Igualdad efectiva según la ley 3/2007 en mutuas de accidentes de trabajo y enfermedades profesionales desde la perspectiva preventiva y laboral

La igualdad efectiva en el ámbito laboral, analizada desde la Ley 3/2007, toma una especial relevancia en el ámbito de las Mutuas de Accidentes de Trabajo y Enfermedades Profesionales. En este estudio pretendemos conocer si las empresas encargadas de la prevención y riesgo laborales cumplen la ley vigente en situaciones de embarazo en el ámbito de la igualdad efectiva entre hombres y mujeres (ley 3/2007), en el ámbito laboral (ley 31/1995 actualizada en la ley 54/2003), así como a nivel preventivo, así como determinar si contemplan entre sus actividades formativas programas de formación específica de maternidad y trabajo. Estudio de carácter descriptivo, observacional y transversal perfilada en el contexto de la investigación en materia de género cuya muestra está conformada por diez mutuas de prevención y riesgo laborales que tienen una mayor tradición y consolidación en la provincia de Sevilla. En cuanto a los resultados, 7 de las 10 mutuas estudiadas cumplen con la normativa vigente, aunque los trámites se inicia cuando la mujer trabajadora realiza su solicitud de prestación por puesto de trabajo de riesgo. Los programas de formación en prevención son escasos, y aunque sí se realiza la evaluación del puesto de trabajo y la propuesta de reubicación de la mujer trabajadora, no se llevan a cabo, salvo en dos mutuas, programas de seguimiento para verificar las propuestas de prevención

Influencia de la carga aplicada sobre bastones de antebrazo en parámetros cinemáticos durante la marcha asistida en sujetos sanos

Diversas afecciones del miembro inferior requieren de un periodo de descarga total o parcial durante el proceso de recuperación. La marcha asistida es una de las estrategias de intervención en Fisioterapia más relevantes para facilitar el proceso de curación de la extremidad inferior afectada. A menudo se emplea el uso de bastones canadienses como dispositivo de ayuda a la ambulación, logrando así una marcha funcionalmente eficiente y biomecánicamente correcta. Sin embargo, su uso incorrecto, el incumplimiento de las cargas prescritas por el fisioterapeuta, la toma de desiciones subjetivas del profesional o del propio paciente pueden provocar: dolor, restricciones del rango de movilidad, alteraciones de la función muscular, compensaciones, recaídas y secuelas secundarias. Pese a su importancia, no hay estudios que aúnen criterios para establecer la progresión en las cargas ni en el número de bastones que deben ser utilizados. Con este estudio pretendemos realizar una propuesta para ayudar a los profesionales a tomar decisiones objetivas y fiables, sobre cuál es el porcentaje de peso más recomendable para emplear dos bastones y cuál será la progresión hacia el uso de un bastón, así como la retirada del mismo. Para ello, será fundamental conocer previamente cómo se desvirtúa el gesto de la marcha y la movilidad en relación con los porcentajes de carga aplicados sobre los bastones. En este estudio, la utilización del Sistema de Medición de Cargas GCH 2.0, que son bastones instrumentados, nos proporcionan la información real del porcentaje de carga aplicado sobre éstos, y junto con el análisis de movimiento tridimensional de cabeza, tronco, pelvis y hemipelvis, nos han permitido analizar la cinemática en los tres planos de movimiento de los mismos. De esta forma, estudiamos la marcha asistida contralateral ejerciendo el 10%, 25% y 50% del peso corporal sobre el bastón, así como la marcha bilateral cargando el 25% y 50% del peso corporal sobre los dos bastones, para ver la influencia sobre el movimiento angular. Esta investigación se engloba en un diseño factorial de medidas repetidas, con una muestra de 22 sujetos sanos. Las conclusiones del estudio son las siguientes: los resultados obtenidos en la marcha normal coinciden con la bibliografía que existe sobre cinemática, excepto en la rotación de la cabeza que se han obtenido valores por encima de la normal, asimismo podemos estimar que los distintos porcentajes de carga provocan cambios en la cinemática normal de la marcha. Concretamente, la cabeza deja de ser una unidad de pasajeros para adquirir un movimiento propio para poder compensar el impacto del bastón contra el suelo y, el aumento de flexión del tronco en la marcha bilateral y la disminución de la flexión del tronco (mayor extensión) en la marcha contralateral unido al aumento de anteversión de la pelvis provocan las mayores alteraciones cinemáticas. Podemos añadir, que la amplitud de movimiento de la cabeza aumentan mientras que el movimiento en tronco, pelvis y hemipelvis disminuyen en todos los planos de movimiento, excepto en la rotación pélvica y flexoextensión de la hemipelvis derecha, que aumentan. La característica más relevante que muestran nuestros resultados es que los eventos más significativos del ciclo de la marcha se retrasan en el tiempo en todas las variables cinemáticas de cabeza, tronco y pelvis lo que influye directamente por ejemplo en el mecanismo de contrarotación entre tronco y pelvis, que se ve alterado. Sólo existe asimetría en la rotación pélvica. Por todo ello, según nuestros resultados en las distintas modalidades de marcha asistida, y en base a la cinemática, podemos realizar una propuesta en cuanto a la progresión de cargas que consideramos más acertada: se debería comenzar con una marcha bilateral tanto al 25% para continuar con una marcha contralateral al 10%. En función de la patología y de la fase de tratamiento hay que tomar en consideración la marcha bilateral al 50% en primer lugar y en pocas ocasiones, la marcha contralateral al 25%, pero en ningún caso la marcha contralateral con el 50% de carga

Intervención mediante feedback auditivo para la mejora del equilibrio en mujeres que realizan actividad física

El equilibrio es un aspecto fundamental para las actividades de la vida diaria y para el deporte. El deterioro en esta capacidad puede ocasionar trastornos o lesiones por caídas. El objetivo de esta intervención es determinar la influencia de un programa de ejercicios propioceptivos con feedback externo auditivo sobre la mejora del equilibrio. Participaron ocho mujeres (M = 38 años, DE = 11.45) que realizaban ejercicio constante, dividas en dos grupos. Grupo 1 programa y feedback auditivo, grupo 2 solo programa. Se creó un equipo de feedback auditivo que fue utilizado para el grupo 1. En los resultados el Grupo 1 tuvo la mejoría significativa en equilibrio medido con los siguientes test: Functional Reach (p = .036), Get Up and Go (p = .021) y Test Dinámico en Barra (p = .044). De acuerdo a los resultados obtenidos, los dos grupos presentan una mejoría en el equilibrio por el programa propioceptivo, pero es el grupo 1 con feedback auditivo, el que tuvo la mayor mejoría. El programa propioceptivo unido a feedback auditivo puede mejorar significativamente el equilibrio.Balance is an essential aspect of daily living and sport appearance. The deterioration of this capacity may cause disorder or injury from falls. The objective of this intervention is to determine the influence of proprioceptive exercise program with external auditory feedback on balance improvement. It involved eight women (M = 38 years, SD = 11.45) who performed constant exercise, divided into two groups. Group 1 program and auditory feedback, group 2 single program. A team of auditory feedback that was used for group 1 was created. Results in Group 1 had a significant improvement in measured equilibrium with the following tests: Functional Reach (p = .036), Get Up and Go (p = .021) and Dynamic Bar test (p = .044). According to the results, the two groups displayed an improvement in the balance by the proprioceptive program, but it was group 1, with auditory feedback, which shown the greatest improvement. The proprioceptive program along with auditory feedback can improve balance significantly.O equilíbrio é um aspecto fundamental para as actividades da vida diária e para o desporto. A deterioração desta capacidade pode originar perturbações ou lesões devido a quedas. O objectivo desta intervenção é determinar a influência de um programa de exercícios propioceptivos com feedback auditivo externo sobre a melhoria do equilíbrio. Participaram no estudo oito mulheres (M = 38 anos, DP = 11.45) que realizavam exercício constante, divididas em dois grupos. Grupo 1 programa e feedback auditivo, Grupo 2 apenas programa. Foi criada uma equipa de feedback auditivo que foi utilizada para o Grupo 1. Os resultados indicam que o Grupo 1 apresentou uma melhoria significativa do equilíbrio medid através dos seguintes testes: Functional Reach (p = .036), Get Up and Go (p = .021) e Teste Dinâmico em Barra (p = .044). De acordo com os resultados obtidos, ambos os grupos apresentam uma melhoria no equilíbrio através do programa propioceptivo, contudo, o Grupo 1 com feedback auditivo, foi o que teve uma melhoria superior. O programa propioceptivo, juntamente com o feedback auditivo, pode melhorar significativamente o equilíbrio

Antibodies to West Nile virus and related flaviviruses in wild boar, red foxes and other mesomammals from Spain

Red foxes (Vulpes vulpes), wild boar (Sus scrofa) and Iberian pigs (Sus scrofa domestica) that are raised extensively outdoors, as well as other wild mesomammals from south central Spain and wild boar from Doñana National Park (DNP), were tested for antibodies against related flaviviruses by ELISA and for antibodies against WNV by VNT. Mean flavivirus seroprevalence according to ELISA was 20.4 ± 7.8% (21 out of 103) in red foxes, 12.6 ± 2.8% (69 out of 545) in wild boars, and 3.3 ± 2.7% (6 out of 177) in Iberian pigs. A stone marten (Martes foina) also tested positive. Flavivirus seroprevalence in wild boar was significantly higher in DNP, and increased with age. Haemolysis of the serum samples limited interpretation of VNT to 28 samples, confirming WNV seroprevalence in one red fox, four Iberian pigs and nine wild boars. ELISA positive, microVNT negative samples suggest presence of non-neutralizing antibodies against WNV or antibodies to other antigenically related flaviviruses. Despite the importance of wetlands for flavivirus maintenance and amplification, WNV/flavivirus seroprevalence in wild boar and red foxes was not associated to wetland habitats. This is the first report of exposure of red foxes to WNV. With view to use of the tested species as sentinels for flavivirus activity, limited exposure of Iberian pigs that would be available for regular sampling, low numbers of foxes collected and concentration of wild boar harvest in the winter season are major drawbacks.This study has been supported by projects PAC08-0296-7771 (JCCM), and AG2008-02504GAN. A.V. Gutierrez-Guzman is a JCCM fellow (PAC08-029).Peer Reviewe

Sex-biased differences in the effects of host individual, host population and environmental traits driving tick parasitism in red deer

The interactions between host individual, host population, and environmental factors modulate parasite abundance in a given host population. Since adult exophilic ticks are highly aggregated in red deer (Cervus elaphus) and this ungulate exhibits significant sexual size dimorphism, life history traits and segregation, we hypothesized that tick parasitism on males and hinds would be differentially influenced by each of these factors. To test the hypothesis, ticks from 306 red deer-182 males and 124 females-were collected during 7 years in a red deer population in south-central Spain. By using generalized linear models, with a negative binomial error distribution and a logarithmic link function, we modeled tick abundance on deer with 20 potential predictors. Three models were developed: one for red deer males, another for hinds, and one combining data for males and females and including >sex> as factor. Our rationale was that if tick burdens on males and hinds relate to the explanatory factors in a differential way, it is not possible to precisely and accurately predict the tick burden on one sex using the model fitted on the other sex, or with the model that combines data from both sexes. Our results showed that deer males were the primary target for ticks, the weight of each factor differed between sexes, and each sex specific model was not able to accurately predict burdens on the animals of the other sex. That is, results support for sex-biased differences. The higher weight of host individual and population factors in the model for males show that intrinsic deer factors more strongly explain tick burden than environmental host-seeking tick abundance. In contrast, environmental variables predominated in the models explaining tick burdens in hinds.This study was supported by project AGL2010-20730-C02 (Spanish Ministry for Economy and Competitiveness) and EU FP7 grant ANTIGONE (278976). F. Ruiz-Fons is supported by a Juan de la Cierva contract from the Spanish Ministry for Economy and Competitiveness. P. Acevedo is funded from the SFRH/BPD/90320/2012 post-doctoral grant by Portuguese Fundação para a Ciência e a Tecnologia (FCT) and European Social Fund.Peer Reviewe

The effects of host and environmental factors on tick parasitism in red deer are modulated by sex

Póster presentado al Joint 8th International Ticks and Tick-borne Pathogens and 12th Biennial Society for Tropical Veterinary Medicine Conference, celebradas en Cape Town (Sudafrica) del 24 al 29 de agosto de 2014.[Objectives]: Host individual, host population and environmental factors interact to modulate parasite abundance in hosts. Since size dimorphism, life history traits and segregation observed in red deer (Cervus elaphus) are linked to sex and this ungulate species constitutes a highly relevant host for adult exophilic ticks, it was hypothesized that tick parasitism on stags and hinds would be differentially influenced by each of these factors. [Method]: Ticks from 306 red deer were collected during 7 years in a red deer population. By generalized linear models we modelled tick abundance on deer with 20 potential predictors. Three models were developed: one for stags, another for hinds, and one combining data from both sexes and including >sex> as factor. Our rationale was that if tick burdens on males and hinds relate to the explanatory factors in a differential way, it is not possible to precisely and accurately predict the tick burden on one sex using the model fitted on the other sex, or with the model that combines data from both sexes. Our results showed that deer males were the primary target for ticks, the weight of each factor differed between sexes, and each sex specific model was not able to accurately predict burdens on the animals of the other sex. [Conclusions]: Results support for sex-biased differences in tick parasitism in red deer. The higher weight of host individual and population factors in the model for stags show that intrinsic deer factors more strongly explain tick burden than environmental host-seeking tick abundance. In contrast, environmental variables better explained tick burdens in hinds.We thank gamekeepers, project AGL2010‐20730‐C02 (Spanish Ministry for Economy and Competitiveness‐MINECO) and EU FP7 grant ANTIGONE (278976). F. Ruiz‐Fons & P. Acevedo are supported by MINECO.Peer Reviewe

Analysis of the Satisfaction Degree of Students at Spain’s Physiotherapy Universities in Relation to Online Teaching during the COVID-19 Pandemic

Student satisfaction is a crucial aspect in the quality assessment of higher education. The aim of the present study was to assess the degree of satisfaction among students in the Faculties of physiotherapy throughout Spain concerning online teaching during the State of Emergency due to the COVID-19 pandemic. This was a quantitative study with a cross-sectional observational design. The online questionnaire DISFISCOVID was distributed to 24 physiotherapy faculties across Spain. A sample of 348 physiotherapy students from 14 Spanish universities completed the questionnaire. It showed high reliability evidence, achieving Cronbach’s alpha indices higher than 0.870, alongside a McDonald’s ωH of 0.876. On the whole, students were not satisfied with online learning during the State of Emergency, considering it unsuitable for their learning in either the theoretical or practical field of subjects in the degree of physiotherapy. In conclusion, the perception of physiotherapy students concerning the teaching they received, as far as practical contents and assessment methods are concerned, was not very satisfactory in those Faculties in which online learning platforms were not being used beforehand, and was more satisfactory when teaching was carried out in-person in the classroom

Telerehabilitation Intervention in Patients with COVID-19 after Hospital Discharge to Improve Functional Capacity and Quality of Life. Study Protocol for a Multicenter Randomized Clinical Trial.

COVID-19 can cause important sequels in the respiratory system and frequently presents loss of strength, dyspnea, polyneuropathies and multi-organic affectation. Physiotherapy interventions acquire a fundamental role in the recovery of the functions and the quality of life. Regarding the recovery phases after hospital discharge, the current evidence available is very preliminary. Telerehabilitation is presented as a promising complementary treatment method to standard physiotherapy. The main objective of this research is to evaluate the effectiveness of a personalized telerehabilitation intervention after discharge from hospital for the improvement of functional capacity and quality of life compared to a program of health education and/or care in a rehabilitation center. As secondary objectives, to identify the satisfaction and perception of patients with the telerehabilitation intervention and the presence of barriers to its implementation, as well as to evaluate the cost-effectiveness from the perspective of the health system. This study protocol will be carried out through a single blind multicenter randomized clinical trial in the south of Spain. We hypothesize that the implementation of a telerehabilitation program presents results not inferior to those obtained with the current standard intervention. If the hypothesis is confirmed, it would be an opportunity to define new policies and interventions to address this disease and its consequences. Trial registration NCT04742946

Association between neuroserpin and molecular markers of brain damage in patients with acute ischemic stroke.

BACKGROUND: Neuroserpin has shown neuroprotective effects in animal models of cerebral ischemia and has been associated with functional outcome after ischemic stroke. Our aim was to study whether neuroserpin serum levels could be associated to biomarkers of excitotoxicity, inflammation and blood brain barrier disruption. METHODS: We prospectively included 129 patients with ischemic stroke (58.1% male; mean age, 72.4 ± 9.6 years) not treated with tPA within 12 hours (h) of symptoms onset (mean time, 4.7 ± 2.1 h). Poor functional outcome at 3 months was considered as a modified Rankin scale score >2. Serum levels of neuroserpin, Interleukin 6 (IL-6), Intercellular adhesion molecule-1 (ICAM-1), active Matrix metalloproteinase 9 (MMP-9), and cellular fibronectin (cFn) (determined by ELISA) and glutamate (determined by HPLC) were measured on admission, 24 and 72 h. The main variable was considered the decrease of neuroserpin levels within the first 24 h. ROC analysis was used to select the best predictive value for neuroserpin to predict poor functional outcome due to a lack of linearity. RESULTS: The decrease of neuroserpin levels within the first 24 h was negatively correlated with serum levels at 24 hours of glutamate (r = -0.642), IL-6 (r = -0.678), ICAM-1 (r = -0.345), MMP-9 (r = -0.554) and cFn (r = -0.703) (all P < 0.0001). In the multivariate analysis, serum levels of glutamate (OR, 1.04; CI95%, 1.01-1.06, p = 0.001); IL-6 (OR, 1.4; CI95%, 1.1-1.7, p = 0.001); and cFn (OR, 1.3; CI95%, 1.1-1.6, p = 0.002) were independently associated with a decrease of neuroserpin levels <70 ng/mL at 24 h after adjusting for confounding factors. CONCLUSIONS: These findings suggest that neuroprotective properties of neuroserpin may be related to the inhibition of excitotoxicity, inflammation, as well as blood brain barrier disruption that occur after acute ischemic stroke