36 research outputs found

    Role and Effects of Hippotherapy in the Treatment of Children with Cerebral Palsy: A Systematic Review of the Literature

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    We thank our medical translator Megan Berry for her services and comments that contributed to improving the manuscript for publication.Cerebral palsy is described as a group of permanent neuromotor-type disorders caused by non-progressive injuries in the developmental stages of the central nervous system, and which have serious repercussions on the quality of life of affected children due to the physical and psychological damage it entails for them. Today, it is the leading cause of physical disability in childhood. Since there is no cure for this disorder, treatment is based on the improvement of symptoms, which is not always achieved through conventional therapies. For this reason, the need arises to investigate other alternative therapies, such as hippotherapy, to determine the main effects of hippotherapy as a rehabilitation therapy in children with cerebral palsy. The review was performed in accordance with the criteria of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) protocol and was registered under the number CRD42021233003. The databases used were PubMed, Dialnet and the web browser Google Scholar. After applying the inclusion criteria, we included 11 articles. As a conclusion, we found that hippotherapy provides benefits at physical, psychological, cognitive and social levels in children with cerebral palsy, and thus it should be considered as a complementary rehabilitation therapy to conventional treatments

    Water Exercise and Quality of Life in Pregnancy: A Randomised Clinical Trial

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    Background: Physical exercise helps to maintain a healthy lifestyle and its practice is recommended for women during pregnancy as a means of limiting the negative effects on the body that may take place and to optimise well-being, mood and sleep patterns, as well as encouraging daily physical activity, enhancing the ability to work and preventing pregnancy-related complications. Aim: To analyse the quality of life in pregnancy for women who complete a programme of moderate physical activity in water, following a designed method that the woman can perform physical exercise safely during pregnancy called the SWEP (study of water exercise during pregnancy) method. Materials and methods: A randomised clinical trial was performed. One hundred and twenty-nine pregnant women were randomly assigned either to an exercise class following the SWEP method (EG, n = 65) or to a control group (CG, n = 64). The trial began in week 20 of pregnancy (May 2016) and ended in week 37 (October 2016). Heath-related quality of life (HRQoL) was evaluated with the SF36v2 health questionnaire at weeks 12 and 35 of pregnancy. Results: The HRQoL score decreased significantly between weeks 12 and 35 of gestation, except for the mental health component, which in the CG fell by -3.28 points and in the EG increased slightly (p > 0.05). Among the CG, the score for the mental health component at week 35 was <42, indicating a positive screening risk of depression (39.20 +/- 4.16). Conclusions: Physical activity programmes in water, such as SWEP, enhance the HRQoL of pregnant women

    Evolution of the COVID-19 Pandemic after the Introduction of School Referral Nurses in the Province of Granada—A Descriptive Study

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    The aim of this research is to describe the evolution of the pandemic in a school context, following the introduction of school nurses into the educational setting. Background: The first wave of COVID-19 in Spain prevented social interaction by imposing lockdowns on the population. All non-essential activities, including face-to-face education, were interrupted, affecting the school-aged population during the second and third trimester of the 2019/2020 school year. Schools are places where prevention, identification and case management measures should be rapidly implemented. Methods: This is a prospective and descriptive study using a quantitative method to study the school population of Granada and its province during the school year 2020/2021, from September 2020 to May 2021. The study participants were all schools under the jurisdiction of the Territorial Delegation of Education of Granada, whether public, private, state-subsidised or charter schools, including all educational stages. Results: The confirmation rate in Granada city (11.2%), in contrast to the Andalusian average (6.9%), places Granada as the province with the highest incidence rate. The infection rates among teachers show the same confirmation rate as the general population of Granada (9%); however, among students this rate is lower (7%). There is a higher incidence of outbreaks taking place outside school and a lower incidence of outbreaks occurring within the school environment. Both partial and total outbreaks are more frequent in early childhood education. Conclusion: The early identification and management of reported suspected cases of COVID-19 in schools is proving effective in preventing infection in the school population, achieving good pandemic control in schools, and reducing the number of outbreaks and people affected. Schools have been confirmed to be safe. Establishing screening for asymptomatic schoolchildren could be a tool to improve control in schools.Colegio Oficial de Enfermeria de Granada (CODEGRA

    Satisfaction rating in a group of women from Granada on birthing care, support and breastfeeding lenght

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    Introducción: El análisis de la satisfacción se está utilizando como instrumento para crear diferentes reformas sanitarias para la mejora de la calidad y numerosos estudios apuntan al incremento de la satisfacción de la madre en relación directa con el cuidado en la maternidad. Objetivos: Identificar el grado de satisfacción de la mujer sobre la atención al parto, el acompañamiento durante el nacimiento y la duración de la lactancia materna. Objetivos: Identificar el grado de satisfacción de la mujer sobre la atención al parto, el acompañamiento durante el nacimiento y la duración de la lactancia materna. Material y método: Estudio descriptivo transversal en el Hospital Universitario San Cecilio de Granada (España), durante el periodo de tiempo agosto del 2011 al 2012, se realizo con una segunda fase de seguimeinto prospectivo a una N= 60 madres. Se utilizó un protocolo (anexo 1) a las 24 horas en el hospital y a los 14 días por teléfono. A los 3 meses, se realizó un seguimeinto relacionado con la alimentación del bebe. Resultados: El nivel de satisfacción global sobre el parto es alto en la población estudiada. Se ha demostrado que la lactancia materna (P=0,514) y el parto vía vaginal sin epidural (P=0,320) crea una mayor satisfacción en la madre. Por otro lado, la satisfacción sobre el parto guarda relación con la duración de la lactancia materna. Conclusión: La opinión satisfactoria de las madres relacionadas con la atención al parto y el acompañamiento durante el nacimiento se incrementa en aquellas mujeres cuyo parto ocurrió de forma eutócica sin epidural e iniciaron la lactancia materna precoz

    Comorbidities in patients with Primary Sjögren's Syndrome and Systemic Lupus Erythematosus: A comparative registries-based study

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    OBJECTIVE: To compare the prevalence of the main comorbidities in 2 large cohorts of patients with primary Sjögren's syndrome (SS) and systemic lupus erythematosus (SLE), with a focus on cardiovascular (CV) diseases. METHODS: This was a cross-sectional multicenter study where the prevalence of more relevant comorbidities in 2 cohorts was compared. Patients under followup from SJOGRENSER (Spanish Rheumatology Society Registry of Primary SS) and RELESSER (Spanish Rheumatology Society Registry of SLE), and who fulfilled the 2002 American-European Consensus Group and 1997 American College of Rheumatology classification criteria, respectively, were included. A binomial logistic regression analysis was carried out to explore potential differences, making general adjustments for age, sex, and disease duration and specific adjustments for each variable, including CV risk factors and treatments, when appropriate. RESULTS: A total of 437 primary SS patients (95% female) and 2,926 SLE patients (89% female) were included. The mean age was 58.6 years (interquartile range [IQR] 50.0-69.9 years) for primary SS patients and 45.1 years (IQR 36.4-56.3 years) for SLE patients (P?<?0.001), and disease duration was 10.4 years (IQR 6.0-16.7 years) and 13.0 years (IQR 7.45-19.76 years), respectively (P?<?0.001). Smoking, dyslipidemia, and arterial hypertension were associated less frequently with primary SS (odds ratio [OR] 0.36 [95% confidence interval (95% CI) 0.28-0.48], 0.74 [95% CI 0.58-0.94], and 0.50 [95% CI 0.38-0.66], respectively) as were life-threatening CV events (i.e., stroke or myocardial infarction; OR 0.57 [95% CI 0.35-0.92]). Conversely, lymphoma was associated more frequently with primary SS (OR 4.41 [95% CI 1.35-14.43]). The prevalence of severe infection was lower in primary SS than in SLE (10.1% versus 16.9%; OR 0.54 [95% CI 0.39-0.76]; P?<?0.001). CONCLUSION: Primary SS patients have a consistently less serious CV comorbidity burden and a lower prevalence of severe infection than those with SLE. In contrast, their risk of lymphoma is greater

    Técnicas de recogida de información y elaboración de documentos técnicos utilizados en la formación del estudiantado

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    El proyecto se concibe como una herramienta didáctica para facilitar al profesorado de la Facultad de Trabajo Social su actividad pedagógica en el aula. Para ello, hemos elaborado un CD que contiene material audiovisual y documentos técnicos profesionales utilizados por los/las trabajadores/as sociales. Este material servirá para realizar la valoración social del caso y el proyecto de intervención social

    The evolution of the ventilatory ratio is a prognostic factor in mechanically ventilated COVID-19 ARDS patients

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    Background: Mortality due to COVID-19 is high, especially in patients requiring mechanical ventilation. The purpose of the study is to investigate associations between mortality and variables measured during the first three days of mechanical ventilation in patients with COVID-19 intubated at ICU admission. Methods: Multicenter, observational, cohort study includes consecutive patients with COVID-19 admitted to 44 Spanish ICUs between February 25 and July 31, 2020, who required intubation at ICU admission and mechanical ventilation for more than three days. We collected demographic and clinical data prior to admission; information about clinical evolution at days 1 and 3 of mechanical ventilation; and outcomes. Results: Of the 2,095 patients with COVID-19 admitted to the ICU, 1,118 (53.3%) were intubated at day 1 and remained under mechanical ventilation at day three. From days 1 to 3, PaO2/FiO2 increased from 115.6 [80.0-171.2] to 180.0 [135.4-227.9] mmHg and the ventilatory ratio from 1.73 [1.33-2.25] to 1.96 [1.61-2.40]. In-hospital mortality was 38.7%. A higher increase between ICU admission and day 3 in the ventilatory ratio (OR 1.04 [CI 1.01-1.07], p = 0.030) and creatinine levels (OR 1.05 [CI 1.01-1.09], p = 0.005) and a lower increase in platelet counts (OR 0.96 [CI 0.93-1.00], p = 0.037) were independently associated with a higher risk of death. No association between mortality and the PaO2/FiO2 variation was observed (OR 0.99 [CI 0.95 to 1.02], p = 0.47). Conclusions: Higher ventilatory ratio and its increase at day 3 is associated with mortality in patients with COVID-19 receiving mechanical ventilation at ICU admission. No association was found in the PaO2/FiO2 variation

    Clustering COVID-19 ARDS patients through the first days of ICU admission. An analysis of the CIBERESUCICOVID Cohort

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    Background Acute respiratory distress syndrome (ARDS) can be classified into sub-phenotypes according to different inflammatory/clinical status. Prognostic enrichment was achieved by grouping patients into hypoinflammatory or hyperinflammatory sub-phenotypes, even though the time of analysis may change the classification according to treatment response or disease evolution. We aimed to evaluate when patients can be clustered in more than 1 group, and how they may change the clustering of patients using data of baseline or day 3, and the prognosis of patients according to their evolution by changing or not the cluster.Methods Multicenter, observational prospective, and retrospective study of patients admitted due to ARDS related to COVID-19 infection in Spain. Patients were grouped according to a clustering mixed-type data algorithm (k-prototypes) using continuous and categorical readily available variables at baseline and day 3.Results Of 6205 patients, 3743 (60%) were included in the study. According to silhouette analysis, patients were grouped in two clusters. At baseline, 1402 (37%) patients were included in cluster 1 and 2341(63%) in cluster 2. On day 3, 1557(42%) patients were included in cluster 1 and 2086 (57%) in cluster 2. The patients included in cluster 2 were older and more frequently hypertensive and had a higher prevalence of shock, organ dysfunction, inflammatory biomarkers, and worst respiratory indexes at both time points. The 90-day mortality was higher in cluster 2 at both clustering processes (43.8% [n = 1025] versus 27.3% [n = 383] at baseline, and 49% [n = 1023] versus 20.6% [n = 321] on day 3). Four hundred and fifty-eight (33%) patients clustered in the first group were clustered in the second group on day 3. In contrast, 638 (27%) patients clustered in the second group were clustered in the first group on day 3.Conclusions During the first days, patients can be clustered into two groups and the process of clustering patients may change as they continue to evolve. This means that despite a vast majority of patients remaining in the same cluster, a minority reaching 33% of patients analyzed may be re-categorized into different clusters based on their progress. Such changes can significantly impact their prognosis
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