[Design of a nursing assessment instrument during pregnancy monitoring in Primary Health care and the validation of its content]. / Diseño de un instrumento de valoración enfermera para el seguimiento de embarazo en Atención Primaria de salud y la validación de su contenido.

OBJECTIVE: This research aims to develop a nursing assessment tool, based on Gordon's Health Functional Patterns, through a content validation by a committee of experts, applying a Delphi technique. DESIGN: An assessment instrument with 53 items has been designed. SITE: It is carried out within the framework of a doctoral thesis, for its implementation by midwives of Primary Health Care. PARTICIPANTS: The committee was made up of 16 professionals with a hide clinical, teaching and research experience who all participated in the entire validation process. INTERVENTION: It has been assessed as a whole and in each of the items through four rounds of consultations, establishing a positive assessment of more than 60% to accept each item, as well as incorporating the suggestions provided by the committee. The final version had to reach a unanimous consensus. MAIN MEASUREMENTS: All items were accepted with a score higher than 60%. RESULTS: There were no contradictions between the inputs provided by the experts, so all of them were integrated into the final version that has a 100% approval by the committee. CONCLUSION: After this process, a new assessment tool is presented to be applied by primary care midwives in the pregnancy monitoring. The questionnaire has been piloted with 50 pregnant women, determining the most prevalent nursing diagnoses, establishing the workload for the midwife of her implementation of individualized care plans to improve some health indicators of pregnant women.

Effectiveness of a 5-Week Virtual Reality Telerehabilitation Program for Children With Duchenne and Becker Muscular Dystrophy: Prospective Quasi-Experimental Study.

Background: Duchenne muscular dystrophy (DMD) and Becker muscular dystrophy (BMD) are neuromuscular diseases. DMD is the most prevalent in children. It affects dystrophin production, reducing the patient's mobility and quality of life. New technologies have become a part of physical therapy in DMD and BMD. During the COVID-19 pandemic, conducting telerehabilitation through virtual reality-based games could help these children maintain their physical abilities. Objective: This study examined if the use of a virtual platform in a multimodal intervention program changes the results of the 6-minute walk test (6MWT) in children with DMD and BMD. The main objective was to test whether children with DMD and BMD obtain different results on the 6MWT after completing 10 telerehabilitation treatment sessions. The secondary objective was to measure whether other specific motor scales also produce different results after the 10 defined sessions. Methods: This was a descriptive, open, and quasi-experimental study with a prospective A-B (control-intervention) design. A sample of 12 participants who fulfilled the inclusion criteria followed the program for 5 weeks with 10 telerehabilitation sessions. During the sessions, the participants used virtual reality glasses to train for the treatment goals. All participants were assessed in person before and after the intervention. Analysis was performed using R software according to the different functional assessments performed for each test. Results: The participants showed a 19.55-meter increase in the 6MWT. Motor function also remained stable according to other scales used to assess it. The North Start Ambulatory Assessment scores were stable in both treatment conditions (P=.20). Furthermore, the timed up and go test results were 0.1 seconds faster in the telerehabilitation condition, and the Motor Function Measure in all of the 3 dimensions showed no significant differences (P=.08). Finally, the Effort Perception Infant scale showed that during the training, fatigue increased in the middle and decreased by the end of the sessions, but the perception throughout the sessions was lower even as the exercise intensity increased. Conclusions: There were no differences between conventional and telerehabilitation treatments, so the telerehabilitation tool could be used without harming children with DMD and BMD, facilitating their access to therapies and stimulating learning to maintain their functional capacity. Therefore, telerehabilitation in general may be helpful in maintaining motor function in children with DMD and BMD. The learning effect helped reduce the feeling of fatigue in the children during the program.

Does Tension Headache Have a Central or Peripheral Origin? Current State of Affairs.

PURPOSE OF REVIEW: The aim of this narrative review is to analyze the evidence about a peripheral or central origin of a tension headache attack in order to provide a further clarification for an appropriate approach. RECENT FINDINGS: Tension headache is a complex and multifactorial pathology, in which both peripheral and central factors could play an important role in the initiation of an attack. Although the exact origin of a tension headache attack has not been conclusively established, correlations have been identified between certain structural parameters of the craniomandibular region and craniocervical muscle activity. Future research should focus on improving our understanding of the pathology with the ultimate goal of improving diagnosis. The pathogenesis of tension-type headache involves both central and peripheral mechanisms, being the perpetuation over time of the headache attacks what would favor the evolution of an episodic tension-type headache to a chronic tension-type headache. The unresolved question is what factors would be involved in the initial activation in a tension headache attack. The evidence that favors a peripheral origin of the tension headache attacks, that is, the initial events occur outside the brain barrier, which suggests the action of vascular and musculoskeletal factors at the beginning of a tension headache attack, factors that would favor the sensitization of the peripheral nervous system as a result of sustained sensory input.

Effectiveness of a 5 weeks telerehabilitation programme with virtual reality glasses in boys with Duchenne and Becker during the COVID-19: A clinical trial.

BACKGROUND: Duchenne and Becker muscular dystrophy (from now "DMD" and "BMD" respectively) are the neuromuscular diseases with the most significant involvement in children. It affects dystrophin production, reducing the patient's mobility and quality of life. New technologies have become part of physical therapy in DMD and BMD. During the COVID-19 pandemic, telerehabilitation through virtual reality-based games could help these children to keep their abilities. OBJECTIVE: The purpose of this study is to know if the use of the virtual platform in a multimodal intervention program achieves changes in the results obtained in the six-minute walk test in children affected by DMD and BMD. To estimate the difference in mobility in patients with DMD and BMD, as measured with the six-minute walking test (6MWT), between 10 conventional and telerehabilitation treatment sessions. As secondary objectives, measuring other specific motor scales was proposed to see whether these had changed after receiving the 10 defined sessions. METHODS: Descriptive, open, quasi-experimental study with prospective A-B (control-intervention) design. Sample size of twelve participants who fulfilled the control criteria followed the program for five weeks, up to 10 telerehabilitation sessions. During the sessions, the participants used virtual reality glasses to train for the treatment goals. All sessions were in person, and participants were assessed before and after the intervention. Analysis was performed using R (R Core Team (2022) according to the different functional assessments performed for each test. RESULTS: The participants showed a 19.55 m increase in the 6MWT scale. The motor function was also kept stable according to other scales used to assess it. North Start result were kept stable in both treatments (P value = .199). Furthermore, Time up and go test was shorter in 0.1 seconds in telerehabilitation time and Motor Function Measure in all of the 3 dimensions shown no significant differences with a P value = .084. Finally, Infant effort (EPInfant) shown that during the training the fatigue increased in the middle and decreased by the end but the perception throughout the sessions, was lower even though the exercise intensity increased. CONCLUSIONS: There is no difference between a conventional and telerehabilitation treatment, so the telerehabilitation tool could be used without harming this type of children, facilitating their access to therapies and stimulating learning to maintain their functional capacity. Telerehabilitation may helpful maintain motor function in children with DMD and BMD. The learning effect helped to reduce the feeling of fatigue in children during the program. CLINICALTRIAL: This trial has the approval of the Andalucía Ethics Committee with PEIBA code 0107-N-20. The results of the research will be disseminated by the investigators to peer-reviewed journals. Trial registration no. NCT03879304.

Occupation and Sickness Absence in the Different Autonomous Communities of Spain.

The occupation of a worker is a determining factor of sickness absence (SA) and can influence both the beginning and continuation of the latter. This study describes SA in Spain, separately in the different Autonomous Communities (AC) in relation to the occupation of workers, with the aim of determining the possible differences in its frequency and duration, relating it also to the diagnosis. A total of 6,543,307 workers, aged 16 years and older, who had at least one episode of SA in the year 2019, constituted the study sample. The obtained results indicate that SA is more frequent and shorter in more elemental occupations. The average duration increases with age and is longer in women, except in technical and administrative occupations, where there is no gender divide. Sickness absences caused by musculoskeletal and mental disorders are more frequent in the lower occupational classes, although their average duration is shorter than in other, more qualified groups. The ACs with shorter duration in almost all the occupational groups are Madrid, Navarre and the Basque Country. In conclusion, SA is more frequent and shorter in lower occupational classes.

Service Quality in Early Intervention Centres: An Analysis of Its Influence on Satisfaction and Family Quality of Life.

Early Intervention (EI) is a set of interventions focused on responding to the needs of children with or at risk of developmental problems. This study aimed to investigate the relationships between the perceived quality of service, satisfaction and family quality of life. METHODS: to conduct a multi-centre, transversal study with a non-probabilistic sample. The participants (N = 1551) were families from 24 Early Intervention Centres (EICs) located in Spain. RESULTS: The results indicated an adequate fit of the measurement and structural models, with the latter showing a capacity of 73% to predict the family quality of life. The structural model established that the perceived service quality was a positive and significant predictor of satisfaction (ß = 0.85; p < 0.001). Both the perceived quality of service (ß = 0.28; p < 0.001) and satisfaction (ß = 0.33; p < 0.001) obtained a similar positive and significant relationship with family quality of life, which was slightly stronger than satisfaction. CONCLUSIONS: This study provided a better understanding of the importance of the services offered in EICs and their influence on the satisfaction and family quality of life of their users. Thus, delving into these relationships was highly relevant for decision-making in the context of EI.

The Use of Virtual Reality Technologies in the Treatment of Duchenne Muscular Dystrophy: Systematic Review.

BACKGROUND: Duchenne muscular dystrophy is a serious and progressive disease affecting one in 3500-6000 live male births. The use of new virtual reality technologies has revolutionized the world of youth rehabilitation. OBJECTIVE: We performed a systematic review to study the effectiveness of the use of virtual reality systems applied in the rehabilitation of the upper limbs of individuals with Duchenne muscular dystrophy. METHODS: Between June 2018 and September 2019, we carried out a series of searches in 5 scientific databases: (1) PubMed, (2) Web of Science, (3) Scopus, (4) The Cochrane Library, and (5) MEDLINE via EBSCO. Two evaluators independently conducted the searches following the PRISMA recommendations for systematic reviews for articles. Two independent evaluators collated the results. Article quality was determined using the PEDro scale. RESULTS: A total of 7 clinical trials were included in the final review. These studies used new technologies as tools for physiotherapeutic rehabilitation of the upper limbs of patients with Duchenne muscular dystrophy. Collectively, the studies showed improvement in functionality, quality of life, and motivation with the use of virtual reality technologies in the rehabilitation of upper limbs of individuals with Duchenne muscular dystrophy. CONCLUSIONS: The treatment of neuromuscular diseases has changed in recent years, from palliative symptom management to preventive methods for capacity building. The use of virtual reality is beginning to be necessary in the treatment of progressive diseases involving movement difficulties, as it provides freedom and facilitates the improvement of results in capacity training. Given that new technologies are increasingly accessible, rehabilitation and physiotherapy programs can use these technologies more frequently, and virtual reality environments can be used to improve task performance, which is essential for people with disabilities. Ultimately, virtual reality can be a great tool for physiotherapy and can be used for Duchenne muscular dystrophy rehabilitation programs to improve patient performance during training. TRIAL REGISTRATION: PROSPERO International Prospective Register of Systematic Reviews CRD42018102548; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=102548.

Analysis of Fall Risk Factors in an Aging Population Living in Long-Term Care Institutions in SPAIN: A Retrospective Cohort Study.

Falls in the elderly are associated with morbidity and mortality. Research about fall risk factors in Spanish care facilities is scarce. This study aimed to assess the prevalence of falls among residents living in long-term care Spanish institutions and to identify fall risk factors in this population. A nationwide retrospective cohort study was conducted in 113 centers. Persons over 70 years old who were living in a residential setting for at least 1 year were included. Simple and multiple regression analyses were conducted to estimate the associations between the main clinical variables registered in the databases and the presence of falls. A total of 2849 subjects were analyzed (mean age 85.21 years). The period prevalence of fallers in the last 12 months was 45.3%, with a proportion of recurrent fallers of 51.7%. The presence of falls was associated with lower Tinetti Scale scores (OR = 1.597, 95% CI: 1.280, 1.991; OR = 1.362, 95% CI: 1.134, 1.635), severe or moderate cognitive impairment (OR= 1.992, 95% CI: 1.472, 2.695; OR = 1.507, 95% CI: 1.231, 1.845, respectively), and polypharmacy (OR = 1.291, 95% CI: 1.039, 1.604). Fall prevention interventions should focus on the prevention of balance and cognitive deterioration and the improvement of these functions when possible. It should also focus on a periodical medication history revision aiming to avoid inappropriate prescriptions.

Descriptive study of sickness absence in Spanish regions in 2018: database study.

OBJECTIVES: To provide a wide and thorough description of sickness absence (SA) in Spain, focussing on the different regions of the country and the main characteristics of SA. METHODS: A study of the SA spells in Spain, managed by the medical units of the National Institute of Social Security in 2018. The geographical scope of this observational study is the regions (Autonomous Community). Incidence, prevalence, and average duration SA in employees and self-employed are described. The study also describes the differences between non-work-related SA and work-related SA. In age and sex variables, the incidence and the average duration are described. The average duration by Diagnostic Chapters (International Classification of Diseases, 10th Revision (ICD-10)) and the highest number of SA spells by occupational activity and diagnosis are analysed. RESULTS: A total of 540 045 SA spells are analysed by non-work-related SA and 63 441 by work-related SA. The national average prevalence in non-work-related SA spells is 32.98/1000 among employed and 30.48/1000 among self-employed; in work-related SA spells, the prevalence is 3.99/1000. The national incidence in non-work-related SA spells is 24.8/1000 for employees and 9.51/1000 for self-employed workers; in work-related SA spells the incidence is 3.55/1000. The average duration is 58.67 days, with the longest duration being neoplasms and the shortest corresponding to infectious disease. The Community of Madrid shows the lowest prevalence, incidence and average duration in work-related SA. Influenza is the diagnosis that generates the largest number of SA spells. Activities of call centres and temporary employment agency activities are the occupations that have the highest number of SA spells. CONCLUSIONS: The biggest differences are found in the incidence and average duration, between the non-work-related SA spells and work-related SA. If those characteristics of the SA in which a region is more in deficit are known, it will be possible to do better management of the SA.

Post-traumatic stress disorder after subsequent birth to a gestational loss: An observational study / Trastorno de estrés postraumático tras una gestación posterior a una pérdida gestacional: Un estudio observacional

Abstract Introduction The loss of a pregnancy puts women at risk of suffering post-traumatic stress disorder. This circumstance can influence a subsequent pregnancy, and the link with the future baby. Objective The main objective of this work was to identify the prevalence of post-traumatic stress disorder (PTSD) among post-partum women who give birth after having suffered a previous gestational loss and to identify possible relationships between PTSD and the variables studied. Method An observational, descriptive, and cross-sectional study. A total of 115 puerperal women who had suffered a previous gestational loss completed questionnaires containing sociodemographic variables, obstetric history, and responses to the Davidson Trauma Scale. Results A score of 40 was established as a cut-off point in the Davidson Trauma Scale for the identification of PTSD. 21.7% of the participants scored 40 or above. Significant differences were found related to age (p = .030), number of pregnancies (p = .033), and number of gestational losses (p = .001). The probability of PTSD increases significantly in relation to the number of losses. Respondents are 2.55 times (β = .94 p = .027) more likely to suffer PTSD the higher the number of gestational losses suffered. Discussion and conclusion There are significant differences in the presence of PTSD among puerperal women in terms of age, number of pregnancies, and number of gestational losses. Post-partum women are more likely to suffer PTSD after a gestational loss the higher the number of gestational losses suffered.

Resumen Introducción La pérdida de un embarazo sitúa a las mujeres en riesgo de padecer un trastorno por estrés postraumático. Esta circunstancia puede influir en un embarazo posterior, y el vínculo con el futuro bebé. Objetivo El objetivo principal de este trabajo fue identificar la prevalencia de trastorno por estrés postraumático entre puérperas que dan a luz tras haber sufrido una pérdida gestacional previa e identificar posibles relaciones entre el trastorno por estrés postraumático y las variables estudiadas. Método Se trata de un estudio observacional, descriptivo y transversal. Un total de 115 puérperas que habían sufrido una pérdida gestacional anterior llenaron cuestionarios que contenían variables sociodemográficas, de la historia obstétrica y la Escala de Trauma de Davidson. Resultados Se estableció 40 como punto de corte en la Escala de Trauma de Davidson para identificar el trastorno por estrés postraumático. Se identificó en un 21.7% de las participantes. Se encontraron diferencias significativas relacionadas con la edad (p = .030), el número de embarazos (p = .033) y el número de pérdidas gestacionales (p = .001). La probabilidad de trastorno por estrés postraumático aumenta significativamente en relación con el número de pérdidas. Es 2.55 veces (β = .94 p = .027) más probable padecer un trastorno por estrés postraumático cuanto mayor sea el número de pérdidas gestacionales sufridas. Discusión y conclusión Existen diferencias significativas en la prevalencia de trastorno por estrés postraumático entre las puérperas en cuanto a la edad, el número de embarazos y el número de pérdidas gestacionales. Es más probable padecer trastorno por estrés postraumático tras una gestación posterior a una pérdida gestacional cuanto mayor sea el número de pérdidas gestacionales sufridas.

The Inventory of Quality in Early Intervention Centres for Service Providers: Preliminary Validating Study in a Spanish Sample.

Evaluating the service quality in early intervention (EI) from the perspective of professionals with knowledge in this area is essential for the improvement of EI centres. In this study, we aimed to test the reliability and validity of the adapted Inventory of Quality in Early Intervention Centres-P (IQEIC-P) in a sample of professionals who worked in EI centres. Three hundred and twenty-four professionals of 85 EI Spanish centres were recruited for this research. Various psychometric analyses were used to evaluate the factorial structure, the internal consistency, factorial validity and construct validity. A 5-dimension structure was obtained in the exploratory factor analysis (EFA). The results showed an adequate internal consistency (Cronbach's alpha values between 0.71 and 0.83, and composite reliability (CR) values higher than 0.70), as well as satisfactory convergent and discriminant validity (average variance extracted (AVE) values above 0.50). In the confirmatory factor analysis, good model fit indicators were observed. The IQEIC-P showed adequate psychometric properties, demonstrating to be a valid instrument for the evaluation of service quality in EI centres from the perspective of professionals. The benefits will influence the professionals themselves, and they will have a positive and direct impact on the families that are attended to in these centres.

Evaluación de la calidad de servicio en Atención Temprana: revisión sistemática / Evaluation of quality of service in Early Intervention: A systematic review

Introducción: La Atención Temprana (AT), como servicio pediátrico, obliga a cuantificar resultados de intervención y calidad de servicio ofrecido. La disposición de instrumentos de medida válidos y fiables permitirá a los profesionales evaluar la calidad de estos servicios. Objetivo principal: Revisar la literatura científica, analizar la calidad metodológica de las herramientas utilizadas en AT para la medición de la calidad de servicio. Métodos: Se realizó una búsqueda en diferentes bases de datos: Medline (a través de Pubmed), Web of Science, PsycINFO, Cochrane, Scopus, ERIC y Scielo. La calidad metodológica de los estudios identificados se evaluó a través de la escala Consensus-based Standards for the Selection of Health Measurement (COSMIN) Resultados: Se seleccionaron 13 artículos que cumplieron los criterios de inclusión, de los cuales 10 obtuvieron una puntuación «buena» o «razonable» según la escala COSMIN. Conclusiones: Pese a su importancia, aún no existe consenso entre los autores sobre la medición de la calidad de servicio en AT. Habitualmente, es la familia de los niños atendidos en AT la población sobre la que se realizan los estudios, aunque la perspectiva de los profesionales toma auge y completa la información

Introduction: Early Intervention (EI), as a paediatric service, has the duty of quantifying the results and the quality of its services provided. The accessibility of valid and reliable tools allows professionals to evaluate the quality of these services. Main objective: The aim of this study is to review the scientific literature on tools used to measure the methodological and service quality in EI. Methods: A search was made in different databases: Medline (from PubMed), Web of Science, PsycINFO, Cochrane, Scopus, ERIC and Scielo. The methodological quality of the studies was tested using the COSMIN scale. Results: A total of 13 manuscripts met the criteria to be included in this review. Ten of them received a "Good" or "reasonable" score based on the COSMIN scale. Conclusions: Despite its importance, there is no consensus among authors on the measurement of service quality in EI. It is often the family of the children attended in EI that are considered the target to study, although the opinion of professionals carries more weight and completes the information

[Evaluation of quality of service in Early Intervention: A systematic review]. / Evaluación de la calidad de servicio en Atención Temprana: revisión sistemática.

INTRODUCTION: Early Intervention (EI), as a paediatric service, has the duty of quantifying the results and the quality of its services provided. The accessibility of valid and reliable tools allows professionals to evaluate the quality of these services. MAIN OBJECTIVE: The aim of this study is to review the scientific literature on tools used to measure the methodological and service quality in EI. METHODS: A search was made in different databases: Medline (from PubMed), Web of Science, PsycINFO, Cochrane, Scopus, ERIC and Scielo. The methodological quality of the studies was tested using the COSMIN scale. RESULTS: A total of 13 manuscripts met the criteria to be included in this review. Ten of them received a "good" or "reasonable" score based on the COSMIN scale. CONCLUSIONS: Despite its importance, there is no consensus among authors on the measurement of service quality in EI. It is often the family of the children attended in EI that are considered the target to study, although the opinion of professionals carries more weight and completes the information.

Post-traumatic stress and related symptoms in a gestation after a gestational loss: narrative review / Estrés postraumático y síntomas relacionados en un embarazo posterior a una pérdida gestacional: revisión narrativa

Abstract Background Around 30% of pregnancies conclude in a gestational loss. Most women who suffer a gestational loss become pregnant again. However, mothers who have experienced this situation live the new pregnancy with fear and anxiety. Objective To perform an update of the main works done in the study of post-traumatic stress and related symptoms during pregnancy after a gestational loss. Method The Medline database was consulted. Articles published from 2007 to date were selected. Key words related to the topic of study were used. Results The studies reviewed showed five entities that deserve attention during a pregnancy achieved after a gestational loss: post-traumatic stress, depression, anxiety, relationship, and relationship with the future child. There is a relationship between the presence of post-traumatic stress and the risk of developing depression and anxiety. Discussion and conclusion Women who experience perinatal loss, regardless of the type of loss and the gestational age in which it occurs, are at risk of continuing grief, symptoms of depression, anxiety, and post-traumatic stress in later pregnancy. The gestational age and the time elapsed between the perinatal loss and the next pregnancy seem to be the most influential factors in the development of post-traumatic stress sindrome, and symptoms of dysfunctional grief, anxiety, and depression.

Resumen Antecedentes Alrededor de un 30% de los embarazos concluyen en una pérdida gestacional; de este porcentaje, la mayoría de las mujeres vuelve a quedar embarazada. Sin embargo quienes han experimentado esta situación viven con miedo y ansiedad su nuevo embarazo. Objetivo Realizar una actualización de los principales trabajos realizados en cuanto al estudio del estrés postraumático y los síntomas relacionados con el embarazo posterior a una pérdida gestacional. Método Se consultó la base de datos Medline y se seleccionaron artículos publicados desde 2007 hasta la fecha. Se emplearon palabras clave relacionadas con el tema de estudio. Resultados Los estudios revisados mostraron cinco entidades que merecen atención durante un embarazo experimentado tras una pérdida gestacional: estrés postraumático, depresión, ansiedad, relación de pareja y vínculo con el futuro infante. Se encontró que existe una relación entre la presencia de estrés postraumático y el riesgo de desarrollar depresión y ansiedad. Discusión y conclusión Las mujeres que experimentan pérdida perinatal, independientemente del tipo de pérdida y de la edad gestacional en la que se produce, corren el riesgo de continuar el duelo, los síntomas de depresión, la ansiedad y el estrés postraumático durante el embarazo posterior. La edad gestacional y el tiempo transcurrido entre la pérdida perinatal y el siguiente embarazo parecen ser los factores más influyentes en el desarrollo del síndrome de estrés postraumático, así como de síntomas de duelo disfuncional, ansiedad y depresión.

Does the acromiohumeral distance matter in chronic rotator cuff related shoulder pain?

BACKGROUND/HYPOTHESIS: The relation between acromiohumeral distance (AHD) and severity of pain, disability and range of movement (ROM) in patients with chronic rotator cuff related shoulder pain (RCRSP) has not been reported. OBJECTIVES: The aim of this study was to investigate the level of association between AHD measured by ultrasonography and pain-disability and shoulder range of movement (ROM), in patients suffering from chronic RCRSP. As a secondary objective, the determination of the intrarater reliability of AHD at both 0 and 60 degrees of shoulder elevation was carried out. DESIGN: This was a cross-sectional study. METHOD: A sample comprised of 97 patients with chronic RCSRP symptoms was recruited from three different primary care centres. Acromio-humeral distance (AHD) measured by ultrasonography at 0 and 60 degrees of shoulder elevation, shoulder pain-function (SPADI) and range of movement (ROM) were taken. RESULTS: There was no correlation between AHD at 0° (-0,215), and at 60° (-0,148), with SPADI. No correlations were found with AHD and shoulder ROM at both 0 and 60°. Intrarater reliability was excellent for AHD at 0 and 60°. CONCLUSIONS: There was a small association between AHD and shoulder pain and function, as well as with shoulder ROM, in patients with chronic RCRSP. Hence, clinicians should consider other possibilities rather than focusing their therapies only in increasing AHD when patients with chronic RCRSP are treated.

Vocación ocupacional y género en estudiantes universitarios de ciencias de la salud / Ocupational vocation and gender in health sciences students / Vocação ocupacional e gênero em estudantes do ensino superior de ciências da saúde

El proceso de elección vocacional está conformado por varios elementos, tales como rasgos de personalidad, intereses vocacionales, aptitudes y habilidades. El objetivo de este estudio es conocer la relación entre la vocación y el género en una muestra española de 156 estudiantes de primer curso de las titulaciones de Ciencias de la Salud de Enfermería, Fisioterapia, Podología y Terapia Ocupacional de la Universidad de Málaga. La metodología es cuantitativa y el alcance de esta investigación es descriptivo. El instrumento utilizado fue el cuestionario The Oregon Vocational Interest Scales (Orvis). Los resultados indicaron que hay diferencias significativas en algunas dimensionestrasrealizarla prueba T-Student: Liderazgo (F=6.532; p=0.012), Organización (F=3.818; p=0.05) y Aventura (F=4.211; p=0.029). No obstante, discutimos la necesidad de realizar estudios que contemplen otras variables que puedan influir.

The process of choosing a vocation consists of several elements,such as personality traits, vocational interests, aptitudes and abilities. The aim of this study is toexamine the association between vocation and gender in a sample of 156 first-year Health Sciencesstudents in Spain studying Nursing, Physiotherapy, Podiatry and Occupational Therapy degrees atthe University of Malaga. The methodology used in the study is quantitative and the scope of thisresearch is descriptive. The instrument used by the researchers was the Oregon Vocational InterestScales (ORVIS) questionnaire. The results indicated that significant differences were found in certain dimensions after performing the T-Student test: Leadership (F=6.532; p=0.012), Organization(F=3.818; p=0.05) and Adventure (F=4.211; p=0.029). However, the authors conclude that it isnecessary to study the influence of other variables.

O processo de escolha profissional é composto por vários elementos, tais como traços de personalidade, interesses profissionais, aptidões e habilidades.Este estudo pretende analisar a associação entre o gênero e a vocação numa amostra espanhola de 156 estudantes de Ciências da Saúde do primeiro ano de Enfermagem, Fisioterapia, Podologia e Terapia Ocupacional da Universidade de Málaga .O instrumento utilizado foi o questionário Oregon Vocational Interest Scales (ORVIS). Os resultados mostram que existem diferenças no gênero em algumas dimensões após realizado o teste de T-Student: Liderança (F=6.532; p=0.012), Organização (F=3.818; p=0.05)e Aventura (F=4.211; p=0.029). Não obstante, discutimos a necessidade de realizar estudos que contemplem outras variáveis de influencia.

Contribution Levels of Intrinsic Risk Factors to the Management of Patients with Plantar Heel Pain A Pilot Study.

BACKGROUND: Of all of the lower-extremity injuries with multifactorial causes, heel pain represents the most frequent reason for visits to health-care professionals. Managing patients with heel pain can be very difficult. The purpose of this research was to identify key variables that can influence foot health in patients with heel pain. METHODS: A cross-sectional observational study was performed with 62 participants recruited from the Educational Welfare Unit of the University of Malaga, Malaga, Spain. Therapists, blinded for the study, acquired the anthropometric information and the Foot Posture Index, and participants completed the Foot Health Status Questionnaire. RESULTS: The most significant results reveal that there is a moderate relationship between clinical variables such as footwear and Foot Health Status Questionnaire commands such as Shoe (r = 0.515; P < .001). The most significant model domain was General Health (P < .001), with the highest determination coefficient (beta not standard = 34.05). The most significant predictable variable was body mass index (-0.110). CONCLUSIONS: The variables that can help us manage clinical patients with heel pain are age, body mass index, footwear, and Foot Posture Index (left foot).

Assessment of Foot Self-Care in Patients With Diabetes: Retrospective Assessment (2008-2014).

INTRODUCTION: The purpose of this article is to assess the current status of the relationship between foot self-care and self-examination and the development of complications of diabetes mellitus. METHODOLOGY: A systematic review of articles. We extracted assessments of health habits with regard to educational and training interventions intended for diabetic foot health care. We included clinical trials, meta-analysis, and Cochrane Reviews from 2008 to December 2014. RESULTS: We included 34 articles in this review. The initial number of articles selected was 35, including 12 from PubMed, 12 from Webs of Knowledge, and 4 Cochrane reviews that were considered valid as they complied with the requirements set: they related to interventions reducing foot complications caused by diabetes. CONCLUSION: Strategies aimed at behavioral changes are effective for the metabolic control of the disease and for the reduction of amputations. However, given the current methodology deficit existing in most studies with regard to sample selection and length of the study, it is necessary to validate a reliable tool or measurement to indicate the status of healthy behavior development and to sustain such measures over time. LEVELS OF EVIDENCE: Therapeutic, Level III: Systematic review of level I-III studies.

Development, validation and psychometric analysis of the diabetic foot self-care questionnaire of the University of Malaga, Spain (DFSQ-UMA).

This paper assessed the reliability and construct validity of a tool to evaluate the foot self-care of diabetic patients. The education of diabetic patients about their foot care is a major issue to avoid complications like amputations and ulcers. Specific tools aimed to assess patient's knowledge in this area are needed. The study had two phases: in Phase 1, item-generation was carried out through a literature review, expert review by a Delphi technique and cognitive interviews with diabetic patients for testing readability and comprehension. In Phase 2, diabetic patients participated in a cross-sectional study for a psychometric evaluation (reliability and construct validity) was carried out on a sample of type I and II diabetic patients. The study was conducted at the University of Malaga (Spain), podiatric clinics and a Diabetic Foot Unit between October 2012 and March 2013. After psychometric-test analyses on a sample of 209 diabetic patients, the questionnaire resulted in 16 questions. Cronbach's alpha was 0.89 after removing 4 items because of their low reliability. Inter-item correlations gave a mean value of 0.34 (range: 0.06-0.74). The rotated solution showed a 3-factor structure (self-care, foot care, and footwear and socks) that jointly accounted for 60.88% of the variance observed. The correlation between the questionnaire scores and HbA1c was significant and inverse, (r = -0.15; p < 0.01). The findings show that the questionnaire is a valid and reliable tool for evaluating foot self-care behavior in diabetic patients.

Estudio de los estresores en los prácticum de grado en enfermería / Study on the stressors experienced by nursing students in clinical practice

El objetivo es conocer los estresores presentes en la realización de las prácticas clínicas y su relación con las variables sociodemográficas de los estudiantes de Enfermería. Se realizó un estudio observacional, correlacional. Se utilizó un cuestionario en línea que contenía once ítems con las variables sociodemográficas y académicas y el instrumento Kezkak para conocer los estresores de las prácticas clínicas. La población estudiada eran los estudiantes matriculados en los prácticum I, II y III de la carrera de Grado en Enfermería en la Universidad de Málaga, durante el curso académico 2011-2012. La muestra estuvo integrada por 229 alumnos. La puntuación global del cuestionario Kezkak nos informa de que los estudiantes percibieron bastante estrés. Los resultados informan de que las dimensiones que más estrés causan a los estudiantes en prácticas son: Falta de competencia; Impotencia e incertidumbre; Dañarse en la relación con el enfermo (AU)

The aim of this paper is to identify the stressors involved in the performance of the clinical practice and its relation with the variables. For the purpose of this study, it was carried out an observational study showing correlations. For the aim of this study it was used a questionnaire on-line including eleven items with the socio-demographic and educational variables. Likewise, the method Kezkak was applied to measure nursing students’ stressors in clinical practice. The study population gathered the nursing students enrolled in the subject clinical practice I, II and III, part of the course of study required for achieving the Official Nursing Degree of the University of Malaga during the academic period 2011-2012. The population of study included 229 students. The overall score of the Kezkak questionnaire evidences that the students felt quite stressed during the clinical practice. The results show that among the reasons causing the stress, there are few of them which are perceived by students to be the most stressful, including: the lack of ability, uncertainty and helplessness feelings and the concern to be hurt within the relation with the patient within the clinical practice (AU)