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Producción Científica, Partially automated robotic systems, such as camera holders, represent a pivotal step towards enhancing efficiency and precision in surgical procedures. Therefore, this paper introduces an approach for real-time tool localization in laparoscopy surgery using convolutional neural networks. The proposed model, based on two Hourglass modules in series, can localize up to two surgical tools simultaneously. This study utilized three datasets: the ITAP dataset, alongside two publicly available datasets, namely Atlas Dione and EndoVis Challenge. Three variations of the Hourglass-based models were proposed, with the best model achieving high accuracy (92.86%) and frame rates (27.64 FPS), suitable for integration into robotic systems. An evaluation on an independent test set yielded slightly lower accuracy, indicating limited generalizability. The model was further analyzed using the Grad-CAM technique to gain insights into its functionality. Overall, this work presents a promising solution for automating aspects of laparoscopic surgery, potentially enhancing surgical efficiency by reducing the need for manual endoscope manipulation., Ministerio de Ciencia, Innovación y Universidades - (project PID2022- 138206OB-C33)

La cirugía mínimamente invasiva y las cirugías asistidas robóticamente son dos de las técnicas quirúrgicas más comunes en la actualidad. A pesar de sus ventajas en comparación con la cirugía tradicional, también presentan algunas dificultades que, normalmente, las hacen más difíciles que sus alternativas. Uno de estos problemas es el control de la cámara. En la práctica clínica, es manejada por un ayudante y es necesario un tiempo para aprender a coordinarse con el cirujano correctamente. Esto también provoca muchos errores que suponen retrasos en el tiempo de recuperación y una disminución en la calidad de vida de los pacientes. En este proyecto, proponemos una conducción automática de la cámara basada en un algoritmo capaz de rastrear las coordenadas de las herramientas de cirugía y enviarlas a una arquitectura de control del robot., Grado en Ingeniería Biomédica

Background: plantar footprint alterations are very common in school children, they vary between decreased or increased plantar curvature, and are linked to musculoskeletal pain. Objective: To determine the prevalence of alterations in the plantar footprint in students of the Francisca Arizaga Toral School of Basic Education. Methodology: descriptive, cross-sectional and observational study with data recording in a form prepared by the author. The tabulation of the data was carried out with the IBM SPSS version 15 program and the graphs were prepared in Microsoft Excel. Quantitative variables are described through dispersion statistics, standard deviation, and central tendency. The qualitative variables are presented through simple and crossed tables with frequencies and percentages. Results: with 268 children evaluated, 52.2% girls, 74.6% from urban areas, mestizos. 48.5% normal weight, 49.3 underweight, 2.2% overweight and obesity. The prevalence of plantar footprint alterations was 75%. Bilateral cavus prevailed 39.2%. Pes cavus prevailed in girls with 45.0%. According to age, in children under 8 years of age, flat feet presented 38.8%, and in those over 8 years of age, cavus presented 47.8%. The prevalent hip and knee angular alteration was bilateral valgus with 27.3%. Conclusions: It is important to assess the plantar footprint in schoolchildren, particularly between 8-13 years of age, the stage where the characteristics of the foot and plantar footprint alterations for adult life are established.

It is difficult for physiotherapists to know in depth the postural behavior of their patients. This is important information to have a complete understanding of the patient's context and the risk factors that contribute to the appearance of musculoskeletal disorders. In this context, we present the development and testing of a real time prototype with skeleton tracking of postures adopted by a person while sitting in front of a computer. The prototype uses a depth camera to obtain the spatial coordinates of the body's joints. These points are used to calculate the angles that describe the individual's posture. A data set of angles is built to train 3 classification methods RNN, RFC and GBC. For all 3 classification methods, the accuracy rate exceeds 70% for the 5 postures studied. The accuracy rate of the prototype used in a physiotherapy case study is not affected by more than 10% compared to the results obtained under controlled conditions. In addition, the results obtained in the study case assisted a specialist to develop a treatment plan.

Background: It has been proven that the SARS-CoV-2 virus generates consequences, mainly at the cardiorespiratory level and in the functional capacity of the individual. The Post-Covid 19 physiotherapeutic evaluation is important, due to the need to know the condition in which the patients are, it can be carried out in person and telematically. Among the multiple evaluations in cardiorespiratory patients are: vital signs, oxygen saturation and heart rate; the scales, Functional Status Post-Covid-19 and MmRC Dyspnea. A first step to implement telerehabilitation will be to describe the results obtained in the evaluation through the two modalities: face-to-face and telematics. This research seeks to generate information for the implementation of evaluation in telerehabilitation. Objectives: To describe the results of vital signs (oxygen saturation and heart rate) and the Post-Covid 19 Functional Status and Dyspnea MmRC scales, in person and online in Post-Covid 19 patients. Methods: it is a quantitative observational study descriptive and transversal. The variables are described with their means and medians in the quantitative variables, frequencies and percentages in the qualitative ones. Methodology: With a quantitative approach, observational study, descriptive level. Results: Most of the patients evaluated are female, the average age of the population studied is 41 years, vital signs are within normal parameters, 52% of patients do not present functional limitations and 47% do not present functional limitations. dyspnea. Conclusion: No statistically significant differences were found between face-to-face and telematic evaluation, which suggests that telemonitoring and face-to-face monitoring are similar.

Background Due to Covid-19 situation, the educational institutions, had to work from home, the teachers are affected by excess of work, it caused Musculoskeletal dysfunction. Having a prevalence of 67,7% with respect to neck pain, which causes loss of quality of life and functional limitation. General objective To determine the relation among the cervical disability index, pain intensity and quality of life of teachers from “Unidad Educativa del Milenio Victoria del Portete” in Cuenca city. Methodology We present a quantitative-transversal study at the correlational level. In which 50 teachers participated to whom the scales applied: Analog Visual Scale, Cervical Disability Index, Shot Form-36 for quality of life. The processing of results was carried out with the SPSS version 15 and Excel program, and are presented the results in tables and graphs. Results As a result, professors who worked from home currently present a considerable pain intensity. In addition, 95% shows cervicales disability plus a notorious affection in their standards of living, specifically at Physical Role = 38. And certainly it’s possible to conclude that there is correlation between disability and pain intensity and also between disability and the six physical dimensions of quality of life.

La problemática energética del mundo pasa por el agotamiento de las reservas de hidrocarburos y por la inestabilidad en el flujo y en el precio de esta materia prima tan fundamental. La energía barata por mucho tiempo sustento el modelo de desarrollo de la humanidad, pero en el camino no todos pudieron disfrutar de las comodidades y bondades pero sí que todos estamos sufriendo las consecuencias de esa vorágine, rápida y sostenidamente hemos llegado al punto de no retorno. Algunos gobiernos han apuntado a poner de su parte para disminuir el grado de destrucción del medio ambiente al que llegamos, dejando atrás el modelo de la energía proveniente de los hidrocarburos y buscando nuevas fuentes de energías renovables como la solar o eólica. El objetivo general de esta investigación es mostrar la factibilidad de los vehículos eléctricos en la problemática energética del mundo. La metodología utilizada se basó en una investigación no experimental, de campo documental y descriptiva exploratoria. Como resultado se obtuvo que los vehículos de combustión interna con su carga de gases residuales deban dar paso a los vehículos eléctricos de cero emisiones. Como conclusión se determinó la factibilidad de los vehículos eléctricos en nuestro país en medio de la problemática energética mundial.

Background: In sport, the plantar footprint is important as it allows determining the points of greatest pressure on the sole of the foot. Thanks to the functions of; cushioning, balance, support and motor, provides stability during practice and transmits forces to the ascending chain. Therefore, any alteration in the footprint will result in an imbalance in the support that in turn leads to a disproportionate and damaging transmission of forces in the athlete. Objective Determine the type of footprint in the players of the Francisco Febres Cordero College football team in Cuenca Methodology The present study was descriptive, prospective, cross-sectional, observational. We worked with the soccer players from the Francisco Febres Cordero school in the city of Cuenca. The Hernández Corvo method was used to measure the footprint and the kinovea software to analyze the type of footprint. The data were processed with SPSS version 15 and Excel. Results In order to establish the frequency of flat feet and cavus, we will determine the type of foot of the soccer players of the Francisco Febres Cordero School to avoid injuries in the future.

Evaluating development is a pillar for the early detection of alterations or warning signs. Skill acquisition is seen as building blocks for children's potential capabilities. Psychomotor development is an evolutionary process, "the result of the maturation of the central nervous system, neuromuscular function and sensory organs" The ASQ-3 questionnaire assesses 5 areas of development and consists of 6 questions respectively. GENERAL OBJECTIVE: To identify the level of psychomotor development through the self-applied questionnaire of ages and stages ASQ-3 in children from 12 to 36 months of age, of the Ministry of economic and social inclusion CDI “Paraíso 6”. METHODOLOGY: A descriptive, quantitative, cross-sectional, participant observation, systematic and uncontrolled study with the children's parents. USE OF RESULTS: Among the participants the mean age: 27 months 21 days. A psychomotor development of 84.3%. The development in the gross motor area (M = 53.9; DE = 7.7), socio-individual (M = 51.2; DE = 9.2) and problem solving (M = 50.4; DE = 10.0); the areas of communication (M = 48.1; SD = 13.7) and fine motor (M = 49.4; SD = 12.2. At the level of development (zone) 80.6% (n = 29) in the white zone, five infants in the communication area, two in the gross motor area and three in the other areas in the gray zone; two individuals in the areas of: communication, gross motor, problem solving and individual partner and three children in the fine motor area were in the black zone Communication was age-related in a strong moderate intensity (rs = 0.497; p = 0.002).

Background: In the sports field, dynamic balance is very important; it provides stability through quick and coordinated responses to unexpected loads or movements. Furthermore, dynamic balance aids the optimal development of techniques-skills and reduces the risk of injury. Objective: To evaluate the level of dynamic balance in the Club Deportivo Cuenca women's first team, by applying the Y Balance Test. Cuenca, December 2019 - May 2020. Methodology: The study has been made with a quantitative and observational descriptive, prospective and cross-sectional approach in the athletes of Club Deportivo Cuenca women's first team. The dynamic balance level was evaluated by applying the Y Balance Test, and was related to variables such as age, BMI (body mass index), lower limb length, history of lower limb injuries, position on the playing field and laterality. The results are presented using frequency tables and graphs, with their percentages, measures of central tendency and dispersion. Results: According to the Y Balance Test, from the 25 evaluated, 68% (n = 17) presented moderate deficit, 24% (n = 6) slight deficit and 8% (n = 2) optimal dynamic equilibrium. Regarding the risk of injury, 68% (n = 17) of the population has a higher risk of suffering an injury, compared to 32% (n = 8). Conclusions: The majority of the study population 92% (n = 23) presented a balance deficit, especially a moderate deficit, a characteristic that predisposes players to have a higher risk of injury compared to those with less balance deficit. Keywords: Dynamic balance. Soccer. Y Balance Test. Injuries.

While Colombia is a country with long mining tradition, expertise and regulation on large-scale mining-waste disposal facilities are scarce. This article describes the current state of the practice of mining waste management in Colombia, particularly tailings, as well as the opportunities and limitations towards the adoption of modern technologies. The traditional practices for tailings management around the world were reviewed, as well as its technical and regulatory aspects in Colombia. In addition, recent technical literature was studied relating emerging technologies for tailings management, focusing on thickening, filtration, cemented-paste backfilling, “piggy-backing”, and submarine tailings disposal. Furthermore, the Colombian regulatory and technological environment was analyzed considering the possible implementation of modern technologies. It is concluded that such emerging technologies minimize mining-project footprints compared to conventional disposal structures, though submarine disposal should currently be avoided. Colombia urgently requires to educate skilled professionals able to tackle the modern massive management of mining waste., Aunque Colombia es un país de amplia tradición minera, las experiencias y reglamentación sobre grandes estructuras de disposición de residuos mineros son escasas. Este artículo describe las prácticas actuales de manejo de residuos mineros en Colombia, particularmente relaves, al igual que las oportunidades y limitaciones para la adopción de tecnologías modernas. Para este manuscrito, se revisaron las prácticas mundiales tradicionales y los aspectos técnico-normativos en Colombia. Adicionalmente, se estudió bibliografía reciente sobre tecnologías emergentes para manejo de relaves, particularmente espesamiento, filtrado, retrollenado, realce y disposición submarina. Finalmente, se analizó la situación normativa y tecnológica en Colombia de cara a la posible adopción de tecnologías modernas. Se concluye que las tecnologías emergentes minimizan el gran pasivo que dejan las estructuras convencionales, aunque actualmente la disposición submarina debe evitarse. En cualquier caso, el país requiere prontamente desarrollar capital humano con competencias para abordar el manejo moderno y masivo de residuos mineros.

Aunque Colombia es un país de amplia tradición minera, las experiencias y reglamentación sobre grandes estructuras de disposición de residuos mineros son escasas. Este artículo describe las prácticas actuales de manejo de residuos mineros en Colombia, particularmente relaves, al igual que las oportunidades y limitaciones para la adopción de tecnologías modernas. Para este manuscrito, se revisaron las prácticas mundiales tradicionales y los aspectos técnico-normativos en Colombia. Adicionalmente, se estudió bibliografía reciente sobre tecnologías emergentes para manejo de relaves, particularmente espesamiento, filtrado, retrollenado, realce y disposición submarina. Finalmente, se analizó la situación normativa y tecnológica en Colombia de cara a la posible adopción de tecnologías modernas. Se concluye que las tecnologías emergentes minimizan el gran pasivo que dejan las estructuras convencionales, aunque actualmente la disposición submarina debe evitarse. En cualquier caso, el país requiere prontamente desarrollar capital humano con competencias para abordar el manejo moderno y masivo de residuos mineros.

Background In soccer an improper alignment of knees or alterations of foot put at risk of suffering injuries to the players because in the inferior member the effort becomes excessive. Therefore, to determine alterations, it is important to carry out an evaluation of the Q angle and footprint measurement. General objective To determine the prevalence of genu valgo, genu varo, flat foot and foot cavo in the female players of the "Carneras" UPS team, Cuenca 2017. Methodology This cross - sectional descriptive study was carried out in 60 players of the Carneras team, 2017. The Arch Index method described by Cavanagh and Rodgers1, was used to measure plantar footprint, and knee alignment was assessed by measuring the Q angle described by Brattstrom2. The database was processed in the PSPP program. Results are expressed using descriptive statistics. Results In reference to the Q angle, bilateral normal knee was present in 72.22% (n= 26), a bilateral variance of 22.22% (n= 8) and a bilateral valgus of 5.56% (n= 2). As for the plantar footprint, bilateral normal foot was present in 54.05% (n= 20), in bilateral flat foot, 37.84% (n= 14) and bilateral foot in 8.11% (n= 3). Conclusions The prevalence of knee and foot alterations found in the Carneras team has a negative effect on the players putting them at risk of injury throughout the lower limb kinetic chain; hence the importance of an early evaluation.

The main musculoskeletal injuries that can be suffered by a driver of vehicles are pain in the lower and upper back, in the neck, shoulders and wrists. They are caused by fatigue of the tendon sheaths, which is cause by the repetitive movement of the tendons by turns, push-ups, extensions, for too many hours. They can also suffer muscle contractures that are produced by the combination of repetitive exercise and sudden changes in temperature (1). The objective of this study was to describe ergonomically the postural overload of professional drivers of the public transport “Tomebamba”, using the Rapid Entire Body Assessment REBA method. The present research descriptive counted whith the participation of 52 drivers who work in the Tomebamba Company S.A. The data were collected through the application of a survey which had information about: age, years of work experience, workday and also the level of ergonomic risk by using the REBA method which was based on an observational and photographic analysis at the time of labor day the results were analyzed, organized and interpreted by using the statistical software SPSS15. The total studied population, 80.8% of them presented an average level of ergonomic risk. The drivers around the about the age of 20-39 years and with1-15 years of work experience were more propense to get have a risk of postural overload with 42.3% and 55.8% respectively. It is important to say that 65.4% of the population presented a working day equal or greater than 14 hours of work. The REBA method determined a midium level of risk for drivers assessed, which required take corrective and / or preventive measures in the workplace to prevent postural overload with the objective to reduce musculoskeletal disorders in the future

Background: Voice is the main element of human communication and in certain professions, as in teaching, it is a working tool. Its use and abuse can have serious consequences on the health of the speech apparatus. General Objective: To determine the disturbance index of the Voice in Teachers of the School of Medical Technology and School of Nursing of the University of Cuenca in the year 2017. Methodology and Materials: A descriptive, cross-sectional study was carried out in 50 teachers of the Faculty of Medical Sciences of the University of Cuenca. A survey, a questionnaire for vocal disability index (VHI-30), and an acoustic record through the Anagraf program were applied, data were processed in SPSS 15.0 program, which were later represented in tables. Results: The disturbance measure with the highest percentage of alteration was Jitter, in 50%. When applying the Voice Handicap Index (VHI), it was evidenced that 98% of the teachers had mild vocal disability. According to the incidence of vocal disturbance (PI), 34% of teachers present a risk of vocal disturbance and 22% present vocal disturbance. Conclusion: 56% of the teachers whose voice was analyzed are outside the normal range, there was no statistically significant association between voice disturbance index (PI) with: age, sex, years of teaching and hours at the week that uses the voice to practice teaching.

The present investigation was done at Santa Mariana of Jesus and Jesus Ochoa Vasquez schools in Cuenca city. It was done with 123 children including from 48 to 72 months. With whom the test of Basic Functions of the authors Olga Berdicewski and Neva Milicic applies. The same that contains the following parameters of evaluation such as: visuomotor coordination, hearing and language discrimination. These in turn contain activities with parameters that are carried out individually or in groups with up to eight children, it is easy to apply, rapid assessment, economic and performed with time. Furthermore an educational guide for intervention was developed with children, who belonged to this study, the same that lasted twelve weeks, with sessions of forty-five minutes a day in order to work with the basic functions unreached and achieve equality of knowledge and finally an evaluation in which the results of the new learning acquired obtained was performed.. The results were: pre poor evaluation: 34.1%; Poor Post evaluation: 0.0%; Pre Regular assessment: 45.5% Regular Post evaluation 13.0% and Good Pre evaluation: 20.3% Good Post evaluation: 87.0%. Checking our hypothesis, with the intervention of Didactic Guide of the Basic Functions the score is higher in the Test of Basic Functions.

General Objective: Determine the effectiveness of a stretching program at the end of sport practice, as a preventive method of musculoskeletal injuries in the B.A No. 27 "PORTETE" Cuenca 2015. Materials and Methods: A quasi-experimental, longitudinal and prospective study type in 132 soldiers who signed informed consent was conducted. Two groups between the 18 and 47 years were formed. Whit the former a stretching program was implemented and the second was the control group who performed a traditional stretching. Both groups were evaluated by a test of hamstring flexibility Ely test for the quadriceps. The data obtained were analyzed and processed using SPSS 20, making charts and graphs in Microsoft Excel. Results: In the test for hamstrings, there was notany significant difference in the before and after of the control group,but in the intervention group there was a significance of 0.000 (p <0.05). When the before and after in the control group is compared in the right test of Ely, this group does not present significant change, since the p value of 1.000 (p> 0.05) meanwhile the participant group has a significant improvement since the p value of 0.000 (p <0.05). On the left leg there is a slight difference between the two groups with p value of 0.087 (p> 0.05). Conclusions: In our study we can conclude that the stretching program was beneficial to reduce the risk of musculoskeletal injury since it improved flexibility

Background: The muscle disorders that compromise the lumbar area are the cause of physical overexertion during working hours resulting in a fatigue that produces alterations in different muscle chains. By which the determination of the number of workers who have these disorders and their association with the risk factors is of great importance, because these data the company can take the respective measures of prevention to reduce the occurrence of new cases. Objective: To determine the prevalence of lumbar muscle disorders and to identify the risk factors associated with its appearance, in the workers of the wineries on the Company Juan Eljuri, Cuenca 2015. Methodology: Analytical cross-sectional study conducted in the workers of the areas of the warehouse of the Company John Eljuri, 2015. The information was obtained about the participants with lumbar muscle disorders, was detected through physical examination and was collected in a medical history and analyzed for its respective distribution and association with the risk factors raised in our study. Results: 60% of workers in the warehouse area presented lumbar muscle disorders, reaching a higher frequency in the age range of 20-29 years, an association was found between the presence of the disorder with the flexing motion more twisting trunk carried more than 20 times, proving this a main risk factor in comparison with the other repetitive movements of the trunk

BACKGROUND: The prevalence of behavioral problems corresponds to 24.8% of 270 children aged 3-5 years (1). According to the Survey of growth, development and maternal health held in Canelones 5,612 children in 36 months 22.1% (1244) have delayed psychomotor development (2). In Cuenca city, Vicente Corral Moscoso Hospital (2014), 327 children under 5 years the highest prevalence of delayed psychomotor development was presented at the preschool population with 7.3% showing a significant difference in males being more affected than women with 8% (3). GENERAL OBJECTIVE: Relate behavioral problems with psychomotor development in children aged 36-60 months in the public schools of the district urban area south of Cuenca city morning session. METHODOLOGY: A descriptive/cross-sectional study, 288 children aged 36-60 months attending public schools in urban district south morning session of the Cuenca city in 2015-2016, an initial assessment of psychomotor development with test Brunet Lézine subsequently evaluated with the Conners Scale for parents and teachers. The conduct of the children assessed by teachers was abnormal in 29.5% and by parents in 34%. Psychomotor development was normal in 50% of children evaluated and the relationship between behavioral problems and delayed psychomotor development was significant (p <0.05). USE OF RESULTS: The results were analyzed and delivered to the different institutions.

General Objective: To assess the effects of treatment with muscle energy technique tensor de la fascia lata for patellofemoral dysfunction in 25 patients attending the Centre Physiotherapy and Osteopathy "Equlibrio" Cuenca, august 2014 - january 2015. Methodology: Quasi-experimental study. It was evaluated and intervened in 25 patients with patellofemoral dysfunction in the period from August to November 2014. For the survey data was used a card with the following records: Q angle value, Ober Test, Verbal Numerical Scale and Scale Lysholm. Later on 10 treatment sessions lasting 20 minutes was applied; using the technique of muscle energy tensor of the fascia lata, at the end he refilled the same record with the pre-intervention values. The values and results obtained were processed and tabulated in the SPSS 22 program and were represented in statistical tables. Results: Applying the test statistic t student the following results were obtained: the pain got a representative decreased 3.96 points starting with an average value of 7.24 considered intense verbal numerical pain scale to 3.28 represented as mild. The functional assessment of the Lysholm knee which initially had an average of 55.08 points equivalent to a rating of bad knee, at study end was worth 75.72 sign of a knee in fair condition. Conclusion: The technique of muscle energy tensor de la fascia lata allowed reduces pain and improve knee function in patients with patellofemoral dysfunction.

Objective: To evaluate the neurodinamia’s technique in the median nerve versus conventional physiotherapy for reducing the symptoms of Carpal Tunnel Syndrome. Methodology: A quasi-experimental pre-post study made in a “Cooperativa de Ahorro y Credito” in Cuenca’s city in about 42 people who were diagnosed with Carpal Tunnel Syndrome of the administrative area, aged between 25 and 40 years. The first group A or experimental, who was applied to the neurodinamia’s technique in the median nerve; and the second group B or control, who received conventional physical therapy. The dates were tabulated and analyzed using the SPSS v 19; expressed in tables and graphs. Results: Among the study groups there are not significant differences by age and gender as seen as equal found (p => 0.05). The results show that treatment with neurodinamia in the median nerve is better than conventional physiotherapy based on pain reduction (p = 0.000 A group with E-31, group B p = 0.000 with E-26), dysesthesia (group A p = 0.000 with E-18, group B p = 0.063) and paresthesia (group A with p = 0.000 E-25; group B p = 0.000); however, they are equally effective in paresis terms (group A p = 0.000; p = 0.000 Group B). Conclusion: The hypothesis is tested, which states that the neurodinamia’s technique in the median nerve compared to conventional physiotherapy is more effective in reducing the symptoms of Carpal Tunnel Syndrome; supporting news similar studies of neurodinamia theory

In the city of Cuenca, according to the 2010 census of the Ecuador´s Statistics and Census Institute (INEC), there were 505,585 inhabitants. According to the Ecuadorian Register of Disabilities National Council on Disabilities (CONADIS), up to May 2013 there were 17,012 people with disabilities, including 9,302 with physical-motor disability, representing a significant segment of the population who should have access to the public buildings of health services as part of good living. The overall objective of this research was to analyze the accessibility of people with physical-motor disability to the public buildings of health units of first level that belong to the Ministry of Public Health (MSP), Cuenca 2014. This research is observational, descriptive-quantitative. For the analysis of the obtained information through the application of accessibility check sheets, the SPSS Statistics v-18 program was used; and a database was created for further processing. The results were displayed in tables. The classification of level of accessibility in 14 public buildings of health in Cuenca city evidences that 27 corridors (51.92%) offer complete accessibility, 13 stairs (86.66%) and 15 ramps (68.18%) are of moderate accessibility. While accessibility in16 bathrooms (88.89%) and 73 doors (50%) is null

General Objective: To compare the effectiviveness of proprioceptive neuromuscular facilitation technique: hold-relax versus passive stretching to relieve neck pain in workers of the Company Pasamaneria S.A. Metodology: quasi-experimental study. In the company Pasamaneria S.A. Kinesthetic therapy treatment was applied to 66 patients diagnosed with cervical, aged between 25 and 54 years. Patients were divided into two groups according to the treatment applied. The first group was applied FNP hold-relax and Keep the second group Passive Stretch. At the beginning of each session an assessment of pain using the Visual Analogue Scale (VAS) was performed, which allowed us the observe the variation of pain subsequently, the data were analyzed and processed though SPSS version 20.0 (SPSS for Windows Release), making tables and graphs depicting the results. Results: The results of the visual analog scale of pain (VAS) obtained at the fifth session were similar in the two treatment groups, since the stretch Liabilities at its maximum decrease came from the value 7 (initial assessment) to 2 (evaluation final) with p = 5,7499E-26 value, and technology-relax PNF keep descended from the value 6 (initial assessment) to 1 (final evaluation) with p = 5,4063E-26 value. But after the third session, the Technical relax PNF keep-down pain starting value 6-3, while the value Passive Stretching 7 to 5. For comparison between independent variables U test was used Mann Whitney, whereas, for comparison of the measures according sessions, the Friedman test was used. Conclusion: Upon completion of the study showed that the two techniques used were beneficial to reduce neck pain; however PNF technique reduces pain in fewer sessions.

Background: Frequent and regular physical activity produces numerous health benefits. On the other hand, physical inactivity is a public health problem because the body is prone to various diseases, considered as the fourth risk factor for overall mortality according to the World Health Organization (WHO) (1). General Objective: Determine the degree of physical inactivity and its causes in the students of the Faculty of Medical Sciences at the University of Cuenca. Methods: A descriptive observational cross-sectional study on 428 students of the Faculty of Medical Sciences, University of Cuenca, on the International Physical Activity Questionnaire (IPAQ) was applied to classify the activity as low, moderate and intense was performed. Sedentary lifestyle also causes were investigated. Results: 43.2% of students are sedentary belonging most of them to the School of Medical Technology. Of the students surveyed, 71% were female. Finally the cause most prevalent with 34.8%, physical inactivity was lack of time. Conclusion: There is a high degree of sedentary students in our faculty, with predominance in the school of Medical Technology and females. Corrective measures will hopefully be taken and implemented plans to help promote healthy lifestyles, considering physical activity as an essential part of primary care in health and disease prevention.

Currently inclusive education is a major issue that seeks to improve and respond to diversity, aiming to provide a quality education for all people with special educational needs with and without disabilities. An investigation of type "Intervention - Action" was performed in order to assess, intervene and make a proposal on inclusive education for children with Down syndrome led to teachers in three schools of Canton Gualaceo. The sample was 51 teachers from schools "Ciudad de Gualaceo”, “Brasil” and “Huertos del Edén”, initial and basic education. Of all the teachers evaluated 35.3 % belong to the age group of 43 years or over, 49% of teachers have 11 or more years of teaching, 52.9 % of the individuals have a level of education teacher, and 88.2 % are teachers in the public sector. One precaps was applied to evaluate the level of knowledge of teachers obtaining a result of 74.5 % "Good" after the educational intervention in poscaps results showed a 56.9% improvement getting results "Very good “. Therefore, the educational intervention improved knowledge of teachers on inclusive education for children with Down syndrome, fulfilling the objective set in the study. DeCS: DOWN SYNDROME, PREVALENCE, TEACHERS, CURRICULUM, PISICOLOGIA EDUCATION, EDUCATION.

Goal: To create and validate a multimedia computer system “En Línea” for the use of Nutrition professionals in the nutritional consultation and assessment of adults in the urban area, Cuenca canton, Azuay province. Materials and Methods: We developed a transversal correlation experimental investigation. The sample comprised 29 Nutrition professionals. We applied two interventions, one previous and posterior the use of the multimedia computer system “En Línea”. Results: According to the surveys we obtained the following results: Personal data: In the previous survey no professional achieved an excellent qualification; in the last survey, 28 obtained it. Clinical data: In the first survey 13 professionals achieved a rating of excellent; in the later survey, 28 obtained it. Biochemical tests: In the previous survey 25 professionals include this parameter. In the second, all include it. Anthropometric data: In the previous survey, 5 professionals reached the excellent score. With "En Línea", 26 obtained this qualification. 24-hour recall: In the first survey, 26 professionals apply and calculate the reminder. With "En Línea" all applied and calculated it. Prescriptions: In the previous survey, 8 professionals have excellent rating; with "En Línea" all obtain this qualification. Consultation time: According to the first survey no professional takes less than 30 minutes, 3 take 30 to 60 minutes and 26 delayed more than an hour; with "En Línea", 6 took less than 30 minutes, and 23 took 30 to 60 minutes. With this result we confirm our hypothesis. Keywords: SOFTWARE VALIDATION; NUTRITION ASSESSMENT; NUTRITIONIST; NUTRITION THERAPY.

Salto en la foliación antigua de la h. 40 a la 42 y de la 43 a la 45

Salto en la foliación antigua de la h. 40 a la 42 y de la 43 a la 45