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Background Since the declaration of the pandemic, humanitarian medicine has been discontinued. Until now, there have been no general recommendations on how humanitarian surgical missions should be organized. Methods Based on our experience in the field of humanitarian surgical missions to Sub-Saharan Africa, a panel of recommendations in times of COVID-19 was developed. The fields under study were as follows: (1) Planning of a multidisciplinary project; (2) Organization of the infrastructure; (3) Screening, management and treatment of SARS-COV-2; (4) Diagnostic tests for SARS-COV-2; (5) Surgical priorization and (6) Context of patients during health-care assistance. We applied a risk bias measurement to obtain a consensus among humanitarian health-care providers with experience in this field. Results A total of 94.36% of agreement were reached for the approval of the recommendations. Emergency surgery must be a priority, and elective surgery adapted. For emergency surgery, we established a priority level 1a (

The aim of this study was to delve into the role of gender differences in social inclusion of children and youth with autism spectrum disorder (ASD) and intellectual disability (ID). A sample of 420 participants with ASD and ID aged between 4 and 21 years was evaluated using the ASD-KidsLife Scale. Females obtained lower scores in most of the items of social inclusion. These differences remained when the covariables of level of ID, support needs, and age were controlled. None of the items presented differential item functioning as a function of gender. Gender differences, as were found in social inclusion, are discussed and recommendations are given in order to provide equal opportunities to girls and boys with ASD.

El aumento de la esperanza de vida de la población con discapacidad intelectual (DI) ha puesto de manifiesto la falta de conocimiento acerca del duelo en este colectivo. Por esta razón, la presente revisión trata de conocer los avances de la última década respecto a las características del proceso en personas en duelo con DI, las herramientas de evaluación con las que se cuenta y los modelos de intervención propuestos. Para ello, se realizó una búsqueda de los estudios llevados a cabo en los años comprendidos entre 2007 y 2017 en diferentes bases de datos. Los resultados arrojan peculiaridades en el proceso, escasez de instrumentos de evaluación específicos para esta población y una falta de consenso en el tipo de intervención a llevar a cabo. Se discute acerca de la importancia de la sistematización de los estudios, el empleo de herramientas que permitan conocer las necesidades de apoyo de la persona con garantías psicométricas y la necesidad de intervenciones basadas en evidencias.

Objective: The primary objective of this research is to examine the psychological reaction of 44 women with SCI during their process of adaptation to spinal cord injury, specifically with regard to coping strategies, motivation, performance anxiety, neuroticism, extraversion, depression and the possible relationship between these variables and others of a socio-demographic nature. Method: this is a correlational study with cross design strategy and evaluation. The selection process was carried out through health centers and associations of people with disabilities. A total of 44 women with LM participated, mostly resident in Principality of Asturias (54.5%) and Basque Country (40.9%), although they have a small representation of women from Valladolid (4.5 %). Results: The significant differences that were found show the highest scores on the depression scale pertain to women who are married and have less schooling. Moreover, the data from the study reflect the existence of individualized processes of adaptation with highly random functioning in terms of the socio-demographic variables, thereby supporting the assumptions on the model of individual differences in the process of adaptation to spinal cord injury. Conclusion: They also suggest therapeutic processes must be sensitive to the appearance of feelings of hopelessness and depression in women with spinal cord injury.

The main goal of this work is focused on detecting the support needs of people with intellectual disabilities during the bereavement process in order to guide about professional interventions and practices aimed to provide more adequate individualized support to their real needs. The sample consists of 93 adults with ID, with ages ranging from 21 to 72 years old (M = 49.9; SD = 11.79), who have suffered the loss of a significant person. The professionals who worked with them and knew them well completed two questionnaires: Staff Attitude Questionnaire (SAQ) and Bereavement Needs Assessment (BNAT). Beside descriptive analyses, results were analyzed according to several variables (i.e., gender, age, level of intellectual disability, and level of dependency). Level of intellectual disability and level of dependency were the ones that resulted significant. In order to provide the best answer to their needs, good practices are suggested such as facilitating the understanding of loss, helping them express feelings and emotions, dealing with each case individually, and encouraging to continue education about death. El objetivo de este trabajo se centra en detectar las necesidades de las personas con discapacidad intelectual durante el proceso de duelo con el fin de orientar las intervenciones y las prácticas profesionales orientadas a proporcionarles apoyos individualizados más adecuados a sus verdaderas necesidades. La muestra se compuso de 93 adultos con DI, con edades comprendidas entre los 21 y los 72 años (M = 49.9; DT = 11.79), que habían sufrido la pérdida de una persona significativa, y sobre los que han informado profesionales que trabajaban con ellos y los conocían bien, que cumplimentaron dos cuestionarios: el Cuestionario de Actitudes (SAQ) y el cuestionario Evaluación de las Necesidades tras la Pérdida (BNAT). Además de análisis descriptivos se llevaron a cabo análisis sobre el proceso de duelo en función de diversas variables (p. e., género, edad, nivel de discapacidad intelectual y nivel de dependencia). Las variables que resultaron más significativas fueron el nivel de discapacidad intelectual y el nivel de dependencia. Con el fin de proporcionar una mejor respuesta a sus necesidades se proponen recomendaciones sobre buenas prácticas, como facilitar la comprensión de la pérdida, ayudar a expresar sentimientos y emociones, atender cada caso de forma individual y fomentar una educación continua sobre la muerte.

Postoperative renal dysfunction in obstructive jaundice (OJ) patients has been associated with hypovolemia and depletion of the extracellular water compartment (ECW). The aim of the study was to evaluate the preoperative status of body compartments in OJ patients measured by two methods. In a prospective study 39 OJ patients (11 benign and 28 malignant obstructions) were investigated, with 15 healthy subjects used as a control group (CG). Bioelectrical impedance analysis (BIA) determinations and values derived from anthropometric measurements were used to assess body compartment status. The coefficient of variation of BIA was below 4% in both OJ and CG subjects. No differences were found in intracellular water. However total body water (TBW) and ECW were reduced in OJ patients (50.5 +/- 4.6 vs. 56 +/- 8% body weight, p = 0.05; and 21 +/- 4.5 vs. 23.8 +/- 2.5% body weight, p0.05, respectively). There were no differences between benign and malignant obstructions. Seventy four percent of OJ patients had an ECW volume below the mean +/- 2 SD in the CG subjects. Anthropometric and BIA determinations correlated closely for TBW measurements in both CG (r = 0.92, p0.001) and OJ patients (r = 0.91, p0.001). Bland-Altman analysis also showed that for TBW the BIA was in agreement with anthropometry. In the present study, BIA offered a good correlation with anthropometric determinations and was a reliable method for body fluid disturbances assessment in jaundiced patients.

Traditionally, web standards in general and Cascading Style Sheets (CSS) in particular take a long time from when they are defined by the W3C until they are implemented by browser vendors. This has been a limitation not only for authors, who had to wait even years before they were able to use certain CSS properties in their web pages, but also for the creators of the specification itself, who were not able to test their proposals in practice.In this paper we present ALMcss, a JavaScript prototype that implements the CSS Template Layout Module, a proposal for an addition to CSS to make it a more capable layout language. It has been developed inside the W3C CSS Working Group by two of the authors of this paper. We present the rationale of the module and an introduction to its syntax, before discussing the design of our prototype.ALMcss has served us as a proof of concept that the Template Layout Module is not only feasible, but it can be in fact implemented in current web browsers using just JavaScript and the Document Object Model (DOM). In addition, ALMcss allows web designers to start to use today the new layout capabilities of CSS that the module provides, even before it becomes an official W3C specification.

[ES] En este trabajo se exponen diversos aspectos sobre la premiada película “Mar adentro”, de Alejandro Amenábar, analizados seis años después de la obtención del Óscar. Es de sobra conocido que el largometraje narra la historia real de un tetrapléjico, Ramón Sampedro, recalcando las vicisitudes del protagonista hasta conseguir poner fin a su vida. Se hace un análisis de los personajes de la cinta, se recogen las críticas tanto las populares como las cinematográficas y se analiza la visión que se ofrece de la discapacidad. Respetando la opción personal del protagonista, y conscientes de que el tema principal no es la discapacidad sino la eutanasia, se presenta una visión crítica del enfoque ofrecido de la tetraplejia y, en última instancia, de la lesión medular, por considerar que indirectamente resalta aspectos negativos en detrimento de un enfoque positivo de la vivencia con dicha discapacidad. En definitiva, por mostrar una imagen contraria a lo que se viene defendiendo desde este equipo, a saber, que la discapacidad, incluida la lesión medular, es compatible con ser feliz.

Desde el ano 2005 el Equipo de Investigacion sobre Discapacidad de la Universidad de Oviedo dirigido por el profesor Aguado, ha llevado a cabo una linea de investigacion para evaluar la situacion y necesidades de los estudiantes con discapacidad en la Universidad de Oviedo. El estudio que aqui se presenta se encuentra en fase de realizacion y tiene como fin realizar una nueva aplicacion de la encuesta sobre la situacion y necesidades de los alumnos con discapacidad matriculados durante el curso 2007-2008 en la Universidad de Oviedo. Con este retest se persigue la consecucion de cuatro objetivos: realizar un seguimiento y un analisis comparativo con los resultados encontrados en el trabajo del que parte, conocer las necesidades de nuevos estudiantes, evaluar el impacto del primer estudio y, por ultimo, analizar las propiedades psicometricas de la escala utilizada, mediante la tecnica test-retest. Este retest se presenta como un estudio pionero en dos cuestiones, sera el primer estudio comparativo en la materia y aportara datos piscometricos de la escala utilizada que permitan mejorar las garantias cientificas en este campo, en el cual solo existen estudios puntuales y escalas construidas ad hoc.

Este artículo tiene como objetivo presentar una revisión de la investigación sobre los aspectos psicológicos y sociales relacionados con la sexualidad de las personas con lesión medular (LM). La importancia que el impacto de la lesión tiene sobre la persona y su entorno, en general, y sobre la esfera de la sexualidad, en particular, la convierte en un área de gran interés científico y social en la actualidad. Esto se explica por el crecimiento constante en la prevalencia y la radicalidad de las alteraciones biopsicosociales que conlleva la LM. Así, en su vida sexual la persona ha de afrontar cambios tanto en lo físico como en lo emocional y relacional. A tal efecto, lo que pretendemos es revisar la bibliografía disponible, intentando abordar y delimitar sucesivamente i) el tipo de publicaciones en las que se trata el tema, ii) las áreas temáticas de estudio iii) la metodología de las investigaciones, para llegar, por último, iv) a las conclusiones de nuestra revisión.

Recientemente se ha llevado a cabo un estudio exhaustivo de la situación de los estudiantes con discapacidad de la Universidad de Oviedo. En el presente artículo se ofrece una síntesis del amplio informe que se elaboró, concretamente del procedimiento seguido, de los principales resultados obtenidos así como de las conclusiones y sugerencias a las que se ha llegado tras el análisis detallado de la entrevista que se pasó a los alumnos con discapacidad matriculados en la universidad asturiana.

En este artículo se presenta un programa de intervención psicológica destinado a proporcionar información sobre cues¬tiones relacionadas con la sexualidad a un grupo de jóvenes con discapacidad intelectual (DI). Dicho programa de educación sexual nace como respuesta a las necesidades planteadas por los profesionales y padres de un grupo de jóvenes con DI pertenecientes a una asociación del Principado de Asturias. En primer lugar, se describen el planteamiento general y los obje¬tivos de dicho programa. En segundo lugar, se detalla el pro¬cedimiento de evaluación seguido tanto para la evaluación inicial como para la valoración de resultados y el seguimiento conse¬cuentes. En tercer lugar, se amplía el diseño y la frecuencia del programa y se concretan las técnicas utilizadas en la ¡mplementación del mismo. En cuarto lugar, se presentan los resultados alcanzados, cuyos datos muestran diferencias sig¬nificativas en las respuestas a los ítems en fundón de los distintos momentos de la evaluación, pretest, posttest y segui¬miento. Las diferencias entre el pretest y el posttest indican que la participación en el programa mejora significativamente el nivel de conocimientos sobre cuestiones relacionadas con la sexua¬lidad, mejora que se mantiene a los tres meses de finalizado el programa. Finalmente, el trabajo termina con la discusión de los resultados y una serie de conclusiones acerca de la eficacia y utilidad del programa con el fin de potenciar su implantación., In this issue a psychological intervention program is presented, aimed at providing information on disability sexuality related issues to a group of youngsters with intellectual disability (ID). Such a sexual education program is bom as a response to the needs raised by professionals and parents of a youngsters group with ID from an association in the Principality of Asturias. Firstly, general approach and objectives of such a program are explained. Secondly, the assessment process used either for the initial assessment or the outcome evaluation as well as the follow up is reported. Thirdly, the program design, frequency and techniques used in its implementation are described. Fourthly, the results obtained are presented. Data show significant differences in items responses according to the assessment different moments, pre-test, post-test and follow up. The differences between pre-test and pos-test point out the significant increasing of acknowledge on sexuality, increasing that is maintained along tree months after the program. Finally, the issue ends with a general discussion about the results and the several conclusions about the program efficacy and utility are commented with the purpose of promoting its implementation.

Carbon microelectrodes have been implemented as sensing phases in order to improve the efficiency of the electrochemical sensing in capillary electrophoresis microchips. Surface and embedded carbon microelectrodes were fabricated on glassy substrates using a laser lithography technique. Both types of microelectrodes were successfully verified and, in the case of embedded microelectrodes, are proving to be an excellent alternative to increase the sensitivity of biosensors based on capillary electrophoresis.

The negative attitudes toward people with disabilities prevailing in our society suggest the need for interventions to modify those attitudes. With this aim a program in changing attitudes towards people with disabilities in primary school children has been developed. 100 children between 7 and 10 years old took part in the study, 39 were assigned to the experimental group and 61 to the control group. Information and contact have been used as change techniques. It has also been followed up for two years and a half. During this time, activities reminders have been made. The assessment instrument used was the Scale of Attitudes toward People with Disabilities (Verdugo, Arias & Jenaro, 1994). The results obtained argue for the effectiveness of these techniques. There are statistically significant differences between pretreatment and posttreatment measures in favor of the experimental group. Also, these changes at follow up have been maintained.

Background/Objective: Ageing and progressive increase in life expectancy in people with intellectual disability present significant challenges. The present study is to examine the needs that arise in the aging process of this population. To detect these needs is fundamental to ensure personal wellbeing; almost no psychometrically sound instruments have been developed. Method: A structured interview was developed and evaluated by a panel of 20 experts to obtain evidence of content validity. The interview was then applied to 1,173 people with intellectual disability. The ages ranged from 35 to 80 (M=52.27; SD=7.5). Results: The interview consisted of 93 items evaluating four areas: perceived needs, personal problems, future perspectives, and solutions required. The results demonstrated the proximity and relationship of the various needs evaluated. In addition it was observed that those with intellectual disability who were older, male and users of residential services tended to indicate more needs, problems, and required more solutions. Conclusions: The instrument has adequate evidence of validity, allowing the evaluation of specific needs of people with intellectual disability. The results advocate the design of transversal intervention policies in order to effectively meet the needs and requirements of this population.

Objetivo: conocer el funcionamiento psicológico de 44 mujeres con LM en el proceso de adaptación a la lesión; en concreto, las estrategias de afrontamiento, la motivación y ansiedad de ejecución, el neuroticismo-extraversión, la depresión y su posible relación con variables sociodemográficas. Método: se trata de un estudio con estrategia correlacional y diseño de evaluación transversal. El proceso de selección ha sido realizado a través de centros sanitarios y de asociaciones de personas con discapacidad. Participaron un total de 44 mujeres con LM, residentes en su mayoría en el Principado de Asturias (54,5 %) y en Euskadi (40,9 %), aunque también contamos con una pequeña representación de mujeres procedentes de Valladolid (4,5 %). Resultados: las diferencias significativas halladas nos muestran puntuaciones más elevadas en la escala de depresión en mujeres casadas y con menor nivel educativo. Los datos de este estudio reflejan la existencia de procesos individualizados de adaptación con un funcionamiento bastante aleatorio respecto a las variables sociodemográficas y, por tanto, apoyan los postulados del modelo de diferencias individuales en el proceso de adaptación a la LM. Conclusión: se sugiere que los procesos terapéuticos deben ser sensibles a la aparición de sentimientos de desesperanza y depresión en las mujeres con LM. Objective: The primary objective of this research is to examine the psychological reaction of 44 women with SCI during their process of adaptation to spinal cord injury, specifically with regard to coping strategies, motivation, performance anxiety, neuroticism, extraversion, depression and the possible relationship between these variables and others of a socio-demographic nature. Method: this is a correlational study with cross design strategy and evaluation. The selection process was carried out through health centers and associations of people with disabilities. A total of 44 women with LM participated, mostly resident in Principality of Asturias (54.5%) and Basque Country (40.9%), although they have a small representation of women from Valladolid (4.5 %). Results: The significant differences that were found show the highest scores on the depression scale pertain to women who are married and have less schooling. Moreover, the data from the study reflect the existence of individualized processes of adaptation with highly random functioning in terms of the socio-demographic variables, thereby supporting the assumptions on the model of individual differences in the process of adaptation to spinal cord injury. Conclusion: They also suggest therapeutic processes must be sensitive to the appearance of feelings of hopelessness and depression in women with spinal cord injury. Objetivo: conhecer o funcionamento psicológico de 44 mulheres com LM no processo de adaptação à lesão; em concreto, as estratégias para enfrentar a doença, a motivação e a ansiedade de execução, o neuroticismo-extraversão, a depressão e a sua possível relação com variáveis sociodemográficas. Método: este é um estudo correlacional com a estratégia de design da cruz e avaliação. O processo de seleção foi realizado por meio de centros de saúde e associações de pessoas com deficiência. Um total de 44 mulheres com LM, a maioria residente no Principado das Astúrias (54,5%) e País Basco (40,9%), embora tenham uma pequena representação das mulheres de Valladolid (4,5 %). Resultados: as diferenças significativas encontradas nos mostram pontuações mais elevadas na escala de depressão em mulheres casadas e com menor nível educativo. Os dados deste estudo refletem a existência de processos individualizados de adaptação com um funcionamento bastante aleatório a respeito das variáveis sociodemográficas. Conclusão: apoiam as premissas do modelo de diferenças individuais no processo de adaptação à LM.

El objetivo de este trabajo es la elaboración de un instrumento para evaluar la calidad de vida (CV) de las personas con discapacidad que envejecen. Se ha aplicado a una muestra de 2.292 personas con discapacidad mayores de 45 años procedentes de distintas comunidades autónomas del territorio español. La necesidad de disponer de instrumentos de evaluación de CV para este colectivo de personas con discapacidad que envejecen, que nos permitan realizar medidas fiables y válidas sobre las que planificar actuaciones y estrategias de intervención eficaces, ha orientado la elaboración de esta Escala de Calidad de Vida (ECV). El análisis de las propiedades psicométricas de la escala muestra una elevada consistencia interna, alfa de Cronbach de 0,92. La dimensionalidad de la escala arroja una solución hexafactorial que muestrea seis de las principales dimensiones de CV, en concreto, bienestar físico, inclusión social, bienestar emocional, desarrollo personal y autodeterminación, relaciones interpersonales y bienestar material. Estos resultados evidencian la adecuación de la ECV para evaluar la CV tal y como es percibida por la muestra de nuestro estudio, las personas con discapacidad que envejecen.