18 research outputs found
Effects of a supervised exercise program in addition to electrical stimulation or kinesio taping in low back pain: a randomized controlled trial
Chronic low back pain it is one of the most common health problems worldwide. Usually is
accompanied by a complex set of symptoms and generates significant direct and indirect
socioeconomic and health costs. From a therapeutic point of view, there are a wide variety of
methods to address the treatment of this pathology, however, these therapies have not been
shown definitive efficacy. To investigate the effect of a mixed treatment with exercise and electrical
stimulation versus exercise and kinesio taping in patients with non-specific chronic low back pain.
A total of 58 patients participated in this single-blinded randomised clinical trial. Participants were
assigned to the exercises- kinesio taping group, or exercises- analgesic current group, both received
12 treatment sessions. Disability, fear of movement, anxiety, depression, sleeps quality, pain, lower
limb mechanosensitivity and pressure-pain thresholds were recorded at baseline and after 4 weeks
of treatment. The 2 × 2 mixed analysis of covariance test showed statistically significant differences
between groups for pain (P = 0.046). Pair-wise comparisons with baseline demonstrated significant
differences for both groups in pain (P ≤ 0.001), disability (P ≤ 0.001), pressure-pain thresholds
(P ≤ 0.044), lower limb mechanosensitivity, (P ≤ 0.047), anxiety (P ≤ 0.001), depression (P ≤ 0.001) and
sleep quality (P ≤ 0.010). Patients with chronic low back pain who received a combined treatment of
exercises and kinesio taping or analgesic current showed an improvement in pain, disability, anxiety,
depression and sleep pattern. Moreover, exercises combined with electrotherapy produces greater
improvements over these variables.FEDER-European Regional Development Fund/European Social Fund "A way to make Europe"/"Investing in your future"Proyecto E-CEPEDOL from the Carlos III Health Institute PI18/00562
PC-0185-2017
PC-0253-2017
PC-0536-201
Effectiveness of video-assisted debriefing versus oral debriefing in simulation-based interdisciplinary health professions education: A randomized trial
* Corresponding author at: Department of Nursing, Faculty of Health Sciences, University of Granada, Granada 18016, Spain.
E-mail address: [email protected] (R. Gil-Gutiérrez).Aim
We aimed to compare the debriefing experience, simulation assessment, reflection, anxiety and simulation satisfaction of using oral debriefing versus video-assisted debriefing after a simulated clinical session in an interdisciplinary cohort of health sciences students.
Background
Debriefing is a reflective process that takes place after a clinical simulation and that can be performed either in a traditional way (oral) or using video-assisted debriefing.
Design
A randomized controlled trial was conducted in 143 health sciences students (35.7% male, 61.5% female).
Methods
The simulation scenario was designed to evaluate the procedure for donning and doffing personal protective equipment. Differences in debriefing experience, simulation assessment, reflection, anxiety and satisfaction were assessed.
Results
Regarding debriefing experience, significant differences were observed for the category “learning” (34.9 (6.13) vs. 36.7 (3.89); p = 0.039). For simulation assessment, significantly higher scores for all categories were identified in video-assisted debriefing compared with oral debriefing (p<0.001). There were also significant differences between the oral debriefing versus video-assisted debriefing for the overall score of reflection ability (86.97 (10.55) vs. 90.74 (9.67); p=0.028) as well as for the category “reflective communication” (24.72 (3.77) vs 26.04 (4.07); p=0.047). Perceived satisfaction was significantly higher in the video-assisted debriefing group compared with oral debriefing group (p <0.001). For anxiety, no significant differences were observed between debriefing groups.
Conclusion
Video-assisted debriefing after a simulated clinical session improves debriefing experience, simulation assessment, reflection and simulation satisfaction, but does not increase anxiety compared with oral debriefing among health sciences students.*Funding for open access charge: Univeresidad de Granada/CBUA
La renovación de la palabra en el bicentenario de la Argentina : los colores de la mirada lingüística
El libro reúne trabajos en los que se exponen resultados de investigaciones presentadas por investigadores de Argentina, Chile, Brasil, España, Italia y Alemania en el XII Congreso de la Sociedad Argentina de Lingüística (SAL), Bicentenario: la renovación de la palabra, realizado en Mendoza, Argentina, entre el 6 y el 9 de abril de 2010. Las temáticas abordadas en los 167 capítulos muestran las grandes líneas de investigación que se desarrollan fundamentalmente en nuestro país, pero también en los otros países mencionados arriba, y señalan además las áreas que recién se inician, con poca tradición en nuestro país y que deberían fomentarse. Los trabajos aquí publicados se enmarcan dentro de las siguientes disciplinas y/o campos de investigación: Fonología, Sintaxis, Semántica y Pragmática, Lingüística Cognitiva, Análisis del Discurso, Psicolingüística, Adquisición de la Lengua, Sociolingüística y Dialectología, Didáctica de la lengua, Lingüística Aplicada, Lingüística Computacional, Historia de la Lengua y la Lingüística, Lenguas Aborígenes, Filosofía del Lenguaje, Lexicología y Terminología
Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries
Abstract
Background
Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres.
Methods
This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries.
Results
In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia.
Conclusion
This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries
Physical therapy approach to vascular alterations and their relationship with the processing of chronic pain and functionality of the upper limb in patients with Raynaud's Phenomenon
El Fenómeno de Raynaud se describe como un conjunto de síntomas producidos por un trastorno vasoespástico que suele afectar a los pequeños vasos de las zonas distales de las extremidades y que se desencadena en respuesta a diversos estímulos como la exposición al frío o el estrés emocional. Se caracteriza por una disminución aguda, transitoria y reversible del flujo sanguíneo, acompañado de un cambio de coloración de la piel y distintos niveles de dolor e impotencia funcional. Se clasifica en dos formas clásicas, Fenómeno de Raynaud primario y secundario En el Fenómeno de Raynaud, la alteración a nivel vascular debería estar relacionada con los procesos de dolor crónico, así como con menores tasas de funcionalidad. Estos aspectos, aún no se han estudiado en profundidad y no se conoce la relación que puede existir entre los niveles de daño vascular y el grado de dolor, sensibilización central y catastrofismo así como la discapacidad en las personas que padecen Fenómeno de Raynaud. Por otra parte, las terapéuticas propuestas hasta la actualidad para abordar este proceso no han demostrado tener efectos concluyentes. En este sentido, consideramos que un tratamiento mediante iontoforesis podría mejorar la sintomatología y la discapacidad de los miembros superiores en estos pacientes, con mínimos efectos secundarios; sin embargo, no hemos encontrado estudios previos que analicen la eficacia de un tratamiento de este tipo.
Los objetivos principales de esta tesis doctoral fueron: 1) Evaluar la relación entre las alteraciones vasculares y los niveles de dolor, los procesos relacionados con el desarrollo de dolor crónico (Sensibilización Central y Catastrofismo), la funcionalidad de la mano y la discapacidad de los miembros superiores en personas con Fenómeno de Raynaud. 2) Evaluar la efectividad de una intervención de electroterapia mediante iontoforesis con agua corriente, en la severidad de los síntomas vasculares, síntomas y procesos relacionados con el desencadenamiento del dolor y la discapacidad percibida a nivel de los miembros superiores en personas con Fenómeno de Raynaud.Raynaud's phenomenon manifests as a set of symptoms produced by a vasospastic disorder usually affecting the small vessels near the surface of the skin in the hands and feet and occurs in response to various stimuli such as exposure to cold or emotional stress. It is characterised by an acute, transient and reversible decrease in blood flow, accompanied by a change in skin colour, different levels of pain and functional impotence. It is classified into two main types, primary and secondary Raynaud's. In Raynaud's phenomenon, the alteration at the vascular level should be related to the processes of chronic pain, as well as with lower rates of functionality. These aspects have not yet been studied in depth and there are little known about the possible relationship between levels of vascular damage and the degree of pain, central sensitization and catastrophizing, as well as disability in people suffering from Raynaud's phenomenon. Furthermore, the effects of treatments proposed to manage this process have so far proved inconclusive. In this sense, we consider that iontophoresis treatment may improve the symptoms and upper limb disability in these patients, with minimal side effects; however, we have found no previous studies analysing the efficacy of this type of treatment.
The main objectives of this thesis were: 1) To evaluate the relationship between vascular abnormalities and levels of pain, the processes related to chronic pain development (Central Sensitization and Catastrophizing), hand functionality and upper limb disability in people with Raynaud's phenomenon. 2) To evaluate the effectiveness of iontophoresis electrotherapy with tap-water on the severity of vascular symptoms, pain-triggering processes and symptoms and perceived upper limb disability in people with Raynaud's phenomenon.Tesis Univ. Granada
Association of core body temperature and peripheral blood flow of the hands with pain intensity, pressure pain hypersensitivity, central sensitization, and fibromyalgia symptoms
Our aim was to analyse body core temperature and peripheral vascular
microcirculation at skin hypothenar eminence of the hands and its relationship to symptoms
in fibromyalgia syndrome (FMS). A total of 80 FMS women and 80 healthy women, matched
on weight, were enrolled in this case–control study. Thermography and infrared thermometer
were used for evaluating the hypothenar regions and core body temperature, respectively. The
main outcome measures were pain pressure thresholds (PPTs) and clinical questionnaires.
Significant associations were observed between overall impact [β = 0.033; 95% confidence
interval (95%CI) = 0.003, 0.062; p = 0.030], daytime dysfunction (β = 0.203; 95%CI = 0.011,
0.395; p = 0.039) and reduced activity (β = 0.045; 95%CI = 0.005, 0.085; p = 0.029) and core
body temperature in FMS women. PPTs including greater trochanter dominant (β = 0.254;
95%CI = 0.003, 0.504; p = 0.047), greater trochanter non-dominant (β = 0.650; 95%CI = 0.141, 1.159;
p = 0.013), as well as sleeping medication (β = −0.242; 95%CI = −0.471, −0.013; p = 0.039) were also
associated with hypothenar eminence temperature. Data highlighted that FMS women showed
correlations among body core temperature and hand temperature with the clinical symptoms
Effects of a supervised exercise program in addition to electrical stimulation or kinesio taping in low back pain: a randomized controlled trial.
Chronic low back pain it is one of the most common health problems worldwide. Usually is accompanied by a complex set of symptoms and generates significant direct and indirect socioeconomic and health costs. From a therapeutic point of view, there are a wide variety of methods to address the treatment of this pathology, however, these therapies have not been shown definitive efficacy. To investigate the effect of a mixed treatment with exercise and electrical stimulation versus exercise and kinesio taping in patients with non-specific chronic low back pain. A total of 58 patients participated in this single-blinded randomised clinical trial. Participants were assigned to the exercises- kinesio taping group, or exercises- analgesic current group, both received 12 treatment sessions. Disability, fear of movement, anxiety, depression, sleeps quality, pain, lower limb mechanosensitivity and pressure-pain thresholds were recorded at baseline and after 4 weeks of treatment. The 2 × 2 mixed analysis of covariance test showed statistically significant differences between groups for pain (P = 0.046). Pair-wise comparisons with baseline demonstrated significant differences for both groups in pain (P ≤ 0.001), disability (P ≤ 0.001), pressure-pain thresholds (P ≤ 0.044), lower limb mechanosensitivity, (P ≤ 0.047), anxiety (P ≤ 0.001), depression (P ≤ 0.001) and sleep quality (P ≤ 0.010). Patients with chronic low back pain who received a combined treatment of exercises and kinesio taping or analgesic current showed an improvement in pain, disability, anxiety, depression and sleep pattern. Moreover, exercises combined with electrotherapy produces greater improvements over these variables.Trial registration: NCT02812459
Functional Status and Body Mass Index in Postmenopausal Women with Fibromyalgia: A Case-control Study.
Reduced functional capacity is a common characteristic of fibromyalgia (FMS). We aimed to investigate the relationship between functional status and body mass index (BMI) in a population with and without FMS. A pilot case-control study was performed in 34 women with FMS and 22 healthy controls which were classified according to their BMI. The main outcome measures were: Balance (MiniBestest, One Leg Stance Test), functional mobility (Timed up and Go), physical disability (Health Assessment Questionnaire Disability Index), spinal range of motion (Spinal Mouse), level of physical activity at work (Leisure Time Physical Activity Instrument), and home and leisure time (Physical Activity at Home and Work). Statistical differences were observed between overweight/obese healthy controls and women with FMS for several indicators of functional capacity. FMS patients reported worse dynamic (p = 0.001) and static balance (right: p = 0.002, left: p = 0.001), poorer functional mobility (p = 0.008), and higher levels of physical disability (p = 0.001). Functional status is altered in FMS women compared to the healthy control group, independently of nutritional status; therefore, BMI is unlikely to play a main role in functional capacity indicators in postmenopausal FMS women. Only dynamic balance seems to reduce the obesity status in this population
Functional Status and Body Mass Index in Postmenopausal Women with Fibromyalgia: A Case–control Study
Reduced functional capacity is a common characteristic of fibromyalgia (FMS). We aimed to investigate the relationship between functional status and body mass index (BMI) in a population with and without FMS. A pilot case–control study was performed in 34 women with FMS and 22 healthy controls which were classified according to their BMI. The main outcome measures were: Balance (MiniBestest, One Leg Stance Test), functional mobility (Timed up and Go), physical disability (Health Assessment Questionnaire Disability Index), spinal range of motion (Spinal Mouse), level of physical activity at work (Leisure Time Physical Activity Instrument), and home and leisure time (Physical Activity at Home and Work). Statistical differences were observed between overweight/obese healthy controls and women with FMS for several indicators of functional capacity. FMS patients reported worse dynamic (p = 0.001) and static balance (right: p = 0.002, left: p = 0.001), poorer functional mobility (p = 0.008), and higher levels of physical disability (p = 0.001). Functional status is altered in FMS women compared to the healthy control group, independently of nutritional status; therefore, BMI is unlikely to play a main role in functional capacity indicators in postmenopausal FMS women. Only dynamic balance seems to reduce the obesity status in this population