Post-graduate education requirements for access to jobs in physical therapy

[Abstract] Objective. To identify if physiotherapist employers require them to have some postgraduate training and, if there are such requirements, to identify them. Material and methods. For this study, a specific survey was designed, in which the clinic director had to answer questions about the training of the professionals hired. Results. The demands of 114 job bidders were analysed. Clinical directors (21.6%), require some postgraduate training so that the professional is able to adapt to the needs of the users of the centre. The most in-demand specialties were sports physiotherapy, gynaecology and obstetrics, osteopathy, neurology, and Pilates. Conclusions. The acquisition of skills and competencies, such as information management skills, problem solving and decision making, are not being adequately integrated into the degree course. Interventions are needed by educational institutions and professionals in the sector to achieve training that meets the needs of the physiotherapy employment market.[Resumen] Objetivo. Identificar si los contratantes de fisioterapeutas exigen como requisito tener alguna formación de posgrado y, de existir dichas exigencias, identificarlas. Material y método. Se diseñó una encuesta específica para este trabajo. En ella, el director de clínica debía responder a preguntas sobre la formación de los profesionales contratados. Resultados. Se analizaron las demandas de 114 ofertantes de empleo. Los directores de clínica, en un 21,6%, exigen alguna formación de posgrado para que el profesional se adecúe a las necesidades de los usuarios del centro. Las especialidades más demandadas fueron la fisioterapia deportiva, ginecología y obstetricia, osteopatía y terapia manual, neurología y Pilates. Conclusiones. La adopción de habilidades y competencias como la capacidad de gestión de la información, resolución de problemas y toma de decisiones no están siendo integradas durante la formación de la carrera de manera adecuada. Son necesarias intervenciones por parte de las instituciones educativas y profesionales del sector para alcanzar una formación que satisfaga las necesidades del mercado laboral en fisioterapia

Reliability of accelerometric assessment of balance in children aged 6–12 years

[EN] Background: Development and evaluation of an accelerometers technique for collecting data for asses balance had reported difficulty due to equilibrium reactions and continuous bursts. The aim of this study is to determine the reliability and internal consistency of accelerometric measurements, related to static equilibrium and gait in children aged 6 to 12 years. Methods: This descriptive and cross-sectional study involved 70 healthy children (50% girls) with a mean age of 9 years old. At the height of the 4th lumbar vertebra and directly on the skin, an accelerometer was placed on each participant. All of them had to complete four trials three times: balancing on one leg with eyes closed and eyes open, dynamic balancing on one leg on a foam mat, and normal gait. Results: Results show that tests performed in older children had higher internal consistency than those performed in younger children (vertical axis r = 0.82, sagittal axis r = 0.77, and perpendicular axis r = 0.74). Tests performed in children aged 8 years or older presented a strong correlation between trials (r > 0.71). The three static equilibrium tests obtained reliability values between 0.76 y 0.84. On the contrary, gait test obtained inferior and poorer results (0.6 < r < 0.71). Conclusions: This method of assessment obtained positive results as an instrument for the quantitative assessment of balance in school-aged children. Values obtained for the three one-leg balance and static tests,were more strongly correlated than the normal gait test for all axes.S

Definition of the proper placement point for balance assessment with accelerometers in older women

[EN] Objective: To compare the behavior of the spinal levels for the accelerometric analysis and thus to define a proper placement point. Method: Using three triaxial accelerometers (in dorsal and in lumbar regions) and a video camera, of 66 older women through one leg balance and standing tests with open and closed eyes, in static and dynamic conditions and gait repeated three times each trial. Results: The accelerometer located in L5 explain the 88% and the 73% of the results obtained with the accelerometers located in the dorsal region and L4, respectively. The results have also showed a high correlation between the age and the average acceleration for dynamic one leg balance. Furthermore, an increase of the acceleration vector in the course of the trials (except in normal gait) was observed. Conclusions: Although, the accelerometric data obtained in L4 and L5 have often been used arbitrarily for balance evaluation, actually there are differences in the records that made. Therefore, choosing the L4 not only reduces the kinematics information provided by the accelerometers but also simplifies the process of evaluation and analysis.S

Satisfaction Of Spanish Primary School Teachers Regarding Anti-Covid Protocols

[Abstract]: After the closure of the Spanish Primary Education Centres in March 2020, academic and educational institutions began the 2020-2021 academic year with the obligation to abide by the anti-Coronavirus protocols. Consequently, students of all academic levels, and especially schoolage children, have experienced, to a greater or lesser degree, a learning crisis. For this reason, this research was carried out with the objective of analysing the perception of Spanish Primary Education teachers. Cross-sectional descriptive study in a representative sample of Spanish Primary Education teachers (n = 263). The research instrument consisted of a closed questionnaire designed ad hoc with a total of ten questions related to the object of study and other questions related to sociodemographic variables. Cohen's t-test and d statistic were used to determine differences between sexes and the ANOVA test, and all statistical analyses were performed with Stata version 12 (StataCorp., United States) with a p value < .05. 76.4% of those surveyed did not identify the protocols established by the state administration as sufficient and correct, and 84% did not consider the resources provided by the administration of their region sufficient. Spanish teachers are not satisfied or in agreement with the protocols implemented by the governments of each Spanish region

Identification of anatomical reference points to assess balance using kinematic devices

[Resumen] Objetivo Analizar el comportamiento de los niveles raquídeos más empleados en el análisis cinemático y definir el punto óptimo de colocación de acelerómetros para la medida del equilibrio en adultos. Material y método Se valoró a un total de 71 sujetos sanos de los que la mayoría fueron mujeres (92,96%), con una edad media ± desviación estándar de 64,86 ± 7,63 años. Para la valoración se utilizaron 3 acelerómetros triaxiales ubicados en esternón, L4 y L5-S1, que registraron datos cinemáticos durante la realización de 2 pruebas de equilibrio: equilibrio monopodal con ojos cerrados y equilibrio dinámico monopodal. Se consideraron criterios de exclusión para participar en el estudio la incapacidad para realizar la marcha de forma independiente, para mantener el equilibrio estático bipodal con ojos abiertos durante 60 s o la presencia de alguna contraindicación. Todos los sujetos realizaron las pruebas descalzos con calcetines. Resultados Se encontró que las oscilaciones producidas en las 3 ubicaciones de referencia analizadas durante las pruebas de equilibrio se incrementan de forma proporcional a la distancia al centro de gravedad. En relación con el punto óptimo de colocación del dispositivo en la región lumbo-pélvica, los resultados obtenidos indicaron que no existen diferencias relevantes entre ubicar el dispositivo al nivel de L4 o L5-S1. Conclusiones Se recomienda la elección de la cuarta vértebra lumbar como punto de medición, ya que así se limita la introducción de ruido en la señal recogida por los acelerómetros derivada de la movilidad intrínseca de la cintura pélvica.[Abstract] Objective This paper has aimed to analyze the behavior of the spinal levels used most in the kinematic analysis and to define the best place for accelerometers to measure balance in adults. Material and method A total of 71 healthy adults were evaluated. Most were women (92.96%), with an average age of 64.86 years (SD ± 7.63). Three tri-axial accelerometers were used to evaluate balance. One was placed on the sternum and two more on L4 and L5-S1. Kinematic data was obtained from two balance tests: eyes closed monopodal balance and monopodal dynamic balance. Exclusion criteria included inability to walk independently; to be unable to maintain bipodal static balance with eyes wide-open for 60 seconds and the existence of contraindications to be tested. All the subjects performed the tests in bare feet with socks. Results The results showed that the three reference locations analyzed during the balance tests proportionally increased to the distance to the center of gravity. Regarding the optimal devise placement point in the lumbar-pelvic regions, the results obtained did not show significant differences between the accelerometer on L4 and L5-S1. Conclusions Using the fourth lumbar vertebra for measurement is recommended because it limits the introduction of noise on the accelerometer signal due to pelvic girdle motion

Quality of care of patients with type-2 diabetes in Galicia (NW Spain) [OBTEDIGA project]

[Abstract] Aims:  The aim of this study was to describe the degree of compliance of agreed practices with reference to primary care patients with Type 2 diabetes of 40 years old and older in Galicia (NW Spain). Methods:  A total of 108 primary care physicians were selected at random from the totality of doctors. Each physician selected 30 patients at random from their patients suffering from diabetes of 40 years old or older. External observers gathered information from each patient’s medical record regarding their characteristics, condition and degree of compliance of selected indicators of good practice. Results:  Group of physicians participated in this study had a mean age of 50 years (standard deviation = 3.9); 48% of them were females; and 17.5% involved in medical residents training. A total of 3078 diabetic patients were included in the study: mean age = 69 years (SD = 10.9), 47.6% women, presence of high blood pressure (72%), hypercholesterolaemia (56%), and regular smokers (10.3%). Compliance with selected indicators such as foot examination (14%), ophthalmological examination (30.6%), abdominal circumference measurement (6.1%), measurement of total or LDL-cholesterol (78.1), blood pressure measurement (84.8), glycosylated haemoglobin measurement < 7% (54.3%) was observed. Adequate monitoring in cases of high blood pressure and hypercholesterolaemia were 34.2% and 27.4%, respectively. Variability between physicians differs according to the different indicators, with interquartile range for compliance of between 16.4 and 66%. Conclusions:  There is a wide margin for improvement in the adaptation of clinical practice to recommendations for diabetic patients. The large variation existing in certain indicators would suggest that certain control objectives are less demanding than advisable in those that comply least, while low compliance and low variability in other indicators point to structural problems or unsatisfactory training of doctors

Modifiable risk factors associated with prediabetes in men and women: A cross-sectional analysis of the cohort study in primary health care on the evolution of patients with prediabetes

Background: Prediabetes is a high-risk state for diabetes development, but little is known about the factors associated with this state. The aim of the study was to identify modifiable risk factors associated with the presence of prediabetes in men and women. Methods: Cohort Study in Primary Health Care on the Evolution of Patients with Prediabetes (PREDAPS-Study) is a prospective study on a cohort of 1184 subjects with prediabetes and another cohort of 838 subjects without glucose metabolism disorders. It is being conducted by 125 general practitioners in Spain. Data for this analysis were collected during the baseline stage in 2012. The modifiable risk factors included were: smoking habit, alcohol consumption, low physical activity, inadequate diet, hypertension, dyslipidemia, and obesity. To assess independent association between each factor and prediabetes, odds ratios (ORs) were estimated using logistic regression models. Results: Abdominal obesity, low plasma levels of high-density lipoprotein cholesterol (HDL-cholesterol), and hypertension were independently associated with the presence of prediabetes in both men and women. After adjusting for all factors, the respective ORs (95% Confidence Intervals) were 1.98 (1.41-2.79), 1.88 (1.23-2.88) and 1.86 (1.39-2.51) for men, and 1.89 (1.36-2.62), 1.58 (1.12-2.23) and 1.44 (1.07-1.92) for women. Also, general obesity was a risk factor in both sexes but did not reach statistical significance among men, after adjusting for all factors. Risky alcohol consumption was a risk factor for prediabetes in men, OR 1.49 (1.00-2.24). Conclusions: Obesity, low HDL-cholesterol levels, and hypertension were modifiable risk factors independently related to the presence of prediabetes in both sexes. The magnitudes of the associations were stronger for men than women. Abdominal obesity in both men and women displayed the strongest association with prediabetes. The findings suggest that there are some differences between men and women, which should be taken into account when implementing specific recommendations to prevent or delay the onset of diabetes in adult population

Definition of the proper placement point for balance assessment with accelerometers in older women

AbstractObjectiveTo compare the behavior of the spinal levels for the accelerometric analysis and thus to define a proper placement point.MethodUsing three triaxial accelerometers (in dorsal and in lumbar regions) and a video camera, of 66 older women through one leg balance and standing tests with open and closed eyes, in static and dynamic conditions and gait repeated three times each trial.ResultsThe accelerometer located in L5 explain the 88% and the 73% of the results obtained with the accelerometers located in the dorsal region and L4, respectively. The results have also showed a high correlation between the age and the average acceleration for dynamic one leg balance. Furthermore, an increase of the acceleration vector in the course of the trials (except in normal gait) was observed.ConclusionsAlthough, the accelerometric data obtained in L4 and L5 have often been used arbitrarily for balance evaluation, actually there are differences in the records that made. Therefore, choosing the L4 not only reduces the kinematics information provided by the accelerometers but also simplifies the process of evaluation and analysis