Artículos

Permanent URI for this collectionhttps://docta.ucm.es/handle/20.500.14352/15

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Diagnostic accuracy of neurodynamic tests in upper-limb entrapment neuropathies: a systematic review and meta-analysis.
(Musculoskeletal science and practice, 2025) Albert Lucena, Daniel; Navarro Santana, Marcos José; Díaz Arribas, María José; Rabanal Rodríguez, Gabriel; Valera Calero, Juan Antonio; Fernández de las Peñas, Cesar; Cook, Chad; Plaza Manzano, Gustavo
Objective: To estimate the screening performances of the most important provocation tests for diagnosing carpal tunnel syndrome (CTS). Design: Diagnostic test accuracy systematic review with meta-analysis. Literature search: We systematically searched the MEDLINE, Scopus, Web of Science, and Cochrane databases from inception to November 2020. Study selection criteria: Observational studies comparing the accuracies of the Durkan test (DT), the hand elevation test (HET), the Phalen test (PT), the Tinel test (TT), and the upper-limb neurodynamic test specific to the median nerve (ULNT1) with electrodiagnosis for screening for CTS. Data synthesis: Random-effects models for the diagnostic odds ratio (dOR) values computed by Moses' constant for a linear model and 95% confidence intervals (CIs) were used to calculate the accuracy of these tests. Hierarchical summary receiver operating characteristic curve analyses were used to summarize the overall test performance. Results: Thirty-seven studies were included in the meta-analysis, with a total sample of 2662 wrists for DT, 864 wrists for HET, 6361 wrists for PT, 6094 wrists for TT, and 571 wrists for ULNT1. The pooled dORs for screening for CTS were 15.84 (95% CI: 3.78, 66.38) for DT, 128.63 (95% CI: 40.64, 407.12) for HET, 7.23 (95% CI: 4.06, 12.86) for PT, 5.31 (95% CI: 3.49, 8.09) for TT, and 1.78 (95% CI: 0.61, 5.19) for ULNT1. Conclusion: HET has the best clinical performance for detecting CTS and should be considered the first screening test of choice during the physical examination. The most common tests (DT, PT, and TT) have good accuracies for screening for CTS. J Orthop Sports Phys Ther 2022;52(8):522-531. Epub: 19 June 2022. doi:10.2519/jospt.2022.10828.
Intrinsic optical response of levitating upconverting single particles
(ACS Photonics, 2025) Martínez Maestro, Laura; Antón Revilla, Miguel Ángel; Cabrera Granado, Eduardo; Weigand Talavera, Rosa María; Hernández Rueda, Francisco Javier
Today, upconverting luminescent particles are routinely used as accurate and reliable probes to remotely measure the temperature of minute volumes of matter in the order of attoliters. Lanthanide-doped particles exhibit adaptability as optical nanothermometers within biological systems, aiding to understand cellular dynamics, pathology, and physiology. Herein, we investigate the intrinsic optical response of Er/Yb-doped single particles levitating in vacuum and compare it with the collective response of ensembles of particles embedded in application-relevant wet and dry environments. We make use of a quadrupole Paul trap that employs a time-varying electric field to confine single Er/Yb-doped particles in vacuum and a thermal bath module to study particles in the above-mentioned environments. Both sub-systems use twin-excitation/detection setups that allow us to record luminescence spectra, covering four orders of magnitude in laser intensity (e.g. 10−1-103 W/cm2 at 980 nm) and temperatures from 20◦C up to 200◦C. We revisit the well-established reliability of ratiometric measurements to accurately measure temperature. We find an almost perfect overlap of the experimental Boltzmann factor as a function of temperature for water, ethanol and air-substrate environments, which is then used to retrieve the temperature of particles levitating in vacuum. We also explore the influence of the surrounding environment for increasing laser intensities by numerically and experimentally examining the balance among relevant emission bands. Our simulations qualitatively reproduce the experimentally measured luminescence in different environments, yielding a single model to simultaneously explain the laser intensity dependence of UV-NIR transitions for both the low and strong laser excitation regimes. Our findings hold great potential to expand the range of applicability of upconverting particles as dual sensors of temperature and laser intensity in different media relevant to biological and nanophotonic applications.
Association among clinical severity indicators, psychological health status and elastic properties of neck muscles in patients with chronic mechanical neck pain.
(European Spine Journal, 2025) Valera Calero, Juan Antonio; Varol, Ulmut; López redondo, Mónica; Díaz Arribas, María José; Navarro Santana, Marcos José; Plaza Manzano, Gustavo
Background: Since objective stifness measures are not consistent with the patients' perception and its correlation with the clinical severity of neck pain is not clear, novel studies assessing the clinical relevance of muscle stiffness are needed. Objectives: To analyze the correlation among psychological factors, clinical severity indicators, and muscle stiffness in neck muscles in patients with chronic mechanical neck pain, and compare these factors with asymptomatic controls. Methods: A cross-sectional observational study was conducted. Participants included cases with chronic neck pain and asymptomatic controls, assessed for muscle stiffness using shear wave elastography, psychological health (anxiety and kinesiophobia), and clinical severity. Data analysis involved correlation matrices and comparison between groups. Results: Although no significant differences in levator scapulae stiffness were observed between groups (p > 0.05), patients exhibited significantly increased stiffness in the anterior scalene and cervical multifidus muscles (p = 0.009 and p = 0.040, respectively). STAI scores were significantly higher in patients for both subscales (STAI-S p = 0.002 and STAI-T p < 0.001), but no kinesiophobic behaviors differences were found (p > 0.05). Significant correlations between pain chronicity, intensity, disability, and psychological factors were confirmed. Notably, the levator scapulae stiffness was positively associated with disability, anxiety, and kinesiophobia (all p < 0.01). However, the anterior scalene and cervical multifidus stiffness, even if significantly associated with demographic factors (p < 0.05), were not associated with clinical or psychological outcomes. Conclusion: The findings underscore the intertwined nature of psychological factors and muscle stiffness in chronic neck pain, suggesting the need for integrated approaches in treatment that consider both physical and psychological dimensions.
Intervenciones enfermeras para pacientes con trastorno por consumo de sustancias: una revisión sistemática
(Enfermería Clínica, 2024) Lucas Guerra, Clara; González Ordi, Héctor; Gallego Lastra, Ramón Del
Objetivo Analizar la evidencia actual disponible sobre intervenciones no farmacológicas para aumentar el tiempo de abstinencia de pacientes con trastorno por consumo de sustancias. Método se ha realizado una revisión sistemática de ensayos clínicos aleatorizados con grupo control donde se lleve a cabo una intervención no farmacológica en la que haya participación enfermera. La búsqueda fue realizada en Pubmed, CINAHL, Web of Science, Scopus y Cochrane. Se seleccionaron ensayos clínicos aleatorizados con grupo control publicados entre 2018 y 2023. Resultados Se seleccionaron 15 artículos. Se observó mayor tiempo de abstinencia en las intervenciones que planteaban un seguimiento telemático personalizado con un sanitario, el establecimiento de la figura del coordinador de cuidados o recompensas económicas en función del tiempo de abstinencia. No se observaron diferencias significativas en la abstinencia en estudios que planteaban educación para la salud (EPS) o técnicas de relajación únicamente. No obstante, las técnicas de relajación combinadas con otras intervenciones sí podrían ser efectivas. Conclusiones Las intervenciones identificadas pueden ser incorporadas a la práctica enfermera. Presentan resultados esperanzadores, aunque sería recomendable estudiar su efectividad a largo plazo.
Shear-wave elastography for measuring the stiffness of latent trigger points and surrounding areas in the infraspinatus muscle: intra- and inter-examiner reliability analysis.
(Archives of physical medicine and rehabilitation, 2025) Kobylarz, Mateusz D; Valera Calero, Juan Antonio; Sánchez Jorge, Sandra; Buffet García, Jorge; Díaz Arribas, María José; Ortega Santiago, Ricardo; Klich, Sebastian
Objective: To explore the intra- and inter-examiner reliability of shear-wave elastograhy (SWE), (an objective alternative to highly subjective procedures with poor inter-rater reliability such as manual palpation) in measuring the stiffness of latent Myofascial trigger points (MTrPs) and healthy surrounding areas in the infraspinatus muscle, pressure pain threshold (PPT), inter-examiner reliability and mean differences in SWE and PPTs between MTrPs and control points DESIGN: Longitudinal observational study: Intra- and inter-examiner reliability study. Setting: A University lab. Participants: Forty participants with latent MTrPs within the infraspinatus muscle. Interventions: None. Main outcome measures: One experienced examiner identified and classified latent MTrPs and selected an asymptomatic control point within the infraspinatus muscle. Later, 2 blinded examiners assessed once the PPTs (blinded to the scores) and acquired 2 SWE images of each location. Reliability estimates were calculated for assessing PPT inter-examiner reliability and SWE intra- and inter-examiner reliability. PPT and SWE scores were compared by location (MTrP and control) and gender (male/female). Results: PPTs were significantly lower in MTrPs compared with control points in males (p=0.003) and females (p=0.006), and lower in females compared with males (MTrP p<0.001; control point p=0.001). Good inter-examiner reliability was found for PPTs (ICC>0.84) and SWE (ICC>0.82). Intra-examiner reliability for SWE was excellent (ICC>0.95) in both the novice and experienced examiners. Conclusion: This study demonstrated excellent SWE intra-examiner reliability (ICCs>0.9) and good inter-examiner reliability (ICCs>0.82). Although PPT scores indicated significant differences in hyperirritability between latent MTrPs and control points, SWE measurements revealed no significant differences in muscle stiffness.
BINOL blocks as accessible triplet state modulators in BODIPY dyes
(Chemical Communications, 2022) Jiménez, Josué; Prieto Montero, Ruth; Serrano, Sergio; Stachelek, Patrycja; Rebollar, Esther; Lora Maroto, Beatriz; Moreno Jiménez, Florencio; Martinez Martinez, Virginia; Pal, Robert; García Moreno, Inmaculada; Moya Cerero, Santiago de la
Testing root trenching and stem girdling as silvicultural treatments in abandoned oak coppices
(Forest Ecology and Management, 2024) Salomón, Roberto L.; Miranda, José Carlos; Rubio Cuadrado, Álvaro; Sobrino Plata, Juan; Rodríguez Calcerrada, Jesús; López, Rosana; Gil, Luis; Valbuena Carabaña, María
Widespread tree growth decline and absence of acorn production are observed in formerly coppiced Quercus pyrenaica stands. Attempts to convert oak coppices into high forests by thinning have failed to date, possibly due to the massive root system developed by trees after centuries of coppicing. We tested root trenching and stem girdling as silvicultural treatments to mitigate this hypothetical root-to-shoot imbalance and enhance the physiological performance of multi-stemmed clonal trees. We expected that severing the roots within a clone by trenching would reduce root respiratory carbon losses. Alternatively, stem girdling would increase carbon availability above the girdled zone, whilst the communal root system is maintained by non-girdled stems. After clonal structure delineation in a one-hectare experimental plot, root trenching and stem girdling were applied to stems belonging to different clones. Twig hydraulic traits, leaf water potential, non-structural carbohydrates (NSC) concentration in twigs, stems and roots, stem xylem [CO2] as an indicator of root respiration, stem growth, and acorn production were discretely monitored up to 12 years after treatment application for comparison with control stems. Stem girdling led to short-term enhancements in NSC pools above the girdled zone. However, hydraulic dysfunction symptoms and canopy dieback were observed four years after girdling, eventually causing mortality. Root trenching initially increased root respiration and reduced stem growth without an apparent decline in the hydraulic function and NSC pools above-ground. Ten years after trenching, stem [NSC] increased while stem growth limitations diminished. Although not statistically significant, slight enhancements in acorn production were observed 6 and 12 years after trenching. We discourage stem girdling as a silvicultural practice to mitigate a root-to-shoot imbalance in abandoned oak coppices, as long-term detrimental effects outweighed potential benefits. Root trenching enhanced tree NSC above ground. However, such improvement may not offset the potential costs of root trenching.
Crystallization of manganese(V) oxides by hydroflux synthesis:control of anisotropic growth and electrochemical stability
(Inorganic Chemistry, 2025) Inocêncio, Carlos; Torres Pardo, María De La Almudena; Montero, David; Roach, Lucien; Autran, Pierre Olivier; Sassoye, Capucine; Aymonier, Cyril; Varela Losada, María Áurea; Parras Vázquez, Marina Marta; Laberty Robert, Christel; Portehault, David
Despite intriguing optical, magnetic, and redox properties, inorganic materials containing pentavalent manganese (MnV) are rare and could never be designed as shape-controlled crystals, which limits the ability to tune properties. Herein, we explore alkali hydroxide mixtures with controlled water content, namely, hydrofluxes, to demonstrate phase, shape, and nanostructure control of Mn(V) oxides. We demonstrate speciation amongKSrMnVO4, Sr5(MnVO4)3OH, and SrMnIVO3 with the water and strontium content and the nature of the alkali cation of the hydroxide salt. We then provide evidence of the key role of water in enabling shape and nanostructure control, which we relate to thepreferential interaction of water with specific crystal facets of the hydroxyapatite Sr5(MnVO4)3OH, and to the impact of water on precursor solubility in water-poor hydrofluxes. We then show that nanostructured Mn(V) hydroxyapatite possesses an acid−base redox stability window, enabling electrochemical operation in strongly oxidative conditions. By correlating the fundamental knowledge of hydrofluxes with crystallization mechanisms, this work sheds light on the possibilities offered by hydrofluxes for crystalshape, size, and property control.
Current state of dry needling practices: a comprehensive analysis on use, training, and safety.
(Medicina (Kaunas), 2024) Valera Calero, Juan Antonio; Plaza Manzano, Gustavo; Rabanal Rodríguez, Gabriel; Díaz Arribas, María José; Fernández de las Peñas, Cesar; Navarro Santana, Marcos José
Background and Objectives: Dry needling (DN) is a technique that involves inserting a thin filament needle through the skin to target myofascial trigger points for the treatment of musculoskeletal pain and dysfunction. Despite its efficacy in a broad plethora of musculoskeletal pain conditions, its safety remains a topic of debate among clinicians and researchers. The aim of this study was to provide an overview of the current practice of DN through a national survey, focusing on the frequency of its use and the incidence of adverse events (AEs), considering factors including physiotherapist experience, clinical workload, the extent of training received by practitioners, and the use of ultrasound guidance. Materials and Methods: An online cross-sectional survey was conducted. Respondents were licensed physical therapists (PTs) working in Spain. The survey covered demographics, professional data, frequency of adverse effects, and if they use ultrasound routinary for guiding interventions. Results: A total of 422 PTs participated in the study, mostly having 21–60 h of DN training (38.6%), less than 2 years of experience (36%), and not using ultrasound during the interventions (85.5%). Post-needling soreness and bent needles were the most common AEs, with most severe events rarely reported. Adverse event frequencies varied significantly based on training hours, experience, patient percentage treated with DN, and weekly clinical dedication. Clinicians with more hours of DN training or fewer years of experience reported higher incidences of certain complications. Conclusions: DN is a common intervention among PTs, with minor AEs frequently occurring and major AEs being less common but still significant. The accidental puncture of non-desired structures highlights the necessity for improving training on anatomical landmarks, needle insertion depth, cross-sectional anatomy education, and patient monitoring. To ensure safe practice, emphasize comprehensive training, adhere to safety protocols, exercise caution, and prioritize the use of ultrasound-guide is encouraged.
Effect of physical activity on tissue perfusion in patients with diabetes mellitus: Systematic review and meta-analysis
(Journal of Tissue Viability, 2023) Palacios Abril, Laura; Tardaguila García, Aroa; Álvaro Afonso, Francisco Javier; García Oreja, Sara; Ejeda Ramírez, Sol; Lázaro Martínez, José Luis
The objective of this systematic review and meta-analysis is to identify and assess the literature exploring the impact of physical activity on enhancing tissue perfusion in the feet of patients with diabetes mellitus (DM). Materials and methods: All the selected studies were evaluated using the Cochrane risk of bias tool, to assess the risk of bias for randomized controlled trials. A thorough search was conducted in April 2024 through PubMed and Web of Science to identify randomized clinical trials (RCTs) and comparative studies that assessed the effect of physical activity enhancing tissue perfusion. Data analysis was performed using RevMan v5.4., employing the Mantel-Haenszel method for dichotomous outcomes. Results: A total of nine studies compared changes in microcirculation before and after physical exercise in patients with DM. A meta-analysis of the data collected from seven studies estimated a mean difference of 4.87 (95 % CI 2.37-7.38) favouring the improvement of microvascular parameters post-exercise, with a minor level of heterogeneity (x2 = 10.54, df = 6, p = 0.1, I2 = 43 %) and a statistically significant difference between the two groups (p ≤ 0.001). However, a second evaluation, which included four studies involving patients with and without DM, indicated high heterogeneity (x2 = 661.32, df = 3, p ≤ 0.00001, I2 = 100 %) with no observable statistically significant differences between the two groups (p = 0.62). Conclusion: Physical activity in patients with DM may be effective in improving blood microcirculation in the lower limbs.
Optical response of levitating upconverting single particles
(ACS Photonics, 2025) Martínez Maestro, Laura; Antón Revilla, Miguel Ángel; Cabrera Granado, Eduardo; Weigand Talavera, Rosa María; Hernández Rueda, Francisco Javier
Today, upconverting luminescent particles are routinely used as accurate and reliable probes to remotely measure the temperature of minute volumes of matter in the order of attoliters. Lanthanide-doped particles exhibit adaptability as optical nanothermometers within biological systems, aiding to understand cellular dynamics, pathology, and physiology. Herein, we investigate the intrinsic optical response of Er/Yb-doped single particles levitating in vacuum and compare it with the collective response of ensembles of particles embedded in application-relevant wet and dry environments. We make use of a quadrupole Paul trap that employs a time-varying electric field to confine single Er/Yb-doped particles in vacuum and a thermal bath module to study particles in the above-mentioned environments. Both sub-systems use twin-excitation/detection setups that allow us to record luminescence spectra, covering four orders of magnitude in laser intensity (e.g. 10−1-103 W/cm2 at 980 nm) and temperatures from 20◦C up to 200◦C. We revisit the well-established reliability of ratiometric measurements to accurately measure temperature. We find an almost perfect overlap of the experimental Boltzmann factor as a function of temperature for water, ethanol and air-substrate environments, which is then used to retrieve the temperature of particles levitating in vacuum. We also explore the influence of the surrounding environment for increasing laser intensities by numerically and experimentally examining the balance among relevant emission bands. Our simulations qualitatively reproduce the experimentally measured luminescence in different environments, yielding a single model to simultaneously explain the laser intensity dependence of UV-NIR transitions for both the low and strong laser excitation regimes. Our findings hold great potential to expand the range of applicability of upconverting particles as dual sensors of temperature and laser intensity in different media relevant to biological and nanophotonic applications.
Non-alcoholic beverage and fast-food consumption, among first- and fourth-year nursing students in Madrid
(Archivos Latinoamericanos de Nutricion, 2022) Ortuño Soriano, Ismael; Zaragoza García, Ignacio; Becerro De Bengoa Vallejo, Ricardo; Losa Iglesias, Marta Elena; López Herranz, Marta; Posada Moreno, María Paloma
Introduction. Sugar-sweetened beverages and fast-food consumption have been associated with non-communicable diseases. Objective. Was to analyze consumption of non-alcoholic beverage and fast-food consumption among first- and fourth-year nursing students. Materials and methods. A questionnaire-based survey was conducted among first-and fourth-year nursing students in Madrid, Spain. Anthropometric data (weight and height) and demographic data were collected, as were data on consumption of specific foods and beverages. Results. The survey was completed by 436 students. Mean (SD) age was 22.0 (6.8) years, 84.1 % of were women.26.2 % of the students were underweight; 6.3 % were overweight. Consumption of sugar-sweetened beverages and diet drinks was moderate. Slightly more than three-quarters of the students (75.5 %) purchased fast food in the previous month. Burger bars were the most frequently visited fast-food outlet (77.2 %). A direct relationship was observed between BMI and fast-food consumption (rho = 0.099; p = 0.042) and between BMI and consumption of diet cola or carbonated drinks (rho = 0.120; p = 0.013). Conclusion. We provide new epidemiological data from a specific university population that could be useful to promote more studies that help design appropriate strategies to increase a healthy lifestyle.
Wetland responses to non-stationary hydro-climatic dynamics in the context of land cover and land use change
(Remote Sensing Applications: Society and Environment, 2024) Aquino, Diego Sebastian; Gavier Pizarro, Gregorio; Rescia Perazzo, Alejandro Javier; Quintana, Rubén Darío
Most ecological processes typically violate the stationarity assumption as its statistical properties do vary with time. Not only is climate a non-stationary driving phenomenon, but biological systems are intrinsically non-stationary as well. Since wetlands’ structure and functioning are determined by its hydrologic regime, they are not simply driven by temperature and rainfall, but also by seasonal and inter-annual phases of flood and drought. Thus, assessment of non-stationary processes might be particularly accurate in regards to dynamically complex or altered wetland ecosystems. Our aim was to address whether wetland vegetation growth dynamics are intrinsically non-stationary and driven by transient interactions with non-stationary hydro-climatic factors in the context of land use and land cover changes (LULLCs). In order to provide better insight into how and when temporal dynamics guiding ecological transitions occur, we decomposed information from six NDVI time-series depicting differing LULCCs scenarios in a mosaic of wetlands. Thus, to better comprehend the simultaneous underlying processes driving wetland dynamics in the non-insular Lower Delta of the Paraná River, Argentina, we applied the Wavelet Transform. Wavelet analysis is free from the assumption of stationarity and successfully addresses the relationships between two time-series, in the context of gradual changes forced by exogenous variables. In general, our main results show that non-stationary wetland vegetation dynamics can significantly and cyclically alter its periodicity across time in the context of LULCCs and because of its significant interactions with non-stationary hydro-climatic drivers. Our results also show that wavelet analysis can aid in understanding multi-scale non-stationary ecological time-series and reveal features that were either unseen or wrongly assumed otherwise, such as stationarity or constant linear relationships. Implementing the wavelet approach, we have demonstrated that it is possible to study irregular, non-stationary NDVI time-series in wetland ecosystems in order to detect weak and transient interactions between hydro-climatic drivers and wetland vegetation growth dynamics. Particularly through wavelet power spectrums, our results not only identified and quantified the main periodic component of given NDVI time-series, but also assessed its progression through time in the context of complex LULCCs. Principally, we observed the greater the LULCC, the weaker the relationship with most hydro-climatic variables. The aforementioned LULCCs seemingly related to both natural and anthropogenic processes occurring at a given moment in time. Thus, it reflected not only on transient interactions with significant hydro-climatic drivers, but also on changes in the dominant periodicity of wetland vegetation dynamics. Our findings suggests that water management infrastructure exerts significant and irreversible impacts on wetlands. Therefore, a comprehensive approach and strategic planning are necessary to minimize the negative impacts of such infrastructure and to ensure the long-term sustainability of wetland ecosystems.
Validation of the Barthel Index as a Predictor of In-Hospital Mortality among COVID-19 Patients
(Healthcare (Switzerland), 2023) Mateos Arroyo, Julio Alberto; Zaragoza García, Ignacio; Sánchez Gómez, Rubén; Posada Moreno, María Paloma; Ortuño Soriano, Ismael
In order to predict the high mortality due to COVID-19, simple, useful and remote instruments are required. To assess the validity of the baseline Barthel Index score as a predictor of in-hospital mortality among COVID-19 patients, a validation study of a clinical prediction tool in a cohort of patients with COVID-19 was conducted. The primary variable was mortality and the Barthel Index was the main explanatory variable. Demographic, clinical and laboratory variables were collected. Other mortality predictor scores were also assessed: Pneumonia Severity Index, CURB-65 and A-DROP. The Receiver Operating Characteristic Area under the Curve (ROC AUC), sensitivity and specificity were calculated for both the Barthel Index and the other predictor scores. An analysis of the association between the main variables was conducted, adjusting by means of three multivariate models. Three hundred and twelve patients were studied. Mortality was 16.4%. A mortality Odds Ratio (OR) of 5.95 was associated with patients with a Barthel Index ≤ 90. The model number 3 was developed to predict in-hospital mortality before COVID-19 infection occurs. It exhibits an OR of 3.44, a ROC AUC of 0.792, a sensitivity of 74.5% and a specificity of 73.9%. The Baseline Barthel Index proved useful in our population as a predictor of in-hospital mortality due to COVID-19.
Experiencia en la generación de estrategias de monitorización y evaluación en la implantación de Guías de Práctica Clínica en España
(MedUNAB, 2023) González María, Esther; Muñoz Jiménez, Daniel; Córcoles Jiménez, María Pilar; Albornos Muñoz, Laura; Alcañiz Mesas, Ana Isabel; Ortuño Soriano, Ismael; Fernández del Palacio, Encarnación; Ruiz García, María Victoria; Moreno Casbas, María Teresa
Introducción. La monitorización de la utilización del conocimiento y la evaluación de resultados permiten conocer la aplicación de la evidencia, cambios en los conocimientos y actitudes, el impacto en resultados de salud y la integración y el mantenimiento de las prácticas adoptadas. Existen debilidades relacionadas con la falta de sistematización, limitaciones de los registros y calidad del proceso. El objetivo de este artículo es describir la experiencia en la generación de estrategias de monitorización y evaluación de resultados de implantación de Guías de Buenas Prácticas en España. División de temas tratados. En primer lugar, se revisan los procesos de medición de resultados en la implantación de Guías, en el marco del Programa Best Practice Spotlight Organizations®, cuya herramienta para liderar el cambio incluye la monitorización y evaluación como una de las seis fases del ciclo de acción. En segundo lugar, se analizan las estrategias de monitorización y evaluación propuestas en la literatura, destacando la Asociación Profesional de Enfermeras de Ontario. Finalmente, se analizan las estrategias de monitorización y evaluación generadas por dos instituciones españolas participantes en el programa, centradas en adecuación de registros, explotación y análisis de indicadores, desarrollo de herramientas, procedimientos de evaluación y mecanismos de difusión y retroalimentación. Conclusiones. La definición de estrategias de monitorización y evaluación planificada de forma temprana contribuye a la viabilidad de la evaluación de la implantación y su sostenibilidad. Es necesario adaptarlas al contexto, con estrategias transversales que alcancen a toda la institución, facilitadas por la institución.
Influence of outdoor time on the spherical equivalent and axial length in childhood myopia: A meta-analysis
(Acta Ophthalmologica, 2025) Martinez-Perez, Clara; Sánchez Tena, Miguel Ángel; Sánchez-González, José María; Villa-Collar, César; Álvarez Peregrina, Cristina
This meta-analysis investigates the effectiveness of outdoor activities in reducing the onset of myopia in children and adolescents by analysing changes in axial elongation and spherical equivalent refractive error. Following PRISMA guidelines and registered in PROSPERO (CRD42024592971), the study included randomized controlled trials (RCTs) and observational studies. The eligibility criteria targeted children and adolescents aged 6 to 18 years with varying levels of outdoor exposure. Primary outcomes were axial elongation and spherical equivalent change. Studies were assessed for quality using GRADE and AMSTAR-2 tools, and data were analysed using Review Manager 5.4, with random-effects models applied when heterogeneity was significant. Fifteen studies (9 RCTs and 6 observational) were included, with a total of 16 597 participants. Outdoor activities significantly reduced or delayed the onset of myopia, with a mean axial length difference of -0.08 mm per year (95% CI: -0.09 to -0.07) and a spherical equivalent difference of 0.16 diopters per year (95% CI: 0.07 to 0.25). These differences were observed after 1 year of intervention and sustained for up to 3 years, with daily outdoor exposure ranging from 40 to 120 min. Heterogeneity was moderate to high, but sensitivity analyses confirmed the robustness of the results. While higher outdoor exposure appeared more effective in reducing myopia progression, the certainty of this evidence was rated as low due to suspected publication bias, as indicated by the GRADE analysis. Outdoor activities, especially with prolonged exposure to intense light, effectively reduce or delay the onset of myopia in children and adolescents. This study emphasizes the importance of light intensity in maximizing the benefits of outdoor interventions and highlights regional differences in effectiveness, suggesting that environmental factors play a significant role in the outcomes.
Tipología y caracterización de las mineralizaciones de grafito asociadas a terrenos metamórficos en facies granulitas de la Sierra de Aracena (Huelva)
(Boletín de la Sociedad Española de Mineralogía, 1998) Rodas González, Magdalena; Fernández Barrenechea, José María; Fernández-Caliani, J. C.; Luque Del Villar, Francisco Javier; Miras, A.
Factors determining roadkills in a mammal carnivore are road-type specific
(Mammalian Biology, 2024) Carmona Castresana, Guillermo; Virgós, Emilio; Burgos, Tamara; Barrientos Yuste, Rafael
Roads threaten the conservation of many wildlife species. Carnivores are one of the most susceptible groups due to their habitat requirements. We explored the roadkill patterns of European polecats (Mustela putorious) on motorways and roads to investigate if these patterns depend on road type, a research topic frequently neglected in the literature. We studied 85 roadkills on motorways and 73 on roads, and the corresponding number of random points with no roadkills in every road type. We characterized them with 7 habitat and 7 road-related variables. Roadkill sites were significantly associated with the abundance of rabbit burrows. However, this effect was stronger on motorways, as they provide more suitable habitat for the establishment of prey species on their wider rights-of-way, or on the road interchange islands, which provide wide unused spaces. In contrast, road interchange islands on conventional roads that are simple intersections and have narrower rights-of-way. Furthermore, roadkills occurred in areas with lower agricultural cover. Thus, natural habitats on roadsides could act as alternative foraging areas for this carnivore increasing their roadkill risk. Our results showed the need to consider the characteristics such as the availability of prey or the surrounding habitat, as well as intrinsic characteristics of the road type when studying wildlife roadkills as the road-type-mediated patterns demand-specific mitigation measures.
The carnivore remains from the hominid-bearing Trinchera-Galería, Sierra de Atapuerca, Middle Pleistocene site (Spain)
(Geobios, 1998) García García, Nuria; Arsuaga Ferreras, Juan Luis
Abstract: The carnivore assemblage of the hominid-bearing Trinchera-Galería karst-fill includes Cuon alpinus europaeus, Canis lupus, Vulpes vulpes, Panthera leo, Lynx pardina spelaea, Felis silvestris, Ursus spelaeus, Meles meles and Mustela sp. Modern analogues of this assemblage inhabit temperate montane forest. The unusual scarcity of hyaena remains might be a consequence of the hominid presence. The presence of Canis lupus and a relatively derived lynx, point to a post-Cromerian Middle Pleistocene age. However, the existence of Ursus spelaeus,, limits the age to at least a terminal Middle Pleistocene when the transition from U. deningeri to U. spelaeus is considered to have occurred.
Cooperación al desarrollo: Conceptualización psicosocial
(Intervención Psicosocial, 1993) Moreno Martín, Florentino
Se realiza una reflexión desde las postulados teóricos de la Psicología Social de las conceptualizaciones de la cooperación al desarrollo, sus dificultades para ser tenida como conducta de cooperación y sus relaciones con la política social y la identidad cultural.

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