Prevalence of Perineal Tear Peripartum after Two Antepartum Perineal Massage Techniques: A Non-Randomised Controlled Trial

[EN] Perineal massage increases elasticity of myofascial perineal tissue and decreases the burn-ing and perineal pain during labour, thus optimising child birth, although an application protocol has not been standardised yet. The objective of this study is to determine the efficiency of massage in perineal tear prevention and identification of possible differences in massage application. Total of 90 pregnant participants were divided into three groups: perineal massage and EPI-NO® device group, applied by an expert physiotherapist, self-massage group, where women were instructed to apply perineal massage in domestic household, and a control group, which received ordinary obstetric attention. Results: The results showed significant differences among the control group and the two perineal massage groups in perineal postpartum pain. Correlations in perineal postpartum pain, labour duration and the baby’s weight were not statistically significant. Lithotomy posture was significantly less prevalent in the massage group than in the other two; this variable is known to have a direct effect on episiotomy incidence and could act as a causal covariate of the different incidence of episiotomy in the groups. Perineal massage reduces postpartum perineal pain, prevalence and severity of perineal tear during delivery.S

Perineal Massage during Pregnancy for the Prevention of Postpartum Urinary Incontinence: Controlled Clinical Trial

[EN] Background and objectives: Urinary incontinence is any involuntary loss of urine. It may result in anxiety, depression, low self-esteem and social isolation. Perineal massage has spread as a prophylactic technique for treating complications during labor. Acknowledged effects of perineal massage are reduction of incidence and severity of perineal tear and use of equipment directly related to the intrapartum perineal trauma. The aim of this study was to determine the effectiveness of massage in urinary incontinence prevention and identification of possible differences in its form of application (self-massage or by a physiotherapist), with the previous assumption that it is effective and that there are differences between the different forms of application. Materials and Methods: A controlled clinical trial with a sample of 81 pregnant women was conducted. The participants were divided into three groups: a group that received the massage applied by a specialized physiotherapist, another group that applied the massage to themselves, and a control group that only received ordinary obstetric care. Results: No differences were identified in the incidence or severity of urinary incontinence among the three groups. The severity of the incontinence was only affected by the body mass index and the weight of the baby at the time of delivery. Conclusions: A relationship between perineal massage interventions and development of urinary incontinence has not been observed.S

Perceptions and Degree of Satisfaction with the Health Sciences University Educational Community Regarding the Measures Adopted for the Prevention of COVID-19 in the Academic Year 2020/2021

[EN] The COVID-19 pandemic caused the start of the academic year 2020/2021 to be conditioned by health and safety regulations. The present research was defined with the aim of analyzing the degree of satisfaction and perceptions on the establishment of bubble groups and pairs and on the use of audiovisual platforms for the development of theoretical and practical university teaching in three degrees of health sciences. A cross-sectional descriptive study was carried out on a representative sample of students and teachers of health sciences in Ponferrada (n = 285). Specific questionnaires designed for this study were completed virtually during April and May 2021. The results indicate that that satisfaction was moderate–high. The perception of the influence of bubble pairs on the quality of teaching can be interpreted as very low. These results increase with the age and academic and professional experience of students and faculty members, respectively. However, the participants belonging to physiotherapy considered that the quality of teaching had worsened much more compared to their counterparts in nursing and podiatry.S

Capital humano: una estrategia para la competitividad personal y empresarial en el actual orden mundial

En la economía mundial el proceso de globalización, ha traído consigo un replanteamiento respecto a los elementos que permiten la competitividad de las organizaciones. Por tanto, en esta nueva etapa la base de los procesos ya no solo se encuentra en los factores de tierra, capital y trabajo, se suma también una nueva perspectiva enmarcada en el ser humano como elemento de competitividad importante por ser el poseedor del capital intelectual, aquellos procesos rutinarios y mecánicos sobre los cuales no se requería mayor calificación de los trabajadores hacen parte del pasado, por el contrario, lo más importante es la capacidad que tengan las personas para aportar aquellas habilidades y competencias que resultan en un valor agregado a la operación que lleva a que la organización obtenga un posicionamiento y por lo tanto sea más competitiva. Es por esto, que este ensayo evidencia cómo ha sido el cambio e importancia que ha tomado el concepto de capital humano, a través de los estudios y puntos de vista de diferentes autores y bajo qué condiciones despierta un interés para las organizaciones, a su vez, cómo los países están adecuando sus políticas y sus estrategias con base en este nuevo , si se puede decir de esta manera, factor de competitividadIn the world economy, the globalization process has brought a rethinking about the elements that allow the competitiveness of organizations. Therefore, in this new stage, the basis of it is not just found in the factors of land, capital and labor, it also adds a new perspective on the human being as important competitive component as holder of intellectual capital, those routine and mechanical processes that did not require high qualification of workers are part of the past. However, the most important is the ability that people may have to provide skills and competencies that result in a added value to the operation that let the organization get a positioning and hence more competitive. This is why, this essay shows how has been the change and importance of the human capital concept through the studies and viewpoints of different authors and under which conditions it arouses an interest for the companies, also, how the countries are adapting their policies and strategies based on the new if it may say so, a competitiveness facto

Does imbalance in chest X-ray datasets produce biased deep learning approaches for COVID-19 screening?

[Abstract] Background The health crisis resulting from the global COVID-19 pandemic highlighted more than ever the need for rapid, reliable and safe methods of diagnosis and monitoring of respiratory diseases. To study pulmonary involvement in detail, one of the most common resources is the use of different lung imaging modalities (like chest radiography) to explore the possible affected areas. Methods The study of patient characteristics like sex and age in pathologies of this type is crucial for gaining knowledge of the disease and for avoiding biases due to the clear scarcity of data when developing representative systems. In this work, we performed an analysis of these factors in chest X-ray images to identify biases. Specifically, 11 imbalance scenarios were defined with female and male COVID-19 patients present in different proportions for the sex analysis, and 6 scenarios where only one specific age range was used for training for the age factor. In each study, 3 different approaches for automatic COVID-19 screening were used: Normal vs COVID-19, Pneumonia vs COVID-19 and Non-COVID-19 vs COVID-19. The study was validated using two public chest X-ray datasets, allowing a reliable analysis to support the clinical decision-making process. Results The results for the sex-related analysis indicate this factor slightly affects the system in the Normal VS COVID-19 and Pneumonia VS COVID-19 approaches, although the identified differences are not relevant enough to worsen considerably the system. Regarding the age-related analysis, this factor was observed to be influencing the system in a more consistent way than the sex factor, as it was present in all considered scenarios. However, this worsening does not represent a major factor, as it is not of great magnitude. Conclusions Multiple studies have been conducted in other fields in order to determine if certain patient characteristics such as sex or age influenced these deep learning systems. However, to the best of our knowledge, this study has not been done for COVID-19 despite the urgency and lack of COVID-19 chest x-ray images. The presented results evidenced that the proposed methodology and tested approaches allow a robust and reliable analysis to support the clinical decision-making process in this pandemic scenario.This research was funded by Instituto de Salud Carlos III, Government of Spain, DTS18/00136 research project; Ministerio de Ciencia e Innovación y Universidades, Government of Spain, RTI2018-095894-B-I00 research project; Ministerio de Ciencia e Innovación, Government of Spain through the research project with reference PID2019-108435RB-I00; Consellería de Cultura, Educación e Universidade, Xunta de Galicia, Grupos de Referencia Competitiva, grant ref. ED431C 2020/24; postdoctoral grant ref. ED481B 2021/059; Axencia Galega de Innovación (GAIN), Xunta de Galicia, grant ref. IN845D 2020/38; CITIC, Centro de Investigación de Galicia ref. ED431G 2019/01, receives financial support from Consellería de Educación, Universidade e Formación Profesional, Xunta de Galicia, through the ERDF (80%) and Secretaría Xeral de Universidades (20%)Xunta de Galicia; ED431C 2020/24Xunta de Galicia; ED481B 2021/059Xunta de Galicia; IN845D 2020/38Xunta de Galicia; ED431G 2019/0

Las tres etapas del outsourcing, ¿en cuál etapa se encuentran las empresas mexicanas?

Nowadays, it is a great challenge for companies to combine their skills and resources to have a competitive advantage in the market in which they operate. There is a practice that since the early 70s has been used worldwide, known as outsourcing. According to the Cambridge Business Dictionary (2010), it is a strategy in which another company is used to perform particular tasks because it can do them more effectively or cheaply. Outsourcing has evolved over the years, from being a simple tool to reduce costs to be a strategy used by companies to find new ways of doing business and innovate in all aspects. In this article we are going to expose the three stages that outsourcing has gone through and we will support it with a literature review of the last twenty years. In addition, we are going to try to position Mexico in one of the stages mentioned above.En la actualidad es un gran reto para las empresas combinar sus habilidades y recursos, para tener una ventaja competitiva en el mercado en el que se desenvuelven. Existe una práctica que des- de principios de los años 70 ha sido utilizada nivel mundial, llamada outsourcing. De acuerdo con el Diccionario de Negocios de Cambridge (2010), es una estrategia en la cual se hace uso de otra empresa para realizar tareas particulares, porque puede hacerlas de manera más efectiva o económica. El outsourcing ha evolucionado a través de los años, pasando de ser una simple herramienta para reducir costos a ser una estrategia que utilizan las empresas para buscar nuevas formas de hacer negocio e innovar en todos los aspectos. En este artículo vamos a exponer las tres etapas por las que ha pasado el outsourcing y lo vamos a sustentar con una revisión de literatura de los últimos veinte años. Además, vamos a tratar de posicionar a México en una de las etapas antes mencionadas

Una valoración del modelo de colaboración "redes de innovación tecnológica" de Guanajuato, México.Una valoración del modelo de colaboración "redes de innovación tecnológica" de Guanajuato, México.

Referenciar la innovación en las organizaciones conlleva un principio colectivo, por tanto, es un retoacuciante gestionar la acción coordinada de los actores involucrados en el proceso innovador. Para ello, numerosos modelos organizacionales se han propuesto: triángulo de Sábato, triple hélice, sistemas nacionales de innovación, entre otros. El objetivo central de este artículo es realizar un análisis sistemático y valorar el modelo de coordinación denominado "redes de innovación tecnológica"puesto en práctica por las empresas manufactureras locales del Estado de Guanajuato, México. Se analizan diversas dimensiones que integran el modelo, mediante un análisis de correlación entre sus características e indicadores de impacto. A partir de dicho análisis y valoración se hace una primera aproximación de los determinantes de éxito en el modelo. Esto como parte de una investigación holística acerca de los sistemas regionales de innovación y su impacto socioeconómico en las MiPYMES de Guanajuato, México.The innovation in the organizations involves a collective principle, that presents several challenges, toward to manage coordinated action among several actors. To confront these, several organization models have been put in practice: Sabato ́s triangle, triple helix, innovation national system, and so on. The aim of this paper is to execute a systematic analysis and assessment of one of this model, denominated "innovation networks", which has been put in practice in the state of Guanajuato, México by local manufacturing companies in many productive sectors. Diverse dimensions that integrate this model are analyzed, using a correlation analysis between its features and impact indicators. From this analysis and assessment are presented an initial proposal of factors for success of technological innovation networks. As part of a holistic research on regional innovation systems and their socioeconomic impact on MSMEs in Guanajuato, Mexico

Reliability and Validity of the Six Spot Step Test in People with Intellectual Disability

[EN] Clinical tests for the evaluation of balance in people with intellectual disability that have been most commonly used depend on the subjective evaluation of the evaluator, easily reach the ceiling effect and are poorly sensitive to small changes; but new tests have been developed, such as the Six Spot Step Test. The aim of this study was to determine the validity and within-day and day-to-day test–retest reliability of the Six Spot Step Test in people with intellectual disability. A descriptive cross-sectional study was conducted with 18 people with intellectual disability. The participants conducted the Six Spot Step Test three times and a set of five clinical tests for the balance assessment. The relative reliability was excellent (Intraclass Correlation Coefficient (ICC) = 0.86 − 0.97), and the absolute reliability ranged between 4.7% and 7.3% for coefficient variation and between 0.6 and 1.2 for the standard error of measurement. Linear regression models showed that that test can explain the results of the Timed Up & Go, Four Square Step Test and the Berg Balance Scale. The Six Spot Step Test proved to be as valid and reliable for the evaluation of dynamic balance in people with intellectual disability as the most frequently used tests for the clinical evaluation of postural control.SIThis research received funding from the VII Research Grant of the Professional College of Physiotherapist of Castilla y León (Spain)

Transcranial direct current stimulation for post-stroke dysphagia: a meta-analysis

[EN] Background: Strokes may cause some swallowing difficulty or associated dysphagia in 25–80% of patients. This phenomenon has been linked to increased morbidity and mortality. Therefore, the aim of this study was to evaluate the efficacy of transcranial direct current stimulation in patients with dysphagia in post-stroke patients. Methods: A systematic search in PubMed, Scopus, Web of Science and MEDLINE was conducted. The articles must have to evaluate an intervention that included transcranial direct current stimulation; the sample had to consist exclusively of patients with post-stroke dysphagia; and the experimental design consisted of randomized controlled trial. Difference in mean differences and their 95% confidence interval were calculated as the between-group difference in means divided by the pooled standard deviation. The I2 statistic was used to determine the degree of heterogeneity. Results: Of the 9 investigations analyzed, all applied transcranial direct current stimulation in combination with conventional dysphagia therapy to the experimental group. All the studies analyzed identified improvements in swallowing function and meta-analysis confirmed their strong effect on reducing the risk of penetration and aspiration (Hedges’s g = 0.55). The results showed that participants who received transcranial direct current stimulation significantly improved swallowing function. Conclusions: Transcranial direct current stimulation has positive effects in the treatment of poststroke dysphagia by improving swallowing function, oral and pharyngeal phase times and the risk of penetration and aspiration. Furthermore, its combination with conventional dysphagia therapy, balloon dilatation with catheter or training of the swallowing muscles ensures improvement of swallowing function. PROSPERO registration ID CRD42022314949.S

Analysis of Postural Control in Sitting by Pressure Mapping in Patients with Multiple Sclerosis, Spinal Cord Injury and Friedreich’s Ataxia: A Case Series Study

[EN], The postural control assessments in patients with neurological diseases lack reliability and sensitivity to small changes in patient functionality. The appearance of pressure mapping has allowed quantitative evaluation of postural control in sitting. This study was carried out to determine the evaluations in pressure mapping and verifying whether they are different between the three sample groups (multiple sclerosis, spinal cord injury and Friedreich’s ataxia), and to determine whether the variables extracted from the pressure mapping analysis are more sensitive than functional tests to evaluate the postural trunk control. A case series study was carried out in a sample of 10 adult patients with multiple sclerosis (n = 2), spinal cord injury (n = 4) and Friedreich’s ataxia (n = 4). The tests applied were: pressure mapping, seated Lateral Reach Test, seated Functional Reach Test, Berg Balance Scale, Posture and Postural Ability Scale, Function in Sitting Test, and Trunk Control Test. The participants with Friedreich’s ataxia showed a tendency to present a higher mean pressure on the seat of subject’s wheelchair compared to other groups. In parallel, users with spinal cord injury showed a tendency to present the highest values of maximum pressure and area of contact. People with different neurological pathologies and similar results in functional tests have very different results in the pressure mapping. Although it is not possible to establish a strong statistical correlation, the relationships between the pressure mapping variables and the functional tests seem to be numerous, especially in the multiple sclerosis group.S