was performed; the model used was a section of mandibular bone with a single implant containing a cemented ceramic-metal crown on a titanium abutment. The following three alloys were compared: rigid (Y-TZP), conventional (Ti-6Al-4V), and hyperelastic (Ti-Nb-Zr). A 150-N static load was tested on the central fossa at 6° relative to the axial axis of the implant. The results showed no differences in the distribution of stress and deformation of the bone for any of the three types of alloys studied, mainly being concentrated at the peri-implant cortical layer. However, there were differences found in the magnitude of the stress transferred to the supporting bone, with the most rigid alloy (Y-TZP) transferring the least stress and deformation to cortical bone. We conclude that there is an effect of the fabrication material of dental implants on the magnitude of the stress and deformation transferred to peri-implant bone

Learning and Treatment of Anaphylaxis by Laypeople: A Simulation Study Using Pupilar Technology

An anaphylactic shock is a time-critical emergency situation. The decision-making during emergencies is an important responsibility but difficult to study. Eye-tracking technology allows us to identify visual patterns involved in the decision-making. The aim of this pilot study was to evaluate two training models for the recognition and treatment of anaphylaxis by laypeople, based on expert assessment and eye-tracking technology. A cross-sectional quasi-experimental simulation study was made to evaluate the identification and treatment of anaphylaxis. 50 subjects were randomly assigned to four groups: three groups watching different training videos with content supervised by sanitary personnel and one control group who received face-to-face training during paediatric practice. To evaluate the learning, a simulation scenario represented by an anaphylaxis’ victim was designed. A device capturing eye movement as well as expert valuation was used to evaluate the performance. The subjects that underwent paediatric face-to-face training achieved better and faster recognition of the anaphylaxis. They also used the adrenaline injector with better precision and less mistakes, and they needed a smaller number of visual fixations to recognise the anaphylaxis and to make the decision to inject epinephrine. Analysing the different video formats, mixed results were obtained. Therefore, they should be tested to evaluate their usability before implementation.S