Conservative Interventions for mobile Pes Planus in Adults: a systematic review

Antecedentes. Pes Adulto planus (pie plano) es un problema común encontrado por muchos profesionales de la salud. A pesar de la percepción de que el pie plano puede causar dolor y deteriorar su función, la disponibilidad y el uso generalizado de diversos tratamientos, no hay consenso sobre la estrategia óptima de tratamiento. Objetivo. Evaluar la efectividad de las intervenciones conservadoras (no quirúrgicos) para pie plano en los adultos. Método. Se realizó una búsqueda sistemática de la literatura. Esto incluye: el Registro Cochrane Central de Ensayos Controlados; los Juicios CMSG Especializados Registro; una búsqueda electrónica se realizó utilizando MEDLINE (1960 a junio de 2012), EMBASE (1980 a junio de 2012), y CINAHL (1982 - junio de 2012). Revistas especializadas, listas de referencias de ensayos y artículos de revisión se realizaron búsquedas manuales. Criterios de selección: Ensayos aleatorios o cuasialeatorios de intervenciones de tratamiento para el pie plano en los adultos. Se excluyeron los ensayos que incluyeron patologías específicas como el dolor plantar del talón, las fracturas por sobrecarga de los metatarsianos, disfunción del tendón tibial posterior-, fracturas de tobillo, patologías del pie reumatoide, enfermedades neuromusculares y las complicaciones del pie diabético. Recopilación y análisis de datos: Dos autores seleccionaron de forma independiente los resultados de la búsqueda para identificar a aquellos que satisfacen los criterios de inclusión y evaluaron la calidad de los incluidos mediante una lista de control basado en la Evaluación de la Colaboración Cochrane de Riesgo. Esta herramienta se centró en el riesgo de la selección, el rendimiento, la detección, la heterogeneidad y el sesgo de notificación. Resultados. Cuatro ensayos, con 140 sujetos, cumplieron los criterios de inclusión para la revisión. Los cuatro fueron juzgados como de alto riesgo de sesgo en al menos un área, y también estaban en riesgo de sesgo incierto en al menos otra zona. Todos anotaron altamente en relación al sesgo de deserción, debido al corto seguimiento tiempos y diseños experimentales utilizados. Los datos no se agruparon debido al alto nivel de heterogeneidad identificada en las intervenciones evaluadas, los participantes seleccionados y medir los resultados. Los resultados de un estudio sugieren que después de cuatro semanas de uso ortesis puede resultar en una mejora significativa en vaivén lateral medio, y pueden resultar en una mejor, aunque no significativa, en general relacionados con la calidad de vida de los pies (Roma 2004). Un estudio (Redmond 2009) sugiere que su efecto sobre la distribución de la presión plantar en el pie puede no depender de si son personalizados o dispositivos prefabricados. Aunque este estudio se identificaron cambios significativos en algunas variables de presión plantar tanto con la costumbre y dispositivos prefabricados, otro (Esterman 2005) no encontró ningún efecto significativo de longitud ¾ ortesis prefabricadas sobre el dolor, la incidencia de lesiones, salud pie o de calidad de vida en un grupo de reclutas de la fuerza aérea. El cuarto estudio (Jung 2009) sugiere que el ejercicio de los músculos intrínsecos del pie puede mejorar el efecto de las ortesis. A pesar de estos resultados, ya que cada estudio incurrió riesgo de sesgo en al menos un área no se pueden sacar conclusiones

El apoyo a la investigación en las bibliotecas universitarias españolas

Los cambios sufridos por los modelos de comunicación científica hacen que las bibliotecas universitarias se vean obligadas a dar nuevos servicios. Para adecuarse al investigador los bibliotecarios están desarrollando habilidades, colaborando con cada vez más estamentos y sustentando el acceso abierto. Apoyándose en una lista de posibles servicios, basada en la literatura especializada, este trabajo pretende cuantificar y evaluar el apoyo a la investigación desde las bibliotecas universitarias españolas. El sondeo demuestra la aparición de nuevos servicios e infraestructuras. Pero estas asistencias no suelen sistematizarse, difundirse ni evaluarse. Y, por otra parte, las consecuentes inversiones en personal y TIC han generado una brecha entre universidades

The origins of the control of information in war coverage

The conflict’s coverage, since its inception, has been closely linked to the relationship that both the military and the media have. The freedom they maintained during their first conflicts, although not without problems, though they suffered strict censorship suffered during World War I, and lastly the straitjacket treatment that they have endured during recent wars. The Vietnam War marked a turning point in this relationship, and after the invasion of Grenada, the military would launch new information guidelines, called Department of Defense National Media Pool. The lack of clear guidance of both control and space, has made for a complicated relationship between media and military, so the rules have evolved after every conflict shaping the future of press coverage and thus, war reporting.

Determining factors of the innovative behavior of cooperatives: an analysis of the case of Castilla y León

Cooperatives have a long historical experience in the Spanish economy and have demonstrated their ability to compete against traditional firms in the market. To maintain this capability, while taking advantage of the competitive advantages associated with their idiosyncrasies as social economy enterprises, they should take into consideration that the economy is increasingly globalized and increasingly knowledge-based, especially with regards to technological content. As a consequence, the innovative capacity appears to be a key aspect in order to be able to challenge competitors. This article characterizes the innovative behavior of cooperatives in the region of Castile and Leon and analyses the internal and external factors affecting their innovative performance, based on data from a survey of 581 cooperatives. The results of the empirical analysis, which is performed by multivariate binary logistic regression on various types of innovation, lead us to identify the size of the organizations, the existence of planning, the R & D activities and the human capital as the main determining factors.

How teachers of Geography and History of Secondary Education assess?

The purpose of this article is to analyse the assessment procedures and instruments used by teachers of Geography and History of Compulsory Secondary School (ESO) in the Region of Murcia (Spain). The data have been extracted implementing a survey technique proceeded by a descriptive analysis. The results show that teachers generally have a traditional conception of assessment, reflected in the fact that they think that assessment should not change when teaching strategies are changed or when they innovate. On the other hand, although they consider that is necessary to employ a variety of instruments to assess well and to prevent school failure, they still use exams as the most objective and essential instrument in the assessment, while they don’t apply continuous assessment, only tests in a continuous way. The implementation of similar research in other areas or in other subjects shows the existence of contrasts in teacher assessment practices.

¡Abre los ojos! Un proyecto de mejora educativa para la prevención de drogas en adolescentes

La Educación para la Salud (EpS) es un tema transversal del currículo que adolece de propuestas didácticas novedosas para la intervención pedagógica. El objetivo del trabajo que se presenta es poner en marcha un plan de mejora para la prevención de drogadicciones en adolescentes. Para ello, se ha trabajado con un total de 142 estudiantes de 3º de Educación Secundaria Obligatoria (ESO) con edades comprendidas entre los 14 y los 16 años que cursan estudios en el Instituto “Francisco Salzillo” de la localidad de Alcantarilla (Murcia). Concretamente, este artículo da luz al Proyecto ¡Abre los ojos!, que forma parte del Plan de Acción Tutorial (PAT) y del Plan de Mejora para la Prevención de Drogas (PMPD) propuesto desde el Departamento de Orientación. Se exponen ad hoc las actividades implementadas durante las 3 sesiones trabajadas con cada uno de los 6 grupos-clase escolarizados en este nivel. Haciendo uso de la reflexión-acción, el alumnado ha desarrollado una conciencia crítica acerca de los riesgos que entraña para la salud el consumo de drogas. Asimismo, mediante la técnica de grupos de discusión los discentes han realizado un interesante debate cuyas ideas han sido organizadas en torno a tres aspectos clave: causas por las que se empieza a consumir, cómo evitar caer en las drogas, y alternativas de ocio y tiempo libre para una vida saludable. Finalmente, se especifica la necesidad de abordar tareas de prevención en los centros educativos así como de facilitar información y de resolver las inquietudes de los jóvenes acerca de esta temática.

Let your feet do the walking: constraints on the stability of bipedal coordination

In this paper we consider whether the behaviour of the neural circuitry that controls lower limb movements in humans is shaped primarily by the spatiotemporal characteristics of bipedal gait patterns, or by selective pressures that are sensitive to considerations of balance and energetics. During the course of normal locomotion, the full dynamics of the neural circuitry are masked by the inertial properties of the limbs. In the present study, participants executed bipedal movements in conditions in which their feet were either unloaded or subject to additional inertial loads. Two patterns of rhythmic coordination were examined. In the in-phase mode, participants were required to flex their ankles and extend their ankles in synchrony. In the out-of-phase mode, the participants flexed one ankle while extending the other and vice versa. The frequency of movement was increased systematically throughout each experimental trial. All participants were able to maintain both the in-phase and the out-of-phase mode of coordination, to the point at which they could no longer increase their frequency of movement. Transitions between the two modes were not observed, and the stability of the out-of-phase and in-phase modes of coordination was equivalent at all movement frequencies. These findings indicate that, in humans, the behaviour of the neural circuitry underlying coordinated movements of the lower limbs is not constrained strongly by the spatiotemporal symmetries of bipedal gait patterns.

Rubén Darío's new unpublished and unknown documents: on La "Isla de Oro", the "Poema del Otoño" and the years of "Mundial"

This article studies and reproduces a group of documents that includes some hand-written and typed texts most likely authored by Rubén Darío, along with others where Darío’s authorship can be easily contested. These documents seem to have originated during the years of Mundial Magazine (1912-1914), and besides the interest for their probably unpublished nature, they also show the cooperation between Darío and his collaborators in the preparation of his original manuscripts right before being sent to the publishers.

Redescubrir la dinámica escultórica desde el trabajo en grupo

La iniciativa que se describe en este artículo, surge de una propuesta de investigación plástica, que se inició espontáneamente en el seno de una asignatura de escultura en la Facultad de Bellas Artes del CES Felipe II-UCM, y que tuvo como principal objetivo explorar nuevos modos de enseñanza artística desde la dinámica creativa en sí misma, con el fin de motivar el aprendizaje desde la participación directa en propuestas creativas que se apoyen en métodos de intervención crítica y que exploren las ventajas de las dinámicas interdisciplinares para complementar las eficacias de los ejercicios individuales, y así poder generar un aprendizaje desde dinámicas de trabajo en grupo. Para ello, hemos puesto en marcha procesos de trabajo cooperativo valorando sobre todo la experiencia directa, ofreciendo a los estudiantes contribuir en la actividad, tomar decisiones, lo que les permite aportar ideas, puntos de vista y opiniones sobre la combinación de nuevas tecnologías y técnicas tradicionales de la escultura, usados en proyectos artísticos actuales.

Wear paths produced by individual hip-replacement patients— A large-scale, long-term follow-up study

Wear particle accumulation is one of the main contributors to osteolysis and implant failure in hip replacements. Altered kinematics produce significant differences in wear rates of hip replacements in simulator studies due to varying degrees of multidirectional motion. Gait analysis data from 153 hip-replacement patients 10-years post-operation were used to model two- and three-dimensional wear paths for each patient. Wear paths were quantified in two dimensions using aspect ratios and in three dimensions using the surface areas of the wear paths, with wear-path surface area correlating poorly with aspect ratio. The average aspect ratio of the patients wear paths was 3.97 (standard deviation ¼ 1.38), ranging from 2.13 to 10.86. Sixty percent of patients displayed aspect ratios between 2.50 and 3.99. However, 13% of patients displayed wear paths with aspect ratios 45.5, which indicates reduced multidirectional motion. The majority of total hip replacement (THR) patients display gait kinematics which produce multidirectional wear paths, but a significant minority display more linear paths.

The influence of wear paths produced by hip replacement patients during normal walking on wear rates

Variation in wear paths is known to greatly affect wear rates in vitro, with multidirectional paths producing much greater wear than unidirectional paths. This study investigated the relationship between multidirectional motion at the hip joint, as measured by aspect ratio, sliding distance, and wear rate for 164 hip replacements. Kinematic input from three-dimensional gait analysis was used to determine the wear paths. Activity cycles were determined for a subgroup of 100 patients using a pedometer study, and the relationship between annual sliding distance and wear rate was analyzed. Poor correlations were found between both aspect ratio and sliding distance and wear rate for the larger group and between annual sliding distance and wear rate for the subgroup. However, patients who experienced a wear rate <0.08 mm/year showed a strong positive correlation between the combination of sliding distance, activity levels, and aspect ratio and wear rate (adjusted r2?=?55.4%). This group may represent those patients who experience conditions that most closely match those that prevail in simulator and laboratory tests. Although the shape of wear paths, their sliding distance, and the number of articulation cycles at the hip joint affect wear rates in simulator studies, this relationship was not seen in this clinical study. Other factors such as lubrication, loading conditions and roughness of the femoral head may influence the wear rate.

Assessing and training standing balance in older adults: A novel approach using the 'Nintendo Wii' Balance Board

Older adults, deemed to be at a high risk of falling, are often unable to participate in dynamic exercises due to physical constraints and/or a fear of falling. Using the Nintendo 'Wii Balance Board' (WBB) (Nintendo, Kyoto, Japan), we have developed an interface that allows a user to accurately calculate a participant's centre of pressure (COP) and incorporate it into a virtual environment to create bespoke diagnostic or training programmes that exploit real-time visual feedback of current COP position. This platform allows researchers to design, control and validate tasks that both train and test balance function. This technology provides a safe, adaptable and low-cost balance training/testing solution for older adults, particularly those at high-risk of falling.

Cement mantle fatigue failure in total hip replacement: Experimental and computational testing

One possible loosening mechanism of the femoral component in total hip replacement is fatigue cracking of the cement mantle. A computational method capable of simulating this process may therefore be a useful tool in the preclinical evaluation of prospective implants. In this study, we investigated the ability of a computational method to predict fatigue cracking in experimental models of the implanted femur construct. Experimental specimens were fabricated such that cement mantle visualisation was possible throughout the test. Two different implant surface finishes were considered: grit blasted and polished. Loading was applied to represent level gait for two million cycles. Computational (finite element) models were generated to the same geometry as the experimental specimens, with residual stress and porosity simulated in the cement mantle. Cement fatigue and creep were modelled over a simulated two million cycles. For the polished stem surface finish, the predicted fracture locations in the finite element models closely matched those on the experimental specimens, and the recorded stem displacements were also comparable. For the grit blasted stem surface finish, no cement mantle fractures were predicted by the computational method, which was again in agreement with the experimental results. It was concluded that the computational method was capable of predicting cement mantle fracture and subsequent stem displacement for the structure considered. (C) 2006 Elsevier Ltd. All rights reserved.

The Structural and Molecular Biology of Type I Galactosemia: Enzymology of Galactose 1-phosphate Uridylyltransferase

Reduced galactose 1-phosphate uridylyltransferase (GAIT) activity is associated with the genetic disease type 1 galactosemia. This results in an increase in the cellular concentration of galactose 1-phosphate. The accumulation of this toxic metabolite, combined with aberrant glycoprotein and glycolipid biosynthesis, is likely to be the major factor in molecular pathology. The mechanism of GAIT was established through classical enzymological methods to be a substituted enzyme in which the reaction with UDP-glucose results in the formation of a covalent, UMP-histidine adduct in the active site. The uridylated enzyme can then react with galactose 1-phosphate to form UDP-galactose. The structure of the enzyme from Escherichia coli reveals a homodimer containing one zinc (II) and one iron (11) ion per subunit. This enzymological and structural knowledge provides the basis for understanding the biochemistry of this critical step in the Leloir pathway. However, a high-resolution crystal structure of human GAIT is required to assist greater understanding of the effects of disease-associated mutations. (C) 2011 IUBMB IUBMB Life, 63(9): 694-700, 2011