Development of a Predictive Model for Skin-to-Skin Contact Immediately after Birth: A Cross-Sectional Study.

The aim of this study was to develop and validate a predictive model for the establishment of skin-to-skin contact immediately after birth. A descriptive cross-sectional study was conducted during the last trimester of 2022 and the first trimester of 2023 with women who had given birth in Spain. A questionnaire containing sociodemographic, psychosocial, and health variables referring to the mother and the newborn, as well as the Bond and Attachment questionnaire (VAMF, for its name in Spanish) for the analysis of the mother-child bond and attachment, were administered. A multivariate analysis was performed, and areas under the ROC curve (AUC) with their 95% confidence intervals (CI) and the predictive characteristics of these models were estimated. In total, 1077 women participated. The prevalence of early skin-to-skin contact after delivery was 50.2% (468) in the derivation cohort and 49.8% (464) in the validation cohort. Multivariate analysis showed that prematurity, type of delivery, and birth experience were statistically significant, so they were included in the model (p ≤ 0.05). The predictive ability (AUC ROC) was good in both the derivation cohort, yielding 0.92 (95% CI: 0.89-0.95), and in the validation cohort, yielding 0.89 (95% CI: 0.85-0.93). This study developed a predictive model identifying factors facilitating early skin-to-skin contact between a mother and her newborn immediately after birth.

Factors related to a disturbance in the mother-child bond and attachment.

INTRODUCTION: Establishing an adequate bond and attachment between a mother and child is essential for preventing pathologies and developing this relationship in the future. PURPOSE: To identify the factors related to a disturbance of the mother-child bond or attachment. METHODS: A cross-sectional descriptive study was carried out with women with a biological child between 6 weeks and 18 months of age. The Mother-Child Bond-Attachment Questionnaire (VAMF, for its name in Spanish) was administered to measure the bond and postnatal attachment together with a questionnaire containing sociodemographic, psychosocial, and health variables referring to the mother and the newborn. RESULTS: 1114 women participated. The multivariate analysis showed that skin-to-skin contact (aOR = 0.58; 95% CI: 0.37, 0.90) and breastfeeding (aOR = 0.55; 95% IC: 0.35, 0.86) reduce the probability of presenting a bond disturbance. Anxiety during pregnancy, childbirth, and the puerperium (aOR = 3.95; 95% CI: 2.57, 6.05) and postpartum complications (aOR = 1.60; 95% CI: 1.03, 2.48) increase the chance of having a bond disturbance. Skin-to-skin contact (aOR = 0.61; 95% CI: 0.38, 1.00), breastfeeding (aOR = 0.47; 95% CI: 0.27, 0.80,) and an older age of the infant (months) (aOR = 0.77: 95% CI: 0.72, 0.82) reduces the probability of presenting an attachment disturbance. CONCLUSIONS: Skin-to-skin contact and breastfeeding are associated with a lower probability of impaired bonding and attachment. Anxiety states during pregnancy, childbirth, and the puerperium, and complications after childbirth increase the probability of developing a bond disorder. The older the age of the infant, the lower the frequency of having an impaired attachment. IMPLICATIONS TO PRACTICE: Identifying the factors associated with the establishment of the mother-child bond and attachment is essential for the development of prevention strategies and early identification of cases that may present alterations and avoid their consequences on the health of the mother and child.

La historia de vida de la enfermera Águeda Medina Soto como elemento clave dela relevancia de la cultura de los cuidados en la enfermería de Jaén / A história de vida da enfermeira Águeda Medina Soto como elemento chave darelevância da cultura do cuidado na enfermagem em Jaén / The life story of the nurse Águeda Medina Soto as a key element of the relevance of the culture of care in nursing in Jaén

In this proposal we present a feminist critical analysis of the importance that nurses haveplayed, being the life story of the nurse Águeda Medina Soto an example of her relevance in Jaén.In this sense, the methodology that facilitates the study of our recent past is life history, this beingpart of a critical-reflective intergenerational analysis, establishing cause-effect between personal experiences, society and Nursing. In addition, linking it with the gender perspective, it provides uswith another necessary analysis to reflect on how society was formed, the access and limitationsthat were presented to women of the time for incorporation into the nursing branch, in addition tothe difference structural and recognition of sex-gender roles between women and men who exercised these trades (nurses and interns respectively). The results obtained show the usefulness offered by the life history, to make visible the differences both structural, academic and sex-genderdifferentiated practices associated with nurses and practitioners. In turn, make visible the socialrelevance of nurses within the health field in the culture of care, through the case of nurse Águeda.(AU)

En esta propuesta presentamos un análisis crítico feminista de la importancia que hanjugado las enfermeras, siendo la historia de vida de la enfermera Águeda Medina Soto un ejemplo de su relevancia en Jaén. En este sentido, la metodología que nos facilita el estudio de nuestro pasado reciente es la historia de vida, siendo esta, parte de un análisis intergeneracional crítico-reflexivo, estableciendo causa-efecto entre las experiencias personales, la sociedad y la Enfermería. Además, enlazándolo con la perspectiva de género, nos presta otro un necesario análisis para reflexionarsobre cómo se conformaba la sociedad, el acceso y limitaciones que se presentaban a las mujeres dela época para la incorporación en la rama de enfermería, además de la diferencia estructural y dereconocimiento de los roles sexo-genéricas entre las mujeres y hombres que ejercían dichos oficios(enfermeras y practicantes respectivamente). Los resultados obtenidos muestran la utilidad queofrece la historia de vida, para visibilizar las diferencias tanto estructurales, académicas y prácticasdiferenciadas sexo-genéricas asociadas a las enfermeras y los practicantes. A su vez, visibilizar larelevancia social de las enfermeras dentro del ámbito sanitario en la cultura de los cuidados, a travésdel caso de la enfermera Águeda.(AU)

Nesta proposta apresentamos uma análise crítica feminista da importância que os enfermeiros têm desempenhado, sendo a história de vida da enfermeira Águeda Medina Soto um exemplo da sua relevância em Jaén. Nesse sentido, a metodologia que facilita o estudo do nosso passadorecente é a história de vida, fazendo parte de uma análise intergeracional crítico-reflexiva, estabelecendo causa-efeito entre experiências pessoais, sociedade e Enfermagem. Além disso, articulando-acom a perspectiva de gênero, nos fornece mais uma análise necessária para refletir sobre como seformou a sociedade, os acessos e limitações que se apresentavam às mulheres da época para incorporação ao ramo da enfermagem, além da diferença estrutural e reconhecimento dos papéis sexogênero entre mulheres e homens que exerciam esses ofícios (enfermeiros e estagiários, respectivamente). Os resultados obtidos mostram a utilidade oferecida pela história de vida, para tornar visíveis as diferenças estruturais, acadêmicas e práticas diferenciadas de gênero associadas a enfermeiros e profissionais. Por sua vez, visibilizar a relevância social dos enfermeiros da área da saúde nacultura do cuidado, através do caso da enfermeira Águeda.(AU)

La apendicitis aguda no aumenta el riesgo de cáncer de colon derecho en mayores 45 años

Objetivo: El objetivo principal consistió en determinar si en nuestra población existía una diferencia en la tasa de diagnóstico de cáncer de colon derecho para los pacientes mayores de 45 años en los 36 meses siguientes, tras apendicitis aguda en comparación con un grupo control. Pacientes y Métodos: Estudio de cohortes retrospectivo con un grupo expuesto de 300 pacientes con diagnóstico histológico de apendicitis aguda y un grupo control de 300 pacientes intervenidos de patología benigna entre enero de 2014 y agosto 2017. Se han realizado referencias cruzadas entre las historias clínicas electrónicas y la base de datos del Registro de Cáncer de Granada. Resultados: Se presentaron 2/300 pacientes (0,7%) mientras que en el grupo control, se presentaron 4/300 (1,3%). Antes estos hallazgos, no existe un mayor riesgo de desarrollar un carcinoma colon en los pacientes con apendicitis (p > 0,05). Discusión: La apendicitis aguda puede tratarse de la primera manifestación de carcinoma de colon derecho, sin embargo, en nuestra revisión no encontramos dicha asociación en nuestra población.

Aim: The main objective was to determine whether in our population there was a difference in the rate of right colon cancer diagnosis for patients over 45 years of age in the 36 months following acute appendicitis compared to a control group. Patients and Methods: Retrospective cohort study with an exposed group of 300 patients with histological diagnosis of acute appendicitis and a control group of 300 patients operated on for benign pathology between January 2014 and August 2017. Electronic medical records and the Granada Cancer Registry database were cross-referenced. Results: 2/300 patients (0.7%) presented while 4/300 (1.3%) presented in the control group. Given these findings, there is no increased risk of developing colon carcinoma in patients with appendicitis (p > 0.05). Discussion: Acute appendicitis may be the first manifestation of right colon carcinoma, however, in our review we found no such association in our population.

Rare earth elements as statistical sentinels of pollution and paleoenvironments?: Application to a highly polluted estuary in southwestern Spain.

Multivariate analyses have been applied to the REE contents of three cores collected in the Tinto estuary, SW Spain, an extremely polluted area. Results indicate an extremely correlation between all REE, which behave as a single variable. A slight natural pollution peak and three anthropogenic pollution peaks are identified, related with the first mining activities, the Roman period and a recent intensive mining accompanied by a heavy industrial pollution. In all these peaks, the increase of Cu is parallel to that of MREE, which are configured as the best indicators of pollution among REE. Statistical analyses clearly differentiate four groups, each consisting of samples from different environments. Although grain size and this strong pollution alter the study of REE as environmental indicators, it is possible to recognise groups of samples with a common origin or to identify the surface extent of a given pollution peak.

Las personas con trastorno mental grave en un programa de alojamiento supervisado por un Equipo Comunitario Asertivo / People with severe mental disorders in a housing program supervised by an Assertive Community Team

El objetivo de este trabajo es evaluar la actitud y satisfacción de 182 pacientes con trastorno mental grave alojados en pisos y residencias supervisadas, sus redes sociales, las necesidades de atención y los cambios clínicos. Se recogieron datos sociodemográficos y clínicos. Se aplicaron los cuestionarios de Actitudes del Usuario (CAU), de Red Social (CURES) y la Escala ENAR-CPB de Valoración de los Niveles de Atención Residencial, con repetición a los dos años. El 86% refirieron mejoría en su vida, 77% en su enfermedad y 50% en sus relaciones sociales. Se observó una reducción significativa en las necesidades de atención a los dos años. Un 86% no tuvo ingresos hospitalarios, frente al 99% del año previo. En general, encontramos una buena aceptación de los alojamientos, con mejoría en las relaciones sociales, la estabilidad clínica y hospitalizaciones. Gracias al tratamiento asertivo comunitario, la mayoría consideraba que había habido una mejoría en su enfermedad y en sus vidas. (AU)

The aim of this work was to evaluate the attitude and satisfaction of 182 patients with severe mental disorder in supervised accommodation, their social networks, their care needs and clinical changes. Sociodemographic and clinical data were collected. The User Attitudes Questionnaire (CAU), the Social Network Questionnaire (CURES) and the Scale of Assessment of the Levels of Residential Attention for people with Severe Mental Disorder (ENAR-CPB) were administered with repetition at two years. 86% of them reported improvement in their life, 77% in their illness, and 50% in their social relationships. There was a significant reduction in care needs at two years. 86% of the participants did not have hospital admissions, compared to 99% the previous year. In general, we found a good acceptance of the accommodations, as well as an improvement in their social relationships, clinical stability, and hospitalizations. Thanks to the assertive community treatment, the majority considered that there was an improvement both in their disease and in their lives. (AU)

Experiencias de mujeres infectadas con COVID-19 durante el embarazo / Experiences of women infected with COVID-19 during pregnancy

Objetivo: Conocer las experiencias vividas de mujeres gestantes ante el diagnóstico de la enfermedad COVID-19. Material y métodos: Estudio cualitativo fenomenológico. Se realizaron 6 entrevistas en profundidad a mujeres embarazadas y puérperas que sufrieron COVID-19 durante la evolución de su embarazo. El acceso a las 6 participantes se realizó por medio de la consulta de la matrona, en sus centros sanitarios de referencia. Se aplicó un análisis de contenido. Resultados: Se detectan cinco emociones relacionadas con la infección por COVID-19, en el embarazo y puerperio: miedo, ansiedad, soledad, culpabilidad y tristeza. El seguimiento profesional a las embarazadas durante la cuarentena en la mayor parte de los casos no se realiza si- guiendo los protocolos establecidos. El apoyo recibido por las mujeres se sustenta en dos pilares: uno ejecutivo, realizado por la pareja y o familia, y otro el medio, por el que reciben el apoyo tanto profesional como fami- liar, donde el teléfono y las redes sociales han sido cruciales. En la mayo- ría de los casos se demanda más información sobre la enfermedad y sus efectos en el embarazo. Conclusiones: La infección por COVID-19 en el embarazo originó en la muestra del estudio una serie de sentimientos negativos que se vieron potenciados por el efecto del aislamiento y la falta de información y de apoyo sanitario. (AU)

Objective: To know the lived experiences of pregnant women before the diagnosis of the COVID-19 disease. Material and methods: Qualitative phenomenological study. 6 in-depth interviews were conducted with pregnant and postpartum women who suffered from COVID-19 during the evolution of their pregnancy. Access to the 6 participants was made through the midwife’s consultation, in their reference health centers. A content analysis was applied. Results: Five emotions related to COVID-19 infection are detected, in pregnancy and postpartum: fear, anxiety, loneliness, guilt and sadness. Professional follow-up of pregnant women during quarantine in most cas- es is not carried out following established protocols. The support received by women is based on two pillars: one executive carried out by the couple and/or family and the other the means by which they receive both profes- sional and family support, where the telephone and social networks have been crucial. In most cases, more information about the disease and its effects on pregnancy is required. Conclusions: COVID-19 infection in pregnancy caused a series of nega- tive feelings in the study sample that were enhanced by the effect of iso- lation, lack of information and health support. (AU)

Did a 3800-year-old Mw ~9.5 earthquake trigger major social disruption in the Atacama Desert?

Early inhabitants along the hyperarid coastal Atacama Desert in northern Chile developed resilience strategies over 12,000 years, allowing these communities to effectively adapt to this extreme environment, including the impact of giant earthquakes and tsunamis. Here, we provide geoarchaeological evidence revealing a major tsunamigenic earthquake that severely affected prehistoric hunter-gatherer-fisher communities ~3800 years ago, causing an exceptional social disruption reflected in contemporary changes in archaeological sites and triggering resilient strategies along these coasts. Together with tsunami modeling results, we suggest that this event resulted from a ~1000-km-long megathrust rupture along the subduction contact of the Nazca and South American plates, highlighting the possibility of Mw ~9.5 tsunamigenic earthquakes in northern Chile, one of the major seismic gaps of the planet. This emphasizes the necessity to account for long temporal scales to better understand the variability, social effects, and human responses favoring resilience to socionatural disasters.

Mechanical Performance of 3D-Printed Biocompatible Polycarbonate for Biomechanical Applications.

Additive manufacturing has experienced remarkable growth in recent years due to the customisation, precision, and cost savings compared to conventional manufacturing techniques. In parallel, materials with great potential have been developed, such as PC-ISO polycarbonate, which has biocompatibility certifications for use in the biomedical industry. However, many of these synthetic materials are not capable of meeting the mechanical stresses to which the biological structure of the human body is naturally subjected. In this study, an exhaustive characterisation of the PC-ISO was carried out, including an investigation on the influence of the printing parameters by fused filament fabrication on its mechanical behaviour. It was found that the effect of the combination of the printing parameters does not have a notable impact on the mass, cost, and manufacturing time of the specimens; however, it is relevant when determining the tensile, bending, shear, impact, and fatigue strengths. The best combinations for its application in biomechanics are proposed, and the need to combine PC-ISO with other materials to achieve the necessary strengths for functioning as a bone scaffold is demonstrated.

The Promotion of Values in Young People in Different Contexts of Sports Practice / La Promoción de Valores en los Jóvenes en los Diferentes Contextos de la Práctica Deportiva

The educational potential of sport is a wide-ly researched topic area in sports science. This potential is greater or lesser depending on the focus given to sports. The objectives of this study are to: (i) Establish the reference values and their hierarchy in participants in the RMF’s Socio-sporting Basketball Schools compared with secondary school students; (ii) Identify whether there are differences according to sex and age group; (iii) To determine if there are differences in the relationships between dimensions comparing the RMF athletes and the group of secondary school students. The study includes 304 participants. Of these, 80 have engaged in sports at the RMF’s Socio-sporting Basketball Schools and 224 are secondary school students who had not played sports in the RMF’s schools. All participants are aged between 12 and 16 (M = 13.94; SD = 1.35). The instrument used is the Questionnaire on Values in Team Sports, in Spanish Cuestionario sobre Valores en los Deportes de Equipo (CUVADE) (12-16 years). This tool allows the researcher to establish the reference values of participants in team sports as well as the hierarchy in which they place these values, both inside and outside the educational and/or sports club setting. The athletes at the RMF Socio-sporting Schools exhibit a greater appreciation of the dimensions of sportsmanship, fair play, and peaceful behaviour. In addition, the boys and girls who play basketball at the RMF Socio-sporting Schools do not display significant differences in any of the six dimensions. However, the secondary school students display differences in the dimensions of personal and team success. According to the data obtained, the sporting-educational model of the RMF can be regarded as contributing to young athletes’ optimal personal development.(AU)

Breastfeeding at 1, 3 and 6 Months after Birth According to the Mode of Birth: A Correlation Study.

BACKGROUND: Breastfeeding is a determinant of child and maternal health. However, evidence is limited on how mode of birth influences breastfeeding. Research aim: To examine the mode of birth and breastfeeding duration and the type of lactation at one, three and six months after birth in XXX, during 2017. METHODS: Correlation study on breastfeeding duration and type of lactation during the six months after birth, and mode of birth, in a randomised sample. Women ≥18 years of age with term singleton infants, were included. Collected data through interviews and hospital records. Pearson's and Spearman's correlation analyses were conducted. SPSSv21 and α = 0.05 were used. RESULTS: Breastfeeding duration was shorter in women with greater parity (-0.055 **) (p < 0.01) and epidural analgesia (0.057 **) (p < 0.01), and longer in mothers with episiotomy (-0.267 **) (p < 0.01). Episiotomy was associated with breastfeeding at one month (0.112 **) (p < 0.01), and at six months (0.347 *) (p < 0.01). The prevalence of breastfeeding was lower in women who received epidural analgesia at three months (-0.140 **) (p < 0.01) and higher at six months (0.013 **) (p < 0.01). The percentages of breastfeeding at three months were significantly greater in women with no perineal tears (2.1) (p < 0.05). At six months, small rates of breastfeeding were found in women with greater parity (0.051 **) (p < 0.01). No significant association was detected, neither between the type of lactation and the mode of birth, nor between breastfeeding duration and the mode of birth. CONCLUSIONS: Epidural analgesia, episiotomy, perineal tears and parity influence the type of lactation and duration of breastfeeding during the six months after birth. The results suggest no association between the type of lactation and the mode of birth or between breastfeeding duration and the mode of birth.

Decreased Consumption of Added Fructose Reduces Waist Circumference and Blood Glucose Concentration in Patients with Overweight and Obesity. The DISFRUTE Study: A Randomised Trial in Primary Care.

The relationship between fructose intake and insulin resistance remains controversial. Our purpose was to determine whether a reduction in dietary fructose is effective in decreasing insulin resistance (HOMA2-IR). This field trial was conducted on 438 adults with overweight and obese status, without diabetes. A total of 121 patients in a low fructose diet (LFD) group and 118 in a standard diet (SD) group completed the 24-week study. Both diets were prescribed with 30-40% of energy intake restriction. There were no between-group differences in HOMA2-IR. However, larger decreases were seen in the LFD group in waist circumference (-7.0 vs. -4.8 = -2.2 cms, 95% CI: -3.7, -0.7) and fasting blood glucose -0.25 vs. -0.11 = -0.14 mmol/L, 95% CI: -0.028, -0.02). The percentage of reduction in calorie intake was similar. Only were differences observed in the % energy intake for some nutrients: total fructose (-2 vs. -0.6 = -1.4, 95% CI: -2.6, -0.3), MUFA (-1.7 vs. -0.4 = -1.3, 95% CI: -2.4, -0.2), protein (5.1 vs. 3.6 = 1.4, 95% CI: 0.1, 2.7). The decrease in fructose consumption originated mainly from the reduction in added fructose (-2.8 vs. -1.9 = -0.9, 95% CI: -1.6, -0.03). These results were corroborated after multivariate adjustments. The low fructose diet did not reduce insulin resistance. However, it reduced waist circumference and fasting blood glucose concentration, which suggests a decrease in hepatic insulin resistance.

Umbilical cord separation time, predictors and healing complications in newborns with dry care.

OBJECTIVE: The objective of this study was to explore the umbilical cord separation time, predictors, and healing complications from birth until the newborn was one month old. DESIGN: A quantitative longitudinal observational analytical study by stratified random sample was adopted. SETTING: Public health system hospitals in southern Spain and at newborns' homes. PARTICIPANTS: Between April 2016 and December 2017, the study included 106 neonates born after 35-42 weeks of gestation whose umbilical cord was cured with water and soap and dried later as well as newborns without umbilical canalisation whose mothers enjoyed a low-risk pregnancy. METHODS: The data collection procedure comprised two blocks: from birth to the time of separation of the umbilical cord and from cord separation to the first month of life of the newborn. Umbilical cord separation time was measured in minutes; socio-demographic and clinical characteristics were measured by means of questionnaires, and the external diameter of the umbilical cord was measured using an electronic stainless-steel calliper and trailing roller. RESULTS: The mean umbilical separation time: 6.61 days (±2.33, IC 95%:6.16-7.05). Incidence of omphalitis was 3.7%; granuloma was 8.6%. Separation time predictors were wetting recurrence, birth weight, intrapartum antibiotics, birth season, and Apgar < 9 (R2 = 0.439 F: 15.361, p <0.01). CONCLUSION: The findings support the World Health Organization recommendations: dry umbilical cord cares is a safe practice that soon detaches the umbilical cord, taking into account the factors studied that will vary the length of time until the umbilical cord is separated.

Experiences and outcomes following diagnosis of congenital foetal anomaly and medical termination of pregnancy: A phenomenological study.

AIM: To determine and describe the experiences of pregnant women who receive a diagnosis of chromosomopathy and/or foetal malformation during a prenatal check-up and who decide to legally terminate the pregnancy. BACKGROUND: When a pregnancy is terminated, the woman must cope with frustrated motherhood. The psychological consequences of this will largely depend on the care and support provided by health professionals. When a congenital anomaly is diagnosed, a patient-centred communication helps understanding, influences adaptation to the new situation and ensures the person concerned has sufficient (autonomy or independence or ability) to make appropriate decisions. METHODS: A qualitative study, based on a phenomenological approach, was carried out through nonparticipant observation and semi-structured interviews with 27 obstetric patients. NVivo 11 software was used, and content analysis was performed. The manuscript was developed using the COREQ guidelines to inform qualitative studies. RESULTS: The clinical relationship may be affected by communication problems such as patients' perceptions of scarce emotional involvement by obstetricians, by poor psychosocial support during the termination of the pregnancy and by insufficient follow-up after discharge. CONCLUSION: Nurses are in a privileged position to promote the empowerment of affected women. It is necessary to improve aspects related to the privacy of patients and the awareness and training of the interdisciplinary team in interpersonal communication. Post-loss follow-up is recommended to assess individual needs, thus facilitating an optimal approach to ease the grieving process. RELEVANCE TO CLINICAL PRACTICE: During the prenatal diagnosis, the existence of a fetal anomaly is emphasized, but support and follow up of the mother may be neglected; therefore, exhaustive knowledge about the obstetric history, the state of health and the expectations of patients is as important as a multidisciplinary team trained in counseling strategies and with a comprehensive care plan that covers all areas, especially those that control maternal emotions.

Silver and copper as pollution tracers in Neogene to Holocene estuarine sediments from southwestern Spain.

Estuaries are very sensitive ecosystems to human activities and the natural evolution of their drainage basins located upstream. Pollution derived from human activities, such as historical mining or recent industrial wastes, can significantly affect their environmental quality. This paper analyzes the silver and copper contents of four cores extracted in two estuaries of SW Spain. Its chronology and vertical evolution allow to differentiate the effects of several pollution episodes (natural, Roman, 19th-20th centuries) on its different sedimentary environments in the last 6 million years. Possible future applications are included in the fields of environmental management or even education.

Is It Possible to Become a Nurse in a Refugee Camp?

The history of the Western Sahara has been marked by several events that have contributed to the protracted refugee situation in which the Sahrawi people have found themselves since 1975: the Spanish colonization and the subsequent decolonization process, the armed struggles between the indigenous population and the states of Morocco and Mauritania to occupy Western Saharan territory, assassinations and repression of the Sahrawi population, and the economic interests of external agents with regards to mineral resources. Twenty-five years ago, in the hostile environment of the Sahrawi refugee camps, a nursing school was founded. Essentially depending on foreign aid, this school has been responsible for training nursing professionals to meet the healthcare needs of the population. The aim of this paper is to provide an approach to the origin and evolution of nursing education for the Sahrawi refugee camps. The Sahrawi are the only refugee camps in the world to host such nursing schools.

Is it possible to become a midwife in a refugee camp?

The historical backdrop of Western Sahara has meant that, for the last 43 years, part of its indigenous population has survived in refugee camps located in the Algerian desert. International aid from abroad has become the main source of sustenance for all people living in this hostile environment. Since the beginning of this type of settlement, the Sahrawi Arab Democratic Republic has been concerned with creating the necessary infrastructures to meet the health needs of the people living in these conditions. As a result, the Ahmed Abdel-Fatah School of Nursing was created in the Sahrawi refugee camps, which began to train midwives to care for women during the stages of pregnancy, childbirth and postpartum in 2002. The aim of this paper is to provide an approach to the origin and evolution of midwifery education for the Sahrawi refugee camps, in the only school of nursing that exists worldwide in a refugee camp.

Dry care versus chlorhexidine cord care for prevention of omphalitis. Systematic review with meta-analysis / Cura a seco versus cura com clorexidina para prevenção da onfalite. Revisão sistemática com metanálise / Cura seca frente a cura con clorhexidina para prevención de onfalitis. Revisión sistemática con metaanálisis

ABSTRACT Objective: to compare the effect of dry care and the application of chlorhexidine to the umbilical cord of newborns at risk of developing omphalitis. Method: systematic review with meta-analysis. Clinical trials comparing dry care with the application of clorexidine to evaluate omphalitis were selected. Methodological quality was evaluated using the Consolidated Standards of Reporting Trials. Results: the joint analysis of the studies shows a significant decrease in the risk of omphalitis in the chlorhexidine group compared to the dry care group (RR=0.58, CI: 0.53-0.64). However, in the analysis by subgroups, chlorhexidine umbilical cord care did not reduce the risk of omphalitis in hospital births (RR=0.82, CI: 0.64-1.05), in countries with a low infant mortality rate (RR=0.8, CI: 0.5-1.28), or at chlorhexidine concentrations below 4% (RR=0.55, CI: 0.31-1). Chlorhexidine acted as a protective factor at a concentration of 4% (RR=0.58, CI: 0.53-0.64), when applied in cases of home births (RR=0.57, CI: 0.51-0.62), in countries with a high infant mortality rate (RR=0.57, CI: 0.52-0.63). Conclusion: dry cord care is effective in countries with low infant mortality rate and in hospital births. However, 4% chlorhexidine for umbilical cord care protects against omphalitis in home births, in countries with a high infant mortality rate.

RESUMO Objetivo: comparar o efeito da cura a seco e da aplicação de clorexidina no cordão umbilical de recém-nascidos em risco de desenvolver onfalite. Método: revisão sistemática com metanálise. Foram selecionados os ensaios clínicos que comparavam a cura a seco com a aplicação de clorexidina para avaliar a onfalite. A qualidade metodológica foi avaliada com Consolidated Standards of Reporting Trials. Resultados: a análise conjunta dos estudos mostra uma redução significativa do risco de onfalite no grupo da clorexidina em comparação com a cura a seco (RR=0,58; IC 0,53-0,64). Entretanto, na análise por subgrupos, a cura com clorexidina não reduziu o risco de onfalite em nascimentos hospitalares (RR=0,82; IC: 0,64-1,05), nos países com baixa taxa de mortalidade infantil (RR=0,8; IC: 0,5-1,28), ou com concentrações de clorexidina abaixo de 4% (RR=0,55; IC: 0,31-1). A clorexidina atuou como fator de proteção na concentração de 4% (RR=0,58; IC: 0,53-0,64), aplicada em nascimentos no domicílio (RR=0,57; IC: 0,51-0,62), em países com taxas de mortalidade infantil elevadas (RR=0,57; IC: 0,52-0,63). Conclusão: a cura a seco é eficaz em países com baixa taxa de mortalidade infantil e em nascimentos no contexto hospitalar. No entanto, a cura com clorexidina 4% protege contra a onfalite nos nascimentos domiciliares, em países com elevada mortalidade infantil.

RESUMEN Objetivo: comparar el efecto de la cura seca y de la aplicación de clorhexidina en el cordón umbilical de los recién nacidos en el riesgo de desarrollo de onfalitis. Método: revisión sistemática con metaanálisis. Se seleccionaron ensayos clínicos que compararan la cura seca con la aplicación de clorhexidina evaluando la onfalitis. Calidad metodológica evaluada con Consolidated Standards of Reporting Trials. Resultados: el análisis conjunto de los estudios muestra una reducción significativa del riesgo de onfalitis en el grupo de clorhexidina en comparación con cura seca (RR=0,58; IC: 0,53-0,64). Sin embargo, en el análisis por subgrupos, la cura con clorhexidina no aportó reducción del riesgo de onfalitis en nacimientos hospitalarios (RR=0,82; IC: 0,64-1,05) en países con baja tasa de mortalidad infantil (RR=0,8; IC: 0,5-1,28), ni a concentraciones de clorhexidina inferiores al 4% (RR=0,55; IC: 0,31-1). La clorhexidina actuó como factor protector a concentraciones del 4% (RR=0,58; IC: 0,53-0,64), aplicada en nacimientos en el hogar (RR=0,57; IC: 0,51-0,62), en países con elevada mortalidad infantil (RR=0,57; IC: 0,52-0,63). Conclusión: la cura seca es eficaz en países con baja tasa de mortalidad infantil y nacimientos en ámbito hospitalario. Sin embargo, la cura con clorhexidina al 4% protege de onfalitis en nacimientos en el hogar, en países con elevada mortalidad infantil.

Efecto de un Programa de Baloncesto Educativo sobre la Deportividad / Effect of an Educational Basketball Program on Sportsmanship / Efeito de um programa educacional de basquete no espírito esportivo

El objetivo del presente estudio fue conocer cómo influye el modelo deportivo de la Fundación Real Madrid (FRM) en los factores personales y sociales de la deportividad. La muestra de estudio estaba formada por 413 jugadores pertenecientes a las Escuelas Sociodeportivas de Baloncesto de la FRM de la Comunidad de Madrid (281 chicos y 132 chicas) de las categorías benjamín, alevín, infantil y cadete. Se utilizó la Escala Multidimensional de Orientaciones hacia la Deportividad. Entre los principales resultados, se detectaron valores más altos en los factores personales que en los factores sociales. Las chicas mostraron valores más elevados en los factores personales (p < .024). Los deportistas que participaban en las competiciones internas de la FRM presentaron actitudes más deportivas que los que no lo hacían (p < .007). Los jugadores pertenecientes a las categorías más pequeñas mostraron mayor orientación hacia la deportividad. Finalmente, se observó una correlación positiva entre ambas dimensiones (rs = 0.542, p < .001). Los datos mostraron que el modelo deportivo de la FRM contribuye al desarrollo de la deportividad de los jóvenes deportistas

The aim of this study was to know how the sports model of the Real Madrid Foundation (FRM) influences the personal and social factors of sportsmanship. The study sample consisted of 413 players from Social-Sports Basketball Schools of the FRM in the Community of Madrid (281 boys and 132 girls) belonging to U10, U12, U14 y U16 categories. The Multidimensional Scale of Orientations towards Sportsmanship was used. Among the main results, higher values were detected in personal factors than in social factors. The girls showed higher values in personal factors (p < .024). Athletes participating in the FRM's internal competitions had more sporting attitudes than those who did not (p < .007). Players in the smaller categories showed a greater orientation towards sportsmanship. Finally, a positive correlation was observed between both dimensions (rs = 0.542, p < .001). The data showed that the FRM's sports model contributes to the development of sportsmanship among young athletes

O objetivo do presente estudo foi conhecer como o modelo esportivo da Fundação Real Madrid (FRM) influencia os fatores pessoais e sociais do esportivismo. A amostra de estudo foi formada por 413 jogadores pertencentes às Escolas de Basquete Sócio-esportivas da FRM da Comunidade de Madri, 281 meninos e 132 meninas, pertencentes às categorias Benjamin, alevín, infantil e cadete. A Escala de Orientação Multidimensional para o Esportismo foi usada. Entre os principais resultados, valores mais altos foram encontrados em fatores pessoais do que em fatores sociais, e as meninas apresentaram valores mais altos em fatores pessoais (p < .024). Os atletas participantes das competições internas do FRM apresentaram mais atitudes esportivas do que aqueles que não participaram deles (p < .007). Os atletas pertencentes às categorias menores mostraram maior orientação para o espírito esportivo. Finalmente, correlação positiva foi observada entre as duas dimensões (rs = 0.542, p < .001). Os resultados mostraram que o modelo esportivo do FRM contribui para o desenvolvimento do espírito esportivo de jovens atletas

Efectividad de una estrategia de apoyo individualizado al empleo para personas con trastornos mentales graves / Effectiveness of individual supported employment for people with severe mental disorders

Objetivo: Valorar la efectividad de una estrategia de apoyo individualizado al empleo (IPS) en personas con enfermedad mental grave en la isla de Tenerife (España). Método: Pacientes de los Servicios de Salud Mental Comunitaria con trastornos mentales graves fueron asignados a dos grupos de forma aleatorizada. En uno de ellos se aplicó el método IPS (n=124) y en el grupo control (n=75) se asesoró en la manera habitual de búsqueda de empleo. Los pacientes fueron seguidos una media de 3,4 años y se analizó cuántos trabajaron al menos un día, el tiempo trabajado, los salarios, el número de contratos y el número de admisiones hospitalarias. Se usaron métodos estadísticos no paramétricos en la comparación de resultados (U de Mann-Whitney). Resultados: Los pacientes asignados al grupo IPS trabajaron al menos un día el 99%, frente al 75% del grupo control; trabajaron de media 30,1 semanas/año vs. 7,4; el salario mensual fue de 777,9 euros vs. 599,9 euros; el número de contratos por persona fue de 3,89 vs. 4,85, y los ingresos hospitalarios fueron 0,19 vs. 2,1. Conclusión: La estrategia IPS es efectiva en la integración laboral de personas con enfermedad mental grave, logrando que trabajen más tiempo, tengan mayor salario y menos ingresos hospitalarios, en un contexto social de alto desempleo

Objective: To assess the effectiveness of an individual placement and support (IPS) strategy in people with severe mental disorders in Tenerife Island (Spain). Methods: Patients of Community Mental Health Services with severe mental disorders were randomly assigned to two groups. One of them received IPS (n=124), and the control group (n=75) was advised in the usual job search. Patients were followed up for an average of 3.4 years and an analysis was made of how many patients worked at least one day, working hours, wages, the number of contracts and the number of hospital admissions. Non-parametric methods were used to compare the results (Mann-Whitney U test). Results: The percentage of patients who worked at least one day was 99% in the IPS group compared with 75% in the control group; they worked on average 30.1 weeks per year vs 7.4; the monthly salary was Euros 777.9 vs Euros 599.9; the number of contracts per person was 3.89 vs 4.85, and hospital admissions were 0.19 vs 2.1. Conclusions: The IPS strategy is effective for the labour integration of people with severe mental illness getting them to work longer, have higher wages and fewer hospital admissions