Elena Williams | Rhodes College (original) (raw)
Papers by Elena Williams
Annals of the Rheumatic Diseases
Background Etanercept is an anti-TNF biological therapy, which is available in either a prefilled... more Background Etanercept is an anti-TNF biological therapy, which is available in either a prefilled syringe or a pen myclic. Nursing staff play an important role in the administration and monitoring of this drug. The use of Enanercept in pen form rather than syringe, within our hospital, has prompted this study. Objectives To evaluate the level of fear prior to the administration, pain post-injection and the level of satisfaction of the patients using prefilled syringe versus pen. To evaluate the usefulness of the training given by nursing staff prior to starting with the pen. To evaluate the preferences of the patients after using both devices: syringe vs pen. Methods The design of the study was cross-sectional, with patients who have chronic arthritis. The data collection was obtained from questionnaires developed for this purpouse. The study was placed at the Hospital Moises Broggi, Barcelona. All the patients were using prefilled syringe at the beggining of the study and changed into a pen during the study. The first phase (October’11), consisted of a theoretical-practical workshop where the new pen was presented, explained and patients practiced how to used it; a questionnaire was then completed. During the second phase (November-December’11), all patients were given the pen. In January’12, these patients were asked to complete a second questionnaire. Results 30 patients were included in the study (21 F, 9 M; mean age 51.3±11.54 years). The mean disease duration was 17.17±11.24 years, with a mean of etanercept treatment of 42.67±36.83 months. Of these, 50% had Rheumatoid Arthritis, 27% Psoriatic Arthritis and 20% Ankylosing Spondylitis mainly. Initially, 86.7% of the patients self-injected with the syringe; this increased to 93.3% with the pen. There were no statistically significant differences either with the management of the device between the syringe and the pen (p=0.27), or with the post-injection pain (p=0.5). However, there was a statistically significant increase in the level of fear felt by the patients prior to injecting with the syringe than with the pen (3.75±3.62 Vs 2.35±2.56; p=0.03). Regarding to the current patients’ satisfaction, the percentage of patients with a normal or good satisfaction was of 90% with the syringe and 93.3% with the pen. The results indicated that 82.7% of patients found good or very good the education given by nursing staff prior to using the prefilled syringe, compared to 96.7% with the pen (p=0.045); in addition, all the patients referred to the usefulness of the training given by nursing staff prior to using the pen as useful (16.7%) or very useful (83.3%). Finally to mention that 64% of the patients preferred the pen over the prefilled syringe. Conclusions The means of fear, pain and the difficulty in management of both the syringe and the pen, were low with both devices. The level of fear prior to the administration with the syringe was greater than with the pen. A majority of patients found that the education provided by the nursing staff was good or very good and this was useful or very useful. The pen was the preferred device chosen by the majority of patients. References Gόmez J et al (2011); Sánchez-Eslava L et al (2011) Paul C et al (2011); Borrás-Blasco J et al (2010) Disclosure of Interest None Declared
![Research paper thumbnail of [Functional assessment for people unable to walk due to spinal muscular atrophy and Duchenne muscular dystrophy. Translation and validation of the Egen Klassifikation 2 scale for the Spanish population]](https://attachments.academia-assets.com/83927405/thumbnails/1.jpg)
](Revista de neurologia
The Egen Klassifikation 2 Scale (EK2), expansion of the EK scale, assesses the functional capacit... more The Egen Klassifikation 2 Scale (EK2), expansion of the EK scale, assesses the functional capacity of people with spinal muscular atrophy (SMA) and Duchenne muscular dystrophy (DMD) that are in wheelchair phase. This version is more specific for SMA than its EK predecessor. To examine the validity and reliability of the Spanish version of the scale as a tool for measuring the functional capacity in patients with DMD and SMA who are in wheelchairs. First, a translation-back-translation into Spanish of the English version of the EK2 was performed; later, we studied the reliability of the translated version. For this, 39 patients, aged between 4 and 60, who were evaluated by two observers, were recruited. To evaluate the intra-observer consistency, two assessments by the same observer were performed, and the inter-observer third assessment was performed by a second observer. The obtained values based on the total score of the scale items (sum EK2) reflect excellent intra- and inter-obs...
The main goal of the present work is to establish the positive influence high-impact physical exe... more The main goal of the present work is to establish the positive influence high-impact physical exercise, specifically high-level basketball, on bone acquisition in adolescent female and verify if the long-term exposure to such programs is the major modifiable factor explaining bone acquisition during adolescence.
![Research paper thumbnail of [Translation and validation of the Egen Klassifikation scale for the Spanish population: functional assessment for non-ambulatory individuals with Duchenne's muscular dystrophy and spinal muscular atrophy.]](https://attachments.academia-assets.com/82488984/thumbnails/1.jpg)
](Revista de neurologia
INTRODUCTION. The Egen Klassifikation (EK) scale is a questionnaire that assesses the functional ... more INTRODUCTION. The Egen Klassifikation (EK) scale is a questionnaire that assesses the functional capacity of people with Duchenne muscular dystrophy and spinal muscular atrophy who can't walk and use a wheelchair. AIM. To translate and validate the scale for the Spanish population as a tool for measuring functional capacity in these patients. PATIENTS AND METHODS. We performed first a translation-back translation of EK in the Spanish population and subsequently practiced reliability study of Spanish translated version of the scale. It held three measurements in 30 patients aged 4 to 67 years. Two of these measurements were performed by the same observer, and the third by a second observer to assess intra- and inter-observer agreement. RESULTS. The values refer to the total score of the scale items, EK sum, and reflect a reliability index of 0.995. They also show a higher reliability to 0.86 in each of the items in both intra- and inter-observations observer. CONCLUSIONS. The Spa...
Physiotherapy, 2015
ABSTRACT Background: Normal stabilometric parameters were studied and published by the French Pos... more ABSTRACT Background: Normal stabilometric parameters were studied and published by the French Posturology Association in 1985, for a cohort of 100 subjects grouped by sex but not by age. Stabilometry is one of the most widely used methods to determine individuals' stability when standing, by studying their displacement from the centre of pressure. The stabilometric standards used today were established with a sampling frequency of 5 Hz. Greater accuracy in the sampling of data is now achieved as a result of progress in technology and processors. Purpose: In this study, we performed the point and interval estimate (IC 95%) of normality for the static stabilometric values of postural control, using posturographic stability variables in amplitude, and the maximum and minimum values for both the X and the Y axis. Methods: The design was a cross-sectional study. We included 177 individuals distributed homogeneously in terms of age and sex (p>0.05), grouped according to age, with 45.2% aged between 18 and 35, 32.2% between 36 and 50, and 22.6% between 51 and 65 years old. Patients presenting musculoskeletal and neurological diseases, and with alterations in the vestibular and visual systems prior to sampling and after any type of surgery were excluded. The sampling was repeated three times over for 51.2 sec using the 40Hz Satel stabilometry platform, with eyes open (EO) and closed (EC). Results: The mean amplitude in X with EO for men aged 18 to 35 (18±4.7) was slightly higher than in the other two age groups. Meanwhile, with EC it was higher in the group aged 36 to 50 (20.8±8.7). Differences between the mean amplitude for men and women were also found for EO and EC. In the maximum X observed for both EO and EC, the mean was in the positive part of the centroid, in contrast to the mean for the minimum X. Significant differences (p=0.029) for age and sex were observed compared to the maximum Y with EC, and for the minimum Y with EO and EC (p=0.025 and 0.005 respectively). In all three cases, the youngest age group differed from the rest among both men and women. Conclusions: No differences were found in the maximum and minimum values for men and women if the age group is not taken into consideration. Implications: These findings will enable physiotherapists to update the normal stability parameters and therefore improve diagnoses by age group and sex. However, due to the biological variability of the variables studied, further study of these stabilometric parameters is required, with consideration of the behaviour curve of the postural strategy during the seconds sampled, using functional data analysis techniques.
Pediatric Physical Therapy, 2015
To investigate the effects of a standing program on the range of motion (ROM) of hip abduction in... more To investigate the effects of a standing program on the range of motion (ROM) of hip abduction in children with spastic diplegic cerebral palsy. The participants were 13 children, Gross Motor Functional Classification System level III, who received physical therapy and a daily standing program using a custom-fabricated stander from 12 to 14 months of age to the age of 5 years. Hip abduction ROM was goniometrically assessed at baseline and at 5 years. Baseline hip abduction was 42° at baseline and 43° at 5 years. This small difference was not clinically significant, but did demonstrate that it was possible to maintain hip abduction ROM in the spastic adductor muscles of children with cerebral palsy with a daily standing program during the children's first 5 years of development.
The European Journal of Health Economics, 2015
This study aims to demonstrate the importance of the opportunity cost in using da Vinci robotic s... more This study aims to demonstrate the importance of the opportunity cost in using da Vinci robotic surgery, assisted by a comprehensive review of the literature to determine the differences in the total cost of surgery and operative time in traditional laparoscopic surgery and da Vinci robotic surgery. We identified the studies comparing the use of traditional laparoscopic surgery with robotics during the period 2002-2012 in the electronic economic evaluation databases, and another electronic search was performed for publications by Spanish hospitals in the same period to calculate the opportunity cost. A meta-analysis of response variables considering the total cost of the intervention and surgical time was completed using the items selected in the first revision, and their differences were analyzed. We then calculated the opportunity cost represented by these time differences using the data obtained from the studies in the second review of the literature. Nine items were selected in the first review and three in the second. Traditional laparoscopic surgery has a lower cost than the da Vinci (p < 0.00001). Robotic surgery takes longer (8.0-65.5 min) than traditional surgery (p < 0.00001), and this difference represents an average opportunity cost for robot use of <euro> 489.98, with a unit cost factor/time which varies according to the pathology dealt with, from <euro> 8.2 to 18.7/min. The opportunity cost is a quantity that must be included in the total cost of using a surgical technology within an economic cost analysis in the context of an economic evaluation.
![Research paper thumbnail of [Spanish translation and validation of the Postural Assessment Scale for Stroke Patients (PASS) to assess balance and postural control in adult post-stroke patients]](https://attachments.academia-assets.com/83986541/thumbnails/1.jpg)
](Revista de neurologia, Jan 16, 2015
INTRODUCTION. In the last years the Postural Assessment Scale for Stroke Patients (PASS) has beco... more INTRODUCTION. In the last years the Postural Assessment Scale for Stroke Patients (PASS) has become in the most common utility to assess balance and postural control in adult patients who have suffered a stroke, especially in the acute and subacute phase. AIM. To translate the PASS into Spanish and to validate it as an instrument to evaluate balance and postural control in adult stroke patients in Spain. PATIENTS AND METHODS. The French version was translated into Spanish, this version was agreed by a team of experts. Later a back-translation was made into French and was sent to original author, who approved this version. To assess the interrater and intrarater reliability were performed four measurements on 60 post-stroke patients which was recorded a videotape. Two of these measurements were performed by the same rater, and the third and fourth by a second and third rater. RESULTS. The values refer to the total score of the scale and reflect a reliability of 0.999. They also show ...
Fisioterapia, 2012
Introduction: Evidence-based practice (EBP) is defined as a process aimed at selecting the best s... more Introduction: Evidence-based practice (EBP) is defined as a process aimed at selecting the best scientific arguments for solving problems within the clinical practice. However, the lack of validated instruments and scientific publications in Spanish is a challenge when it comes to establishing what is the current status of this scientific approach within Physiotherapy in Spain. The aim of this study was to analyze and assess the reliability of EBP in physiotherapy using a questionnaire adapted to Spanish. Material and methods: A back-translation of the questionnaire on EBP was performed in order to conduct a prospective test-retest study for the analysis of the psychometric properties of the Spanish version of the questionnaire. A sample of 41 licensed clinical physiotherapists participated in the study. None of them had prior training in EBP or advanced research methodology. Results: Values for the ICC were in the range of 0.333-0.885, resulting in a moderate to good reproducibility in all items (ICC> 0.400). The Cronbach's alpha analysis was set at alpha> 0.700, obtaining a good overall internal consistency. The analysis of intra-observer reliability using kappa index was 0.396-0.688 for dichotomous items. Conclusions: Through the analysis of the psychometric properties of the adapted and translated Spanish version of the questionnaire on EBP designed by Jette et al., this study has obtained sufficient validity for its use as a tool for collecting data for research.
Población y Salud en Mesoamérica, 2013
The objective of this research is to determine if different causes of death would explain gender ... more The objective of this research is to determine if different causes of death would explain gender inequality in mortality at advanced ages between 1991 and 2011 in the province of Tarragona (Catalonia, Spain). Mortality tables are made based on deaths according to age and sex from statistics provided by Instituto Nacional de Estadística español (INE) and Institut d'Estadística de Catalunya (IDESCAT) in order to show the evolution of mortality. From this, a homogenous group of the main causes of death is produced. Indirect standardization is the methodology used to carry out an exact interpretation of the classification of deadly diseases and comparison between areas. The results show that life expectancy differs between sexes by six years, with women having a greater life expectancy. However, for the first time in the twentieth century, male life expectancy grows more than female life expectancy. As for causes of death, Tarragona has lower mortality than Spain in 1991 (0.71 and 0.75) and for women in 2001 (0.90) and a higher incidence of deaths from the set of "other diseases" (greater than 1): new degenerative diseases, mental, nervous and endocrine illnesses, etc. Public health policies should give more priority to advances in longevity, especially in women. They reach the highest levels of life expectancy from birth and create new epidemiological patterns. Additionally, they develop new diseases, such as mental and nervous illnesses at the moment.
Enfermería Clínica, 2013
The aims of this study are to evaluate the level of fear of post-injection pain prior to the admi... more The aims of this study are to evaluate the level of fear of post-injection pain prior to the administration, the difficulty in handling the device, and the level of satisfaction of patients using a pre-filled syringe versus an etanercept pen, as well as to evaluate the usefulness of the training given by nursing staff prior to starting with the pen, and the preferences of patients after using both devices. A prospective study was designed to follow-up a cohort of patients during a 6 months period. The data was collected using questionnaires and analyzed with SPSS 18.00. Rank and McNemar tests were performed. Statistical significance was pre-set at an α level of 0.05. A total of 29 patients were included, of whom 69% female, and with a mean age 52.5±10.9 years. Of these, 48% had rheumatoid arthritis, 28% psoriatic arthritis, 21% ankylosing spondylitis, and 3% undifferentiated spondyloarthropathy. There were no statistically significant differences either with the fear or pain or handling of the device between the syringe and the pen (P=.469; P=.812; P=.169 respectively). At 6 months, 59% of patients referred to being satisfied or very satisfied with the pen. Almost all (93%) found useful or very useful the training given by nursing staff prior to using the pen, and 55% preferred the pen over the pre-filled syringe. The etanercept pen is another subcutaneous device option for patients with chronic arthritis. According to the present study, nursing educational workshops before starting this therapy are recommended.
Fisioterapia, 2014
ABSTRACT Introduction Mobility alterations of coxofemoral or hip rotation may be present in condi... more ABSTRACT Introduction Mobility alterations of coxofemoral or hip rotation may be present in conditions having a mechanical component. These conditions, which frequently appear in professional and amateur athletes, include lumbar pain, sacroiliac dysfunction, patelofemoral pain syndrome, hip osteoarthritis, anterior cruciate ligament injury, hyperpronation and lower leg discrepancy. Pendular goniometer makes it possible to measure coxofemoral rotations in the lower leg position - with coxofemoral in neutral position and knee in extension - the closest position acquired by the hip and knee in the support phase in which most of the biomechanics compensations appears. Objective To analyze intraobservational and interobservational reliability of pendular goniometer for measuring coxofemoral rotation. Material and methods A study was made of reliability and correlation on a sample made up of 30 individuals and 60 measurements. Each rater individually evaluated 60 hip external rotations (ER) and 60 hip internal rotations (IR) from 30 participants 2 times in the same day with an interval of hour and a half hours between measurements, always under the conditions. Results The results show an intra-rater reliability with an interrater correlation coefficient (IRC) of 0.8 for ER and of 0.9 for IR; inter-rater reliability with an IRC of 0.7 for ER and of 0.9 for IR. The Cronbach's alpha internal consistency was 0.9. Conclusions It is concluded that this instrument has a high reliability for measuring coxofemoral rotations.
Annals of the Rheumatic Diseases
Background Etanercept is an anti-TNF biological therapy, which is available in either a prefilled... more Background Etanercept is an anti-TNF biological therapy, which is available in either a prefilled syringe or a pen myclic. Nursing staff play an important role in the administration and monitoring of this drug. The use of Enanercept in pen form rather than syringe, within our hospital, has prompted this study. Objectives To evaluate the level of fear prior to the administration, pain post-injection and the level of satisfaction of the patients using prefilled syringe versus pen. To evaluate the usefulness of the training given by nursing staff prior to starting with the pen. To evaluate the preferences of the patients after using both devices: syringe vs pen. Methods The design of the study was cross-sectional, with patients who have chronic arthritis. The data collection was obtained from questionnaires developed for this purpouse. The study was placed at the Hospital Moises Broggi, Barcelona. All the patients were using prefilled syringe at the beggining of the study and changed into a pen during the study. The first phase (October’11), consisted of a theoretical-practical workshop where the new pen was presented, explained and patients practiced how to used it; a questionnaire was then completed. During the second phase (November-December’11), all patients were given the pen. In January’12, these patients were asked to complete a second questionnaire. Results 30 patients were included in the study (21 F, 9 M; mean age 51.3±11.54 years). The mean disease duration was 17.17±11.24 years, with a mean of etanercept treatment of 42.67±36.83 months. Of these, 50% had Rheumatoid Arthritis, 27% Psoriatic Arthritis and 20% Ankylosing Spondylitis mainly. Initially, 86.7% of the patients self-injected with the syringe; this increased to 93.3% with the pen. There were no statistically significant differences either with the management of the device between the syringe and the pen (p=0.27), or with the post-injection pain (p=0.5). However, there was a statistically significant increase in the level of fear felt by the patients prior to injecting with the syringe than with the pen (3.75±3.62 Vs 2.35±2.56; p=0.03). Regarding to the current patients’ satisfaction, the percentage of patients with a normal or good satisfaction was of 90% with the syringe and 93.3% with the pen. The results indicated that 82.7% of patients found good or very good the education given by nursing staff prior to using the prefilled syringe, compared to 96.7% with the pen (p=0.045); in addition, all the patients referred to the usefulness of the training given by nursing staff prior to using the pen as useful (16.7%) or very useful (83.3%). Finally to mention that 64% of the patients preferred the pen over the prefilled syringe. Conclusions The means of fear, pain and the difficulty in management of both the syringe and the pen, were low with both devices. The level of fear prior to the administration with the syringe was greater than with the pen. A majority of patients found that the education provided by the nursing staff was good or very good and this was useful or very useful. The pen was the preferred device chosen by the majority of patients. References Gόmez J et al (2011); Sánchez-Eslava L et al (2011) Paul C et al (2011); Borrás-Blasco J et al (2010) Disclosure of Interest None Declared
Revista de neurologia
The Egen Klassifikation 2 Scale (EK2), expansion of the EK scale, assesses the functional capacit... more The Egen Klassifikation 2 Scale (EK2), expansion of the EK scale, assesses the functional capacity of people with spinal muscular atrophy (SMA) and Duchenne muscular dystrophy (DMD) that are in wheelchair phase. This version is more specific for SMA than its EK predecessor. To examine the validity and reliability of the Spanish version of the scale as a tool for measuring the functional capacity in patients with DMD and SMA who are in wheelchairs. First, a translation-back-translation into Spanish of the English version of the EK2 was performed; later, we studied the reliability of the translated version. For this, 39 patients, aged between 4 and 60, who were evaluated by two observers, were recruited. To evaluate the intra-observer consistency, two assessments by the same observer were performed, and the inter-observer third assessment was performed by a second observer. The obtained values based on the total score of the scale items (sum EK2) reflect excellent intra- and inter-obs...
The main goal of the present work is to establish the positive influence high-impact physical exe... more The main goal of the present work is to establish the positive influence high-impact physical exercise, specifically high-level basketball, on bone acquisition in adolescent female and verify if the long-term exposure to such programs is the major modifiable factor explaining bone acquisition during adolescence.
Revista de neurologia
INTRODUCTION. The Egen Klassifikation (EK) scale is a questionnaire that assesses the functional ... more INTRODUCTION. The Egen Klassifikation (EK) scale is a questionnaire that assesses the functional capacity of people with Duchenne muscular dystrophy and spinal muscular atrophy who can't walk and use a wheelchair. AIM. To translate and validate the scale for the Spanish population as a tool for measuring functional capacity in these patients. PATIENTS AND METHODS. We performed first a translation-back translation of EK in the Spanish population and subsequently practiced reliability study of Spanish translated version of the scale. It held three measurements in 30 patients aged 4 to 67 years. Two of these measurements were performed by the same observer, and the third by a second observer to assess intra- and inter-observer agreement. RESULTS. The values refer to the total score of the scale items, EK sum, and reflect a reliability index of 0.995. They also show a higher reliability to 0.86 in each of the items in both intra- and inter-observations observer. CONCLUSIONS. The Spa...
Physiotherapy, 2015
ABSTRACT Background: Normal stabilometric parameters were studied and published by the French Pos... more ABSTRACT Background: Normal stabilometric parameters were studied and published by the French Posturology Association in 1985, for a cohort of 100 subjects grouped by sex but not by age. Stabilometry is one of the most widely used methods to determine individuals' stability when standing, by studying their displacement from the centre of pressure. The stabilometric standards used today were established with a sampling frequency of 5 Hz. Greater accuracy in the sampling of data is now achieved as a result of progress in technology and processors. Purpose: In this study, we performed the point and interval estimate (IC 95%) of normality for the static stabilometric values of postural control, using posturographic stability variables in amplitude, and the maximum and minimum values for both the X and the Y axis. Methods: The design was a cross-sectional study. We included 177 individuals distributed homogeneously in terms of age and sex (p>0.05), grouped according to age, with 45.2% aged between 18 and 35, 32.2% between 36 and 50, and 22.6% between 51 and 65 years old. Patients presenting musculoskeletal and neurological diseases, and with alterations in the vestibular and visual systems prior to sampling and after any type of surgery were excluded. The sampling was repeated three times over for 51.2 sec using the 40Hz Satel stabilometry platform, with eyes open (EO) and closed (EC). Results: The mean amplitude in X with EO for men aged 18 to 35 (18±4.7) was slightly higher than in the other two age groups. Meanwhile, with EC it was higher in the group aged 36 to 50 (20.8±8.7). Differences between the mean amplitude for men and women were also found for EO and EC. In the maximum X observed for both EO and EC, the mean was in the positive part of the centroid, in contrast to the mean for the minimum X. Significant differences (p=0.029) for age and sex were observed compared to the maximum Y with EC, and for the minimum Y with EO and EC (p=0.025 and 0.005 respectively). In all three cases, the youngest age group differed from the rest among both men and women. Conclusions: No differences were found in the maximum and minimum values for men and women if the age group is not taken into consideration. Implications: These findings will enable physiotherapists to update the normal stability parameters and therefore improve diagnoses by age group and sex. However, due to the biological variability of the variables studied, further study of these stabilometric parameters is required, with consideration of the behaviour curve of the postural strategy during the seconds sampled, using functional data analysis techniques.
Pediatric Physical Therapy, 2015
To investigate the effects of a standing program on the range of motion (ROM) of hip abduction in... more To investigate the effects of a standing program on the range of motion (ROM) of hip abduction in children with spastic diplegic cerebral palsy. The participants were 13 children, Gross Motor Functional Classification System level III, who received physical therapy and a daily standing program using a custom-fabricated stander from 12 to 14 months of age to the age of 5 years. Hip abduction ROM was goniometrically assessed at baseline and at 5 years. Baseline hip abduction was 42° at baseline and 43° at 5 years. This small difference was not clinically significant, but did demonstrate that it was possible to maintain hip abduction ROM in the spastic adductor muscles of children with cerebral palsy with a daily standing program during the children's first 5 years of development.
The European Journal of Health Economics, 2015
This study aims to demonstrate the importance of the opportunity cost in using da Vinci robotic s... more This study aims to demonstrate the importance of the opportunity cost in using da Vinci robotic surgery, assisted by a comprehensive review of the literature to determine the differences in the total cost of surgery and operative time in traditional laparoscopic surgery and da Vinci robotic surgery. We identified the studies comparing the use of traditional laparoscopic surgery with robotics during the period 2002-2012 in the electronic economic evaluation databases, and another electronic search was performed for publications by Spanish hospitals in the same period to calculate the opportunity cost. A meta-analysis of response variables considering the total cost of the intervention and surgical time was completed using the items selected in the first revision, and their differences were analyzed. We then calculated the opportunity cost represented by these time differences using the data obtained from the studies in the second review of the literature. Nine items were selected in the first review and three in the second. Traditional laparoscopic surgery has a lower cost than the da Vinci (p < 0.00001). Robotic surgery takes longer (8.0-65.5 min) than traditional surgery (p < 0.00001), and this difference represents an average opportunity cost for robot use of <euro> 489.98, with a unit cost factor/time which varies according to the pathology dealt with, from <euro> 8.2 to 18.7/min. The opportunity cost is a quantity that must be included in the total cost of using a surgical technology within an economic cost analysis in the context of an economic evaluation.
Revista de neurologia, Jan 16, 2015
INTRODUCTION. In the last years the Postural Assessment Scale for Stroke Patients (PASS) has beco... more INTRODUCTION. In the last years the Postural Assessment Scale for Stroke Patients (PASS) has become in the most common utility to assess balance and postural control in adult patients who have suffered a stroke, especially in the acute and subacute phase. AIM. To translate the PASS into Spanish and to validate it as an instrument to evaluate balance and postural control in adult stroke patients in Spain. PATIENTS AND METHODS. The French version was translated into Spanish, this version was agreed by a team of experts. Later a back-translation was made into French and was sent to original author, who approved this version. To assess the interrater and intrarater reliability were performed four measurements on 60 post-stroke patients which was recorded a videotape. Two of these measurements were performed by the same rater, and the third and fourth by a second and third rater. RESULTS. The values refer to the total score of the scale and reflect a reliability of 0.999. They also show ...
Fisioterapia, 2012
Introduction: Evidence-based practice (EBP) is defined as a process aimed at selecting the best s... more Introduction: Evidence-based practice (EBP) is defined as a process aimed at selecting the best scientific arguments for solving problems within the clinical practice. However, the lack of validated instruments and scientific publications in Spanish is a challenge when it comes to establishing what is the current status of this scientific approach within Physiotherapy in Spain. The aim of this study was to analyze and assess the reliability of EBP in physiotherapy using a questionnaire adapted to Spanish. Material and methods: A back-translation of the questionnaire on EBP was performed in order to conduct a prospective test-retest study for the analysis of the psychometric properties of the Spanish version of the questionnaire. A sample of 41 licensed clinical physiotherapists participated in the study. None of them had prior training in EBP or advanced research methodology. Results: Values for the ICC were in the range of 0.333-0.885, resulting in a moderate to good reproducibility in all items (ICC> 0.400). The Cronbach's alpha analysis was set at alpha> 0.700, obtaining a good overall internal consistency. The analysis of intra-observer reliability using kappa index was 0.396-0.688 for dichotomous items. Conclusions: Through the analysis of the psychometric properties of the adapted and translated Spanish version of the questionnaire on EBP designed by Jette et al., this study has obtained sufficient validity for its use as a tool for collecting data for research.
Población y Salud en Mesoamérica, 2013
The objective of this research is to determine if different causes of death would explain gender ... more The objective of this research is to determine if different causes of death would explain gender inequality in mortality at advanced ages between 1991 and 2011 in the province of Tarragona (Catalonia, Spain). Mortality tables are made based on deaths according to age and sex from statistics provided by Instituto Nacional de Estadística español (INE) and Institut d'Estadística de Catalunya (IDESCAT) in order to show the evolution of mortality. From this, a homogenous group of the main causes of death is produced. Indirect standardization is the methodology used to carry out an exact interpretation of the classification of deadly diseases and comparison between areas. The results show that life expectancy differs between sexes by six years, with women having a greater life expectancy. However, for the first time in the twentieth century, male life expectancy grows more than female life expectancy. As for causes of death, Tarragona has lower mortality than Spain in 1991 (0.71 and 0.75) and for women in 2001 (0.90) and a higher incidence of deaths from the set of "other diseases" (greater than 1): new degenerative diseases, mental, nervous and endocrine illnesses, etc. Public health policies should give more priority to advances in longevity, especially in women. They reach the highest levels of life expectancy from birth and create new epidemiological patterns. Additionally, they develop new diseases, such as mental and nervous illnesses at the moment.
Enfermería Clínica, 2013
The aims of this study are to evaluate the level of fear of post-injection pain prior to the admi... more The aims of this study are to evaluate the level of fear of post-injection pain prior to the administration, the difficulty in handling the device, and the level of satisfaction of patients using a pre-filled syringe versus an etanercept pen, as well as to evaluate the usefulness of the training given by nursing staff prior to starting with the pen, and the preferences of patients after using both devices. A prospective study was designed to follow-up a cohort of patients during a 6 months period. The data was collected using questionnaires and analyzed with SPSS 18.00. Rank and McNemar tests were performed. Statistical significance was pre-set at an α level of 0.05. A total of 29 patients were included, of whom 69% female, and with a mean age 52.5±10.9 years. Of these, 48% had rheumatoid arthritis, 28% psoriatic arthritis, 21% ankylosing spondylitis, and 3% undifferentiated spondyloarthropathy. There were no statistically significant differences either with the fear or pain or handling of the device between the syringe and the pen (P=.469; P=.812; P=.169 respectively). At 6 months, 59% of patients referred to being satisfied or very satisfied with the pen. Almost all (93%) found useful or very useful the training given by nursing staff prior to using the pen, and 55% preferred the pen over the pre-filled syringe. The etanercept pen is another subcutaneous device option for patients with chronic arthritis. According to the present study, nursing educational workshops before starting this therapy are recommended.
Fisioterapia, 2014
ABSTRACT Introduction Mobility alterations of coxofemoral or hip rotation may be present in condi... more ABSTRACT Introduction Mobility alterations of coxofemoral or hip rotation may be present in conditions having a mechanical component. These conditions, which frequently appear in professional and amateur athletes, include lumbar pain, sacroiliac dysfunction, patelofemoral pain syndrome, hip osteoarthritis, anterior cruciate ligament injury, hyperpronation and lower leg discrepancy. Pendular goniometer makes it possible to measure coxofemoral rotations in the lower leg position - with coxofemoral in neutral position and knee in extension - the closest position acquired by the hip and knee in the support phase in which most of the biomechanics compensations appears. Objective To analyze intraobservational and interobservational reliability of pendular goniometer for measuring coxofemoral rotation. Material and methods A study was made of reliability and correlation on a sample made up of 30 individuals and 60 measurements. Each rater individually evaluated 60 hip external rotations (ER) and 60 hip internal rotations (IR) from 30 participants 2 times in the same day with an interval of hour and a half hours between measurements, always under the conditions. Results The results show an intra-rater reliability with an interrater correlation coefficient (IRC) of 0.8 for ER and of 0.9 for IR; inter-rater reliability with an IRC of 0.7 for ER and of 0.9 for IR. The Cronbach's alpha internal consistency was 0.9. Conclusions It is concluded that this instrument has a high reliability for measuring coxofemoral rotations.